Background Clinical guidelines are systematically proven statements that help physicians to make healthcare decisions for specific medical conditions. Non-adherence to clinical guidelines is believed to contribute significantly to poor delivery of clinical care, and hence poor clinical outcomes. This study aimed at investigating adherence of doctors to hypertension clinical guidelines in Academy Charity Teaching Hospital, Khartoum, Sudan. Methods A cross-sectional hospital-based study was conducted during the period from January 2017 to October 2017 on a sample of 150 doctors. Adherence of doctors to hypertension guidelines was measured through the modified JNC7 adherence tool. Descriptive statistics was used to summarize the data (mean, standard deviation, median) and analyzed by frequency tables. Chi square test used to determine association among categorized variables. Logistic regression analysis was conducted to determine the relation between adherence to hypertension guidelines and the explanatory variables. All statistical tests were considered statistically significant when p value < 0.05. Results Of the 150 participants, 92% (138/150) were aware of the major hypertension treatment guidelines. 71% (98/138) reported the use of guidelines recommendations in their practice. Whereas 52% (78/150) were aware of local Sudanese guidelines. High adherence rate was highly statistically associated with job titles ( p = 0.000), and also associated with age of the participants ( p = 0.024) and duration of clinical experience ( p = 0.012). However, the logistic regression analysis revealed despite all those variables were contributing to adherence to the treatment guidelines, only duration of clinical experience was statistically significant ( p = 0.022). Conclusion The overall adherence of doctors to hypertension treatment guidelines was very low. This study highlights how a gap in clinical governance contributes to low adherence to clinical guidelines. Establishing regular clinical audit, issuing regulations to enforce the use of updated guidelines, along with introducing training programs in hospitals and continuous assessment to the practicing doctors are suggested as crucial interventions. Considerable efforts to build clinical governance in Sudan are required.

Background: In order to prevent postpartum depression many primary preventive programs were done. Psychological interventions are thought to be effective in decreasing the incidence of postnatal depression. This study aimed to evaluate the effect of Psychotherapy in treatment of postpartum depression. Methods: An electronic search was obtained in MEDLINE and EMBASE databases with search terms such as psychology, postpartum, depression, intervention, effectiveness. The primary search resulted in 128 studies which have been screened for eligibility. After exclusion of irrelevant, duplicated and review studies, 11 studies were included in the review as they met the inclusion criteria. Results: Psychotherapy decrease the likelihood of postpartum depression and decrease postpartum depressive symptoms, increased awareness, depression reduction, general improvement and psychological health and prevention of postpartum depression, improve depression, functioning and anxiety. Training for health visitors' intervention was found to be cost-effective in reducing the proportion of women at risk. It was only noted that there was no outcome difference between behavioral approach and person-centered approach groups. Health visitor raining was noted to have preventive effect for depression. Conclusions: There is evidence to recommend that interventions carried in pregnancy can be effective in preventing postnatal depression. Interventions are mainly effective when grounded on psychological treatments and provided to women suffering from antenatal depression.

Background: treatment of borderline personality disorders include in addition to medications several evidence-based psychotherapy treatment models, including schema focused therapy, dialectical behavior therapy, transference focused psychotherapy and cognitive behavioral therapy. Objective: this study aimed to evaluate all randomized controls trials of pharmacological interventions in comparison with psycho educational group interventions in the treatment of borderline personality disorders. Methods and Materials: this was an electronic search and it was conducted by using search strategy of cognitive psychotherapy and borderline personality disorder in MEDLINE, EMBASE and PsycINFO databases. Trials included in this review were clinical trials with cognitive interventions for subjects meeting DSM or ICD criteria for personality disorder. Results: the search of the literature, after exclusion of irrelevant, duplicated and review studies, revealed 24 randomized controls trials that met the inclusion criteria. Included studies aimed to assess the effectiveness of a cognitive behavior therapy in treatment of border line personality disorders. Conclusions: we concluded that the use of cognitive therapy is important in treatment of borderline personality disorder in addition to pharmacological treatment and treatment as usual. Doctors must choose the most effective type of cognitive therapy according to their patients' diagnosis, duration of the treatment and the available resources.

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