كلية الطب والعلوم الصحية

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Health education program in knowledge, attitude and practice among primary school students towards dental caries in Najran - Saudi Arabia
(AL-Neelain University, 1998) Nahid khalil El Faki Idrees
Abstract Background: Health education program about dental health is one of the reasons behind the declining of dental caries' rates in many industrialized countries. Other reasons include consumption of fluoridated toothpastes, effective and accessible oral health services. Objectives: The aim of the present study was to assess the effect of health education program in knowledge, attitudes and practice towards dental caries among school children during the period from 2013- 2016. Material & Methods: School-based interventional study design was adopted. A systemic random sample technique was used to obtain sample of 288 students from 3 different public primary schools for girls. The principal method of data collection was a semi structured questionnaire beside clinical examination that guided by DMFT index. Results: The result shows that 209 students out of 288 have dental caries (a rate of 72.57%). DMFT mean of the surveyed subjects was 0.73. Around 16% of the examined students didn't know the causes of dental caries. The study also revealed that 37% of the students get their knowledge about oral issues from their parents. 90% of students with dental problems have positive family history. After conducting the health education program the students' knowledge was significantly (p< 0.01) improved about fluoridated toothpastes, hygiene practices and the importance of visiting dentists was significantly (p< 0.01) increased. Conclusion: Poor oral hygiene practices, lack of parental guidance, hereditary factor together with lack of appropriate dental knowledge and frequent exposure to cariogenic foods are the main risk factors for dental decay among the surveyed students. Recommendation: Extra emphasis on dental health education programs in cooperation between education and medical authorities should be considered and implemented in Najran area. Key words: Dental caries, health education, school children, DMFT index. XI 12 ملخص الدراسة: خلفیة الدراسة: یعد التثقیف الصحي عن صحة الفم و الأسنان أحد الأسباب وراء انخفاض معدلات انتشار تسوس الأسنان لدى أطفال في الدول الصناعیة. أما الأسباب الأخرى فتشمل على سبیل المثال استخدام معاجین الأسنان التي تحتوى على مادة الفلور و سھولة التعامل و استخدام خدمات صحة الفم و الأسنان بالإضافة إلى تطور برامج التثقیف الصحي المدرسي مما زاد من مفھوم صحة الفم. ھدف الدراسة: أجریت ھذه الدراسة التطبیقیة في المدارس الابتدائیة للبنات بمدینة نجران بالمملكة العربیة السعودیة بھدف تقییم مدى تأثیر برنامج التوعیة والتثقیف الصحي في رفع مستوى المعرفة و السلوكیات والممارسات الصحیة لصحة الفم. وذلك في الفترة من 2013 وحتى 2016 م. منھج الدراسة: تعد ھذه الدراسة دراسة تطبیقیة و فیھا تم اختیار 288 طالبة عن طریق العینة العشوائیة –العدلیة- المتعددة المراحل من ثلاثة مدارس. كما تم جمع البیانات عن طریق إستبانة تحتوي على عدد من الأسئلة شبھ مفتوحة و مغلقة بالإضافة لاستمارة للكشف الطبي للفم DMFT و الأسنان للطالبات. وقد تم الكشف على الطالبات بواسطة مؤشر معروف یسمى (تكسر وفقدان الأسنان ووجود حشوة الأسنان) ومن ثم تم جمع البیانات على مرحلتین قبل وبعد إعطاء برنامج التوعیة والتثقیف الصحي حول صحة الفم وتسوس الأسنان. النتائج: قبل إعطاء برنامج التوعیة الصحیة وجد أن نسبة انتشار تسوس الأسنان بلغ %72.57 ومتوسط انتشار المؤشر بمعدل 0.73 وقد تبین أن 16 % من الطلبات لا یعرفن سبب تسوس الأسنان. وحوالي 70 % من الطالبات لا یعرفن أھمیة إضافة الفلور فى معجون الأسنان بالإضافة الى 37 % منھن یتحصلن على معلوماتھن من الوالدین. كما اتضح أن ھنالك علاقة عكسیة بین انتشار تسوس الأسنان لدى الطالبات و مستوى تعلیم الوالدین. بالإضافة إلى أن 90 % من الطالبات اللاتي تعانین من التسوس لدیھن تسوس وسط العائلة. وبعد إعطاء البرنامج ارتفعت نسبة وعى ومعرفة الطالبات من ذي قبل وبالمقارنة الإحصائیة وجدنا احتمال وارتفعت معرفة الطالبات عن الفلور المضاف .(p< ذلك كبیر ونسبة الاحتمال بلغت ( 0.01 بالمقارنة من ذي قبل. وانخفضت نسبة (p< = لمعجون الأسنان بنسبة احتمال بلغت ( 0.01 .( إلى ( 0.7 DMFT مؤشر الخلاصة و التوصیات: واستنتجنا أن معدل انتشارت سوس الأسنان وسط الطالبات منتشر جدا ولھ علاقة وراثیة وسط الأسر. ومعرفة الطالبات بأسباب التسوس منخفضة جدا ومرتبطة بمعرفة الوالدین غیر المتعلمین. وعلیھ ننصح بإدخال برنامج الصحة المدرسیة فى المدارس للتوعیة بأھمیة الصحة وصحة الفم بالخصوص لرفع مستوى وعى الطلاب والأسر. (DMFT) الكلمات الأساسیة: تسوس الأسنان، تثقیف صحي، طالبات المدارس، مؤشر
Etiology of Community Acquired Pneumonia in Sudanese patients in KTH and ATH
(ALNEELAIN UNIVERSITY, 2003-02) Afrah Yousif Adam Haroon
Abstract This is a prospective study which was conducted in Khartoum teaching hospital, Alshaab teaching hospital and Alakademia charity hospital to determine the etiology of community acquired pneumonia in adult patients who required hospitalization and the antibiotics sensitivity ofthe isolated pathogen. lO4 patients were diagnosed as having community acquired pneumonia CAP during the period between July 2000- December 2002. The microbiological diagnosis was based on the results of sputum culture. In 47 patients (45.2%) the causative pathogen was isolated. Streptococcus pneumonae was isolated in 25 patients (24.8%), and it proved so tar as the most common organism responsible for CAP among patients in the study group which is similar when compared with that in western countries. Six patients (5.8%) proved to have tuberculosis as cause otiCAP. Most ofthe isolated Strept pneumonae was found to be sensitive to penicillin. Resistance to penicillin was detected in one patient who is originally from Chad. Most ofthe isolates were sensitive to cephalosporin and Quinolones.
Hypoiaemia in children with sickle cell anaemia in Khartoum state
(ALNEELAIN UNIVERSITY, 2004-07) Yassin Hag Mohammed Hamid
ABSTRACT Sickle cell disease is often complicated acutely or chronically by hypoxaemia. This is a descriptive cross-sectional hospital based study aimed to determine the frequency and possible associated factors of hypoxemia in patients with sickle cell anaemia in their steady state and crises. it was conducted in the sickle cell anaemia referral clinic in KCEH and paediatric wards in most of Khartoum state hospitals in the period from the 15' of April to the 30"‘ of June 2004. The total number of children enrolled in the study was 149 children with sickle cell anaemia aged 0 - £16 yrs, 100 of them in their steady state while 49 were in crises and 80(53.7%) were males while 69(46.3%) were females . Oxygen saturation (SpO2) was measured for all children by pulse oximeter and haematological investigations were also done. The overall frequency of hypoxaemia (SpO2 s 90%) was found to be 37.6% and the mean SpO2 was 92.3% 1 6.0. The frequency of hypoxaemia in patients with steady state was 39% while in those with crises was 34.6% and there was no significant difference between the two groups (p = 0.373). There was no signiﬁcant correlation between hypoxaemia and gender of patient but hypoxaemia was found to be more frequent in older age groups (p = 0.001) and in those with low weight centile (p= 0.028) but not with height (p = 0.864). Hypoxaemia was found to be associated with history of recurrent chest infection (p = 0.009) but not with history of blood transfusion or recurrent painful episodes. In patients with crises hypoxaemia was found to be correlated with breathlessness as a presenting symptoms (p =0.002) and there was a signiﬁcant correlation with the type of crises (p = 0.031). Hypoxaemia was found to be correlated with low Hb (p = 0.000), low PCV (p = 0.005) and HbF (p = 0.001) but there was no correlation with retics count (p = 0.310)
Mechanisms on childhood overweight and obesity at high altitude
(AL-Neelain University, 2005) Humeda Suekit Humeda
Abstract Objectives: The present study with its three parts, was undertaken to: (a) Describe the body composition and determine the prevalence of overweight and obesity in high altitude children‟s population and compare them their counterparts at low altitude, (b) Determine the possible mechanisms by which high altitude influences childhood body composition and the prevalence of overweight and obesity, (c) Explore the possible role of administration of antioxidants during pregnancy at high altitude in preventing late childhood overweight and obesity. Materials and methods: The first part was a cross-sectional prospective study of 145 Saudi children born and living permanently at high altitude (3100m) and 154 Saudi children born and living permanently at relatively low altitude (500m). For each child selected information regarding birth weight and breast feeding were taken from his or her file. Anthropometric measurements were then performed. Body mass index was calculated using the equation BMI=(Weight (kg)/Height (m2). Fat mass and fat free mass percentages were derived from triceps skinfold measurement. Resting pulse rate (beats/min), blood pressure, haemoglobin concentration and haematocrit value were measured. Physical activity level was determined using the short form of international physical activity questionnaire (IPAQ-SF). The second part was also a cross-sectional prospective study which included 25 healthy pregnant women and their healthy newborns from high altitude and equal numbers from low altitude. Measurements of maternal haemoglobin concentration, haematocrit value and blood pressure were made at the end of gestation. Foetal haemoglobin concentration and haematocrit value were determined immediately after delivery. Determination of the newborn's body shape and
