Patterns of Tumors Involving the Orbit in Patients Seen at Menellik II Referral Hospital, Addis Ababa, Ethiopia.

Yilikal adamu ¹, Sara Abebaw ²

ABSTRACT

Purpose: To determine the pattern of tumors involving the orbit among patients seen at Menellik II referral hospital.

Methods: Hospital based, prospective cross sectional study was conducted at Menellik II referral hospital, Addis Ababa, Ethiopia from April 2015 to July 2016 on 144 patients with orbital tumors who underwent surgical intervention and biopsy. Parameters included age, sex, patient complaint, duration and location of the lesion, description of the lesion, preoperative clinical diagnosis, and histopathological diagnosis.

Results: From a total of 144 patients, 48.7% were males and 51.3% were females with mean age of 23.8 ± 21.2 years. The most prevalent histopathological diagnoses for patients under 15 years of age were retinoblastoma (RB) (31.1%) followed by dermoid cyst (28.4%), and rhabdomyosarcoma (12.2). For patients above 15 years of age, the most frequently seen tumors were squamous cell carcinoma (SCC) (23%), dermoid cyst (13.1%) and malignant lacrimal gland tumor (13.1%).

Conclusion: Orbital tumors demonstrate a broad spectrum of biological behavior. The most common malignant  tumor involving the orbit were retinoblastoma and squamous cell carcinoma for patients  under and above 15 years of age respectively and the  most common benign was dermoid cyst in both age categories. Majority of the tumors in this study were secondary orbital tumors which imply late presentation of patients.

Key Words: Pattern, Tumors, Orbit, Menellik II Hospital, Addis Ababa, Ethiopia.

Background: The introduction of nephrectomy and subsequent surgical interventions for renal diseases provided clinical information and histopathological insight that form the basis of current concepts regarding renal diseases.

Objective: To describe the indications and outcomes of nephrectomy in upper urinary tract lesions including tumors

Patients and Methods: This is a retrospective study of all patients who underwent nephrectomy in Ayder comprehensive specialized(ACSH) and Mekelle hospitals during a five-year study period (January 1,2013 to December 31,2017). Relevant information was retrieved from case notes and analyzed.

Results: There were 106 patients who underwent nephrectomy in Ayder and Mekelle hospitals. The age ranged from 1-85 years with slight male preponderance. Most 78(73.6%) were carried out for benign conditions. Majority 53(50%) for non-excreting kidneys due to stone diseases, followed by PUJ obstruction 15(14.2%), benign renal masses 3(2.8%) and renovascular hypertension 3(2.8%). Twenty-eight (18.8%) patients had nephrectomy for malignant renal diseases, mainly adenocarcinoma and Wilm’s tumor accounting for 20(18.8%) and 6(5.6%), respectively. The overall complication rate was 42(39.6%) which was higher in those patients operated for renal neoplasms, the commonest being postoperative bleeding that required transfusion 16(15.1%). There was one death (0.9%).

Conclusion: In this study, the rate of nephrectomy for non-excreting kidneys due to stone disease appeared to be higher, mostly affecting the younger age groups. Hence, early intervention with effective preventive and organ sparing therapy measures can reduce most of the preventable benign conditions for nephrectomy.

Key words: Nephrectomy, indication, outcome, Mekelle

Background:-There is scarcity of published studies describing the burden of surgical disease in Africa .Patterns of admission can narrow the gap of health care information despite its limitation.

Objective:-The purpose of the study is to determine the patterns of surgical admission at teaching hospital.

Methodology:-A three years retrospective cross sectional study was conducted at SPHMMC. Data was collected from electronically documented patient information and monthly mortality & morbidity analysis. The study have included all patients admitted to urology and general surgery wards .

Result: - Totally 7117 patients were admitted in general surgery (GS) and urology unit, out of which 6618(93%) patients underwent surgical intervention. Acute appendicitis and its complications was the most common indication for admission 1429(20.08%) followed by goiter 653(9.18%), Cholelithiasis 637(8.95%) and trauma 459 (6.45%).The mean age of patients was 40.1years. In the urology unit BPH was the leading reason for admission, followed by urethral stricture and nephrolithiasis. The average hospital stay for elective patients was 9.4days. The inpatient mortality rate was found to be 2.9%.

Conclusion:The contribution of emergency admission was huge with acute abdomen and trauma being the commonest emergency admission while Goiter and Cholelithiasis were commonest elective admission in general surgery.

Key Words: Burden of surgical disease, Admission pattern, Acute Abdomen , Goiter , Cholelithiasis

Aims/Purpose:

This study was done to determine if there are significant morphological differences between a previously sectioned and non-operated lower uterine segment in an African population.

Methods:

This was a prospective, descriptive, comparative study of thirty-eight pregnant women with previous Cesarean section and 45 pregnant women with no previous uterine surgery. They had transabdominal sonographic measurement of their lower uterine segment thickness between 35 and 37 weeks gestation. Mann-Whitney U test was used for comparison of means.

Results:

The lower uterine segment was significantly thinner in women with previous Cesarean group compared to the controls (mean of 4.9 ± 2.5 mm and 3.4 ± 2.2 mm versus 6.4 ± 2.8 mm and 4.5 ± 2.2mm for full and myometrial thicknesses, respectively; P= 0.006 and 0.007, respectively). Normal lower uterine segment appearance and thicknesses were seen in the majority of previously sectioned women. The previous scar site was identified in 8 (10.7%) of women with previous scar.

Conclusion:             

In women desirous of attempted vaginal birth after a previous Cesarean section, ultrasonography of the lower uterine segment could be done to rule-out abnormal scarring and thus aid in planning a safe trial of scar.

