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Rigor Over Convenience: Upholding Methodological Standards in Crisis-affected Research
No full textThis is an Editorial and does not have an abstract. Please download the PDF or view the article in HTML
Knowledge, Practice, and Compliance of Surgeons to Surgical Antibiotic Prophylaxis in Sudan: A Multicenter Cross-sectional Study
No full textBackground: Surgical site infection (SSI) is a type of healthcare-associated infection that usually occurs within 30 days postoperatively. Preoperative surgical antibiotic prophylaxis (SAP) reduces the risk of SSI. This study aims to determine surgeons’ knowledge, practice, and compliance with SAP guidelines across multiple departments.
Methods: A descriptive cross-sectional study was conducted among surgeons in multiple departments to evaluate their knowledge, practice, and compliance with SAP. A four-section questionnaire was designed and delivered to surgeons eligible for the study. The American Society of Health-System Pharmacists (ASHP) guidelines were used to classify surgeons’ responses.
Results: A total of 119 surgeons were included in this study. The majority of surgeons practiced in the general surgery department: 38 (31.9%) were general surgeons, and 72 (60.5%) were specialists. Moreover, 63 (52.9%) of the participants were male. Most participants (69, 58%) had 1–5 years of experience in surgical settings. Regarding knowledge, 113 (95%) correctly indicated that vancomycin is an appropriate choice in MRSA colonization, and 53 (44.5%) emphasized its use in cases of beta-lactam allergy. However, 62 (52.1%) incorrectly advised the use of meropenem as SAP. Regarding surgeons’ practice, significant inconsistencies were observed in the timing of SAP administration, redosing considerations, and the use of broad-spectrum antibiotics as SAP. Third-generation cephalosporin—ceftriaxone—was regarded as the first-line choice for SAP by the majority of surgeons (24.2%).
Conclusion: Although the knowledge of surgeons regarding SAP was deemed to be fair (overall noncompliance of knowledge with ASHP = 35.17%), the practice of surgeons was considered to be inadequate for guiding SAP (overall noncompliance of practice with ASHP = 53.2%). Educational interventions are needed to equip surgeons with evidence-based practices in SAP
Implementing Point-of-Care Newborn Screening for Sickle Cell Disease in Sudan: Cross-sectional Evidence from Khartoum State
No full textBackground: Sickle cell disease (SCD) is responsible for 50–90% of under-five mortality in sub-Saharan Africa. Delayed SCD detection beyond infancy prevents early comprehensive treatment and leads to the tragic progression of the disease. This research aims to determine the prevalence of sickle cell anemia (SCA) in neonates in Khartoum State using a point-of-care (POC) test.
Methods: This was a descriptive, hospital-based, cross-sectional study conducted in Khartoum state from August 2021 to January 2022. In total, 111 neonates from each selected hospital were tested with a POC test to determine their hemoglobin phenotype, and a simple questionnaire was used to collect demographic characteristics.
Results: Of the 333 neonates included in the study, 156 (46.8%) were male, and 177 (53.2%) were female. A total of 179 neonates belonged to the Afro-Asiatic ethnicity (53.8%), 130 (39%) to the Nilo-Saharan, and 24 (7.2%) to the Niger-Congo. While SCA was detected in 1 (0.3%) neonate, 23 (6.9%) neonates were heterozygous for Hb AS; of these, 17 (73.9%) had no family history of the disease. Hb AC was also detected in one neonate, representing 0.3% of the study population.
Conclusion: This study demonstrated the feasibility and efficiency of POC testing for detecting abnormal hemoglobin phenotypes in neonates. However, limited confirmatory testing and low public awareness highlight the urgent need for comprehensive neonatal screening programs. Both early detection and public education are crucial for timely intervention and reducing SCD-related morbidity and mortality in Sudan
Outcomes of Patients with Acute Ischemic Stroke Who Declined Intravenous Thrombolytic Therapy in the Emergency Department: A Retrospective Cohort Study
No full textBackground: This study retrospectively examined patients who presented to the emergency department within 4.5 hours of symptom onset and were diagnosed with ischemic stroke. We aimed to compare the outcomes of patients who met the criteria for intravenous thrombolytic therapy but refused treatment with those who received it.
