Browsing by Author "Solomon Yoseph"

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    Epidemiology and Clinical Features of Patients with Hepatocellular Carcinoma in Tikur Anbessa Specialized Hospital
    (Addis Ababa University, 2023-07) Solomon Yoseph; Abdurahman Zeki
    Introduction: Hepatocellular carcinoma (HCC) is a primary malignant neoplasm derived from hepatocytes, accounting for about 80% of all liver cancers. HCC ranks as the 5th most prevalent malignancy and the 2nd-leading cause of cancer-related death worldwide. The incidence of HCC varies widely according to geographic location. The distribution of HCC also differs among racial and ethnic groups within the same country. Methods: Descriptive cross – sectional study design was used. The study was conducted at Tikur Ambessa Specialized Hospital from April 2018 to March 2023. Data was gathered from HMIS, patient charts, and EMR by trained residents and interns. Results: From a cohort of 145 participants, 106 were male and 39 were female. The mean and the median age of the study participants were 52.8 years and 55 years respectively. we found that 16.55% had one or more co-morbid conditions. In our cohort, 32.41% of HCC cases were attributed to HBV infection, while 19.31% tested positive for HCV. Patients with HBV-associated HCC had a median age of 43 years and a mean age of 44.85 years. We identified 36 patients with a history of alcohol use. Among our study participants, 19 individuals (22.62%) were diagnosed with decompensated cirrhosis. Conclusion: HCC presenting to TASH affects more males than females. Hepatitis B virus infection is the leading etiological risk factor associated with HCC. Health facilities should implement policies that: Prevent HBV/HCV transmission and implement surveillance for high-risk groups. There is an urgent need to improve education of the population on hepatitis and its dreaded complication HCC. Health care providers should also be provided with HCC surveillance education and should establish programmes to implement surveillance. Key Words: Clinical feature, Epidemiology, Hepatocellular carcinoma.
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    Perioperative outcomes among Patients Undergoing open Biliary Bypass Surgery for Malignant Biliary Obstruction in a Low Resource Setting: a Multi-Centre Prospective Cohort
    (Addis Ababa University, 2023-07) Solomon Yoseph; Nigussie Shimelis
    Introduction: Obstructive jaundice is the most common symptom of malignantdiseases of the extrahepatic biliary system and necessitates either non-operative oroperative biliary bypass. Because of percutaneous and endoscopic approaches, the useof palliative surgical procedures has decreased in recent years. However, in resource-limited situations, open biliary bypasses remain a viable option. This study aimed toidentify factors associated with adverse perioperative outcomes following open biliarybypass. Methods: From June 2022 to May 2023, 69 patients underwent open biliary bypass formalignant biliary obstruction. Postoperative morbidity and mortality within 30 days ofsurgery were assessed. A Kaplan-Meier was used for categorical variables, and a log-rank test was used to determine the statistically significant difference betweenvariables. A Cox regression analysis was conducted to identify factors associated totime to develop complications. Results: The hazard of developing complications among those with preoperative cholangitis was 2.49 times higher than those without preoperative cholangitis (HR 2.49,95% CI [1.06, 5.84]). For every hour increment in the length of surgery, the hazard ofgetting complications increased by 2.47 times (HR 2.47, 95% CI [1.28, 4.77]). Asserum bilirubin increased by 1mg/dl, the hazard of developing complications increasedby 14% (HR 1.14, 95% CI [1.03, 1.17]). Conclusion: Patients who had long operation times, preoperative cholangitis, andelevated total bilirubin levels are at increased risk for poor perioperative outcomes.Clinicians may use these results to optimize these patients to decrease their elevated risk of serious morbidity and mortality