Ethiopian Journal of Health Sciences

Table of content

Yibeltal Siraneh — Thu, 07 Dec 2023 00:00:00 +0000

Table of content

The Acute Needs for Palliative Care Services in Ethiopia (Editorial Message)

Endalew Hailu — Thu, 07 Dec 2023 00:00:00 +0000

Editorial message

The Effect of a Decade Implemented Project in Improving the Uptake of Comprehensive Contraception: Difference-In-Difference Analysis

Addisalem Titiyos, Jemal Kassaw, Kathryn A. O’Connell — Thu, 07 Dec 2023 00:00:00 +0000

BACKGROUND: Promotion and use of family planning in countries with high birth rates have the potential to avert a third of all maternal deaths and nearly a tenth of childhood deaths. To support government efforts in creating wider access to comprehensive contraceptive methods, EngenderHealth has contributed to the government of Ethiopia’s long-term goal of improving maternal health outcomes through its Access to Better Reproductive Health Initiative project.

METHODS: Difference-in-Difference approach is the main methodology in this analysis to estimate the “contribution” or “effect” of the ABRI intervention by comparing the changes in family planning outcomes from 2005 to 2016 between the ABRI and non-ABRI areas. This analysis was based on pooled data from the 2005 and 2016 Ethiopian Demographic and Health Surveys. To track temporal changes in the family planning indicators in the ABRI and non-ABRI areas, we employed simple trend analysis.

RESULTS: The results show that overall contraceptive prevalence rate, use of injectables, women’s knowledge of Long-Acting Reversible Contraception (LARC) methods, and their exposure to family planning information/messages from health workers all significantly improved in the ABRI intervention areas beyond what occurred in the non-ABRI areas. The greatest increase in the use of modern contraception was among adolescents aged 15-19 years, with a DID estimate of 22.4% (p=0.007), ABRI areas compared to no-ABRI areas.

CONCLUSION: In the ABRI areas, family planning indicators recorded positive and significant changes. EngenderHealth has contributed its part in improving access to the uptake of comprehensive contraception and supporting government programs.

Safe Drinking Water, Sanitation and Mother’s Hygiene Practice as Stunting Risk Factors: A Case Control Study in a Rural Area of Ciawi Sub-district, Tasikmalaya District, West Java, Indonesia

Siti Novianti, Emy Huriyati, Retna Siwi Padmawati — Thu, 07 Dec 2023 00:00:00 +0000

BACKGROUND: Stunting is associated with disorders of the small intestines caused by environmental factors and poor hygiene practices. Prevention of stunting should be conducted in the first 1,000 days of life; namely, from conception until the child is two years old. This research aimed to analyze the relationship between environmental risk factors and maternal personal hygiene with the incidence of stunting in children aged 6-23 months.

METHODS: This study was conducted using a case-control design, with a total sample of 212 (106 cases and 106 controls) enrolled purposively. Data were collected through interviews using a questionnaire. The analysis used chi-square tests and multiple logistic regression.

RESULTS: The results of multivariate analysis showed the independent variables that have a significant association on the incidence of stunting are access to safe drinking water and maternal hygiene practices. The external variables that have a significant relationship is birth length and feeding practice.

CONCLUSION: Having no access to safe drinking water, not proper sanitation, and poor maternal hygiene practices have a higher risk of stunting in children aged 6-23 months. The implications of this research include the need for increased access to a safe environment and improvement of mother’s behavior as essential efforts to prevent stunting.

The Association between Intrahousehold Food Allocation Social Norms and Thinness among Young Adolescent Girls: A Community-Based Study

Thu, 07 Dec 2023 00:00:00 +0000

BACKGROUND: Inequalities in food allocation related to social norms among household members significantly affect the nutritional status and well-being of the vulnerable members of the household, such as adolescent girls. This study assesses the association between social norms related to intrahousehold food allocation and young adolescent girls' thinness.

MATERIALS AND METHODS: The study involved 1,083 pairs of mothers/caregivers and young adolescent girls. Data were collected using a structured and pretested questionnaire. Multilevel mixed-effect logistic regression analysis was employed to examine associations using STATA/SE V.14 statistical software. In addition, a stratified analysis was done to investigate the effect of social norms on thinness in food-secure and food-insecure households.

