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Item Assessment of Prevalence and Associated Factors of Postoperative Arrhythmia and its outcome Among Patients Who Underwent Open Heart Surgery at Tikur Anbessa Specialized Hospital and Cardiac Center-Ethiopia,2025(Addis Ababa University, 2025-06) Eliyas,Segni; Bezabih,Abebe(Assistant Professor of Cardiothoracic Surgery)Background: Arrhythmia is a prevalent and significant complication following open heart surgery, affecting a significant number of patients and leading to increased morbidity, mortality, and healthcare costs. There is limited data on the prevalence of postoperative arrhythmia following cardiac surgery in Ethiopia. This is because advanced cardiac surgery had been introduced in recent years. This study will benefit the cardiac team in identifying the prevalence, patterns and factors associated with postoperative arrhythmia after open heart surgery. Objectives: To assess the prevalence and associated factors of postoperative arrhythmia and it’s outcome in patients who underwent open heart Surgery at TASH and Cardiac Center-Ethiopia, Ethiopia. Methods: A Multi facility-based, cross-sectional study was conducted at TASH and Cardiac Center- Ethiopia, Addis Ababa. Data was collected using a structured checklist, and then it was entered and analyzed using SPSS version 27. Descriptive analysis along with chi square test and Student t test analyses was employed to identify factors associated with development of arrhythmia. A p-value <0.05 will be considered significant. Tables and figures were used to present the results. Results: This study included data from 215 patients who underwent open heart surgery with age range from 1 to73 years. Out of 215 participants, 52 individuals (24.2%) were from TASH. The remaining 163 individuals (75.8%) were from CCE. Among the study participants, more than half (128; 59.5%) were females and the remaining 87 (40.5%) were males. Overall, 29 patients (13.5%) developed arrhythmia during the postoperative period following open heart surgery, and the most frequently observed postoperative arrhythmia was supraventricular tachycardia (24%). Statistically significant difference between the arrhythmic and non-arrhythmic group were noted in relation to cardiopulmonary bypass time (153Vs 108.7 mins) and aortic clamping time (98.4 Vs 66.07 mins), with p value <0.05. Moreover, this study identified a significant association between postoperative hypokalemia and the occurrence of cardiac rhythm disturbances yielding a p-value of 0.008. Conclusion: Cardiac arrhythmias in the early postoperative phase are prevalent in patients who underwent open heart surgery, although a substantial proportion of the conduction abnormalities exhibit favorable recovery. The most commonly detected postoperative arrhythmia was supraventricular tachycardia, succeeded by Atrial fibrillation and Junctional ectopic tachycardia. ICU stay was longer in arrhythmic groups when compared to non-arrhythmic group. Prolonged ischemia duration, extended cardiopulmonary bypass duration, and postoperative hypokalemia were factors that elevated the incidence of arrhythmias in the postoperative phase following open heart surgeryItem Factors Affecting Duration Of stay in the intensive Care Unit among Patients Who Underwent open Heart Surgery: A Multicenter retrospective Study(Addis Ababa University, 2025-06) Bereda,Metasebiya; Tilahun,Rahel(Dr.)BACKGROUND: Cardiopulmonary bypass (OHS) surgery has become a routine strategy for treating complex cardiac problems, including coronary artery bypass, heart valve replacement, and congenital heart defect corrections. Despite advancements in surgical techniques, perioperative care, and postoperative management, the duration of stay in the intensive care unit (ICU) following OHS remains a significant concern for healthcare providers and patients alike. Prolonged ICU stays are associated with increased healthcare costs, resource utilization, and potential complications, while also impacting patient outcomes and quality of life. OBJECTIVE: Assess factors affecting duration of stay in the intensive care unit among patients who underwent open-heart surgery METHODS: An institution-based Retrospective study design was conducted from March to May 2025. All adult cardiac patients who were admitted at TASH, Tazma and cardiac center Ethiopia ICU. Cardiac patients who were admitted at TASH, Tazma and cardiac center Ethiopia and undergo cardio pulmonary bypass and aged >18 years during the data collection period was included. The sample size for the study was determined by using the single population proportion formula. By taking the magnitude of ICU stay 51%. The data collection (DC) process was organized and lead by the PI and patient chart was reviewed to extract pertinent data. RESULTS: Among 239 postoperative open-heart patients, the mean ICU length of stay range 2–18 days. Prolonged ICU stay (defined as ≥5 days) occurred in 118 patients (49.4%). In bivariate comparisons, patients with prolonged ICU stays were older and more likely to have complications: for example, acute kidney injury (AKI) occurred in 17.8% of the prolonged-stay group versus 5.0% of the shorter-stay group, and nosocomial infections and ventilator-associated pneumonia (VAP) also occurred predominantly in the prolonged-stay group. In multivariable logistic regression, advanced age (adjusted OR ~1.08 per year, critical preoperative state and the presence of any postoperative complication independently predicted prolonged ICU stay. CONCLUSION: This multicenter Ethiopian paper illustrates that elderly patients and those with significant perioperative complications are more likely to require considerably longer ICU management after open-heart surgery.Item Morbidity and Mortality Among Pediatric Congenital Heart Disease Patients on Waiting List at Cardiac Center –Ethiopia.