University of Dongola

Pressure injuries remain a significant and largely preventable cause of morbidity among hospitalized patients. Accurate and complete risk assessment using validated tools such as the Braden Scale is fundamental to effective prevention; however, documentation practices are often inconsistent, particularly in resource-limited settings. To evaluate the completeness of Braden Scale documentation in the Internal Medicine Department at Dongola Specialized Hospital and to assess the impact of a targeted quality-improvement intervention through a closed-loop clinical audit. A prospective closed-loop clinical audit was conducted over two cycles, each reviewing 51 patient records. Baseline documentation practices (Cycle 1) were assessed against predefined standards derived from international pressure-injury prevention guidelines. Following a structured two-month intervention comprising staff education, reinforcement of documentation expectations, and introduction of a standardized Braden documentation form, a second audit cycle (Cycle 2) was performed using identical criteria. Documentation completeness was analyzed using descriptive statistics, and differences between cycles were assessed using chi-square tests. At baseline, none of the Braden subscale scores, total scores, risk levels, or preventive actions were documented. Following the intervention, documentation of all six Braden subscales improved to near-universal completion (96.4-100%). Documentation of total Braden score, risk level, and preventive actions increased to 89.1%, 83.6%, and 89.1%, respectively (all p < 0.001). Significant improvements were also observed in consultant identification and bed number documentation. Conversely, completion rates for certain demographic fields, particularly hospital number and admission date, declined in Cycle 2. This audit demonstrates that targeted education and standardized documentation tools can lead to substantial and statistically significant improvements in Braden Scale documentation. While clinical risk assessment practices improved markedly, persistent gaps in administrative documentation highlight the need for sustained monitoring and system-level reinforcement. Closed-loop clinical audits represent an effective strategy for strengthening pressure-injury risk assessment practices in hospital settings.

Key Clinical MessageTrichobezoar is the pathological formation of a hair mass within the gastrointestinal tract, usually correlated with psychiatric conditions like trichotillomania and trichophagia. Intestinal obstruction represents a significant potential complication. Trichobezoar should be included in the differential diagnosis for young females exhibiting nonspecific gastrointestinal symptoms accompanied by abnormal psychiatric behavior.

Medications, while beneficial, can also cause significant harm, often due to medication errors (MEs) and adverse drug reactions (ADRs). This study aimed to evaluate the knowledge, attitudes, and practices (KAP) of healthcare providers (HCPs) regarding ME and ADR reporting. A hospital-based cross-sectional study was conducted in Dongola and data were collected using a mixed-method approach with a semi-structured questionnaire. Analysis was performed using SPSS version 26, considering significance at p < 0.05. Out of 272 targeted HCPs, 216 responded (response rate: 79.4%). Most participants were female (71.8%) and aged ≤ 28 years (81%). For MEs reporting, average knowledge (59.3%), low attitudes (29.2%), and low practices (25%) were observed. Regarding ADRs reporting, knowledge was poor (35.2%), attitudes were positive (81.9%), and practices remained low (29.6%). Knowledge significantly associated with reporting practices for both MEs and ADRs, using Chi-Square Test (p < 0.001). Nurses showed better MEs reporting practices compared to physicians and pharmacists (p = 0.008). Positive attitudes significantly correlated with improved ADRs practices (p = 0.001). The primary barrier to reporting was lack of knowledge (28.9%), while the most suggested improvement was implementing a mandatory reporting system (37.5%). In conclusion, the participants had inadequate knowledge and practices regarding MEs and ADRs reporting, emphasizing the need for targeted interventions to improve reporting practices.