RESULT: The overall prevalence of young adolescent girls' thinness was 15.70% (95% CI 13.52–17.86%). Young adolescent girls' thinness was associated with mothers’/caregivers' conformity to inequitable intrahousehold food allocation social norms in food-secure households [Adjusted odds ratio (AOR): 1.43, 95% CI: 1.14–1.80] but not in food-insecure households.

CONCLUSION: Nearly 16% of adolescent girls were thin. Mothers/female caregivers conforming to inequitable intrahousehold food allocation social norms compromise the nutritional status of adolescent girls, particularly in food-secure households. The lack of statistically significant association in food-insecure households hints at the need to address inequality in food-secure households while addressing food shortage to improve the nutritional status of adolescents in low-income countries. We also recommend more studies in different sociocultural contexts to fully gather the evidence for adopting appropriate policies and practices.

Hematologic Derangements among Children with Unoperated Cyanotic Congenital Heart Disease in Ethiopia

Selamawit Alemseged, Endale Tefera — Thu, 07 Dec 2023 00:00:00 +0000

BACKGROUND: Surgical treatment has transformed the course and outcome of congenital heart defects in high-income countries, but children with congenital heart diseases in sub-Saharan Africa, where access to cardiac surgery is limited, often experience the natural course of untreated lesions and their complications. The objective of this study was to determine the prevalence of hematologic derangements among Ethiopian children with unoperated cyanoticcongenital heart diseases, to identify factors associated with coagulopathy in this population, and to describe how these complications are managed in this setting.

METHODS: In this single-center cross-sectional study, we prospectively collected clinical and demographic data from children (<18 years) with cyanotic congenital heart diseases. Blood samples were collected to measure hematologic parameters. Polycythemia was defined as hematocrit >50% and thrombocytopenia as <150,000 per microliter.

RESULTS: Among 70 children recruited, the overall prevalence of polycythemia and thrombocytopenia was 63% (n=44) and 26% (n=18), respectively. On multivariate logistic regression analysis, hematocrit ³65% (p-value=.024), and oxygen saturation <85% (p-value=.018) were independently associated with moderate or severe thrombocytopenia. Thirty-one (44%) patients had undergone therapeutic phlebotomy, and 84% (26/31) of these patients received iron supplementation.

CONCLUSION: We report a high prevalence of polycythemia and thrombocytopenia in Ethiopian children with untreated cyanotic congenital heart diseases. There was variable implementation of iron supplementation and therapeutic phlebotomy, highlighting the need to optimize supportive management strategies in this population to mitigate the risk of life-threatening complications.

Are We Missing Hypothyroidism among Children with Sickle Cell Anaemia?

Akodu SO, Adekanmbi AF, Ogunlesi TA, Fetuga MB — Thu, 07 Dec 2023 00:00:00 +0000

BACKGROUND: Children with sickle cell anaemia have been reported to have potential risk of hypothyroidism from chronic blood transfusions and probable thyroid tissue ischaemia. However, few studies on hypothyroidism status of children with sickle cell anaemia in Nigeria are available. The objective of this study was to determine the prevalence of hypothyroidism among children with sickle cell anaemia.

METHODS: A cross sectional study that assayed the thyroid hormones and thyroid stimulating hormone (TSH) of 71 children with sickle cell anaemia was conducted at Olabisi Onabanjo University Teaching Hospital Sagamu. Using age appropriate hormonal reference values, the subjects were classified into sub-clinical, primary and secondary hypothyroidism.

RESULTS: The mean serum TSH, Free T3, and Free T4 were comparable irrespective of age category (p > 0.05). No subject was identified to have low TSH value while 7.0% had high TSH value. Low free T3 was identified in 1.4% and 8.5% had high free T3 values. Low free T3 and free T4 were seen in 11.3% each of the subjects. The overall prevalence of primary, secondary and sub-clinical hypothyroidism was 0%, 0% and 4.2%, respectively.

CONCLUSION: Sub-clinical hypothyroidism does occur in Nigerian children with sickle cell anaemia. Routine screening for hypothyroidism is advocated in all children with sickle cell anaemia.