(Addis Ababa University, 2025-07) Negash,Ashenafi; Bezabih,Abebe(Ass.Prof.)Introduction: Congenital heart diseases are prevalent globally, causing significant morbidity and mortality, particularly in low-to-middle income countries where limited cardiac care infrastructure, like in Ethiopia, leads to protracted surgical waiting lists exceeding 15,000 patients. Despite these known challenges, there is a scarcity of local data on the specific burden of morbidity and mortality, and their predictors among paediatric CHD patients on the surgical waiting lists in Ethiopia. Objective: Assessed the morbidity and mortality patterns, and their predictors, among paediatric CHD patients waiting open-heart surgery at the Children’s Heart Fund Cardiac Center-Ethiopia. Methods: A retrospective cohort study was conducted at the Children’s Heart Fund Cardiac Center-Ethiopia, analyzing data from pediatric congenital heart disease patients registered for open-heart surgery between September 1st, 2019, and August 31st, 2021. Patients under 15 years old who were candidates for open-heart surgery constituted the study population. Follow-up was conducted retrospectively until December 31st, 2024. Data on patient demographics, clinical status, nutritional status, and outcomes (survival, date/cause of death, morbidity events) were primarily abstracted from medical records, with phone contact used to ascertain missing information. Statistical analysis involved descriptive statistics, Kaplan-Meier survival curves with log-rank tests, and multivariable Cox proportional hazards models to identify mortality predictors. All analyses were performed using STATA version 15.0 and SPSS version 26. Result: In this retrospective cohort study of 297 paediatric CHD patients on a waiting list for open-heart surgery, 11.8% underwent surgery, 22.6% died, and 65.7% remained waiting. The overall incidence death rate was 614.4 per 100 person-years of observation, with 67 deaths occurring over 4,000 person-days of follow-up. The median time from enrolment to death was 517 days (17 months), while the median time to surgery was 721 days (24 months). Significant predictors of mortality were weight at enrolment (HR=0.78; 95% CI: 0.66, 0.93), number of OPD visits (HR=0.92; 95% CI: 0.86, 0.99), complication (HR=4.58; 95% CI: 2.53, 8.28), and Cyanotic CHD (HR=2.60; 95% CI: 1.45, 4.66). Conclusion: This study revealed a high waitlist mortality, a prolonged waiting period, low surgery rate, and high morbidity. Lower weight, fewer outpatient visits, the occurrence of complications, and having cyanotic heart disease are determinants of mortality.Item Elective Endocrine and Breast Surgical Procedures: Health-Realated Quality of Life Outcomes and Patients' Experiences: A Mixed Methods Study.(Addis Ababa University, 2025-08) Bayeh,Agegnehu Berie; Anberber,Endale(MD, General, Endocrine and Breast Surgeon); Tamrat,Girmaye(MD,General, Endocrine and Breast Surgeon)Background: Endocrine and breast elective surgeries are among commonly done procedures globally. With excellent outcomes achieved for thyroid diseases and breast cancer, a fundamental shift from the traditional treatment outcome measures, mortality and morbidity, to maintaining improved quality of life has received an increasing attention. However, Hr-QoL after all types of surgeries in general and after elective thyroid and breast surgeries in particular is still an under-researched area. This gap is conspicuously seen and felt in developing countries like Ethiopia. Objectives: The main objective of this study was to assess the health-related quality of life outcomes and experiences of post-thyroidectomy+ and post-mastectomy cases treated in Endocrine and Breast Surgery Unit at TASH, Central Ethiopia in comparison with health institution-based normal individuals. Methods and Materials: A comparative cross-sectional study was conducted. A self-developed questionnaire and SF-36 tool to measure Hr-QoL outcomes have been used. The collected data were analyzed using SPSS windows version 21. The central tendency measures of the Hr-QoL outcomes were compared among the study groups and major findings of the study have been presented in texts, tables and figures. Result: Three hundred sixty-six participants for the breast and 318 ones for the thyroid group were included in the final analysis. Post-total thyroidectomy participants had median SF-36 scores ranging from 33.3 for Role-Emotional (RE) to 85.0 for Physical Functioning (PF). The scores for the post-partial thyroidectomy group varied from 42.0 for Bodily Pain (BP) to 85.0 for PF. On the other hand, post-mastectomy cases had median SF-36 scores ranging from 33.3 for RE to 75.0 for Role-Physical (RP). Post-total thyroidectomy participants had statistically significantly lower General Health, Vitality, RE, and Mental Health compared to the controls. All SF-36 scales except PF and RP were significantly lower among post-mastectomy participants than controls. Conclusion: Quality of life after thyroidectomy and curative-intent mastectomy was found to be lower. The mental health status was more affected than the physical health following thyroid surgery. General Health, Vitality, Role-Emotional and Mental Health were significantly lower as the extent of thyroidectomy increased. Among post-mastectomy participants, scales measuring mental health, both physical and mental health, and bodily pain were significantly lower. Optimal treatment and an organized psychosocial and emotional support by establishing, strengthening and expanding survivorship and support groups can improve such low outcome measures.Item Determinants of Breast Cancer Recurrence Among Breast cancer Patients Attending Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia 2025.(Addis Ababa University, 2025-06) Ejeta,Tadesse; Tamrat,Girmaye(General surgeon, Endocrine and Breast Surgery Subspecialist); Afework,Veronica( General Surgeon, Endocrine and Breast surgery Subspecialist)Background: Breast cancer is one of the most common cancers in women and it is the leading cause of cancer related death. Multi modality treatments are provided to improve the outcome of patients with breast cancer. Patients with post treatment recurrence have poor prognosis than those with no recurrence. Factors related to the patient, tumor histopathology and treatment modalities determine the recurrence of this disease. Objective: The study was aimed at identifying determinants of breast cancer recurrence among breast cancer patients attending Tikur Anbessa specialized Hospital, college of Health sciences, Addis Ababa University, Ethiopia 2025 Methods: Facility based, unmatched case-control study design was conducted among 237 breast cancer patients attending Addis Ababa University Tikur Anbessa Specialized hospital from November 1, 2024- December 1,2024 GC.. The cases were recurrent breast cancer patients and controls were patients with no breast cancer recurrence. Cases were selected consecutively and following each case two controls were selected. Data were extracted from patients chart using structured questioner by trained