Browsing by Author "Moges Tamirat"

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    Assessment Knowledge, Attitude and Practice of Nurses towards Neonatal Pain Management and Determinant Factors at Public Hospitals in Addis Ababa, Ethiopia, 2021.
    (Addis Abeba University, 2021-08) Marelign Solomon; Moges Tamirat
    Background: Pain is a significant global problem in the field of health.Recent advances inneurobiology, clinical medicine and neonatal research have established that the fetus andnewborn may experience acute, established, and chronic pain and that controlling pain has short-and long-term benefits for all newborns (1)(2). Despite the growing knowledge about pain assessment and intervention, the neonatal pain remains unrecognized and undertreated (3).Appropriate management of neonatal painprevents unnecessary hospital stay and suffering themfrom pain. In clinical settings, nurses play a vital role in pain assessment and management and must be knowledgeable regarding how to best access and manage the pain. Objective: The aim of the study was to assess the neonatal ICU nurses’ knowledge andpracticeand factors associated regarding neonatal pain management at public hospital of AddisAbaba,Ethiopia, 2020. Method: -Institutional based cross-sectional study design will be used to collect data fromfourselected public hospitals in Addis Ababa, from 21July-22August 2021. Simple random samplingwill be used to recruit study participants using structured, self-administered questionnaire. Data will be cleaned and entered using SPSS version 26.0 software and data will analysis. Result:Majority (98(87.5.0%)) and (87(77.7%)) of the nurse had good overall knowledge andattitude. However, one third (42(37.5%) of the respondents have good practice. Conclusion:Most nurses had poor practice in managing neonatal pain but majority of nurses had adequate knowledge concerning neonatal painmanagement. There was gap between their knowledge and practice.
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    Clinical Profile and outcome of Repaired Cases of Coarctation of Aorta at TASH Paediatric Cardiology unit Ethiopia From Jan 2009 to Feb 2017G.C
    (2017-10) Gebremeskel Kalkidan; Moges Tamirat
    Introduction:Coarctation of aorta (COA) is one of the acyanotic congenital heart disease where the portion of aorta gets narrowed often involving the descending aorta distal to the aortic isthmus. It requires treatment with definitive surgery or balloon dilation and if not treated associated with many complication. But even after the advert of multiple surgical approach it is associated with post- operative complication at times may also need lifelong post op follow up. Little experience is available in Ethiopia regarding post coarctation of aorta repair. Objectives:To determine clinical profile and post-repair outcome of children with COA who underwent repair for COA. Methodology: The study was conducted from March 2017 to Sept 30 of 2017 with a retrospective chart review of 39 patients with repair for native COA from Jan 2003 to Feb 2017 both at local and outside of the country. In this study clinical profile, immediate complication and outcome were assessed. Result : A total of 39 patient with repair of COA of which 27(67.3%) were male and 12(30.8%) female. The age at time of intervention ranges from 3months to 25 years, with mean age of 6.9 ±5.7 yrs. 82.1% of the patients were hypertensive before intervention. 15(38.5%) had complex COA,13(33.3%) discrete COA,7(17.9) simple COA,4(10.3%) with interrupted aorta. Type of intervention was balloon angioplasty with or without stent in 20(51.3%), end to end resection and anastomosis 14(35.9%) and patch arthroplasty in 5(12.8%). Immediate complication seen were rebound hypertension 18(46.15%), post coarctectomy syndrome 3(7.69%). Other complication include Intracranial hemorrage, spinal cord injury ,pneumomedastinium ,chylothorax, Infective endocarditis, pericardial effusion, hemodynamic collapse 2ry to bleeding , lung atelectasis complicate 1(2.56%) each. There was no death following surgery. At 6 month 35 patient were evaluated at follow up clinic and only 40% of patients where hypertensive and echocardiography shows residual COA in 7(20%) and aneurism in 1(2.85%) patient. Conclusion: the most practiced method of the repair in the study was balloon angioplasty. Rebound hypertension was the most common immediate complication encountered. Mortality rate is very low comparing it from other setting. Surgical repair has significant association with rebound hypertension. Six month follow up echocardiography showed significant number of re-coarctation
