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Item 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.Item Assessment of adequacy of surgical resection for colorectal cancer at Tikur Anbessa specialized hospital from2016-2019, Addis Ababa, Ethiopia.(Addis Abeba University, 2020-10) Nibret, Yonas; Seyoum, Nebyou(MD, Associate Prof. of Surgery); Kotisso, Berhanu(MD, Prof. of Surgery)Background: Colorectal carcinoma is a malignant neoplasm of the colon and rectum. It is the most common malignancy of the gastrointestinal tract. The enbloc removal of the presenting malignancy, to include adequate margins plus the lymphatic nodal basin, remains the hallmark of surgical treatment for cure. Adequate lymph node evaluation is required for proper staging of colorectal cancer, and the number of lymph nodes examined is associated with survival Objectives: To determine the adequacy of surgical resection of patients operated for colorectal cancer at Tikur Anbessa Specialized Hospital. Methods: A retrospective cross-sectional study was conducted by a review of the medical records of all patients who had undergone resection of colorectal cancer at Tikur Anbessa Specialized hospital from January 1, 2016 to December 31, 2019. The data was obtained from the patient’s record review; data was collected using a pretested questionnaire and checklist. Data were checked and entered into Epi data version 3.1 then exported to statically package for social science version 24 for analysis. Result: From the total of study participants above the half 48(53.3%) are male, with male to female ratio of 1.14:1. The majority 44(48.9%) of study participants were found in the age groups of <50 years followed by 50-64 years 26(28.9%).The mean of LN harvested was 10.35(SD ±7.86) with a maximum of 41 and a minimum of 0.And only40% of patients had Adequate LN harvested (≥12). female patients were 2.12 times more likely to have adequate LN harvested as compared to male patients with AOR=2.12(1.49-3.96). Similarly, patients found in the age group of ≥65 were less likely to have adequate LN harvested as compared to patients found in the age group of <50 years with AOR=1.22 (1.60-4.88). Those patients with an age group of ≥65 years were 2.04 times more likely to have radial Margin involvement as compared to others, while fixed tumors are 2.81 times more likely to have radial margin involvement relative to mobile tumors. Conclusion: In this retrospective study, we described the adequacy of nodal harvest in colorectal cancer and evaluated possible factors that may affect the adequacy nodal harvest. Only 40 % of the patients in this study have adequate nodal harvest based on current guidelines. Younger patients less than 50 years of age and female patients were associated with improved nodal harvest. In this study, age≥65 years and fixed tumors are more likely to have radial margin involvement.Item Assessment of Characteristics and Outcome of Cardiac Patients who Underwent Open-heart Surgery at Cardiac Center of Ethiopia, FEB, 2009–DEC, 2020: Retrospective Cross Sectional Study(Addis Abeba University, 2021-07) Amdihun, Rekiya; Dr. Bezabih, Abebe(Cardiothoracic surgeon)Background: - The first successful open heart surgery using extracorporeal circulation technique was performed by John Gibbon in 1953 during an atrial septal defect closure. Cardiovascular diseases (CVD) are group of diseases and injuries that affect the cardiovascular system. As the main cause of death on the planet, cardiovascular disease (CVD) in all its forms is an important public health problem. Most commonly CVD affect the blood vessels of the heart and brain. In general they affect all people in both child and adulthood life. Objective:-The objective of this study is to assess characteristics and outcomes of patients who underwent open heart surgery from FEB, 2009 to DEC, 2020at cardiac center of Ethiopia. Method:-Institutional based cross-sectional study design was conducted. Sampling and Sample size determination: The sample size for the study was determined using single population proportion formula. And Simple random sampling retrospective chart review technique was used. RESULTS:-In this study a total of 320 patients were analyzed, from this 186 (58.1%)of the patients were female and 134(41.9%) were male. The majority of participants were found in the age group 6-18yrs 148(43.7%). The primary diagnosis from this study were ASD 54 (16.8%), VSD covered 42(13.1%), severe MR 40(12.5%). Only eight (2.5%) of patients had post-operative acute kidney injury and 5(1.6%) patients had post-operative bleeding. the immediate overall mortality were 3(0.9%). Conclusion and Recommendation: The present study had identified that more than half 58.1% of the patients were female. It also identified ASD the commonest CHDs followed by VSD. This study report that MV replacements were the most common valve surgery. Open heart surgery can be performed with excellent outcome in cardiac center of Ethiopia. We recommend that doing further research on associated factor for this outcome. That may better to know which variable has association for good outcome .and also quality improvement and increase number of surgeons is good for doing all the surgeries by local team.Item Assessment of Coagulation Profile among Adult Cardiac Outpatient Department of Tikur Anbessa Hospital, Addis Ababa, Ethiopia.