Background: Drug-resistant TB has emerged as a major challenge facing tuberculosis prevention and control efforts in Ethiopia.  Chest radiograph is the primary most important imaging modality used to suggest the diagnosis of pulmonary tuberculosis. Therefore, this research will provide base line information to clinicians and radiologist about the chest radiographic pattern of MDR tuberculosis.

Methodology: A retrospective Cross-sectional study was conducted in Alert hospital in Addis Ababa. All culture proven MDR TB patients from January 2012   to June 2014 G.C. and who had chest radiograph available were included in the study. 

Result: Chest radiograph of 128  culture proven MDR TB  patients  analyzed and 72.7% (93/128) patients  had abnormal chest radiographic  findings among which the three most common radiographic findings were  fibrosis 45(35.5%) cavities 33(25.8%) and consolidations 22(17.2%) with most of the abnormal radiographic findings (77.4) were seen in either of the upper or bilateral upper lobes.

Discussion: even if most literatures revealed hilar and mediastinal nodal disease is the most common CXR findings in patients with MDR tuberculosis, fibrosis and csvitation was the most common pattern seen in our cases. There was no significant radiological differences seen in those who have HIV confection and those who don’t.

Conclusion: One cannot suggest the diagnosis of MDR tuberculosis based on CXR findings and normal CXR cannot guarantee the possibility of MDR tuberculosis.

Abstract

Background: Ethiopia is one of the countries with high MDR-TB burden. MDR-TB medications have sever adverse effects. However, little is known about adverse effects of MDR-TB medications in Ethiopia. Therefore this study is aimed at determining incidence of severe adverse effects associated with MDR-TB therapy.

Methods: A cross sectional study design using retrospective medical record review of 238 patients with Drug-Resistant Tuberculosis was conducted. Applying multiple logistic regression models, adjusted odds ratio and their 95% confidence intervals were used to select important risk factors associated with treatment adverse effects.

Results: One or more adverse effects developed in 219 cases (92 %). These effects led the clinicians to suspend one or more drugs from the treatment regimen in 46 cases (19.3%). Adverse effects observed most frequently include: Gastrointestinal Effect (79.4%), Hypokalemia (49.3%), Arthralgia (32%), Sleep Disturbance (13.7%), Psychosis (8.2%), Hypothyroidism (6.4%), Renal Toxicity (5.6%), Neuropathy (3.7%), and Hepatotoxicity (0.9%). Co morbid conditions of HIV/AIDS, and diabetes mellitus, older age group and homelessness were identified as important predictors of sever adverse effect.

Conclusion: Sever adverse reactions to MDR-TB therapy were common, and resulted in suspension of one or more drugs. We suggest that efforts should be made to continue treatment in the face of adverse effects. All diagnostic procedures and ancillary medications need to be always available for early detection, treatment and follow up of adverse events. Special attention should be given for elderly, homeless, HIV/MDR-TB, and Diabetes/MDR-TB co- infected patients.

Key words: Sever Adverse Effect, MDR-TB therapy, ALERT Hospital, Ethiopia

Abstract

Background: TB/HIV co-infection remains the major public health challenges worldwide. TB co-infection with HIV exacerbates the challenges in diagnosis and treatment of patients. The occurrence of these two diseases together can potentiate one another. This study was designed to determine the effect of HIV co-infection on tuberculosis treatment among tuberculosis patients.

Methods: A retrospective cohort study was conducted on 1952 tuberculosis patients. The treatment outcomes of tuberculosis patients with HIV infection were compared with those who were HIV negative.

Result: TB/HIV co-infected patients had significantly lower cure rate than HIV negative TB patients (10.3% vs 16.7%) with AOR=0.599, P<0.028 and 95%CI= 0.380-0.946. Treatment completion rate was significantly lower in TB/HIV co-infected patients than HIV negative TB patients (41.2% vs 47.2%) with AOR=0.584, P=0.001 and 95%CI=0.431-0.792. But TB/HIV co-infected patients had significantly higher death rate than HIV negative TB patients (10.2% vs 2.2%) with AOR=3.053, p<0.001 and 95%CI=1.736-5.378.

Conclusion and recommendation: The effect of HIV co-infection was significantly higher on tuberculosis treatment. There was the significantly lower cure and completion rate while the death rate was higher among HIV positive tuberculosis patients. Strengthening TB and HIV collaboration activities is important to improve treatment outcome of TB patients.

Keywords

Retrospective, tuberculosis, Cure, completion, death

Background: Low birth weight (LBW) occurrence has steadily risen in Ethiopia over the last five years, from 11% in 2011 to around 13% currently. Understanding the socio-economic gradient involved in LBW occurrence is vital to plan equitable strategies to help eliminate unjust inequalities in LBW between the poor and rich.

Objective: The study aims to investigate socioeconomic inequalities in LBW occurrence between poor and rich individuals in Ethiopia.

Method: The dataset for the analysis came from the 2016 Ethiopia Demographic and Health Survey. The prepared version of the dataset was transferred to RStudio software for analysis. Socio-economic inequalities in the occurrence of LBW were measured through the computation of a concentration index using the ‘decomp’ package. Decomposition analysis was done to evaluate the percentage contributions of the explanatory variables to the observed inequalities in LBW.

Result: LBW appeared to be slightly concentrated among poorer families. The disparity in LBW along the socio-economic spectrum was mainly accounted for by differences in ethnicities.  

Conclusion and recommendation: LBW was concentrated among the poor in the studied population. The observed disparity in the distribution of LBW across wealth categories was majorly attributed to the uneven distribution of LBW-reducing strategies among ethnicities. Equitable strategies that can function well in all ethnic groups are recommended to end the poor-rich inequality in the prevalence of LBW.

Keywords: Low Birth Weight; socio-economic inequality; Ethiopia