Browsing by Author "Girma Yonas"

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    Comparison of Modified Papanicolaou and Dane-Herman Stain with Routine Hematoxylin and Eosin Stain for Demonstration of Keratin in Tissue Sections
    (Addis Ababa University, 2019-04) Sori Moti; Bekuretsion Yonas; Girma Yonas
    Background: Keratins are intermediate filament forming proteins with specific physicochemical properties produced in any vertebrate epithelia. Having characteristic findings in many epithelial pathologies made them diagnostically important marker. Hematoxylin and Eosin(HE) stain, the routine dye, does not distinguish different eosinophilic components of connective tissue distinctly. On the other hand, special stains like modified Papanicolaou( Mod Pap) and Dane-Herman(D-H) stain can prove to be a simple solution to detect the presence and pattern of keratin histologically. Objectives: To compare modified Papanicolaou stain and Dane Herman stain with routine Hematoxylin and Eosin Stain for demonstration of keratin and also there basic staining characteristics on paraffin blocks tissue sections. Methodology: A total of 116 Formalin-Fixed Paraffin-Embedded(FFPE) tissue blocks were taken of known keratin containing tissue which included Squamous Cell Carcinoma(SCC), Squamous Papilloma, Verrucous Carcinoma and Odontogenic Keratocyst. The tissue blocks were retrieved from the archive of Tikur Anbessa Specialized Hospital(TASH), Department of Pathology. Three sections of 4µm thick tissue from each paraffin block were made and stained with HE, Mod PAP and D-H stains. Then the three stains were evaluated for Nuclear stain(NS), Cytoplasmic stain(CS), Uniformity of staining(US), Background stain(BS) and Keratin pattern(KP) by two pathologists. Finally, the third Senior pathologist was used as a tie breaker. Result: Mod PAP showed agreement with HE by showing Mc Nemar’s P value of 0.219 for NS, 0.727 for CS, 0.851 for US, 0.824 for BS and 1.00 for KP. Whereas D-H showed disagreement with HE for the first four parameters(P=0.000). But D-H showed agreement for KP. Thus, these results show that keratin was stained by D-H, Mod PAP and HE stains distinctly. Mod PAP stain showed similar result when compared with HE stain with parameters-NS, CS, US and BS. However, D-H stain showed statistically significant difference when crosschecked with HE stains. Special stains agreement were analyzed using McNemar as a statistical data tool, P< 0.05 were considered statistically significant. Conclusion: Mod PAP and D-H stains showed similar result for staining of keratin compared to HE stain. For the other four parameters Mod PAP showed an excellent result but not D-H.
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    Evaluation of Fine Needle Aspiration Cytology in Primary Soft Tissue Tumors with its Histopathological Correlation in Tikur Anbessa Specialized Hospital Addis Ababa, Ethiopia: A Five Year Retrospective Study from July 2016 to July 2021.