(Addis Abeba University, 2021-02) Fantahun, Ibrahim; Bezabeh, Abebe(MD, Cardiothoracic Surgery)Background; the coagulation process is initiated by platelets forming a plug at the location of the injury within few seconds of a breach in the vascular integrity. This constitutes the primary haemostatic mechanism. Secondary homeostasis is a multifaceted interaction between plasma coagulation factors, which results in the creation of fibrin strands strengthening the platelet plug. A hospital based cross sectional (retrospective chart review) study design was employed and simple random sampling techniques was used. Sample size is calculated by taking assumptions of 95% confidence level, there is no other study conducted related with this title to being use as a reference proportion so I took 50% (P=0.5) as a reference proportion. And adding 10 % nonrespondents rate. The total population under study, which means total patient number who attend cardiac clinic in last month, was 1000 so by using correction formula the sample size becomes 306. In this study we found that the mean INR value of a patient under study was 3.037 (SD: ±1.43) and the median was 2.9.While the quarantines was 2.0 – 3.65. According to our study, the data confirmed that the mean platelet count of the study unit was 282248(SD: ±89589). However, the mean PTT value of patients was 41.7 seconds (SD: ±11seconds). While the minimum PTT was 22 seconds and the maximum was 77 seconds. as this study is hospital based with limited representativeness population based studies are recommended.Item Assessment of the Effect of Lactate on Patient Outcomes and Associated factors among Patients who Underwent Cardiopulmonary Bypass Surgery at Cardiac Center Ethiopia, Addis Ababa, Ethiopia 2021.(Addis Abeba University, 2021-02) Tesfaye, Tigist; Dr. Bezabih, Abebe(Assistant professor)Introduction: Hyperlactatemia and lactic acidosis are commonly encountered during and after cardiac surgery. Perioperative lactate production increases in the myocardium, skeletal muscle, lungs and in the splanchnic circulation during cardiopulmonary bypass. Hyperlactatemia is highly suggestive of tissue ischemia and is associated with a prolonged intensive care unit stay, a prolonged requirement for respiratory and cardiovascular support and increased postoperative mortality. Objective: The objective of the study was to assess effect of lactate on patient outcomes and associated factors among patients who underwent cardiopulmonary bypass surgery at Cardiac Center Ethiopia, Addis Ababa, Ethiopia from December 2020 to February 2021. Method: An institution-based retrospective cross-sectional study was done among all patients who underwent cardiopulmonary bypass surgery from December to January. Data was collected from patient chart review. The collected data was entered into Epidata version 4.2 and export to SPSS 23 for analysis. Descriptive statistics for categorical and continuous variables was done. A chi-square test was done to show the presence of an association between the outcome variable and independent variables. A variables fitted on bivariate analysis was entered into multivariable analysis to show the strength of association and statically significant variable. Result: The prevalence of hyperlactatemia in this study among patients who underwent cardiac surgery procedures at Cardiac Center Ethiopia was 37.5 %. Rise in lactate level prolongs ICU stay, Prolongs intubation duration and increase need of Inotropes support. Lactate level was measured on immediate postoperative day within 10 hours after the surgery and was defined as lactate level > 3 mmol/L in the first hour after surgery. Age > 50 years [AOR: 6.8 (95% CI 1.725), P=<0.008]. female gender [AOR: 1.8 (95% CI 1.1-3.8), P=0.048]. Variables statistically significant were declared at 95 % CI, p-value < 0.05. Conclusion and Recommended: Early rise in lactate level in patients who underwent cardiopulmonary bypass surgery is a strong and robust predictor of morbidity and mortality. Different patient and operative factors involved in this pathophysiology. As a result, strict follow up management of those factors are recommended.Item Audit of Operation Notes in Plastic and Reconstructive Surgery Unit, All Africa Leprosy Tuberculosis and Rehabilitation Training Center (ALERT) Hospital(Addis Ababa University, 2021-12) Legesse, Hellina; Baraki, Ataklitie(MD, FCS-ECSA,Ass. Professor of surgery)Introduction: High quality operation notes are one of the most crucial parts of patient care as it is a means of communication among professionals, source of data for audits and researches, and a source of information in court. The Royal College of Surgeons of England has produced a guideline in 2014 that outlines the minimum standards that need to be documented on operation notes. This study aims to assess the adherence of ALERT hospital plastic and reconstructive unit to these guidelines. Objectives: To evaluate operation notes in the plastic and reconstructive unit of ALERT hospital against RCSEng GSP 2014 standards, identify causes of incompleteness and suggest possible ways of improvement in the quality of operation notes. Methods: The study is conducted, plastic and reconstructive unit of ALERT hospital. It is a cross sectional retrospective study conducted using stratified random sampling of 341operation notes written since April 1, 2020, supplemented by survey questionnaire administered to 22 doctors (consultants, fellows and residents) to assess their experience and opinion regarding operation note standards. Results: None of the RCSEng GSP 2014 standards were consistently documented. Only 3 standards were documented in more than 90% of operation notes. Most operation notes were written by residents. Survey questionnaire administered results showed the participants believe that lack of quality of operation notes affects follow up and future interventions for patients. More than 95% of the respondents reported that they do not write all the standards consistently and most commonly attributed reasons are absence of formal education on the subject and operation note proforma incompleteness according to the standard. Among the measures suggested by the survey participants to improve the quality of