Browsing by Author "Zewdu Tigist"
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Item Analysis of the Cause, Classification and Associated Injuries of Pelvic Fracture in Patients Pressing to Tikur Anbessa Specialized Hospital Emergency Department, Addis Abeba, Ethiopia.(Addis Abeba University, 2018-07) Worku Kindalem; Engida Hywet; Zewdu TigistBack ground; The trauma, a world public health problem, has been a major cause of morbidity and mortality, as it affects more than 50 million people today, an aggravated circumstance in urban centers, mainly due to the growing number of vehicles and the aggressiveness in traffic Which cause accidents with high energy and leading to an increase in the number of deaths and injuries.Among the orthopedic traumas, pelvic injuries are considered the third cause of death due to auto accidents; represent 20% to 25% of fractures in poly traumatized patients.However the pattern of pelvic fracture is not known in our setting. Objectives;The purpose of this study was to analyze the cause, classification and associated injuries in pelvic fracture in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia during the time of september1, 2016 – September 1, 2017. Methodology: A Retrospectivedescriptive study was conducted on 60 patients who were admitted to adult emergency medicine department of Tikur Anbessa specialized hospital, Addis Ababa university, Addis Ababa, Ethiopia with a diagnosis of pelvic fracture during the study period. The data were collected using structured pretested data collection tools and analyzed using SPSS for windows version 21.0. Results:From total of sixty patients enrolled in study thirty five patients were males (58.33%) and twenty five patients were females (41.67%).Age ranges from 13-75 years with a mean of 31.3 years (SD ± 14.8) and mode and median of 22 and 25.5years respectively. There were 2 deaths in this study 2/60(3.3%) both of them were in the ICU. Conclusion:In the data presented in this study 39/60 (65%) of hospitalized pelvic fractures were caused by transport accidents, and the mean length of stay is 11.3,7 and 13 days in Tile A, Tile B and Tile C respectively.Item Assesment of Patterns and Outcomes of Chest Injury among Adult Patients Received Trauma Care at Tikur Anbesa Specialized Hospital, Addis Ababa, Ethhiopia(Addis Ababa University, 2017-06) W/Giorgis Ermiyas; Zewdu TigistIntroduction: Globally, injury continues to be an important cause of morbidity and mortality both in the developed and developing countries. It is the major public health problem in every country across the world and causing approximately 5.8 million deaths per year. The Chest trauma is a disease that has worsened long with growing urbanization and industrialization; due to worldwide increases in violence, constructions and vehicle number. Objective: The objective of this study was to assess the patterns and outcomes of chest injuries among adult patients admitted with chest trauma in Tikur Anbessa specialized teaching hospital (TASTH) over one year period between January 1, 2016 to December 31, 2016. Methods and Materials: Hospital based retrospective descriptive cross- sectional study designs were used to assess magnitude and outcomes of chest injury among patients admitted to TASTH. The collected data were to Epi data software version 3.3.1. Then, the entered data was exported to SPSS, version 21 for analyses. Descriptive statistics was used to present the results. Logistic regression was used to determine association between dependent and independent variables.Association between variables was taken as statistically significant for all variables resulted in p-value of <0.05 on multiple logistic regression. RESULTS: A total of 192 chest injury patients were treated at TASTH. Fifty three of them were died during treatment. Age [AOR 8.9(95% CI, 1.51-53.24)], time of presentation to hospital after injury [AOR 4.6(95% CI, 1.19-18.00)], Length of stay in hospital [AOR 0.12(95% CI, 0.02-0.58)], presence of extra-thoracic associated body region injury [AOR 25(95% CI, 4.18-150.02)]and development of complications [AOR 23(95% CI, 10-550)] were determinant of mortality in the present study. Conclusions and recommendations: Chest trauma predominantly affects the male and economically productive age group with high morbidity and mortality in this environment. Road traffic accident was the leading cause of chest trauma in this study outcome. The study calls forearly recognition and management of complications, awareness creations to society on their health seeking behavior, adequate provision of ambulance service and road traffic accidents prevention to reduce the morbidity and mortality resulting from chest injuries. Key Words: Injuries, Chest injuries, Tikur Anbessa Specialized Teaching Hospital, EthiopiaItem Assessment of Prevalence, Risk Factors, and Outcomes of Acute Kidney Injury Patients Admitted