Browsing by Author "Tarig Mohamed Ahmed Mohamed"

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    Detection of CTX-M Gene β-Lactamase in Gram Negative Bacteria Isolate from Shendi Health Facilities
    (جامعة الشيخ عبدالله البدري, 2022-05-24) Entisar Ayoub Ahmed1 , 1 ,1 , 2* ,; Leila M. Abdelgadeir; Ghanem M. Mahjaf; Mosab Nouraldein Mohammed Hamad; Tarig Mohamed Ahmed Mohamed
    Abstract: Background: The emergence of antibiotic resistance pathogen is an important health risk, usually gram negative bacteria acquire resistance to antibiotics by the production of beta-lactamase enzyme, CTX-M-type enzymes are a group of class A extended-spectrum B-lactamases (ESBLs) that are rapidly Spreading among gram-negative worldwide. CTX-M-type ESBLs exhibit powerful activity against cefotaxime and ceftriaxone antibiotics but generally not against ceftazidime, in some geographical areas, CTX-M is now the most prevalent ESBLs in Enterobacteriaceae. There are 172 known variants of CTX-M genes identified until August 25, 2016. Objectives: This present study aims to identify the gene, namely: CTX-M, Responsible for extended-spectrum beta-lactamase (ESBL) among Enterobacteriaceae isolated from different samples of Sudanese patients in Shendi city (urine, pus, and wound). Methodology: 200 samples were identified as gram-negative bacteria. Identification of the isolates was done by using conventional biochemical methods, and ESBLs were screened according to (CLSI) guidelines. ESBLs Positive strains were tested for the presence of ESBL encoding CTX-M, Gene by using PCR with specific primers for the detection of CTX-M. Results: ESBL found to be higher in P. aeruginosa n=18(78.3%) Klebsiella spp n=45 (64.2%). Escherichia coli n=51(57.3%) Proteus n=8(53.3%) the total of ESBL from all gram-negative isolate represent n=122 (61%). The presence of the CTX-M, the gene was confirmed in n=57(46.8%) in all isolates. The CTX-M gene were detected in n= 17 (37.8%) Klebsiella spp, n=28(55%) of Escherichia coli, n=3(37.5%) in Proteus and n=9 (50%) in P. aeruginosa isolates. Conclusion: P. aeruginosa isolates represent a high percentage of ESBL producers followed by Klebsiella spp, then Escherichia coli and proteus spp CTX-M gen detected commonly in Escherichia coli followed by P. aeruginosa then Klebsiella spp and Proteus spp. The study concludes that the ESBL production within gram-negative bacteria was high and the CTX-M gene was spread in Shendi city.
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    Efficacy of Pethidine in the Treatment of Postoperative Shivering on Elective Caesarean Section Patients at Wad Madani Maternity Teaching Hospital, Gezira State, Sudan
    (جامعة الشيخ عبدالله البدري, 2022-05-24) Jamil A. Alshdadi; Mohammed K. Ahmed; Sonia A. Ahmed; Ghanem M. Mahjaf; Mosab Nouraldein Mohammed Hamad; Tarig Mohamed Ahmed Mohamed
    Abstract: Shivering is one of the most common complications of neuraxial blockade. Some patients find shivering sensation worse than surgical pain post-operatively. Therefore, both prevention and treatment of established shivering should be regarded as clinically relevant interventions during the preoperative period. This prospective experimental study was conducted at Wad Madani Maternity Teaching Hospital and aimed to measure the efficacy of pethidine when used for the treatment of postoperative shivering following spinal anesthesia during the period from November 2018 to February 2019. The sample size included of 40Patients within the American Society of Anesthesia type two physical statuses;25 mg pethidine diluted in 5 ml Normal saline-injected intra veins. All patients were monitored for temperature, heart rate, blood pressure, and oxygen saturation, these parameters were recorded preoperative, and post 10 minutes of operative, then after 10 minutes of pethidine dose administration. Data were analyzed by using a statistical package for social sciences (SPSS). The statistical results showed that there was a significant relationship between hypothermia and the presence of shivering. 90% of cases resolved to shivering, whereas 10% did not resolve, just 2.5% had Nausea and Vomiting and no side effects on the Respiratory and cardiac Systems. Based on those results the study concluded that: a small dose of pethidine 25 mg intra veins is very effective in resolving postoperative shivering with minimum side effects in the gastrointestinal tract and Good Cardiopulmonary stability. The study recommended that: warming tools should be available for patients to prevent heat loss, close monitoring of Patient's temperature intraoperative and in the recovery room, and use of 25mg Pethidine in the Presence of shivering intraoperative or post-spinal anesthesia.
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    Evaluate the adequacy of Warfarin Treatment among Patients who were on long term Anticoagulation Therapy in Ahmed Gasim Cardiac Center, Khartoum- Suda
    (جامعة الشيخ عبدالله البدري, 2022-07-17) Tarig Mohamed Ahmed Mohamed; Ghanem Mohammed Mahjaf; Mosab Nouraldein Mohammed Hamad
    Abstract: Warfarin therapy for the prevention and treatment of thromboembolic diseases is safe and effective when it is maintained with a narrow therapeutic window measured by the international normalization ratio (I.N.R).Failure to provide adequate anticoagulation consistently predict thromboembolic events( eg stroke and pulmonary embolism), while excessively anticoagulated patients were at risk of bleeding. The management of therapy within this narrow window is complicated by numerous factors including drug interaction, comorbid acute, and chronic diseases, diet, and a variety of patient responses to warfarin therapy. The study was conducted in Ahmed Gasim cardiac center outpatient anticoagulation clinic. The study was carried out in the period from January to December 2012. Patients admitted or attending Ahmed Gasim cardiac center for followup of their long-term anticoagulation therapy. From all these results during the follow-up period. We found the percentage of those who were adequately controlled at the normal therapeutic I.N.R range was (54.7%) versus (45.3%) for uncontrolled patients. Of those who were controlled, we found(133) patients (60.7%) of them were fully educated about the interaction between diet and medications, while (31) patients (38.3%) were not receiving education about such interaction. On the other hand, those who were not controlled according to their therapeutic I.N.R (50) patients (61.7%) were not having educated and (86) patients (39.7%) were educated and have knowledge about dietary and drug interaction. P-value (0.01).The study of the adequacy of anticoagulation shows suboptimal control in (45.3%) of patients on patients attending INR clinics, however, the adequacy varies with age group with elderly patients poorly anticoagulated. Finally, the overall research conclude that the adequacy of anticoagulation was suboptimal with (54.6%) adequately controlled versus (45.3%) uncontrolled. In conclusion, the INR range of anticoagulation at the referral clinic mostly falls in the “under anticoagulated range”. Areas to be considered are patient attendance, staffing and at the same time increasing the efficiency of services. Improvement should be directed not only toward attaining better patient attendance at the clinic but also to educate patients on the importance of adequate control.