operation note include introduction of formal teaching about operation note writing, updating the existing operation note proforma to include the RCSEng GSP 2014 standards and educating the staff about the standards. Conclusion: Operation notes in plastic and reconstructive surgery unit of ALERT hospital are not up to standard per RCSEng GSP 2014 guideline. Formal education, update of existing operation note proforma, posting aide memoires in the operation theatres and clinical education of the staff about the standards are some of the proposed solutions to improve the quality of the operation notes.Item Characteristic, Outcome and Associated factors of COVID 19 Cases Admitted to ICU and Mechanically Ventilated at Eka Kotebe General Hospital, Addis Ababa, Ethiopia, 2020: Retrospective Cross Sectional Study(Addis Abeba University, 2021-02) Meded, Semira; Dr.Nega, Birhanu(Associate professor); Abagero, Abdulnasir(MPH, Resident Advisor Field Epidemiology program)Introduction: As the COVID-19 pandemic is rapidly spreading throughout the world it has taken millions of lives. Among the population the critically ill and those who have other co morbidities are largely affected by it. In order to accommodate the growing number of critically ill patients and those who require mechanical ventilation hospitals are constantly expanding and trying to meet the overwhelming demand. Therefore, identifying COVID-19 characteristics, outcomes and associated factors among patients requiring mechanical ventilation is crucial for resource planning and proper management. This study is mainly aimed to assess the characteristic and outcome of COVID 19 cases admitted to ICU and mechanically ventilated patients. Objectives: The objective of this study is to assess characteristic, outcome and associated factors of COVID 19 cases admitted to ICU and mechanically ventilated at Eka Kotebe General Hospital. Study design: hospital based prospective cross sectional study design was used. Results: a total of 179 patients were included in this study and the 30 days mortality rate was 59.2 %. 77.1 % of the patients had comorbidities. Male gender, history of Diabetes, CKD and uses of vasopressor and laxatives were associated with 30 days patient mortality. Recommendation: We recommend that Male patients, patients diagnosed with Diabetes Miletus, CKD and who are receiving vasopressor therapy should be given a higher priority and carefully followed in the ICU to decrease the mortality rate.Item Clinical Outcomes and Prognostic Determinants of Surgically Treated Depressed Skull Fracture in Addis Ababa University Neurosurgical Teaching Hospitals: A Prospective Multicenter Observational Study(Addis Abeba University, 2020-10) Hussein, Abdulaziz Abdellah; Laeke, Tsegazeab ( MD, FCS (ECSA) 2Background: Depressed skull fracture (DSF) is one of the commonest neurosurgical emergencies in Ethiopia. The clinical outcome after surgical management and what factors predict the outcome is not well-studied, especially in low-income countries like Ethiopia. Our study aimed to assess the clinical outcomes of DSF and identify predictors of the outcome in surgically treated adult patients. Methodology: A prospective, multicenter, observational study was undertaken on 197 surgically treated patients with DSF from June 1, 2018, to June 30, 2020, at four selected neurosurgical teaching hospitals in Ethiopia. Adult patients with clinically palpable or CT evidence of DSF who underwent surgery for the primary indication of the DSF were included in this study. Data on patients‟ socio-demographics, mechanisms of injury, clinical findings at presentation, imaging, and intraoperative findings, and postoperative course was collected and analyzed. The outcome was assessed by the extended Glasgow outcome scale (GOS-E): as favorable or unfavorable. Bivariate analysis was done to identify factors that correlate with the clinical outcome and multivariate logistic regression analysis was done to identify independent predictors of the outcome. Results: The overall clinical outcome was favorable in 81.2% of 197 patients. The mean age of participants was 27.77 +/- 10.21 years with a male to female ratio of 23.6:1. The most common mode of injury was violence-related 157 (79.7%). The DSF was compound in 186 (94.4%). Posttraumatic motor deficit and early posttraumatic seizures were witnessed in 24.4% and 8.1% respectively. Based on post-resuscitation GCS 182(92.2%) patients had mild TBI, 12(6.1%) moderate TBI, and only 3(1.5%) were in severe TBI. The most common site of fracture was frontal bone involved in 103 (52.3%) of cases, followed by parietal bone in 48 (24.4%). Associated intracranial lesion was identified in 172 (87.3%) of cases. The median days of hospital stay were 4.7 days. Totally 8(4.1%) patients underwent reoperation and the overall mortality was 0.5%. In bivariate and multivariate analysis, posttraumatic motor deficit (adjusted OR 13.8, 95% CI: 4.13-46.17, P=0.000), post-resuscitation GCS ≤13 (adjusted OR 10.36, 95% CI: 1.93-55.56, P=0.006), pneumocephalus on brain CT scan (adjusted OR 12.93, 95% CI: 3.1253.52, P=0.000), hospital stay for ≥ 3 days (adjusted OR 4.39, 95% CI: 1.18-16.3, P=0.027) and reoperation (adjusted OR 6.92, 95% CI: 1.091- 43.97, P=0.04) were statistically significant independent predictors of unfavorable outcome. Conclusion: The overall outcome of surgical treatment for DSF in this study was favorable. The presence of motor deficit, post-resuscitation GCS ≤ 13, pneumocephalus, reoperation, and hospital stays for ≥ 3 days were independent predictors of an unfavorable outcome.Item Delays in Laparatomy for Acute Abdomen: An Observational Study of Pre Hospital Factors, Conducted in two Hospitals (ZMH, MIIH) from January to June2020GC Addis Ababa, Ethiopia(Addis Abeba University, 