Introduction: Glaucoma blindness is burdensome. Knowing glaucoma management challenges can reduce glaucoma blindness burden.The aim of this study was to determine challenges of glaucoma management in Nigeria

Methods: A descriptive cross sectional survey of Eye Care Physicians (ECP) on challenges of glaucoma management in Nigeria.  

Results: One hundred and twenty three ECP, mean age 44, 56.1% males. Most (68.3%) always and 31.7% often manage glaucoma. Glaucoma features; most 98.4% affirm glaucoma deserves special consideration among eye conditions. Most (87.8%) at least agree glaucoma management is very challenging. Presentation and treatment affordability; most ECP at least agree: most patients present late (110, 89.4%), cannot afford standard investigations (87, 70.7%), cannot afford treatment 62.6%. However, most ECP at least disagree most patients readily access drugs through health insurance 83.7%.Preferred treatment; most ECP at least agree: most patients prefer medical treatment 91.9%. being comfortable managing glaucoma with drugs 66.7%, medical treatment being cost effective than trabeculectomy 82.9%, and being as comfortable performing trabeculectomy as with cataract surgery51.2%. Drugs Availability; most ECP at least agree: common anti-glaucoma drugs are readily available (112, 91.1%), and drugs are expensive for most patients (105, 85.4%). Equipment; many ECP at least disagree: there is functioning OCT to investigate glaucoma (76, 61.8%), there is fundal camera for optic disc photography (62, 50.4%).

Conclusions: Glaucoma management remains challenging especially late presentation, treatment non-affordability and inadequate resource for glaucoma care. Medical treatment is a preferred choice among patients. The need to improve uptake of surgical glaucoma services underscored.

Background: -Knowledge of the characteristics and outcomes of critically ill children admitted to PICU in low income countries may help with the identification of priorities and the resources required for improvement of the care of critically ill patients.

Aim: The objective of this study is to describe the pattern of admission and outcome of patients admitted to the pediatric intensive care unit (PICU) in Gondar University Hospital.

Methods: - A retrospective study of all children (beyond 30 days of age and <14yrs of age) admitted to the pediatric ICU of Gondar University hospitalwas made for a period of 3 years from August 2013 to July 2016.  Data was retrieved from all available patient Charts and health management information system (HMIS) documentation log of PICU in the study period.

Results: Total of 330 (80%) patient case note was available for review out of which 197(59.7%) were male and the rest 133(40.3%) were female giving the male: female ratio was 1.5:1. The median age at admission was 6years (range 1month-14 yrs.). Neurologic (31.1%), infectious (13.3%) and renal (11.2%) disorders are the three commonest reasons for admission.  Median duration of stay in the PICU regardless of outcome was 3 days. The overall mortality among PICU admitted patients was 30.9% and 51% of all death occurs in the first 24 hours..

Conclusion: The mortality in PICU was very high. The highest number of deaths occurred within 24 hours of admission. Neurologic and infectious contribute the primary cause of mortality. 

Background: The aim of this study was to provide the prevalence of VIA positive cervical lesions and its associated factors among women visiting gynecology department of Felege Hiwot Referral Hospital (FHRH).

Methods: A cross sectional study was conducted from December 2016 to June 2017 on 428 women at FHRH. Relevant sociology-demographic data were collected by using structured questioner. Women who visited the hospital gynecology department were recruited VIA using 5% acetic acid as per cervical cancer prevention guideline for low-resource settings. Data was entered, cleaned and analysed using Statistical Software Package for Social Sciences (SPSS) v23.

Result:  Most of the participants at 270 (63.1%), 296 (69.2%), 379 (88.6%), 247 (57.7%) and 194 (45.3%) were from urban settings, married, fertile (gave birth), used long term contraceptive and HIV positive, respectively.  Similarly, the majority at 242 (56.5%) were in the age group of 39-49 years with the median age at 35.0 years (ranged: 17-60). The prevalence of VIA positive lesions were at 61(14.3%; 95%CI: 11.3-17.9) of which some 23% (14/61) were suspicious for cancer. Among VIA positive participants, 75.4% (46/61) were eligible for cryotherapy and got the treatment in the screening centre. The odds of having VIA positive result was lowered by 24% among women who engaged in private business than government employees [AOR: 0.24, 95%CI (0.07-0.85)].

Conclusion: The observed prevalence of VIA positive result calls stakeholders to strengthen cervical cancer prevention strategies in the study area.