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    Magnitude of Early Postoperative Arrhythmias after Cardiac Surgery in Children at the Cardiac Center-Ethiopia, Ethiopia
    (Addis Abeba University, 2021-11) Fesseha Bezamariam; Moges Tamirat
    Background: Early postoperative arrhythmias are a widely recognized complication of cardiothoracic surgery in the pediatric populations with CHDs. They have potentially grave consequences, particularly if they are not managed promptly. However, there remains lack of information in Ethiopian setting regarding postoperative cardiac rhythm disturbances although cardiothoracic surgeries have been performed since recently. Objective: To assess the magnitude of early postoperative arrhythmia and its associated factors among CHD patients who underwent cardiac surgery at the Cardiac Center-Ethiopia, Addis Ababa, Ethiopia from January 1st, 2018 to December 31st, 2020. Methodology: A facility-based, cross-sectional study was conducted at Cardiac Center Ethiopia, Addis Ababa. Data was collected using a structured checklist, and then entered and analyzed using SPSS version 26. Descriptive analysis along with chi square test and Student t test analyses were employed to identify factors associated with development of arrhythmia. A p-value. Results: The study evaluated medical records of 202 pediatric CHD patients who underwent cardiothoracic surgery. Their age ranged from 1 month to 14 years, and of all, females represented 54.5% (110). Arrhythmia was documented in 16 (7.9%) of the patients, and junctional ectopic tachycardia was the most common form of arrhythmia (43.8%). Statistically significant difference between the arrhythmic and non-arrhythmic group were noted in relation to cardiopulmonary bypass time (132.87 vs. 84.63mins) and aortic clamping time (89.47 vs. 51.40 mins), with p value Chi square test showed that cyanotic CHDs and patients with TOF are at higher risk of developing post-surgery arrhythmia. Conclusion: Early postoperative arrhythmias following surgery for congenital heart disease are not uncommon in the paediatric population. Longer ischemic time, bypass time, cyanotic heart diseases and presence of TOF were all risk factors that increased the incidence of postoperative arrhythmias.
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    Neonatal Intestinal Obstruction: A 3- Year Review in a Teaching Hospital Addis Ababa, Ethiopia
    (Addis Ababa University, 2014) Mustefa Mohammed; Moges Tamirat
    Background: Intestinal obstruction is the most common surgical emergency in the newborn period. It is a life threatening condition with high mortality especially in developing countries. Neonates with intestinal obstruction require specialized care and facilities for survival. Objective: We aim to study the etiology, presentation, outcome, and factors associated with mortality in the setting of Tertiary university hospital at Addis Ababa, Ethiopia. Method: Records of all cases of NIO managed at TASH, NICU during the period of January 1, 2010 to December 31, 2013 were retrospectively reviewed and all the possible factors that may result in mortality were analyzed. Results: Fifty-one neonates with intestinal obstruction were managed, representing 0.0058% of the neonatal admissions during the study period. Forty-one (80.4%) were males, 9(17.6%) were females (M: F=4.55:1), while one newborn had ambiguous genitalia. All patients presented with in the first week of life. Anorectal malformation constituted 56.9% of the causes of NIO, while intestinal atresias including duodenal, jejunal, ileal atresias accounted for 13.7% of cases. Other causes included Hirschprung’s disease, intestinal malrotation, meconium plug, congenital band, paralytic ileus, blind sigmoid colon, and spontaneous gastric perforation. There were 10 deaths, with a mortality rate of 19.6%. Perioperative sepsis was significant determinant of mortality. Conclusion: Early presentation, prevention and prompt management of sepsis is needed to decrease the high mortality seen in this study. There is a need for improved facilities including Intensive Care Units for pre- and postoperative management of neonatal intestinal obstruction. Key words: Intestinal obstruction, neonates, anorectal malformation, intestinal atresia
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    Perception on Socio-Economic and Demographic Causes of Deforestation and Its Consequences in Chena Woreda: The Case of Kafa Zone, SNNPRS
    (Addis Ababa University, 2010-06) Moges Tamirat; Degefa Terefe