to Adult Intensive Care Unit at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia, 2019(Addis Abeba University, 2019-12) Getahun Edmialem; Abebe Asmamaw ; Zewdu TigistIntroduction: Acute kidney injury is a syndrome characterized by the rapid loss of the kidney'sexcretory function and is typically diagnosed by -the accumulation of end products of nitrogen metabolism (urea and creatinine) or decreased urine output, or both. In critically ill patients Acute Kidney Injury (AKI)occurs frequently and it allied with great rates of morbidity and mortality. Objective: This study aims to assess the prevalence, risk factors and outcome of acute kidneyinjury in patients admitted in the intensive care unit of Saint Paul's Hospital Millennium Medical College from January 2017 to December 2019. Methods: The study design was a facility-based retrospective; the cross-sectional study was conducted. Medical records of 108 were revised. Data collection checklist was developed and the data were extracted from the patients' medical records. Data entry and analysis were conduct by using the Epi-Data-4.2 and Statistical Package for the Social Sciences (SPSS) software version25.0 respectively. The logistic regression model was used for analysis. Result: AKI in critically ill patients covered 16.1% with a mean age of 34 ± 15 age distribution and female predominance (66.7%). Being female and Anemia were the leading risk factors to develop AKI, 72 (66.7%)and 56 (51.9%) respectively. Sepsis was more likely associated to kill the patients with AKI. Most 81 (75%) AKI critically ill patients were initiated renal replacement therapy. Stage three AKI were account for 66(61.1%). Length of hospital stay ranged from 1 day to 52 days with a mean stay of 10.7 days. Critically ill patients with AKI(48.1%) had died in the study period. Conclusion: AKI is the most common cause for critically ill patient's morbidity I too observed the higher prevalence of AKI in critically ill patients with younger age groups and female predominance. The mortality rate of AKI in critically ill patients was near to half of all respondents during the study period.Item Assessment of Incidence and Treatment Outcome of Septic Shock among Patients Admitted to Adult Intensive Care Unit of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia(Addis Ababa University, 2017-06) Teklemichael Hiyab; Zewdu TigistIntroduction :Septic shock is a major healthcare problem, affecting millions of people around the world each year, killing one in four and increasing in incidence. In most developed countries, the incidence of Septic shock has been identified as between 50 and 100 cases per 100,000 people in thepopulation. The mortality rate from severe sepsis in the developed countries has been estimatedas being between 28 and 50%, ranging from 15% in patients with sepsis and up to 40-50% inpatients with septic shock with multi-organ dysfunction syndrome (MODS) ObjectiveThe study aims to explore the incidence and the factors associated with outcome among patientswith septic shock admitted to the intensive care unit, TASH, Addis Ababa, Ethiopia. MethodA retrospective cross-sectional study was carried out at intensive care unit of our hospital. This study included all patients with septic shockadmitted to adult ICU of TASH during Jan 2014-Dec 2017. Data was collected using a structured checklist and statistical analysis was done usingSPSS version 21. Regression model was applied to identify the factors contributing to the outcome of septic shock. P-value less than 0.05 were considered statistically significant. Results Of 820 admissions, 115 (14%) patients had septic shock. Majority (60%) was female and themean age was 47.9+16.5 years. The most common sites of infection were the respiratory tract infection (54.8%) followed by urethral tract infection (14.8%), Gram-negative bacteria,particularly Escherichia coli (4.3%) and Klebsiella pneumonia (3%), were the major infecting micro-organisms. All patients have received antibiotic and fluid therapy. 23.5% patients started treatment within the first hr. of ICU stay and the overall 28-day mortality rate was 58.3%. ConclusionThe study revealed that septic shock is a frequent cause of ICU admission with a high mortality rate. This can be explained by the fact that septic shock patients have more comorbidity, a worstprevious state of health and requires more life support therapies. Therefore early identification of high risk population, implementation of appropriate treatment and the design of future clinicalstudies are crucial to improve the outcome of septic shockItem Assessment of Magnitude and Outcomes of Head Injury in Myungsung Christian Medical Center (KOREA Hospital), Addis Ababa, Ethiopia.