Napata Scientific Journal

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Memorial of a Sudanese Scholar Dr. Abd-Allah Eltayeb Abd-Allah (1921-2003)
(Napata College, 2022) Mohammed Elhassan Altikaena
Professor Tigani El Mahi (1911-1970)
(Napata College, 2022-04) M. Eltikeina
The Republic of the Sudan has, since its independence in 1956 (2), to the best of its ability attempted to promote the absolute necessity of education and has seen to it that it manifests itself as a participant in the world stage. Despite this, Sudanese scholars are almost never mentioned in popular academic media. Here in NSJ, we have decided to manifest ourselves as a force of change and to, to the best of our ability, see to it that these under-recognized scholars are shined forth as they always should have. In this edition of NSJ, our persona of the edition is the father of African psychiatry, Professor Tigani El Mahi of the Republic of the Sudan.
Book Review
(Napata College, 2022-04)
The Sudan Manual for Medical Emergencies is a compact and wide-ranging handbook that is meant for practicing and student physicians handing acute and critical medical and psychiatric patients. A group of experts contributed to the Manual by putting together updated international guidelines as well as standard of care practices. It also includes comprehensive and illustrative diagrams in addition to an index of included drugs to aid with quick reference. Attempts have been made at providing different patient lifesaving approaches whenever optimal ways are unavailable.
Kingdom of NAPATA
(Napata College, 2022-04) Elzubair Bashir Taha
Archaeological relics and findings of historical research indicate that Sudan has witnessed the rise and fall of regional civilizations for more than ten thousand years. Of all those civilizations the era of the Sudanese Napatan Empire was the greatest in sub-Saharan Africa. Napata Empire began to blossom mid eleventh century BC and survived for a thousand years. The most prosperous period of the Napatan Empire is represented in Egyptology by the 25th dynasty particularly during the pharoship of Taharka (690-660 BC) during whose rule extensive pyramids, settlements and temples were built, the remains of which can still be seen. with its vast economic and distinctive political organization the Napatan civilization was able to spread its territory to include Ethiopia east, Darfur west, Upper Nile South and across lower and upper Egypt thru to Southern Turkey Anatolia. In the seventh century before Christ, the Napatan army defeated the Assyrians and chased them out of entire Syria and Palestine thus librating the sacred city. Taharga, the third Napatan pharaoh, was named in the bible as the protector of Orshleem AlGuds. By assuming full control over the red sea, the Napatan Empire has played an important role in international trade connecting Far East to Egyptian ports thus interacting with Southern Europe via the Mediterranean.
Editorial Introduction to the First Issue” Napata Scientific Journal March
(Napata College, 2022-04) Zahir Hilmi
Genetic variation among Sudanese Leishmania donovani origin and evolution
(Napata College, 2022-04) S.H. Hamad; A.M. Musa; E.A.G. Khalil
Introduction: Leishmaniasis is a geographically widespread severe disease, with an increasing incidence of two million cases per year, and 350 million people from 88 countries at risk. The causative agents are species of Leishmania, a protozoan flagellate. Visceral leishmaniasis, the most severe form of the disease, lethal if untreated, is caused by species of the Leishmania donovani complex. These species are morphologically indistinguishable but have been identified by molecular methods. This study aimed to explore intra specific diversity among Sudanese L. donovani strains and compare it to Ethiopian and Indian strains. Methods: In this study Random Amplified Polymorphic DNA (RAPD) was used to detect intra specific diversity for the Leishmania donovani in ninety five L.donovani isolates collected from eastern Sudan. Results& Discussion: this study found three different genotypes of Sudanese strains. The similarity between Sudanese strains and Ethiopian and Indian reference strains was measured. Diversity among Sudanese genotypes and the detection of one genotype closely related to the Indian and Ethiopian genotype: led to an evolutionary hypothesis for the origin and dispersal of the species. This proposes that the genus Leishmania may have originated in eastern Sudan. Conclusion: Leishmania donovani isolates from Sudan are genetically diverse. This parasite 4 Napata Scientific journal- issue One- March 2022 could be the ancestor of the leishmania parasites, and its distribution started from Sudan to all of the worlds.
