Vol 63, No 1 (2025): JANUARY 2025 VOL 1 NO 1

Introduction: Mineral bone disease (MBD) abnormalities are common complications in patients with chronic kidney disease (CKD). The MBD abnormalities are known to be associated with increased morbidity and mortality. In spite of their importance, there is limited data on CKD-MBD abnormalities in Ethiopia. This study looked in to the magnitude and factors associated with biochemical CKD-MBD abnormalities among predialysis CKD patients.    

Methods: A cross-sectional study was conducted from July 1 to September 30, 2020 in Tikur Anbessa specialized hospital. One hundred patients who have had follow-up for at least 6 months with estimated glomerular filtration rate (eGFR) <60ml/min/1.73m² using CKD-EPI equation without race factor were included. Serum calcium, albumin, phosphorus and PTH levels were determined. Demographic and clinical data were collected using a structured questionnaire. IBM SPSS software version 26 was used for analysis.

Results: Among the 100 patients included in this study; the median age was 58 years with IQR of 73. The male to female ratio was 2.7:1. Patients in stages 3a, 3b, 4 and 5 CKD accounted for 23%, 29%, 26% and 22% respectively. The main causes of CKD were diabetes and hypertension. Among the patients 31% had hyperphosphatemia, 36% had hypocalcemia, and 89% had hyperparathyroidism. Estimated GFR correlated negatively with serum parathyroid hormone (PTH) level but correlated positively with serum calcium level. The mean values of calcium in CKD stage 3a,3b,4 and 5 were 8.91, 8.81, 8.7 and 7.14mg/dl respectively where as those of serum phosphorus were 3.58, 3.83, 3.83 and 5.53mg/dl respectively. The median values of PTH were 140.6, 137.2, 274.05 and 440.85Pg/ml respectively.

Conclusion: Hypocalcemia, hyperparathyroidism, and hyperphosphatemia are common biochemical CKD-MBD abnormalities among predialysis CKD patients in renal clinic of Tikur Anbessa specialized hospital. Monitoring for CKD‑MBD should begin earlier on and treatment should be initiated accordingly to improve patient outcome. 

Background: Esophageal cancer is the eighth leading cancer and the top sixth cause of cancer mortality worldwide. According to Globocan 2012 estimate, in Ethiopia, esophageal cancer ranks the seventh and eighth as the leading cause of cancer mortality and morbidity respectively.

Methods: A retrospective cross-sectional study using record review was employed at Gastroenterology and Hepatology Unit  and Department of Pathology of SPHMMC with the aim to assess the clinical, pathological and endoscopic characteristics of esophageal cancer patient attending at St Paul Hospital Millennium Medical College (SPHMMC) from January, 2015  to December, 2019 in Addis Ababa, Ethiopia. . All newly confirmed esophageal cancer patients (n=255) who were registered at SPHMMC from January 2015 to December 2019 were included in this study. Patients chart, Endoscopy report and Histology data were reviewed . Finally, basic descriptive statistics (frequency, mean, median), bivariate and multivariable analysis   were performed.

Result: A total of 255 esophageal cancer patients’ charts were reviewed. and 222 patients have confirmed Histology report of esophageal cancer. There were 173 (77.9%) cases of squamous cell carcinoma. The mean age at diagnosis was 57 years  with comparable male to female ratio. The Upper ,  middle . lower esophagus are involved in 10.4%,38.4%, and 48.6% of the patients respectively. Most patients 220(86.6%) seek esophagogastrduodenoscopy for dysphagia and only 15(6.8%) of patients have staging work up  and majority presented at stage 4(80%).

Conclusion: Squamous cell carcinoma was the most predominant histologic type followed by adenocarcinoma affecting males and females equally. Most of the esophageal cancer patients were diagnosed in advanced stages affecting the treatment outcome of esophageal patients. 

