SSMJ November 2025
Editorials
Postpartum haemorrhage, severe bleeding after childbirth – diagnosed as a blood loss of 500 mL or more – is a leading cause of maternal mortality worldwide, “affects millions of women annually and causes nearly 45,000 deaths.
News, Reports and Policy
The East, Central, and Southern African College of Physicians (ECSACOP) Council, during its meeting held during the 10th annual ECSACOP conference in Mombasa on 28th August 2025, approved the admission of the Physicians’ Association of South Sudan (PASS) as a Member body of ECSACOP. South Sudan became the seventh Member of the College.
Statement on the Position of the Association of Gynecologists and Obstetricians of South Sudan (AGOSS) on the Use of Paracetamol During Pregnancy and Its Linkage with Neurodevelopmental
Disorders Among Children: September 2025
Clinical Guidance
No documents found.
Research
By the beginning of the 20th century, several methods for intestinal suturing had been described, and the essential principles of intestinal anastomosis were firmly established. These principles are: a well-nourished patient with no systemic illness; no faecal or purulent contamination; adequate exposure and access; gentle tissue handling; well-vascularized tissues; absence of tension and distal obstruction; approximation of well-vascularized bowel ends; and meticulous surgical technique.
Two-layered anastomosis consists of an inner layer of continuous or interrupted absorbable sutures and an outer layer of interrupted absorbable or non-absorbable sutures. A one-layer anastomosis consists of a single layer of interrupted or continuous absorbable sutures.
Caring for complicated abdominal wounds is one of the most challenging tasks in the surgical field. Impairment of abdominal wound healing might show up as either spontaneous dehiscence (gapping) or the requirement for reopening. Surgical site infections, along with patient-related variables such as malnourishment, advanced age, and alcohol misuse, frequently result in impaired abdominal wound healing.
Public health in rural areas faces complex challenges that are shaped by the interplay of geography, environmental factors, and sociocultural factors. Limited access to clean, safe water, dependence on contaminated water sources, and poor hygiene and sanitation practices create unique health burdens across different regions of the world. Globally, 80% of rural health issues are water and sanitation-related, with diarrhoea remaining the second leading cause of death in children under five. In the United States, Appalachian coal mining communities were found to have a 30% higher prevalence of chronic respiratory diseases due to coal dust exposure and contaminated water.
Iron is a micronutrient essential for numerous physiological processes, including oxygen transport and cellular metabolism. The lack of iron is associated with impaired cellular metabolic processes and anaemia. Iron deficiency (ID) is common in individuals with chronic heart failure (CHF) and is an independent indicator of poor cardiovascular outcomes.
Innovation is essential for firm survival in low-income countries (LICs). The Oslo Manual defines innovation as “the implementation of a new or significantly improved product (goods or services) or process, a new marketing method, or a new organizational method in business practices, workplace organization, or external relations.” Accepted indicators for innovation include research and development (R&D) investments, patents owned or requested, and scientific publications.
South Sudan records some of the highest under-five mortality rates globally. Contributing factors include malnutrition, infectious diseases (e.g. malaria, pneumonia, and diarrhoea), limited access to quality healthcare, and shortages of trained health personnel. Paediatric death audits (PDA’s) provide information about the causes surrounding child deaths and inform interventions.
The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) define anaemia differently depending on age, sex, and pregnancy status. Anaemia in pregnancy is defined as haemoglobin of less than 11g/dL throughout pregnancy. This may be further divided into mild (10-10.9g/dL), moderate (7-9.9g/dL), and severe anaemia (<7g/dL).
Diabetes mellitus is a chronic and progressive metabolic disorder affecting over 537 million adults globally, and its complications place significant burdens on individuals and healthcare systems. One of the most serious complications is diabetic foot ulcers (DFUs), which are associated with prolonged healing times, infection, amputation, and increased mortality risk. Impaired wound healing in diabetes is multifactorial, involving hyperglycemia-induced neuropathy, vascular insufficiency, and compromised immune response.
Case Reports
Systemic lupus erythematosus (SLE) and antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) are two distinct autoimmune conditions and rarely occur together. Their coexistence can result in potentially fatal complications, especially rapidly progressive glomerulonephritis (RPGN). This disease entity, known as Lupus Nephritis–AAV Overlap Syndrome, was initially defined in 2008. It exhibits overlapping presentations in terms of clinical, pathological, and serological findings.[8-10] The pathogenesis of overlap syndrome remains elusive.
Pseudomonas mendocina is a motile, aerobic, Gram-negative bacillus rarely implicated in human disease. Typically isolated from soil and water, it has emerged as an opportunistic pathogen, with approximately 22 human infections reported worldwide since the first case in Argentina in 1992. Clinical presentations include endocarditis, meningitis, bacteraemia, and soft tissue infections, primarily in immunocompromised individuals.
Summaries
Gender-based violence (GBV) is defined as any act of violence that is inflicted upon an individual because of his or her gender or sexual orientation. It includes different forms of violence, such as physical, sexual, or psychological, and harmful practices, such as child marriage, female genital cutting, sex trafficking, selective abortion, and honour killings.
Intimate partner violence is defined as a pattern of abusive behaviour in an intimate relationship, including marriage, where one person uses to gain or maintain power and control over the other person.
The CAGE questionnaire is widely used for screening alcohol use disorders but may yield misleading results in practicing Muslim communities, where alcohol is religiously prohibited and culturally stigmatized. The four questions focus on Cutting down, Annoyance by criticism, Guilty feeling, and Eye-openers, giving the acronym “CAGE”. Feelings of guilt or the desire to abstain may reflect religious conviction rather than pathological use, risking false-positive diagnoses. This paper explores the cultural limitations of the CAGE among practicing Muslims and highlights the ethical and clinical consequences of its uncritical application.
Tuberculosis (TB) is a major global health issue, affecting an estimated 10.6 million people in 2022, including 1.1 million children under 15 years. Paediatric TB represents a significant burden, especially in high-incidence, low- and middle-income countries (LMICs). However, its detection and management lag behind that of adult TB. Diagnosing TB in children is challenging due to non-specific symptoms, paucibacillary disease, and frequent smear-negative results, leading to under-diagnosis, delayed treatment, and preventable morbidity and mortality.