nurses. Data were entered into Epi data version 3.1; exported and analyzed by SPSS version 25. All independent variables with p-value < 0.25 in the bi-variate logistic regression analysis were entered into multivariable binary logistic regression analysis. Model fitness was checked by Hosmel-lemshow goodness of fit. An adjusted odds ratio with a 95% CI and a p-value of <0.05 was used to identify determinants of breast cancer recurrence. Result: A total of 237 patients (79 cases and 158 controls) were included in the study. The mean age of cases and controls were 46.2 (SD ± 13.3) and 48.5 (SD ± 12.9) years, respectively. No family history of breast cancer(AOR=0.17, 95% CI: 0.03, 0.08), tumor size (AOR= 0.76, 95% CI: 0.60, 0.96),High nuclear grade (AOR= 3.4, 95% CI: 1.49,7.71), Lympho vascular invasion(AOR= 2.3, 95 % CI: 1.02, 5.34) positive surgical margin(AOR= 4.4, 95% CI: 1.05, 38.6) and Estrogen receptor negative(AOR= 5.7, 95%CI: 1.51, 21.5)were found to be determinants of breast cancer recurrence. Conclusion and Recommendations: Family history, tumor size, high nuclear grade tumor, positive surgical margin, lympho vascular invasion and negative estrogen receptor were determinant of breast cancer recurrence. Breast cancer with these recurrence determinants require more aggressive treatment and intensive followup.Item Postoperative Outcome and Associated Factors in patients who underwent Revascularization procedure of lower extremity Chronic limb threatening ischemia : A study in Tikur Anbessa Specialized Teaching Hospital(Addis Ababa University, 2025-07) Dires,Fentahun; Getachew,Feron(MD,Ass.Prof.)Background: Chronic limb-threatening ischemia (CLTI) is a severe impairment of limb perfusion to the level that blood flow to the limb could not be able to maintain basal metabolic function. Revascularization of a limb is the most important management strategy to salvage a limb. Patients are optimized preoperatively based on their demographic, comorbidity and clinical profile so that they have decreased mortality and limb loss. There is no study done in Ethiopia regarding postoperative outcome and associated factors of CLTI revascularization. So this study aimed to identify the pattern and post operative outcome of CLTI in our country and be used as a base for intervention. Method:A retrospective study was conducted among CLTI who underwent revascularization Surgery from December 30,2020 to May 30,2024 at TASH. Patients basic data was traced from OR logbook. Using the OR logbook and patients electronic medical records, relevant data was collected using questionnaires. Demographic and clinical data of study population were analyzed using descriptive statistics. Binary Logistic regression model was applied to identify predictors of postoperative outcomes of revascularization. Statistical analysis was performed using SPSS version 25. Results: A total of 151 patients who had revascularization procedures for CLTI were included for the final analysis. Among patients who underwent revascularization 70.9% were male and 29.1% were female. Revascularized patients data were retrieved and their follow up was analyzed 1 year after revascularization . Analysis of patients data showed 39 patients ( 25.8% ) had major amputation with in 1 year of revascularization and all cause mortality rate was 4.6%(7 patients). Analysis of post operative outcome further showed that 1 year amputation free survival rate was 71.5% . Conclusion: The study showed a relatively younger population compared to other studies with male to female ratio of 2.5:1. The number of smoker patients were found to be small compared to others. The rate of major amputation and amputation free survival was comparable with other studies. Patients with diabetes and Surgical site infection had a low amputation free survival compared to other patients who had no diabetes and did not develop surgical site infection.Item Prevalence and Associated Factors of Post-ThyroidectomyHypocalemia in Patients who UnderwentThyroidectomy in Tikur Anbessa Specialized Hospital:A Retrospective Stydy.(Addis Ababa University, 2025-07) Bayou,Berari; Tamrat,Girmaye(MD, General, Endocrine and Breast surgeon); Yeshitila,Hiwot(MD, General, Endocrine and Breast surgeon)Background: Thyroid disease is a common disorder of endocrine system globally. Thyroidectomy is one of the most common surgeries performed worldwide. Post-thyroidectomy hypocalcemia is one of the most dreaded complications following thyroidectomy, which can lead to considerable morbidity and deleterious effect in the quality of life of affected patients. Despite advancements in surgical techniques and perioperative care, the incidence of hypocalcemia remains a considerable challenge. It primarily occurs due to inadvertent damage or removal of the parathyroid glands during surgery, leading to a transient or permanent decrease in serum calcium levels.There is inadequate information regarding the prevalence and associated factors of post-thyroidectomy hypocalcemia in the study area and this study is intended to investigate it. Objective: To determine the prevalence of Post-thyroidectomy hypocalcemia and associated factors among patients who underwent total and completion thyroidectomy with or without central/lateral neck dissections in Tikur Anbessa Specialized Hospital (TASH), from January 2021 to June 2024. Methods and Materials: A retrospective study design was employed to conduct this study. Secondary data was collected from patient medical record by using structured checklist checked for its completeness, entered, edited, cleaned and analyzed by SPSS version 25. The study period was from May 2025 to June 2025. Result: The result showed the overall prevalence of post-thyroidectomy hypocalcemia was 32.6% with prevalence of post-thyroidectomy transient hypocalcemia 25.7%, and permanent hypocalcemia 6.9%. The study revealed that the rate of post-thyroidectomy hypocalcemia varied with type of thyroidectomy and pathologic diagnosis. The rate was higher (39.3%) for TT with CND and/or MRND than TT and completion thyroidectomy alone,which was 31.0% and 31.3% respectively. This study also showed that patients with intraoperative identification of 4 PT glands were at higher risk of developing post-thyroidectomy hypocalcemia than those patients in which PT gland identification was not achieved with AOR=2.93(1.28,6.71)(p=0.011). This study showed that out of 28 patients who stayed in the hospital for >3 days to week,19(67.9%) were those with