Browsing by Author "Gulilat Amare"

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    Assessment of the Diagnosis, Follow-up and Treatment Outcomes in Patients with Hyperthyroidism at Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia
    (Addis Abeba University, 2021-05) Gulilat Amare; Tarekegn Getahun
    Background:Hyperthyroidism is a disease condition characterized by increased synthesis and secretion of thyroid hormone by the thyroid gland. A diagnosis of hyperthyroidism is made based on clinical presentation and abnormality in TFT characterized by low level of TSH and elevated thyroid hormones Diagno singthedifferentformsofhyperthyroidismbasedonclinical manifestations andTFT alone is challenging. Objective :To assess the diagnosis, followup and treatmentoutcomesin patients with hyperthyroidism at Endocrine Clinic, TASH. Methods A retrospective follow-up study was employed to evaluate the diagnosis, follow-up and treatmentoutcomes of patients with hyperthyroidism at Endocrine Clinic, TASH. A census was performedto those patients who were aged 18 years and above, diagnosed to have hyperthyroidism onAntithyroid drug for more than 18 months on follow up from September 2009 to August 2012 E.C,excluding pregnant women. Patients’ response to different treatment options were evaluated. Also,factors associated with treatment outcomes were identifiedWhile descriptive statistics (mean,proportion, percentage and standard Deviations) were used to summarize the results, multivariatelogistic regression and chi square test were used as appropriate to check the association betweendependent and independent variables. Statistical significance was determined at a p value of < 0.05and CI of 95%. Results In this study, a total of 230 patients with hyperthyroidism were involved, of which 208[ 90.4%] ofthem were female and 22[ 9.6%] were male. The female to male ratio was 9.4 to 1. The mean ageof the participants was 44 years +/-13 SD. In about 60 % of patients the duration of diagnosis ofhyperthyroidism was less than 04 years. The most common symptom and sign were palpitationand goiter accounting [89.6%] and [78.2%] respectively. Significant association was found with therapy and duration of treatments. Those patients who hadbeen following treatment for four years and above, were more likely to have improved outcome compared to those who were following their treatment for less than four year (AOR=2.869,CI=1.173-7.0211, p=0.021). In addition, those patients who were on initial combination therapy(Beta adrenergic blocker + ATD) were 2.189 times highly likely to have improved outcomescompared to those who took single therapy (ATD or Beta-adrenergic blocker) (AOR=2.189,CI=1.144-4.187, p=0.018). ConclusionsIn this study, the most common cause of hyperthyroidism was TMNG and Treatment outcome was strongly associated with duration of hyperthyroidism and initial usage of combinationtherapy.
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    Self-Identification and Management of Hypoglycemia Symptoms among Insulin or Sulphonylurea Treated Diabetic Patients Holding a Valid Driving License; A Multicentre KAP Survey.
    (Addis Abeba University, 2021-07) Alachew Kalkidan; Demssie Yared; KebedeTedla; Tarekegn Getahun; Gulilat Amare; Guta Tsega
    Background- Diabetic patients on sulphonylureas and insulin are at higher risk of hypoglycemic events. The body’s response to hypoglycemia include neuroglycopenic symptoms which can affect the capacity of the individual to operate motor vehicles. The level of knowledge about the dangers of driving in relation to hypoglycemia and the appropriate way to manage it among diabetic patients in Ethiopia is not known Objective-This survey aims to investigate the knowledge, attitude and practice of insulin/sulphonyl urea treated diabetic patients in relation to identifying and managing symptoms of hypoglycemia Method-This is a multicenter KAP survey which will use data collected from 100 completed questionnaires from two different centers between September 2020 and March 2021. The result will be analyzed and reported as proportions for each item in the questionnaire and comparison between the groups will be made using the Chi-square test using SPSS version 21.A P value of <0.05 will be used for statistical significance Results-Among 106 participants, less than half (49%) identified more than half of the hypoglycemia symptoms, with only 6% knowing all of the symptoms listed in the questionnaire. Regarding having experienced hypoglycemia symptoms while driving,23( 22% )said they did, with the majority of these still not carrying glucometer while driving(78%) and never checking blood sugar before driving ( 81%). An equal percentage said they always carry hypoglycemia treatment in the car when driving andnever ( 48% Vs 41%). Having had previous hypoglycemia while driving was associatedwith more people carrying some form of treatment in the car ( p-<0.01). The majority of participants ( 65%) said they'd stop, eat some food or have a sugary drink and then rest for at least half an hour before driving again if they experienced hypoglycemia while driving. More than half of the participants ( 54%)have never received any advice on hypoglycemia and driving despite holding a valid driving license. Conclusion-There is a wide gap in knowledge and practice when it comes to preventing and treating hypoglycemia among diabetic patients getting care both in private and government hospitals .Frequent and adequate education on the risks associated with hypoglycemia while driving could improve the practices and should be given to all patient attending diabetic clinics. In the future, the motor vehicle driving licensing authority should mandate evidence of awareness of hypoglycemia and effective measures to mitigate the risk related to driving as a necessary requirement for renewal of licenses. should also mandate evidence that proper education has been received inthese patients before renewal of their licenses