Neuroprotective Potential of L-NAME as Anti-Oxidant and Anti-Inflammatory in Cerebral Injury Induced By Transient Focal Ischemia Reperfusion in Rats
(AL-Neelain University, 2005) Hiba Ahmed Alsheekh Awooda
Abstract: Background: Stroke is a major cause of death and disability globally. The function of nitric oxide (NO) in cerebral ischemia/reperfusion (I/R) has been intensively investigated; however, the exact role of NO inhibition in cerebral ischemia remains controversial. Aim: This study explored the possible neuroprotective effect of nonselective Nitric Oxide Synthase (NOS) inhibitor N-Nitro-L-Arginine-Methylester (L-NAME) in rat’s transient cerebral I/R. Materials and Methods: 30 adult male Wistar rats (150-250g) were divided into three groups 10 rats in each: First group was sham-operated and served as a control. I/R group of rats infused with 0.9% normal saline intraperitoneally 15 minutes prior to 30 minutes of left common carotid artery occlusion, followed by reperfusion for 24-hour, and a test group infused with L-NAME (15 mg/kg per weight) intraperitoneally 15 minutes prior to similar I/R periods. Neurobehavioral assessments were evaluated, Western blotting was used to estimated Nuclear factor kappa B (NF-қB) and quantitative -Enzymewas measured by α) -α (TNF-Tumor necrosis factormeasurement of nitrite and nitrate), and NO metabolites ( )ELISA(linked immuno sorbent assay malondialdehyde (MDA), and total antioxidant capacity (TAC) were measured colorimetrically in both plasma and affected cerebral hemisphere. Results: The L-NAME group showed a significant improvement in neurological deficit (M±SD = 15.07±0.584) compared to both I/R and control groups (12.798±0.689, 17.50±0.707, respectively P <0.001). In I/R rats NF-қB was significantly increased (129.2±1.7 RGB unit/mg protein) compared to the control group (53±1.03RGB unit/mg protein) and L-NAME pretreatment resulted in a significant decrease in NF-қB (44.4±1.3RGB unit/mg protein, P <0.001) compared to I/R group. The serum level of TNF-α was significantly increased in I/R group (734.8±108.9 pg/ml) compared to the control group (37.18±10.183 pg/ml), while L-NAME administration resulted in a significant decrease in serum TNF- α (64.36±11.053, P <0.001) compared to the I/R group. The brain tissue of TNF-α in the I/R group (110.4±6.2pg/mg protein) was significantly increased compared to the control group (4.9±0.8 pg/mg protein), L-NAME administration resulted in a significant decrease in tissue level of TNF-α (21.60±2.289, P <0.001) in compared to the control and I/R groups. Serum level of MDA and NO were significantly increased in I/R group (14.88±1.14 nmol/mL, 42.03±4.558 μmol/L respectively) compared to the control group (5.43±0.44 nmol/mL, 17.84±0.701 μmol/L respectively, P <0.001), while L-NAME administration resulted in a significant decrease in serum MDA and NO (7.18±0.135 nmol/mL, 18.44±0.513μmol/L respectively) compared to the I/R group. The serum level of TAC in the I/R group (1.21±0.169 mM/L) was significantly lower compared to the control group (2.52±0.062 mM/L), L-NAME pretreatment resulted in significant higher serum level of TAC (2.53±0.067 mM/L, P <0.001) compared to rats treated with normal saline. Regarding brain tissue levels of MDA and NO, the I/R group demonstrated a significant increase in the tissue level of both MDA and NO (8.56±0.658, 8.88±0.572 nmol/mg protein) compared to the control group (3.24±0.226, 3.48±0.228 nmol/mg protein, P <0.001). The L-NAME group showed a significant decrease in tissue level of MDA and NO (3.18±0.155, 4.47±0.392 nmol/mg protein, P <0.001) compared to the I/R group. The brain TAC level of the I/R group (0.0186±0.00373 mmol/mg protein) was significantly decreased compared to the control group (0.070±0.0085 mmol/mg protein, P < 0.001) On the contrary, administration of L-NAME prior to ischemia resulted in significant increase of brain TAC level (0.0747±0.00563 mmol/mg protein, P < 0.001) compared to rats subjected to saline infusion. NAME -These data demonstrated that L :nclusionsCoand Discussion significantly improve neurological deficit and L-NAME showed a potential ’sinflammatory effect in a rat-oxidant and anti-antiis through it tionneuroprotecmodel of transient focal cerebral ischemia reperfusion. الخلفيه: السكتة الدماغية هي سبب رئيسي للوفاة والعجز البدني عالميا. وقد تم التحقيق بشكل مكثف في دور أكسيد النيتريك (NO) في الفاقه الدمويه و اعاده ضخ الدم للدماغ, وبالرغم من ذلك فان الدور الفعلي لتثبيط NO في نقص الترويه الدماغي لايزال مثيرا للجدل. الأهداف: استنادا إلى هذه الملاحظات فان الغرض الرئيسي من الدراسه الحاليه هو استكشاف التاثير الوقائي المحتمل للاعصاب الناتج عن المثبط للانزيم المصنع لاكسيد النيتريك N-Nitro-L-Arginine-Methylester (L-NAME) خلال الفاقه الدمويه المؤقته للمخ و اعاده ضخ الدم في الفئران. المواد والطرق: اجريت هذه الدراسه علي 30 فئرا ذكرا بالغا من فصيله ويستار(تتراوح اوزانهم بين 150– 250جم) وتم تقسيمهم الي ثلاثه مجموعات تجريبيه 10 فئران في كل مجموعه. المجموعة الاولى (المجموعة المراقبة): وقد اجريت لهم عمليه خادعه. المجموعة الثانيه: قد خضعوا الى 30 دقيقه من نقص التروية الدماغية بواسطه انسداد الشريان السباتي الأيسر المشترك وتلاها اعاده لضخ الدم لمدة 24 ساعة, وقبل اجراء العمليه بخمسه عشر دقيقه تم حقنهم بمحلول ملحي بتركيز 0.9٪ داخل البرتونيوم. المجموعة الثالثه: تم حقنهم بماده L-NAMEداخل البرتونيوم خمسه عشر دقيقه قبل ان يخضعوا لنقص تروية دماغي عابر لمدة 30 دقيقة واعاده لضخ الدم لمدة 24 ساعة. وقد أجريت التجارب على السلوك العصبي قبل وفي أوقات مختلفة خلال الدراسة التجريبية في كل المجموعات. وفي نهاية الفترة التجريبية قتلت كل الفئران وقد أزيل المخ بسرعة وتم التقييم الكمي للموادالتاليه: Nuclear factor kappaβ (NF-қβ) باستخدام طريقه western blotting وقياس Tumor necrosis factor-α (TNF-α) بواسطه الانزيم اميونو ايسي وتم قياس اكسيد النتريك (النتريت والنترات)، و إجمالي القدرة المضادة للأكسدة Total antioxidant capacity(TAC) وقياس Malondialdehyde(MDA) عن طريق القياس اللوني في كل من من البلازما ونصف الكرة المخية المتأثرة. النتائج: تم التعبير عن النتائج بواسطه (الوسيط ± الانحراف المعياري), بعد حقن L-NAME لوحظ تحسن كبير في العجز العصبي والاعاقه الجسديه (15.07±0.584) بالمقارنة مع المجموعتين الاولي والثانيه (0 12.798±0.689, 17.50±0.707على التوالي P <0.001). فيما يتعلق بمستوى NF-қβ الذي قيس في نصف الكرة المخية المتأثرة, فقد لوحظ زياده ذات دلاله احصائيه وثيقه في المجموعه الثانيه (129.2±1.7 RGB unit/mg protein) مقارنة مع المجموعة المراقبة (53±1.03RGB unit/mg protein) وعلاوة على ذلك, فان المعالجه بواسطه L-NAME قبل نقص التروية
Prevalence of Intestinal Parasitic Infections among Displaced Children in Kassala Town
(Al Neelain University, 2005-01) Mamoun Magzoub Mohamed Osman
Four hundred and ﬁfty faecal specimens were collected from 450 displaced children around Kassala town aged from 6 moths to 13 years old and examined under microscope for the detection and identiﬁcation of intestinal parasites. Microscopical examinations by two techniques were done (wet preparation and concentration technique by simple centrifugation). The examination explained that 80 (17.8%) were found to harbour stages of infective parasites. Four species of infective parasites were identiﬁed from individuals in all areas (displaced areas). These comprised the following Giardia lamblia (12.3%), H. nana (4.9%), E. histolytica (0.4%) and T. trichiura (0.2%) ' Out of 450 stool samples collected from children in urban area (Waw—nour) inside Kassala town 45 were found to harbour cysts trophozoites or eggs of pathogenic parasites. This constituted on overall prevalence (10%), two species of pathogenic parasites were identiﬁed from individuals in Waw—nour (urban area). These comprised the following: G. lamblia (08%) and H. nana (02%). The factors responsible for the spread of diseases include the low standard hygiene and environmental conditions and the lack of proper disease control measures. Also a comparison between two mentioned techniques was done on all specimens: displaced children specimens and urban children specimens.