BackgroundPreoperative anxiety is a common psychological condition, and many patients express a desire for more information before surgery. Understanding the prevalence and associated factors of both preoperative anxiety and the desire for information can improve patient care.ObjectiveThis study aimed to assess the prevalence of preoperative anxiety and desire for information, as well as their associated sociodemographic, medical, and surgical factors, among patients undergoing elective surgery in Northern State, Sudan.MethodsA hospital-based, multicenter, cross-sectional study was conducted from November 2024 to February 2025 in Northern State, Sudan, involving patients undergoing elective surgery. Data were collected through face-to-face interviews using a structured questionnaire and the validated Arabic version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Chi-square tests and univariate and multivariate logistic regression were performed to identify the associated factors and the magnitude, with statistical significance set at P<.05.ResultsOf the 380 patients approached, 305 participated in the study (response rate=80.3%): 173 of the 305 participants (56.7%) were male, and the median age was 43 (IQR 30‐64) years. Most participants were married (n=207, 67.9%), educated (n=248, 81.3%), and had family support (n=253, 83.0%). Regarding surgical characteristics, the majority underwent either intermediate (n=136, 44.6%) or major (n=142, 46.6%) procedures. General anesthesia was the most common type used (n=159, 52.2%), and most participants (n=169, 55.4%) underwent surgery in public hospitals. Most participants reported that their surgeries were not covered by insurance (n=264, 86.6%) and described good sleep quality the night before surgery (n=221, 72.5%). Of the 305 participants, 75 (24.6%) experienced preoperative anxiety, whereas 92 (30.1%) expressed a moderate to high desire for information. Preoperative anxiety was significantly associated with family support (adjusted odds ratio [aOR] 7.12, 95% CI 2.64‐19.23; P<.001), surgery in public hospitals (aOR 4.31, 95% CI 2.30‐8.07; P<.001), poor sleep quality the night before surgery (aOR 2.85, 95% CI 1.51‐5.38; P=.001), and American Society of Anesthesiologists (ASA) classification III/IV (aOR 2.36, 95% CI 1.00‐5.54; P=.049). Similarly, a higher desire for information was significantly associated with being educated (aOR 2.48, 95% CI 1.00‐6.11; P=.049), having family support (aOR 4.10, 95% CI 1.81‐9.30; P=.001), undergoing surgery in a public hospital (aOR 3.57, 95% CI 1.93‐6.61; P<.001), and being classified as ASA III/IV (aOR 3.26, 95% CI 1.39‐7.64; P=.001).ConclusionsPreoperative anxiety and desire for information are common among Sudanese patients. Family involvement may paradoxically increase anxiety and the desire for more information due to shared concerns and cultural factors. Other significant predictors of anxiety include poor sleep quality and higher ASA classification. Additionally, education, family support, and chronic diseases were associated with a higher desire for information. Addressing these factors may alleviate preoperative anxiety, satisfy communication needs, and improve preoperative care.

Abstract Aim This study asssed the prevalence of preoperative anxiety and the desire for information, as well as associated sicio-demographic, medical, and surgical factors among patients undergoing elective surgery in Northern state, Sudan. Method A Hospital-based, multi-center cross-sectional study was conducted over two months in Northern state, Sudan, involving 153 elective surgery patients. Data wer collected through face-to-face interview, using the Amsterdam Preoperative Anxiety and Information Scale (APAIS), and analyzed using SPSS, version 26. Chi-square test, univeriate and multivariate logistic regression analysis were used to identify risk factors, with statistical significance set at p&amp;lt;0.05. Results OF the 153 participants, 56.9% were female, and 69.3% were aged &amp;lt;50 years, with a mean age of 37 years (IQR: 28-60). Most wre educated (86.9%), married (71.9%), and earned an average monthly income of $50-250 (49.0%). Nearly half underwent major surgery (45.8%) under general anesthesia (47.7%). Poor sleep quality the night before surgery (31.7%) and chronic diseases (37.9%) were common. The prevalence of preoperative anxiety and desire for information were 34.6% and 37.9%, respectively. Poor sleep quality (aOR = 3.37, 95% CI: 1.55–7.34, p = 0.002) and family support (aOR = 4.34, 95% CI: 1.52–12.34, p = 0.006) were the significant predictors of anxiety among the patients. Conclusions Preoperative anxiety is common among elective surgical patients in Northern State, Sudan. Addressing poor sleep quality, reducing the frequency and duration of family visits, and enhancing preoperative counseling may help alleviate anxiety and improve patient outcomes.

Background: Blood transfusion is a critical, life-saving medical intervention performed worldwide. However, it carries potential risks, including the transmission of transfusion-transmissible infections (TTIs), particularly viral hepatitis. Hepatitis B virus (HBV) and hepatitis C virus (HCV) are significant causes of liver disease and hepatocellular carcinoma. Objective: This study aimed to determine the prevalence of HBV and HCV infections among blood donors at Dongola Hospital. Methods: A descriptive cross-sectional study was conducted in 2025 involving 100 voluntary blood donors. Participants were evaluated based on demographic characteristics, donation history, and risk factors such as previous surgery, tattooing or hijama (Islamic wet cupping), and history of jaundice. Screening for HBV and HCV was performed using immunochromatographic testing (ICT). Results: In this study 100 patients were the age of 61 (61%) of them 18 – 30 years old, 24 (24%) aged 31 – 40 Years, while 11(11%) aged 41- 50 years old and, 4 (4%) were aged 51 years old and older. and there are 61 (61%) of them have History of Donation, while 39 (39%) of them have no History of Blood Donation. 93 (93%) of them have Negative result of HBV Test, while 7 (7%) of them have Positive result of HBV test. 100 (100%) of them have Negative result of HCV Test. involved in this study, 2 (2%) of them have History of Tatto or Islamic Higama, while 98 (98%) of them have No History of Tatto or Islamic Higama and there are 3 (3%) of them have History of Surgery, while 97 (97%) of them have no History of Surgery. were 6 (6%) of them have History of Jaundice, while 94 (94%) of them have No History of Jaundice. in this study, 1% in Hafer and Mgaser, 3% live in Baden, Shaikh Sharive and Kmnar, 5% of them live in Altety, while 6% live in Grada, Algoled, 7% live in Aldem, 12% in Alselam, and 53% in Dongola. Conclusion: This study highlights the presence of Hepatitis B Virus (HBV) among blood donors at Dongola Hospital. The results suggest that although the prevalence of HCV is low in this population, HBV remains a significant concern, particularly among younger donors aged 18–30 years. The current screening method using Immunochromatographic Test (ICT) showed limitations in accuracy, indicating the necessity for more reliable diagnostic tools such as Polymerase Chain Reaction (PCR) and Enzyme-Linked Immunosorbent Assay (ELISA).

