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30 Day Perioperative Outcome and Associated Factors For Morbidity and Mortality of Patients that Undergo Elective Surgical Intervention for Colonic Cancer in Tikur Anbesa and Zewditu Memorial Hospital: A Cross-Sectional Prospective Study
(Addis Ababa University, 2024-12-10) Adamzer Mulugeta; Abel Shiferaw
Colorectal cancer remains a significant global health challenge, particularly in Ethiopia, where the incidence is rising. With this rise has come the increment of surgeries being done with curative intent with subsequent implications on morbidity and mortality of patients.
30 day’ Post-operative complicationsof Intracranial Meningioma Surgery
(Addis Abeba University, 2020-01) Sileshi, Dagmawi; Kasahun, Azarias( MD, FCS (ECSA), Assistant professor)
Background: Meningioma is the most common primary intracranial tumor. Even though different management options exist in modern medicine, surgery is still the only cure for this benign tumor. Surgical options are not without risk. Identifying and predicting the short-term complications in an Ethiopian setup might be useful in the decision-making process before surgery for our patients. This study uses a prospective design that aims to assess 30 days of posoperative complications of intracranial meningioma. Methods: Aprospective study that was conducted at TASH, ZMH & MCM hospital between November 1, 2019, and September 1, 2020. Assessment of postoperative complications was determined in-person using a standard questionnaire in both inpatient & outpatient setup. For the investigation, pathology & Intraoperative findings data were collected from medical charts, radiology, and pathology archives.Data were checked for completeness and quality control aftewhich, it was entered on SPSS version 21 for analysis using logistic regression. Results:A total of 77 patients were enrolled in the study. The mean age of the patients was 40.94 years. 71 (92%) patients presented with headache and 62 (80.5%) patients had one or more focal neurologic deficits. Tumor was classified based on location and size. 47 (61%) of the tumors were skull base tumors.The surgical mortality rate which was defined as death within one month was 9.1%. Among all patients, 37 (48.1%)had one or more postoperative complications of which new-onset or worsened focal deficit was the commonest. A significant association was seen between skull base tumors and postoperative complications in both bivariate and multivariate analyses witha p-value of 0.01 (OR=5.79, 95% CI: 2.061-16.312. Conclusion: Even though the complications and mortality rates were high, surgery led to symptom improvement in a large proportion of patients. Skull base meningioma, anesthesia time more than 5 hours, and blood loss more than 1000ml hada significant association with postoperative complications.
A cross-sectional descriptive study on knowledge, attitude and perception of oral and maxillofacial surgery specialty among healthcare professionals in Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia
(Addis Ababa University, 2023-09) Tibebu, Hiwot Demisachew; Negussie,Samson (PhD); Adula, Surafel (PhD)
Background: Oral and maxillofacial surgery evolves around the head and neck region, and acts as a connecting bridge between medical and dental specialties. In many health services communities, the scope of oral and maxillofacial surgery (OMFS) as a discipline is frequently not probably understood. Good awareness of OMFS among different branches of health service providers is essential for better referral strategies and will be for the benefit of the patient. Objective: The main objective of this study is to assess the knowledge, attitude and perception of oral and maxillofacial surgery specialty among healthcare professionals at TikurAnbessa Specialized Hospital in Addis Ababa, Ethiopia. Method: A descriptive cross-sectional study design and a convenient sampling method isused. Self-administered questionnaires were prepared and filled out by the healthcare professionals. Descriptive statistics such as demographic data, knowledge, attitude and perception of study participants from their responses of the questionnaire were recorded and analyzed using SPSS version 25 software. Time frame: The study was conducted from December, 2022 to July, 2023. Result: A total of 125 healthcare professionals were participated in this study. Out of which, 75 were males and 50 were females. Most of participants were in the age range between 20 and 30 years. And, most of them have been in clinical practice in a range of 2 to 5 years. Regarding knowledge and attitude of healthcare professionals, the result of this study showed that 76 (60.8%) have poor knowledge and 49 (39.2) have good knowledge. Similarly, most participants have poor attitude towards oral and maxillofacial surgery specialty which accounts for about 79 (63.2%) of participants and 46 (36.8) of them have good attitude. On the contrary, the perception of healthcare professionals towards the level of oral and maxillofacial surgery service given in TikurAnbessa specialized hospital is good in majority of them (76, 60.8%) and the rest 49 (39.2%) participants have poor perception. Conclusion: The study concluded that there is poor knowledge and attitude of oral andmaxillofacial surgery specialty among study participants.