Methods: Intravenous recombinant tissue plasminogen activator (IV rtPA) was offered to all eligible patients. For those unable to provide consent, information was shared with first-degree relatives. Patients were assigned to the treatment group (TG) if they accepted therapy and to the refusal group (RG) if they declined.
Results: A total of 274 patients were included in the study. Comorbidities like diabetes, coronary artery disease, and hyperlipidemia were more prevalent in RG. TG patients presented with more severe strokes (higher National Institutes of Health Stroke Scale Score [NIHSS], lower Glasgow Coma Scale [GCS]). RG had better 90-day outcomes (Modified Rankin Score [mRS] 0–1) and greater functional independence (mRS 0–2). Poor outcomes (mRS 4–6) and complications, particularly intracranial hemorrhage, were more common in TG. No link was found between thrombolysis timing and complication rates. In patients under 80, RG outcomes were better; in those ≥80, outcomes were similar between groups.
Conclusion: This study indicates that patients who refuse intravenous thrombolytic therapy, especially those under the age of 80, tend to have milder strokes and better short-term functional outcomes. Conversely, patients who receive treatment often face more complications and worse outcomes, likely because their initial strokes are more severe. We recommend that thrombolytic treatment decisions be individualized based on stroke severity, age, and patient preferences. Additionally, efforts should be made to enhance communication strategies during emergencies to facilitate informed decisionmaking
Urbanization Inequalities on the Incidence of Intraocular Cancers in Iran: An 11-Year Nationwide Retrospective Ecological Study
No full textPurpose: To report the relationship between urbanization and the incidence of intraocular cancers in Iran.
Methods: In this retrospective ecological study, data were extracted from the Statistical Center of Iran, the Meteorological Organization, and the Iranian National Population-based Cancer Registry (INPCR, 2006–2016). The urbanization index (UI) was calculated using principal component analysis, and weighted multiple linear regression was used to assess the relationship between the UI and the age-standardized incidence rate (ASIR) of intraocular cancers.
Results: Six hundred and fifty-four intraocular cancer cases with a gender ratio (male-to-female) of 1:13 were recorded. The mean total 11-year ASIR of intraocular cancers was 0.093 per 100,000 population. The mean ASIR showed a decrease of 0.051 per 100,000 from 2006 to 2016 (P = 0.022). Retinoblastoma (66.1%) and uveal melanoma (24.6%) were the most commonly diagnosed intraocular cancers, and their ASIR declined between 2006 and 2016. Once adjusted for environmental pollutants, an increase in the area-based UI was significantly associated with lower total ASIR of intraocular cancers in males (β = –0.14).
Conclusion: Urbanization was associated with a reduction in ASIR of intraocular cancers, which can be attributed to improved access to eye care facilities for timely diagnosis. However, given that the INPCR cases were verified only by histology, future research should be conducted on hospital-based registries using multiple data sources to address confounders and exposure factors and prevent underestimation of incidence rates
The Lag in Adoption of Educational Innovations in Medical Education: Challenges and Opportunities: A Narrative Review
No full textBackground: Medical education (ME) has evolved to address shifting healthcare needs, technological advances, and competency-based training. Innovative teaching practices are essential for enhancing education quality and preparing graduates for modern healthcare challenges. This narrative review illustrates the need for innovation implementation in ME while evaluating the lag in its adoption. Despite extensive evidence supporting the advantages of innovations, the lag in implementation persists and remains poorly investigated. The review aims to outline the key benefits of major innovation models in ME and identify the challenges and facilitators of their implementation.
Methods: Relevant literature was identified through a structured search of PubMed, Scopus, and Google Scholar for English-language articles published between 2000 and 2024. The data were thematically analyzed, synthesized, and verified with experts in the field.
Results: Innovations were identified within two main domains: Educational Approaches and Digital Transformation Approaches, with a 14- to 27-year lag in adoption. Challenges included resources, resistance, faculty training, and curricular integration.