Background: Extrahepatic biliary tree obstruction (EHBO) is a common problem in surgical gastroenterological practice. The condition can be caused by the obstruction of the bile duct with gall stones, strictures and hepato-biliary malignancy.

Objective: - assess the etiological spectrum, clinical presentation, treatment and outcome of patients with EHBO who were admitted and operated at St. Paul Hospital Millennium Medical College (SPHMMC) surgical department from January 1^st 2012- December 30 2015 G.C

Methodology: A retrospectives analysis of all patients admitted and operated at SPHMMC with a diagnosis of EHBO in the three years period was done. Operation theater log book was used to identify patients’ medical records. Data was collected using a pretested structured data collection format and analyzed with SPSS version 20.

Results: Totally 116 patients, 62 (53.4%) females, were operated for EHBO. Age of patients ranged from 21-80 with a mean of 40.3years. Abdominal pain 107(92.2%) and jaundice 98(84.5%) were the two most common presenting complaint. Abdominal U/S was the main imaging modality and diagnosed the etiology in of 88.8% of the patients. Benign conditions were the most common causes of EHBO 79 (68.1%), CBD stone being the main diagnosis 70(60.3%).  Pancreatic head tumor (PHT) was the commonest cause of malignant EHBO19(51.3%) followed by  cholangiocarcinoma 15(40.5%). The commonest operations were cholidochoduodenostomy, 50(43.1%) and cholecystojejunostomy with Braun’s anastomosis 22(19%).

Conclusion: Abdominal pain and jaundice were the main presenting symptoms of EHBO which was mainly caused by CBD stone and PHT.  The main surgeries were bypass operation

Key word:  CBD, Stone, Jaundice

Introduction: Road traffic injuries are among the leading causes of preventable death and lifelong disability globally. We also see an increasing trend in such injuries in Ethiopia.

Objective: The objective of this study was to assess common types and patterns of bone fractures and their hospital prevalence among victims with road traffic injury.

Materials: We conducted a cross sectional study of two years’ data collected retrospectively. Study sample size was 384. Data were collected by using a structured questionnaire. Bivariate analysis was conducted and P-values were computed using the Chi-square test. A P-value <0.05 was set as level of significance

Results: Out of 13,526 road traffic injury victims, 384 were included in the study. Extremities and head region were the most commonly injured areas, accounting for 45.1 % and 20.6 % respectively. Over 60% of the patients were pedestrians. The most common patterns of injuries 227 seen in (59.1%) were soft tissue injuries followed by fractures in 92 (24%) of the cases. There was statistically significant association between the age of road traffic injury and multiple site fractures (P=0.037).

Conclusion: Our study revealed that the commonly affected anatomic regions by RTI are extremities, head and chest, extremities being most affected. Besides fracture, soft tissue injuries were also common. Half of the fractured patients had an isolated/single bone fracture. Multiple regions were injured in about one fifth of the patients, indicating multidisciplinary team work is needed in hospitals handling such trauma.  

Keywords: Road Traffic Injury (RTI), Fractures, Pedestrian Accidents, Polytrauma, STI

Abstract

Objectives: To determine the prevalence of overweight/obesity existing among civil servants in southern Ethiopia.    

Methods: It was a cross-sectional study carried out in SNNPR in Ethiopia, 2015. Stratified cluster sampling method was used to select 375 representatives of the total population ranging from18-65 years old (221) men and (153) women. Margin error of 5%, 95% confidence level and 50% response distribution is tolerable. BMI was measured using weight scale and height measuring tape by the help of trained professionals. Chi square test and Multinomial logistic regression model was Statistical analysis performed using IBM SPSS version20.

Result: Totally 54% of office workers are at risk of overweight/obesity and only 42.0% were have desirable weight while 4.0% were under weight. Women are found more obese than men where as men are more overweight than women. Statistically significant association between gender, age, marital status and BMI was discovered, (x² (3) = 8.56, p = 0.036) for gender and (x² (9) = 71.190, p = 0.000) for age, (x² (9) = 51.116, p = 0.000) for marital status.

Conclusion: More than half of the productive population is exposed to the deleterious health effects associates with overweight/obesity. From every two adults, one is overweight or obese and the figure will accelerate fast if failed to intervene. The consequences will be appeared difficult to manage unless starting intervention before getting severe level.

Key words: BMI, Healthy weight, underweight, deleterious health effects, mortality.

