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Background Oxygen is an essential drug that is commonly used in clinical practice, and its misadministration can result in severe consequences. This research sought to evaluate the knowledge and perceptions of physicians and nurses regarding acute oxygen therapy and delivery barriers. Methodology This was a cross-sectional hospital-based survey. The study was conducted at Managil Teaching Hospital, Sudan. The study included 159 physicians and 25 nurses who were working at the hospital during the study period. The previously validated acute oxygen therapy questionnaire (AOTQ) was used to assess knowledge and barriers regarding acute oxygen therapy (AOT). The collected data were then analysed via R software. Results A total of 184 medical professionals were included in the survey. The mean age of the study participants was 26 years, and 66.2% of all participants were male. A total of 74% of the physicians were junior physicians. Among the physicians, 15 (9.4%) had good knowledge (score > 80%), 75 (47.2%) had moderate knowledge (score > 60% & less than 80%), and 69 (43.4%) had poor knowledge about acute oxygen therapy (score < 60%). Among the nurses, 2 (8%) had good knowledge, 10 (40%) had moderate knowledge, and 13 (52%) had poor knowledge. Most of them were from medical departments, with 33% from physicians and 40% from nurses. Approximately 64% of the physicians and 68% of the nurses stated that oxygen is not a medication rather than a supportive therapy, and only 13% of the physicians and 28% of the nurses knew that oxygen should be given only after the doctor’s prescription. The availability of oxygen was reported as a barrier by 85% of the physicians and 72% of the nurses. Conclusion A considerable percentage of physicians and nurses exhibited a limited understanding of acute oxygen therapy, demonstrated infrequent adherence to AOT guidelines due to a lack of awareness, and reported germane barriers to delivery that necessitate administrative and educational interventions.

Key Clinical Message Trichobezoar is the pathological formation of a hair mass within the gastrointestinal tract, usually correlated with psychiatric conditions like trichotillomania and trichophagia. Intestinal obstruction represents a significant potential complication. Trichobezoar should be included in the differential diagnosis for young females exhibiting nonspecific gastrointestinal symptoms accompanied by abnormal psychiatric behavior.

Background Effective discharge documentation is essential for ensuring patient safety, care continuity, and communication among healthcare providers. However, in resource-limited settings like Sudan, documentation quality is often suboptimal, leading to gaps in care and poor patient outcomes. This quality improvement project (QIP) at Dongola Specialized Hospital aimed to address these challenges by implementing a standardized discharge card and providing targeted staff training. Methods  The study was conducted over two cycles, with data collected from 50 discharge cards in each cycle, selected using a simple randomization technique. The first cycle assessed baseline documentation practices, revealing significant inconsistencies. A standardized discharge card was then developed and implemented, accompanied by training sessions for healthcare providers. The second cycle evaluated the intervention's effectiveness, measuring compliance and completeness of patient information (e.g., clinical summaries, discharge plans, and medication lists). Feedback from healthcare providers and patients was also collected to assess the new system's impact. Results The intervention led to significant improvements in discharge documentation quality. Compliance with the new format increased from 66% in the first cycle to 92% in the second cycle. Completeness of patient information reached 100%, while clinical summaries and discharge plans improved by 40% and 30%, respectively. Medication list accuracy also increased to 88%. Preliminary data indicated a 15% reduction in readmission rates, attributed to clearer postdischarge instructions. However, challenges such as incomplete documentation in certain sections and time constraints for healthcare providers remained. Conclusion The implementation of a standardized discharge card significantly improved the quality of discharge documentation at Dongola Specialized Hospital, contributing to better patient outcomes and reduced readmission rates. The findings highlight the importance of structured documentation and regular audits in enhancing patient safety and care continuity, particularly in resource-limited settings. Ongoing efforts are needed to address remaining challenges, such as incomplete documentation and time constraints, to ensure sustained improvements in the discharge process. This study serves as a model for similar healthcare facilities aiming to improve documentation practices and patient care.