2021) Tadesse, Aemro; Dr.Tadesse, Amezene(Associate Professor, Consultant General and Pediatric surgery, AAU CHS TASH )Surgical Acute Abdomen is an emergency that requires prompt surgical intervention. Multiple studies have established a direct link between delays in presentation and surgical outcome in terms of morbidity and mortality. There are 4 layers/levels within the healthcare system: the Environment, the Organization, the Health Care Team and the Patient. When analyzing delays it is prudent to identify deficiencies at all 4 levels of the healthcare model interventions to correct or mitigate deficiencies will be different at each. Even though reasons for delay are multi factorial, it is prudent to identify deficiencies at all 4 levels of the healthcare model. This study mainly focuses on the influences of patient and primary health care factors for surgical delay in pre hospital time. We tried to see why patients delay in seeking help, and some factors after reaching healthcare system. Studies that have attempted to describe factors that significantly affect Health Seeking Behaviour(HSB) during illness episodes can be broadly classified into two. Studies which emphasize the utilization of formal health system, or health care seeking behavior of people. These involve creating models that describe series of steps people take towards health care model such as The Anderson, pathway models .The Andersen healthcare utilization model is a conceptual model aimed at demonstrating the factors that lead to the use of health services. According to the model, usage of health services is determined by three dynamics: Predisposing, Enabling factors and Need. Our study is under the second group. The Second group of studies demonstrate that decision to engage with particular channel is influenced by variety of factors such as socioeconomic status, age ,sex ,social status, type of illness access to service and perceived quality of service. The second group comprises those studies which emphasize the process of illness or HSB. Focus on specific genres of determinants which lie between patients and services such as geographical social economic cultural and organizational factors.Item Determinants of cardiothoracic surgery outcomes among patients underwent cardiothoracic surgery at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia, 2021(Addis Ababa University, 2021-07) Getahun, Hewan; Tsige, Yosief (Ass. Prof); Alemu, TsionBackground: Associated diseases and risk factors are the major causes of postoperative complications after cardiothoracic surgery. Outcome of Cardiothoracic surgery is generally associated with high incidence of myocardial, neurological, renal dysfunction, bleeding, surgical site infection which account up to 10% mortality depending on age, sex, comorbidity, preoperative medication and reoperation. Objective: To assess the determinants of cardiothoracic surgery outcomes at Tikur Anbessa Specialized Hospital Addis Ababa Ethiopia. Methodology: A retrospective institutional based cross-sectional study design was conducted among 323 randomly selected patient records. Systematic random sampling technique was used to select medical records. Data was gathered from the medical records of cardiothoracic patients registered during the past five years (from November 2015- November 2020) using a pretested checklist. Result: Male participants were found to be involved more than female participants. The following were final predictors of cardiothoracic surgery outcomes. Ages between 18 and 28, 1.398 times more likely to develop poor outcomes postoperative compared to the rest age groups. [AOR=1.398, 95% CI=1.179-1.656]. Patients with chronic pulmonary disease are 1.713 times more likely to develop poor outcomes as compared to patients with other comorbidities and no known comorbidities [AOR=1.713, 95% CI=1.041-2.818]. And patients whose duration of surgery is 2-3hrs 2.306 times more likely to develop poor outcomes postoperative as compared to 3-4hrs duration of surgery [AOR=2.306 95% CI=1.241-4.283]. Personal habits, waiting time for surgery since admission lost their significance. Conclusion: In this study age, comorbidities (chronic pulmonary disease), and duration of surgery were factors associated with the outcomes. Further investigation during perioperative period like adjusting medications, chest physiotherapies, preoperative and postoperative patient care in order to reduce the poor outcomes.Item Incidence and pattern of mandible fractures in AAU affiliated hospitals (Yekatit 12 Hosptial Medical College and St.Peter’s specialized Hospital) Addis Ababa, Ethiopia.(Addis Abeba University, 2020-08) Abera, Assefa; Dr.Dejene, Demerew (Assistant Professor of Oral and Maxillofacial Surgery); Dr.Uma, Girma (Assistant Professor of Oral and Maxillofacial Surgery)Objectives: The objective of this study was to assess the incidence and pattern of mandible fractures in AAU affiliated hospitals in Addis Ababa, Ethiopia over a retrospective period of 3 years from January 2017 to December 2019 G C. Methodology: Retrospective review of pat ient’s records was conducted among those patients who visited AAU affiliated hospitals having mandibular fractures. The study was conducted from November, 2019 to August, 2020. The patients chart with incomplete information and those which are absent from shelf were excluded from the study. The data was entered, cleaned and analyzed using Epi info data version 7.0 Software. Descriptive analysis was computed as frequency of fractures, distribution of age, gender, etiology, diagnosis, and anatomical sites of mandibular fractures. Results: A total of 247 patients who were retrospectively evaluated at Yekatit 12 HMC and St.Peter’s specialized hospital between January 2017 and December 2019 sustained 343 mandibular fractures (mean of 1.4, range 1-3). The incidence of mandibular fracture was higher in male patients (83%) than in females (17%) (Male: Female ratio 5:1), and the peak incidence was during the third decade for both genders. The most common site of fracture was the body (26.53%), followed by the angle (23.9%), and parasymphysis (19.82%). Overall, interpersonal violence (46.15%) was the most common cause followed by RTA (27.53%). In male patients, the most common cause was interpersonal violence (50%); in females it was a RTA (34.14%). The anatomical sites of fracture reflected their cause. A total of (n=76, 30.76%) patients sustained other non-maxillofacial injuries of which head injury (n=58, 23.48%) is the most common. Conclusions: The most common cause of mandibular fracture was interpersonal violence. Mandibular fractures were more common in males than females with most patients aged 21-30 years. The most common fracture site was body of the mandible. The predominant treatment modality was open reduction and internal fixation (ORIF).Item Incidence and Prevalence of BenignodontogenicTumours Among Patients Visiting Tikur Anbessa Specialized HospitalandiIt’s Affliated Hospitals (AAU Dental Center and St. Peter Specialized Hospital) from January 2020,December 2021,AA,Ethiopia(Addis Ababa University, 2022-03) Regassa, Berhanu; Dejene, Demerew(Assistant Professor of Oral and Maxillofacial Surgery)Background: Pathological processes of oral and maxillofacial region are generally classified as benign or malignant based on specific histological criteria, including the presence or absence of necrosis, mitotic figures as well as basic understanding of the entity. Odontogenic tumor (OT) comprises a large heterogeneous group of lesions arising from the tooth producing tissues or its remnants. It ranges from hamartomatous or non-neoplastic proliferations to benign and malignant neoplasm with variable aggressiveness and metastatic potential. OTs cause facial disfiguring that necessitates subsequent reconstructive surgery. The objective of this study was to determine the types, prevalence and demographic distribution of benign Odontogenic tumor among patients treated at tikuranbessa specialized hospital and its affiliated hospitals. Objective: To assess the incidence and prevalence of benign Odontogenic tumor among patients treated at tikuranbessa specialized hospital and its affiliated Hospitals in Addis Ababa, Ethiopia over a retrospective period of 2 years from January 2020 to December2021. Methods: Retrospective review of patients records will be conducted among those patients who visited tikuranbessa specialized hospital and its affiliated hospitals diagnosed with benign Odontogenic tumors’ in the time period of January 2020 to December 2021 G.C. Data such as age, gender, duration of lesion, location of the tumors, size of the tumors, type of tumors, type of surgical treatment, and complaints during follow-up were reviewed. All the collected data were then coded, checked, edited and entered to SPSS windows 25. Finally, the data was analyzed by descriptive statistics. Results::A total of 68 patient’s socio-demographic, and clinical data were reviewed from the registry book of patients who were diagnosed with OT. The complete data set was obtained for 55 patients, comprising 28(50.9 %) males and 27 (49.1 %) females. The mean age of patients was 30.4, with a range of (6–68) years. Concerning the location of OTs, 20 (36.4 %) occurred in the maxilla, and the vast majority 35(63.6%) in the mandible. Ameloblastoma with predilection for the mandible was the most frequent OT (32.7%), followed by keratocystic Odontogenic tumours (KCOT) (24.45 %). Conclusions: OTs were found in both genders with similar proportion. Checkup and/or visit to dentists could help early case detection, and management of OT.Item Intraspinal Tumors: analysis of 155 surgically treated cases in three hospitals, Addis Ababa, Ethiopia.(Addis Abeba University, 2020-11) Mohammed, Salahadin Bedru; Bogale, Thomas (M.D,Assistant professor of Neurosurgery)Background: intraspinal tumors are one of the rare tumors of the CNS. The occurrence and distribution of intraspinal tumors by sex, age, and pathology are different among races andregions. There is a paucity of information on operated cases of spinal tumors in patients in sub-Saharan Africa Objective: Theobjective of this study is to evaluate the demographics, histologic pattern, anatomic distribution, and extent and outcome of surgery of Ethiopian patients with spinal tumors. Methodology: A retrospective study comprising a cohort of patients who underwent surgery for spinal tumors in three teaching institutions in Addis Ababa, Ethiopia, from January 1,2015, to June 30 th , 2020. Data obtained included patient demographics, duration of symptoms, anatomic location, imaging findings, McCormick scale before and after surgery, and type and outcome of the surgery. The data was collected from the patient’s medical chart using a data collection checklist and was encoded into IBM/SPSS version 25. Descriptive statistics and Binary and multivariate Logistic Regression analysis was made to identify predictors of outcome. P<0.05 was considered significant Result:A total of 155 patients were included. The mean age was 39.5 years. The mean duration of illness was 13.9 months. 