A Review of Parasites of Freshwater Fishes of the Sudan from 1902 to 2020
(Napata College, 2022-04) Z. N. Mahmoud; R. M. Abdalla
Background This review was conducted from 1996 to 2020 aiming to compile the findings of parasites of freshwater fishes of Sudan in a single document. Methods The present review was based on 105 scientific paper, 3 conferences abstracts, 3 graduation dissertation, 7 master and 2 Ph.D. theses, one unpublished reports, 10 books, and one technical report. The work covered the period from 1902 to 2020. Results Some thousands of freshwater fish specimens were examined for their ecto-parasites and/or endo-parasites. Fifty-eight fish species were reported infected and 162 parasitic species including 32 new species were collected. The parasites found were three bacterial and three fungal species collected from Oreochromis niloticus. From 10 species of fish, 19 protozoans were described. From 10 species of fish, 22 Monogenean species were found including 7 new species. One new Aspidogastrean species was collected from Labeobarbus bynni. From 29 fish species 23 Digenean species were collected including five new ones. From 41 species of fish, 44 species of cestodes parasites were collected including 11 species new to science. Twenty parasitic Nematodes species including seven new ones were collected from 32 fish species. From 12 fish species 9 Crustacean were described. Nine Acanthocephalans including one new species from Ichthyborus besse were collected from 11 fish species. Co-infection was observed. Conclusions: The collected parasites included 31 new species to science. One new subfamily Sandonellinae from Heterotis niloticus was erected; and 10 new genera, Brevicaecum, Sandonia, Afromacroderoides (Digenea); Wenyonia, Sandonella, Amirthalingamia, Barsonella lafoni (Cestoda) and Dichelyne, Nilonema, (Nematoda) were described. Revision of parasitic species designated as CithariniellaTrypanosoma type 1, 2, 3; Dactylogyrus species type 1, 2, 3, 4, 5; Dogielius sp. 1;Amplicaecum type 1 and Amplicaecum type 2; Contracaecum sp. Third stage-larvae Type 2; Procamallanustype 1, 2, 3 and those parasites identified to the genus level should be given due attention. Some recommendations for further research were offered
Phytochemical Analysis of Ethanolic Extracts of Three Sudanese Tribulus species
(Napata College, 2022-04) Z. A. Hilmi; H. H. EL-Kamali; A. M. Aldai
This study aims to explore the phytochemically bioactive compounds of three Sudanese Tribulus species. Threewild species of Tribulus; T. terrestris, T.longipetalous and T.pentandrus,were collected from KhartoumState. Their bioactive compounds were extracted by ethanol, from their roots, aerial parts, and fruits. Gas-Chromatography-Mass Spectroscopy (GCMS) was used for phytochemical analysis of their bioactive compounds.In T. terrestris different compounds (20 from roots), (27 from aerial parts) & (29 from fruits) were identified by GC/MS. Six classes of chemical compounds were found; sugars, fatty acids, terpenes, steroids, alkanes and alcohols. Major components were sucrose (28.72%) in roots and 4-O-methyl-mannose in aerial parts (49.60%) and in fruits (43.66%). In T.longipetalous many compounds were identified; 23 from roots, 20 from aerial parts, and 29 from fruits. These compounds were classified into four groups; Sugars, fatty acids, terpenes alcohols. The most commonly detected compound was 4-O-methyl mannose; 73.11% (in roots), 43.24% (in aerial parts) and 35.75% (in fruits). In T.pentandrus more compounds were identified, 31 (roots), 31 (aerial parts) and 42 from fruits. These compounds were grouped into eight classes; sugars, fatty acids, terpenes, steroids, alkanes, alcohols, steroidal sapogenins and alkaloids. The major component also was 4-O-methylmannose 47.86 % (in roots), 44.75 % (in aerial parts) and 55.05 % (in fruits).The most commonly found classes of compounds in the three Tribulus species were; sugars, fatty acids, terpenes, steroids and alcohols. The major compound found in all parts of the three Tribulus species was 4-O-methylmannose. In addition other compounds were identified from T.pentandrus
Somebody relationships in 15 populations of two Nile Cichlids in the Sudan.
