Ethiopian Medical Journal最新文献

{"title":"REFERRAL OF EMERGENCY SURGICAL PATIENTS IN A\u0000TERTIARY HOSPITAL, ADDIS ABABA, ETHIOPIA.","authors":"Engida Abebe,&nbsp;Henok Teshome,&nbsp;Mahteme Bekele","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Referral is part of patient care when done appropriately. Common reasons for referral include seeking\u0000expert advice, technical examination and/or intervention, care beyond the facility’s capacity.\u0000Objectives: Determine the rate, reason for and type of cases referred among patients seen at surgical Emergency\u0000Room of SPHMMC during May to July 2015.</p><p><strong>Patients and methods: </strong>Cross sectional study was done at St. Paul’s Hospital Millennium Medical College Emergency\u0000Room, including all surgical patients seen in three months period. Data was collected from the individual\u0000patient’s medical records, records of the ER and the liaison office and Interns morning reporting book. Data was\u0000analyzed with SPSS version 20.</p><p><strong>Results: </strong>Total of 2,492 patients were seen. The mean number of patients seen per day was 27.7 with a range from\u000013 to 51. Trauma made 70% (1746) of all cases seen. Cases that needed admission made 30.1% (755), but only\u000049.5 % (374) of them were admitted. The overall referral rate was 15.3%. The referral rate in patients who needed\u0000admission was 50.5 % (381). Trauma made 77.4% (295) of the referrals, mainly orthopedic, 54.6% (161) and\u0000neuro-traumas, 38% (112). Among non trauma cases acute abdominal conditions tops, 75% (56). Lack of inpatient\u0000beds was the main reason for referral 65.6% (250). Specialist care need was the reason for referral in 34.5%\u0000(131) of cases. Among patients referred only 14.4% (55) left the hospital at the time of referrals. Four percent (13)\u0000of the kept patients died in the ER waiting for referrals.</p><p><strong>Conclusions: </strong>The rate of referral from St. Paul’s Hospital Millennium Medical College Emergency Room is high.\u0000It is higher in trauma cases, specifically orthopedic and neuro-traumas. Main reason for referrals was lack of bed.\u0000The capacity of the hospital and other hospitals in AA in absorbing traumas, specifically orthopedic and neurotraumas\u0000need to be evaluated and necessary policy adjustments should be implemented. Further study at each hospital\u0000and the whole city gives better picture of referrals among hospitals in Addis Ababa.</p>","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35585553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RECURRENT MYXOMA ARISING FROM MULTIPLE CARDIAC\u0000CHAMBERS WITH SYSTEMIC EMBOLIZATION:A CASE REPORT.","authors":"Azene Dessie Mengistu,&nbsp;Sunita Maheshwari,&nbsp;Colin John,&nbsp;Sejal Shah","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Myxomas occupying multiple chambers of the heart are extremely rare, being more common in familial cases. Recurrence\u0000of these tumors after surgical excision is also a rare condition, observed in about 3% of patients in sporadic\u0000cases. Systemic embolization especially to the brain is one of the common presentations of cardiac myxomas\u0000apart from intracardiac obstruction and systemic symptoms.\u0000We report an adolescent girl presenting with recurrent myxoma arising from multiple cardiac chambers with systemic\u0000embolization. As a diagnostic and preventive measure of recurrence and chronic systemic embolization, we\u0000recommend a regular follow up of such patients with echocardiographic evaluation following surgical resection.</p>","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35586041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PATTERN AND OUTCOME OF NEONATAL SURGICAL CASES\u0000AT TIKUR ANBESSA UNIVERSITY TEACHING HOSPITAL,\u0000ADDIS ABABA, ETHIOPIA.","authors":"Nebiyu Shitaye,&nbsp;Belachew Dejene","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The survival of neonates with surgical conditions has greatly improved in developed countries, but\u0000still remains poor in developing countries. Available evidence suggests that this is due to several challenges encountered\u0000in neonates requiring surgical care. The aim of this study was to determine causes and outcomes of\u0000neonatal surgical admissions.</p><p><strong>Patients and methods: </strong>retrospective review of medical records of neonates who were admitted and treated at Tikur\u0000Anbessa Hospital between January1, 2010 and December 31, 2014. Data were analyzed using descriptive statistics\u0000and association between variables measured using regression analysis on SPSS version 16 statistical software.</p><p><strong>Results: </strong>There were a total of 652 surgical neonatal admissions during the study period of which 396 were males,\u0000252 females and 4 with indeterminate genitalia. The male to female ratio was 1.6:1. Majority of the cases 562\u0000(86.2%) had congenital malformation. Lesions of the gastrointestinal tract 282(43.3%), mainly Anorectal malformations\u0000followed by abdominal wall defects. Two-third (66.6%) of the cases were surgically managed. Nearly onequarter\u0000of them died. The proportion who died ranged from 0.03% for Hirschsprung’s disease to 73.2% for esophageal\u0000atresia. The immediate causes of death among these series of neonates were ascribed to septic shock and\u0000respiratory failure.