South Sudan Medical Journal <p>The SSMJ is the a multi-professional journal in the South Sudan which caters for the needs of Doctors, Nurses, Midwives, Clinical Officers, Pharmacists and all other cadres in the health profession. Its vision is to see a well-trained, skilled professionals delivering high quality healthcare to the population of the South Sudan.</p> <p>The mission of SSMJ is to publish research and clinical guidance that will positively influence the development of healthcare services in South Sudan.</p> <p>Other websites associated with this journal:&nbsp;<a title="" href="" target="_blank" rel="noopener"></a></p> en-US The copyright belongs to The South Sudan Doctors Association (Publisher). (Edward Eremugo Luka (Dr.)) (Dr. Wani Mena (Associate Editor)) Tue, 30 Mar 2021 16:54:57 +0000 OJS 60 COVID-19 clinical presentations: the modern mimic of other conditions <p>The coronavirus pandemic (COVID-19) has placed enormous challenges on the health sector. Diagnosis is one of these challenges, where a clinical presentation may suggest a disease other than COVID-19. In this review we describe many presentations unrelated to the respiratory system. The ACE2 receptor is present in a wide variety of body tissues and it appears that this may be a link with the clinical pathology. To find these data we searched the major academic research engines, Google Scholar, and Pubmed, as well as the most recent case reports and original research published in specialized journals. An awareness of these uncommon presentations helps health workers to recognize and treat the disease early and appropriately.</p> <p><strong>Keywords</strong>: COVID-19, coronavirus, pandemic, ACE2, unusual symptoms, review </p> Mohamed Eltayieb Elawad, Abrar Bakry Elmalik, Doaa Mohamed Ahmed Hassan, Fatima Salaheldin Ibrahim Mohammed, Onaisa Hassan Kabroun Idris, Nasreen Sulaiman Omar Abdulaziz, Ibrahim A. Ali Copyright (c) Tue, 30 Mar 2021 00:00:00 +0000 How to screen a paediatric elbow X-ray for injuries <p>Elbow injuries are common in the paediatric population. Diagnosing these injuries relies on X-rays taken on initial presentation in the emergency department. Interpreting these radiographs can occasionally be challenging, partly because of the sequential appearance of secondary ossification centres in the paediatric elbow. We propose a methodical approach that would help a clinician identify these injuries, especially the radiographically subtle ones. Evaluating these X-rays should start with a lateral view which identifies the majority of elbow injuries. Anterior cortical disruption, fat pad sign, and the anterior humeral line can be evaluated on this view, and if present, alerts the clinician to a possible subtle fracture. On this view also, the clinician can evaluate the radio-capitellar line and then proceed to evaluate it again on the anteroposterior view. With this approach almost all fractures and dislocations around the elbow can be identified.</p> <p><strong>Keywords</strong>: Humeral supracondylar fractures, elbow, anterior cortical disruption, anterior humeral line, fat pad, radio-capitellar line </p> Brian Madison, Patrick Tshizubu Copyright (c) Tue, 30 Mar 2021 00:00:00 +0000 Antimicrobial stewardship - what is possible <p>Antimicrobial drugs are the basis of modern medicine, saving lives and allowing surgery and chemotherapy to be possible.&nbsp; Inappropriate use of antimicrobials has led to resistance, meaning we can no longer rely on them being effective. This is further complicated by a lack of new drugs coming to market. Antimicrobial resistance is a well-documented global problem and threatens low and middle-income countries (LMIC) disproportionately. A “One Health” approach is needed, tackling antimicrobial use inhuman, veterinary, agriculture and environmental sectors. Many health professionals are aware of antimicrobial resistance but struggle to know how to change their practice safely. Here, the author reports on her experience as an antimicrobial pharmacist at Betsi Cadwaladr University Health Board (BCUHB) in Wales and observing practices in Eswatini. BCUHB used various strategies and tools to support prescribers to change prescribing practice. Some of these tools were specifically aimed at primary care prescribers. Similar tools could be developed to support prescribers in LMIC. Antimicrobial resistance cannot be ignored and action is needed now.</p> <p><strong>Keywords</strong>: Antimicrobial Stewardship (AMS), Antimicrobial Resistance (AMR), antibiotics, low and middle-income countries (LMIC),&nbsp; primary care </p> Pauline Roberts Copyright (c) Tue, 30 Mar 2021 00:00:00 +0000 South Sudan should mask up while waiting for COVID-19 vaccines <p>No Abstract.</p> Edward Eremugo Kenyi Copyright (c) Tue, 30 Mar 2021 00:00:00 +0000 A living WHO guideline on drugs for COVID-19 <p>No Abstract.</p> Edward Eremugo Luka Copyright (c) Tue, 30 Mar 2021 00:00:00 +0000 Preparing for MRCP UK examinations for International Medical Graduates (IMGs) <p>The MRCP UK examination is one of the most difficult for UK graduates. International Medical Graduates (IMGs) will find it even harder&nbsp; for a variety of reasons. I moved to the UK in 2010 after leaving an international public health career. Travelling from one country to another with a family had become difficult. After GMC registration in 2011, I worked for three years as a foundation doctor followed by being a locum. In August 2014, I secured a permanent non-training post as a Clinical Fellow in Medicine of the Elderly at the Royal Infirmary of Edinburgh. I started preparing for the MRCP UK examinations in 2016 and completed all three examinations by October 2018. This article is a reflection of my personal experience navigating through these examinations written with the intention of sharing helpful information with fellow IMGs aspiring to succeed in the MRCP UK examinations.</p> <p><strong>Key words</strong>: International Medical Graduates, MRCP UK examinations, Practical Assessment of Clinical Examination Skills (PACES),&nbsp; examination preparation, feedback. </p> Zerihun Demissie Tefera Copyright (c) Tue, 30 Mar 2021 00:00:00 +0000 Anaesthetic management of a patient with morbid obesity: case report <p>The purpose of this case report is to describe our experience of the anaesthetic management of a patient with morbid obesity&nbsp; undergoing general surgery. The obese patient is at great risk of problems with endotracheal intubation and developing peri-operative respiratory and cardiovascular complications. The difficulties in moving and positioning the patient and gaining venous access add to the problems. Anaesthesia and surgery on an obese patient should not be undertaken lightly without a full understanding of the potential problems.</p> <p><strong>Keywords</strong>: obesity; morbid obesity; body mass index (BMI); ideal body weight (IBW); peri-operative management; Botswana.</p> Arop M.D. Kual, Nkhabe Chinyepi, Katlo Rainy Diane, Karabo Ngwako, Rashid Lwango Copyright (c) Tue, 30 Mar 2021 00:00:00 +0000 Needle-like subtarsal foreign body in a patient with no history of injury: case report <p>Subtarsal foreign bodies (FB) are a significant cause of ocular discomfort and are often missed on slit lamp examination of the everted upper eye lid. We report a patient with a needle-like subtarsal FB which was missed on repeated examinations over a three-month period. Staining with fluorescein and observation of scratch marks on epithelial surface of the cornea can give a clue to the presence of such a FB.</p> <p><strong>Key words</strong>: Subtarsal foreign bodies, ocular morbidity, fluorescein staining, case report</p> Wani G. Mena Copyright (c) Tue, 30 Mar 2021 00:00:00 +0000