75.4% had lower limb weakness. Thoracic tumors predominate 46.9% followed by cervical tumors 20.6%. The majority of the tumors were IDEM 51.6%. GTR was achieved in 67%. The most common histological origin was meningioma 35.9%. An overall complication rate of 16.8% was observed, the commonest being new/worsening of neurologic deficit occurred in 12.3%, a significant association was found in cervical tumors (p=0.048). The operative mortality was 5.8%, cervical tumors (p=0.05), postoperative complications (neurologic deficit (p=0.023), infection (p<0.001) and bedsore(P<0.001), and astrocytic tumors (p<0.001)were found to be independent risk factors for mortality. Although neurological improvement was seen in 87%, patients with preoperative poor ambulatory status (p<0.001) and sensory deficit (p=0.012) and discharged with worsened status (p<0.001)were found to be independent risk factors for poor neurologic outcome. Conclusion: Most of the patients improved in their clinical outcome, cervical tumors are prone to postop complications and mortality. Patients who came with poor neurologic status and sensory deficits will develop a poor neurologic outcome.Item Knowledge of Cardiovascular Disease Risk factors among Patients Attending Cardiac follow up Clinic in Tikur Anbesa Specialized Hospital.(Addis Abeba University, 2021-02) Tesfaye, Azeb; Dr.Nega, Berhanu(Associate Professor of Surgery,Cardiothoracic Surgeon)Introduction: as the largest single cause of death on the planet, cardiovascular disease (CVD) in all its forms is an important public health problem. CVD is not a single disease, but a cluster of diseases and injuries that affect the cardiovascular system. These are most commonly diseases of the heart and of the blood vessels of the heart and brain. In general they affect people in beginning and later life. The aim of this study is to asses Knowlegde of cardiovascular disease riskfactors among patients attending cardiac follow up clinic in Tikur Anbes Specialized Hospital. Methods: A Cross sectional study Design was conducted in Tikur anbesa specialized Hospital. The sample size of this study is 305. The sampling method of this study is systematic random sampling. Epi-info was used for data entry and SPSS for analysis. Descriptive statistics is applied for analysis and Mean, standard deviation, tables and graphs used for data summary and presentation. Result: Among of all the respondents, 163 (54.3%) had good knowledge while the rest 137 (45.7%) were found to be not knowledgeable. Two third of the respondents, 190 (63.3%), reported that Consumption of alcohol is not a risk factor for CVD while only the rest 110 (36.7%) reported alcohol is a risk factor for CVD. Considering Diabetes mellitus, 246 (82%) of them reported that having Diabetes mellitus is a risk factor for CVD. Conclusion: The knowledge of CVD patients in the current study area was found to be low. The habit of physical exercise of the study subjects is found to be poor with most of them travelling using cars or buses. The proportion of study subjects with risk factors like overweight, cigarette smoking and Alcohol consumption was found to be high. Ethiopian Federal ministry of health should focus on awareness raising programs including broadcasting messages for the whole population. Physical activities should be promoted by acknowledging and scale up the monthly street sport festivity to weekly or bi-weekly.Item Mini-cholecystectomy: A 5-year retrospective cross-sectional study(Addis Abeba University, 2020-10) Bekele, Solomon; Prof.Ersumo, Tessema( Ass. Professor of Surgery, CHS, AAUandProfessor of Surgery); Tamirat, Girmaye(MD, Consultant General and EndocrineSurgeon)Background: Gallstone disease is one of the most common surgical pathology. cholecystectomy is main mode of management for gallstones. Laparoscopic cholecystectomy, open cholecystectomy, and mini cholecystectomy are options for surgical removal of the gallbladder.Several studies showed that minicholecystectomy offers minimal trauma to the patient with similar complication rate. Objectives: This study is aimed to determine and analyze the outcomes of Mini-Cholecystectomy performed at Betezatha General Hospital from January 1, 2014 to December 31, 2019. Patients and Methods: A 5-Year retrospective cross-sectional study ofall patients who underwent mini-cholecystectomies from January 1, 2014 through December 31, 2019 at Betezatha General Hospital. Results: A total of 206 patients underwent mini-cholecystectomy. With a male to female ratio of 1:6. Most patients (57%) presented with RUQ pain. Almost 70% of patients were found to have at least one comorbidity along with gallstone disease. The average operation time was 35minutes. Patients with chronic contracted cholecystitis were found to have difficult minicholecystectomy. Conversion rate to standard cholecystectomy was 2.9%. Bile duct injury occurred in 1 patient (0.45%). Almost all patients (98%) had hospital stay of less than 72hrs. Conclusions: Mini-cholecystectomy is a safe method of cholecystectomy which can be practiced in a resource limited setting without undue complications.Item Operative outcome of neonates with intestinal obstruction: a one year prospective study from January 2020 to December 2020 at Tikur anbessa specialized hospital Addis Ababa, Ethiopia.(Addis Abeba University, 2021-12) Gebremichael, Ashagre; Getachew, Hanna(MD, Associate Professor Of Pediatric Surgery, AAU, College Of Medicine And Health Science, Department Of Surgery)Background Neonatal intestinal obstruction (NIO) is one of the most common emergency conditions a pediatric surgeon is called upon to assess during the neonatal period. Successful management of NIO depends on timely diagnosis and referral for therapy. In developing countries, like Ethiopia, many challenges are encountered in managing these neonates and the outcomes remain poor. Despite TASH having been offering treatment for neonates with intestinal obstruction for many years, the pattern and outcomes (morbidity and mortality) of these patients remain unknown. This necessitates local research on this disease not only as an audit of our care but also to generate more information on this complex disease process. The purpose/aim of this study was to review the pattern of intestinal obstruction in the neonatal