Effect of Diabetes Self-Management Education on Glycaemic Control in Sudanese Adults with Type 2 Diabetes

Research Background: The high prevalence of diabetes in Sudan, estimated at 16%, highlights the importance of effective health education in diabetes management. Diabetes self-management education has been identified as a crucial tool in enhancing the knowledge, attitudes, and abilities necessary for self-management among individuals with diabetes. Aim: To assess the impact of diabetes self-management education on medication adherence and glycemic control in Sudanese adults with type 2 diabetes before and 3 months after the DSME intervention. Method: The study was conducted in Sudan between September 2022 and March 2023, it was an interventional, one-group, pre- and post-test study that aimed to assess the impact of diabetes self-management education (DSME) on medication adherence and diabetes control in Sudanese adults with type 2 diabetes. The research was conducted in primary health care centers in six cities in Sudan and involved 244 participants. The data entry and statistical analysis were conducted using the Statistical Package for Social Sciences version 27.0. A paired t test was used for analysis. Results: The study included 244 participants, 67% of whom were males. The age mean ± SD was 48.6 ± 9.3 years, and 85.3% of participants were married. Age at onset of diabetes mean ± SD was 40.60 ± 7.81 years;44.6% had diabetes for less than 5 years;and 84.1% had a positive family history of diabetes mellitus. The levels of poor, low, and partial adherence to medication decreased by 8.2%, 4%, and 20.6%, respectively, after the intervention. The levels of good and high medication regime adherence increased by 13% and 19.8%, respectively;BMI decreased by 1.1 ± 0.73 kg/m2 (p = 0.005). The fasting blood sugar decreased by 69 ± 32.9 mg/dl (p = 0.049), and the glycated hemoglobin decreased by 1.21 ± 0.28% (p = 0.001). Conclusions: The findings of this study reinforce the importance of patient education in improving glycemic control and enhancing self-management behaviors. Patient education plays a critical role in enhancing glycemic control and self-management behaviors. It is essential for healthcare providers to adopt a patient-centered approach, taking into account the individual's beliefs, attitudes, and knowledge about their illness and treatment. Overcoming these challenges necessitates a comprehensive approach, including enhancing healthcare professionals’ knowledge and communication skills, offering accessible and culturally sensitive diabetes education programs, and addressing barriers to resources and support for self-management.

Mental Health Consequences among Sudanese Due to the Armed Conflicts and Civil Unrest of 2023: One Year Later

Aim: To investigate depression, anxiety, PTSD, and insomnia levels among Sudanese citizens after a year has passed since the start of Armed Forces conflict in Sudan. Methods: An online survey was distributed. It is composed of five parts, covering the following areas: 1) sociodemographic data;2) depression assessment;3) generalized anxiety disorder assessment;4) post-traumatic stress disorder assessment;and 5) insomnia assessment. Statistical Package for Social Sciences version 27 was used for data analysis;frequency and percentage were used to describe the qualitative variables. Spearman’s correlation analysis and Chi-square test were used for correlation and association analysis;a P-value equal to or less than 0.05 was considered statistically significant. Results: The study included 283 participants, primarily female (76.0%), with a mean age of 35.26 ± 6.96 years. The majority of participants were married (50.5%) and had a university level of education (50.2%). At the start of the war, 70.3% of participants were inside the war zones, and at the time of data collection, 73.5% were outside Sudan. The length of stay in the war zone ranged from 1 to 300 days, with a mean of 48.59 ± 70.284 days. Additionally, 63.3% of participants stated that they did not receive any form of mental health intervention, and the remaining did not provide an answer. There was a high prevalence of moderate-severe depression (50.5%), moderate anxiety (35.3%), PTSD (56.5%), and sub-threshold insomnia (53.4%) among the participants. Correlation analyses revealed associations between demographic factors such as sex, age, marital status, and education and mental health issues. Notably, female participants showed a higher prevalence of PTSD (53.0%) compared to male participants (67.6%). Conclusions: There is a substantial impact of war-related trauma on mental health, revealing a high prevalence of moderate-severe depression, moderate anxiety, PTSD, and sub-threshold insomnia among the participants. This emphasizes the importance of tailored interventions and support systems to address the unique needs of individuals affected by war trauma.