post-thyroidectomy hypocalcemia and out of 11 patients who stayed in the hospital for >1 week,9(81.8%) were those with post-thyroidectomy VII hypocalcemia,showing that post-thyroidectomy hypocalcemia is associated with prolonged hospitalization. There was no statistically significant association between post-thyroidectomy hypocalcemia and age, sex,type of thyroid disease, or pathologic diagnosis in this study. Conclusion and Recommendation: This study highlighted that post-thyroidectomy hypocalcemia is prevalent among 32.6% of patients who underwent total and completion thyroidectomy with or without central and/or lateral neck dissections. The study also showed excessive dissection during thyroidectomy to identify PT glands may compromise their blood supply and may predispose patients to postoperative hypocalcemia. Post-thyroidectomy hypocalcemia was associated with prolonged postoperative hospital stay in this study. The study also revealed the effect of calcium and vitamin D supplementation on the reduction of transient post-thyroidectomy hypocalcemia. Therefore,routine supplementation of calcium and vitamin D for patients after total thyroidectomy and completion thyroidectomy should be encouraged practice in endocrine and breast surgery unit. The unit has to make measurement of postoperative serum calcium and preoperative vitamin D a routine practice. Additionally the unit has to stick to the practice of capsular dissection technique with minimal manipulation around PT glands during thyroidectomy. The hospital administration has to equip the laboratories in the hospital with biochemical tests such as serum vitamin D,serum calcium and iPTH. Finally,for strong and reliable results,undergoing prospective multicenter study with larger sample size is recommended.Item Incidence of Paravalvular Leak and Prosthetic Valve Stuck within 30 Days After Open Heart Valve Replacement Surgery Retrospective Study in Addis Ababa,Ethiopia,2025.(Addis Ababa University, 2025-01) Tadesse,Daniel; Abebe,Yonatan(Dr.)Introduction: Valvular heart disease (VHD) remains a critical global health burden, with causes differing by region: age-related degeneration dominates in high-income countries, while rheumatic heart disease (RHD) drives cases in sub-Saharan Africa, particularly Ethiopia. Open-heart valve replacement, the primary intervention in Ethiopia, faces challenges such as limited access to advanced technologies, inconsistent anticoagulation monitoring (e.g., INR), and inadequate follow-up. Early postoperative complications—paravalvular leak (PVL) and prosthetic valve thrombosis ("stuck valve")—are life-threatening yet understudied in Ethiopia, despite their high incidence linked to resource constraints and surgical limitations. This study investigates the 30-day postoperative incidence of PVL and valve thrombosis in Ethiopian patients, aiming to inform strategies to reduce complications and improve outcomes in low-resource settings. Objective: To assess the incidence of paravalvular leak and prosthetic valve thrombosis (stuck valve) within 30 days following open-heart valve replacement surgery in Ethiopia. Methodology: An institution-based retrospective study design will be conducted to determine the immediate outcomes of patients who underwent valve replacement surgery during the designated data collection period. The sample size was calculated to be 192 using a population reduction formula. The data collection process will be organized and led by the Principal Investigator (PI). Patient charts will be reviewed to extract pertinent clinical data from the participants. Before commencing the data collection process, the study objectives will be clearly explained to the respective personnel responsible for managing the medical charts.Item Prevalence and Factors Associated with Surgical Site Infection in Patients Undergoing Hepato-Pancreaticobiliary Surgery: A Crossectional Multicentric Study, Addis Ababa(Addis Ababa University, 2025-07) Edasu,Gemeda Nebi; Abdurahman,Zeki(Consultant General and HPB Surgeon)Background: Acute cholangitis (AC) is a life threatening infection of the biliary system, most commonly caused by choledocholithiasis or malignant biliary obstruction. Despite advances in diagnostics and treatment, its burden in low resource settings remains under characterized. Objective :This study aimed to evaluate the clinical profile, etiological factors, management practices, and outcomes of patients diagnosed with acute cholangitis over a five year period at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods :A retrospective hospital based study was conducted involving 81 patients admitted with acute cholangitis from January 2020 to December 2024. Data were collected from medical records using a structured form and analyzed using SPSS version 25. Logistic and linear regression were performed to identify predictors of adverse outcomes and severity grading. Results :The mean age of patients was 53.96 years; 56.8% were female. Choledocholithiasis and malignant obstruction were the most common etiologies of acute cholangitis attributing for 50.6% and 40.7% respectively. Jaundice (95.1%) and RUQ abdominal pain (71.6%) were the most frequent presenting symptoms. Only 18.5% fulfilled Charcot’s triad. About 71.6% of patients had definite acute cholangitis while 28.4% had suspected acute cholangitis based on Tokyo Guidelines (TG13. About 85.2% of cases were successfully treated with medical management alone. About 39.5% of patients had unfavorable outcomes. Multivariate analysis identified age AOR : 4.7, 95% CI : 1.04, 21.47; p=0.04 44), presence of morbidity (AOR: 4.7, 95% CI: 1.05, 21.55; p=0.043), TG13 Grade III (AOR:3.1, 95% CI: 2.11, 8.36; p=0.024) to be significantly associated with unfavorable outcome. Conclusion :This study of acute cholangitis reveals a patient population with distinct demographic and etiological features, including a majority of female patients and a high rate of malignant obstruction (40.7%). The diagnostic utility of Charcot's triad was low (18.5%), while the Tokyo Guidelines (TG13) provided a definitive diagnosis in the majority of cases (71.6%). Current management, favoring open surgery (92.6%), is associated with negative outcomes, including prolonged hospital stays and high complication rates. These findings suggest that a shift toward minimally invasive techniques and adherence to the TG13 diagnostic criteria are necessary to improve patient outcomes.Item Patterns of Cardiothoracic Surgery Practice at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2025.