    (Addis Ababa University, 2021-10) Birhanu Tadele; Girma Yonas
    Soft tissue tumors constitute a large and heterogeneous group of neoplasms. Benign tumors out number their malignant counterparts by a ratio of about 100:1 in hospital population. FNAC has emerged as a major outpatient procedure for the diagnosis of soft tissue tumors due to low cost of the procedure, less complications, feasibility, quick results and high therapeutic efficiency with specificity and sensitivity of approximately 95%. The diagnostic accuracy of FNAC of soft tissue tumors in distinguishing benign and malignant lesion is also very high. The objectives of this study will be to study the role of FNAC in the diagnosis of soft tissue tumors and its correlation with histopathology. Also, this study aimed at studying various cytomorphological patterns of soft tissue tumors and correlating cytological grading with histopathological grading. The aim of this study is to determine the role of fine needle aspiration cytology in softtissue tumors and its histopathological correlation in Tikur Anbessa Specialized Hospital. The study applies retrospective cross-sectional descriptive method to review the role of fine needle aspiration cytology in soft tissue tumors and its histopathological correlation in the five years period (July 2016 to July 2021).The data is collected from the pathology data archives and data analysis will be done by Using IBM SPSS 25.0.Both FNAC and biopsy done for soft tissue tumors are more common in males than females and for malignant tumors than benign tumors. The most common age at which both FNAC and biopsy done is from 2nd to 4th decade for benign soft tissue tumors and from 2nd to 6th decade for malignant soft tissue tumors. The commonest site for both benign and malignant soft tissue tumors were lower extremities followed by trunk and upper extremities. The commonest soft tissue tumors for which both FNAC and biopsy done were under spindle cell, adipocytic and small round blue cell tumor categories. Out of total of 34 sarcomas majority are grade 3 followed by 1 and most are under the group of small round blue cell sarcoma and spindle cell sarcomas. The diagnostic accuracy of FNAC of soft tissue tumors is about 81.08%. Majority of discordant rate was found to be under a group of spindle cell tumor. Excisional biopsy was recommended for majority of soft tissue tumors after FNAC especially for malignant soft tissue tumors.In this study soft tissue tumors are more common in males than females and the peak age at presentation was from 10 to 29 years. The top three commonest location of soft tissue tumors were lower extremities, trunk and head and neck regions. Malignant tumors outnumbered benign tumors and the commonest soft tissue tumors were grouped under spindle cell, adipocytic and small round blue cell tumors. The majority of soft tissue tumor cytological diagnosis was a group diagnosis not specific diagnosis for which excisional biopsy was recommended. The majority of soft tissue sarcomas were high grade which has high concordance rate with histopathological grading. In general FNA cytology was found to be fairly reliable diagnostic procedure for early diagnosis of soft tissue tumors
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    Histopathologic Patterns of Uterine Corpus Neoplasms in in a Tertiary Level Teaching Hospital,CHS,Tikur Anbessa Specialized Hospital, AAU, Addis Ababa, Ethiopia, a Retrospective Study over a 5 year period, August ,2016-2020.
    (Addis Ababa University, 2020-10) Teshome Hiwot; Girma Yonas
    Background: Malignant Uterine corpus tumors (UCT ) are increasing in alarming rate throughout the word. Even if most common of this endometrial carcinoma; is prevalent in western & high income countries ,due to change in life style, increasing obesity, metabolic syndrome and exogenous hormone use its incidence is raising in middle income & developing nations. Many studies of large series has been conducted worldwide on uterine corpus tumors. However, in Ethiopia, epidemiological analysis of these tumors are very scarce. The present paper is a retrospective study of 1126 cases of uterine corpus lesions from a single institution, in Addis Ababa University, TASH. According to global cancer observatory estimate in2018 there were total 67,573 new cancer cases, and 47,954 deaths in Ethiopia. Out of this corpus uterine contributes 762 new cases (1.13%) and 404 deaths( 0.08) And Addis Ababa Cancer Registry 2015 report had estimated 961 new cases of uterine cancer ranked 9th commonest cancer among women; with ASIR OF 3.2% and CIR 1.9 %. Objectives: The aim of this study is to determine histopathologic patterns of uterine corpus lesions and their frequency .in Tikur Anbessa Specialized Hospital. Methods and materials: A retrospective analysis of histopathological pattern of Uterine corpus tumors was carried out in the Department of Pathology, college of health sciences, Tikur Anbessa Specialized Referral Hospital (TAH), Addis Ababa university , Addis Ababa, Ethiopia. Patients data was retrieved from the archives of the department of Pathology for a period of 5 years from August 2016-2020 and analyzed using spss version 26. Result: Out of 1126 cases ,benign lesions accounted 88.4% and the rest 11.6% are malignant lesion .Leiomyoma is most frequent benign lesions. with peak age b/n 31-40yrs.and cellular leiomyoma is commonest histologic type. From malignant lesions ,epithelial origin is the most frequent accounting 55% followed by MMMT (13%), Leiomyosarcoma (9.2%), ESS ,choriocarcinoma, Invasive mole each contribute ( 6.9%).other sarcoma’s group; one rhabdomyosarcoma & two undifferentiated pleomorphic sarcoma total 3 cases (2.3%) is found. Endometroid carcinoma is most common endometrial carcinoma type. Mean age of occurrence for endometrial carcinoma is younger than endometrial sarcomas. Conclusion: In this study benign neoplasms are way more prevalent than malignant lesions,but for age above 50 yr malignancy appeared to be a common cause of uterine bleeding. Both benign & malignant lesions have common clinical presentation majority having AUB ,b/s of this histopathology remains the mainstay of final and definitive diagnosis.