</p><p><strong>Conclusion: </strong>Neonatal surgical admission is common in the Hospital. The overall number of deaths in this series of\u0000neonatal surgical cases was high. The type of principal diagnosis and the age of the neonates at admission were\u0000significantly associated with outcome. Creating awareness about neonatal surgical conditions may help to improve\u0000the current poor result.</p>","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35585552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A FOUR-YEAR REVIEW OF GERIATRIC MENTAL HEALTH SERVICES.\u0000IN A LAGOS BASED HOSPITAL, NIGERIA","authors":"Richard Ademola Adebayo,&nbsp;Andrew Toyin Olagunju,&nbsp;Michael Olasunkanmi Olutoki,&nbsp;Babatunde Fadipe,&nbsp;Taiwo Olamide Oduguwa,&nbsp;Rahman Abolore Lawal","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>There is a growing global concern about the public health implications of the increasing population\u0000of the elderly. One main issue of concern is centered on how to address their mental health needs using homegrown\u0000interventions and services. We expect that important lessons on geriatric mental health issues would be\u0000brought to fore in this report.</p><p><strong>Methods: </strong>This is a four-year (2007-2011) retrospective report on the mental health services rendered to 938 clients\u0000aged 60 years and above at a Lagos based mental health treatment facility in Nigeria. Designed questionnaires\u0000were filled with socio-demographic and clinical data obtained from patients case notes based on the objectives\u0000of the study.</p><p><strong>Results: </strong>The mean (standard deviation) age of elders was (±7.93) 69.6 years, and 65.5% were females. Majority\u0000were married, self-employed and belonged to low socio-economic status (73.1%, 63.1% and 63.2%, respectively).\u0000Close to two-thirds (62.4%) commute for at least one hour to get treatment. The commonest diagnosis was psychotic\u0000disorders (34.8%), while 5.5% had Alzheimer’s dementia. Some 96.5% of the elders were solely on medications.\u0000About a quarter had past history of mental illness and 48.5% reported co-morbid medical conditions, with\u0000cardiovascular problems (53.0%) being the commonest physical comorbidity. The middle old along with very old\u0000elders (aged≥70 years), and those with at least tertiary education, were more likely to present with dementia were more likely to present with index episode of mental illness and receive outpatient care</p><p><strong>Conclusion: </strong>The elders were managed for a wide range of treatable mental illnesses and other comorbidities and\u0000commute for hours to access care. Pharmacotherapy was the preponderant sole treatment modality. There is need\u0000for sustained development of expertise to enhance multimodal care and scaling up of comprehensive geriatric\u0000mental health services. Further research is needed on how to appropriately link and/or integrate geriatric care\u0000with services at all-tiers of health care delivery.</p>","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35582413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"REVIEW OF THE CLINICAL, COMPUTERIZED TOMOGRAPHY SCAN AND/OR\u0000MAGNETIC RESONANCE IMAGING FINDINGS OF INTRACRANIAL\u0000TUBERCULOMA IN AN ETHIOPIAN TEACHING HOSPITAL.","authors":"Getachew Assefa,&nbsp;Fathia Omar,&nbsp;Hagos Biluts,&nbsp;Mersha Abebe","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Ackground: </strong>Ethiopia is one of the countries that has high burden of all forms of tuberculosis and there is no published\u0000report on computerized tomography scan and/or magnetic resonance imaging of intracranial tuberculomas.\u0000Objective : to review the clinical, computerized tomography and/or magnetic resonance imaging features of intracranial tuberculoma.</p><p><strong>Methods: </strong>retrospective review of patient’s medical records of patients operated for intracranial mass that had\u0000computerized tomography and/or magnetic resonance imaging brain scans and had histopathological diagnoses,\u0000at Tikur Anbessa Specialized Hospital between January 2009 and June 2013.</p><p><strong>Results: </strong>Of 222 operated cases of intracranial mass subjected to histopathological test 29 (14.6%) were found to\u0000have tuberculomas, 28 (14.1%) had caseous necrosis and one was a tuberculous abscess, in 25 cases imaging was\u0000available for review and were included in the study . There were 15 males and 10 females with age range being 2\u0000to 65 years and with the Median age being 13 years. Twenty patients had computerized tomography and five patients\u0000had magnetic resonance imaging. Seizure 15/25 (60%) and headache 11/25 (44%) were the commonest\u0000presentation. Solitary or confluent large lesions were seen in 12/25 (48%) of patients. 14/25 (56%) of the lesions\u0000had their size between 2 cm and 5 cm. Majority of the lesions 15/25 (60%) were in the frontal and parietal lobes.\u0000The lesions were isodense on CT in 18/25 (72%) of the pre-contrast studies and 21/25 (84%) showed ring or rim\u0000enhancement after intravenous administration of the contrast medium.</p><p><strong>Conclusion: </strong>Tuberculoma, more frequently, presented with non-specific clinical findings and chronic seizure disorder\u0000and comonly occurred in young patients and often seen infratentorialy. It is often complicated with hydrocephalus\u0000in the pediatric age group. Computerized tomography scan and/or magnetic resonance imaging features\u0000are not different from reports from other countries.