Seroepidemiologic Study of Brucellosis in Febrile Patients in Khartoum State
(Al Neelain University, 2008) Adam Ahmed Adam Mustafa
Biucellosis is a zoonotic disease caused by bacteria of the genus Brucella. Humans are infected mostly due to animal contact especially through consumption of unpasteurized milk or its raw products from infected animals. Consumption and handling of other raw products of animals also constitute an important mode of transmission. Human brucellosis is a debilitating disease which is commonly misdiagnosed for other infectious and non-infectious febrile diseases. The objective of this study was to provide baseline data on human brucellosis among febrile patients in Khartoum State. The diagnosis of brucellosis case in this study depended on a clinical manifestation which was fever for at least two weeks coupled with serum antibody titre of 1:160 or more to Brucella melitensis or Brucella abortus by using Standard Tube agglutinatonTest technique. The prevalence of human brucellosis was 8.9% among febrile patients in Khartoum State. Sixty three (70.8%) of the brucellosis patients were males, and 26 (29.2%) were females. Males constituted a significantly high number of patients than females. The males to females ratio was 2.4:l. ~ Fifty four (60.7%) of the brucellosis patients had signiﬁcant titres to Brucella melitensis with a mean serum titre of 1:373. Twenty three (25.8%) patients had signiﬁcant titres to Brucella abortus with a mean serum titre of 1:327. Twelve (13.5 %) of the patients had significant titres to both Brucella melitensis and Bruqella abortus with mean serum titres of 1:332 and 1:321 respectively. Risk factors for Human brucellosis include animal contact, particularly among people of certain occupations such as herdsmen, milkmen and those involved in meat industry. In addition, males were more exposed to infection than females, while both males and females at their mid-forties were more susceptible to infection than other age groups. High index of clinical suspicion of human brucellosis is needed for early diagnosis and management of the disease. More studies on the biology and epidemiology of Brucella species are important so as to reach a rational strategy for diagnosis, treatment and prevention of the infection.
Seroepidemiologic Study of Brucellosis in Febrile Patients in Khartoum State
(Neelain University, 2008) Adam Ahmed Adam Mustafa
Abstract Brucellosis is a zoonotic disease caused by bacteria of the genus Brucella. Humans are infected mostly due to animal contact especially through consumption of unpasteurized milk or its raw products from infected animals. Consumption and handling of other raw products’ of animals also constitute an important mode of transmission. Human brucellosis is a debilitating disease which is commonly misdiagnosed for other infectious and non-infectious febrile diseases. The objective of this study was to provide baseline data on human brucellosis among febrile patients in Khartoum State. The diagnosis of brucellosis case in this study depended on a clinical manifestation which was fever for at least two weeks coupled with serum antibody titre of 1:160 or more to Brucella melitensis or Brucella abortus by using Standard Tube agglutinatonTest technique. The prevalence of human brucellosis was 8.9% among febrile patients in Khartoum State. Sixty three (70.8%) of the brucellosis patients were males, and 26 (29.2%) were females. Males constituted a signiﬁcantly high number of patients than females. The males to females ratio was 2.4: 1. Fifty four (60.7%) of the brucellosis patients had significant titres to Brucella melitensis with a mean serum titre of 1:373. Twenty three (25.8%) patients had significant titres to Brucella abortus with a mean serum titre of 1:327. Twelve (13.5 %) of the patients had significant titres to both Brucella melitensis and Brucella abortus with mean serum titres of 1:332 and 1:321 respectively. Risk factors for Human brucellosis include animal contact, particularly among people of certain occupations such as herdsmcn, milkmen and those involved in meat industry. In addition, males were more exposed to infection than females, while both males and females at their mid-forties were more susceptible to infection than other age groups. High index of clinical suspicion of human brucellosis is needed for early diagnosis and management of the disease. More studies on the biology and epidemiology of Brucella species are important so as to reach a rational strategy for diagnosis, treatment and prevention of the infection.
Heart Rate Variability and Asthma Control Test
(ALNEELAIN UNIVERSITY, 2008) Mohamed Faisal Mohamed Lutﬁ
ABSTRACT Background HRV is widely accepted to have prognostic signiﬁcance in patients with cardiovascular diseases especially after acute myocardial infarction. However, recently. interest has grown in relating some pathologies with abnormal autonomic activity based on HRV studies. Although asthmatics are known to have enhanced cholinergic activity, little I-[RV studies were done on asthma patients. Moreover, the results of these studies are not reproducible, probably due to inter-individual differences of autonomic balance in test group or inadequately designed methods. Objectives l. To develop an effective spirometric score that can faithfully reﬂect ventilatory functions of the lungs and efﬁciently discriminating asthmatics from non- asthmatics 2. To detect reliability and validity of Asthma Control Test (ACT) and National Asthma Education and Prevention Program (NAEPP) in the classiﬁcation of studied asthmatic patients based on above-mentioned spirometric score. 3. To correlate asthma control (using ACT and NAEPP) and ventilatory function with parameters of autonomic balance. 4. To detect the pattem of autonomic balance in asthmatics using a parameter known to be inﬂuenced by sympathetic and parasympathetic e.g. airways narrowing indicated by spirometry, blood pressure and blood glucose concentration. Methods The study involved 56 apparently healthy subjects and gender and an age matched group of 100 asthma patients classiﬁed into subgroups according to asthma severity using ACT and NAEPP classiﬁcations. Blood pressure, anthropometric. spirometric, HRV measurements together with drug therapy, blood level of glucose, hemoglobin and electrolytes were assessed for every subject. All spirometric measurements were condensed into one representative score (discrimination analysis score (DAS)) using discrimination analysis. Sensitivity and speciﬁty of DAS were tested using conditional ratios and Receiver Operating Characteristic (ROC) curve. Screening of studied variables for signiﬁcant correlations and mean differences among different groups with adjustment for possible confounding factors was perfonned using appropriate statistical techniques. Results Spirometry: Correlations between all spirometric measurements and DAS were highly signiﬁcant (P = 0.000 for all correlations). DAS when compared with F EVl% (at the most accurate cutoff equal to 80%) as a predictive measurement for presence of asthma, is proved to be more sensitive (8l.00% for DAS and 71.00% for FEVl%). speciﬁc (94.14% for DAS and 92.86% for FEV1%) and accurate (86.54% for DAS and 78.85% for FEV1%). For further veriﬁcation, accuracy of DAS was compared with the remaining of spirometric measurements using ROC curves. DAS is proved to be the most sensitive measure in diagnosing asthma (area under the curve = 0.933, P = 2.77E-l9 and 95% conﬁdence interval 0.897 - 0.971). Of asymptomatic asthma patients, 34.0 % were labeled poorly controlled and 41.5% were labeled uncontrolled. ACT score was higher while NAEPP class was lower in symptoms free compared with symptomatic asthmatic patients (P = 0.000 and 0.005 respectively). DAS correlate signiﬁcantly, but moderately, with ACT score and NAEPP class (P = 0.000 for both, CC = 0.38 and -0.49 respectively). Heart Rate Variability: Sympathetic tone (LF Nonn) of mild asthmatics was signiﬁcantly lower while parasympathetic tone (HF Nonn) was signiﬁcantly higher compared with apparently healthy subjects (P = 0.016 and 0.017 respectively). This was also true when mild asthmatics are compared with severe asthma patients (P = 0.020 and 0.015 respectively). ACT state of asthmatics correlate signiﬁcantly, but weakly, with LF Norm (CC = 0.292, P = 0.003) and HF NOHTL (CC = 0.309, P = 0.002). Blood Pressure and Blood Glucose Concentration: ln contrast to systolic and mean arterial blood pressures, diastolic blood pressure was signiﬁcantly higher in asthmatics compared with non-asthmatics (P = 0.002). Blood pressures correlate positively with sympathetic and negatively with parasympathetic activity in non- asthmatics (P < 0.05 for all). However, these correlations are lost in asthmatics. Blood glucose concentrations in asthmatic patients were signiﬁcantly higher as compared with healthy subjects (P = 0.000). Blood glucose concentrations correlate positively with parasympathetic and negatively with sympathetic in non-asthmatics (P < 0.05 for all). Nevertheless, these correlations are lost in asthmatic patients. Conclusions DAS is more sensitive, speciﬁc and accurate compared with other spirometric measurements, but like other indicators it fails to reach 100% sensitivity and speciﬁty on asthma diagnosis. Presence or absence of symptoms did not correlate with asthma control which draws attention to asthma classiﬁcation criteria. The autonomic balance of mild asthma (showing high parasympathetic and low sympathetic activities) is different compared to the severe form of the disease (which showed normal parasympathetic and sympathetic activities). Autonomic balance might inﬂuence symptomatology but not ventilatory function Many signs of functional impairment (control of blood pressure and blood glucose concentrations) of the autonomic nervous system are noted in asthmatic patients. XIV