The Current Conservation Efforts and Future Prospects for the Endangered Nubian Ibex (Capra nubiana ibex) in Sudan

A comprehensive action plan for the conservation of the endangered species, the Nubian ibex in Sudan, can be developed by gaining a thorough understanding of their current status, conservation strategy, and relevant laws and regulations, as well as raising awareness about the importance of protecting endangered species. The Nubian ibex is listed as an endangered species on The International Union for Conservation of Nature (IUCN) Red List, highlighting the need for further research on population conservation efforts due to insufficient population data. To address this knowledge gap, a questionnaire was conducted with various stakeholders, including police officers, researchers, and lecturers, representing a diverse range of organizations and universities. The findings revealed that hunting is the primary factor contributing to endangerment. Mammals account for 80% of endangered species, while reptiles comprise less than one-tenth. Research centers are recognized as the main governing body, and 85% of participants are concerned about the declining population. Hunting accounted for less than half of the threats to the ibex population in Sudan, while habitat loss made up a quarter. Mining, climate change, human activity, and agriculture were also identified as risks. However, there were no plans, strategies, procedures, or measures in place to conserve the Nubian ibex. There were also no initiatives to preserve its biodiversity, and awareness about endangered species was lacking. Although participants believed that laws were effective in protecting the ibex, no licenses were issued for its conservation, and annual surveys were not conducted. Additionally, there were no recorded instances of Mukhalfat related to the Nubian ibex. In light of these findings, we propose various conservation measures to address these challenges. These measures include the implementation of laws and regulations, conducting annual surveys to monitor population trends, protecting habitats, establishing breeding and releasing programs, launching awareness campaigns, undertaking rehabilitation efforts, enhancing research efforts, and developing comprehensive conservation strategies. Additionally, it is crucial to foster cooperation among wildlife institutes to ensure the effective implementation of these conservation measures.

Pattern of Potential Laboratory Markers for COVID-19 in Eastern Sudan

Background: Coronavirus disease 2019 (COVID-19) is a recent global health crisis. One of the major issues of COVID-19 is its unpredictable manifestations and serious outcomes. Many hematological parameters are thought to change dramatically during the course of the disease. These include white blood cells, red blood cells, and platelets. This study aimed at evaluating certain laboratory results;peripheral blood lymphopenia, relative neutrophilia, high neutrophil-lymphocyte ratio, and elevated C-reactive protein as potential laboratory markers of COVID-19 in Eastern Sudanese patients. Methods: We, retrospectively, aimed at the evaluation of peripheral blood leucocytes count, neutrophil-lymphocyte ratio NLR and C-reactive protein (CRP) levels in confirmed COVID-19 eastern Sudanese patients during the course of the disease. Results: The mean total leucocytes count, % neutrophils count, absolute neutrophils count and C-reactive protein (CRP) were significantly higher (P. value = 0.000) in COVID-19 patients than in the control group while the mean % lymphocytes count and % mixed cells count were found to be significantly lower in COVID-19 patients than in the control group (P. value 0.000). Conclusion: Peripheral blood leucocyte alterations (simultaneous presence of lymphopenia, relative neutrophilia and high neutrophil lymphocyte ratio (NLR) along with elevated CRP levels may be valuable biomarkers associated with COVID-19 in Port Sudan city, Red Sea state, Sudan. These markers might be important in prediction, inspection of disease progression and prognosis.