A Prospective Cross Sectional Study to Evaluate the Incidence of Acute Transfusion Reaction and its Associated Risk Factors in Ateritiary Care Center in Ethiopia.
(Addis Ababa University, 2023-02) Assefa,Temesgen; Tadesse,Fissehatsion(Ass.Prof.)
Background:Transfusion reactions are adverse events associated with the transfusion of whole blood or one of its components. There is no institutional or national data in Ethiopia regarding the incidence of ATR & their risk factors. Theaim of this study is to measure the incidence of ATRs, frequency& time of occurrence of each ATR & evaluate their association with risk factors there by contributing to the institutional & national hem vigilance system. Objective:The main objective of the study is to measure the incidence of ATR & determine their association with different clinical variables. Methods: Prospective cross sectional study design is used to study in patient & outpatient adult transfusion recipients at the department of internal medicine, data was collected with a structured check list, analyzed with IBM SPSS version 24 software. Result: A total of 210 study participants with the age of 13 & above were included in the study from September 1, 2022 – November 30 2022. 50.5 % of study participants are male & 49.5% are females ,the most common age group are between the age of 18 -40,the commonest blood group was O positive.Acute myelogenous leukemia is the commonest underlying diagnosis of the study participants; PRBC is transfused for the majority of patients given for 74.8% of cases. ATR incidence is found to be 10%,ATR was reported in 19.6%of platelet transfused patients as compared to 7% of PRBC, and none of FFP transfused patients develop ATR. FNHTR & urticaria are the commonest ATR observed. Significant association is seen between ATR & female gender, autoimmune disease & ABO incompatible platelettransfusion. Conclusion:The incidence of ATR is higher than reported from previous studies indicating the need to improve institutional transfusion services particularly in high risk patients.
Acceptability of COVID 19 Vaccines among Health Care Workers and its Determinants in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2021G.C.
(Addis Abeba University, 2021-11) Abraham, Yisehak; Dr. Tilahun, Rahel(Senior Anesthesiologist); Dr.Birhanu. Tseganesh (Senior Anesthesiologist)
Background: Healthcare workers who have negative attitudes, are averted, or are hesitant about vaccinations share these unfavorable attitudes and tend to recommend vaccination to their patients infrequently(1). Despite the huge efforts made to achieve successful COVID-19 vaccines, a major hindrance can be related to vaccine hesitancy towards the approved and prospective COVID-19 vaccination(2). The willingness to accept the vaccine among health care workers range from 28% lowest in Congo to 77% in France(3,4). Objective: To assess the acceptability of a COVID-19 vaccine among healthcare workers in Tikur Anbessa specialized hospital, Addis Ababa 2020G.C. Method: Institutional based descriptive cross sectional study was conducted among health care workers of Tikur Anbessa specialized hospital. Which is one of the tertiary hospital in the country. The source population was health care worker of Tikur Anbessa specialized hospital. Stratified random sampling was used with a final sample size of 384. The data was collected using an online questionnaire. Data was checked for completeness and imported to SPSS 20 software for analysis. Descriptive analysis was done for Socio-demographic and clinical characteristics of the participants. Bivariate logistic regression was done for each predictor variable and outcome variable. Multiple logistic regressions were done and statistical significance p-value less than 0.05 was taken as a determinant factor. Result: Of the total 390 health care worker who started the online questionnaire 384 completed it a (98.4% completion rate). Among the 384 participants 256(66.7%) respondents were willing to have the COVID 19 vaccine, 50.8 % were willing to be vaccinated as soon as the vaccine becomes available while 49.2% would delay vaccination until the vaccine's safety is confirmed. Having a high risk of contracting COVID and believing that the COVID-19 vaccine should be compulsory for all increased probability of getting vaccinated Conclusion and recommendation: Healthcare workers are at great risk of contracting and spreading the disease and, unless wide-acceptance of the vaccine is achieved. One of the crucial method is to alleviate fear of side effects.