Conclusion: Educational innovations hold great potential to transform healthcare. Sustainable adoption requires leadership commitment, contextualization, faculty development, incremental integration, curricular reform, benchmarking, and cultural change
Barriers and Motivations for Research among Sudanese Plastic Surgeons: A Cross-sectional Survey
No full textBackground: Over the last few years, Sudan has faced numerous challenges in research, particularly in medical research, which have been reflected in the poor quality of its health services. The field of plastic surgery is not an excuse for these publication challenges. This study explores the main challenges faced by plastic surgery publications in Sudan.
Methods: A well-structured questionnaire was used in this quantitative, descriptive, cross-sectional survey and was distributed among certified Sudanese plastic surgeons.
Results: Of the 55 surgeons, 45 responded. The Cronbach’s alpha coefficient for the entire questionnaire was 0.755. Most were male (73%). Only 22% had published their theses, and 64% had published research, mainly outside the field of plastic surgery. The key motivators for conducting research were improving patient care (87.2%) and reshaping health policy (84.8%). The primary barriers to conducting research were insufficient funds (80.4%), lack of mentorship (78.2%), and limited institutional collaboration (77.4%).
Conclusion: The overall attitude toward research is generally positive, with improvements in patient care and the reshaping of health policy as key motivators. The main barriers include a lack of funding, mentorship, and adequate institutional collaboration. Addressing these challenges by providing additional research funding and institutional partnerships will enhance the Sudanese plastic surgeon’s research output
Communication Transformation in Libraries: The Impact of Digital Culture on Librarian-user Interaction
No full textThis research explores the impact of digital culture on communication in library environments, focusing on the changing interactions between librarians and users. In this rapidly evolving digital era, libraries face new challenges and opportunities in managing their communications and services. This research uses desk research, collecting data by understanding and studying theories from various literatures related to this topic. The results show that digital culture, including social media, library apps, and digital communication platforms, can change the way librarians interact with users and the way information is delivered. Librarians can now utilize digital channels to provide services, share information, and communicate with users. Meanwhile, users are also showing a preference for communicating through digital platforms and accessing services online. The study identifies several challenges, including the need for adequate digital skills among librarians and the management of information privacy and security. It also highlighted opportunities to increase user engagement and expand the reach of library services through digital innovation. The findings of this study are expected to guide libraries in adapting their communication strategies to meet the demands of the digital era and improve service quality
Intelligence in Media and Public Participation: Analysis and Implications
No full textIn the emerging era of technology, social media is an important part of everyday life. However, if not properly directed, it can have negative impacts. Emotional skills are essential for positive social media behavior. This study aims to evaluate the relationship between emotional intelligence and public participation in social media. Using a qualitative method consisting of interviews and observations, this study found that a negative correlation between emotional intelligence and social media intensity where more emotional intelligence was related to less social media intensification, and vice versa. The results show that emotional Intelligence plays an important role in guiding positive social media behavior on a ceremonial basis
Preaching From the Perspective of Family Fiqh
No full textRecently, there has been an escalation in the number of social crimes including the bullying of elementary school students at school, brawls, drug crimes, motorbike gangs, parental neglect, and the heartbreaking incident, namely of an elderly couple who died and rotted in their house. In fact, all parties, including the government, law enforcers, and preachers, have played their respective roles in preventing, overcoming, and even imposing sanctions on law violators. For example, the role of da’wah, whether openly or virtually, through electronic media (television), is to broadcast moral messages relating to people’s lives and their problems. This article will focus on discussing childcare and parenting since the role of parents and family is very important in this problem. Due to these cases, the problem arises of how to convey da’wah to a family so that it becomes a sakinah and harmonious family. We refer to Presidential Instruction Number 1 of 1991 concerning the Compilation of Islamic Law (KHI), which regulates the issue of child care (hadonah), then the correlation with Law Number 23 of 2022 concerning Child Protection (Articles 14-15), namely that children have the right to be cared for by their parents, obtain protection from abuse, torture and involvement in social unrest. da’wah bi al-hal, which is a type of da’wah that is carried out with examples of real actions, is then very relevant for carrying out the da’wah process to the family and creating a peaceful and harmonious household