Frequency of Rotavirus among under 5 Children Admitted to Wad Madani Pediatric Teaching Hospital with Diarrhea, Gezira State, Sudan (2021-2022)

Rotavirus is the leading cause of acute gastroenteritis and responsible for 20% of death in children under 5 years of age approximately 111 million episodes of gastroenteritis due to Rotavirus in under 5 children, which result in 25 million visits to clinic, 2 million hospitalization and 352,000 - 592,000 deaths. Children in the poorest countries account 82% of rotaviruses death. Diarrhea disease are major cause of death and disease among children under five years, a child on average suffers 2 to 3 attacks of diarrhea every year. Stools samples were collected from 196 children suffering from diarrhea and were tested for rotaviruses by immune chromatography test antigen (ICT-Ag), ELISA and RT PCR The data were analyzed using statistical package for the Social Sciences (SPSS). The results showed that prevalence of rotavirus was 26/196 (13.3%) by ICT Ag and ELISA and confirmed by RT-PC R. 87.8% of the children were vaccinated by Rota vaccine, 70% of their mothers not using soap for cleaning the children and thought diarrhea not infectious disease and believed it was caused by teething. In conclusion there was a decrease in prevalence of diarrhea by Rotavirus due to insertion of Rota vaccine in routine vaccination, rotavirus infection mostly occurs in poor family that not able to provide safe water and due to poor sanitation and low education of mother beside that some children suffered from malnutrition, so it recommended to incorporate ELISA as a diagnostic tool in routine diagnosis of rotavirus among children suffered from gastroenteritis.

Diversity, Abundance and Distribution Patterns of Epibenthic Echinoderms in Dungonab Bay, Red Sea, Sudan

The abundance, distribution and diversity of epibenthic echinoderm were investigated at Dungonab Bay in the Red Sea coastal water of the Sudan. Four permanent line transects were chosen. Eight (30 × 2) square metre belt transects along each permanent line transect at 20 metre intervals were used to collect data. The data were subjected to univariate and multivariate analyses. Spatial variations of epibenthic echinoderm abundance were assessed with one-way analysis of variance. Hierarchical agglomerative clustering was used to identify and illustrate the similarities in echinoderm abundance between line transects and between belt transects. Indices of richness (d), diversity (H'), evenness (J') and dominance (C) were used to explain the diversity of epibenthic echinoderm species. The distribution pattern of each echinoderm species was determined in each permanent line transect. A total of 986 individuals were recorded within sixteen species of epibenthic echinoderms in the four line transects. Holothuriidae was the dominant family (5 species and 342 individuals). The most abundant echinoderms species was Pearsonothuria graeffei (77 individuals, about 7.81%). Abundances intra-transects and intra-families were insignificant (f = 1.67, p = 0.183, df = 3 and f = 3.24, p = 0.083, df = 9, respectively). The highest values of Shannon-Wiener diversity index (H'), Pielou evenness index (J'), Margalef species richness index (d), and Simpson Dominance index (C) were 2.738, 0.9875, 2.791 and 0.07159, respectively. The distribution patterns of all species in the study transects varied between clumped and uniform, with the exception of Asthenosoma varium of the Echinothuridae family, which had clumped distribution patterns in all transects. The study concluded that Dungonab Bay supports rich and diverse communities of epibenthic echinoderms.

Exploring Trees Diversity and Ecological Value of Mountain Forests in the Blue Nile Region of Sudan

We carried out this research at Abu-Gaddaf Natural Forest Reserve (ANFR) which is located east of Blue Nile River, in Blue Nile State, Sudan. It aims at exploring tree composition assessing their diversity indices, and ecological importance values. For survey of types and estimation of density of tree species in the forest, we randomly distributed 97 circular sample plots (0.1 hectare (ha)). In each sample plot we identified all trees to the species level, recorded their frequencies and computed species diversity and importance value indices (IVI). A total of 13 tree species, which belong to 12 genera and nine families, were identified in the tree layer of the forest. Mean tree density in ANFR was 116 trees/ha, composed mainly of Boswellia papyrifera (Del.) Hochst. (48), followed by Combretum hartmannianu (19) and Lannea fruticosa (18). Fabaceae was the most common family followed by Combretaceae and Malvaceae. B. papyrifera Delile Hochst was the most abundant while Acacia seyal was the least abundant species. Species richness (R = 1.71), evenness (E = 0.69), dominance (0.24) indices and Simpson’s Index of Diversity (D' = 0.76) suggest a moderate diversity, moderate numbers of individuals in each species and a moderate community stability. The research provides empirical results on diversity and ecological importance value of species, signifies the urging need to safeguard threatened species and to prioritize them for conservation, as well as the need to promote management of abundant species to provide multiple forest ecosystem services.

