Browsing by Author "Melka Dereje"

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    Assessment of Sleep Disorder Pattern of Patients with Parkinson Disease Attending Neurology Referral Clinic in Tikur Anbessa Specialized and Zewditu Memorial Hospitals, Addis Ababa, Ethiopia
    (Addis Ababa University, 2015-11) Melka Dereje; Tafesse Abenet
    Background: Parkinson’s disease (PD) is progressive neurodegenerative disorder characterized by abnormal motor symptoms such as bradykinesia, tremor, rigidity, and postural instability.However, the nonmotor symptoms (NMS) of PD, including cognitive impairment, depression,psychosis,& sleep disorders are also important and could have greater significance for disability,decreased quality of life, and reduced lifespan of the patients. Sleep-related problems specific toPD may occur early and even predate the diagnosis of the disease but are generally morefrequent and more severe in patients with advanced PD. Little is known about sleep disorderpattern in people with Parkinson’s disease (PD) in Ethiopia and Africa. Objective: To assess the prevalence of sleep disorder pattern and their associated predictors in PD patients in Tikur Anbessa Specialized Hospital and Zewditu Memorial Hospital, Addis Ababa, Ethiopia. Methods: A cross-sectional follow up study was used to collect data on all 155 study respondents who visited the clinic over the four months of the study period. Data was collected using tool (standardized questionnaire) by trained neurology nurses and neurology residents.All the respondents were identified using a selection a criterion satisfying the required ethicalclearance procedure was used including securing verbal consent before data collection. Then collected data was cleaned and analyzed using SPSS version 20 to determine the magnitude/prevalence of sleep disorder and regression with p-value to determine the associatedfactors that explained the dependent variable.Included: All PD patients on follow up or diagnosed during a study period fulfilling the UKBrain Bank Criteria for idiopathic PD. Exclusion criteria: included the following: PD Patientswith cognitive impairment who was unable to respond for the PDSS-2, PD Patients who didn’thave willingness to give informed consent and PD patients out of the study period.The data included 155 PD patients. We used the PDSS-2 to collect sleep disorder Symptoms. Data were entered and analyzed by a computer software SPSS version 20. First bivariate analysis was done to identify those factors that determine the dependent variable then multivariate analysis andChi-Squares were used to determine those factors that determine the their possible associated predicting factors. P values<0.05 at confidence interval 95% were considered significant. Results: Majoirity, 127 (81.9%) of the respondents were male. Almost all 140(90.6%) of the respondents getting up at night to pass urine at least one day per week and followed by 104(67% who were unable to turn around while in bed in at least one day in a week. Patients reported problems on all items of sleep disorder, the least score being 4 and maximum score being 39 which indicates there was no patient without sleep disturbance pattern. The most striking point was 13.5% of patient had a score of more than 30. Over all 30.1% of patient slept well for less than 3 days per week. About one third of Parkinson disease (PD) patients (35%) Wake up early in the morning with painful posturing of limbs. Patient’s age, marital status, employment status,Page vi PD symptom duration, historical reportable sleep disturbance and disease severity were related to advanced sleep disturbance with p- value of 0.04, 0.02, 0.00, 0.01, 0.002 and 0.001 respectively. Conclusions: Sleep disturbance symptoms on PD patients are prevalent in our study. When disaggregated, it increase with age ,higher disease severity, disease duration, being un married and un employed and presence of reportable previous sleep disturbance before PD symptoms.Considering the prominence of sleep disturbance in PD patients in this study, there warrantsincrease clinical awareness and efficacious therapies by neurology department on internal medicine and neurology residents as part of teaching and learning activities.
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    Assessment of Sleep Disorder Pattern of Patients with Parkinson Disease Attending Neurology Referral Clinic in Tikur Anbessa Specialized and Zewditu Memorial Hospitals, Addis Ababa, Ethiopia
    (Addis Ababa University, 2015-11) Melka Dereje; Tafesse Abenet
    Background: Parkinson’s disease (PD) is progressive neurodegenerative disorder characterizedby abnormal motor symptoms such as bradykinesia, tremor, rigidity, and postural instability.However, the nonmotor symptoms (NMS) of PD, including cognitive impairment, depression,psychosis,& sleep disorders are also important and could have greater significance for disability,decreased quality of life, and reduced lifespan of the patients. Sleep-related problems specific toPD may occur early and even predate the diagnosis of the disease but are generally morefrequent and more severe in patients with advanced PD. Little is known about sleep disorderpattern in people with Parkinson’s disease (PD) in Ethiopia and Africa. Objective: To assess the prevalence of sleep disorder pattern and their associated predictors inPD patients in Tikur Anbessa Specialized Hospital and Zewditu Memorial Hospital, AddisAbaba, Ethiopia. Methods: A cross-sectional follow up study was used to collect data on all 155 studyrespondents who visited the clinic over the four months of the study period. Data was collectedusing tool (standardized questionnaire) by trained neurology nurses and neurology residents.All the respondents were identified using a selection a criterion satisfying the required ethicalclearance procedure was used including securing verbal consent before data collection. Thencollected data was