Why do people prefer traditional bonesetters in Sudan?

Background: In Sudan as in other developing nations, traditional bonesetters play a significant role in primary fracture care. There is widespread belief in our society that TBS are better at fracture treatment than orthodox practitioners. Significant numbers of patients with fractures present first to the traditional bonesetters before coming to the hospital and therefore this mode of care delivery cannot be overlooked in Sudan. Objectives: A prospective study designed to determine the reasons of why a considerable number of people prefer to go to the traditional bonesetters in Sudan.Patients and methods: This prospective two stages study was carried out in two different stages, 1st stage in 2006 targeted general population, and the 2nd stage in the period from May 2009 to September 2009 targeted traditional bonesetters and their patients. In the 1st stage of the study we distributed a predesigned questionnaire to general population, while in the 2nd stage of the study we visited different traditional bonesetter in order to interview them and their visitors and completing the early prepared Performa. We excluded the too elderly patients and children who have nodecisions to choose TBS.Results: In the 1st stage of study the participants were 199 of them, 192 participants responded well to the questionnaire. The reasons why they went to traditional bonesetters were; in 71 participants (37%) was their beliefs, in 27 (14.06%) was due to the low cost, and in 27 (14.06%) was due to fear of plaster. In the 2nd stage of the study 276 participants fulfilled the criteria of the research. The reason why they went to traditional bonesetters; in 63 candidates (22.8%) was their beliefs (P value < 0.003), in 53 (19.2%) was low cost (P value < 0.05), and in 46 (16.7%) was due to fear of cast or amputation. Study included sixteen traditional bonesetters, of them 14 were males and 2 were females. One of them has a bachelor graduation from faculty of sciences. 11 (68.8%) traditional bonesetters accepted the idea of regular training under medical supervision.Conclusion: Despite an adequate number of physicians practising in the region, traditional bonesetters continue to be consulted. Study showed that a belief is the most leading cause of consulting traditional bonesetters, other causes including fear of plaster or amputation and less cost. We recommend that the efficacy of their treatments have to be further assessed.Keywords: Traditional bonesetter (TBS); Beliefs, medical services

Acute Perforated Peptic Ulcer at El Obeid Hospital, Western Sudan

Background: The pattern of peptic ulcer disease and its complications has changed during the last two to three decades.Objectives: To state the frequency of acute peptic ulcer perforations and outcomes of their management at El Obeid Hospital, Western Sudan.Materials and Methods: This is an audit of patients with acute perforated peptic ulcer admitted to the emergency wards of the University Surgical Unit at El Obeid Teaching Hospital, Western Sudan during the period from January 2006 to December 2012.Results: There were 53 patients, 94.3% were males. The age ranged between 18 and 77 years. Most of the patients reported late and 45.3% during Ramadan and Shawal. All patients had emergency peritoneal lavage and simple closure with omental patch followed by anti-ulcer therapy. The postoperative mortality was 7.6%.Conclusions: Perforated peptic ulcer in this community was mainly  duodenal. Emergency peritoneal lavage and simple closure with omental patch followed by anti-ulcer therapy resulted in excellent outcomes. Old age, shock, peritonitis and septicaemia were the major risk factors formortality.Key words: Perforated duodenal and gastric ulcers

Adenosine A1 receptor: Functional receptor-receptor interactions in the brain

Over the past decade, many lines of investigation have shown that receptor-mediated signaling exhibits greater diversity than previously appreciated. Signal diversity arises from numerous factors, which include the formation of receptor dimers and interplay between different receptors. Using adenosine A1 receptors as a paradigm of G protein-coupled receptors, this review focuses on how receptor-receptor interactions may contribute to regulation of the synaptic transmission within the central nervous system. The interactions with metabotropic dopamine, adenosine A2A, A3, neuropeptide Y, and purinergic P2Y1 receptors will be described in the first part. The second part deals with interactions between A1Rs and ionotropic receptors, especially GABAA, NMDA, and P2X receptors as well as ATP-sensitive K+ channels. Finally, the review will discuss new approaches towards treating neurological disorders

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Assessment of physicochemical parameters in groundwater quality of desert area (Tharparkar) of Pakistan