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    Histopathologic Patters of Liver Diseases: a Five Year Retrospective Study in Tertiary Level Teaching Hospital, Tikur Anbessa Specialized Hospital, Ethiopia.
    (Addis Ababa University, 2020-12) Shitahun Mengistu; Girma Yonas
    Introduction: Liver diseases account for a significant number of morbidity and mortality worldwide being affected by a wide spectrum of various primary and secondary diseases. The major primary diseases of the liver are viral hepatitis, nonalcoholic fatty liver disease (NAFLD), alcoholic liver disease, and hepatocellular carcinoma (HCC). Distinguishing among them can be challenging, but the distinction is critically important given the differing prognostic and therapeutic implications. These diseases can be diagnosed with the help of clinical, biochemical or radiological examinations. However, liver histopathology remains the mainstay in diagnosis as well as management of various liver diseases. Objectives: The aim of this study was to assess histopathologic patterns of liver diseases Methods and Materials: A retrospective descriptive histopathological analysis of histopathological pattern of liver disease was carried out in the Postgraduate Department of Pathology, college of health sciences, Tikur Anbessa Specialized Referral Hospital (TAH), Addis Ababa, Ethiopia. Patients data was retrieved from the archives of the department of Pathology for a period of 4 years and 8 months from January 2016 to August 2020). Result : In this study a total of 116 cases were included. Of the total cases 60(51.7%) were females and 56(48.3%) were males with female to male ratio of 1.1:1. Most of the ages ranges from 30 to 79 years, which accounts for 86.2% of cases and with mean, standard deviation, lowest and highest age range of 49, 17.97, 6 months and 79 years respectively. The peak age was the 7 decade. Malignant lesions were the most common diagnoses accounted for 56.9%, HCC being the most frequent malignant lesion 19.8% of all cases followed by secondary carcinoma 17.2%, cholangiocarcinoma 6.9%, neuroendocrine tumor 3.4%, secondary high grade sarcoma 2.6%, adenocarcinoma with neuroendocrine differentiation 1.7%, hepatoblastoma 1.7%, malignant undifferentiated tumor 0.9 %, lymphoma 0.9%, secondary epitheloid GIST 0.9% and suspicious for malignancy 0.9% in decreasing frequency. HCC was more common in males with male to female ratio of 2.8 : 1. Almost all benign liver lesions were found in females with female to male ratio of 12 : 1. Hemangioma was the most common benign neoplastic lesion accounting for 7.8% followed by benign liver cyst 1.7% and FNH 0.95%. TB was most common non neoplastic lesion 3.4%. And the remaining histologic patterns included hydatid cyst 3(2.6%), abscess 2(1.7%), seatosis/fatty change 2(1.7%), cirrhosis 1(0.9%), biliary atresia with cirrhosis 1(0.9 %), chronic active hepatitis 1(0.9%), acute alcoholic hepatitis 1(0.9%), acute complete intrahepatic cholestasis with ascending cholangitis + stage 3 fibrosis 1(0.9%), chronic nonspecific inflammation of the cyst wall 1(0.9%), non diagnostic 1( 0.9%) and 3(2.6%) of cases were reported as normal histology. 13.8% of cases were descriptive reports. Conclusion : HCC is the most common liver lesion and most common malignant histopathologic diagnosis in this study which agrees to some studies in India. In most African studies infectious and inflammatory lesions are the most common. The diagnoses of malignant lesions in this study were at later ages than most of other studies. Hemangioma was significant in amount.