(Addis Ababa University, 2025-07) Muluneh,Natnael; Bezabih,Abebe(MD,Ass.Prof.)Introduction: Cardiothoracic surgery (CTS) addresses critical conditions like coronary artery disease, valvular disorders, and congenital heart defects, which are rising globally. In Ethiopia, CTS demand is increasing, yet data on practice patterns remain limited. This study evaluates CTS practices at Tikur Anbessa Specialized Hospital (TASH), Ethiopia. Objectives: Patterns of cardiothoracic surgery practice at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2022-2024. Methods: A retrospective cross sectional study was conducted among patient operated at Tikur Anbessa specialized hospital. The study subjects was all CTS patients treated at TASH over the past three years. Data was collected using a semi-structured questionnaire and checklist. Data was entered and analyzed using SPSS version 20. In the analysis process, frequency distribution of variables was calculated. To ascertain the association between dependent and independent variables, odds ratio with 95% confidence interval was calculated. Results: Mean patient age was 30.59 years (±20.28), with 33.9% young adults and 34.9% pediatric cases. Gender distribution was balanced (50.9% male, 49.1% female), and most patients were urban residents (68.7%). Cardiac surgeries (35.7%) is less frequent than thoracic (64.7%), peaking in 2024 (73cardiac surgery). Leading indications were congenital heart defects (26.5%) and malignancies (22.7%). Survival rate was 97.2%, with 2.8% mortality and 10.4% readmission. Conclusion: TASH manages Ethiopia‘s high burden of congenital and infectious cardiac diseases effectively, though infrastructure and surgical volume lag behind high-income settings. Recommendations include expanding training, improving referrals, and enhancing postoperative care.Item Indications, Types, and Peri-operative Outcomes of Pulmonary Resections: A 5-Year Retrospective Cross-Sectional Study at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.(Addis Ababa University, 2025) Mekonnen,Abenezer; Gulililat,Dereje(MD, Ass.Prof.)Background: Pulmonary resections are essential surgical interventions for a range of benign and malignant lung diseases. In Ethiopia, tuberculosis (TB) and HIV remain significant public health challenges, complicating pulmonary disease management. This study aimed to assess the clinical indications, types, and peri-operative outcomes of pulmonary resections performed at Tikur Anbessa Specialized Hospital (TASH) over five years (2020–2024), in a resource-limited, high TB/HIV burden setting. Methods: A retrospective cross-sectional study was conducted on all patients who underwent pulmonary resection at TASH from 2020 to 2024. Data were collected from surgical logs, medical records, and follow-up contacts. Descriptive statistics, bivariate, and multivariate logistic regression analyses were used to evaluate factors associated with postoperative complications. Results: A total of 100 patients underwent pulmonary resection, with a male predominance (63%) and a relatively young age profile (35% under 35 years). Lung cancer (35%) was the leading surgical indication, followed by TB-related complications (21%) and aspergilloma (18%). Over time, a trend was observed in which benign and infectious conditions were predominant early on, shifting to lung cancer in 2023 and 2024. Lobectomy (49%) and pneumonectomy (30%) were the most frequently performed procedures, all conducted via open thoracotomy. 95% of patients had no comorbiditie and HIV positivity was rare (3%). Postoperative complications occurred in 12% of cases such as primarily infections and prolonged air leaks. Only one postoperative death (1%) was recorded. 62% of the patients were discharged within 8–14 days, and 79% resumed normal activity within one month. Multivariate analysis revealed that a diagnosis of lung cancer was significantly associated with reduced odds of complications (AOR = 0.065; p = 0.016). Conclusion: This study reveals a shifting pattern in pulmonary resection indications from infectious to malignant diseases in Ethiopia. Surgical outcomes were favorable, with low complication and mortality rates despite resource limitations. The findings underscore the growing burden of lung cancer and highlight the need for expanded access to thoracic surgery and improved peri-operative care.Item Extracranial Carotid Artery Stenosis Among Ischemic Stroke and Transient Ischemic Attack Patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A Cross-Sectional Study(Addis Ababa University, 2025-07) Taeme,Mulugeta; Teklesilase,Henok(MSc, Ass.Prof.); Mamushet,Yared(Ass.Prof.)Background: Carotid artery stenosis, a common large artery disease caused by atherosclerosis, can lead to ischemic stroke or TIA. Early revascularization in severe cases significantly lowers the risk of recurrent stroke. Although well-studied in developed countries, data from developing regions are scarce. This study aimed to assess the prevalence and associated factors of carotid artery stenosis among ischemic stroke patients, as no prior research has been conducted in our country Objective: To assess clinical profile, prevalence and corelated factors associated with extra cranial carotid artery stenosis among ischemic stroke and TIA patients. Methods: A cross-sectional study was conducted at a single tertiary hospital on 186 patients with ischemic stroke and transient ischemic attack (TIA) who were either being followed at the neurology referral clinic or newly admitted to the hyperacute stroke unit between November 1, 2024, and April 30, 2025. All patients who underwent carotid Doppler ultrasonography were included. Data on demographic characteristics and vascular risk factors were collected. Carotid Doppler ultrasound findings, including the degree of stenosis and the anatomical distribution of lesions in the extracranial carotid arteries, were recorded. Results: The prevalence of significant extra cranial CAS among ischemic stroke and TIA patients was 21.5% with the internal carotid artery (67.5%) being the most frequently affected site in our study. Moderate stenosis (50–69%) was the most frequently observed, particularly in unilateral cases, which accounted for 80% of the total. Patients with significant CAS were slightly older and more often female. Multivariable analysis identified female sex (AOR = 0.339; 95% CI: 0.139–0.800; p = 0.020), hypertension (AOR = 3.458; 95% CI: 1.304–9.421; p = 0.014), and dyslipidemia (AOR = 6.789; 95% CI: 2.017–22.848; p = 0.004 as significant predictors of CAS. Conclusion: This study highlights a substantial burden of significant extra cranial carotid artery stenosis (CAS) among ischemic stroke and TIA patients in a developing country setting, emphasizing the importance of routine carotid screening. Identifying high-risk groups can guide targeted prevention and timely intervention, potentially reducing recurrent stroke through appropriate management such as revascularization.Item Assessment of Knowledge,Perceptions ,Carrer Interest of Plastic Surgery among Medical Interns' in Selected Health Science College and Public Teaching Universitiy Hospital in Ethiopia ,2025.