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Introduction: diabetic Ketoacidosis is the leading cause of mortality in children and adolescents with T1DM and accounts for about 50% of all deaths in patients younger than 24 years with diabetes. It affects 8 out of 1000 people with diabetes annually, with a worldwide mortality rate of 2-10%. The purpose of this study is to assess the knowledge and practice towards DKA among patients with diabetes attending three diabetes clinics in Khartoum., Methods: we conducted a cross-sectional institution-based study. It included all patients with diabetes attending three diabetes clinics in Khartoum state over the period July - September 2016. A self-administered questionnaire was used to assess and score knowledge and practice towards DKA among patients with diabetes. Data were analyzed using SPSS 23.0., Results: one hundred and ten patients participated in the study, of whom 86 had heard of DKA and were questioned further. Fifty-six point nine percent of participants had poor knowledge (0-8 out of 24) and low practice scores (0-2 out of 6). There was a strong association between knowledge scores and attended clinics., Conclusion: there was an evident lack of knowledge and poor practice towards DKA among patients with diabetes attending diabetes clinics in Khartoum, Sudan., Competing Interests: The authors declare no competing interests., (Copyright: Almutasim Billah Elbagir Elhassan et al.)

Type 1 diabetes mellitus (T1DM) is the most common endocrine disorder in children. The glycated haemoglobin (HbA1C) level was found to be correlated with the academic skills and classroom attention in children with T1DM. This study aimed to assess the impact of T1DM status and control on the academic performance of school children. A cross-sectional survey was conducted among diabetic children attending two secondary care hospitals in Khartoum, Sudan. We applied the total coverage sampling method to include all T1DM patients who presented in the period from July to October 2016. A total of 122 T1DM children aged 6-18 years, who were registered as formal school students were included. Most of the participants (63.1%) had HbA1C levels more than 9.5% and near half of them (47.5%) had chronic T1DM-related complications. Academic performance was negatively correlated with higher HbA1C levels ( r s = -0.192, p > 0.001) and longer duration of the illness ( r s = -.362, p = 0.034). However, academic scores did not differ significantly between diabetic children with chronic complications and those without chronic complications ( χ 2 = 8.01, p = 0.091). This study showed that T1DM influenced the academic performance of school children., (Copyright © Sudanese Association of Pediatricians.)

Mothers are the major role players with regard to their children's immunisation. The aim of this study is to assess the knowledge, attitude and practice of mothers of children below 5 years of age with regard to immunisation in Northern State, Sudan. This was a cross-sectional survey which was conducted in three villages in 2016. All mothers having at least one child below the age of 5 years were included. Data were collected by interviews using a self-structured questionnaire. Descriptive statistics were displayed and chi-square test was used to assess associations. A total of 127 mothers of 191 children were included. The mean knowledge score about the names of vaccines/diseases prevented was 3.47 out of 10. The most correctly named vaccines by the mothers were measles (87.4%) and polio (86.6%), whereas the least ones were hepatitis (7.1%) and diphtheria (8.7%). The majority (99.2%) of the mothers had a positive attitude. The mean knowledge score about the timing of doses was 4.12 out of 5. The most correctly timed dose by the mothers was the dose at 6 weeks 'dose 1' (96.1%) and the least one was the dose at birth 'dose 0' (60.6%). About half (48.7%) of the children were completely immunised, 46% were only missing their 'dose 0', mostly because of closed vaccination units on the day of birth (73.6%), and 5.3% were incompletely immunised. Hospital delivery, availability of vaccination card and good socioeconomic status were associated with complete immunisation status, with p -values equal to 0.00, 0.00 and 0.03, respectively. Educating mothers about immunisation, increasing the days of immunisation and providing outreach services for home-delivered newborns are important interventions to increase the immunisation coverage., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © Sudanese Association of Pediatricians.)

The aim of this study is to measure the incidence and prevalence of type 1 diabetes mellitus in children and adolescents in Khartoum State, Sudan. Records of all patients aged 6 months-19 years, living in Khartoum State and who were known to have or newly diagnosed with type 1 diabetes in all health institutes (both governmental and private) during the period January to December 2015, were reviewed. In addition to the records, interviews with patients and caregivers attending the clinics were conducted. Names were double-checked with the Sudanese Childhood Diabetes Association's central registry. Data were analysed using the Statistical Package for the Social Sciences software (SPSS 20). A total of 2,393 children were identified. Males were 1,117 (46.6%) and females were 1,276 (53.3%) with a ratio of 1:1.4, with no significant difference. The prevalence rate was 0.74/1,000. The overall incidence rate was 10.1/100,000. The peak incidence age was between 11 and 15 years (15.9/100,000). The incidence rates in below 5 years and 16-19 years were 8.4 and 7.7/100,000, respectively. There was no significant difference between males and females. In most of the cases, the onset was in the winter months. The commonest month of birth was June.The incidence of type 1 diabetes in Sudan is still considered among the high rate group in the world and in the region. There was an obvious increase in the incidence among the below-5 years age group (8.4/100,000) compared to a figure of 3.5 which was reported earlier from Sudan. For the first time, we report the incidence among the 16-19 age group (7.7/100,000)., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © Sudanese Association of Pediatricians.)

This study evaluated the effects of inclusion of Yucca schidigera extract (YSE) in two diets with different levels of crude protein (CP) for dogs on facal odour, nutrient digestibility, ammonia concentration in feces and hematological and serum biochemical profiles. Twenty adults Beagles were used, distributed in a randomized block design in a 2 × 4 factorial design (two diets, 25% and 34% CP, and four YSE levels: 0, 250, 500 and 750 mg/kg) with five replicates, obtained during two experimental periods. The fecal odour reduced (P < 0.05) when 500 mg/kg of YSE was used in diets with higher CP. The inclusion of YSE reduced (P < 0.05) fecal ammonia, and the inclusion of 250 and 500 mg/kg YSE reduced intestinal gas. The inclusion of 750 mg/kg YSE increased the mean corpuscular hemoglobin (MCH), alanine aminotransferase (ALT) activity and tended to increase the serum cholesterol concentration, regardless of the protein level of the diets. There was no effect on the digestibility of nutrients, fecal consistency, nitrogen balance and thickness of the intestinal wall. The inclusion of 500 mg/kg YSE is effective in reducing fecal odour in dogs receiving diets with 34% of CP. Regardless of the protein content, YSE reduces fecal ammonia, but may cause adverse effects if included at higher doses., (© 2016 Japanese Society of Animal Science.)

This study evaluated the effects of adding an acidifying agent based on phosphoric acid (A), a yeast extract from a specific strain (Saccharomyces cerevisiae) (Y) and the combination of these two additives in food for adult cats. A test was conducted with 24 animals (mean 3.5 years old), mixed breed, weighing 3.72 ± 0.74 kg, kept in individual metabolic cages and distributed in a completely randomized design with a 2 × 2 factorial design (with or without A 0.6% of dry matter, with or without Y 1.5% of dry matter) totalling four treatments and six replicates of each condition. The experimental period was 15 days. The A or the Y reduced (P< 0.01) the dry matter intake, but the effect was not observed when they were associated. The association improved (P<0.05) the digestibility of dry matter and ashes. The A reduced urine pH (P=0.05) regardless of the presence of the Y. There was no effect (P>0.09) on other parameters evaluated. Results of this study show that the isolated use of 0.6% A or 1.5% Y in diets for cats is not recommended. However, the association of these two additives was beneficial in increasing nutrient digestibility., (© 2014 Japanese Society of Animal Science.)