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    Histopathological Pattern of Central Nervous System Tumors:A 5-Year Retrospective Study, at a Tertiary Hospital in Ethiopia.
    (Addis Ababa University, 2019-10) Assefa Meseret; Girma Yonas
    Introduction: Central nervous system tumors are a heterogeneous group of neoplasms, they differ not only in their histomorphological features but also have a distinct biological background and disease course. CNS tumors are confined to the brain, spinal cord, meninges, cranial and Para spinal nerves, with each tumor having its own features, location, morphology, prognosis and treatment. Objective:The purpose of this study is to provide the histopathological pattern of CNS tumors in a tertiary care center in Ethiopia. Material and method: A retrospective descriptive histopathological analysis of central nervous system tumors carried out in the Postgraduate Department of Pathology in Tikur Anbessa Specialized Referral Hospital (TAH), Addis Ababa, Ethiopia. Patients data were retrieved from the archives of the department of Pathology for a period of 5 years from January 01, 2015 to August 31, 2019. Result:A total of 565 cases were analyzed and a wide range of histopathological diagnosis of CNS tumors was observed. Patients ages ranged from 2minths-80 years with a mean age of 36.9 years and a male to female ratio of 1:1.11. Majority of tumors had intracranial location (499 cases, 88.3%).Most of CNS tumors were low grade belonged to Grade I 70% followed by grade II 14. 8%. Tumors of meningeal tissue were most common 51.9% followed by neuroepithelial 24.2 %. When examining the data pertaining to specific types of tumors, most frequent typeofCNS tumorswasmeningioma(272 cases, 48.1 followed by astrocytoma (86 cases,15.2%) Conclusion: The present study thus reflects the histopathological patterns of CNS tumors from our center. Although there is availability of advanced imaging techniques at present, still histopathological examination is gold standard in their diagnosis.The conventional H & E staining is the mainstay for pathologic diagnosis, and IHC also plays a major role in differential diagnosis and improving diagnostic accuracy.
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    On Saving and Credit Cooperatives’ Outreach The Effects of Governance : The Case of Addis Ababa Saving and Credit Cooperatives
    (A.A.U, 2021-06) Girma Yonas; Abite Asres
    Saving and credit cooperatives has been growingly playing essential role enhancing the welfare of the society during the last few decades. Despite their great contribution, they are facing several challenges that typically emanates from their organizational and governance problems. Consequently, many studies have been undertaken on saving and credit cooperatives that targeted to examine the nature and consequences of their governance. However, many of them have approached the subject focused on the relationship between an aspect of governance and a chosen measure of performance. This partly has led to quite huge lack of consistency in the research outcomes pertaining to the essential nature of the relationship between governance and performance of saving and credit cooperatives. The purpose of this research is to underline the true nature of the relationship between governance and outreach of saving and credit cooperatives in Addis Ababa. Explanatory research approach is employed, and mainly secondary data are used with supplementary primary information. The study used a panel data framework that pools observations on cross-section of units over the last three years periods (2017/18 to 1019/20). The unit of analysis are 232 currently operational primary saving and credit cooperatives that are enrolled under Addis Ababa saving and credit union. Samples of 60 units are randomly taken and primary data are collected using self-administered semi structured questioner and secondary data are collected using documents review. The research statistically examined whether the data met the underlying assumptions of ordinary least square method. Then Pearson correlation analysis has been carried out to examine the net effects of each explanatory variable over the response variables. Finally, the nature and magnitude of the relationship between governance and outreach is underlined through the analysis of the joint effects of the explanatory variables on the response variables using multiple regression technique. The study has found that the independent variables board competency, board meeting frequency, and internal control mechanism have strong positive effects on outreach of SCCO both in terms of the number of clients served and the average loan size. It has also found that weak positive association exists between the explanatory variables board size, board diversity, and incentive mechanism with the response variables number of borrowers and the average loan size.