Spoligotyping patterns and drug resistant of Mycobacterium tuberculosis in Sudan
(Al-Neelain University, 2009) Ghada Suliman Sharaf-Eldin
ABSTRACT . Sudan has a high burden of tuberculosis with an estimated 93,000 new cases each year. The purpose of this study was to investigate the genotypic patterns of M. tuberculosis strains circulating in Sudan and to assess their susceptibly to anti-tuberculosis drugs. Isolates from 237 smear positive tuberculosis patients were collected from different geographic regions of the country. Spoligotyping was performed by the Kamerbeek method and results were compared with the international SpolDB4 database (Institut Pasteur, Guadeloupe). Results revealed 28 clusters ranging in size from 12 to 57 isolates. Seventy unique (unclustered) strains were observed, representing 30% of the strains examined. The most frequently observed spoligotype patterns belonged to the CAS family which represented 115 (48.5%) of isolates studied. T1, H3, U and Beijing strains were found in 12 (5.1%), 11 (4.6%), 7 (3%) and 6 (2.5%) patients respectively. Strains belonging to the Beijing family were found mainly in Western Sudan. Resistance to isoniazid, rifampicin, ethambutol and streptomycin was observed in 18.1, 22.4, 22.2 and 32% of strains respectively. Twenty patients (8.4%) had MDR-TB of which 10 were new cases. Seventeen patients with rifampicin resistant tuberculosis were infected with CAS1-DELHI strains matching SIT 25 of the SpolDB4 database and 3 were of the SIT 1 Beijing family. 15 loci MIRU-VNTR typing subdivided the 17 CAS strains into one cluster of 5, two clusters of 2 and 8 individual MIRU types. Similarly the 3 Beijing spoligotypes were differentiated into a cluster of 2 and a single strain. x The use of molecular strain typing provides a proactive approach that may be used to initiate, and not just augment, traditional surveillance outbreak investigation in Sudan. However, caution must be used when interpreting clustered spoligotype patterns in this region. xi مستخلص يقدر عدد الحال ت الجديدة من المصابين بمرض السل الرئوي كل عام بحوالي 93 ألف حالة. تهدف هذه الدراسة إلى إجراء اختبارا ت تنمط نوعي على عينا ت من سلل ت الجراثيم الدقيقة المنتشرة في السودان ، إضافة إلى عمل تقييم قابلية استجابتها لعقاقير المضادة لحال ت السل الرئوي . تم عزل اللطاخا ت الموجبة لعدد 237 مريض من مرضى السل الرئوي الذين تم جمع عيناتهم من مناطق جغرافية مختلفة من القطر . حيث تم إجراء عمليا ت التنميط النوعي بواسطة طريقة كامربيك وتم إجراء مقارنة مع قواعد بيانا ت ذا ت معايير دولية تمثلت في معهد باستير قوادالوبي . أظهر ت النتائج أن إجمالي المجموعا ت المفحوصة بلغ 28 مجموعة تفاوتت أحجام العزل لها بين 12 إلى 57 . ولوحظ أن هناك 70 نوعاً من النواع الفريدة من تلك السلل ت غير المنضوية تحت عوائل مجموعة محددة وأن ما نسبته 30 %من تلك السلل ت قد أجريت عليه الختبارا ت . وقد لوحظ أن أكثر النماذج التي أجريت عليها اختبارا ت التنميط النوعي تعود لعوائل موطنها الصلي أواسط قارة آسيا ، وقد أجريت عليها دراسا ت عزل قد بلغت في مجملها 115 دراسة ـ أي ما نسبته 48 ، %فيما وجد أن عدد ونسبة المر ضى المصابين بالسل الرئوي من سلل ت توسكاني 1 ، هارليم 3 ،يورال وبيجينغ قد بلغت 12 ) بنسبة 1.5 ، (%11 ) بنسبة 6.4 ، (%7) بنسبة 3 (%و 6) بنسبة 5.2 (%على التوالي. وتتواجد السلل ت التي تنتمي إلى عائلة بيجينغ بصفة رئيسية في غرب السودان. حيث لوحظ أن نسبة تواجد مقاومة العزل ، للريفامبيسين ، إثامبيوتول والستريبتومايسين في بعض العوائل بلغت 1.18، 4.22 ، 2.22 وبنسبة إجمالية 32 %على التوالي . عشرون من مرضى السل الرئوي وجد أن لديهم خاصية مقاومة عقاقير متعددة للمرض وبما نسبته (4.8 (%سجلت عشرة حال ت منهم كحال ت جديدة. أثبت المسح أن سبعة عشر مريضاً ممن يتناولون مضاد الريفامبيسين للسل الرئوي مصابون بالمرض الذي ينحدر من عوائل يعود موطنها الصلي لواسط قارة آسيا – دلهي حيث يتطابق ذلك مع 25 منهم 4 شملهم الفحص بواسطة قواعد البيانا ت SpolDB و 3 من النواع الشائعة ST من عائلة بيجينغ حيث جاء التقسيم الفرعي لـ 17 سللة تحت سللة رئيسية واحدة من أصل 5 ، سللتان من أصل إثنين و 8 من السلل ت الفردية أصبح تحت فرع العوائل المستجيبة لنواع الـميرو MIRU . وعلى ذا ت المنوال انفصل التنميط النوعي لسللة بيجينغ إلى سللتين وسللة فردية واحدة .إن استخدام التنميط الجزئي للسللة يوفر طرق فعالة من تلك الطرق التي يستهل بها تصنيف العوائل السللية وليس الدمج فحسب، بل حتى في طرق الرقابة التقليدية للمسوحا ت المنتشرة في السودان . وفي ذا ت الصدد ؛ يجب أخذ الحيطة عند عمل التحاليل التفسيرية لنماذج التنميط لعوائل المجموعا ت في هذه المنطقة.
Spoligotyping patterns and drug resistant of Mycobacterium tuberculosis in Sudan
(Al Neelain University, 2009) Ghada Suliman Sharaf-Eldin
. Sudan has a high burden of tuberculosis with an estimated 93,000 new cases each year. The purpose of this study was to investigate the genotypic patterns of M. tuberculosis strains circulating in Sudan and to assess their susceptibly to anti-tuberculosis drugs. Isolates from 237 smear positive tuberculosis patients were collected from different geographic regions of the country. Spoligotyping was performed by the Kamerbeek method and results were compared with the international SpolDB4 database (Institut Pasteur, Guadeloupe). Results revealed 28 clusters ranging in size from 12 to 57 isolates. Seventy unique (unclustered) strains were observed, representing 30% of the strains examined. The most frequently observed spoligotype patterns belonged to the CAS family which represented 115 (48.5%) of isolates studied. T1, H3, U and Beijing strains were found in 12 (5.1%), 11 (4.6%), 7 (3%) and 6 (2.5%) patients respectively. Strains belonging to the Beijing family were found mainly in Western Sudan. Resistance to isoniazid, rifampicin, ethambutol and streptomycin was observed in 18.1, 22.4, 22.2 and 32% of strains respectively. Twenty patients (8.4%) had MDR-TB of which 10 were new cases. Seventeen patients with rifampicin resistant tuberculosis were infected with CAS1-DELHI strains matching SIT 25 of the SpolDB4 database and 3 were of the SIT 1 Beijing family. 15 loci MIRU-VNTR typing subdivided the 17 CAS strains into one cluster of 5, two clusters of 2 and 8 individual MIRU types. Similarly the 3 Beijing spoligotypes were differentiated into a cluster of 2 and a single strain. x The use of molecular strain typing provides a proactive approach that may be used to initiate, and not just augment, traditional surveillance outbreak investigation in Sudan. However, caution must be used when interpreting clustered spoligotype patterns in this region
Effect of an educational program on health related behaviors for secondary school students in Saudi Arabia
(Neelain University, 2010) Ahmed Adam ballal Mohammed
Abstract This is an intervention study which is carried out by the researcher to evaluate the knowledge and practice of the Saudi students in secondary schools after implementation of health education program. The area of the study was Alameer Sultan bin Abdul-Aziz secondary school, in northern Ola province. The target population was the secondary school students and the sample size was the students of the ﬁrst year and the subject was consisted of 106 students who were chosen randomly. Their ages ranges between l4 and 17 years old and they were male. The researcher used tow tools to collect the data; structure interview questionnaire sheet. This sheet was developed after the review of the literature by the researcher to collect the demographic data such as (age and family health history) and Students lmowledge, health beliefs and practices towards (smoking, obesity, infectious diseases, oral hygiene) deﬁnition, causes, risk factors, signs and symptoms, complications, investigations, prevention and control. It was as pre- and-post test. Physical assessment sheet, This tool is used for recording data obtained as baseline assessment, and follow-up. Every student was weighed using a standardized calibrated weighing scale. The student was weighed without shoes and their height was estimated. This was done before and after the program. The health education program was designed to improve student's knowledge and practices of students after the program implementation. It included the following topics:- 1/ Smoking deﬁnition, causes, complications and how to quit.2/ Obesity: deﬁnition, causes, complications and how to avoid obesity.3/ Infectious diseases: deﬁnition, causes, ways of transmission, complication and how to prevent it.4/ Oral and dental hygiene: beneﬁts of teeth brushing, decay its causes and how to prevent it. The study was conducted in four phases, which took a period of 4 months from January 2008 to April 2008. 1/Assessment phase: The researcher designed the two tools (questionnaire & physical assessment). Feasibility and legibility of the instruments are done. 2/ Planning phase: Health education program was planned and designed by the researcher based on the result of the assessment phases. Health education program was developed and scheduled.Asseetive materials are prepared (video tabes, pamphlets, and posters). 3/ Implementation phase: The health education program was implemented by the researcher through ten sessions were carried out in Elmer Sultan bin Abdul-Azizi secondary school. Teaching session were given for one hour per day. 4/Evaluation phase: A post test was done for the students, immediately to evaluate effect of the program. The results showed that there was an increase in the students‘ knowledge regarding the four topics that has been discussed, speciﬁcally there was decrease in number of students who smoke by 20% , and decrease in those were obese by 3%, also there is decrease in the number of students with infectious diseases by 3% and number of students \vho began teeth brushing increased by 25% which mean positive behavior of the students (p > 0.05 ). The study recommend that there should be continuous health education amongcstudentsmsing the modern media to convey the message of health education. Also the study recommended that schools should be facilitated with a nurse or professional health educator, Because of their preventive roles.