 Arterial blood gas (ABG) analysis is a critical diagnostic tool used in emergency and intensive care settings to assess a patient's acid-base balance, ventilation, and oxygenation. Despite its importance, ABG interpretation remains challenging for junior doctors, particularly when dealing with complex cases involving mixed respiratory and metabolic disturbances. This clinical audit was conducted to evaluate the baseline competency of junior doctors in ABG interpretation and to measure the impact of targeted educational interventions.  Aim: This study aims to evaluate the baseline knowledge of junior doctors in ABG interpretation and to assess the impact of targeted educational interventions on improving their interpretation skills.  A prospective, two-cycle clinical audit was conducted at Dongola Teaching Hospital in Northern Sudan, involving 110 questionnaires, 55 in each cycle. The first cycle served as a baseline assessment using structured clinical scenarios based on American Thoracic Society (ATS) guidelines. After identifying deficiencies, educational interventions were implemented over a two-week period. These included focused lectures, visual posters, and small-group case discussions. The second cycle reassessed the same parameters using a revised version of the questionnaire to reduce recall bias. Data were analyzed using SPSS version 25, and statistical significance was evaluated using the chi-square test with p < 0.05 considered significant.  Results: Significant improvements were observed in most key areas of ABG interpretation. The ability to assess compensation improved from 23 (42%) to 40 (72%) (p = 0.002), identifying respiratory vs. metabolic origin increased from 37 (68%) to 50 (90%) (p = 0.005), and detection of mixed acid-base disorders rose from 30 (54%) to 43 (78%) (p = 0.015). The calculation of anion gap improved from 35 (64%) to 47 (86%) (p = 0.009), and basic interpretation of pH disturbances increased from 41 (74%) to 48 (88%) (p = 0.15). Although some gains were not statistically significant, all areas demonstrated clinical relevance and educational benefit.  The findings demonstrate that structured educational interventions can significantly enhance ABG interpretation skills among junior doctors, particularly in resource-limited settings. This audit supports the integration of focused, practical ABG training into routine junior doctor education and highlights the importance of ongoing assessment through audit cycles. Wider adoption of such strategies may contribute to improved diagnostic accuracy, timely interventions, and better patient outcomes.

Clinical notes are essential for patient care, guiding treatment decisions, and supporting research. This study explores how structured documentation impacts the quality of clinical notes in resource-limited settings like Sudan. This retrospective-prospective clinical audit was conducted in the Internal Medicine Department at Dongola Specialised Hospital. A checklist, developed using the National Institute for Health and Care Excellence (NICE) guidelines, assessed 10 key documentation areas, including patient history, vital signs, and management plans. Data from 50 randomly selected clinical notes were analyzed for each of two audit cycles: July 2024 (retrospective) and September 2024 (prospective, following the implementation of a structured template and staff training). Statistical analysis was employed to evaluate compliance improvements across cycles. Compliance improved significantly from 31.1% in the first cycle to 84.9% in the second. Specific improvements included chief complaint documentation (22% to 92%), current medications (18% to 86%), and lab results (12% to 86%). These findings highlight the positive impact of structured templates and targeted staff training on documentation quality. The study's findings are limited by its small sample size, which may not fully represent the broader patient population. Future research should address this limitation to validate and generalize the results. Implementing a standardized template and training improved the quality of medical documentation at Dongola Specialised Hospital.

Malaria represents a major public health challenge in Sudan. Adherence to national malaria diagnosis and treatment guidelines by healthcare providers is critical for effective disease control, preventing drug resistance, and ensuring optimal patient outcomes. This audit aimed to assess and improve physicians' adherence to malaria guidelines. A two-cycle audit was conducted at Dongola Specialized Hospital, specifically targeting doctors' clinical practices. The first cycle (N=42) assessed baseline adherence among physicians to key standards, including protocol compliance, diagnostic accuracy, and appropriate treatment regimens for various Plasmodium species and patient groups (e.g., severe malaria, malaria in pregnancy). Following this, targeted interventions - such as physician training sessions and dissemination of updated clinical guidelines - were introduced. A second cycle (N=39) was then conducted to re-evaluate doctors' adherence and assess the impact of these interventions. Data were collected on predefined indicators and compared across both cycles. The first cycle identified the areas of low adherence, with general protocol adherence at 13 (30.95%), correct intramuscular (IM) artesunate injection site at 13 (30.95%), and second-line treatment for uncomplicated malaria in pregnancy (MIP) at 10 (23.81%). However, there was high adherence at 38 (90.48%) for the first-line treatment for P. falciparum. The second cycle demonstrated significant improvements across almost all standards. Protocol adherence surged to 35 (89.74%) (a 58.79% improvement), correct IM artesunate site to 31 (79.49%), and second-line treatment for uncomplicated MIP to 25 (64.10%) with 40.29% improvement. Intermittent preventive treatment of MIP with the correct drug sulfadoxine/pyrimethamine also saw a substantial increase to 36 (92.31%) with 49.45% improvement. Adherence to first-line artemether/lumefantrine for P. falciparum was maintained at 100%. The audit findings confirm that the implemented interventions were effective in improving adherence to national malaria diagnosis and treatment guidelines in Sudan. The improvements across critical indicators highlight the importance of continuous training and auditing to improve the quality of malaria management and contribute to better patient outcomes and reduced disease burden in endemic settings.