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    Tuberculosis Lymphadenitis Among HIV-Positive Individuals and its Correlation to CD4 Count, Cytomorphological Pattern and Clinical Diagnosis in Mekell University Ayder Comprehensive Specialized Referral Hospital
    (Addis Ababa University, 2020-05) Alemseged Kesete; Girma Yonas
    Background: Tuberculosis is the second leading cause of death from infectious disease globally with its impact more dramatic in resource limited settings. Individuals with human immunodeficiency virus infection who also develop tuberculosis represent a significant challenge to TB control. HIV not only increases the number of TB cases, but also alters the clinical course of TB disease. As HIV related immunosuppression increases, the clinical pattern of TB changes, with increasing numbers of smear-negative and extrapulmonary cases. Lymphadenopathy is one of the most common manifestations at any stage of HIV/AIDS with different underlying pathogenesis. Tuberculous Lymphadenitis is the most common form of extrapulmonary TB and typically presents with asymmetric involvement of multiple nodes 1 cm or larger in size. Cervical and axillary nodes are most frequently affected.CD4 T cells play central roles in the function of the immune system and are important mediators of immunologic memory, Objective: the objective of this study is to determine the prevalence of tuberculosis lymphadenitis infection among HIV/AIDS positive patients and its correlation to CD4-count, morphological patterns and clinical Diagnosis. Method: A cross sectional study design was conducted from January 10/2019 to July 10/2019. A total of 90 HIV positive patients who develop lymph node were enrolled into the study by contacting the patients during their visit to the ART clinic. Socio -demographic characteristics and other variables were collected using a pretested semi-structured questionnaire. Detailed clinical history and laboratory investigations were considered in all patients. The statistical software and methods including the level of statistical significance were explained and employed for data analysis and interpretation. The results were then analyzed statistically using the statistical package for social sciences (SPSS) version 23 for Windows. Result: Maximum number of tuberculosis lymphadenitis is seen in the age group of 21-30 years followed by age group of 31-42 and with a decreasing trend in elderly. There was a female preponderance of cases. Most cases of Tuberculosis lymphadenitis emerged as the 2nd most frequent Cytomorphological pattern of diagnosis next to reactive lymphoid hyperplasia to be associated with HIV infection With the typical caseous necrosis and Epitheloid granuloma.CD4 count <200/mm3 and WHO Severe clinical stage of the disease were found to be predictors of tuberculosis lymphadenitis and cervical and axillary group of lymph node were found to be the most involved site. Finally Tuberculosis lymphadenitis is over diagnosed clinically compared to Cyto-morphological Diagnosis. Conclusion; Caseous necrosis and Epitheloid granuloma were leading causes of Tuberculosis lymphadenitis .CD4 count <200/mm3 and Sever clinical stage (stage IV) of the disease were found to be predictors of tuberculosis lymphadenitis. So initiation of Anti-retroviral treatment before the CD4 count drops below 350 /mm3 should be encouraged and intervention aimed atpreventing and treating HIV Associated tuberculosis lymphadenitis is crucial.The cervical and auxiliary region was found to be the most involved site respectively and Tuberculosis lymphadenitis is over diagnosed in clinical Diagnosis compare to Cytomorphological Diagnosis suggesting the need of diagnostic test(s) like cytomorphological examination to supplement the clinical examinations. Recommendation: cytologic examination of fine needle aspirates should be included in the diagnostic work-up of any patient suspected for TBLN in health institutions with limited laboratory capacity like regional or district Hospitals. Intervention aimed at preventing and treating HIV associated Tuberculosis lymphadenitis are crucial. High quality services should provide by incorporating an efficient quality control system and a molecular technique that detects DNA sequences specific for Mycobacterium tuberculosis by polymerase chain reaction can be used as screening test. In addition since culture is considered as golden standard emphasis should be given in detection of mycobacterium tuberculosis from lymph node aspiration.