Vol 53, No 3 (2015): July issue

Background: Neural tube defects (NTDs), one of the most common congenital malformations, are potentially preventable cause of perinatal morbidity and mortality. 

Objectives: To give baseline description of NTDs and their outcome at two teaching hospitals in Addis Ababa, Ethiopia.

Materials and Methods: A retrospective cross sectional descriptive study conducted from September 2009 to August 2012.

Results: During the study period out of 28,961 deliveries 177 cases of NTDs were identified, giving an overall NTD prevalence of 6.1/1000. Only 12% (21/177) were diagnosed before 28 weeks of gestation. The mean gestational age at diagnosis of NTDs was 33.8 weeks (±5.5). Majority, 93.2% (165/177), had antenatal care (ANC) follow-up. Most, 72% (127/177), were diagnosed by ultrasound before delivery while 28% (50/177) were identified at the time of delivery or expulsion. Majority, 85.3% (151/177), never received folic acid supplementation. Only less than 1% (2/177) of the mothers started taking folic acid supplementation pre-conceptionally. Only a third, 33.3% (59/177), of the fetuses were born alive while only 13.6% (24/177) were discharged alive. Myelomeningocele, identified in 51.4% (91/177), was the commonest NTD in this study.

Conclusion and recommendations: The proportion of NTDs in this study is among the highest globally reported rates. The practice of preiconceptional folic acid supplementation is negligible. And although most had ANC follow-up the vast majority of NTDs were diagnosed late in the third trimester. It is, therefore, highly recommended to consider implementing national preventive strategies to reduce the prevalence of NTDs in Ethiopia.

Key words: NTD, Myelomeningocele, Spina Bifida 

Background: Hepatocellular carcinoma (HCC) is a major cause of cancer death worldwide, accounting for over half a million deaths per year. Hepatocellular carcinoma can occur secondary to viral hepatitis, HBV or HCV. It can also occur secondary to other causes of Cirrhosis (alcoholism being the other most common cause).

Objectives: To describe clinical and laboratory characteristics of  Hepatocellular carcinoma in a tertiary care hospital in Addis Ababa, Ethiopia

Methods: A retrospective study was conducted in patients admitted to Tikur Anbassa specialized Hospital with a diagnosis of Hepatocellular carcinoma during the period of January 1,2013 to Dec. 31, 2015. Data were collected using structured questionnaire on basic demographic factors, behavioral risks, laboratory profiles and imaging reports. Descriptive analysis was performed on the data collected.

Results: Fifty one patients fulfilled the criteria for Hepatocellular carcinoma in the study period.  Thirty nine were males and 12 were females. Hepatitis B and C viruses were found to be the causes for HCC in 48% of the cases. History of alcohol abuse was documented in 45% % of the individuals.

About 26% of the patients had Ascites, 35 % were found to have portal vein thrombosis, The child-Pugh score for  patients who had complete profile were Child A 46%, Child B an equal percentage of 46% and for Child C 0.7%.

Conclusion: The contribution of Hepatitis virus is high with equivalent proportion of HBV and HCV. Alcohol intake and unidentified risk factors have also played for another half of the causes. Almost a third of patients have Portal vein thrombosis and 96% were either Child Pugh A or B. Enhancing immunization coverage frequent use of infection prevention and availability of treatment for viral hepatitis will help to reduce Hepatocellular carcinoma.

Key words :- Hepatocellular carcinoma, risk factors, Ethiopia

Background: Increased urbanization with change in lifestyle in many developing countries exposed them to the challenge of double disease burden, battling with the existing communicable infectious diseases as well as the emerging epidemic of NCDs

Objective: To describe trends of medical intensive care unit admission over thirty years in Ethiopia.

Methods: MICU registries at Tikur Anbessa Specialized Hospital over a thirty year period were examined for discharge diagnosis. Data included for analysis were selected at ten-year interval of equivalent six- months’ period from December to May of 1981/82, 1991/92, 2001/02 and 2011/12. Variables included were age, gender, residence, discharge diagnosis, duration of stay in hospital, discharge status, admission date, and admission source. Obtained data were cleaned, coded, recoded and edited. The analysis was done using SPSS 15.0 statistical soft ware.

Results:  A total of 500 cases are included for analysis. Among these 284 (57%) were male. The mean age was 40.2 ± 18 years ranging from 13 to 87 years. The aggregate cardiovascular disease, other non communicable disease and infectious disease as a cause of admission in the past thirty years were 213(42.6), 141(22.8), 105(20.0) respectively. Unlike the other disease category cardiovascular disease increased steeply over the past thirty years. Overall case fatality rate at MICU was 31.6% ranging from 24.8% of other-NCD to 46.7% of infectious diseases.

Conclusion:  Cardiovascular disease has steeply increased till it became predominant in the last decade at MICU of TASH.

Keywords: Cardiovascular disease, Medical Intensive Care Unit

Background: Injury remains the major cause of death and disability worldwide, and places an enormous burden on countries with limited resources in which Ethiopia is included.

Objective: It is obvious that pre-hospital care is a essential part of the treatment process in many acute disease and trauma

Methods: Cross sectional study design using structured interviewing questionnaire which was conducted in 437 Trauma patients who came to emergency department of Tikur Anbesa Specialized Hospital from February 1 to March 30, 2013.

Results: Only 73(16.7%) patients  got some kind of basic cars like stop bleeding, positioning, immobilization by ambulance staff 41(51.2%), relatives 24(30%) and police and bystanders 14 (20.3%). Commonest means of transportation in which 59% of cases arrived by taxi while about 14.4% were brought in by ambulance. Most patients  arrived to definitive care from the scene after are (the golden) hour of injury, has passed; only 81(18.5%) of patients arrived in less than and within one hour.

Conclusion: Proportion of patients, who received care before they arrived in the hospital was very small. Time of arrival to definitive care was prolonged and use of ambulances for transportation was minimal.

Keywords: Pre-hospital care ,Trauma ,Emergency department  and Golden hour