    Forests are essential natural resources that make an important contribution to the wealth of the country. They provide wood for fuel, poles and timber for construction, furnish cattle with shelter and fodder and protect the soil from erosion. On the other hand, destruction of forest leads human beings and the environment to various problems. Departing from this backdrop, the research focuses on the perception on socio-economic and demographic causes of deforestation and its consequences in Chena Woreda-The case of Kefa Zone, SNNPRS. The study examines the relation between household size, level of education, social exclusion, land/forest tenure rights and deforestation and further assesses the consequences of deforestation and community perceptions of deforestation and its possible causes. Both primary and secondary data such as household surveys sources through questionnaire, key informants interview, Focus Group Discussions and literatures were used. The data were analyzed by descriptive way using percentage and frequency rank weight. The major causes of deforestation in the study area were found to be rapid population growth, social exclusion, dependency on agriculture, resettlement and inappropriate investment program, among others the consequences of deforestation relate to local climate change, soil erosion, shortage of fuel wood, etc. It is suggested that creating community awareness to reduce fertility, strengthening the relation between Menjas and the majority Kefa people, providing substitute for wood and providing opportunities for the people to involve on other off-farming activities could be possible alternatives to overcome problems of deforestation.
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    Prevalence, Risk Factors and outcome of Neonatal Acute Bilirubin Encephalopathy among Neonates Admitted to Neonatal Intensive Care unit in Tash and Gmh, Addis Ababa, Case Control Study, 2024/25 G.C.
    (Addis Ababa University, 2025-04-05) Mente Yoseph; Moges Tamirat
    Background – Acute bilirubin encephalopathy (ABE) is a clinical syndrome associated with bilirubin toxicity in the CNS, resulting in chronic and permanent sequelae. Despite ABE complications contribute to a substantial burden of neonatal deaths and several neurodevelopmental disorders in the country, there is limited study showing the prevalence and factors associated to ABE. Even the available limited studies were only showing the prevalence of jaundice rather than ABE. Objective – To determine Prevalence, risk factors and outcome of neonatal acute bilirubin encephalopathy among neonates admitted to neonatal intensive care unit of Tikur Anbesa Specialized Hospital (TASH) and Ghandi memorial hospital (GMH) from September 11, 2020 to September 11, 2023 G.C. Methods: A Case Control study was conducted on 218 neonates admitted to intensive care unit of TASH and GMH in Addis Ababa. From the total 2492 of neonates who have neonatal jaundice, 109 neonates who develop acute bilirubin encephalopathy and 109 neonates who did not develop acute bilirubin encephalopathy was included in the study. The total neonates who develop acute bilirubin encephalopathy were 109 and we take all. Simple random sampling was used to select neonates without acute bilirubin encephalopathy. Descriptive statistics used to present the prevalence, the socio-demographic and medical profile of the study participants. Binary and multiple logistic regression analyses were done to identify factors associated with ABE. Finding was reported using adjusted odds ratios with 95% confidence interval and statistical difference was declared at P-value. Result: A total of 218 neonates were studied in case control study (ABE vs non ABE among jaundiced neonates) and the prevalence of ABE is 4.4%. Factors associated with ABE in study were incompatibility (ABO and RH), previous history of jaundice, neonatal sepsis, severity of hyperbilirubinemia, preterm birth and low Apgar score. In this study, Outcome even after treating with phototherapy and double exchange transfusion were death (16.5%) and chronic bilirubin encephalopathy or kernicterus (11%) Conclusion and Recommendation: The prevalence of ABE in this study was still high as compared other studies With regard to this high ABE prevalence, there is need for health care providers in TASH and GMH to put more emphasis on RH and ABO incompatibility all women tested early as possible during ANC follow up and if women blood group O should be always considered ABO setup. Keywords Acute Bilirubin Encephalopathy, Neonatal Jaundice, Neonates