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Item Prevalence and Pattern of Jaw Cysts among Patients who Visited Maxillofacial Surgery Department from January 2018 to January 2020, Retrospective Analysis.(Addis Ababa University, 2022-07) Getahun, Etsegenet; Dr.Dejene, Demerew (Ass. Prof., OMFS); Dr.Adula, Surafel(Ass. Prof., OMFS)Background: Cysts are pathologic cavity within the hard and soft tissue which may contain fluid, semi fluid or gaseous material either lined by an epithelium, fibrous tissue or neoplastic tissue involving the bone and soft tissue. It occurs more in the jaw bones commonly due to the presence of numerous rests of odontogenic epithelium that remain after tooth development (1). Epithelial intraoseaous cysts can either be odontogenic or nonodontogenic. Odontogenic cysts are cysts that arise from tooth germ apparatus. Nonodontogenic cysts are cysts that arise from the epithelial remnants of embryonic structures(2). Depending on the type of cystic lesion whether odontogenic or nonodontogenic their distribution seems to vary according to different age groups as well as sex distributions(8,9). Some even seem to show preference to specific anatomic sites and demographics differences (2,11). Methodology: Cross sectional retrospective study were conducted on patients report cards from patients who visited the oral and maxillo facial surgery outpatient department(OPD) in both black lion hospital & dental center at Addiss Abeba University college of health science, whom were registered from January 2018 up to January 2020. All the data from the charts with a diagnosis of odontogenic and nonodontogenic cysts who fulfilled the criteria were used in the study. Data's regarding demography, duration, cystic type, anatomic location and specific cystic diagnosed and intervention were reviewed from the chart. Result: From a total of 70 cases 59(84.3%) were Odontogenic cyst and 11(15.7%) were non odontogenic, in which 38(54.3%) were females and 32(45.7%) were males, with a female to male ration off 1.19.The mean and median ages were 30.01 and 26 respectively (SD=13.844). Among this 51(72.9%) were Periapical cysts, 4(5.7%) were Dentigerous cysts. The most prevalent remaining Nonodontogenic cyst were Nasolabial, Nasopalatine cysts, Lateral periodontal and Residual cysts. The commonest age groups were the first and second decades of life. The location of this cysts were mostly in Anterior maxilla 49(70%). Conclusion: Odontogenic cysts were the most frequent lesion of the jaw that was in this study. Females were more commonly affected. Periapical cyst followed by Dentigerous cyst were the most common inflammatory and developmental odontogenic cysts respectively.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 Retrospective Analysis of Primary Oral and Maxillofacial Malignancy Patient Seen at Tikur Anbesa Specialized Hospital(Addis Ababa University, 2022-05) Ararsa, Chala; Dr.Dejene, DemerewBackground; orofacial cancer is a malignant neoplastic proliferation of epithelial and ectomesenchymal tissue of oral and maxillofacial origin. The late presentation of patient, aggressive nature of orofacial malignancy and the anatomic site closure to vital organ make orofacial cancer management challenging but no sufficient pioneer data in Ethiopia Objective: to assess the patters of primary orofacial malignancy patient visited Tikur Anbesa specialized hospital Materials and Methods: consecutive cross sectional retrospective study was conducted on 175 patients diagnosed with primary oral and maxillofacial malignancy seen at, Tikur Anbesa specialized Hospital over a period of January 2020 to December 2021. Data were collected by chart review and entered to SPSS 25.0 for statistical analysis and results were presented with table, figures and charts. Percentage and frequency were employed for categorical data while mean was used for continuous variables. Result: Of 175 primary orofacial case analyzed male were 57.1 %{ n=100} with male to female ratio 1.48: 1, mean age of (48.21 ± 16.93 years) and range (12–91 years). Squamous cell carcinoma was the commonest cancer (52.0%) followed by mucoepidermoid carcinoma. About 34.% of patient had known risk factor. Majority of the patient were diagnosed as stage IV, 65.7%. Distance metastases were identified in 8.6 % of the studied patient and 41.7% of patients were treated surgically. Conclusion: The study showed as carcinoma was the most prevalent cause of orofacial cancer. Majority of patients were presented with advanced stage of disease and surgery was the main means of treatment modality.Item Prevalence and Patterns of Salivary Gland Disease in AddisAbeba University Maxillofacial Surgery, Affiliated Hospital, Addis Abeba University Ethiopia(Addis Ababa University, 2022-05) Beyene, Million; Dejene, DemerewBACKGROUND The salivary gland located in cheek, mouth, floor of mouth they have different functions like digestion, protection of mouth and teeth. Numerous conditions affect this glands, sialolithiasis/stone in salivary glands and ducts/ inflammatory conditions and tumors are among the most common. OBJECTIVE To assess the prevalence and pattern of salivary gland disease in patients who visited Maxillofacial Surgery departments (TASH & St. Peter hospital) from Jan 2019- Dec, 2021. METHODS AND MATERIALSA multicenterfacility based retrospective cross sectional study was conducted by reviewing secondary data from chart of patients who were evaluated and managed with diagnosis of salivary gland disease during three years period. Data was collected, coded and entered to SPSS 21.0 for statistical analysis and results were presented with table and charts. RESULTS The study showed prevalence of chronic disease among patients with salivary gland disease as 7% .Thirty patients (52.6%)had salivary gland disease located in submandibular gland the commonest salivary gland disease was seen to be sialadenitis which was 29.8%. All of the benign tumors were a pleomorphic adenoma, and out of 11 malignant tumors 9 were