Fatal Road Traffic Accidents and Associated Factors in North Shewa Zone, Central Ethiopia: A Cross-Sectional Study

Tilahun Deresse, Akine Eshete, Minyahil Hailu, Megbar Dessalegn — Thu, 07 Dec 2023 00:00:00 +0000

BACKGROUND: Road traffic accidents (RTAs) are among the top three global causes of death among people aged 15 to 44 years. More importantly, it is the main cause of death and permanent disability among young people aged 15 to 29 years. This study aimed to assess the magnitude of fatal traffic accidents and the factors associated with them in the North Shewa Zone, Central Ethiopia, from 2013 to 2018.

METHOD: An institution-based cross-sectional study was conducted in all registered RTAs from July 2013 to June 2018 that had full documentation. The data extraction tool was developed based on the daily RTA registration book format that was utilized. Data was entered into Epi-data version 3.1 and then exported to SPSS version 21 for analysis. Logistic regression analysis was used to assess the relationship between the factors and the fatality of RTA. P-values less than 0.05 were reported as statistically significant.

RESULTS: Among 846 RTAs studied, 351 (41.5%) were found fatal, while 495 (58.5%) caused non-fatal injuries. Failure to give priority to pedestrians was 2.8 times (AOR = 2.8, 95% CI: 1.3, 5.9) more likely to cause fatal RTAs than drivers who failed to maintain distance between vehicles. Pedestrians were 2.7 times (AOR = 2.7, 95% CI: 1.1, 6.7) more likely to die in RTAs than drivers.

CONCLUSION: The fatality of RTA was high. Failure to give priority to pedestrians and being a pedestrian were strong predictors of death. The North Shewa Zone Traffic Police Department and police officers should focus on enforcing traffic safety laws.

Imaging Patterns of Temporal Bone Fracture among Patients with Head Injury at Tikur Anbessa Specialized Hospital, Ethiopia

Elsabeth Wondwossen Yimam, Amal Saleh Nour, Tequam Debebe, Tewodros Endale — Thu, 07 Dec 2023 00:00:00 +0000

BACKGROUND: Temporal bone fracture is usually a sequel of significant blunt head injury. Fracture of the temporal bone is mainly classified according to the orientation of the fracture plane and whether there is involvement of the otic capsule. Despite its frequent occurrence, there is limited research on the frequency and pattern of temporal bone fractures in our setup.

METHODS: Retrospective cross-sectional hospital - based study of 60 patients who underwent computed tomography of the head for head trauma at Tikur Anbessa Specialized Hospital during the study period from October 2020 – October 2022.

RESULTS: Among the 60 patients enrolled in the study, the mean age of presentation was 31.1 years with a male-to-female ratio of 4:1. There were 69 temporal bone fractures, 9(15%) were bilateral and 51(85%) unilateral. The longitudinal fracture pattern was the most common fracture pattern, occurring in 40(78.4%) of unilateral cases, 15(83.3%) of bilateral cases. Otic capsule sparing fractures accounted for 49(96.07%) of unilateral fracture cases, and all patients with bilateral involvement had an otic capsule sparing fracture. Among the 42 patients for whom data regarding post-traumatic hearing outcome was available, 4 patients had post-traumatic hearing impairment. Anatomically, the squamous portion of the temporal bone was involved in 30(43.5%) of cases.

CONCLUSIONS: Fractures affecting the squamous portion of the temporal bone, longitudinal fracture patterns, and otic capsule sparing were the most frequent forms. The majority of temporal bone fractures were associated with other bone fractures and intracranial injuries.

Pattern of Radiographic and Sonographic Findings of Adult Patients Presented with Shoulder Pain at Tikur Anbessa Hospital, Addis Ababa, Ethiopia

Bemnet Taye Gebregiorgis, Moges Zenebe Wegayehu — Thu, 07 Dec 2023 00:00:00 +0000

BACKGROUND: Shoulder pain is one of the most common presentations in the orthopedic clinic. Multiple factors have been found to cause shoulder pain. Radiographs and ultrasound are widely available, relatively cheap modalities in assessing shoulder pain. The aim of this study is to assess the radiographic and sonographic imaging patterns of shoulder pain.