(Addis Ababa University, 2025-07) Tesfaye,Moti; Baraki,Atakilite(Ass.Prof.)Item Costs Associated with Preoperative Evaluation Among Vascular Patients in Tikur Anbessa Specialized Hospital(Addis Ababa University, 2025-07) David,Karenzi Irenee; Gebregiorgis,Dawit(Ass.Prof.)Background :Preoperative evaluation is essential for safe vascular surgery. However, routine tests can impose financial burden on patients, especially in resource-limited settings. This study aim was to assess preoperative evaluation in vascular patients with its associated direct patient costs and cost drivers in Tikur Anbessa Specialized Hospital (TASH). Methods :An institutional-based retrospective cross-sectional study was conducted for vascular patients operated from January 2022 to December 2024 at TASH, assessing costs associated with preoperative investigations among vascular patients. Data were collected from patients’ records, and phone calls. National Institute for Health and Care Excellence (NICE) guidelines 2016 served as reference to characterize investigation tests. Costs were determined using TASH service fees and private center rates. Data were analyzed using SPSS version 21. Results A total of 165 elective vascular surgery patients were recruited. Mean age was 49.6 years,88 males, 77 females. Peripheral artery disease was the most common diagnosis (47.3%). The average hospital stay was 13.7 days. The mean total cost of preoperative investigations per patient was 9,717.40 ETB, average imaging cost: 8,797 ETB, laboratory tests cost was 1,328 ETB. CT scans (82.4%) and echocardiography (61.2%) were the most requested imaging. Notably, 20% of ECGs and 43.5% of echocardiograms were not clinically indicated. The mean cost of unindicated tests was 648.99 ETB per patient, with a maximum of 3,565 ETB. Advancing age, having comorbidity, diagnosis type, procedure type and increasing hospital stay, were significantly associated with higher investigation costs. Over 61.3% of patients reported that the cost of investigations was unaffordable to them. Conclusion : Preoperative evaluation in vascular surgery at TASH is characterized by excessive use of routine and advanced investigations, some of which lack clinical indication. These practices contribute to substantial patient expenses, primarily through out of pocket payment. There is also gap in providing some necessary investigation tests. A large proportion of imaging tests were done in private centers which imposed financial burden to vascular patients. Developing and implementing evidence based testing guidelines could limit the cost and bridge the gap observed.Item Surgical Treatment Outcomes of Graves’ Disease: A Retrospective Multicenter Study in Ethiopia(Addis Ababa University, 2025-07) Bejiga,Gosa Hundie; Anberbir,Endale(MD, GS, Endocrine and Breast Surgeon); Aga,Tesfaye(MD, GS, Endocrine and Breast Surgeon)Background: Graves’ disease (GD) is the most common cause of hyperthyroidism. In general, thyroidectomy is the preferred modality in the presence of severe eye disease, failure or contraindications to other treatment options, if rapid reversal of hyperthyroidism is needed, presence of concomitant suspicious thyroid nodules, large goiters with compressive symptoms, and pregnancy or breastfeeding states. Despite advancements in medical management, total thyroidectomy remains a definitive treatment, especially in resource-limited settings. However, data on surgical outcomes and predictors of complications in low-income countries remain limited. Objective: To evaluate the surgical treatment outcome of GD at our centers and to identify clinical and demographic predictors of unfavorable outcomes, including recurrent laryngeal nerve injury (RLNI) and permanent hypocalcemia. Materials and methods: A years, multicenter retrospective study was conducted across four hospitals in Ethiopia from December 1, 2021 to December 31, 2024. A total of 43 patients for whom thyroidectomy done for GD were included. Data were analyzed using SPSS version 26. Bivariate and multivariate logistic regression analyses were employed to identify predictors of surgical outcomes. P<0.05 declared statistically significant. Favorable outcome was defined as the absence of RLNI or permanent hypocalcemia. Result: The majority of patients were female (74.4%) with a mean age of 36.4 years. Total thyroidectomy was performed in 95.3% of cases. The most frequent symptoms/signs were goiter (95.3%), palpitations (72.1%), and exophthalmos (69.8%). Postoperative complications included permanent hypocalcemia (9.3%), RLNI (4.7%), external branch of superior laryngeal injury in 1patient, temporary hypocalcemia in 1 patient and seroma in 2patients. Favorable outcomes were achieved in 86% of patients. On multivariate analysis, exophthalmos was significantly associated with favorable surgical outcome (p = .020), with the AOR=15.83, 95% CI [1.53 – 163.55]. Other factors such as gender, comorbidities, duration of antithyroid drug therapy, and preop-thyroid function status were not statistically significant. Conclusion: In well-prepared patients, surgical management of Graves’ disease is safe and effective, with high rates of favorable outcomes. Exophthalmos was identified as a strong independent predictor of favorable prognosis. These findings support early surgical referral and highlight the importance of surgeon expertise and preoperative optimization. Further prospective studies are recommended to confirm these findings and guide clinical practice.Item Prevalence and determinants of treatment choices for Haemorrhoids among the residents of Addis Ababa, Ethiopia, a community-based study.