Evaluating the Impacts of Human Activities on Diversity, Abundance, and Distribution of Large Mammals in Nimule National Park, South Sudan

Globally, human activities have a significant impact on the diversity, abundance, and distribution of large mammals in Protected Areas (PAs). These disturbances increase human pressure on biodiversity and species habitats, highlighting the need for conservation. This study aimed to assess the abundance and distribution of large mammals in different habitat types within Nimule National Park (NNP) and understand the impacts of human activities on them. Data on the abundance and distribution of large mammals and their respective habitat types were collected through line transect surveys. Human activity signs were observed and recorded along the transect lines. To estimate the impacts of human activities on the diversity, abundance, and distribution of large mammal species, as well as to identify any significant differences between them and their habitat types, the study utilized the Kruskal Wallis test, Polynomial multiple regressions, and diversity indices. The findings from the Shannon-Weiner and Simpson indices indicated that large mammal species were more diverse inside the park (H’ = 1.136;D = 0.570) compared to the buffer zone (H’ = 0.413;D = 0.171), with 85% (443 out of 510 samples) recorded within Nimule National Park. The species abundance showed a semi-balanced status (0.58). The diversity results among different habitat types revealed that large mammals were more diverse and highly distributed in both open woodlands (244) and dense woodlands (192), while riverine vegetation had the lowest diversity (8). Statistical tests demonstrated a highly significant difference at a 99% confidence interval (p-value = 0.01) between habitat types and identified species of large mammals. Additionally, the results highlighted the high abundance of Uganda kob (274), baboons (141), and warthog (57) across most habitat types, accounting for at least 75% of their distribution. The most prevalent human activities observed were cattle footprints (27%) and cattle dung (14%). Human footprints and tree cutting combined accounted for 9%, indicating the practice of livestock grazing, poaching, encroachment, and fuelwood collection by local communities. However, these activities did not appear to significantly impact the diversity, abundance, and distribution of large mammals in Nimule National Park. Therefore, it is crucial to foster shared responsibilities and engage relevant stakeholders in the management and conservation of large wildlife species. Regular community awareness programs should be implemented to cultivate a sense of ownership. Moreover, it is recommended that a comprehensive survey be conducted on the population status of all mammal species in Nimule National Park, including its surrounding Buffer Zone. Monitoring the impact of human activities on their behavior and habitats using satellite images should also be carried out at least every five to ten years.

Seroprevalence Survey of HIV and Hepatitis B Virus and Behavioral Characteristics among Heavy Truck Drivers along Port Sudan-Khartoum Highways

The prevalence of human immunodeficiency virus (AIDS) and hepatitis B virus among heavy truck drivers and their assistants has been well documented globally in correlation with their behavioral characteristics. The present study aimed to screen for human immunodeficiency virus (HIV), hepatitis B virus (HBV), and behavioral characteristics among heavy truck drivers in Port Sudan. A cross-sectional study was conducted on 274 heavy truck drivers and their assistants who used the highway Port Sudan-Khartoum in Port Sudan city during 2019-2021. Data on behavioral characteristics and substance use habits were collected using a structured questionnaire, and an ELISA test was used to screen for HIV and HBV infections in the study participants. The chi-square test, odds ratio, and confidence intervals were used to find the association between behavioral characteristics and seropositive HIV/HBV. Of the 274 enrolled participants, the seroprevalence rates of HIV were 2.7% and HBV was 23.7%. Ninety-four (34.3%) of them had a history of high-risk sexual behavior outside of marriage;only two (0.7%) used condoms;14.2% of participants reported alcohol use;and 1.1% reported drug use. Univariate analysis revealed that having a sex history outside of marriage with ≥1 sex partner and never using a condom with a spouse or casual partner were significant risk factors for HIV and HBV among drivers. Fortunately, we found that most of the drivers reported low alcohol and drug use. Concerning this study, the seroprevalence of HIV and HBV is highly associated with a history of having sex outside of marriage and sexual behavior among truck drivers and assistances. Additional studies are needed to further investigate other STIs and behavioral characteristics associated with factors in truck drivers/assistance in different truck stop regions in Sudan.