Abstract                                                                                                     

Background: Trabeculectomy with mitomycin C has been performed for glaucoma patients in Menelik II Hospital for years but the outcome has never been evaluated.

Objective: To evaluate the tonometric outcome of primary trabeculectomy with Mitomycin-C in primary open angle glaucoma and pseudoexfoliative glaucoma patients.

Subjects and methods: A retrospective study of patients seen at Menelik II Hospital, 40 years and above, with primary open angle glaucoma and pseudoexfoliative glaucoma of any stage that underwent primary trabeculectomy with Mitomycin-C in 2014 was evaluated. The surgery was done by two glaucoma specialists.                              

Results: A total of 166 charts were revised; and 98 (59%) were males and 68 (41%) were females. Primary open angle glaucoma accounted for 52.4% and pseudoexfoliative glaucoma 47.6%. Majority of patients were between 50-79yrs of age (91%).The mean intraocular pressure before surgery was 31.4±8.4mmHg and 11.8±6.5mmHg six months after surgery. At 6month post-operative follow up, complete success was found to be 60.2% and qualified success 27.1%, failure 9.6% and Hypotony 3.0%; and the overall success 87.3%. The overall success at six month follow up was 88.5% in Primary open angle glaucoma patients and 86.1% in Pseudoexfoliative glaucoma patients.                                   

Conclusions: Primary trabeculectomy with Mitomycin-C is safe and has good short-term outcome in Ethiopian patients at Menelik II glaucoma patients. The procedure has comparable success in both Primary open angle glaucoma and Pseudoexfoliative glaucoma patients.

Key words: Primary open angle glaucoma, Pseudoexfoliative glaucoma, Mitomycin-C, Trabeculectomy, Intra ocular pressure.

Background: Ultrasound is one of the non-invasive methods for fetal sex determination and with its introduction visualization of the fetal genitalia has become possible.  Although mainly fetal sex determination is done for parental curiosity it has also some clinical implication. Accurate prenatal Estimated Fetal weight in late pregnancy and labor is extremely useful in management of labor

Objective: the study was conducted to assess accuracy of ultrasound in fetal sex and weight determination in 2^nd & 3^rd trimesters when it is performed by those with lesser experience and exposure

Methods: perineal US of the fetus was done on 600 pregnant women with GA of 16 weeks-to-term. Complete data and information was available in only 550 of the study participants. For fetal weight accuracy study, 235 mothers with gestational age of ? 38weeks were included. The sex & weight was confirmed at the expected time of delivery through phone calls and for some by revising their medical cards.

Results: Out of 570 fetuses ultrasound determined the sex for 527 (92.5%); 287 of whom were female and 240 were male. Overall accuracy was 84.92%. Accuracy for females was 91.63% and for males was 92.08%. Accuracy of ultrasound fetal weight estimation for those with GA>38wks was 85.5%.

Conclusion: Ultrasound is an accurate method to determine the fetal sex and weight even when performed by those less experience and exposure. The over estimation of LBW (Low Birth weight) and under estimation of macrosomia found in ultrasound weight estimation should be given due attention

Abstract

Background

Premature rupture of membranes(PROM), if not followed by natural labor or delivered with in limited time period, it will get complicated by infection and reduced amniotic fluid. These complications will negatively affect maternal and perinatal outcome. Several factors affect the success of labor induction in women with term PROM and the practice varies from institution to institution. This study compares the pregnancy outcome and success of induction of labor in women with term PROM, low BISHOP score, managed with direct oxytocin induction protocol and prostaglandin followed by oxytocin protocol.

Methodology

Facility based prospective comparative cross sectional study design was used on cases of term PROM, low BISHOP score in the three teaching hospitals of Addis Ababa University. As both protocols are practiced in these hospitals, mothers managed with direct oxytocin induction protocol were compared with those managed with prostaglandin and oxytocin protocol for induction of labor.

Results

From the total 98 term PROM with low BISHOP included in the study, 49 mothers were managed with direct oxytocin protocol while the remaining were managed with prostaglandin and oxytocin protocol. Increased cesarean delivery for failed induction and non-reassuring fetal heart pattern was observed in direct oxytocin protocol group.

Conclusion 

Prostaglandin cervical ripening reduces the burden of cesarean section in cases of term PROM with low BISHOP.

Key Words: Term PROM, Direct Oxytocin, Prostaglandin, Induction