The Quality Control Assessment of Fresh Frozen Plasma Produced From Whole Blood in National Blood Bank of Sudan
(Al-Neelain University, 2010) Hanaa Abdallah Abd Elrahman Shareef
Abstract BACKGROUND: This is a cross sectional study preformed to evaluate the quality control (QC) of prepared fresh frozen plasma (FFP) in National Blood Bank of Sudan the during the period between May and July 2010. Seventy units were obtained to assess the quality control (QC) of FFP in term of the volume units, temperature of storage and factor VIII level assay. The results of QC testing were analyzed and compared according to the acceptance criteria for Council of Europe. METHODS: Seventy sample of FFP were obtained from fresh frozen plasma (FFP) units which were produced by centrifugation method at (1700 RPM) and screened for HIV, HBV& HCV tests. After thawed the FFP units, 2ml were collected from each unit of FFP using sterile syringe to test the volume, storage temperature and concentration of factor VIII. RESULTS: The mean volume, storage temperature and concentration of FVIII in FFP were 124 ±28mL (mean ±STD), - 44±1.43 ْC (mean ±STD), and 44 ± 13.6 IU/dl (mean ±STD), respectively. DISCUSSION: The volume of prepared FFP units were less than standard in 55 (78.57%) units and 65 (98.53%) of FFP units had low FVIII concentration according to the criteria of CE but the storage temperature of FFP was within the acceptable range of the criteria of CE and Guideline of AABB. CONCLUSION & RECOMMENDATIONS: The study revealed that the volume and factor VIII concentration in fresh frozen plasma were not met standard criteria of council of Europe. In order to provide FFP which is safety and efficiency are ensured, we should define the quality control of FFP considering the requirements testing for QC parameters. VII Furthermore blood centers should establish a Total Quality System (TQS) in order to ensure their processes and procedures including donor recruitment, collection of blood, laboratory testing, preparation of blood components and distribution. VIII ملخص الدراســ ة المقدمة: هــذه الدراســ ة المقطعيــ ة لتقييــم ضــبط الجــودة فــى وحــدات البلمزم ة الطامزج ة المجمدة بخـدمات بنـك الـدم القـوم ي فـ ي السـودان، تـم إجراء هذه الدراس ة ف ي الفترة مـا بيـن شـهري مـايو ويوليـو 2010 .أخـذت سبعين وحدة مزجاجي ة من البلمزم ة المجمدة لقياس ضبط الجــودة والمتمثلــ ة فى قياس حجم الزجاج ة، درج ة حرارة التخزين وكمي ة عامل التجلط الثامن. وحللت نتائج الختبارات وقورنت بنا ًءا علـ ي توصـيات المواصـفات القنصـلي ة الوربي ة. ُ ال لجراء هذه الدراس ة أخذت ُطقرق: سبعين عين ة بلمزما من وحدات البلمزم ة الطامزج ة المجمدة والت ي تم تحضيرها بطريق ة الطرد المركــزى (1700دورة فـ ي الدقيقـ ة)، و اجـراء اختبـارات فحـص اليـدمز والتهـاب الكبـد الفيروسـ ي (ب،س). ثم مـن بعـد أن تـم تـذويب وحـدات البلمزمـ ة الطامزجـ ة فـى جهـامز ُ الحمام المائى، أخذ 2 مل من كل وحدة مزجاجي ة علـى حـدا بواسـط ة حقنـ ة معقم ة لجراء إختبارات قياس حجم الزجاج ة، درج ة حرارة التخزيــن وكميــ ة عامل التجلط الثامن . النتيجة : كان متوسط القيم لحجم الزجاج ة، درج ة حرارة التخزيــن وكميــ ة عامـل التجلـط الثـامن فـ ي وحـدات البلمزمـ ة الطامزجـ ة المجمـدة بـالترتيب كالتى 124 ±28 مل (الوسط الحسابى± النحـراف المعيـارى) ، - 44± IU/dl 13.6 ± 44- و) المعيـارى النحـراف ±الحسـابى الوسـط (م ْ1.4 (الوسط الحسابى ± النحراف المعيارى) على التوال ي. المناقشة : وجد ف ي هذه الدراس ة نقصان فـى الحجـم لخمسـ ة وخمسـين وحدة مزجاجي ة وكـانت نسـبتهم 57.78 ((%وإنخفـاض كميـ ة عامـل التجلـط الثامن ف ي خمس ة وستين وحدة مزجاجي ة وكانت نسبتهم ((53.98 %مقارنـ ً ة بمواصفات القنصلي ة الوربي ة أما نتيج ة درج ة حرارة التخزيـن كـانت مطابقـ ة لمواصفات القنصلي ة الوربي ة واتحاد بنوك الدم المريكي ة. الخلةصة والتوةصيات: وجدنا فى هذه الدراسـ ة أن حجـم الزجاجـ ة وكميـ ة عامل التجلط الثامن فـى وحـدات البلمزمـ ة الطامزجـ ة المجمـدة غيرمطابقـ ة للمعايير التى وصت بها المواصفات القنصلي ة الوربيـ ة. وبالتـالى لكـ ي نـوفر نعـ ضـبط ّ بلمزم ة طامزجـ ة مجمـدة ذات كفـاءة عاليـ ة وسـليم ة يجـب أن رف الجودة فى وحدات البلمزم ة الطامزج ة المجمدة مع وضع التــى فــ ي العتبــار: اجراء الختبارات المطلوب ة لمقاييس ضـبط الجـودة.بـل يجـب علـى مراكـز بنوك الدم أن تثبت نظام ضبط الجودة الشامل ة لتتأكــد مـن نظــام العمــل و طريقته فيما يشمل اختيار المتبرع، جمع الدم، الختبارات المعملي ة، تحضير مكونات الدم ومن ثم تومزيعه
Knowledge, Attitude and Practice towards Reproductive Health among Youth Population in Internally Displaced Camps at West Darfur- Al Genina-Sudan-2020
(2010) Mohammed Ahmed Abdulkarim Ali-MBBS- Faculty of
Abstract Introduction The census of young people and youth between ages 10 and 24 in the African Region will increase from 315 million in 2015 to 453 million in the year 2030 Global interest in the health of adolescents and youth has manifested itself in the many expressions of commitment to their healthy personal, spiritual, social, mental and physical development. The overall objective of the research was to study the reproductive health status of the youth of both genders in the identified state disaggregated by gender, age, and geographical camps. Research methods The research was conducted in three IDP camps in West Darfur State 49,863 population (three IDP camps in West Darfur State (Abu Zar 10063 – Krinding 26564 and El Riadd 13236) The study population was composed of the youth population aged 15-24 years of both genders including displaced groups. A multi-stage cluster sampling technique was used to draw the sample. The data were collected using mixed methods. Ethical approval was obtained from the Research Ethics Committee- State Ministry of Health and Social Development. Informed consent was obtained from each study participant before the interview. SPSS version 21 was used for analyzing the data set and generating outputs. The analysis was mostly univariate descriptive to generate indicators of interest. Besides, the bi-variate analysis was conducted to find relations between variables of interest. Results 54% of the sampled male youths in IDP camps that they had known puberty before experiencing it while 73% of the sampled female youths in IDPs camps that they had had such knowledge with a statistically significant difference by gender. 41% of the male youths ever heard about reproductive health while 69% of female youths ever heard about reproductive health. Adolescent and youth health as a component of reproductive health was identified respectively by 11.83% of the male youths and 24.26% of the female youths. Other components of reproductive health were inappropriately identified by male and female youths. 64.55% of male youths and 66.15% of female youths respectively responded that female genital cutting was practiced by their families. 