Vol 53, No 4 (2015): October issue

Background: Pulmonary tuberculosis (PTB) is one of the most common infectious diseases worldwide, and contributes significantly to morbidity and mortality in developing countries. Despite availability of effective treatment, a significant number of patients  suffer from permanent lung damage, which predisposes patients to numerous pulmonary complications.

Objective: To assess chronic sequelae of patients treated for PTB in a chest clinic at Tikur Anbessa Hospital

Methods: This was a retrospective, cross-sectional analysis of patients registered in a clinical database at the chest clinic of Tikur Anbessa specialized Hospital between January and December 2013. Patients with a history of pulmonary tuberculosis treatment were identified and included in the analysis.

Results: Among all patients having follow-up at the chest clinic of TASH during the study period, 134 (18.5%) presented with chronic pulmonary complications of TB. Seventy two patients (54%) were male, and the mean and median ages were 40 and 37 years, respectively. Of the study population, 83 (61.9%) patients had clinically significant parenchymal scarring and fibrosis, 40 (29.9%) had bronchiectasis, 5(3.7%) had Aspergilloma, 4(3%) had granuloma/calcification, one patient (0.7%) had pleural thickening, and one patient (0.7%) underwent pneumonectomy during the study period.

Conclusions: Fibrosis and bronchiectasis were the most common pulmonary complications of tuberculosis among patients encountered at the TASH chest clinic during the study period. This demonstrates the impact of pulmonary tuberculosis is beyond management of active disease. 

Keywords: Sequelae,  PTB, chest clinic , TASH

ABSTRACT

 Background & Aims: Hepatitis C viral infection is a significant public health challenge with potential risk of progressing to liver cirrhosis and hepatocellular carcinoma (HCC). Actively infected mothers can transmit the virus to their babies who may develop liver cirrhosis and HCC as young adults. We determined the seroprevalence of HCV, its antigenaemia and associated risk factors among pregnant women.

Methods: We recruited 400 pregnant women and tested their serum for HCV antibodies using immune-chromatographic test and determined the HCV core antigenaemia among HCV sero-positives by enzyme-immuno-assay (EIA). The bio-socio-demographic variables of the participants were statistically correlated to the test results.

Results: Seroprevalence of HCV was 5.8% (23/400) and the prevalence of HCV core antigenaemia was 73.9% (17/23). None of the bio-socio-demographic variables of the participants and other known risk factors evaluated had significant influence on either seroprevalence of HCV or its antigenaemia. Only the employment status of the participants’ husbands (p=0.01) significantly affected seropositivity of HCV.

Conclusion: HCV core antigenaemia is high among pregnant women who have antibodies to HCV in our environment and this signifies an active hepatitis C virus infection.

Key Words: HCV, core antigen, antibodies, pregnancy, Nigeria

Abstract

Background -Assessment of clinical skills of medical students has a central role in medical education yet the suitable evaluation methods have persistently debated by educators and students.

Objectives – To assess perceptions of final year medical students about the Organized Structured Clinical Exam (OSCE)

Methods and materials - A cross sectional study was performed to assess views of final year medical students who had taken the OSCE in the Department of Surgery of Mekelle University College of Health Sciences, as well as other traditional exam formats in other departments in the medical school

Results - Of the 154 students who took the final qualifying exam, 127 (82.5%) responded to the survey. Eighty-four (66%) of the respondents were males. The OSCE was considered as the best assessment method of practical exams by 70 (55.1%) of the respondents, with the conventional long exam next in preference, by 47 (37%) students. For questions addressing the advantages of the OSCE, the average favorability score was between 4.2 - 4.6 out of Likert’s type 5-point scale rating. Coverage of common and relevant topics, uniform student assessment, and communication skill assessment were items receiving high favorability scores by a particularly high percentage of students, (96.9%, 95.3% and 70.9% of all students, respectively)

Conclusions - Most of the students favored the OSCE compared to conventional exam styles. Though the study should be confirmed and extended in other settings, we recommend OSCE to be the main exam type for clinical year surgery examinations.

Key words – Final year medical Students, Perceptions, OSCE

Background: In East Africa, particularly in Ethiopia, bacterial keratitis is a major cause of blindness.  

Objective: The aims of this study were to identify risk factors of bacterial keratitis and the spectrum of bacterial etiologies, and to assess the in-vitro antimicrobial susceptibility of these bacterial isolates at Jimma University Specialized Hospital, Southwest Ethiopia.

Methods: A prospective study was employed from January 2012 to June 2012 from which a total of 24 patients with bacterial keratitis were included in the study. Corneal scrapings were collected, transported and microbiologically processed using standard operating procedures.

Results: Four different predisposing factors for bacterial keratitis were identified: corneal trauma 9 (37.5%), blepharitis 7 (29.2%), herpetic keratitis, and use of contaminated medications 4.. Bilateral corneal infection was found in 5 (20.8%) of the cases. A total of 24 corneal scrapings were collected for microbiological evaluation, of which 20 (83%) had bacterial growth. The isolated bacterial pathogens were Pseudomonas aeruginosa 10 (41.7%), Staphyloccus aureus 5 (20.8%), Serratia marcescens 3 (12.5%), followed by Streptococcus pneumoniae 2 (8.3%). Antimicrobial susceptibility testing revealed that 85% of Gram-negative bacilli were susceptible to gentamicin and ciprofloxacin, while 86% of Gram-positive cocci were susceptible to vancomycin and Ciprofloxacin.

Conclusions: Corneal trauma was the most common risk factor for bacterial keratitis followed by blepharitis. Bacteriological analysis of corneal scrapings also revealed that P. aeruginosa was the most common isolate followed by S. aureus; the antibiotic with the highest susceptibility was ciprofloxacin. As drug resistance among bacterial pathogens is an evolving process, routine surveillance and monitoring studies should be conducted to provide an update and most effective empirical treatment for bacterial keratitis.

Keywords: Antibacterial susceptibility, Bacterial pathogens, corneal trauma, Bacterial Keratitis, Jimma, Ethiopia 

Background: Malignant lymphoma is a common pri­mary hematopoietic malignancy.Cross sectional imaging are used commonly. US’s wide prevalence and its diagnostic potential make the modality at the fore front in our set up. Therefore, evaluating the US pattern makes it important especially in the absence of local imaging based studies and late arrival of our patients.

Objective: Assess thepattern of abdominal organ involvement and ultrasound findings in patients with abdominal lymphoma

Material and Methods: Consecutive 69 patients who came to the US unit of TASH with the diagnosis of lymphoma arescanned. All examinations were performed by the authors based on standard scanning techniques. Cine and spot images are stored for analysis and finding recorded on a pre-prepared and pretested format.

Results: Eighty nine percent of our patients are below the age of 60and64 % are males. Chest x-ray and US are the modalities commonly used, while only 6/69 have CT. Non-Hodgkin’s lymphoma account for 81% of the cases. Lymphnodesare the common organ involved and abdominal node account for 62% of cases.Homogenous and hypoechoic echo appearance seen in 52% and their pattern of involvement is multiple and discrete nodes.Liver followed by spleen are the common abdominal organs involved.

Conclusion: Our study stressed the continued role of US forlymphoma patientsand recommend that, it should be the main stay of diagnostic modality in countries like ours.  The US findings and pattern of organ involvement is found to be comparable with previous studies.