Vol 58, No 03 (2020): July 2020 Issue

Aims/purpose   

Poor hypertension control contributes significantly to the growing burden of Disability Adjusted Life Years. Despite the awareness and availability of interventions, only a small number of patients achieve the desired outcome, and the factors associated with poor control remain unclear. Therefore, the current study aimed to determine the prevalence of, and factors associated with poor hypertension control.

Methods

We conducted a hospital-based cross-sectional study between June and August 2018. At the medical outpatient clinic, hypertensive patients 18 years and above who gave consent were enrolled. An interview schedule was used to collect the general characteristics, followed by blood pressure recording. Poor hypertension control was defined as two consecutive high blood pressure of one month apart among patients on anti-hypertensive. Logistic regression was performed to determine factors associated with poor control.

Results

 A total of 300 patients were enrolled in this study. More than half (52.0%) of the participants were female and living in rural (57.3%).  The mean (±SD) age of participants was 64.1 (±12.02) years. More than three quarter (86.7%) of the participants had poor control. Factors associated with poor control were; older age (cOR=1.05, 95% CI=1.02-1.08), being unemployed (cOR=3.46, 95% CI=1.30-9.14), and duration on anti-hypertensive (cOR=1.05, 95% CI=1.00-1.11).

Conclusion

Eight in every ten hypertensive patients had poor control. The poor control in this population was associated with unemployment, age and duration on anti-hypertensive.  The results call for more concerted efforts to address hypertension management.

INTRODUCTION: Induction of labor is an increasingly common intervention in obstetrics and known to decrease maternal and perinatal mortalities; therefore, it is necessary to determine the safety and effectiveness of our institutions’ cervical ripening methods and labor induction process.

 METHODS: A cross sectional prospective quantitative study was done. Data was collected from a sample of 339 induction cases that were selected consecutively during the study period. Data were collected from medical records of cases using a structured questionnaire Data were analyzed using SPSS. Study was approved by the Institutional Review Board of Addis Ababa University.

 RESULT: The rate of failed induction was 25.4%. The rate of Cesarean Section was 37.8%. Failed induction contributed to 66.7% of indications for Cesarean section among the induced labors. Direct oxytocin was used in 39.2%, vaginal misoprostol in 27.7%, PGE2 in 23.6% and Foley Catheter in only 9.4%. There is significant association between failed induction and unfavorable Bishop Score, indication for induction, gestational age and nulliparity, all having a P<.01. There was no association between failed induction and method used with maternal and fetal outcomes. A favorable Bishop Score was achieved in only 20% of cases.

 CONCLUSION: Failed induction and associated cesarean section rate is high in our setup compared with global rates. Therefore, reviewing our institutions’ induction guideline in an attempt to increase the success of vaginal delivery is important.

Background: Primary juvenile open-angle glaucoma is a rare form glaucoma that affects young individuals below the age of 40 years. It is characterized by rapid progression of the disease with severely high intraocular pressure. The purpose of this study was described the clinical features of Ethiopian patients with this form of glaucoma at the time of presentation to tertiary eye center.

Methods: A retrospective cross-sectional medical record review of patients’ with the diagnosis of primary juvenile open-angle glaucoma of five years period between 2013- and 2017. Central tendency, measures of dispersion, frequency and percentage were calculated using SPSS version 21 statistical software.

Results: A total of 55 cases were included during the study period. The mean age was 27.0 + 7.7, range: 5 to 35 years. Vision reduction was the commonest presenting complaint in 26 (47.3%) and 17 (30.9%) cases were identified while presenting for other complaints. The mean intraocular pressure of 98 eyes with glaucoma with and without medication was 37.2 + 11.3 mm Hg, range, 15 - 69 mm Hg. Based on visual acuity <3/60 and central 10 degree involving visual field, bilateral and unilateral blindness was identified in 9 (16.4%) and 27 (49.1%) cases, respectively. Glaucomatous optic nerve head damage was advanced in 68 (69.4%) of the eyes.

