Vol 61, No 3 (2023): JULY 2023 VOLUME 61 NUMBER 3

Background: Thoracotomy is a major surgical procedure requiring a thorough understanding of cardiorespiratory mechanics. Postoperative care requires a high-dependency environment and trained and well-experienced staff. The aim of this study was to determine the post-op outcomes, estimate the time to full post-op recovery, and identify predictors associated with these outcomes among patients who underwent first time thoracotomy at Tikur Anbessa Specialized Hospital (TASH) from April 1, 2011 to March 31, 2012 in Ethiopia.

Methodology: A retrospective chart review was conducted among 148 patients. Descriptive analysis using frequencies with percentages and mean survival times were used to characterize the study population. To compare the mean time to post-thoracotomy recovery between groups, Kaplan-Meier survival plot together with Log-rank test was used. To identify significant predictors of post-thoracotomy outcomes and time to post-thoracotomy recovery, a robust Poisson regression model and Cox proportional hazard survival model were run at 5% level of statistical significance.

Results: From the 148 patients, 115 (77.7%, 95% CI=71.5%-85.6%) fully recovered, 27 (18.2%, 95% CI=12.0%-23.6%) have recovered with complications and 6 (4.1%, 95% CI=1.4%-6.9%) died. The overall mean time to post-thoracotomy recovery was 13.2 days (95% CI=10.1-16.4).  Significant predictors of major complications and death were being male (ARR=1.99, 95% CI=1.02, 3.94, p=0.049), pre-op WHO Performance status score of 3 and 4 (ARR=2.56, 95% CI=1.19, 5.48, p=0.015), developing intraoperative complication (ARR=2.29, 95%CI=1.14, 4.59, p=0.020) and taking systemic analgesia (ARR=4.13, 95% CI=1.05, 16.23, p=0.042). Significant predictors of time to post-op recovery were being male (AHR=0.62, 95% CI=0.42,0.92, p=0.017) and developing intraoperative complication (AHR=0.38, 95% CI=0.18, 0.80, p=0.011).

Conclusion: The post-thoracotomy morbidity and mortality in the study population is similar to previous reports, and the mean recovery time is within the expected range for a good outcome. For further improvement in these outcomes, it is crucial to mitigate risks during the preoperative period and closely monitor and manage high-risk patients during the postoperative period.

Background: There is a scarcity of data on the clinical features, severity of disease and treatment outcomes of COVID-19 during pregnancy in Sub-Saharan Africa. The main purpose of this study was to evaluate illness severity and pregnancy.

Methods: Between May 21, 2020 and May 20, 2021, medical records were reviewed as part of this single-center retrospective cohort study. Descriptive statistics, including chi-square tests, two independent sample  t-tests, and the Mann-Whitney U test, were used as needed. A Poisson regression was also done to determine the effect of pregnancy on severity independently.

Results: There were no differences in the comorbidities between pregnant and non-pregnant  groups, except for hypertension, which was more common among non-pregnant women. Pregnant women had a greater number of headaches, myalgia, and anosmia. In the pregnant group, absolute lymphocyte counts below 1000/mm³, and platelet counts below 150,000/mm³ were more common. Regarding the severity of the diseases, there were similarities between the groups. There was no difference between the groups in terms of disease severity, in-patient care unit admission, type of treatment given, and mortality. Non-pregnant women, however, have a shorter length of hospital stay. Two (5.0 %) of the 40 patients who gave birth at the study facility had a neonatal outcome of death. In a multivariable regression analysis, there was no association between pregnancy and disease severity.

Conclusion: Although some of the symptoms and laboratory factors were more prevalent in pregnant women, pregnancy was not found to affect severity or mortality from COVID-19.

Background: Infants under the age of six months are considered to have severe acute malnutrition if their weight for length Z-score is below -3 standard deviations (SD) and/or they exhibit bilateral pitting edema. It is frequently diagnosed in infants under 6 months of age and is frequently associated with higher rates of morbidity and mortality in infants than in older children. The current study aimed to assess the treatment outcome of severe acute malnutrition and associated factors among infants under 6 months of age in Hawassa Comprehensive Specialized Hospital, southern Ethiopia

Methods: An institution-based cross-sectional study was carried out in September to November 2021. Between September 2007 and October 2021, a total of 261 records were evaluated. After the data was collected, it was input into EPI-data version 31 and then exported to STATA version 16 for analysis. Before exporting anthropometry data to Stata, Z scores of anthropometric measurements were calculated using WHO Anthro V3.2.2 software.

Results: Our study included 261 infants with severe acute malnutrition who were admitted, the outcomes were: cure, default, transfer out, non-respondent, death, and unknown and the rates were 57.2%, 11.5%, 9.2%, 4.2%, 14.2%, and 3.8% respectively. Gestational age, pneumonia, Pre-lacteal feeding, and tuberculosis were significantly associated with mortality.

Conclusion: The mortality of malnutrition was high in this study. While administering treatment for severe acute malnutrition to infants younger than 6 months, attention should be paid to infants who have pneumonia and tuberculosis. Counseling on the risk of Pre-lacteal feeding through health education is necessary

Background: The surgical informed consent process and format are not uniform nationally and internationally. The objective of this study was to assess the knowledge and perception of adult patients towards the legal nature of surgical informed consent in Arbaminch and Jinka General Hospitals, South Ethiopia. 

Methods: Responses from 423 post-operative adult surgical patients were taken using pretested structured interviewer-administered questionnaires for five months. A hospital-based cross-sectional study of all adult surgical patients who were operated were involved before discharged from December 1 2021-April 30, 2022 in Arbaminch and Jinka general hospitals, Southern Ethiopia. Stratified sampling technique was used. The collected data entered into EPI-data version 3.1 and exported to SPSS (version 25) software for statistical analyses. A significant level was determined at a P-value <0.05 with 95% confidence interval.

Results: A total of 423 adults with a response rate of 100% were included in the study.  Of the respondent's consent, only 210 (49.6%) was taken by an operating surgeon, and the majority was taken by a general practitioner, nurse, and midwife. Surprisingly consent taken by the porter was 5(1.2%). Of the respondents, only 188(44.4%) had good knowledge and only 58 (13.7%) had a good perception regarding surgical informed consent. Patients exposed for consent signing previously, had 4.06 times higher knowledge than those unexposed (AOR=4.06, 95%CI :-( 1.80, 4.492)). Those patients living in an urban area were well aware of surgical informed consent (AOR=0.246, 95% CI :- (0.212, 1.660)). Level of understanding of surgical informed consent, significantly increased for those informed by an operating surgeon (AOR=4.45, 95% CI :- ( 1.95, 5.09)).

Conclusion: Majority of our patients had poor knowledge and poor perception regarding the legal nature of surgical informed consent. Living in urban, signing informed consent previously and consent taken by operating surgeon affected level of knowledge positively. The consent had to be taken at least by the operating surgeon.