period, its associated complications and outcome of management in order to determine factors associated with death of these newborns in TASH, Addis Ababa , Ethiopia. Methodology A Prospective describtive single-center study of neonates who were operated for intestinal obstruction at TASH were studied. Factors that determine post-operative outcome and associated morbidity and mortalities were analyzed in all patients. Results: During the twelve months period, One thousand four hundred sixty babies were admitted at the pediatric ward and NICU. Eighty two (5.6%) of these were cases of neonatal intestinal obstruction. There were 59 males and 23 females, with male to female ratio of 2.5:1. The mean weight of the neonates was 2.7kg (range 1.5-4.0kg). The average age at operation was 6.8 days (1-34days), the mean duration of symptoms before presentation was 4.2 days. The major indication for operation was Anorectal malformation53 patients {64.6%}, Hirschsprung’s disease11 {11.5%}, Intestinal atresia 15 patients {18.3%) }, malrotation 3 patients (3.6%). The overall mortality recorded in this study due to intestinal obstruction was 20.7% (17 patients). Severe sepsis with multi organ failure was ascribed for the death of 10(58.8%) of neonates. Conclusion: The morbidity and mortality of neonatal intestinal obstruction in this hospital is due to the problems of late presentation and sepsis at presentation. The findings are at variance with those in developed countriesItem Outcomes of decompressive craniectomy in adults with severe traumatic brain injury.(Addis Abeba University, 2020-12) Assefa, Samson; Biluts, Hagos(MD, Associate professor, Neurosurgery Unit, Department of surgery, Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia )Objective: The aim of this study is to assess the outcome of decompressive craniectomy in adult patients with severe traumatic brain injury and to identify factors responsible for poor outcome Methodology: A retrospective study of 36 patients with severe TBI who had undergone decompressive craniectomy in a period of 40 months (May 2017 to March 2020). Adult patients, aged between 15 and 73 years of both genders undergoing DC were selected. Variables assessed were Sex, age, presence of comorbid illness, mechanism of injury, presence of associated injury, pre-operative GCS and motor score, pupillary reaction, CT finding, degree of midline shift, the status of the basal cisterns, Rotterdam score, and timing of surgery. The outcome of patients was assessed using the Extended Glasgow Outcome Scale. Student’s t-test and Chi-square test were used to identify possible factors responsible for poor outcome. Results: 36 patients (31males and 5 females) underwent surgical decompressive craniectomy with a mean time of 25.6 hours (SD=26.2) after trauma. Mean age of patients was 33.39 years (SD=13.92), old (range: 15 to 73 years). The mean duration of follow up was 5.78months. 33.3% of patients had a favorable outcome (GOSE=5-8), 66.7% had unfavorable outcomes (GOSE= 14) and the mortality rate was 52.8%. Among patients that survived, 70% had a favorable outcome and 30% had an unfavorable outcomes. Cranioplasty was done in 11 of the discharged patients (61%). The mean timing of cranioplasty was 6.2 months post craniectomy. Patients with the following conditions had significantly worse outcomes; presence of associated extracranial injury, preoperative GCS ≤ 5, motor score of 2 to 3, abnormal pupillary reaction, absent basal cisterns on CT scan, and high Rotterdam score. There was also a significantly significant association between older age and mortality. Complications included hydrocephalus (one patient), surgical site infection (SSI) in nine patients, six of the SSI were infection of the bone flap kept in the abdomen. Conclusion: The result of this study indicates that the majority of survivors after decompressive craniectomy have a good functional outcome as analyzed by GOSE. Poor functional outcome and death were observed in patients having poor prognosticators. Improving patient selection may further improve outcome in these very severely brain-injured patients.Item Outcomes of Outcomes of Anerior sagittal Ano-Rectoplasty in the Management of Rectoves Tibular Fistula at Two Referral Hospitals(Addis Abeba University, 2021-05) Beker, Zinedin; Dr.Tadesse, Amezene (MD,FCS-ECSA ,Associate Professor of Surgery Consultant General and Pediatric Surgeon)Background Over the years, a great deal of information has been acquired concerning the many variants of ARM. The current mortality for these anomalies for the most part has been very low and is related to associated anomalies and unfavourable chromosomal and genetic syndromes rather than the result of treatment of the ARM per se. In general, agreement has been reached regarding some embryologic and anatomic considerations, diagnostic evaluation, and preoperative assessment. Most investigators would agree that results are better following repair of low defects when compared to intermediate and high anomalies and those with cloaca. There remain several areas of controversy regarding the choice and timing of the procedure and methodology used to assess results. Certain poor prognostic factors have been identified, including abnormal sacrum, deficient pelvic innervation, poor perineal musculature and disorders of colonic motility. Objectives To investigate the overall outcome ASARP in the management of recto vestibular fistula in Tikur Anebessa Hospital & Minilik Referral Hospital , Ethiopia from January 1, 2015 to December 30, 2020 Methods A cross-sectional study design with convenience sampling technique was used on 74 patients who had ARM with RVF. Krickenbecks bowel function scoring system was used to assess the bowel functions score. Patients cards, follow-up charts and direct