IntroductionLittle is known about the pattern and outcome of Acute Kidney injury (AKI) in Sudan. This study aimed to determine the etiology and outcome of AKI among Sudanese adults.MethodsA retrospective cohort study was conducted in a tertiary level hospital, Soba University Hospital, Sudan. The medical records of all adults admitted to hospital from the 1st of January to 31st of December 2014 were reviewed. The diagnosis and severity of AKI was defined as per the Kidney Disease Improving Global Outcomes (KDIGO) recommendations.ResultsThe medical records of 6769 patients were reviewed. AKI was diagnosed in 384 patients (5.7%); being community acquired in 82.6% of cases. Sepsis, volume depletion, obstructive uropathy, heart failure, acute glomerulonephritis and severe malaria were the commonest causes of AKI diagnosed in 44%, 38.5%, 8.9%, 5.7%, 4.7% and 3.1% of patients, respectively. Following treatment complete renal recovery was seen in 35.7% of patients; whereas 31.2% of patients died. Predictors of increased risk of death were old age [OR 1.03, 95% CI (1.01-1.057); P=0.003], presence of chronic liver disease [OR 2.877, 95% CI (1.5-5.5); P=0.001], sepsis [OR 2.51, 95% CI (1.912-4.493);P=0.002] and the severity of AKI [OR 3.873, 95% CI(1.498-10.013);P=0.005].ConclusionAKI was diagnosed in 5.7% of adults admitted to hospital. Most patients were having community acquired AKI. Old age, the presence of chronic liver disease, sepsis, and the severity of AKI as per KDIQO staging were significant predictors of mortality.

The purpose of this study was to identify obstacles health care workers face in providing care for people living with HIV and AIDS (PLWHA). Based on these findings, health authorities can design interventions to support health care workers in providing better medical care for PLWHA. Thirty in-depth interviews were conducted with physicians and nurses in one 300-bed tertiary care public hospital in Giza, Egypt. Thematic analysis was conducted by 2 investigators. Five main themes were identified (1) fear of infection; (2) disbelief in effectiveness of infection control measures to protect against HIV; (3) misconceptions regarding medical care for PLWHA; (4) fear of secondary stigma; and (5) moral judgments toward PLWHA and negative connotations related to HIV. Interventions targeting health care workers should be multidimensional, including knowledge and skills building as well as value and attitude change. Reducing stigma among health care workers will improve access to care for PLWHA.

Purpose: Cervical traumas are frequent in emergency department and X-ray, CT, and MRI are the essential imaging modalities in the diagnosis. However, especially for pregnant and morbid obese patients and children, these techniques can be challenging. We tested the success of point-of-care ultrasound in the evaluation of cervical traumas. Methods: This is a case series of cervical vertebra imaging with ultrasound in emergency department. We used linear probe and placed it anterolaterally to the neck, parallel to cervical spine. Images were obtained by an ultrasound-certified emergency physician. The height of the anterior wall of vertebral body, irregularity in vertebral body, and intervertebral space were assessed. Results: We presented a case series of six patients. Ultrasound images of cervical vertebral bodies and intervertebral spaces were able to obtain for all the patients. Any pathology was not observed in ultrasound imaging. This finding was compatible with cervical X-ray and CT scans and all the patients were discharged. Conclusions: However, this is a case series report of minor cervical trauma, and we were able to obtain ultrasound images of cervical vertebra bodies with point-of-care ultrasound examination by an emergency physician. This technique can be important for the patients contraindicated to CT or MRI. Also, it can give additional information to X-ray and CT scans especially for soft tissues. A2 A new technique in verifying the placement of a nasogastric tube: obtaining the longitudinal view of nasogastric tube in addition to transverse view with ultrasound

Introduction: Percutaneous injuries, caused by needle sticks and other sharps, are a serious concern for all health care workers (HCWs) and pose a significant risk of occupational transmission of blood borne pathogen. Two million injuries are believed to occur each year among HCWs. Methodology: The study group consisted of 249 HCWs of various categories of a tertiary care hospital in Khartoum, Sudan. Data collection was carried out using a standardized questionnaire. To measure knowledge, attitude and practices on needle stick injuries. Results:70% of respondents were females and around 47% of participants were nurses Half of participants attended a biosafety course, and around 90% of them followed what they was trained on in all or most of times. Most of respondents graded their knowledge about as good and the main source of knowledge was the university curriculum. In our study 46% had NSI with a mean of 6.1 injuries/year of 6.14 most of them were among nurses 40%. Almost thirty percent didn't hear about the term post exposure prophylaxis more than 90% knew that HIV, HBV, and HIV can be transmitted through NSI. More than 83% of respondents were worried about NSI. Regarding the most recent NSI, Most of injuries occurred in the ward followed by emergency room, lab, and theatre. In half of cases the culprit was the victim himself during usage of syringe. The most common procedure associated with NSI was blood sampling. The frequent action was to wash the injury site using antiseptic solution. Almost two thirds of respondents who had NSI didn't report it. Around 4.3% had NSI of HIV patient yet, the majority of them did not receive any medication. Out the 7 participants who had a NSI from a HBV positive patient, 5 were fully vaccinated all of which didn't check their vaccination status. Moreover, none of the 5 participants received PEP. Conclusion and recommendation: prevalence of NSI was relatively low but there were many deficient area such as checking immune status of HBV, knowledge about importance and methods of PEP, role of wearing gloves during handling needles, and procedure of reporting injuries. HCW =health care worker NSI = needle stick injuries PEP= post exposure prophylaxis