In Tharparkar desert, the main source of water supply is groundwater. Water for domestic use is normally collected from open dug wells. For this study, twenty-five groundwater samples were collected from the open dug well of Talukas of Tharparkar, Southern Sindh, Pakistan, to evaluate its quality and suitability for drinking, domestic, and agricultural use. The findings in this paper are based on an examination of regional variations and the use of a geographic information system (GIS), which incorporates the results of 25 well water samples collected from six villages in Taluka Mithi Tharparkar. The study's findings reveal excessive concentrations of physical and chemical characteristics in the majority of locations, in contradiction to the World Health Organization's (WHO) recommendations for drinking water. Majority of wells in the studied area the TDS were ranging from 800 to 11,000 mg/l. However, villages of Madhu, Dharar and Mithi were found to have high TDS that exceeded 1000 mg/L, which was a major cause of health problems in the area. Moreover, the total concentration of arsenic and fluoride in water samples varied between 0.0015 and 80 μg/L and 0.1–5.1 mg/l respectively. The inorganic form of As, was found to be 95% of the total As level in the regional drinking water. The concentration of Fluoride in areas of Mithi, Dharar, Harmar and Satar was found above the permissible limits. Furthermore, results indicate that correlations among water parameters dropped, and examined values were inconsequential. Statistical analysis (a linear regression method) was performed, for predicting the concentrations of groundwater quality parameters. A significant positive association between 1% and 4% was found between different parameters. The collected health data indicate that the study area has waterborne diseases. Therefore, comprehensive groundwater monitoring and management are required in the studied area to protect populations from various diseases caused by poor water quality

In-house resource efficiency improvements supplementing the end of pipe treatments in textile SMEs under a circular economy fashion

The choice of cleaner production practices within the supply chain can improve the textile industry's environmental, financial, and operational advantages. The objective of this study is to evaluate smart environmental management practices (SEMPs) for minimizing the pollution load (energy waste, water consumption, wastewater generation, and chemical waste) within the supply chain in five textile production units of Lahore, Faisalabad (Punjab), and Karachi (Sindh) in Pakistan and to assist and get comprehensive knowledge on resource saving through cleaner production techniques. A multi-criteria decision-making method was used to identify the possibilities and use for cleaner production and SEMPs. A total of 36 SEMPs have been recorded with three benchmarking levels based on investment and business priority: i) low/no-cost high return, ii) high-cost high return, and iii) medium-cost medium return. After an initial assessment, SEMPs were implemented and post-assessments were conducted after gap of months. It was found that about 1.3 million m(3) of water was saved which constituted up 21% of the total water consumption. Moreover, 34,600 tons of chemicals and 1,441,500 kWh energy were also saved. This resource saving also helped industries save 0.792 million USD. Using the SEMPs proposed in this article, the annual GHG emission was significantly reduced for industries where the potential varied from 200 to 8,500 tons of CO2 for different industries

Knowledge of COVID-19 Infection Guidelines among the Dental Health Care Professionals of Jazan Region, Saudi Arabia

Background: This study aimed to assess the knowledge about guidelines related to COVID-19 infection control procedures among dental health care professionals (DHCPs) in the Jazan region. Methods: A cross-sectional study involving DHCPs (dental students, interns, and dentists) of the Jazan region between January and March 2021. A questionnaire with 35 items was developed and circulated online among the DHCPs. The dimensionality of the questionnaire was assessed using exploratory factor analysis (EFA). The level of awareness (LOA) was compared across the genders, level of professional experience, and exposure to guidelines. Participants were considered to have high LOA when they responded to 26 or more items correctly. Results: A total of 363 DHCPs participated in the survey. The questionnaire was found to be valid and reliable. EFA revealed a distinct three-factor structure. Moreover, 61.2% of the respondents had high LOA related to COVID-19 infection prevention. Among those who had high LOA, dentists (65.5%) were relatively more than the students (62.5%) and interns (46.2%). Among the six guideline statements related explicitly to operative dentistry, more than 50% of the respondents were aware of 3 guideline statements, while less than 50% of the respondents were aware of the remaining statements. Conclusions: Most DHCP had a high LOA for general COVID-19 infection prevention and control guidelines. Dentists, males, and those who read the guidelines had higher LOA than their counterparts.Full Tex