(Napata College, 2022-04) O.M. Omer; A.H Abdalla; E A. Hagar; Z.N. Mahmoud
Background: The objective of this work is to quantify the body weight, body depth and standard length relationship of Oreochromis niloticus, Sarotherodon galilaeus from the Nile and its tributaries to find out the population of best traits. Methods: Fish body weight was recorded to 0.1gm using an electronic field balance. The standard length and body depth were measured using a measuring tape to the nearest cm. Results: The standard length-body weight relationship of O. niloticus and S. galilaeus 15 populations, was significant (p<0.05 top<0.001), except for S. galilaeus populations from Wad Medani and Shendi (p>0.05). The growth mode of the different populations of O. niloticus and S. galilaeus ranged from negative allometric, isometric to positive allometric.The standard length-body depth relationship of O. niloticus and S. galilaeus was mostly significant (p<0.05 top<0.001 Conclusions: The study concluded that there is a relatively high level of polymorphism and genetic diversity within and between O. niloticus and S. galilaeus and a comparatively high overall interspecies pair wise divergence. The population of O. niloticus from Al Kalakla is quite different from other populations, and thus can be recommended for improvement of other tilapias varieties.
Phytochemical Screening, Antimicrobial and Antioxidant Activities of Ziziphus spina-christi (L.)Leaves extracts
(Napata College, 2022-04) Yasmin Hassan Elshiekh
This study aimed to explore the phytochemical profile, antimicrobial and antioxidant activities of n-hexane, ethyl acetate and methanol extracts. Plate agar diffusion method was used to assess the antimicrobial activity of these extracts using four bacterial species; two Gram positive; Bacillus subtilis, Staphylococcus aureus, two Gram negative; Escherichia coli, Pseudomonas aeruginosa and two fungal species; Aspergillus niger and Candida albicans. The methanol extract showed a significantly higher antibacterial activity in comparison to the other extracts. No antifungal activity was detected in this research with all extracts of Ziziphus spina-christi leaves.
Association of Serum Lipid Profile Levels in Chronic Kidney Disease Patients with Cardiovascular Disease a case control study, Khartoum State
(Napata College, 2022-07) Mohammed M.A; Mohammed I.A; Ismail A.M; Ali A.M; Dafaalla M.H; Mohammed R.K; Edris S.M; Ali S.Y; Nourallah S.A; Abdalla I.A; Mohamed E.A; Mohamed A.A; Ali A.O; Alnil A.H
Background: The burden of chronic kidney disease (CKD) is increasing rapidly worldwide and has become a major health problem and most of these patients die due to cardiovascular disease (CVD) before progression to end stage renal disease (ESRD). Therefore, poor cardiovascular outcomes in CKD patients have prompted nephrologists to look for biomarkers that may improve risk stratification in this population. The objective of this study was to evaluate serum lipid profile levels in CKD patients and to determine their association with cardiovascular diseases. Materials & Methods: This analytical case control study was conducted at Ibnsina and Military hospitals in the period from February 2016 to March 2019, (n = 150) clinically diagnosed CKD patients (age range between 22 - 76 years, 105 males and 45 females), and 150 healthy subjects were included as controls. Serum lipid profile and serum creatinine were estimated by Cobas C-311® fully automated analyzer, hemoglobin by Sysmix, glomerular filtration rate (GFR) was calculated by Cocroft-Gault formula and blood pressure was measured by using mercuric sphygmomanometer. Results:The results of the current study indicated that, the means of total cholesterol, triglyceride, LDL-C, creatinine, systolic blood pressure (SBP), diastolic blood pressure (DBP) and body mass index (BMI) were significantly (P-value ≤0.05) higher in CKD patients when compared with that of controls, while HDL-C, hemoglobin and GFR were significantly (P-value ≤0.05) lower. Moreover, serum SBP and DBP were significantly (P-value ≤0.05) higher in CKD patients with cardiovascular disease (CVD) than CKD patients without CVD, while the means of cholesterol, TG, LDL-C, BMI and creatinine were insignificantly (P-value ˃0.05) increased, meanwhile the mean of HDL-C, GFR and hemoglobin were insignificantly (P-value ˃0.05) decreased. In addition there is insignificant increase in the means of TG, LDL-C, BMI, SBP, DBP, creatinine and hemoglobin, and insignificant decrease in the mean of cholesterol, HDL-C and GFR in male when compared with female in CKD patients. Conclusion:dyslipidemia (high levels of cholesterol, TG, LDL-C and low levels of HDL-C) was higher in patients with CKD. Thus, the lipid profile levels were strongly associated with cardiovascular events in patients who have CKD and are on maintenance hemodialysis (HD).
Community attitudes toward efficacy of standard COVID- 19 preventive measures in Khartoum state
(Napata College, 2022-07) Mohamed E.O; Ahmed E.A; Gismalla K.A; Bastawi M.A; Khojali E.M; Salih A.E
Background: The emerging COVID-19 is a devastating life-threatening disease, which is characterized by high morbidity, with more than 6 million people worldwide, and a fatality rate ranging between 5-10%. In Sudan, approximately more than 10.000 confirmed cases were reported since the onset of the outbreak. Attitudes and behavior play a major role in preventing the emerging and re-emerging diseases. This study aimed at assessing attitude and behavior of participants towards COVID 19. Materials & Methods: This is a descriptive cross sectional community based study. It was carried out in Khartoum State (Khartoum, Bahri and Omdurman localities). A total of 1200 participants were randomly interviewed face-to-face using close ended questionnaire. A multistage cluster sampling technique was applied. Statistical Package for Social Science (SPSS) Smart PLS was used. Logistic regression, factor analysis and tree analysis were performed. Results: Negative attitude was reported in greater than half of the participants[(52.7%,n=632,(95% 𝐶𝐼, 49.9% − 55.5%)],whilst positive attitude [(47.3%, n=568, (95% 𝐶𝐼, 44.5% − 50.1%)].Regarding behavior, more than the half of the participants [(55.3%,n=663,(95%𝐶𝐼,52.5%− 58.1%)]had poor behavior, whereas [(44.7%, n= 537, (95% 𝐶𝐼, 41.9% − 47.5%)] had good behavior. Factor analysis revealed that, three factors explain 56% of change occurring attitudes towards COVID 19 of the surveyed participants which were misconceptions about COVID19, infodemics of COVID19, and negative stereotyping. The spectrum of behavior was noted in response to isolation strategy, anticipated stigma, and enacted stigma (61%). Logistic regression showed that, participants that had a monthly income between 2000-2999 SDG a month were 2.25 times more likely to have negative attitudes towards COVID19 (𝛽 = 0.809,p<0.001,AOR=2.25, 95% C.I.; 1.48 -3.41,). Education was statistically associated with attitudes towards COVID19 (p<0.001). Males were 0.62 less likely to have poor behavior in comparison with females (𝛽=−0.48,p<0.05,AOR=0.62,95%C.I.;0.43-0.89). Participants with a monthly income ranging from 2000-2999 SDG were 2.83 times more likely to have poor behavior towards COVID19 (𝛽=1.04,p<0.001,AOR=2.83,95%C.I.;1.77-4.52). Tree analysis revealed that attitude was the best predictor of behavior towards COVID19. Locality was the best predictor of negative attitude. Conclusion: Behavior and attitude comprised have a potential effect on preventing and controlling COVID19.
