Purpose: The aim of this review is to collect information in the available literature (PubMed central, Google scholar, Science direct and Medline and others) to reflect on the traditional remedies used to treat snakebite in Sudan. Methodology: This is a systemic electronic database review accomplished by searching randomly selected databases including: PubMed central, Google scholar, Science direct and Medline and others. Data concerning Sudan was selected and written in a narrative descriptive format. Findings: The data collected was written in a narrative descriptive style including the classification of venomous snakes with specific reference to the magnitude of the problem in Sudan and a reflection on the global magnitude of the problem. Unique contribution to theory, policy, and practice: Snakebite is considered one of the neglected tropical diseases in the tropical and subtropical regions including Sudan, the heart of Africa. The significance of this problem is related to the fact that the snakebite in Sudan is sometimes sadly fatal and affects the young farmers and herders impacting the agricultural economy which is the backbone of the economy of the country.

A b s t r a c t A r t i c l e I n f oDiabetic ketoacidosis (DKA) is the most common hyperglycaemic emergency in patients with diabetes mellitus. This study aimed to determine the precipitating factors, diagnostic criteria and management strategies of adult diabetic ketoacidosis at Elobied Hospital. In this hospital-based retrospective study, the records of 53 patients who were admitted to medical wards in period from January 2015 to December 2015 were reviewed. The records of 53 patients admitted to the medical wards with diabetic ketacidosis were reviewed. Sixteen (30%) were females while 37 (70%) were males. The common presenting symptoms were polyuria (57%), polydypsia (55%), nausea and vomiting (30%), fever (30%), and epigastric pain (19%). Infections were the leading precipitating factors for DKA (47%). Malaria constituted almost half of these infections (48%). Interrupted insulin therapy was the second common precipitating factor for DKA reported in 28% of patients (noncompliance). Seventeen (32%) of patients were newly diagnosed diabetics and presented with DKA. The diagnosis of DKA was made depending on the presenting symptoms, hyperglycaemia, and the presence of glucose and acetone in the urine. Mean blood glucose level in patients with DKA was 368 ± 72 mg/dl. In this study all patients admitted with DKA were managed by giving soluble insulin for hyperglycaemia and 0.9% NaCl for correction of fluid deficit beside treatment of infections if present. Records showed no evidence of bicarbonate or potassium administration. Since the majority of cases of DKA occurs in patients who are known diabetics, this complication should be largely preventable by education of patients, health care professionals and the general public. Laboratory facilities at Elobied hospital must be improved to encourage early proper diagnosis of DKA and determine the severity of DKA to decide where the patient can be managed, in the intensive care unit or in the general medical wards. Intensive care unit (ICU) must be established to provide good care for severe DKA and other emergency cases.

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The history of Sudanese traditional medicine is well-established and ancient since the civilization of Kush and Meroe, through the Islamic kingdoms in Sennar, Kordofan, and Darfur, up to the period of Turkish and English-Egyptian colonization, and the development of traditional medicine until it reached what it is now in Sudan from the spread of folk healers. Traditional medicine healers are those who practice medicine by genetics, experience, knowledge, and subjective experience. In this chapter, the most important traditional healing practices such as Alfaki, Alkaiy, All Basir, etc. have been highlighted throughout history.

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