</p>","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35582414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RE-EXPANSION PULMONARY EDEMA FOLLOWING REPAIR OF MISSED POST TRAUMATIC DIAPHRAGMATIC HERNIA A CASE REPORT AND REVIEW OF LITERATURES.","authors":"Ephraim Teffera","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Reexpansion pulmonary edema following repair of missed diaphragmatic hernia is very rare .Here reported is a case of bilateral reexpansion pulmonary edema occurring after reconstruction of left sided post traumatic diaphragmatic hernia. The patient was re intubated and ventilated later put on supplemental oxygen via a catheter through the endotracheal tube followed by extubation and non re breather face mask to compensate for hypoxemia. He was given intravenous diuretics and inotropic support. Forty-eight hours after the acute event, the patient recovered with minimal residual hypoxemia. Reexpansion pulmonary edema after repair of missed diaphragmatic hernia is a rare complication with a high mortality rate of up to 20%. It should be considered in cases of hypoxemia following any chest reexpansion procedure. The exact pathophysiology leading to this complication is not clear but it is believed to be permeability pulmonary edema as a result of pulmonary micro vascular damage. Risk factors for reexpansion pulmonary edema should be evaluated and considered prior to insertion of chest tubes. Treatment is supportive and emphasis should be given for preventive measures.</p>","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35583253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FEMALE GENITAL MUTILATION AS AN ISSUE OF GENDER DISPARITY\u0000IN THE 21ST CENTURY: LEVERAGING OPPORTUNITIES TO\u0000REVERSE CURRENT TRENDS.","authors":"Workenesh Ayele,&nbsp;Sileshi Lulseged","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35582408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DETERMINANTS OF FEMALE GENITAL MUTILATION PRACTICES IN EAST\u0000GOJJAM ZONE, WESTERN AMHARA, ETHIOPIA.","authors":"Mulusew Andualem","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Female genital mutilation is one of the harmful traditional practices among women and girls. More\u0000than 130 million girls and women live today who have undergone female genital mutilation. In Ethiopia, a high\u0000prevalence (74.3% national and 68.5% in Amhara region) has been reported. This study was aimed to identify\u0000determinant factors of female genital mutilation practices in East Gojjam Zone, Western Amhara, Ethiopia</p><p><strong>Methods: </strong>community based cross sectional study was conducted among 730 women aged 15-49 years and having\u0000children < 5 years old in September, 2014. Data were collected using a pretested interviewer administered\u0000questionnaire. Descriptive statistics were used to describe study objectives, and bivariate and multivariate analysis\u0000to identify determinant factors to female genital mutilation.</p><p><strong>Results: </strong>718 women and 805 daughters participated in the study. FGM prevalence was 689 (96%) and 403 (49%)\u0000among women and daughters< 5 years of age, respectively. Type1 and type 2 FGMs were common and daughters\u0000<1 years of age exhibited 91% female genital mutilation. Daughters' age, parent education level, residence,\u0000women circumcision history, culture, health education, frequent health extension workers follow up and participation\u0000in anti FGM interventions were risk factors to female genital mutilation practice.</p><p><strong>Conclusions: </strong>Female genital mutilation practices continues to be a major problem to women and daughter <5\u0000years of age in the study area. A number of factors were associated with FGM practices including daughters’ age,\u0000parent education level, residence, health education, culture, mothers circumcision history, frequent health extensions\u0000workers follow up and participation in anti FGM interventions were determinants to higher FGM practices.</p>","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35582409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LESSONS FOR THE FUTURE IN THE HEALTH SECTOR IN ETHIOPIA:\u0000SHARING EXPERIENCES WITH THE NEW GENERATION.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35583254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HYDATID CYST DISEASE IN THE LEFT LATERAL NECK:\u0000AN UNCOMMON PRESENTATION.","authors":"Engida Abebe,&nbsp;Ayeligh Tsehay","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cysts commonly occurring in the neck include thyroglossal cyst and dermoid cysts in the midline, cystic thyroid\u0000nodules, branchial cysts and cystic Hygroma in the lateral neck. Hydatid cyst disease is commonly seen in the right\u0000lobe of the liver, the lung and rarely in other parts of the body. In general, cysts in the neck are not common in the\u0000second decade of life. In this article, we present a case of hydatid cyst presenting as left lateral cystic mass in an\u0000Ethiopian boy. The diagnostic difficulty, the need for diagnostic suspicion and consideration of hydatid cyst in the\u0000differential diagnosis and the management options are discussed.</p>","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35583252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}