Background: A surgical site infection (SSI) has significant clinical, humanistic and economic consequences. Surgical antimicrobials prophylaxis (SAP) is a reliable standard to prevent SSIs. Objective: The objective was to test that the clinical pharmacist’s interventions may facilitate the implementation of SAP protocol and subsequent reduction of SSIs. Methods: This was double blinded randomized controlled interventional hospital-based-study at Khartoum State-Sudan. A total of 226 subjects underwent general surgeries at four surgical units. Subjects were randomized to interventions and controls in a (1:1) ratio where patient, assessors and physician were blinded. The surgical team has received structured educational and behavioral SAP protocol mini courses by way of directed lecturers, workshops, seminars and awareness campaigns delivered by the clinical pharmacist. The clinical pharmacist provided SAP protocol to the interventions group. The outcome measure was the primary reduction in SSIs. Results: There were (51.8%, 117/226) females, (61/113 interventions versus 56/113 controls), and (48.2%, 109/226) males (52 interventions and 57 controls). The overall rate of SSIs was assessed during 14 days post-operatively and was documented in (35.4%, 80/226). The difference in adherence to locally developed SAP protocol regarding the recommended antimicrobial was significant (P <0.001) between the interventions group (78, 69%) and the controls group (59, 52.2%). The clinical pharmacist’s implementation of the SAP protocol revealed significant differences in SSIs with reduction in SSIs from 42.5% to 25.7% versus the controls group from 57.5% to 44.2% respectively, P = 0.001 between the interventions group and the controls group respectively. Conclusion: The clinical pharmacist’s interventions were very effective in sustainable adherence to SAP protocol and subsequent reduction in SSIs within the interventions group. Pharmacy Practice is a free full-text journal with a scope on the practice of pharmacy. Pharmacy Practice covers pharmaceutical care, social pharmacy, pharmacy education, process and outcome research, health promotion and education, health informatics, pharmacoepidemiology

Background: Anemia is a deleterious complication of end stage renal disease (ESRD). It is highly prevalent in sub-saharan Africa. The predictors of control of hemoglobin levels in ESRD patients in Sudan are unknown. Methods: A prospective observational study was conducted to evaluate the prevalence of anemia and factors affecting the control of hemoglobin levels in ESRD patients. A standardized data collection form was used for collecting patient information. A total of 1015 hemodialysis patients were recruited from twelve centers. Results: The 534 (52.6%) patients were included in the final analysis. Those were excluded, including, 194 (19.1%) patients were transferred to other centers before completion of the study, 165 (16.3%) died, 38 (3.7%) underwent renal transplantation and 84 (8.3%) were lost to follow-up. Among the patients who included in the final analysis, 307 (57.5%) were males and the mean age was 48.7±16.1 years. All the analyzed patients were anemic (hemoglobin level<12 g/dL), 67% had a hemoglobin level <10 g/dL. In multivariate analysis the variables which had statistically significant associations with hemoglobin levels equal or higher than 10 g/dL were insured patients [OR = 1.53, 95% CI (1.04–2.25)]; and two drug combinations: "Erythropioesis simulating agent (ESA), intravenous (IV) iron, oral iron, and vitamins" [OR = 1.87, (1.27–2.76)] and "ESA, oral iron and vitamins" [OR = 6.67, (2.98–14.94)]. While, a family history of ESRD [OR = 0.57, (0.35–0.94)] and duration of hypertension for "6-9 years" [OR = 0.47, (0.25–0.87)]; Female patients were identified as being more likely to have lower hemoglobin in both univariate and multivariate analyses. Conclusion: There was suboptimal treated anemia requiring attention in this population. Patients with a family history of ESRD and duration of hypertension for "6-9 years" were predicted to have lower hemoglobin levels. More concern should be paid to uninsured patients and anemia drugs, including the ESA and iron preparations. The results of this study increase our knowledge about the prevalence of anemia and the factors that contribute to control of hemoglobin levels in Sudan. Keywords: Prevalence, Anemia in ESRD, Hemodialysis, Erythropioesis Stimulating Agents, Hemoglobin Level, Health Insurance, Hypertension, Family History of ESRD, Sudan, Khartoum.

Diabetic peripheral neuropathy (DPN) is a common and costly complication that occurs in both Type 1 and Type 2 diabetes mellitus. The prevalence of neuropa

Background: Anti-retroviral therapy-related adverse drug events are accounted as a main cause of anti-retroviral therapy non-adherence. In Sudan, pharmacovigilance studies are relatively rare and obstructed by the problem of under-reporting. It is a well-defined issue worldwide and is highly reported in developing countries. This study aimed to evaluate the prevalence of adverse events associated with anti-retroviral therapy among adult patients with immunodeficiency virus at Omdurman Voluntary Counselling and Testing and Anti-retroviral Therapy Center. Methods: The study was a descriptive cross-sectional study conducted through direct interviews with 429 patients at the selected center using the Adverse Drug Events (ADEs) reporting form. The collected data were analyzed by The Statistical Package for Social Sciences. Results: More than half (55.5%) of the participants experienced adverse events, with 48.7% having experienced them at the beginning of treatment. Central nervous system manifestations were the most common adverse events. By using the Naranjo scale, most adverse events showed a “probable” relationship to anti-retroviral medicines. Based on the chi-square test, medication regimen was significantly associated with the presence of ADEs (namely abdominal pain and jaundice) (p values = 0.03 and 0.001), respectively. Conclusion: This study clearly stated that ART-related ADEs are common among Sudanese PLHIV and with central nervous system being the main adverse events. More pharmacovigilance studies and efforts by healthcare providers should be applied targeting ART-related ADEs under-reporting in Sudanese healthcare facilities.

Background: Active management of third stage of labour (AMTSL) by administration of prophylactic uterotonic drugs immediately after delivery can reduce the rate of postpartum haemorrhage (PPH). This study aimed to evaluate oxytocin use in the prevention of primary PPH at Omdurman Maternity Hospital, Khartoum, Sudan. Methods: An observational comparative, prospective, hospital-based study recruited 1,797 pregnant women with plan for normal delivery. Females at risk of PPH were selected and given oxytocin. The Sample was divided into two groups: group one women without identifiable PPH risk (low PPH risk group) and group two women with known PPH risk (risk group). Collected data has been analyzed using SPSS V.21. Results: Only 110 of women (6.1%) developed PPH. Oxytocin 30 units, were mainly used for both high risk and low risk groups in AMTSL for prevention of PPH for both groups it was given as IV bolus plus IV infusion. Out of 110 women with PPH 89 women (81%) received only 1–2 units of blood and 20 women (18.2%) did not received any blood. Only one woman (0.9%) received 3 units of blood. Conclusions: Prophylactic oxytocin reduces the rate of PPH in both groups however the rate is lower among the low risk group. The use of prophylactic oxytocin reduces the need for blood transfusion in Sudanese Women.