Conclusion: Ethiopians with primary Juvenile open-angel glaucoma are presenting to ophthalmic evaluation at advanced stage of the disease with very high intraocular pressure and vision loss. 

Key words: Juvenile open-angle glaucoma, intraocular pressure, glaucomatous optic nerve head

Background: Needle stick and sharp object injury is a common occupational hazard of healthcare workers. And it is a cause of concern for it can affect once wellbeing.

Objective: The study aims in assessing the occurrence and circumstances surrounding needle stick & sharp injuries and behavior associated with the reporting of injuries among residents practicing surgical intervention.

Methodology: A cross sectional study was employed, among residents on training in St. Paul’s hospital millennium medical college (SPHMMC) and who practice surgical intervention on patient. Data was collected using pretested, structured questionnaire from all residents practicing surgical intervention and who are at different post graduate year of their specialty training from February 1st, 2018 till March 30th, 2018.

Result: A total of 122 residents practicing surgery in our study area participated on the study, of which 32.8% are general surgery residents. The others are from department of orthopedics and traumatology (12.3%), ENT (6.6%), department of obstetrics and gynecology (29.5%), maxillofacial (5.7%), Ophthalmology (7.4%) and department of emergency medicine (5.4%). Of the respondents, 84(68.9%) residents sustained NSSI at least once over the study period, among which only 14.8% are involved in high risk patients. Highest level of injury is seen among residents from departments of orthopedics & traumatology and maxillofacial whereas the least injury seen from department of ophthalmology.

Conclusion: Results of our study are comparable to literatures in terms of incidence of NSSI and reporting habit of residents after the injury.

Abstract

Methods: A total of 32,370 surgically treated patients were  included in the study. Thirteen years retrospective data were collected from medical records (Log Books and Electronic Databases) at St. Paulos Tertiary Referral Hospital, September 2005 to 2017. Open surgical treatments related to urolithiasis were identified via a thorough review of patient medical records. Data were analyzed using descriptive statistics, and using Graph Pad Prism 6 Software.

Results:  In the last 13 years, the overall urinary stone  surgery was seen in 2.3% (757) patients. Trends in the number of urolithiasis increased by 38.7%  from 2005 (1.3%) to 2017 (40.0%). The mean age at which the stones treated was 42.5 years. The prevalence of stone diseases was found to be higher in males (68.2%) than females (31.8%). The majority of stones (22.2%) were prevalent between 30 and 39 years of age, being the highest (63.1%) among males. Urolithiasis  increased in men and declined in women as age increased. The majority (46.5%) of stones were  located in the kidneys, being higher on the left. Stone surgeries due to recurrent stone formers were 1.32% (10). The most common comorbidities associated with urolithiasis were reduced urinary output, and benign prostatic hyperplasia.

Diabetic ketoacidosis is a medical emergency that requires prompt hospital admission and treatment.  It contributes significantly to morbidity and mortality in children with type-1 diabetes mellitus. DKA is a result of absolute or relative shortage of insulin deficiency, resulted in hyperglycemia, ketonemia, acidemia, and systemic inflammation.

Objective: To study the prevalence of diabetic ketoacidosis and associated factors among pediatric diabetic age group in Hawassa University teaching hospital from September 2014 to August 2019 G.C.

Methodology: The research area is in a pediatric clinic, Hawassa University teaching hospital. This study is a retrospective cross-sectional study of 150 cases had diabetes mellitus. Data were collected from patient records by trained Data collectors. Data intended for our study that consists of the patient's history, physical examination, progress notes, treatment results, and a summary of deaths from September 2014 until August 2019.

Result: DKA prevalence is 72 percent. It was common among the age group 10 to 14 years, which is 28.7 per cent. The majority of them, 98.7 percent are type 1 DM. Of all patients with DKA 50 (46.2%) were on drugs, of which 48 (96%) had used insulin and 2 (4%) were on oral hypoglycemic agents.

Conclusion: Diabetic ketoacidosis was high among patients with Type-1 diabetes. Most patients with DKA presented with symptoms of poly (polyphagia, polydipsia, and polyuria).