73% of the interviewed female youths were subjected to any form of female genital cutting while 27% of them were not subjected to any form. 10.36% of the female youths were subjected to the pharaonic type of female genital cutting, 60.20% of them were subjected to clitorectomy while 26.42% of them did not know the type. 81.04% of the female youths ever heard about HIV/AIDS while 68.58% of male youths ever heard about HIV/AIDS. 33% of both male and 31% of female youths ever heard about sexually transmitted infections other the HIV/AIDS. 8.8% of male youths had ever been tested for HIV while 9.7% of female youths had been ever tested for HIV with a statistically significant association by gender 31% of the sampled male youths and 11% of the sampled female youths respectively ever heard about pre-marital care/examination. Conclusions: • The results reflect the marked gaps in the knowledge of both genders about changes other than physical changes commonly associated with adolescence. Female youths are less knowledgeable compared to male youths about adolescent issues. • The overall situation of knowledge about reproductive health and its components among youths was found to be insufficiently evidenced by their low responses to the questions around the reproductive health • The prevalence rate of female genital cutting among youths mounted to 72% in Krinding while in the two IDPs mounted to about 68% in Abu Zar and El Riadd IDP camps. • A low level of knowledge about pre-marital care is due to poor addressing of the pre-marital care/examination in the delivered IEC messages and the non-inclusion of pre-marital care/examination within the delivered RH package. • 25.6% of male youths stated that the main source of health knowledge was Health care providers while 51.2% of female youths stated the main source of health knowledge was Health care providers. • Gender-based violence is widely practiced during conflicts and attacks by armed groups and this markedly affects the health status of vulnerable groups such as pregnant women, early-married young girls. Recommendations The West Darfur state gender-sensitive, human rights-based comprehensive strategy of youth reproductive health is strongly recommended to the integration of youth reproductive health into existing primary health care services and ensuring that the health care providers to ensure all health problems/issues of youth address. No conflict of interest (COI) is a situation with the organization is involved in multiple interests, financial and otherwise. A risk that professional judgment or action ns regarding a primary interest will be unduly influenced by a secondary interest المستخلص المقدمة: سيزداد تعداد الشباب الذين تتراوح أعمارهم بين 10 و 24 عامًا في المنطقة الأفريقية من 315 مليونًا في عام 2015 إلى 453 مليونًا في عام 2030 ، يجلى الاهتمام العالمي بصحة المراهقين والشباب في العديد من التعبيرات عن الالتزام بنموهم الشخصي والروحي والاجتماعي والعقلي والبدني الصحي. الهدف العام للمسح هو دراسة حالة الصحة الإنجابية للشباب من كلا الجنسين في الولايات المحددة مصنفة حسب الجنس والعمر والمخيمات الجغرافية. طرق البحث: تم إجراء البحث في ثلاثة معسكرات للنازحين في غرب دارفور 49863 نسمة (ثلاثة مخيمات للنازحين في ولاية غرب دارفور (أبو ذار 10063 – كريندينق 26564 والرياض 13236). يتألف مجتمع الدراسة من الشباب الذين تتراوح أعمارهم بين 15-24 عامًا من كلا الجنسين. متضمنة المجموعات النازحة. ثم وزعت العينة بالتناسب مع حجم السكان الشباب في كل المعكرات واستخدمت تقنية أخذ العينات العنقودية متعددة المراحل لسحب العينة وتم جمع البيانات باستخدام طرق مختلطة وتم الحصول على الموافقة الأخلاقية من لجنة أخلاقيات البحوث - وزارة الصحة والتنمية الاجتماعية بالولاية. تم الحصول على موافقة مستنيرة من كل مشارك في الدراسة قبل المقابلة. تم استخدام الإصدار 21 من SPSS لتحليل مجموعة البيانات وانشاء المخرجات. كان التحليل في الغالب وصفيًا أحادي المتغير من أجل إنشاء مؤشرات بالإضافة إلى ذلك، تم إجراء تحليل ثنائي المتغيرات لإيجاد العلاقات بين المتغيرات ذات الأهمية. النتائج: ذكر 54 ٪ من الشباب الذكور الذين تم أخذهم كعينات أنهم كانوا على دراية بالبلوغ قبل أن يمروا به ، بينما ذكر 73 ٪ من الشابات الاناث الذين تم أخذهم كعينات أنهن لديهن مثل هذه المعرفة مع وجود فرق ذي دلالة إحصائية حسب الجنس (اختبار فيشر الدقيق ، قيمة P = 0.027). 41٪ من الشباب الذكور سمعوا عن الصحة الإنجابية بينما سمع 69٪ من الشابات سمعوا عن الصحة الإنجابية. تم تحديد صحة المراهقين والشباب كعنصر من مكونات الصحة الإنجابية على التوالي بنسبة 11.83٪ من الشباب الذكور و 24.26٪ من الشابات الإناث. تم تحديد المكونات الأخرى للصحة الإنجابية بشكل غير مناسب من قبل الشباب من الذكور والإناث. أجاب 64.55٪ من الشباب الذكور و 66.15٪ من الشابات الإناث على التوالي بأن بتر الأعضاء التانلسية للإناث كان يمارس من قبل أسرهم. 73٪ من الشابات اللاتي تمت مقابلتهن تعرضن لأي شكل من أشكال بتر الأعضاء التانلسية للإناث بينما 27٪ منهن لم يتعرضن لأي شكل. 10.36٪ من الشابات تعرضن للنوع الفرعوني من بتر الأعضاء التانلسية للإناث، 60.20٪ منهن تعرضن لاستئصال البظر بينما 26.42٪ منهن لا يعرفن النوع. 81.04٪ من الشابات سمعن عن فيروس نقص المناعة البشرية / الإيدز بينما سمع 68.58٪ من الشباب عن فيروس نقص المناعة البشرية / الإيدز. 33٪ من كل من الذكور و 31٪ من الإناث سمعوا عن الأمراض المنقولة جنسياً الأخرى المتعلقة بفيروس نقص المناعة البشرية / الإيدز. تم اختبار 8.8 ٪ من الشباب الذكور بحثًا عن فيروس نقص المناعة البشرية في حين تم اختبار 9.7 ٪ من الشابات الاناث لفيروس نقص المناعة البشرية مع ارتباط ذي دلالة إحصائية حسب الجنس (اختبار فيشر الدقيق، قيمة P ثنائية الذيل = 0.0301). سمع 31٪ من الشبان الذكور في العينة و 11٪ من الشابات الإناث في العينة على التوالي عن الرعاية / الفحص قبل الزواج. الاستنتاجات: المخاطر الصحية والصحية خلال فترة المراهقة: • كانت هناك فجوات ملحوظة في معرفة كلا الجنسين حول التغيرات غير الجسدية المرتبطة عادة بالمراهقة. • كانت الشابات أقل دراية مقارنة بالشباب بقضايا المراهقة، ويرجع ذلك في الغالب إلى العوائق الاجتماعية والثقافية التي تجعل الشابات غير قادرين على الوصول إلى هذه المعرفة. المعرفة ومصدر المعلومات حول البلوغ: • كشفت الدراسة عن فجوات معرفية لكل من الذكور والإناث فيما يتعلق بأكثر سن البلوغ شيوعًا لكل من الأولاد والبنات. برامج الصحة الإنجابية بين الشباب: • تبين أن الوضع العام للمعرفة حول الصحة الإنجابية ومكوناتها بين الشباب غير كافٍ، كما يتضح من ردودهم المنخفضة على الأسئلة المتعلقة بالصحة الإنجابية. • لا توجد برامج متخصصة / مصممة أو موجهة بشكل أساسي نحو الصحة الإنجابية بين الشباب. بتر الأعضاء التناسلية الأنثوية: • كشفت الدراسة عن مواقف سلبية لدى الشباب من الذكور تجاه القضاء على تشويه الأعضاء التناسلية للإناث الشباب مما قد يعيق الجهود والتقدم نحو القضاء على بتر الأعضاء التانلسية للإناث. • 73٪ من الشابات اللواتي تمت مقابلتهن تعرضن لأي شكل من أشكال بتر الأعضاء التانلسية للإناث، بينما 10٪ من الشابات تعرضن للنوع الفرعوني، 60٪ منهن تعرضن لاستئصال البظر بينما 26٪ منهن لم يعرفن النوع. تشير نتائج الدراسة إلى أن قطع الأعضاء التناسلية الأنثوية لا يزال يمارس على نطاق واسع في منطقة الدراسة مع تحول ملحوظ من النوع الفرعوني إلى استئصال البظر. فيروس نقص المناعة البشرية / الإيدز والأمراض المنقولة جنسيا: • تعكس الردود المستوى المنخفض للمعرفة حول فيروس نقص المناعة البشرية / الإيدز. • نقص رسائل IEC حول فيروس نقص المناعة البشرية / الإيدز بدلاً من الأمراض المنقولة جنسيا أو حتى الأمراض المنقولة بالاتصال الجنسي لم يتم تناولها في رسائل IEC التي تم تسليمها. رعاية / فحص ما قبل الزواج: • تدل النتيجة على انخفاض مستوى المعرفة خاصة بين الشباب الذكور الذين تم أخذ عينات منهم حول الرعاية / الفحص قبل الزواج. هذا المستوى المنخفض من المعرفة يرجع إلى سوء معالجة الرعاية قبل الزواج. تنظيم الأسرة والحمل المبكر: • كشفت نتائج الدراسة عن اختلافات ملحوظة في اتجاهات الشباب من الذكور والإناث نحو تنظيم الأسرة. • أوضحت الدراسة أن الشابات بشكل عام كان لهن موقف إيجابي تجاه الحمل المبكر كقضية تتعلق بالصحة الإنجابية مقارنة بالشباب الذكور. العنف القائم على النوع الاجتماعي وقضايا النوع الاجتماعي الأخرى: • أكد المشاركون أن العنف القائم على النوع الاجتماعي يُمارس على نطاق واسع أثناء النزاعات والهجمات التي تشنها الجماعات المسلحة وهذا يؤثر بشكل ملحوظ على الحالة الصحية للفئات الضعيفة مثل النساء الحوامل والفتيات الصغيرات المتزوجات في سن مبكرة. التوصيات: يوصى بشدة باستراتيجية ولاية غرب دارفور الشاملة التي تراعي الفوارق بين الجنسين والقائمة على حقوق الإنسان للصحة الإنجابية للشباب من أجل دمج الصحة الإنجابية للشباب في خدمات الرعاية الصحية الأولية الحالية والتأكد من أن مقدمي الرعاية الصحية يتعاملون مع جميع المشاكل الصحية / قضايا الشباب.
Neurogenetics Spectrum of Sq related spinal muscular atrophies (lower motor neuron syndromes) in Sudanese and Saudi populations; a multicentre clinical and Molecular Study.