Accuracy of Ultrasound in Fetal Sex and Weight Determination in the 2nd & 3rd Trimester When Performed By Radiology Residents & Recent Graduates: A Cross Sectional Facility Based Study
(Addis Ababa University, 2015-10) Hashim, Yasmin; Kebede, Tesfaye(Associate professor)
Background: Ultrasound is one of the non invasive methods for fetal sex determination and with its introduction visualization of the fetal genitalia has become possible. Although mainly fetal sex determination is done for parental curiosity it has also some clinical implication. Accurate prenatal EFW in late pregnancy and labor is extremely useful in management of labor, aiding in decision making about instrumental delivery, trial of labor after caesarean delivery and elective Cesarean section for patients suspected of having a macrosomic fetus. Objective: Purpose of this study was to assess the accuracy of ultrasound in fetal sex determination in 2nd & 3rd trimester & weight determination in those ≥ 38wks when it is performed by those with lesser experience and exposure Methods: Obstetric ultrasound and ultrasound of the perineal region of the fetus was done on 600 pregnant women to detect the sex of the fetus with gestational age from 16 weeks to term. Completer data and information was available in 55o of the study. There were 20 twins in the study making the overall fetuses in the study 570. For fetal weight accuracy study 235 mothers with gestational age of ≥38weeks were included. Ultrasound results were registered on pre-prepared form at the time of examination. The sex & weight was confirmed at the expected time of delivery through a phone call to the mothers and for some by revising their medical cards. Results: Out of 570 fetuses ultrasound was able to determine the sex for 527 (92.5%); 287 of whom were confirmed female and 240were male. Overall accuracy was 84.92%. Accuracy for females was 91.63% and for males was 92.08%. When the not sure cases are excluded and samples for which actual sex determination was done are analyzed the accuracy was found to be 92%. From the 235 samples with GA of ≥38 weeks the accuracy of ultrasound fetal weight estimation within 10% of actual birth weights was 85.5%. The mean absolute error of estimated fetal weight was 226.67gm. Ultrasound generally underestimated the birth weight. Specifically ultrasound overestimated the fetal weight in those <2500gm and underestimated in those>4000gm. Conclusion: Ultrasound is an accurate method to determine the fetal sex in the second and third trimesters with a sensitivity of 90% and specificity of 93.2% even when it is performed by those with less experience and exposure. In conclusion EFW by ultrasound in term pregnancies using the Hadlock formula was found to have a high accuracy rate when it is performed by those with less experience and exposure. So it can be applicable to make clinical decisions even when it is done by those with less experience. The over estimation of LBW and under estimation of macrosomia found in ultrasound weight estimation should be given due attention
Acute Limb Ischemia Presentation and Outcome Among Cardiac Patients in Resource-Limited Setup, Single Institution Experience, Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2024
(Addis Ababa University, 2024-12-13) Weini Tekle; Henok Teklesilasie
Acute Limb Ischemia (ALI) is a sudden drop in limb perfusion, posing a threat to viability. Cardiac conditions such as atrial fibrillation, valvular disease, and ischemic heart disease are major risk factors. In resource-limited settings like Tikur Anbessa Specialized Hospital, understanding ALI presentation and outcomes in cardiac patients is crucial for improving management and reducing morbidity and mortality
Adherence to pre-operative fasting guidelines and associated factors among pediatric surgical patients in selected government referral hospitals, Addis Ababa, Ethiopia, 2020.
(Addis Abeba University, 2020-06) Yimer, Aragaw Hamza; Haddis, Lidya(B.Sc. M.Sc.); Abrar, Meron(B.Sc. M.Sc.)
Background: Fasting of children before anesthesia is mandatory with the aim of to reduce the complications of due to regurgitation, vomiting, aspiration during anesthesia and surgery. Prolonged fasting times have several negative implications in children due to high ﬂuid turnover quickly leads to dehydration, perioperative hypotension, metabolic disturbances and hypoglycemia which leads to poor anesthetic outcomes. Objective: The aim of this study was to assess adherence to preoperative fasting guidelines and associated factors among pediatrics patients undergoing elective surgery in Addis Ababa selected government Hospitals, Ethiopia, 2020. Method: A cross-sectional survey was conducted in Addis Ababa selected government hospitals, Ethiopia in 2020. A total sample of 279 pediatric patients with age up 17 years scheduled for elective surgery included in the data collection. The data analysis was done with SPSS V.21 and the value of the variables and its associated factors was checked its association with logistic regression. Significance was determined at P -value <0.05. The result was presented by using text, tables, charts, and graphs. Results: A total of 279 pediatrics patients were responded in the analysis with a 98.6% response rate. Majority of the participants 251(89.96%) were not followed the guidelines of preoperative fasting. The mean fasting time for clear liquids was 10±4.03 (2-18 hrs.), for breast milk 7.18±2.26 (3.5-12 hrs.), and for solid foods 13.5±2.76 (8-19 hrs.). The reasons for which the preoperative fasting delayed was due to incorrect order 35.1% , prior cases procedures took longer times 34.1% changing sequence of schedule was 20.8%. Conclusion: The majority of children were still having prolonged fasting practice. The staff’s instructions and sequences of schedules are challenged to follow the international fasting guidelines protocol.