(Addis Ababa University, 2025-07) Habteyohannes,Tadesse; Asefa,Zelalem(MD, Ass.Prof.)Background: Hemorrhoids are a common anorectal condition influenced by sociodemographic, lifestyle, and healthcare factors. This study explores the prevalence, risk factors, and determinants of treatment preferences among residents of Addis Ababa, Ethiopia, offering insights into modern and traditional healthcare utilization. Methods: A cross-sectional study was conducted with 630 participants, achieving a 99.5% response rate. Data were collected using structured interviews and analyzed using descriptive statistics and logistic regression to identify determinants of hemorrhoid prevalence and treatment choices. Results: The prevalence of hemorrhoids was 6.8%. Significant determinants included smoking (AOR = 4.5, 95% CI = 1.24–16.57), constipation in the past year (AOR = 4.7, 95% CI = 2.35–9.23), and awareness of treatment options (AOR = 3.7, 95% CI = 1.74–7.87). Conservative treatment preferences were strongly linked to older age (≥60 years, AOR = 10.7, 95% CI = 2.89–39.32), higher education levels (AOR = 3.9 for primary education, 95% CI = 1.44–10.85), and rectal symptoms (AOR = 5.2, 95% CI = 2.06–13.13). Modern medicine was preferred by 80.3% of participants, while 12.2% opted for traditional remedies. Despite high geographic access to healthcare facilities (99.5% within 5 km), financial constraints (41.7%) and lack of awareness (52.4%) were key barriers to treatment. Conclusion: The study highlights a moderate prevalence of hemorrhoids, with strong associations to lifestyle and medical history factors. Treatment preferences reflect increasing trust in modern medicine, yet barriers such as affordability and awareness hinder optimal healthcare utilization. Integration of traditional practices with modern medicine and targeted education campaigns are recommended to improve prevention and management strategies.Item Ten Years Prevalence And Patterns of Palatal Fistula Following Primary Palate Repair at Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia(Addis Ababa University, 2025-08) Tafese,Firegenet Woldearegay; Eshete,Mekonen(MD, PHD, FACS, FCS (ECSA)); kelemu,Dagmawi(MD, Plastic and reconstructive surgeon)Background: Palatal fistula is a common complication following primary cleft palate repair, negatively impacting speech, swallowing, and quality of life. The incidence of palatal fistula varies significantly depending on surgical techniques, cleft severity, and perioperative care. However, there is limited data regarding the patterns and rates of palatal fistula in Ethiopia. This study aims to determine the rate of palatal fistula post-surgery at Yekatit 12 Hospital Medical College, and assess the risk factors associated with their development Methods: A hospital based retrospective study was conducted by reviewing the medical records of all patients who underwent primary cleft palate repair at Yekatit 12 Hospital from 2014 to 2024. A structured data abstraction form was used to collect the information on patient demographics, cleft characteristics, surgical techniques, and postoperative outcomes. The data was analyzed using SPSS version 26, employing descriptive statistics to determine the palatal fistula rate. Results: A total of 47 participants with documented fistula surgeries were included in the study. Of these, 51.1% were female, with a mean age of 12 years at the time of surgery. The majority (80.9%) presented with cleft lip and palate, and 55.3% underwent repair at Yekatit 12 Hospital. 53.2% of participants presented for fistula surgery within five years post-repair, with an average presentation of 6.6 years. Local flap techniques accounted for 59.6% of surgeries, while the Bardach palatoplasty was the most common surgical method performed for palate repair. Demographic factors, including age and sex, did not significantly correlate with fistula formation (p=0.11 and p=0.54, respectively). Conclusion: This study highlights the need for ongoing evaluation and improved surgical techniques to reduce the incidence of palatal fistulas and enhance patient outcomes. Future research should focus on long-term follow-up and the effectiveness of various surgical interventions in mitigating complications associated with palatal repair.Item Clinical Profile and Hepatocellular Cancer Treatment Patterns in Resource Limited Settings a prospective cross sectional study at Two Tertiary Referral Teaching Hospitals, Ethiopia(Addis Ababa University, 2025-07) Jemal,Tebarek; Nigussie,Shimelis(MD, Ass. Prof. ); Teshome,Henok(MD, Ass. Prof. )Background: Hepatocellular carcinoma (HCC) exerts a substantial global burden, significantly contributing to worldwide mortality, morbidity, economic costs, and hospitalization rates. A significant treatment gap exists in low and middle income countries (LMICs), characterized by a low rate of curative surgical interventions for HCC, making access to effective surgical care for this disease one of the most inequitable aspects of healthcare globally. Objective: To assess the etiological and treatment patterns of Hepatocellular Carcinoma (HCC) in patients visited to Tikur Anbessa Specialized Hospital (TASH) and St. Paul's Hospital Millennium Medical College (SPHMMC) in Addis Ababa, Ethiopia in 2025. Methods: A cross sectional, hospital based prospective study was conducted to investigate the etiological and treatment patterns of Hepatocellular Carcinoma (HCC). The study included a sample size of 130 HCC patients. To ensure appropriate statistical analysis, the normality of continuous variables was assessed using the Shapiro Wilk test. Normally distributed data were described using means and standard deviations, while medians and interquartile ranges were used to summarize skewed data. Results: Our analysis of 130 Hepatocellular Carcinoma (HCC) patients requiring surgical intervention, Loco regional, systemic therapy, or supportive care revealed a mean age of 54.5 ± 16.5 years, with a slight male predominance (82/130, 63.1%). A significant proportion of participants (62/130, 47.7%) had a history of hepatitis infection while unidentified risk factor for HCC was alarmingly high (48/130, 37%). Among those with hepatitis, the majority were infected with Hepatitis B Virus (HBV) (45/62, 72.6%), while a smaller proportion had Hepatitis C Virus (HCV) (14/62, 22.6%). The majority of HCC cases presented as either multinodular/multifocal (58/130, 44.6%) or single/solitary (57/130, 44.5%) lesions, with a mean size of 10.0± 4.6cm.In those with imaging features of cirrhosis (58/130), vast majority (29/58, 