(ALNEELAIN UNIVERSITY, 2010-10) Ali Alsanousi
Abstract Background Spinal muscular atrophy is one of the most common autosomal recessive neurogcnetics disorders in East Africa and Middle East countries, also considered as a leading genetic killer under the age of two years, with high carriers‘ frequency exceeds 1:50 in Europe. The most common presentation is proximal muscle weakness as a consequence of anterior hom cells degeneration. A mutation in the telomeric copy of the survival motor neuron gene (SMNI) considered as main underlying causative factor. Most carriers of SMA have one chromosome 5 with a normal SMNI gene and one with a deleted SMNIcopy. Although no large-scale population-based study has been established in the region; a previous estimation has indicated that incidence of SMA is much higher in Arab population compared with other ethnic groups, partly because of high prevalence of tribal and consanguineous marriages. Objectives General objective The project has been designed to introduce the molecular medicine advanced technology to improve the accuracy in the diagnosis of lower motor neuron disorders presented in a form of SMA as translational reseach for our cun'ent knoweledge of the pathogenic chromosomal region (5ql3). The speciﬁc objectives were: '2' To Introduce the SMA Molecular diagnostics and the carrier detection methods in Sudan. '1' To review the role of SMNI and other candidate genes (NAIPs genes in susceptibility to SMA in Middle East countries and Arab ethnic groups). To establish a method could help detection of other possible mutations in SMA nondeleted patients (~5% of SMA Patients). '3' To explore the possibility of increasing the sensitivity of the diagnostic molecular technology for 5qSMA cases from 95 to~99%. '2' To correlate the genotype (SMNI and SMN2 copy number) with the phenotype and carrier status in diagnosed patients within special type of SMA families. ¢ 0.0 Material and methods Materials bower Motor neurone/5qSMA diagnosis retrospective study included 259 of DNA samples each sample extracted from clinically symptomatic patient during the year 2005 and 2006. Material for SMA carrier analysis study included Total number of 2000 healthy volunteers. Material for SMNI-Exon7 nondeleted patients’ analysis study Included 80 patients showed SMA clinical phenotype. Material for Sq SMA families without SMNI common deletion Included Ten (10) families (36 individuals) for SMA patients didn't show SMNI-exon7 deletion. Methods DNA extraction ﬁ'om peripheral blood using QIAGEN (QIAamp DNA Blood Midi Kit) has been used for all samples included in this project; an altemative rapid extraction method l.raCode paper has been used for heterozygousity carriers testing. Ampliﬁcation ofSMNI exon7 and 8 PCR performed in l2.5 ul total volumes containing l00 ng of DNA; the PCR products then digested with Dral and Ddel enzyme to visualize and identify the SMNI copy. Multiplex-PCR has been used as quantitative-PCR to determine the presence of single SMNlcopy (gene dosage scan) and stndardized as SMA carriers’ detection method as we used it also to detennine SMNI/2 copies and NAIF deletions in SMA family study. SMNI Long-Range PCR (LR-PCR) Selective ampliﬁcation of SMNI gene by LR-PCR method was initiated to detect the single nucleotide mutation possibilities on SqSMA eases without SMNI common deletions. Fluorescenct~Based PCR SSCA (Single Strand Conformational Analysis) has been established as pre- sequencing methods to determine SMNI-exons with possible mutation. Sequencing has been performed using a dye terminator cycle sequencing kit (Perkin Elmer, Wanington, UK) and an automatic Sequencer (Applied Biosystem 373) for speciﬁc SMNI exons puriﬁed from the LR-PCR product. Outcomes and Results patients presented with lower motor neuron pheotype showed SMNl—Exon7 deletion therefore had a oonﬁnnation of Sq SMA diagnosis were (8l.08%). SMNI gene was absent or interrupted in 97 out of 137 (70.8%) of SMA types l patients, although SMA type II patients showed deletion in (93.1%) i.e. 8| out of 87; while (9l.4%) i.e. 32 out of 35 type-lll patients showed the same deletion mutation. The initial controls of the healthy carriers screening study included [87 normal individuals showed carrier frequency of 5%, i.e. one carrier in each 20 persons compared to one in 50-80 in other parts of the world. Therefore we expanded the healthy volunteers number to include i869 subjects. Only 43 i.e. (2.3%) individuals showed single copy of SMNIthis make the carrier frequency one in 34. 5 Ali Alsanousi-October/2010 ____ _ SMNI-Exon7 nondeleted SMA came study: included 80 patients classiﬁed into three classes. 5% of them showed SMN]-Exon8 deletions. Class] patients (SMNI-Exon7 nondeleted independent patients) results showed 21.05% of those patients showed deletion mutation of NAIP gene Exons.Class2 (SMN1 -Exon7 Nondeleted patient investigated in correlation with their family SMN genetic proﬁle) showed deletion mutation in NAIP in 6.25%. Class 3 (included patients wit11 Exon7- SMN2 deletion) showed NAIP gene mutation in 50% of patients included from this group. Futher molecular analysis of the SMA families investigated for SMN!/SMN2 copies number using gene dosage scan analysis showed (100%) patients in this group were SMNI- Exon7 nondeleted. Gene dosage scan classiﬁed class 2 into further 3 classes; i.e. patients showed single copy of SMN! and single copy of SMN2 (IT/1C) represented 10% of this group. Patients showed 2 copies of SMN] and no copy of SMN2 (2T/0C) represented 30% of this group. While the majority of this group (60%) showed 2 copies of SMN] and one copy of SMN2 (2T/1C). We have established in this study a newly invented method using the Long range PCR to determine SMN! by ampliﬁcation of 13 Kb of the SMN! genes i.e. (ex0n2a to exon8).The selective ampliﬁcation of SMN! successfully performed using LR-PCR as substituting method for SMNI gene cloning from cDNA. Using 10% of class 2 patients (i.e. patients form showed single copy of SMNI in gene dosage scan).SMNl has been visualized then puriﬁed for speciﬁc Exon SSCA/SSCP which is optimized using I5 samples with known gene dosage scan proﬁle. Two samples (13.3%) showed abnormal migration curve in SSCP therefore selected for optimimtion of the sequence analysis study. Both abnomially migrating SMN-Exon6 samples showed a normal or nonmuatated sequence. ln conclusions The project presented both the SMA diagnostic method together with a method for carriers testing with the highest sensitivity and speciﬁcity; then could be considered a comer stone to stop the spread of this fatal diabling disease. Homozygous deletion of Sll/ﬂVI-exons7 was found in 93.1 to 91% while SMNI-exon8 deletion detected in 87% of patients included therefore could present a conﬁmiatory diagnosis for SMA with high conﬁdence. Healthy volunteers’ carriers study revealed relatively higher carrier frequency in comparison with other ethnics (2.34% i.e. one in 34). SMA families study gave an evidence of a possible underlying genetics mechanism related to S1vﬂV gene conversion and Sq 13 region rearrangements indicated by the gene dose scan analysis and NAIP gene deletions in SMA nondeleted patients. Ali Alsnnnusi-October/2010 6 Ali Alsanousi-October/2010
The Effectiveness of Nursing Counseling Intervention on The Social Adaptation Among HIV/AIDS Patients In Khartoum Teaching Hospital 2006-2011
(Al-Neelain University, 2011) Saadia Abdalla Gesm Elseed
Abstract This study aims to assess the Effectiveness of nursing Counseling Intervention on the social adaptation among HIV/AIDS patients in voluntary Counseling Test Center (VCT) at Khartoum Teaching Hospital. The method of the study is interventional programs consist of 24 sessions applied in. intervention group compare with non intervention group. Tools for data collection which involve Self Esteem Scale, Self concept scale, hospital anxiety and depression, social desirability, social function sheet, assessment sheet for patients satisfaction during counseling sessions and assessment .sheet to assess the program Participants are HIV/AIDS patients at VCT Center in KTH. Inclusion criteria are adult HIV /AIDS patients, receiving antiviral and willing to participate. Exclusion criteria are HIV/AIDS patients not receiving antiviral, refused to participate and children. The sample size is 200 HIV/AIDS patients (200 intervention and200 non interventions). Ethical considerations are involved in application; for permission from the Hospital Authority to conduct the study was obtained and verbal .informed consent of participants whom are given code numbers was attained The research results are disseminated to the Voluntary Counseling Test Centers, to help HIV/AIDS .patient to achieve social adaptation and live positively The present study reveals that results in non intervention group which received standard nursing care in self esteem scale, which measures attitude towards myself varies between 60-70% in disagree and strongly disagree, this is indication to low self-esteem (table 4-1).However after the implementation of the program in intervention group self-esteem of patients results varies between 70-75% in agree and strongly agree this indicates that the implementation of the program is very effective in enhancing patients self-esteem (table 4 -8). Also, the study shows that the results of self concept scales which measure physical selfmoral, ethical-self, personal, family and social in non intervention group various between 75-85% in strongly disagree (table 4-2), in spite of experimental group these results between 75-85% in agrees and strongly agree an indication the increase in self-concept (table 4-9). The study reveals that in the assessment of the program and patient satisfaction (tables 4-6/4-7) there is low satisfaction in non intervention group, compare with high satisfaction and responses(tables 4-13/4-14) in intervention group during counseling sessions. Results of the study indicate marked improvement in patient's communication, interaction, span of attention, socialization and social performance. This is supported by Roy Adaptation theory and Orem Self care theory. Then this