METHODS: A descriptive prospective cross-sectional hospital-based study was conducted at the Department of Radiology of Tikur Anbessa Specialized Hospital among patients with shoulder pain that came for imaging from August 2021-January 2022.

RESULT: Of the 73 patients with shoulder pain included in the study, 67% were females while 33% males. The mean age was 51.7 years. Radiographs found pathology in 53% of the cases. Acromioclavicular joint osteoarthritis, greater tuberosity degenerative changes, rotator cuff calcification were common radiographic findings. Ultrasound detected pathologies in 87% of the cases. The common pathologies were rotator cuff pathologies, biceps tendon pathologies, acromioclavicular joint degeneration, greater tuberosity degenerative changes, subacromial subdeltoid bursitis, and adhesive capsulitis. There was a significant association between greater tuberocity degenerative changes and supraspinatous pathologies with age, greater tuberocity degenerative changes with supraspinatous pathologies, acromiohumeral distance of <7mm with supraspinatous pathology.

CONCLUSION: Radiographs and ultrasound are valuable imaging modalities for shoulder pain. Low acromiohumeral interval, greater tuberosity degenerative changes, and acromioclavicular joint osteoarthritis are associated with rotator cuff tears. Rotator cuff pathologies are the most common pathologies observed in ultrasound. We recommend ultrasound to be second step after radiograph due to its low cost and wide availability.

Demographic Pattern and Clinical Characteristics of Patients Undergoing Haemodialysis in a Tertiary Centre of a Developing Country: A Review of 280 Cases

Bamikefa T.A, Uduagbamen P.K, Adelaja M.A, Ala O — Thu, 07 Dec 2023 00:00:00 +0000

BACKGROUND: Globally, renal replacement therapy especially haemodialysis remains pivotal in the effective care of patients with kidney diseases since its acceptance as a treatment modality. Despite being widely embraced as a therapeutic option, several factors still hamper its utilization. A clinical audit of this modality option will allow elucidation of haemodialysis practises and peculiarities.

METHODS: The charts and records of 280 patients with renal impairments dialyzed between March 1^st 2019 and February 28^th 2023 were evaluated in retrospect. Data on retrieved demographic and clinical information were analyzed using SPSS 25 and patients’ short-term survival was determined using the Kaplan Meier survival analysis and log rank test.

RESULTS: Out of the 280 patients who had 1716 dialysis sessions, 184 (65.7%) were males. The mean age was 47.9 ± 17.5 years. The majority (80.7%) of the patients had chronic kidney disease (CKD), as 90.2% of the dialysis sessions were for CKD. There was a male preponderance (69.1%) in the population. Hypertension was the commonest cause of CKD (41.2%) while sepsis was the commonest cause of acute kidney injury (50%). The median number of dialysis session was 4.0. The mean pre-dialysis hematocrit was 24.4 ± 7.1% and the mean single pool Kt/V was 0.9 ± 0.02. The femoral vein was the most used vascular access (95.4%). The short-term survival was positively related to the dialysis frequency on Kaplan-Meier analysis.

CONCLUSION: Haemodialytic therapy in patients with renal disease is still of huge impact on survival despite the numerous factors affecting its effective delivery, especially in low-income nations.

Computed Tomography Dose Level in Selected Five Principal Hospitals in Ethiopia

Gebremedhin Kide Kinfe, Birhanu Tsegaye Wores — Thu, 07 Dec 2023 00:00:00 +0000

BACKGROUND: X-ray Computed Tomography dose levels have been varying among modalities and scanning body regions due to the absence of incessant routine follow-up. Thus, the study aimed to compute the dose index discrepancies in Ethiopia for the most recurring scan protocols (head, chest, abdomen, and pelvis).

METHODS: A purposive sampling method was employed to select the hospitals due to the rare existence of functional CT scanners in Ethiopia. From the selected hospitals, a total of 1,385 (249 heads, 804 chests, 132 abdomens, and 200 pelvis) were collected in terms of standard dose metric values in the period of December 2019-March 2020. Patients’ DLP was computed into mean value using IBM SPSS Statistics 20 software. From the mean DLP, we can compute the effective dose.