Background Clinical audits serve as a critical tool for quality improvement, evaluating current practices to enhance patient care. Radiology request forms (RRFs) are essential for accurate diagnosis and treatment but often face challenges like incomplete or inaccurate information, illegibility, and non-compliance with established guidelines. This audit aimed to assess the adequacy of RRF completion at Othman Digna Teaching Hospital, Sudan, and implement interventions to improve compliance with guidelines. Materials and methods A prospective audit was conducted between November and December 2024. The first cycle involved assessing 50 randomly selected RRFs for adherence to the Royal College of Radiologists (RCR) guidelines. Interventions included introducing standardized forms and providing physician training. A second cycle of 50 RRFs was evaluated post-intervention. Data were analyzed using descriptive statistics and graphical representations. Results Compliance with eight key standards improved significantly post-intervention. Patient name compliance increased from 98% to 100%, while patient age rose from 12% to 98%. The inclusion of clinical background details and the question to be answered both reached 100% from initial rates of 16% and 4%, respectively. Overall mean compliance improved from 26% to 95.5%. Conclusions The study demonstrated significant improvements in the completion of RRFs following targeted interventions. Regular audits, standardized procedures, and continuous training are essential to sustaining compliance and improving communication between clinicians and radiologists, ultimately enhancing patient care.

IntroductionDouble-J (DJ) stents are essential and frequently utilized devices in urology. Typically, the DJ stent must be replaced or removed within 6 weeks to 6 months to prevent issues such as encrustation, stone formation, fractures, and blockages. Unfortunately, in numerous instances, the stent is neglected[1].It was first introduced to practice in 1967 by Zimskind et al[2]. Stents help maintain the ureter patent, promote the resolution of edema, and facilitate healing of mucosal injuries. As a result, they are regarded as an effective approach in the postoperative care of patients with conditions such as ureteric calculi, ureteric strictures, retroperitoneal tumors or fibrosis, uretero-pelvic junction obstruction, or any iatrogenic ureteric injuries.The longer the duration of DJ stent the more likely to development of stone. It has been reported that the rates of stent encrustation are 9.2%, 47.5%, and 76.3% when the stent remains in place for 6 weeks, 6–12 weeks, and over 12 weeks, respectively[3].Forgotten DJ stents can lead to serious complications. The educational level of patients and their families, as well as counseling provided before and after the procedure, could be crucial in minimizing stent-related issues[1].Initial efforts to remove encrusted ureteral stents can be difficult. The approach depends on the extent of stone formation and encrustation at both ends of the stent. Various methods have been used to remove encrusted stents, including open surgery, percutaneous nephrolithotomy (PCNL), extracorporeal shockwave lithotripsy (SWL), cystolitholapaxy, ureteroscopic laser lithotripsy, and cystolitholapaxy[4].This paper discusses a case of a patient with a long-term neglected DJ stent, originally inserted five years ago after stone removal surgery, which eventually caused the formation of a bladder stone and renal stone, following the updated consensus-based case report (SCARE) guidelines.

Background: Mobile phones used by healthcare workers (HCWs) have emerged as potential reservoirs for pathogens, posing a risk of healthcare-associated infections (HAIs). This study aimed to investigate the prevalence of bacterial contamination on HCWs' mobile phones, determine the antimicrobial susceptibility patterns, and compare findings with global data. Methods: We collected swabs from 94 mobile phones of HCWs across two hospitals in Khartoum. We identified bacterial isolates using standard microbiological techniques and evaluated antimicrobial resistance using the Kirby-Bauer disk diffusion method. Results: Bacterial contamination appeared in 93.6% of mobile phones. Gram-positive bacteria, such as Coagulase-negative staphylococci (36%) and S. aureus (31.8%) were prevalent. Gram-negative organisms were isolated. The predominant organisms were Klebsiella pneumoniae 15 (37%) isolates followed by Pseudomonas aeruginosa 12 (30%) isolates, Proteus mirabilis 5 (12%) isolates, Acintobacter baumannii 4 (10%), Enterobacter spp 3(8%) and Escherichia coli 1 (3%). Antimicrobial susceptibility tests revealed high resistance to penicillin among Gram-positive isolates. The tests revealed no multidrug-resistant (MDR) or extended-spectrum beta-lactamase (ESBL) production. Conclusion: HCWs' mobile phones represent a critical vector for bacterial transmission in hospitals. Stringent infection control measures and regular disinfection should mitigate the associated risks.