Admission Pattern and Treatment of Solid Tumors at Tikur Anbessa Specialized Hospital Radiotherapy Center from July 2020 to February 2021.
(Addis Ababa University, 2022-02) Hagos, Gebrekirstos; Dr.Assefa, Mathewos(Consultant Clinical Oncologist, Internist, Associate Professor of Medicine)
Background: The incidence of cancer has increased dramatically worldwide in the last two decade. Cancer in sub-Saharan Africa (SSA) is on the rise caused by a rapid population growth, increased life expectancy and adoption of unhealthy lifestyles. In Ethiopia the incidence of cancer is increasing over years with an estimated 67, 573 new cases and over 46, 373 deaths in 2018. At TASH RT center there was no study that tried to evaluate admission pattern and intent of therapy of solid tumors. So this study was conducted to determine admission pattern and treatment intent of solid tumor in TASH radiotherapy (RT) center. Objective: To assess the admission pattern and treatment intent of Solid Tumors at TASH RT center from July 2020 to February 2021. Method: A cross sectional study was conducted to assess admission pattern and treatment of solid tumors among patients admitted for chemotherapy in TASH RT wards from July 2020 to February 2021 who fulfilled the inclusion criteria. Data was extracted from the Oncology Patient Registration System, then it was checked for completeness. Descriptive statistic was conducted using SPSS version 23. Association of patient address with cancer stage and intent of therapy was evaluated. Result: A total of 434 patients were admitted during the study period. Median age was 43.0 years, ranging from 18 years to 80 years. Almost half (50.5%) of the patients were females and most patients (87.6%) had no any known comorbidity and 7.4% had HIV infection. Most of the patients came from Addis Ababa City (44.5%), followed by Oromia region (30%) and Amhara region (11.8%). The most common anatomic sites of the cancers were GIT (37.1%), head and neck (25.6) and genito-urinary (15.0%). Based on histology, adenocarcinoma and SCC accounted for about 38.5% and 36.9% respectively. Most patients were admitted with stage IV (72.1%) and stage III accounts 21%. The treatment intent was palliative in 59.4%, neo-adjuvant in 23.3%, adjuvant in 14.3% and radical in 3%. Conclusion: Most patients presented with advanced stage and more than half of all the patients were treated with palliative intent.
Admission Pattern and Treatment Outcomes among Patients Admitted to Pediatric Intensive Care unit in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia ,2020/21:A Cross-sectional Study
(Addis Ababa University, 2021-06) Eshetu, Oliyad; Tafessa, Dawit (BSc MSc; Seifu, Ashenafi (BSc MSc
ABSTRACT BACKGROUND: The knowledge of the pattern of admission and treatment outcome of critically diseased pediatric patients admitted to pediatric intensive care units in developing countries where the resource is scarce may help for the identification of priorities and resources to make the facility better. The prevalence of pediatric intensive care unit mortality often varies globally, depending on the facilities of the intensive care unit, the availability of workers, and admission patterns. OBJECTIVE: The objective of this study was to assess admission pattern and treatment outcome of children admitted to a pediatric intensive care unit (PICU), at Tikur Anbessa specialized hospital, Addis Ababa Ethiopia, from October 2018 to October 2020 METHODS: The study was a cross-sectional study design among 361 pediatrics patients admitted to the pediatric intensive care unit of Tikur Anbessa Specialized Hospital Addis Ababa Ethiopia from October 2018-October 2020 by using a systematic random sampling technique. Descriptive statistics were summarized with data, tables, and figures for display results. The distribution of the data was checked with a normality curve. Bivariate and multivariate analyses were used to see the association of an independent variable on the outcome variable. Factors with a p-value of less than 0.2 in bivariate analysis were exported to multivariate analysis to see if they are independent factors for the outcome variable. The adjusted odds ratio was used to show the strength of association with a 95% confidence interval and the p-value of less than 0.05 was taken as statistical significance in multivariate analysis. RESULTS: A total of 361(100%) charts were sampled for data collection; 197 (54.6%) were male and 164(45.4) were female. The most common cause of admission was, septic shock (27.14%), whereas the least cause of admission was Asthma 9(2.50%). The mean age at admission was 39.44±44.87 months. The overall mortality rate of our pediatric intensive care unit was 43.8%. From multivariate regression analysis need for mechanical ventilation (AOR= 11.08, 4.25-28.87, 95%CI, P=0.001), need for inotropic (AOR = 10.67, 4.09-27.81, 95%CI P<0.001), comorbidity (AOR=8.38, 3.5-20.5 , 95%CI P<0.001), length of PICU stay from 2-7 days (AOR =7.27, 1.7330.55, 95%CI P=0.007) and severe GCS (<8) with (AOR =10.51, 3.81-29.05, 95%CI P<0.001) were independent determinant of mortality. CONCLUSION: The mortality rate at our PICU was 43.8%. Septic shock and meningitis were the common cause of death and the largest death has happened in less than 7 days of admission.