cleaned and analyzed using SPSS version 20 to determine themagnitude/prevalence of sleep disorder and regression with p-value to determine the associatedfactors that explained the dependent variable.Included: All PD patients on follow up or diagnosed during a study period fulfilling the UKBrain Bank Criteria for idiopathic PD. Exclusion criteria: included the following: PD Patientswith cognitive impairment who was unable to respond for the PDSS-2, PD Patients who didn’thave willingness to give informed consent and PD patients out of the study period.The dataincluded 155 PD patients. We used the PDSS-2 to collect sleep disorder Symptoms. Data wereentered and analyzed by a computer software SPSS version 20. First bivariate analysis was doneto identify those factors that determine the dependent variable then multivariate analysis andChi-Squares were used to determine those factors that determine the their possible associatedpredicting factors. P values<0.05 at confidence interval 95% were considered significant. Results: Majoirity, 127 (81.9%) of the respondents were male. Almost all 140(90.6%) of therespondents getting up at night to pass urine at least one day per week and followed by 104(67%)who were unable to turn around while in bed in at least one day in a week. Patients reportedproblems on all items of sleep disorder, the least score being 4 and maximum score being 39which indicates there was no patient without sleep disturbance pattern. The most striking pointwas 13.5% of patient had a score of more than 30. Over all 30.1% of patient slept well for lessthan 3 days per week. About one third of Parkinson disease (PD) patients (35%) Wake up earlyin the morning with painful posturing of limbs. Patient’s age, marital status, employment status,Page viPD symptom duration, historical reportable sleep disturbance and disease severity were related toadvanced sleep disturbance with p- value of 0.04, 0.02, 0.00, 0.01, 0.002 and 0.001 respectively. Conclusions: Sleep disturbance symptoms on PD patients are prevalent in our study. When disaggregated, it increase with age ,higher disease severity, disease duration, being un married and un employed and presence of reportable previous sleep disturbance before PD symptoms.Considering the prominence of sleep disturbance in PD patients in this study, there warrants
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    Knowledge, Attitude and Practiceof Residentson Brain Death in Tikur Anbesa Specialized Hospital: a Cross Sectional Study
    (Addis Abeba University, 2020-12) Beyazn Guadie; Mengistu Getahun ; Melka Dereje ; Zenebe Yared
    Background and Aims:Brain death is defined as irreversible and complete cessation of all brain function including that of the brainstem. The aim of this study was to assess the level of knowledge, attitude and practice of brain-death declaration among residents in Tikur Anbessa specialized hospital in the year 2020. Methods:This was a hospital based cross-sectional study in which residents from variousfield of specialty were included using convenient sampling method. Pretested questionnaire consisting of questions related to knowledge, attitude and performance of brain-death declaration were distributed among residents as per the inclusion criteria to fill. Statistical tools used were mean and standard deviation, and Chi-square test. Results: A total 123 residents responded to the questionnaire. About 81{68%}correctly defined it as complete cessation of brain activity including brainstem reflexes. Sixty-five {54.6%} of the residents do not agree on brain death to serve to declare legal death .Only 11.7% of the study participants have ever attempted brain death test. Conclusion: The majority of the residents know about the definition of brain death but most of them have difficulties in identifying the basic physiologic limits which are pre conditions to diagnose brain death. More than half of them don not accept brain death as a legal determinant of death .Practice of brain death testing was poor
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    A Two-Yearretrospective Review on Theclinical and Electrophysiologic Profiles of Guillain-Barre Syndrome at two Centers in Addis Ababa,Ethiopia
    (Addis Abeba University, 2020-12) Mulugeta Abel; Mengistu Getahun; Melka Dereje; Zenebe Yared; DNuri Hussien; AlemayehuSamson
    Background: The clinical manifestations and electrophysiologic patterns of Guillain-BarreSyndrome(GBS)have been established with several studies previously.Nerve conduction studyhas been known to be one of the diagnostic tool complementing the clinical presentation ofGBS patients. The aim of this study was to assess the clinical characteristicsandelectrophysiologic pattern of GBSpatients at two facilities in Addis Ababa,Ethiopia. Methods:A retrospective cross-sectional study was conducted from October 1-30, 2020 upto byreviewing the medical record of GBS patientswho visited the neurology clinics at two facilitiesin Addis Ababa between from September 01, 2017 and September 30, 2019. Demographic,clinical, biochemical and electrophysiologic data were collected and analyzed. Results:A total of 59 GBS patients’ medical records were reviewed.Majority 46(72.8%)of thepatients were male.The dominant age category was from 21-35 years of age having 26(44.1%)share.The mean age of the participants was 32.96 (15.04)years .Preceding illnesses weredocumented in 21patients wherediarrheal illness was reported by the majority (38%)followed byupper respiratory tract infections. Quadriparesis was the most frequent presenting symptom with38(64.4%) patients. .Following the Nerve conduction test the two most common GBS variantsidentified were Acute Motor Axonal Neuropathy variant(AMAN)and AcuteInflammatoryDemyelinating Polyneuropathy variants of GBS Conclusion: The majority of GBS patientsincluded in our study were young adults whopresented with quadriparesis, with the most common variant of GBS being AMAN variant.