Variables affecting compliance of diabetic patients with their respective Management Protocol at Ribat University Hospital, Khartoum – Sudan 2021
(Napata College, 2022-07) Osman R.I; EzzaldeinR.B; Osman N.B; Rashid.M.S
Background: This study attempts to investigate the variants affecting diabetic patients compliance to their diabetic management protocols, such as their level of awareness towards their treatment being much more than just medications to be taken, but rather an overall package of medication and life-style changing, and their level of willingness to change in order to decrease morbidity and mortality associated with diabetes. Objectives: To determine the level of compliance of diabetic patients to their respective treatment protocol at Ribat University Hospital in Khartoum, Sudan 2021, and the variants affecting such compliance. Materials & Tools: This is meant to be a Cross sectional facility based study with total sample sizeis101, random systemic sampling was used to select the participants for this research, data was collected using self-made questionnaires, and the data was analyzed using an SPSS based cross tabulation analysis. Results: The overall compliance rate in this study was 63%. Females were found to be more significantly compliant (P value <0.05) in comparison to males. Married individuals also had a better compliance (P value <0.05) in comparison to single, widowed, or divorced individuals. There was also, a statistically significant relationship between higher educational levels and compliance rate, p value of (<0.001) the higher education level was linked with a better compliance level. Middle and higher socio-economic statuses (SES) diabetic patients had higher compliance rates. Middle SES had a p value of <0.04, and wealthier classes had a p value of 0.05 respectively, while lower socio-economic groups had significantly lower compliance levels. Age groups>66 years was shown to be statistically significant in regards compliance (p value 0.05) in comparison to younger age groups. No significant relationship was found between compliance and co-morbidities. Conclusion: This study highlights the importance of conduction of awareness raising campaign regarding the importance of patient’s compliance to these protocols.
Changes in the degree of ventricular hypertrophy following administration of Losartan potassium compared to L-NAME (L – Arginine Methyl Ester)
(Napata College, 2022-07) Muhanad S A; Abdelwahab H M; Osman K A
Background: The main goal of the study is to investigate the effect of Losartan on the degree of heart hypertrophy compared to L-NAME, also is this changes associated with redistribution of the left ventricular MHCs ratio? Methods: forty six white adult Swiss mice CD1 (weight range between 18g and 33g, and their ages range between 8-10 weeks) were used in this study. Animals were distributed randomly into four groups, each consist of eleven mice as follows: Control group left without treatment during the whole period of the study, group A ( given 600mg/L of L-NAME) , group B (given Losartan potassium 1g/L and L-NAME 600mg/L), and group S ( given 1g/L of Losartan potassium). All treatment were mixed with the drinking water , and given for 35 days. Sodium Dodecyl Sulfate - Polyacrylamide Gel Electrophoresis (SDS-PAGE) was used for the separation of the ventricular myocin heavy chains. Results: Administration of Losartan either alone or in combination with L-NAME cause’s significant decreases in the HW/BW ratio with P values 0.000 &0.000 respectively, and this reduction in the degree of the heart hypertrophy shows a shift in α: β ratio towards β LVMHCs compared to control (P values 0.000 &0.001 respectively). While L-NAME treatment in the group A cause’s marginal insignificant increase in HW/BW ratio, P values 0.054, with shifting of α: β MHCs ratio towards β LVMHCs compared to control P values 0.019 . Conclusion: L-NAME treatment changed the LVMHCs from alpha to beta, and this changing occurs before left ventricular hypertrophy. Also treatment with Losartan either alone or in combination with L-NAME produced a shift in the α: β ratio towards β LVMHCs with a decrease in the HW/BW ratio
Direct fragment reattachment of a complicated crown root fracture of maxillary lateral incisor A case report
(Napata College, 2022-07) Awooda E.M; Elsheikh A.M; Abdalhaleem I.M
A 19-year-oldwomansubjected to a blow by an object on one of her upper front teeth presented with tooth mobility and pain during biting. The tooth was upper left lateral incisor and was diagnosed clinically and radio-graphically as a complicated crown root fracture. Treatment done was crown lengthening root canal treatment and fragment reattachment. In case of anterior complicated crown root fracture of permanent teeth with the fracture line extended below the alveolar bone crest; the treatment option is through root canal treatment, crown lengthening and direct fragment reattachment, hence the result will be immediate restoration of aesthetic and function.