(Addis Ababa University, 2017-06) Woldmeskel Asfawosen; Zewdu TigistBackground: Trauma, especially head trauma, is an expanding major public health problem and the leading cause of death of the young and productive part of the world’s population. Objective: To assess the magnitude and outcomes of head injury among patients presented to adult emergency department of Myungsung Christian medical center, from January 01, 2016 to January 01, 2017, Addis Ababa Ethiopia. Methods: Institutional based retrospective, cross sectional study was conducted at Myungsung Christian medical center, from January 01, 2016 to January 01, 2017, Addis Ababa Ethiopia.All head injury patients who fulfills inclusion criteria and visited Myungsung Christian medical center during the period from January 01, 2016 to January 01, 2017 were selected for the study. Result. From total of 673 trauma patients visited adult emergency of MCM hospital from January 12016 to January 1, 2017, there were 168 head injury patients and included in this study of which 124 (73.8%) were males and 44(26.2%) were females. From the 168 head injury patients, severity of head injury was categorized depending on GCS and 11(6.4%) severe, 73(43.5%) moderate and 84(50%) were mild type of head injury. Road traffic accident was the leading 59(43.3%) followed by fall down accident 49(35.8%) and assault or fighting measures for 29(21.2%) of head injury patients. The majority of the patients 99(58.8%) were improved,28(16.7%) cured, 7(4.2%) died and 34(20.2%) were with unknown outcome because they were referred to other hospitals. Conclusion: the analysis of this study revealed that road traffic accident is the major cause of head injury and head injury patient with associated injury are more at risk to develop complications than with no associative injury. Key words: head injury, magnitude, outcomes, retrospective, Myungsung Christian medical center.Item Outcome and Associated Factors of Acute Adult Poisoning in Emergency Department, Zewditu Memorial Hospital Addis Ababa(Addis Ababa University, 2024-01-05) Alemu Robel; Zewdu TigistAcute poisoning is a prevalent medical emergency around the world because a huge variety of substances and medications are widely accessible. Poisoning-related morbidity and mortality is becoming a major public health concern in many nations. Although it is well known that this public health issue is a pressing one in Ethiopia, the scope and magnitude of poisoning have yet to be thoroughly investigated.Item Pain Treatment Practice and Its Impact on Patient Satisfaction in Emergency Department: Experience From Tikur Anbessa Specialized Hospital, Ethiopia, 2019.(Addis Abeba University, 2019-08) Gezahegn Demmelash; Azazh Aklilu ; Zewdu TigistBackground: Undertreatment of pain is common in emergency department. The major reasons are lack of staff training in recognition, measurement and adequate pain treatment. Despite the global attention being given over the years, undertreatment of pain in the clinical practice is still an issue. Objective: The general objective of this study is to assess the pain treatment practice and its impact on patient satisfaction in the emergency department of Tikur Anbessa Specialized Hospital, July 15-19, 2019 Addis Ababa Ethiopia. Methodology: Single cantered, prospective, observational study for a continuous 24 hours of 5 days was conducted on total of 106 patients with history of recent pain. Numeric Rating Scale was used to assess patient’s severity of pain. Each patient was evaluated twice, initially at triage and 2-4 hours after arrival. The desire for analgesics was assessed at triage and Patient’s level of satisfaction was also assessed during the second evaluation. Data was analysed with SPSS version 21 Results: Out of 106 patients male account for 57.5% with M:F ratio of 1.3. The mean age of participants was 42.53years, with SD =16.3 years. The majority of patients were having medial emergencyfollowed by oncologic emergency and trauma. The mean initial numeric rating scale was 5.88(SD=2.09) measured out of 10. The proportion of patients who did not receive analgesics priorto emergency department were 77.4% (n=82), despite the fact that 57.5% (n=61) of them were referred by primary care taker. Desire for analgesics was found to be significantly associated with initial numeric rating scale. Despite the fact that 80.2% (n=85) of the patients desired analgesia, it was prescribed only for 51%(n=54) patients and actually taken by only 41.5%(n=44). Asking for analgesics and patient presentation during day time were significantly associated (p<0.05) with physician analgesics prescription. The overall satisfaction with pain treatment was reported in 68.87% (n=73) patients, despite the presence of undertreatment in 54% (n=52). Coming at day time and lower repeat numeric repeat scale has statistically significant association with over all emergency department in pain treatment satisfaction. Conclusion: There was a significant undertreatment of pain in the emergency department of Tikur Anbessa Specialized Hospital. Under