RESULTS: Patients’ dose level disparity was observed in this study though it is below the ICRP standard level for all body regions except for pelvis DLP (593.37 mGy-cm) at Black Lion. The dose level for the head and chest are computed within the recommended level at all hospitals. Effective doses for the pelvis at four hospitals (Teklehaimanot, Black Lion, ALERT, Paul’s, and Ayder hospitals) were computed as 6.45, 8.90, 5.08, 6.54, and 6.84 mSv respectively, and the effective doses for abdomen at Ayder Hospital was obtained to be 8.90 mSv, which is above the recommended value.

CONCLUSION: X-ray CT scanners are somewhat properly functioning although some sort of justification and optimization for pelvis and abdomen examinations are strongly recommended to implement as low as reasonably achievable principle.

Assessment of Epidemiological Indicators for Evaluation of National Malaria Elimination Programme: A Retrospective Study

Hima Sree Polisetti, K R Vinay Rajan, K Eswar Kumar — Thu, 07 Dec 2023 00:00:00 +0000

BACKGROUND: Malaria has been one of India's most considerable health problems since 1940. The objective of our study is to determine the status of the National Malaria Elimination Programme in India by using epidemiological indicators.

METHODS AND MATERIALS: The annual reports of malaria for the years 2014-2021 and monthly reports for 2020 and 2021 were collected from the official web portal and were analysed for study specific assessments.

RESULTS: The API has shown a statistically significant reduction from 2017-2021 in all states along with category-1(P=0.003) and category-2(P=0.029) states/UTs, but there was no statistically significant reduction from 2017-2021 in category-3 (P=0.166) states/UTs. The zero indigenous cases had not been achieved in category-1 states/UTs. The overall percentage reduction in number of malaria cases in 2020 at the national level compared with 2014 was 83.6%. Despite states with strong health systems such as Gujarat, Maharashtra and Karnataka, have not shown zero indigenous cases in 2020 and the malaria cases noted were very far from reaching the targets.

CONCLUSIONS: Although we observed a significant drop in malaria incidence from 2014 to 2020, demonstrating that the country is moving nearer to malaria elimination, it is crucial to implement the strategies to reduce Plasmodium falciparum% and re-establish surveillance programmes and execute national and state programmes in order to achieve the success of the National Malaria Elimination Programme. The recategorization of states/UTs are in accordance to the API, and implementation strategies were also needed.

Abdominal Pain of Functional Gastrointestinal Disorders in Dietary Diversity Patterns and Its Determinants among Healthy Adults in Jimma City, Southwest Ethiopia

Belay Zawdie, Kalkidan Hassen Abate, Dessalegn Tamiru, Tefera Belachew — Thu, 07 Dec 2023 00:00:00 +0000

BACKGROUND: Functional Gastrointestinal Disorders (FGIDs) and their risk factors vary from region to region. Therefore, this study aimed to determine the prevalence of abdominal pain of FGIDs in different dietary diversity score (DDS) and its determinant factors among adults in Jimma City, Southwest Ethiopia.

METHODS: A community-based cross-sectional study was conducted from July 17 to October 27, 2019. The study included systematically selected healthy adults aged ≥ 18years. Data were collected on gastrointestinal symptoms (Rome III), and DDS (24-dietary recall).

RESULTS: Of 865 healthy adults, the prevalence of abdominal pain symptoms co-occurrence was 168(19.4%), dyspepsia, 152(17.6%) and IBS, 133(15.4). Similarly, the co-occurrence was distributed as 81(9.4%) in middle, 64(7.4%) in high and 23(2.6%) in low DDS groups. Although this distribution was different in the DDS groups, it is not significantly associated. With potential confounders adjusted, the behavioral factors associated with the co-occurrence with an AOR (95% CI) were khat chewing: 7.37 (1.76 - 30.87), drinking alcohol: 3.24 (1.15 - 9.18), sedentary life: 12.28 (3.19 - 48.40) and less physical activity: 4.44 (1.43-13.75). Moreover, elevated TAG: 5.44 (2.78 - 8.10), elevated LDL: 4.26 (1.61-11.29), central obesity: 2.78 (1.08 -7), low HDL 5.89 (2.22-15.60), positive H.pylori stool test: 2.7 (1.86 -7.72), being diabetic: 2.7 (1.79 -7.79) and hypertensive: 2.79 (1.08 - 7.14) were associated with the co-occurrence.