Key words: Esophageal Cancer; Histology; endoscopic site; Ethiopia

Extracellular vesicles (EVs) are known to be secreted from all bacteria, including those causing sepsis, and are distributed throughout the bloodstream and then excreted in the urine. In this study, an analysis of bacterial-derived extracellular vesicles in the urine of patients with sepsis and healthy controls was performed. A total of 25 patients, including 9 cases with positive cultures of bacteria in meaningful clinical specimens and 11 healthy controls, were evaluated. Midstream or Foley catheter urine was collected before starting the antibiotic treatment, and EVs were isolated by centrifugation. Metagenomic analysis was performed on the isolated EV samples to target the bacterial 16S rDNA. In all the febrile patients with culture-positive cases, the genetic material of multiple bacterial genera was detected, whereas those of cultured bacteria were not found in most cases. The bacterial distributions in the normal control group were very different from those of the febrile patients. The results suggested that bacterial components enter the bloodstream from several sites of the body in the form of extracellular vesicles in both septic and normal states. The reason why the bacterial distributions in the urine of sepsis patients are different from healthy people’s warrants further study.

Background: Intrathecal opioids are routinely used during spinal anesthesia for post-cesarean analgesia. In this research, the analgesic effects of adding pethidine or morphine to intrathecal bupivacaine have been compared. 

Methods: 110 parturients who were scheduled for elective cesarean section were randomized into two groups of 55 patients each. In one group, 12 mg of bupivacaine (0.5%) plus 200 mcg of intrathecal morphine, and in the second group 12 mg of bupivacaine (0.5%) plus 20 mg of pethidine in a total volume of 3 cc was injected as an intrathecal injection. Data variables were recorded at 1st, 4th, and 24th hours post-operatively. The primary outcome was the pain intensity numerical rating scale (0-10). The secondary outcomes were nausea, vomiting, itching, sedation (Ramsey Sedation Scale), shivering, and demand for analgesic medication.

Results: No statistically significant differences were found between the two groups regarding shivering, sedation, pain and pain severity, duration of painlessness period, number of demanded analgesics, and level of sensory block, at 1st, 4th, and 24th hours post-operatively.  At 24 hours after surgery, the rate of nausea and vomiting was significantly lower in the pethidine group (3 vs. 11, p=0.02). Still, at the same time, itching complaints were higher in the morphine group (10 vs. 0, p=0.001).

Conclusion: Adding intrathecal morphine and pethidine to bupivacaine in spinal anesthesia for cesarean section surgery both creates long-term and acceptable analgesia. However, in controlling itching, nausea, and vomiting, pethidine was shown to be more effective than morphine. Thus, it is suggested that 12 mg of bupivacaine (0.5%) is applied in combination with 20 mg of pethidine in spinal anesthesia for this surgery.

Background: There is a lack of research done on imaging findings of acute headaches in Ethiopia. Most studies available for cross-reference are done in developed countries and do not take into consideration clinical and epidemiologic factors unique to developing countries.

Methodology: A retrospective cross-sectional analysis was adopted in this study. The brain MRI reports and files of 497 patients who were referred for the evaluation of acute headache (less than or equal to one month duration) to Wudassie Diagnostic Center in Addis Ababa, Ethiopia from January 2016 to September 2018 were analyzed. The demographic variables and the clinical data of the patients were correlated to the imaging findings. Data analysis was done using IBM SPSS Statistics for Windows, Version 20.0.

Results: 60% of the patients referred for the evaluation of acute headache had abnormal MRI findings. Non-specific white matter lesions, (which neither explain the reason for acute headache nor alter patient outcome and management) was the most frequently observed radiologic diagnosis (16%) followed by neoplasms (11%) and infections (8%). Tuberculoma is the most frequently diagnosed infectious cause. The majority of patients with comorbid illnesses (hypertension and HIV) had abnormal imaging findings. Age had a weak but significant positive correlation with abnormal imaging findings.

Conclusion: The majority of patients who presented with acute headaches had normal or minor MRI findings. The most frequently clinically significant brain MRI findings were neoplasms and infections. Older age is associated with an increased rate of abnormal imaging findings. The most common infectious cause of acute headaches was found to be Tuberculoma.