First Report of the Bee Fly Eurycarenus dichopticus Bezzi (Diptera: Bombyliidae) in North Kordofan State, Sudan

Sudan’s semi-arid land constitutes a diversity of habitats, species, and genetic resources of high ecological and economic value. This diversity is gradually degrading due to climate change and human misuse. Biodiversity monitoring began in Sudan before independence when a considerable number of flora and fauna species were identified. Insects were among the identified fauna where many orders, families, and species were classified especially those of economic, medicinal, and veterinary importance. Bombyliidae or bee flies are considered native to African countries and confined to the semi-arid ecosystem as pollinators of higher plants. The bee fly, Eurycarenus dichopticus recorded from these ecosystems, has gained little attention, and meager data on its biology and reproduction have been published. Adults of this insect are nectar feeders, and females also feed on pollen grains while larvae are parasitoids on certain insects. This study was conducted in three Sudanese states that lie within the semi-arid ecosystem;Khartoum, Gezira, and North Kordofan. Field surveys were conducted in these states and insect fauna was obtained and identified. Bee fly specimens were collected from North Kordofan using the butterfly net method. The specimens were then preserved and sent to the Agricultural Research Corporation ARC in (2020) where they were identified as Eurycarenus dichopticus Bezzi (Diptera: Bombyliidae) which is the first report in North Kordofan. This identification may contribute to the understanding of its ecological significance and role.

Hematological Alterations in an Eastern Sudanese Chronic Kidney Disease Patient Population

Background: Chronic Kidney Disease (CKD), associated with a slow and progressive loss of kidney function over a period of several years, is an important clinical disaster with an increasing rate of morbidity and mortality especially in the least developed countries. Many hematological parameters are thought to alter dramatically during the course of the disease. These include white blood cells, red blood cells, and platelets. Methods: We tried, retrospectively, to evaluate the peripheral blood hematological alterations in a group of patients undergoing hemodialysis in an eastern Sudan dialysis center to add local medical information. Results: Anemia (Low hemoglobin and hematocrit) was detected in 94% of the patients’ group. Mean Erythrocyte count (3.32vs.4.76 (×109/L)), Hemoglobin concentration (9.4vs.13 (g/dl)), Hematocrit (28.7vs.38.7 (L/L)) and platelet count (296 vs. 238 (×109/L)) were significantly lower in the patients’ group than in the control group (P-values Conclusion: Five out of eight studied parameters (Red cell count, hemoglobin, hematocrit, mean cell hemoglobin concentration, and platelets count) have shown a significant alteration in CKD patients. As the complete blood count (CBC) test is the most utilized test in clinical laboratory practice, these alterations may be considered as early indicators for CKD. Furthermore, all patients with CKD must be routinely checked for these alterations.

Spatial and Temporal Analysis of Maximum and Minimum Temperature Trends in Northern Sudan during (1990-2019)

The study addresses an urgent and globally significant issue of climate change by focusing on the detailed spatial and temporal analysis of temperature trends in Northern Sudan. It fills a critical research gap by providing localized data over a substantial period (1990-2019), which could help in understanding the nuanced impacts of climate change in Sahel regions like Northern Sudan. In addition, the comprehensive coverage of both spatial and temporal dimensions, supported by a substantial dataset from five meteorological stations, provides a thorough understanding of the subject area. The utilization of robust statistical methods (Mann-Kendall test and Sen’s slope analysis) for analyzing temperature trends adds scientific rigor and credibility to the findings. Our results reveal a consistently increasing trend in maximum temperatures across most stations, particularly during the hot season (AMJ). However, the wet season (JAS) shows high maximum temperatures but no significant trend. Moreover, significant increasing trends in minimum temperatures were observed in all stations except Abu Hamed, where the trend, although increasing, did not reach statistical significance during the hot and cold seasons, and the coldest temperatures were observed during the cold season. These findings underscore the complex temperature dynamics in Northern Sudan and highlight the need for continued monitoring and adaptive measures in response to ongoing climate changes in the region.