Adverse Childhood Experiences and Their Association With Common Mental Disorders Among Addis Ababa University College of Health Sciences Undergraduate Students
(Addis Ababa University, 2023-12) Gezahegn,Yishak; Worku,Benyam (Ass.Prof.); Pain,Clare(Prof.); Mihretu,Awoke (PhD)
Background: Adverse Childhood Experiences refer to various traumatic or challenging events and circumstances that can occur during childhood. These experiences can have long-lasting negative effects on an individual’s physical, mental, and emotional well-being. Objective: The aim of this study was to describe Adverse Childhood Experiences and their association with common mental disorders among College of Health Science Students at Addis Ababa University. Methods and materials: A cross-sectional study was conducted employing a stratified random sampling with a sample of 345 undergraduate students. The data was collected through a self-administered questionnaire. Socio demographic, ACE-IQ, PHQ-9, GAD- 7, and a brief assessment tool for substance use was used. Binary and multivariate logistic regressions were used to determine the association between ACEs, dependent and independent variables. Result: In the total sample (N = 345), the participant’s mean age was 22.2, with the majority being females (58%). 15.9% of the participants had depression symptoms (scored more than 10 in PHQ-9 score) and 14.2% had anxiety symptoms (scored more than 10 in GAD 7 score). Majority of the participants (80%) had at least one ACE and one fourth (25.2%) of the participants had experienced 4 or more ACEs. The most prevalent type of ACE was community violence (35.4%). One fifth (20%) of the participants had reported having experienced childhood sexual abuse. After controlling for confounding variables, those with 4 or more ACEs were 6.17 times (aOR 6.17; 2.51, 15.18) and 6.0 times (aOR 6.0; 2.25, 16.02) more likely to have depression and anxiety respectively. Conclusion: There is a high prevalence of depression and anxiety among undergraduate college of health science students of Addis Ababa University. Adverse childhood experiences are also highly prevalent among the participants. There was a dose response relationship between ACEs and both anxiety and depression after controlling for confounding variables. Recommendation: Identifying and preventing ACEs at an early stage could contribute to reducing the prevalence of depression and anxiety among college students. Effort to prevent ACEs should target not just individuals but also extend to households and communities.
Aerobic Bacteria in Post-Surgical Wound Infection and Pattern of Their Antibiotic Susceptibility in Hawassa Teaching and Referral Hospital, Southern Ethiopia
(Addis Ababa University, 2001-05) Dessalegn, Lopiso; Gebre-Selassie, Solomon(PhD); Shemeles, Techalew
Background: Post-operative wound infections have been found to pose a major problem in the field of surgery for a long time. Advances in control of infections have not completely eradicated this problem because of development of drug resistance. This condition is serious in developing countries where irrational prescription of antimicrobial agents is common. Objective: To determine the distribution of common aerobic bacteria in post-surgical wound infected patients and their antimicrobial susceptibility patterns. Materials and Methods: This cross sectional study was carried out in a total of 194 patients with post surgical wound infections at Hawassa Teaching and Referral Hospital, from November 2010 to March 2011. Physicians collected data on socio-demography and clinical profiles using designed formats. Moreover, pus swabs were collected, processed and cultured using the standard bacteriological methods. Isolated organisms were tested for pattern of antimicrobial susceptibility using the standard disk diffusion method. The data were entered in to a computer and analyzed using SPSS Version-16 software. Results: The prevalence of aerobic bacteria was 71.1%, and majority of the isolates (59.3 %) were Gram-negative organisms. The most frequently isolated aerobic bacteria was S. aureus (37.3%), followed by E .coli (25.4%) and Klebsiella species (13.6%). All bacterial isolates were resistant to at least one antibiotic, and 86.4 % were resistant to more than one antibiotic (multiple drug resistance). Conclusion: Single and multiple drug resistance to the commonly used antibiotics in the study area was found to be very high leaving clinicians with a very few choices of drugs for the treatment of post surgical wound infected patients. Therefore, it is critical that use of antimicrobial agents with in hospitals, public healthcare providers as well as private ones should be reviewed and further studies to find out the overall resistance patterns and their possible causes and associated factors in the region at large need to be carried out. Key words: Aerobic bacteria, post-surgical wound, antimicrobial, susceptibility
Air way and breathing management knowledge and practice of nurses working in emergency department of selected governmental hospitals under health bureau of Addis Ababa, Ethiopia, 2021.