Prof. Mahjoub Obied Taha
(Napata College, 2022-07) Mohammed Elhassan Altikaena
Prof. Mahjoub was born in 1937 in Eldewim town (a small town, 120 Kilometer south of Khartoum) where his family domiciled. His original home town is Elgitaina (70km south of Khartoum, on the eastern bank of the White Nile) He read for his Bachelor Degree in Mathematics in the University of Durham and the PhD in Cambridge. He distinguished himself in presenting the first relativistic generalization of Fadeev‘s Equations and by formulating Taha Sum Rule. Since then he became an outstanding professor in theoretical physics and won King Faisal Prize in physics.
Design of Multi-Epitope Vaccine from Nipah Virus proteome using Immunoinformatics approach
(Napata College, 2022-07) Zaki E.A; Mohamed S.B; Hamad S.H; Ali S.S
Background: Nipah virus (NiV) is a zoonotic virus of the paramyxovirus family that sporadically breaks out from livestock and human. Annual review of diseases prioritized under the R&D WHO Blueprint listed the Nipah virus as one of the emerging infectious diseases requiring urgent research and development effort. Moreover, there is a major layback in the development of effective vaccines or drugs against NiV. The aim of this study is to design a non-toxic and potent multi-epitope vaccine against NiV using bioinformatics approach. Materials & Method: In this study, T and B-cell epitopes of NiV protein were predicted and screened based on the antigenicity, toxicity, allergenicity and IFN induction features. The epitopes were linked by suitable linkers. Four different adjuvants were attached to the vaccine constructs, then secondary and the 3D structure of the vaccines was predicted. The refinement process was performed to improve the quality of the 3D model structure; the validation process performed using the Ramachandran plot. The designed vaccines binding affinity to HLA molecules, TLR 8 and TLR were evaluated by molecular docking, and select the best docking score for all vaccines against TLR8. Finally, in silico gene cloning was performed in the pET28a (+) vector. Result: The proposed vaccine was shown to be antigenic in VaxiJen server, non-allergenic in Allertop server and non-toxic in Toxinpred server. Thephysiochemical properties of the vaccine showed constructed vaccines stable and can be soluble overexpression.Regarding MHC-I, predicted epitopes for studied proteins (G, FG, M, N, P, L, V and W) ranged from 6 to 52, with an IC50 from 1 to 100, while in MHC-II, predicted epitopes ranged from 1 to 61 with an IC50 1 to 500. Vaccine tertiary structure was predicted, refined and validated to assess the stability of the vaccine via Ramachandran plot. Moreover, solubility of the vaccine construct was greater than the average solubility provided by protein SOL and SOLpro servers. Disulfide engineering was performed to reduce the high mobile regions in the vaccine to enhance stability which was predicted for the vaccines constructed, except L proposed vaccine which was dispensed. Docking of the vaccine construct with TLR8 showed the best binding energy with all proposed vaccines, TLR8 ligand result was taken for all next studies. Immune-simulation significantly provided high levels of immunoglobulins, T-helper cells, T-cytotoxic cells and INF-γ. Upon cloning, the vaccine protein was reverse transcribed into DNA sequence and cloned into pET28a (+) vector to ensure translational potency and microbial expression. Conclusion: The overall results of the study proved that the multi- epitope construct is a potential candidate for an efficient protective vaccine against NiV. The immunoinformatics approaches accelerate vaccine development process to reduce the risk of in vitro pre-clinical trials.
