Background: Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disorder that needs a comprehensive management plan. The integral role of nutrition therapy in diabetes management is getting special attention in guidelines though practice is in the primitive stage, especially in resource limited settings where lifestyle modifications have a large role in the overburdened healthcare system. Understanding the existing gap at a larger scale is important in designing effective strategy. Therefore, the study aimed to assess the dietary practice and its association with level of glycemic control among T2DM patients who were on follow-up at two referral hospitals in Ethiopia.

Methods: A hospital based cross sectional study was conducted from January to March 2023 among 314 systematically selected T2DM patients who were on follow-up at the diabetes clinics of St. Paul’s Hospital Millennium Medical College and Tikur Anbessa Specialized Hospital. Data was collected using a pre-tested structured questionnaire and summarized using frequency and median (interquartile range). To examine the association of dietary practice with level of glycemic control, a binary logistic regression model was run at 5% level of significance where Adjusted Odds Ratio (AOR) and 95% CI for AOR were used to interpret the results.

Results: From the 314 participants, 146 (46.5%) patients had adequate knowledge regarding the recommended dietary practices and only 42 (13.4%) of the individuals practiced a healthy diet. A total of 107 (34.1%, 95% CI= 29.0%-39.2%) had optimal glycemic control. Poor dietary practice (AOR=7.93, 95% CI= 2.63-23.89, p<0.001), obesity (AOR=2.74, 95% CI= 1.05-7.18%, p=0.04), and taking combination oral anti-diabetic drugs (AOR=6.22, 95% CI= 3.05-12.69, p<0.001) were significantly associated with suboptimal glycemic control.

Conclusions: Dietary knowledge and practice among T2DM patients were very low, as is the level of glycemic control, which are similar to studies conducted years back, indicating a lack of improvement in the desired behavior over time. Poor dietary practice in turn was associated with suboptimal glycemic control. It is important to target interventions that enhance the understanding and application of dietary practice in individuals with T2DM. Furthermore, clinicians should be cautious in the management of patients with the identified significant factors.

Aim: To explore the social and psychological consequences of stroke among stroke survivors and their caregivers in Addis Ababa, Ethiopia. 

Methods: We conducted in-depth interviews with stroke survivors (n=13) and their caregivers (n=13) in Addis Ababa, Ethiopia. Interviews were conducted in Amharic and were audiotaped. After repeated listening to the records and reading the transcripts, a thematic analysis was conducted. 

Results: six themes emerged: explanatory model, new body, living on a bread line, psychological toll, elephant in the room, and finding a silver lining. Stroke survivors described stroke as a sudden event that changed their life forever.

Some participants attributed it to the devil’s doing, spirit possession (“ልክፍት”) and their sins. Both survivors and their caregivers reported financial crises related to the disability, inability to return to work, treatment, and transportation costs. Both survivors and caregivers described the psychological tolls such as emotional ups and downs, anxiety, frustration, sleep problem, and suicidal ideation. Survivors reported distancing themselves from social activities or events whereas; caregivers reported that they did not have enough time to be a part of one. Stroke survivors considered surviving the stroke as a blessing. Caregivers say they have set their minds to be thankful to God that they have their loved ones around despite all the limitations.

Conclusion: Stroke survivors and their caregivers suffer from financial crises and emotional rollercoasters. This warrants the need for compressive social and psychological interventions in addition to the usual physical care provided for such cases in low-income countries.

Abstract

Background: Lens-induced glaucoma after untreated mature cataract is the commonest cause of secondary glaucoma in the developing world. The purpose of this study was to determine the common clinical features of lens-induced glaucoma, its management, and its outcome at Menelik II tertiary hospital, in Ethiopia.

Methods and Materials: This was a retrospective study of cases that were seen at the hospital from January to December 2020. Lens-induced glaucoma patients who undergo cataract extraction were included in the study. Medical charts review was performed, and analysis was done using SPSS version 24.0 Software.

Results: Forty-four lens-induced glaucoma patients were included in this study. Female participants were 65.9%. The mean age was 63.3(±Standard deviation (SD) 8.7) years. Phacomorphic glaucoma 88.6% was the leading cause. The common clinical symptoms identified were eye pain (100%), visual reduction (97.7%), and redness (38.8%). Visual acuity (3/60) or worse was reported in all patients with mean intraocular pressure of 37.3mmHg. After cataract surgery, the mean intraocular pressure reduced to 14.5± 6.55 mmHg while vision improved to better than 6/60 in 28 (63.6%) of patients. Of these, 21 (75%) patients seek medical treatment in the first two weeks of initial symptom.

Conclusion: This study has identified the main cause of LIG was phacomorphic with the common clinical findings of pain, redness, and visual reduction. Early cataract extraction was associated with better final visual recovery and intraocular pressure control. An intraoperative complication was often observed in those with delayed presentation. Therefore, creating awareness among the general population and healthcare givers is key to the timely management of lens-induced glaucoma.