found to be MECA.. Surgical treatment was used for the 89 % of the patientsItem 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 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 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 Redo Pull-through: Patient Characteristics, Indications & Outcome at Tikur Anbessa Hospital, Ethiopia, 2010-2019(Addis Abeba University, 2021-11) Tesfay, Hadush; Dr.Getachew, Hanna(Associate Professor of General & Pediatric Surgery)Background: HSD is a developmental disorder of the intrinsic nervious system of the distal colon. The management is pull through procedure and majority of patients do well after surgery; but 32% of patients continue to have complaints after surgery & up to 8.6% of patients can require repeat pull through. Objective: To describe indications for reoperation, surgical technique adopted, complications, and outcome of patients who underwent a redo pull-through procedure in Tikur Anbessa hospital, Ethiopia from Methodology: Retrospective descriptive study design was used and the sampling procedure was a multistage sampling. Descriptive statistics (mean, SD, frequency, percentage, graph and table) was generated by using SPSS version 21. Results: In our study a total of 18(4.87% of all PT) patients underwent redo pull through from 2010- 2019. 13 (72.2%) were males & 5 (27.8%) were females with male to female ratio of 2.6:1. Soave pull through was the most frequent type of pull through on first time; done on 16(94.2%) of patients, two being primary TERPT, and Duhamel pull through for one(5.9%) patient. The type of initial PT wasn’t known in one. The indication for redo PT was pathologically confirmed persistent/aquired aganglionosis in 8(50%) patients. 5(27.8%) patients had anastomotic site stricture confirmed with examination under anesthesia. Three of them were done for persistent obstructive features with clinical impression of aganglionosis. Twisted colon & anastomotic failure with colonic retraction accounted for one patient each. Swenson procedure was performed on 15 (83.3%)patients & Soave pull through was done on 3(16.7%) patients as the procedure for the redo PT. Long term outcome of patients after redo pull through was measured using Holschneider’s FII score. Of the patients FII score was obtained (11 of them), 6 patients achieved good continence,3 has fair continence sttus & one patient was incontinent & required bowel management program to stay clean. One patient was less than 4 years old & not toilet trained yet. In 7 patients the Hilschneider FII score couldn’t be obtained. Conclusion : The indication for redo pull through was persistent obstructive features in 77.8% of patients. The causes of persistent obstructive symptoms after an initial pull-through procedure are pull through of aganglionated segment (50%) and anastomotic site stricture (27.8%). 81.8% of those for whom the Holschneider FII score was obtained has fair t good continence.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 Surgical management of biliary tree diseases in children at Tikur Anbessa Specialized Hospital :a10 year retrospective study(Addis Abeba University, 2021-06) Teshome, Abraham; Dr.Getachew, Hanna (Assistant Professor of General & Pediatric Surgery)Abstract Background Information-biliary tree diseases are diseases affecting bile ducts, gallbladder and other structures involved in production and transportation of bile. A diverse spectrum of diseases affects the biliary system, often presenting with similar clinical signs and symptoms. These conditions include gallstones, cholecystitis, cholangitis, biliary tract cysts, congenital biliary atresia and others. Biliary atresia is a progressive obstructive cholangiopathy of unknown etiology, occurring during the perinatal period. If left untreated it progresses to liver fibrosis and cirrhosis in the first few months of life. Timely Kasai porto-enterostomy restores bile flow enhancing survival and thus age at diagnosis is a potentially modifiable risk factor. choledocal cyst is a rare congenital anomaly of the bile duct which is defined as pathological dilatation of the bile duct. If left untreated it has complications which range from biliary duct obstruction to cholangiocarcinoma. Total cyst excision and biliary reconstruction is the treatment of choice. Little is known about the epidemiology of cholelithiasis in children. Cholelithiasis and choledocholithiasis have been increasingly diagnosed in recent years in children. This phenomenon may be attributed to better medical imaging (especially ultrasonography) and its usage in investigating children with unexplained abdominal pain and/or a genuine increase in the incidence. Objective- to assess clinical presentation, clinical course and outcome of pediatric patients operated at TASH with biliary tree diseases. Methodology: a retrospective study using structured questionnaire was used to collect data on pediatric patients operated at TASH for the diagnosis of biliary tree diseases from Jan 2010 to Jan 2020.The collected data was checked for completeness and analyzed using software SPSS 23. Results and discussion-60% of patients operated for biliary tree and 87% of choledocal cysts were females. More than 60% of biliary atresia patients were operated within the 1 3 months.75% of choledocal cyst was type I and the rest type II.1/3 of patients operated for BA had their jaundice cleared on follow up. Conclusion-age at KPE and post kasai jaundice clearance is low in our setting but similar with other African countries. Type II choledocal cyst is the 2 nd commonest type in our setting unlike other studies.Item Social Impact of a Colostomy on Families of Children with Colorectal Disorders: A Mixed methods Study(Addis Abeba University, 2021-11) Negash, Samuel; Temesgen, Fisseha(Assistant professor of pediatric surgery)Background: Colostomy is one of the most commonly performed pediatric surgical procedures in Tikur Anbessa Hospital. Even though most of the pediatric colostomies are reversible, patients