(Addis Abeba University, 2021-06) Nigatu, Mulachew; Dr. Debebe, Finot (EMCCP, ICS, Lecturer); Tuli, Wagari(EMCCN, MSc, Lecturer)
Background: Management of airway and breathing is one of the most important initial interventions to save the lives of patients and is a cornerstone of excellent emergency care. The first few minutes after an emergency condition are vital to providing these lifesaving interventions. Objective: This study aimed to assess the knowledge, and practice of nurses regarding airway and breathing management who were working in selected hospitals under Addis Ababa health bureau, Addis Ababa, Ethiopia from March to April 30, 2021. Methods: The study used an institutional-based cross-sectional descriptive study with a complete enumeration of all respondents by using the census method during the study period from March to April 30, 2021. A self-administered and structured questionnaire was used for collecting data from the respondents. Data quality was controlled by pre-testing the tools and providing training to the data collectors. The SPSS version 26 software was used for analyzing the data. Mean, frequency, binary, and multiple logistic regression analyses were used. Only Pvalue less than 0.05 was considered statistically significant. Result: About 102 respondents were included in this study with a response rate of 98%. Among those, 54(52.9%) were females. Findings from this study showed that 71.57% and 64.71% of the respondents had good knowledge and practice respectively. Being trained in training related to airway and breathing management before was statistically associated with knowledge and practice on both binary and multiple logistic regression at p<0.05. Conclusion and recommendation: This study showed relatively good knowledge and practice of nurses on airway and breathing management. Even though the finding is good, a significant number of participants had poor knowledge and practice. Therefore, it is very crucial to provide training since it was significantly associated with good practice and knowledge.
Ambulatory Blood Pressure Control Pattern in Hypertensive Patients at Tikur Anbesa Specialized Hospital: A Cross Sectional Study
(Addis Abeba University, 2021-05) Alemayehu, Mulualem; Dr.Abebe, Sintayehu; Dr.Yadeta, Dejuma; Dr.Alemayehu, Bekele
Background: Hypertension is the most common cardiovascular problem globally with a particularly increasing burden in developing countries like Ethiopia. Ambulatory blood pressure (ABPM) is superior to office blood pressure (OBP) measurement for diagnosing, prognosticating and following treatment efficacy for hypertension. There is no available data on ABPM control pattern in Ethiopians. This study will determine the ABPM control patterns in Ethiopian hypertensive patients on treatment. Material and Methods: This was a cross sectional study in hypertensive patients at Tikur Anbessa Specialized Hospitals outpatient departments carried out during January to May 2021. ABPM values of 244 consecutively sampled patients were analyzed. All patients had their BP monitored over 24 h with a Tonoport V (GE CS V6 71), and the data was interpreted using GE CardiosoftTM ABPM software in accordance with European Society of hypertension guidelines. Ethical clearance was given by Addis Ababa University Institutional Review Board and the study was conducted in compliance to standard ethical guidelines. Results: The study involved 244 adult hypertensive patients; mean age of the patients was 59.4years and, 54% were females. 58.6% of patients had controlled OBP, while only 45.1% had controlled ABPM. The mean OBP was 137 (19)/81 (10) mmHg and mean 24-hr ABP was 137 (16)/81 (10) mmHg; mean daytime BP was 136/79 ± 17/11 mmHg; mean night-time BP, 138/84 ± 16/11 mmHg. Mean ABPM values were not significantly different between men and women. Comparison of ABPM values with OBP revealed high prevalence of the white coat effect (32%) and masked uncontrolled hypertension (46%). Presence of comorbidities particularly diabetes predicted poor ABPM control. Conclusion: More than half of patients had uncontrolled BP as per ABPM criteria and significant discrepancy exists between ABPM and OBP in assessing adequacy of BP control. Guiding management decisions using ABPM can improve BP control rates.