phone contacts with families were used to collect data from selected ARM patients who undergone ASARP in the two of the referral Hospitals from January 1,2015 to December 30, 2020. Result : In this study we do not found statistically significant associations between the type of operations and the occurrence of Post-operative early wound complications or anal stricture But the overall frequency of early post-operative complications more in two staged ASARP (14.8%) and anal stenosis is observed in the Three staged ASARP group more frequently (21%) . This study also found lower rates of screening for associated anomalies and higher rate of postoperative neo anal stricture (17.6%). Majority studied patient have an excellent bowel function (96.2%).Item Outcomes of Patients Operated for Exstrophy-EpispadiasComplex at Tikur Anbessa Specialized Hospital and Menelik-II Specialized Hospital, Addis Ababa, Ethiopia(Addis Abeba University, 2021-11) Hailemariam, Yeshigeta; Dr.Kiflu, Woubedil(Assistant Professor of General Pediatric Surgery)Background: Exstrophy epispadias complex (EEC) is a spectrum of congenital abnormalities that involves urinary system, musculoskeletal system, pelvis, pelvic floor, abdominal wall, genitalia, and sometimes the spine and anus. It encompasses epispadias, classic bladder exstrophy, cloacal exstrophy and other exstrophy variants. The management of EEC is primarily surgical. The surgical procedures are either functional anatomic reconstruction (single staged or multiple staged) and urinary diversions. The principal goals of surgical reconstruction in EEC are achieving urinary continence with volitional voiding, preservation of renal function, and functional and cosmetic external genitalia. Objective: Describe the outcomes of patients operated for exstrophy epispadias complex at Tikur Anbessa Specialized Hospital (TASH) and Menelik II specialized Hospital (NH) from September 1 , 2012 up to August 31 st , 2019. Method: Retrospective descriptive study which assessed the outcomes of patients operated for exstrophy epispadias complex at TASH and MH from September 1 st , 2012 until August 31 Results: One hundred and forty patients with EEC operated during study period, 91 patients (18 isolated epispadias, 66 classic bladder exstrophy, 3 cloacal exstrophy, and 4 variant exstrophy) were included in the study. No patient diagnosed during pregnancy. The median age at first hospital presentation was 5 months (birth to 12 years), and first operation was done at median age of 48 months (4 days to 12 years). The commonest type of EEC was classic bladder exstrophy (71.4%). Associated congenital anomalies was found in 26 (28.6%) of patients. Primary urinary diversions were done for 23 (25.3%) patients. Functional anatomic reconstructive procedures were performed for 68 (74.7%) patients. Most patients with classic bladder exstrophy have failed anatomic functional reconstruction and require urinary diversion to achieve continence. Early postoperative complications occurred in 76 (89.4%) patients. Forty-two patients (29 Mainz pouch II, 7 augmentation ileocystoplasty with catheterizable stoma, 5 epispadias repair and 1 complete primary repair of bladder exstrophy) achieved urinary continence. More than half (52.3%) patients disappeared from their regular postoperative hospital visits. Conclusion: Urinary continence after anatomic functional reconstruction to EEC usually require urinary diversion (Mainz pouch II or augmentation ileocystoplasty) except in isolated epispadias. st , 2019.Item Pattern of Major Maxillofacial Surgeries at Addis Ababa University Tikur Anbessa Specialized Hospital Oral & Maxillofacial Surgery Affiliate Hospitals: 3 Years Retrospective Analysis.(Addis Abeba University, 2020-08) Adula, Surafel; Dana, Demerew Dejene (Assistant Professor of oral& maxillofacial surgery)Background: Oral and maxillofacial (OMF) region is an area that is prone to multitude of disease conditions which may be of developmental nature or acquired nature which require surgical intervention in many occasions. Objectives: To describe the indications, pattern and types of major oral and maxillofacial surgical procedures carried out at Addis Ababa university Oral & Maxillofacial Surgery (OMFS) affiliate Hospitals (Yekatit 12 Hospital Medical College and St.Peters Specialized Hospital) in a period of 3 years from January 2017 to December2019. Methods: A retrospective study of operation records of all patients who had undergone oral and maxillofacial surgeries under general anaesthesia at Yekatit 12 Hospital Medical College and St.Peters Specialized Hospital in a period of 3 years from January 2017 to December 2019 was done. Descriptive statistics such as biodata, indication for surgery and type of surgery were recorded and analyzed using the Epi info version 7 software. Time frame: The study was conducted from November 2019 to August 2020. Result: A total of 689 patients with oral and maxillofacial conditions were managed during the study period. The male to female ratio was 2.48:1, and the mean age of patients was 29.05 years with standard deviation of ±15.5.The predominant indications for surgery were traumatic conditions (50.71%, n=354), followed by neoplastic(benign and malignant)conditions (18.7%, n=129), and tumorlike /cystic conditions (16.5%, n=115). Open reduction and internal fixation the most common (43.7%,n=313) surgical procedure performed under general anaesthesia. Conclusion: The field of Oral and Maxillofacial surgery in our climes is a relatively new one, however, it is evolving and its relevance is growing. With the observed relatively high frequency of traumatic conditions, especially among younger populations, efforts geared at prevention and adequate preparedness for proper surgical management of such patients should be commenced.