study proves the effectiveness of the constructed nursing counseling program on the social adaptation of the chronically HIV/AIDS patient's (through a planned therapeutic program) as well as the influence of the nursing role throughout the processes of treating the chronically HIV/AIDS patients. On the light of these study findings, it is recommended that nursing counseling program should be implemented early to patients and their families, nursing counseling program should include selfcare, coping strategies, problem solving, communication, decision making and assertiveness skills. A counseling nursing program should be, established to qualify personnel to conduct counseling sessions for the HIV/AIDS patients. III مستـخـلـص البحــث تهدف هذه الدشراسة الي تقييم فعالية تدخل الشرشاد النفسي التمريضي علي التكيف التجتماعي بين مرضى اليدز بمركز الشرشاد النفسي للفحص الطــوعي الختيــاشري بمستشفي الخرطــوم التعليمـي. تتخذ الدشراسة منهج البرامج التداخليه التي تتكون من أشربعة وعشرين تجلسة تطبق علي مجموعة تجريبية (تداخلية) مقاشرنة بمجمموعة غير تداخلية تتضمن أدوات تجمع البيانات ، مقياس إحترام الذات ، مقياس مفهوم الذات ، القلق والكتئاب الناتج عن التواتجد بالمستشفي ، الرغبه التجتماعية ، إستماشرة الوظيفة التجتماعية ، إستماشرة تقييم شرضا المرضى إثناء الجلسات الشرشادية وإستماشرة تقييم البرنامج. المشاشركون مرضى اليدز بمركز الفحص الطوعي الختياشري بمستشفي الخرطوم التعليمي معايير التضمين هي مرضى أيدز بالغين ، يتناولوا مضادات الفيروس ، والرغبه في المشاشركة ، معايير الستبعاد هى مرضى أيدزل يتناولوا مضادات الفيروس غير موافقين على المشاشركة والطفال حجم العينه مائتين مريض ايدز( مائتين مجموعة تداخلية ومائتين غير تداخلية ). عُشرعيت العتباشرات الخليقية في طلب الدشراسة وتم الحصول علي إذن من سلطات المستشفي لتجراء الدشراسة كما أخذت شفاهة الموافقة المستنيرة للمشاشركين الذين أعطوا أشريقام ًا سرية ، ستوزع نتائج البحث علي مراكز الشرشاد النفسي للفحص الطوعي الختياشري لمساعدة مرضى اليدز علي تحقيق التكيف التجتماعي ومماشرسة حياة إيجابية . كشفت الدشراسة أن النتائج في المجموعة الغير تداخلية التي تلقت شرعاية تمريضية نموزتجية في تقدير الذات علي مقياس تقدير الذات الذي يقيس مويقف المريض تجاه ذاته ، كشفت أن 60 - %70 %يتراوحون مابين غير موافقين وغير موافقين بشدة وهذا يشير الي تدني إحترام الذات تجدول (1-4 (ومع ذلك تراوحت نسبة احترام الذات بين 70% 75 %موافقين وموافقين بشدة بين مجموعة المرضى بعد تنفيذ برنامج التدخل ممايشير الي أن البرنامج كان في غاية الفعالية في تعزيز تقدير الذات لدى المرضى تجدول(4-8.(كما بينت نتائج مقياس مفهوم الذات التي تقيس النواحي الجسمانية والمعنوية والخليقية والشخصية والعائلية والتجتماعية. أن هذه النواحي في المجموعة الغير تداخلية تتراوج IV مابين 75 - %85 %غير موافين بشدة تجدول (2-4 (بينما تراوحت النتيجة في المجموعة التداخلية بين 75 - %85 %موافقين وموافقين بشدة المر الذي يشير الي تحسين مفهوم الذات تجدول (4-9.( أوضحت الدشراسة فيما يختص بتقييم البرنامج من ناحية شرضا المرضى أثناء الرعاية التمريضية تجدولين (6/4 – 7/4 ( أن نسبة الرضا متدنية بين أفراد المجموعة الغيرتداخلية بينما يلحظ إشرتفاع نسبة الرضا والستجابة بين أفراد المجموعة التداخلية تجدولين(13/4– .( 4/14 أثبتت الدشراسة فعالية برنامج الشرشاد النفسي التمريضي الموتجه فيما يتعلق بالتكيف التجتماعي لمرضى اليدز المزمنيين ، كما تشير نتائج الدشراسة الي تحسن ملحوظ في تواصل المرضى وتفاعلهم في دشرتجة إهتمامهم والندماج والداء التجتماعي ، يؤيد ذلك نظرية شروئي للتكيف ونظرية الهتمام الذاتي لوشرم ، بالضافة الي ذلك أثبتت الدشراسة فعالية برنامج الشرشاد النفسي التمريضي وتأثير دوشر التمريض خلل عمليات علج مرضى اليدز المزمنيين وإخضاعهم لبرنامج علتجي موتجه ، علي ضوء نتائج هذه الدشراسة نوصي بالتي :- - ينبغي تطبيق برنامج اشرشاد نفسي تمريضي علي المرضى واسرهم في مرحلة مبكرة. - كما يجب أن يتضمن البرنامج المذكوشر مهاشرات الرعاية الذاتية واستراتيجيات التغلب علي المشكلت والتواصل وصنع القراشر وتؤكيد الذات . ينبغي أن ينشأ برنامج إشرشاد نفسي تمريضي لتأهيل الممرضين والممرضات لتجراء الجلسات الشرشادية لمرضى اليدز.
Evaluation of critical nurses’ knowledge and practice regarding care of postoperative cardiac patient in ICU (2010-2011
(2011) AWADIA ELMIN BABIKIR MOHAMMED
Determination of Antiphospholipid antibodies and Thrombophilia in women with Recurrent Miscarriage
(Al Neelain University, 2011) Tagwa Yousif Elsayed Yousif
Recurrent miscarriage is a_critical problem in which many factors play a crucial role such as antiphospholipid antibodies (APA) and anticardiolipin antibodies (ACA). This study was a case control study, was conducted from Febraury-2008 to February - 2011 in Khartoum State; it determined the haemostatic abnormalities and the frequency of the primary and secondary antiphospholipid syndrome in women with history of recurrent miscarriage (RM). A total of 100 women with three or more consecutive recurrent miscarriage as case group and 100 non complicated pregnant women as control group were enrolled in this study and were interviewed through clinically structured questionnaire to assess the risk factors for RM and an informed consent were obtained from them. Patient and control groups were screened for the presence of antinuclear antibodies (ANA), anti-double stranded DNA (anti- dsDNA), antiphospholipid antibodies (APA IgM/IgG), and anticardiolipin antibodies (ACA/IgG) by using Enzyme linked Immuno-Sorbent assay (ELISA). The platelets were counted using Sysmex KXN-21. Activated Partial thromboplastin time (APTT), Prothrombin time (PT) and Thrombin Time (TT) were measured using coagulometer biobas 10. Women positive for APA were repeated the measuring of APA level after 6 as conﬁrmatory test. All tests were analyzed using Statistical Packages of Social Sciences Version 17 (SPSS program). Results showed that the frequencies for both APA and ACA were 20%, ANA and Anti- dsDNA were 12%, thrombocytopenia was 8%, LA was 20% , 5% had prolonged PT, where as the remaining patient and control groups had normal results. There were a signiﬁcant correlation between Age and the presence of APA (P=0.03), ACA (IgG) (P=0.04), ANA and Anti-dsDNA (P=0.0l3), LA (P=0.033) and thrombocytopenia (P=0.02), whereas PT had not inﬂuenced by age. The data concluded_ that the frequencies of APA, ACA, ANA, Anti-dsDNA, LA and thrombocytopenia in women with RM obtained in this study were in agreement to the frequencies for these parameters obtained in previous studies and their presence were signiﬁcantly associated with recurrent miscarriage. The current study recommends measuring of APA, ACA, Anti-dsDNA-antibodies, APTT and PT in all women with 3 or more consecutive pregnancy loss.
The Effectiveness of Nursing Counseling Intervention on The Social Adaptation Among HIVIAIDS Patients In Khartoum Teaching Hospital 2006-2011
(Neelain University, 2011) Saadia Abdalla Gesm Elseed
Abstract This study aims to assess the Effectiveness ofnursing Counseling lntervention on the social adaptation among HIV/AIDS patients in voluntary Counseling Test Center (VCT) at Khartoum Teaching Hospital. The method of the study is interventional programs consist of 24 sessions applied in. intervention group compare with non intervention group. Tools for data collection which involve Self Esteem Scale, Self concept scale, hospital anxiety and depression, social desirability, social function sheet, assessment sheet for patients satisfaction during counseling sessions and assessment sheet to assess the program. Participants are HlV/AIDS patients at VCT Center in KTH. lnclusion criteria are adult HIV /AIDS patients, receiving antiviral and willing to participate. Exclusion criteria are HIV/AIDS patients not receiving antiviral, refused to participate and children. The sample size is 200 HIV/AIDS patients (200 intervention and200 non interventions). Ethical considerations are involved in application; for permission from the Hospital Authority to conduct the study was obtained and verbal informed consent ofparticipants whom are given code numbers \vas attained. The research results are disseminated to the Voluntary Counseling Test Centers, to help HIV/AlDS patient to achieve social adaptation and live positively. The present study reveals that results in non intervention group which received standard nursing care in self esteem scale, which measures attitude towards myself varies between 60-70% in disagree and strongly disagree, this is indication to low self-esteem (table 4-l).However after the implementation of the program in intervention group self-esteem of patients results varies between 70-75% in agree and strongly agree this indicates that the implementation of the program is very effective in enhancing patients self-esteem (table 4 -8). ' Also, the study shows that the results of self concept scales which measure physical self- moral, ethical-self, personal, family and social in non intervention group various between 75-85% in strongly disagree (table 4-2), in spite of experimental group these results between 75-85% in agrees and strongly agree an indication the increase in self-concept (table 4-9). The study reveals that in the assessment of the program and patient satisfaction (tables 4-6/4-7) there is low satisfaction in non intervention group, compare with high satisfaction and responses(tables 4-l3/4-14) in intervention group during counseling sessions. Results of the study indicate marked improvement in patient's communication, interaction, span of attention, socialization and social perfomtance. This is supported by Roy Adaptation theory and Orenr Selfcare theory. Then this study proves the effectiveness ofthe constructed nursing counseling program on the social adaptation of the chronically HIV/AIDS patient's (through a planned therapeutic program) as well as the influence of the nursing role throughout the processes of treating the chronically HIV/AIDS patients. On the light of these study findings, it is recommended that nursing counseling program should be implemented early to patients and their families, nursing counseling program should include self- care, coping strategies, problem solving, communication, decision making and assertiveness skills. A counseling nursing program should be, established to qualify personnel to conduct counseling sessions for the HIV/AIDS patients.
ROLE OF RHO-KINASE AND NITRIC OXIDE SYNTHASE INHIBITION IN CEREBRAL INJURY INDUCED BY ISCHEIVHA REPERFUSION IN RATS AND THE EFFECT OF ISCHEMIC PRECONDITIONING
(Neelain University, 2011) Hiba Ahmed Al Sheekh Avyooda