Analgesic Effect of Intrathecal Neostigmine + Bupivacaine,Morphine+Bupivacaine and Bupivacaine Alone among Postoperative Patient Who Undergone Lower Extremities Orthopedics Procedure at Asella Referral and Teaching Hospital,South West Ethiopia,2019.
(Addis Ababa University, 2019-05) Bekele, Ayele; Aregawi, Adunga(Assistant professor); Getachew, Lemlem(MSc in Anesthesia)
Background: Spinal anaesthesia is a commonly used regional technique for lower abdominal and lower limb surgeries. Bupivacaine is the most commonly employed local anaesthetic for sub arachnoid block. Perioperative hemodynamic status and post-operative pain relief are important issues with Bupivacaine. Different studies have been conducted to establish best adjuvants to overcome these demerits and so as to enhance bupivacaine induced post-operative analgesia and provide a stable intraoperative condition. Objective: To compare analgesic effectiveness of intrathecal morphine + bupivacaine + neostigmine bupivacaine and bupivacaine alone for a patient who undergone lower extremities orthopedics procedure Methodology: In this institutional based prospective cohort study, 102 patients with American Society of Anesthesiologists (ASA) class I or II status, age≥18 who undergone lower extremities orthopedics were grouped into bupivacaine 12.5 with morphine(0.2mg) n=34, bupivacaine 12.5mg with Neostigmine (50mcg), n=34 and Bupivacaine alone group (15mg) based on the decision of responsible anesthetist. Data collection method includes preoperative chart review, intraoperative observation and postoperatively patient interview and chart review. Postoperatively duration & consumption of analgesia, first analgesia request as well as severity of pain using 10cm NRS score were assessed over 24hrs. The data were entered into EPI INFO and transport to SPSS version 22 for analysis of variable using one-way ANOVA, kuruska-walih H rank test, and chi square. Results: There was significant difference in maximal level of sensory block, time to maximum sensory and motor block among the three groups. The morphine group had longer time to first rescue analgesics than the neostigmine and bupivacaine group (P <0.05). Overall 24-hr NRS pain scores were significantly higher in the bupivacaine group v/s the morphine and neostigmine groups (P <0.05) Conclusion and recommendation: Morphine 0.2mg produce prolonged postoperative analgesia with few side effects than neostigmine and bupivacaine alone.
Analgesic effect of intravenous Dexamethasone prior to Spinal Anesthesia among parturient undergo cesarean section at Gandhi Memorial Hospital, ADDIS ABABA, ETHITIOPIA, Prospective Cohort Study, 2018/19
(Addis Ababa University, 2019-06) Tesfaye, Adamu; M, Eyayalem(B.Sc. M.Sc.); D, Tinbet(B.Sc. M.Sc.)
Background: By prolonging the duration of spinal anesthesia sensory block co-administration of adjuvant has the potential to improve efficacy of regional blocks. However this technique has its own complications. Hence, drugs having minimal side effects and prolonged analgesia is always looked for. This is because postoperative pain in obstetric patients is left untreated and it’s the main cause of chronic pain among women. Objective: to determine the effect of preoperative dexamethasone on prolongation of the analgesic effect of spinal anesthesia after elective cesarean section. Methods: Observational prospective cohort study was conducted at Gandhi Memorial in 64 patients scheduled for elective Cesarean Section under spinal anesthesia and systematic random sampling was used to randomly select patients. Data was checked manually for completeness and then it was coded and entered, cleaned and analyzed with SPSS version 20 computer program. Normality of the data was checked by Shapiro wilk test. Chi square test was used for categorical variables and Manny Whitney test used for comparing numerical variables of skewed data or student's t-test used for comparing numerical variables normally distributed data of two groups. P-value less than 0.05 considered as statistically significant. Result: The demographic and clinical characteristics were comparable between groups. Groups’ comparison indicated significant difference in terms of severity of postoperative pain, in which the dexamethasone group were lower with p value < 0.015. Similarly, time to the requirement of first rescue analgesia was prolonged in dexamethasone group with median (interquartile range) score of 6.5(2.4) as compared to non-dexamethasone group 4.1(1.8). The median score for total consumption of Tramadol in 24hrs post operatively has been lower in dexamethasone group with p value < 0.0001. There is no statistically significant difference in median score of total diclofenac consumption between the two groups with p value of 0.2. Conclusion: we concluded that preoperative administration of dexamethasone 0.1mg/kg intravenously before administrating spinal anesthesia for cesarean section is efficient in reducing postoperative pain, total Tramadol consumption on the first postoperative day and prolonging the time to the requirement of first rescue analgesia.