Language Planning & Policy(LPP) in Sudan

The paper gives an overview of language planning and policy( LPP) in Sudan. It mainly focuses on language problem in two different periods, namely, the colonial period and the post colonial one. The question of Arabicization of Education in Sudan is also discussed, followed by a critical conclusion.

The Contending Claim Over Abyei by Sudan and South Sudan:Challenges Ahead

This article focuses on examining entangled factors that complicate the claim over Abyei and have therebyhindered any peaceful settlement of the dispute on the county. Many works of literature that presented the conflictin Abyei as natural resource conflict or identity-driven within a broader picture of conflicts in Sudan are factuallyflawed and poorly explained the nature and causes of the conflict. This paper contends that multiplicity of factorshas reinforced each other, thus these factors in unison created a stalemate and continuing claim over Abyei. Inexamining these interwoven factors, the paper employed a qualitative approach to conduct the study. Both primaryand secondary data sources were used adequately. Various academic pieces of literature, researches, and conferencereports have been used as secondary data sources. Key informant interviews were used to gather primary data totest secondary sources. Hence, the study comes up with three basic findings. First, claim over Abyei has beensustained by the elites’ manipulation of identity for their political and economic goals that hinder peacefulco-existence among communities in Abyei. Second, the competition over resources chiefly oil and locally, pastureand water complicated already fragile and tense relation by alluring national actors that even more protractedconflict on the ground to control these resources. Finally, the double standard in U.S. policy towards Abyei, by andlarge, helps Khartoum to continue its obstruction tactics to maintain the status quo.

Review of China-Sudan Oil Cooperation

There are abundant proved oil reserves in Sudan and South Sudan,and Chinese companies are looking for petroleum business opportunities in Sudan and South Sudan.There is a bright future for cooperation in oil development in both Sudan and South Sudan.China,Sudan and South Sudan will continue to benefit from collaboration in petroleum industry.

杂交苏丹草(Sorghum bicolor×S.sudanense)修复DDT污染土壤效果研究

采用盆栽试验,研究了杂交苏丹草吸收和富集DDT的规律及其对DDT污染土壤的修复效果.结果表明:①土壤中添加高浓度的DDT,对杂交苏丹草的生物量没有显著影响,说明杂交苏丹草对DDT有耐受能力;②杂交苏丹草对DDT及其主要降解产物都有吸收,在旺盛生长期,植株中DDT的累积速率也较快;③杂交苏丹草根系中DDT及其主要降解产物的浓度是茎叶中相应组分浓度的4.81～10.32倍,质量比在0.57～1.55倍之间;④杂交苏丹草从土壤中吸收DDT占添加量的11.3%,而在其生长期间,土壤中DDT消失量为56.0%.

Intestinal protozoa and intestinal helminthic infections among schoolchildren in Central Sudan

Objective:To determine the prevalence of intestinal parasitic infections and soil-transmitted helminths(STHs) among primary schoolchildren in El dhayga,Central Sudan.Methods:In this cross-sectional study,three fresh faecal samples were collected from each child,which were examined by direct wet mount,brine flotation,formalin-ether and Kato-Katz techniques.The intensity of each STH infection was expressed as the mean of eggs per gram counts of the three samples.Results:In total,142(90.4%) of 157 children harboured at least one type of intestinal parasite.Ascaris lumbricoides,Hymenolepis nana,Entamoeba histolytica and Giardia lamblia were the most common parasites found,with prevalence rates of 32.5%,30.6%,33.1%and 19.7%,respectively.Out of these 157 children,29(18.5%) harboured more than two intestinal parasitic infections.No cases of Schistosoma mansoni or Enterobius vermicularis were identified. Conclusions:The study demonstrates significant burden of intestinal protozoa and STH infections in this part of Sudan and highlights the need for preventive and intervention measures.