Background: Diabetic Retinopathy, one of the chronic micro vascular complications, is a major global cause of total blindness. As the global prevalence of diabetes increases, so will the numbers of people with diabetic retinopathy. Hence, this study aimed to determining the magnitude and severity of diabetic retinopathy in newly diagnosed type 2 diabetes patients in Menelik II Hospital.

 Method: Institution based cross sectional study was conducted on newly diagnosed type 2 DM patients. Data were analyzed using Statistical Package for Social Science (SPSS) 20 version computer software.

Result: A total of 111 patients with newly diagnosed type II diabetes participated in this study. The mean age of the study participants was 50.5 (± 10.6years) with a range of 30-70 years.  Almost half of the   respondents (47.7%) completed their secondary school education. The average BMI of the participants was 25.0 ± 3.6kg/m²_. Diabetic retinopathy was detected in 24 (21.6%) patients out of whom 7 (29.16%) had mild non-proliferative diabetic retinopathy, 8 (33.3%) moderate non-proliferative diabetic retinopathy, Severe non-proliferative diabetic retinopathy 5(20.8%) and 4 (16.7%) proliferative diabetic retinopathy.

Conclusion: The prevalence of diabetic retinopathy at time of diagnosis among type II diabetes was 21.6%. This high number of undiagnosed diabetic retinopathy indicated for an early and regular screening for diabetic retinopathy among diabetic patients and more aggressive management of modifiable risk factors could reduce the numbers of people who develop vision-threatening retinopathy. 

Background: Premenstrual syndrome, a common cyclic disorder of young and middle-aged women, is characterized by emotional and physical symptoms that consistently occur during the luteal phase of the menstrual cycle. The Primary objective of the study was to determine the prevalence of premenstrual syndrome and its effect on academic and social performances among medical students of College of Health Sciences, Addis Ababa University.

Methods: A cross sectional descriptive study was done among systematically selected female medical students of College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia on March, 2019. A self-administered semi-structured questionnaire was used to collect data from 226 Students during the study period.

Results: Among the respondents, 129(57.07%) students fulfilled the Diagnostic and Statistical Manual of Mental Disorders V criteria for Premenstrual syndrome. Hundred and four (53.0%) of the participants reported academic performance impairment in their learning activities. Among those who reported performance impairment due to PMS, 67(29.6%) reported missing class lectures, seminars, bed sides or rounds, 11(4.8%) missed examination and 3(1.3%) of them reported withdrawal from their study. Hundred and two (52.9%) participants reported impairment in their social life activities. Body Mass Index of <18.5 kg/m² and age of menarche between 13 and 15 years had statistically significant association with premenstrual syndrome.

Conclusion: Our study revealed a high prevalence and negative impact of PMS on medical students of Addis Ababa University. Therefore, health education, appropriate medical treatment and counseling services should be provided to affected medical students.

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Background: Diabetes imposes large economic burdens on individuals, their families and on national health care system and national economy. The aim of this study was to assess the economic burden of diabetic mellitus to patients and their families.

Method: Institution based cross-sectional study design was employed in selected health facilities in Addis Ababa city from April 1 to May 4, 2015. Structured questionnaires were used to collect the data. Data were entered and analyzed using SPSS version 20. Descriptive and analytical statistics were applied. A correlation was done in order to determine the relationship between dependent and independent variables with Spearman's rho correlation coefficient, which identifies the main variable of the study which is cost.

Result: This study included 404 diabetic patients. The median direct cost of caring for a diabetic patient was USD 21.8 per month. The median of the total indirect cost was 6 days (mean 17.29) for the patient and their caregiver in the last 6 months. The direct cost was higher in those who had higher education level, higher family income, frequently had laboratory tests, the source of medication costs in correlation degree of (0.1 to 0.6 or -0.1 to -0.6) at p-value < 0.05.

Conclusion: Medical costs were the major contributor to the direct cost of diabetes patients and caregivers. Moreover, it needs efforts to increase medical services at low cost to all diabetic patients.