Analgesic effectiveness of intrathecal tramadol added to Bupivacaine compared with Bupivacaine alone for spinal anesthesia For Mothers Delivered by Cesarean Section at Empress Zewditu Memorial Hospital, Addis Ababa, Ethiopia.
(Addis Ababa Universty, 2018-06) Abera, Abebe; Sitot, Mulualem(Bsc, Msc. In Anesthesia, Lecturer)
Background: Spinal Anesthesia has become more widely practiced anesthetic technique. It is simple to institute, rapid in its effect and produces excellent operating conditions. Postoperative pain after cesarean section is common and more intense compared to post vaginal delivery pain. Therefore, intrathecal adjuvants play an important role in maternal analgesia in the postoperative time. It has been shown in clinical studies that using tramadol intrathecal can provide longer duration of analgesia, without the common side effects of opioids. Objective: To compare analgesic effectiveness of intrathecal tramadol as an adjuvant with bupivacaine in comparison with bupivacaine alone for mother delivered by cesarean section at Empress Zewditu Memorial Hospital from January 1 to March 30, 2018. Methods: Hospital based observational prospective cohort study was employed for 62 laboring mothers who fulfilled inclusion and deliver by cesarean section under spinal anesthesia selected with systematic random sampling from schedule list. Data was collected immediately after SA administration at 5, 10, 15, 20, 30, 40 minutes. Starting from the immediate postoperative time, an assessment was done at 1, 2, 3, 4, 5, 6 and 12 hours for numerical rating scale (NRS). Based on normality assumption, analysis was done by independent t test, Mann –Whitney U test, χ2 or Fisher’s exact test as appropriate. P-value <0.05 was consider as statistically significant. Result: Hemodynamic change was comparable and there was no adverse effect between the groups. The median pain scores were lower in exposed (BT) group at the 2nd, 3rd, 4th and 5th hours postoperatively and there was statistical significant difference at 2nd, 3rd, 4th and 5th hours postoperatively between exposed (BT) and non-exposed (BA) groups (p<0.001). The duration of anesthesia was effectively prolonged in group BT (245.33 ± 22.854 minutes) compared to group BA (135.00 ± 21.735 minute) (p<0.001). Conclusion and Recommendation: This study showed that intrathecal tramadol (20 mg) can safely be used along with bupivacaine in subarachnoid blockade to prolong the duration of analgesia. We recommend the use of intrathecal tramadol additive for effective post-operative analgesia for cesarean section.
Analysis of Concurrent Chemoradiation Dosimetryin Nasopharyngeal Cancer at Black Lion Hospital: A1-Year Retrospective Study
(Addis Ababa University, 2024-12-13) Yared Desalegn; Sonia Worku
This study aimed to analyze the dosimetric parameters in NPC patients specifically on target dose coverage, conformity index (CI), homogeneity index (HI), OAR sparing, and adherence to international target volume coverage guidelines and protocols. Methods: A retrospective institution-based observational court study conducted dosimetric analysis for 50 NPC patients treated with RT from June 2023 to June 2024. Dosimetric parameters were analyzed for each PTV at 70Gy, 59,4Gy, and 54Gy. Conformity index (CI) and homogeneity index (HI) were calculated to evaluate target coverage and OAR sparing. Dose-volume histograms form treatment planning software (TPS) were analyzed and compared with published tolerance doses in the literature. One-tailed Wilcoxon Signed Rank test was performed to compare dosimetric findings with guideline recommendations
Analysis of Major Orthopedic Surgical Procedures at Black Lion Specialized Hospital, Addis Ababa University, Ethiopia
(Addis Ababa University, 2024-10-17) Mengistu Gebeyehu; Biruk. L
Musculoskeletal disease (MSD) is a major cause of disability in the global burden of disease, yet data regarding the magnitude of this burden in orthopedic surgical services in low and middle-income countries (LMICs) are lacking
Analysis of Postcholecystectomy Syndrome, Single Institution Experience, Zewditu Memorial Hospital, Addis Ababa, Ethiopia, 2024
(Addis Ababa University, 2024-12-13) Bamlack Shewandagn; Sahlu Wondimu
Gallstone disease ranks among the most prevalent surgical conditions, with cholecystectomy being the primary treatment for gallstones. Post-cholecystectomy syndrome (PCS) refers to a variety of symptoms that occur in patients following gallbladder removal

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