Preliminary Phytochemical Screening, Antimicrobial and Antioxidant Activities of Xylopia aethiopica (Dunal) A. Rich Fruits
(Napata College, 2022-07) Elshiekh Y.H; Alnoor G.H; Hussein S.E; Abdalrhman M.I; Rahmtalla H.A
Background: This current study was carried out to investigate possible antibacterial; antioxidant activities and phytochemical screening of Petroleum ether, ethyl acetate and 70% ethanol extract of Xylopia aethiopica. Materials & Methods: Phytochemical analysis of the crude extract was performed to detect the presence of different kinds of phytoconstituents. The antibacterial activity was investigated against five standard microbial strains: four bacterial strains (Escherichia coli, Pseudomonas aeruginosa, Bacillus subtilis and Staphylococcus aureus) and one standard strain of fungi (Candida albicans) by using the disc diffusion method. Results: All extracts showed high, moderate or weak antimicrobial activity against all the strains used. Antioxidant activity showed that, the ethanol extract was the most active extract (60±0.07) in comparison to the other extracts. Conclusion: Phytochemical screening showed the presence and absence of the secondary metabolites among the entire sample tested.
Assessment of Nurses’ Knowledge, Attitude and Practice of Oral Hygiene for Intensive Care Unit Patients at seven Governmental Hospital In Khartoum State, Sudan, 2020-2021
(Napata College, 2022-09-20) Mazin Babiker; Emad Abd alkarim; Amar Nooraldin
Background: Oral care is a vital procedure for critically ill patients in the intensive care unit (ICU). Oral care may affect the clinical result as well as the wellness of intensive care patients. Adequate knowledge about oral nursing care guidelines is important for nurses to deliver appropriate oral care. Materials & Methods: A descriptive cross sectional hospital based study was conducted aimed to assess knowledge, attitude and practice of intensive care nurses regarding oral care in critically ill patients in seven governmental hospitals in Khartoum State. The sample size consisted of 95 nurses in ICUs. Data were collected using interview questionnaire; data was analyzed using Statistical Package for Social Sciences (SPSS). Results: The results revealed that 65.3% of nurses had 1 to 3 years of experience. Regarding the definition of dental plaque, 63.2% of participants responded with correct answers. Only 4.2% knew that gingivitisisagum disease and 24.2%said that gingivitis is due to plaque. A percentage of 64.2% participants knew that periodontitis is an inflammation of tooth supporting structure, and 24.2% said that plaque is the cause of periodontitis. Regarding the practice of mouth care twice per a day, 57.9% participants do practice it.
Case study: Contributory Factors to In-hospital Maternal Mortality in a Governmental Hospital in Khartoum State in 2006
(Napata College, 2022-09-24) Christelle Evans; Mutasim El-Feel; Abdelmageed Osman
Background: In-hospital maternal mortality rates in Sudan are currently high, at 0.09%(1). According to World Health Organisation standards, in-hospital maternal mortality should not exceed 0.025%(2). Common contributory factors are numerous, both in-hospital and in the community. This study aims to identify specific contributors to maternal mortality and morbidity in a governmental hospital to make recommendations to minimize them. Materials and Methods: The study basis was an initial case study of maternal morbidity in a governmental hospital with subsequent exploration of contributory factors. A participatory rapid appraisal approach was used, employing observational checklists and semi-structured interviews in order to identify problems at every level of the hospital system, cross-checking information with different stakeholders. Results: Results identified primary delays in seeking care and suboptimal care delivery as the main contributors to in-hospital maternal mortality and morbidity. Interviews with patients and staff also highlighted a need for more patient education and more supervision and training opportunities for junior staff.

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