stay a long time with the stoma because of the long wait list for surgery. Apart from medical complications, this treatment imposes a tremendous change in lifestyle. It can cause social, financial and psychological problems. Since parents play an important role in child’s life, it also impacts the whole family as well. Objective To assess the social awareness to colostomy and the social, economic and psychosocial impact on children and their care givers Methods: The study was a cross-sectional study with prospective data collection conducted from October – December 2020. Both quantitative and qualitative data was collected in a convergent parallel design. Convenience sampling technique was utilized to select participants from Tikur Anbessa hospital. Results: Thirty caregivers were interviewed for this study. Most of the parents were married (90%), young (mean age 30.6 years) and living in urban areas (70%). The indications for colostomy were ARM (53%) and HD (47%). The procedure was mostly performed in infants (mean age 6.5 months) and as an emergency (87%). Children stayed with a colostomy from 4 months to 6years (mean 22.8 months). Medical complications occurred in half of the children but only 20% required reoperation. The first reaction towards the colostomy was anxiety. Most parents stated that they did not get adequate counseling or training from doctors. Learning from other patients was the most helpful source of information. None of the patients used a colostomy bag and they expressed significant issues with stoma care. Almost all participants had to stay home to take care of the child and many lost their jobs. They also faced difficulties in their social life because people are uncomfortable around a colostomy. Older children were not able to attend school. Around half of the participants experienced economic challenges because of the colostomy. Conclusion: We found a high rate of psychological, social and economic problems on families of children with colostomy. We recommend for the Ethiopian pediatric surgery association to work on educating the public as well as providing materials, training and support groups for families suffering with this condition. These children should also be given priority on surgical waiting lists.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 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 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 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 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 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 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.Item Prospective evaluation of factors affecting post thyroidectomy outcome at three teaching hospitals from october1,2019-april30,2020,in Addis Ababa, Ethiopia.(Addis Abeba University, 2019-10) Hayato, Telile; Dr.Seife, Henok(MD,Surgeon,Assistant Prof, of Hepatobiliery Surgoen)Background: Postoperative complications after thyroidectomy are problematic for patients and surgeons. The postoperative outcome of thyroidectomies is related to risk factors concerning the patient, the thyroid disease and the surgeon. Thyroidectomy complications may be divided into transient or permanent. The transient may vary from severe, life threatening ones, all the way to mild and meaningless events. Permanent complications, which prevalence is variable, represent the main concern of those who treat thyroid diseases surgically. Despite its importance, the risk factors associated with post-thyroidectomy complications are not enough analyzed. Objectives: To evaluate factor affecting post thyroidectomy outcome in three teaching Hospitals in Addis Ababa Ethiopia. Method: A prospective study was conducted in surgical department of Black Lion, Yekatit and Zewuditu Memorial Hospital. The study has included patients diagnosed for thyroid swelling and operated from October 1 2019 –April 30, 2020, meeting the following criteria: MNG; operation by surgeons with various experiences; and minimum follow-up of 1 month. Age, thyroid function test, indication for surgery, types of surgery, surgeon experience, intraoperative adhesion and estimated blood loss were analyzed as risk factors for post thyroidectomy outcome. Data was analyzed using SPSS version 20.0. P values < 0.05 were considered statistically Significant. Result: During the study period 120 thyroidectomies were performed. There were 20 (16.66%)males and 100 females (83.33%)with Male to female ratio was 1:5.Total Thyroidectomy+,LND performed in 4(3.3%) and Total thyroidectomy alone was performed in 10(8.3.%) patients. Total complications occurred was 23 (19.16%) in 120 patients. Wound infection was the most complication seen in 7(5.8%)of patients and hematoma was seen in 6(5%)patients. 3(2.5%)of patients suffered from recurrent laryngeal nerve palsy and hypocalcemia. There was association b/n early postoperative complication with age (p value=.025 b ), Indication for Surgery (p value.031 b, )and type of surgery (p value.045 ). Estimated Blood Loss was significantly associated with hematoma (p value.000 b b ). Early postoperative complication also has significantly associated with thyroid function test (p value.005 b ), adhesion (p value.035b) and operating surgeon (p value .022b). no association b/n early postoperative complication with, size and duration of goiter There was no postoperative mortality in this study. Conclusion The factors affecting post thyroidectomy outcome were indication for surgery, estimated blood loss, type of surgery, thyroid function test, adhesion and surgeon experience. Patient with these factors should be advised for possible higher rate of complications and the surgeon should be prepared beforehand. Recommendation: Patients with thyroid malignancy, with considerable intraoperative bleeding needs careful hemostasis, can rebleed and develope hematoma. Further study is necessary to identify the cause of wound site infection as commonest complication observed was sugical site infection.