50%) exhibited Child Pugh score B. However, a large proportion of patients in our study presented with advanced stage disease, as evidenced by the Barcelona Clinic Liver Cancer (BCLC) staging system: BCLC stage C was observed in 83 participants (63.8%). Curative Liver resection was performed in only 23 participants (17.7%), while Transarterial Chemoembolization (TACE) was utilized in 27.7% of cases. Conclusion: Despite advancements in the surgical management of Hepatocellular Carcinoma (HCC), there remain notable challenges in providing access to curative treatments such as liver resection, transplantation, and Radiofrequency Ablation (RFA). These limitations are primarily attributable to deficiencies in highly trained human resource, inadequate infrastructure, and policy gaps, which hinder the effective delivery of potentially life saving interventions.Item Recurrence after Fistula in Ano surgery and its associated factors at Tikur Anbessa Specialized Hospitaland Zewditu Memorial Hospital in Addis Ababa,Ethiopia :a Two Year retrospective medical record review study From July 1,2022-June 30,2024.(Addis Ababa University, 2025-07) BIadgie,Destaw; Kotisso,Berhanu(Prof.)Background: Fistula-in Ano (FIA) is a benign disease and its surgical management is still challenging since antiquity. Recurrence and persistent of fistula continue to frustrate both patients and treating physicians and it affects quality of life of patients. The main objective of this study was to determine the overall recurrence rate after FIA surgery and to identify factors associated with it at Tikur Anbessa Specialized Hospital (TASH) and Zewditu Memorial Hospital (ZMH) in Addis Ababa, Ethiopia. Method and Materials: We conducted a Retrospective medical record review of patients after surgery in two hospitals (TASH and ZMH) from July 1,2022-June 31,2024 the patient’s medical record in electronic forms and hard copy of the medical record was reviewed to collect the variables (with a well-structured check-lists), the missed information was collected through phone calls. Data was entered to SPSS version 25. Descriptive statistics was performed to characterize socio- demographics, characters of fistula, procedure types, surgical outcomes. Bivariable and multivariable logistic regression was performed to determine the factors that affect the rate of recurrence. Adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to assess strength of associations and p-value≤0.05 was taken as significance to determine factors affecting recurrence. Results: From the total 170 patients included in this study 138 were males and 38 years of median age (range 18-79 years) and median follow of 11 months (range 6-24 months. Thirteen (7.7 %) of patients had recurrence and 12(7.1%) patients had presentence of fistulas. Comorbidity significantly increased the odds of having persistence of FIA after surgery (AOR 31.786 ;95% CI 1.924 352.630; p value=0.005) whereas patients who had non sphincteric sparing procedure were protective form developing persistence of FIA by 84.5% (AOR 0.155;95% CI 84.7 %); p value= 0.050) but no predictors found to affect the recurrence rate on multi variable logistic regression. Conclusions: Recurrence and persistence of the FIA were 7.7 and 7.1 respectively in our study. Comorbidities increased the persistence of the FIA but non-sphincteric sparing surgical procedure prevents it. No significant predictors were found for the recurrence after FIA surgery. Strategies that optimize preoperative patient selection, addressing the medical comorbidities and tailor procedure choice to fistula anatomy my reduce the persistence of fistula and recurrence.Item Thirty-day perioperative outcome of segment III bypass surgery for malignant hilar biliary obstruction: multicenter cohort retrospective study, Ethiopia, 2025.(Addis Ababa University, 2025-07) Embiale,Nebiat; Seife,Henok(Consultant General and HPB surgeon)Background: Segment 3 bypass surgery, which was once the most commonly done procedure, is the construction of biliary enteric anastomosis between segment 3 intrahepatic bile duct and proximal jejunum. Mostly it is done as palliative treatment for Malignant Hilar Biliary Obstruction (MHBO). This procedure has been done worldwide starting from the early 20th century but rarely being done nowadays. The 30- day perioperative mortality of this procedure falls in the range between 0-31%. There is no study in Ethiopia, to the best of author knowledge, assessing clinical profile and 30- day perioperative outcome of segment III bypass surgery. Objectives: The objective of this study was to assess thirty-day perioperative outcomes (effectiveness, morbidity, mortality, complication rates) of patients after Segment 3 bypass surgery and its contributing factors after bypass surgery. Method: Multicenter retrospective cohort study was conducted in Addis Ababa, Ethiopia. Data was collected from medical records of patients with a structured questionnaire and data was entered into SPSS version 27. Descriptive analysis and non-parametric dependent (Wilcoxon) related sample test were done to know the effect of bypass surgery on liver enzymes and serum bilirubin level. Variables with P-value less than 0.05 were considered to know and declare the effect size of bypass surgery. Result: A total of 35 cases has undergone segment III bypass surgery from January 2020 to December 2024. Out of these it was possible to retrieve the data of 25 cases and 2 of the cases were having incomplete data and were not included in the analysis. The mean age of the patients was 52.87 years. More than half of (56.5%) the cases were males. Hilar cholangiocarcinoma accounts for the majority (78.3%) of causes for hilar biliary obstruction followed by gallbladder cancer. The median duration of surgery was 180.0 (70.0) minutes and the median intraoperative bleeding was around 700.0 (600.0) ml. Three patients (13.0%) patients were died within 30-day of operation and 4 (17.4%) patients developed allover morbidity rate within 30 days of operation. Serum bilirubin and ALP level significantly dropped after the bypass surgery (z=3.724 p= <0.001 and z= 2.659 p=0.008 respectively). Only 1 (4.3) patient developed major complication requiring re operation. The common surgical complications identified were bile leak, surgical site infection, and bleeding. Conclusion: Segment III bypass surgery gives effective palliation of cholestatic symptoms with acceptable 30-day perioperative mortality and morbidity rate.