Background: Treatment of patients with fractures of the proximal humerus remains an urgent problem of modern traumatology and orthopedics. The aim of this work was to study the results of surgical treatment of patients with proximal humerus fractures in which plates with angular stability of screws were used for osteosynthesis.

Materials and methods: Thirty six patients aged 18 to 75 years with fractures of the proximal humerus, ,were observed after treated in the polytrauma department of the City Clinical Hospital No. 4 in Almaty, Kazakhstan during the period from August 2019 to December 2021. There were12 men (33.4%) and 24 women (66.6%). According to the C.S., Neer patients were distributed as follows: two-part patients - 17 (47.2%), three-part patients - 11 (30.6%), four-partpatients-5(13.9%), fracture-dislocations of the humerus head-3 (8.3% ). Most of the patients applied before 3 days after injury (53.0%).

Results: Positive treatment results were achieved in most cases with two and three fragmentary fractures and in those operated early (from 3 to 7 days) after injury. Plates with angular stability of the screws provided excellent and good treatment results in 69.5%, and a satisfactory result in 16.7%. The unsatisfactory results of treatment were 13.8%, and the incidence of postoperative complications was 19.4%.

Conclusions: Performing stable osteosynthesis in three- to four-fragment fractures and fracture-dislocations of the humerus head is technically a difficult operation. A study of our material and literature has shown that the incidence of complications after extra-cortical osteosynthesis of the humerus is associated not only with the surgical technique of implant placement, but also with the nature of the damage, including osteoporosis, osteonecrosis, and pathology of bone tissue regeneration.

Abstract

Background: Cancer is the leading cause of death globally and is on the rise in Africa. Cutaneous neoplasms are becoming increasingly common worldwide. Understanding the pattern of this disease is essential for developing data-driven preventive, screening, and treatment services. However, there are limited studies in Ethiopia so far. Therefore, the study aimed to assess the pattern and associated factors of cutaneous neoplasm among patients with histopathologically confirmed biopsy results at a tertiary teaching hospital in Ethiopia from March 2014 to October 2022.

Methods: A retrospective record review study was conducted among 1006 patients with histopathologically confirmed cutaneous neoplasms from the biopsies that were assessed at St. Paul’s Hospital Millennium Medical College. Data was summarized using frequencies, percentages, median (interquartile range), and graphs. To identify significant factors associated with malignant cutaneous neoplasm, a multivariable binary logistic regression model was fitted, where Adjusted Odds ratio (AOR), 95% CIs for AOR, and p-values were used for interpretation of results.

Result: From the 1006 cases, 265 (26.3%, 95%CI=23.5%-29.3%) were malignant, of which sarcoma (26.0%) and squamous cell carcinoma (25.7%) were the most frequent and found to be prevalent in younger (19-29 years) and older (≥60 years) patients, respectively. The trunk was the commonest site (54.2%) for all the malignancies, especially sarcoma (80.4%). Age was found to be a significant exposure that is associated with the development of malignant cutaneous neoplasm for those ≥30 years as compared with those ≤18 years, with the odds increasing with age (AOR=2.66, 95% CI=1.10,6.45 for 30-39 years, AOR=4.98, 95% CI= 2.01,12.36 for 40-49 years, AOR=5.33, 95% CI=2.15,13.22 for 50-59 years and AOR= 6.62, 95% CI=2.79,15.66 for ≥60).

Conclusion: The prevalence of malignant cutaneous neoplasm is higher than previously reported in the country and the malignancy pattern and distribution are different from what is known so far. This could signal a shift in disease epidemiology, and the findings should be factored into clinical decision making and program design for disease prevention, screening, and treatment. It also calls for further prospective research to learn more about the conditions in the context of additional relevant personal and clinical characteristics

Abstract

Background: There are some controversial results regarding the association between quality of life (QOL) and adherence to drug treatment and glycemic control. Therefore, this study was designed for the evaluation of the association between treatment adherence in patients with type 2 diabetes with their QOL.

Methods: This cross-sectional study was conducted on 279 diabetic type 2 positive cases referred to the Endocrinology clinic in Hamadan City in the first six months of 2020. The short-form health survey SF-36 and Persian version of MMAS-8 were used for assessing health-related QOL and treatment adherence of patients, respectively. Correlations between each QOL domain with treatment adherence were tested with Pearson's r coefficient.

Results: The number of 154 (55.2%) of them were male and the vast majority of them were urban dwellers (91.07%). 101 (36.07%) of the patients had high treatment adherence. There was a significant positive correlation between treatment adherence and domains of emotional wellbeing, social functioning, general health, and total score of QOL (P>0.05). While there was a significant negative correlation between treatment adherence and role limitations due to physical health (r=-0.14, P=0.02).

Conclusion: Based on the findings of this study, diabetic patients with poor QOL may have less treatment adherence, then such patients should be integrated e.g. in self-care education programs and reinforcement interventions to improve QOL and treatment adherence.