recognition of pain by physicians and decision not to prescribe was the major reason patients didn’t take analgesics. Despite that, patient satisfaction was good and repeat mean numeric rating scale was also decreased.Item Retrospective Study of Clinical Profile of Patients with Hypertensive Crises in Addis Ababa University Tikur Anbessa Specialized Hospital(Addis Abeba University, 2020-09) Merga Borchala; Worku Tigist; Zewdu TigistBackground Hypertension is an Increasing public health problem in many developing countries IncludinEthiopia. The Joint National Committee on Prevention, Detection, Evaluation, and Treatment High Blood Pressure Reported that chronic hypertension is affecting over one billion Individualworld wide If hypertension is not controlled, it may lead to hypertensive crises, consisting of hypertensiveUrgencies with no End organ damage or hypertensive Emergencies with End organ damage.The incidence of conditions such as strokes,Myocardial infarction left ventricular failure,Aorticdissection,pulmonary Edema or chronic kidney disease is correlated with the leveof high BP. The aim of this study is to Asses the clinical profile of patients with hypertensive crises in TASHadult ED.(1) Evidences and observational studies in Ethiopia estimated,the prevalence of hypertension is 2030%. In Addis ababa 2 population based studies conducted and showed prevalence of 30.3 &25% respectively. Population based studies in northern part of Ethiopia also revealed a prevalence of 28.3 &27.9%,while the prevalence is 7.7% in one inistitutional based study inGonder.2Methodology Retrospective Cross Sectional study was conducted from Jan 2019 to December 2019. Thestudy period was Jan 2020- December 2020. subjects included are Adults 13 years and abovepresenting to Emergency department with hypertensive crises,Collectedusing structuredquestionnaires,to document Demographic information, clinical presentation and management outcome. Data was Cleaned, Edited, and analyzed using SPSS statistical software. RESULT OF THE STUDY Among a total of 626 patients who was screened for Hypertensive crises From Data registry,In the Emergency unit of Addis Ababa University TikurAnbessa Specialized Hospital In the Studyperiod January2019 to December 2019 , 212 patients met the criteria for hypertensive crises.Of these, 109 (51.41%) had Hypertensive urgency and 103(48.58%) had HypertensiveEmergency. Out of 103 hypertensive Emergency patients, 37.86% were discharged from ED,29.1% ward Admission, 18.4% ICU admissions,11.65% were ED Death, 2.9% were transferredout. And when compared to hypertensive urgency patients with hypertensive emergency are associated with poor out come. Hypertensive Emergency had Significant association with predominant patients complain like Decreased urine out put, chest pain, and Higher Diastolic Bp and patients clinical presentation like Extremity weakness ,Change in mentation (p - <0.01).since this study revealed that majority of patients with hypertensive crises present withcomplaint of headache, extremity weakness or other non specific complains, it is mandatory totake blood pressure and evaluate for possible hypertensive crises for patients presenting to EDwith any complain. Similar to most other studies, patients with hypertensive Emergency in this study areassociated with poor outcome when compared to hypertensive urgency. so this study recommend the importance of early detection, proper follow up to arrest further progressionof patients with hypertension.Dissemination of results Federal Ministry of Health, Federal Ministry of Education, Addis Ababa University and other responsible stakeholders and policy makers will be communicated about the results and recommendations of this research. Results will be disseminated throughout the scientific community after publication.Item Sepsis in the Emergency Department in Tikure Anbessa Specialized Hospital Addis Ababa Ethiopia(Addis Ababa University, 2013-10) Zewdu Tigist; Teklu SisayBackground: Sepsis is a medical emergency and one of the leading causes of death worldwide. It is best defined as a life threateninginflammatory disorder representing deraignment of the immune response to infection.Sepsis likely contributes to the high burden of infectious diseases morbidity and mortality in low income countries .data regarding sepsis management in sub-Saharan Africa is limited.Available data on sepsis management of adults in resource-limited settings suggest that this high mortality is associated withineffective management including delayed and improper empiric antimicrobial therapy as well as sub-optimal fluid resuscitation[10,11]. Thus, attention to reducing the mortality from sepsis by focusing on improved management in these settings is urgently neededItem Workplace Violence Against Emergency Residents and Nurses in Emergency Departments of Tikur Anbessa Specialized Hospital and AABET (Addis Ababa Burn, Emergency, and Trauma) Hospital(Addis Ababa Universty, 2018-06) Weldu Daniel ; Zewdu TigistBackground: Violence is a common day to day occurrence in the Emergency Department, locally as well as globally. It has negative effects on health care workers career, and therefore on the quality of care patient receives; however, it is under studied, and down played problem. Its extent is not equally felt across all stakeholders. Objectives: Explore the incidence, characteristics, associated factors and inciting causes of workplace violence experienced by the Emergency Residents and Nurses and explore the formal reporting of these incidences in TASH and AaBET hospital Adult Medical, surgical and trauma ED in the last 05 months. Methods: Cross sectional Survey study was performed on Emergency physicians and Nurses in Adult Emergency Departments in Tikur Anbessa and AaBET Hospitals. Standardized questionnaire developed by the WHO, which is modified and applied it to the current project, was used to collect data. Results: A total of 181 subjects were studied. Most of them (>70%) were BSc. Nurses. In the last 05 months, 86.75% of health care workers were subjected to violence; and furthermore, 86.6% were subjected to psychological violence and 19.9% to physical violence. For physical violence, being married and more year of experience were found to be victimized by 1.66 times and 5.18 times less likely than living with a partner and a less year of experience. However, for psychological violence, being single was 3.070 times less chance of being attacked psychologically than being married. Overall, relatives were the most common perpetrators. Only 13.9% of the physically attacked and 5.1% of the psychologically attacked have reported their assault; and in only 22.2% of the physical assault and 10.9% of the psychological assault were formal investigation done. More than half of the psychological violence and more than two thirds of the physical violence victims claimed it could have been prevented. The commonest reasons from the ED related reasons for the attack were overcrowding, inadequate security and negative media coverage. Conclusion: Violence was shown to be a rampant event in the ED and underreporting makes it undermined. However, it is shown to be preventable. Recommendation: Preventive strategies should be thoroughly sought and applied.Item Workplace Violence Against Emergency Residents and Nurses in Emergency Departments of Tikur Anbessa Specialized Hospital and AaBET(Addis Abeba Burn, Emergency ,and Trauma)Hospital.(Addis Abeba University, 2018-06) Weldu Daniel; Zewdu Tigist; Kebede SofiaBackground: Violence is a common day to day occurrence in the Emergency Department, locally as well as globally. It has negative effects on health care workers career, and therefore on the quality of care patient receives; however, it is under studied, and down played problem. Its extent is not equally felt across all stakeholders. Objectives: Explore the incidence, characteristics, associated factors and inciting causes of workplace violence experienced by the Emergency Residents and Nurses and explore the formal reporting of these incidences in TASH and AaBET hospital Adult Medical, surgical and trauma ED in the last 05 months. Methods: Cross sectional Survey study was performed on Emergency physicians and Nurses in Adult Emergency Departments in Tikur Anbessa and AaBET Hospitals. Standardized questionnaire developed by the WHO, which is modified and applied it to the current project, was used to collect data. Results: A total of 181 subjects were studied. Most of them (>70%) were BSc.Nurses. In the last 05 months, 86.75% of health care workers were subjected to violence; and furthermore, 86.6% were subjected to psychological violence and 19.9% to physical violence. For physical violence, being married and more year of experience were found to be victimized by 1.66 times and 5.18 times less likely than living with a partner and a less year of experience. However, for psychological violence, being single was 3.070 times less chance of being attacke psychologically than being married. Overall, relatives were the most common perpetrators. Only 13.9% of the physically attacked and 5.1% of the psychologically attacked have reported their assault; and in only 22.2% of the physical assault and 10.9% of the psychological assault were formal investigation done. More than half of the psychological violence and more than two thirds of the physical violence victims claimed it could have been prevented. The commonest reasons from the ED related reasons for the attack were overcrowding, inadequate security and negative media coverage. Conclusion: Violence was shown to be a rampant event in the ED and underreporting makes it undermined. However, it is shown to be preventable. Recommendation: Preventive strategies should be thoroughly sought and applied.