Frequency of diabetic retinopathy and associated risk factors in Khartoum,Sudan:population based study

AIM： To assess the frequency and associated risk fac- tors of diabetic retinopathy among Sudanese individuals with diabetes attending Makka Eye complex in Khartoum, Sudan. METHODS： The cross sectional hospital based study recruited 316 individuals with diabetes from Makkah Eye Complex Retina Clinic. Standard questionnaire was used to collect demographic data, medical history and life style characteristics. Blood samples were taken to measure HbAlc and lipid profile. Fundus and slit lamp examination were performed for screening of diabetic retinopathy. RESULTS： Among 316 participants, 187 （59.2%） were males and 129 （40.8%） were females. The mean age of participants was 58.7＋_10.5y. The overall frequency of retinopathy was 261 （82.6%）. The percentages of the total participants with proliferative diabetic retinopathy （PDR） were 126 （39.9%） and non-proliferative diabetic retinopathy （NPDR） were 135 （42.7%）. importantly, duration of diabetes mellitus （DM） （72.2% of more than 10y）, being on oral hypoglycaemic drugs （versus insulin）, and hypertension were all significant risk factors for diabetic retinopathy （P=0.00, 0.01 and 0.00 respectively）. Complications ofdiabetes like diabetic foot （17.7%）, history of amputation （6.7%） and clinically significant macular edema （CSME） （47.4%） of the eyes were all significant risk factors （P〈0.05）. Logistic regression analysis showed that duration of diabetes, hypertension and CSME were found to be absolute risk factors （P=-0.007, 0.003 and 0,000 respectively）. Duration of DM of more than 10y have more than double risk （OR--2.8）, while having hypertension triples the risk of retinopathy （OR=3.1）. CONCLUSION： High rates of diabetic retinopathy are noted among individuals with diabetes attending Makkah Eye hospital in capital Khartoum. Urgent strategies are needed to monitor and treat hypertension and optimize diabetes control in individuals with diabetes. More investment in diabetes services is urgently needed.

Misuse of prophylactic antibiotics and prevalence of postoperative wound infection in obstetrics and gynecology department in a Sudanese hospital

Purpose: This study was conducted to audit prophylactic antibiotic use and to quantify the rate of wound infection. Methods: Across-sectional prospective study was conducted in the Obstetrics and Gynecology Department in Khartoum Teaching Hospital, Sudan during March 1st to 31st October 2010. All Patients (aged >18 years) were included. Results: Overall 725 patients were included. The performed surgical procedures were 751;of these 578 (76.9%) were Caesarean sections. Overall rate of wound infection was 7.8%. The rate of wound infection among patients operated on for caesarean section and abdominal hysterectomy was 8.3%, and 9.2%, respectively. Multivariate logistic analysis showed that body mass index [BMI] ≥ 30 kg/m2 OR 2.1, 95% CI (1.1 - 4.0), (P = 0.019) was the major independent risk factor for occurrence of wound infection. Evaluation of prescriptions’ parameters against the stated criteria showed that 113 (15.8%) patients were given antibiotics with adequate spectrum of activity, 611 (85.3%) given sub-dose/s, 83 (11.6%) received the first preoperative dose/s in a proper time window, and 716 (100%) had prophylaxis for extended duration. Overall conformity to the stated criteria for the evaluation of prescription’s parameters was not achieved in all prescriptions. Conclusions: In this setting, antibiotics were irrationally used and wound infection rate was high, and the situation calls for multiple interventions to correct the situation, through the activation of the infection control committee in the hospital and development of antimicrobial subcommittee to develop policies for the use and auditing of prophylactic antibiotics.