CONCLUSION: Abdominal pain and FGIDs had significant distribution among adults in Jimma City. Therefore, early screening and managing FGIDs in the community is recommendable.

Magnitude and Associated Factors of Suicidal Ideation and Attempts among High School Adolescents of Jimma Town, Ethiopia

Hayat Mohamed Aliy, Habtamu Abebe Getahun, Lelisa Sena Dadi — Thu, 07 Dec 2023 00:00:00 +0000

BACKGROUND: Studies show that suicidal ideation and attempt are major predictors of suicide. Flourishing technologies such cyber bullying, increased local and global events, like pandemics, wars, and effects of climate change exacerbate vulnerability of adolescents to mental health problems. Thus, timely epidemiological information is important for evidence-based practices. Therefore, the aim of this study was to assess the magnitude and associated factors of suicidal ideation and suicidal attempt among school adolescents.

METHODS: A school-based cross-sectional study was conducted in June 2022 on randomly selected 1144 school adolescents using multistage sampling technique. Data were collected using a self-administered questionnaire. Then, data were cleaned, entered into Epi-data V.3.1 and analyzed using SPSS version 26. Multivariable logistic regression was done to identify predictors of suicidal ideation and suicidal attempt among adolescents. Adjusted odds ratio and confidence interval (CI) were respectively used to measure statistical associations and their statistical significance.

RESULTS: The prevalence of lifetime suicidal ideation and attempt were 22.5%, and 13.3%, respectively, while 12-month suicidal ideation and attempt were found to be 14.6% and 10%, respectively. Being female, disappointment in school results, family history of suicide attempt, current alcohol intake, anxiety, and chronic medical condition were significantly associated with both suicidal ideation and attempt while cyber bullying was significantly associated with suicidal ideation only.

CONCLUSIONS: Unsupportive home environment plus behavioral and medical conditions predispose school adolescents to suicidal ideation and attempt. The Ministry of Education and school administrations should facilitate favorable environment that enhance mental health awareness and protection of school adolescents. Building better parent-child relationship and parental discretion on the use of mobile phones can mitigate suicidal ideation and attempt.

Effective and Economical Option of Anesthesia in Retrograde Intrarenal Surgery

Thu, 07 Dec 2023 00:00:00 +0000

BACKGROUND: There is only limited data in the literature showing the effect of anesthesia methods on the success of retrograd intrarenal surgery. The aim of this study was to compare and evaluate retrograd intrarenal surgery cases performed under spinal and general anesthesia in terms of effectiveness, cost, hospitalization time and complications.

METHODS: A total of 337 patients who underwent retrograd intrarenal surgery due to kidney stones between 2014 and 2019 were retrospectively evaluated. In our study, the patients were divided into two groups according to the anesthesia method administered: Group 1 consisted of 172 patients who received spinal anesthesia and Group 2 comprised 165 patients administered general anesthesia. Both groups were compared in terms of demographic data, localization and size of stone, radiographic stone density, operation time, complications, need for postoperative analgesia, length of hospitalization, and stone free rate.

RESULTS: The cost of general anesthesia was significantly higher compared to that of spinal anesthesia (p < 0.001). The analgesia application administered within the first six postoperative hours was significantly higher in the general anesthesia group (p < 0.001). In other findings, there was no statistically significant difference between the two groups.

CONCLUSION: Retrograd intrarenal surgery can be performed with similar safety and effectiveness under both general and spinal anesthesia. However, spinal anesthesia seems to be more advantageous due to the patients' lower need for analgesics in the early postoperative period and the lower cost of the anesthetics used.

The Effectiveness of Cefazolin Prophylaxis on Infection after Transureteral Lithotripsy: A Randomized Clinical Trial

Mohammad Taheri, Ahmad Kameli, Ramin Haghighi — Thu, 07 Dec 2023 00:00:00 +0000

BACKGROUND: Transureteral lithotripsy (TUL) is one of the most common surgeries in urology, and many TUL procedures have been performed with antibiotics prophylaxis. The present study investigates the effect of antibiotic prophylaxis on the rate of urinary infection after TUL.

METHODS: This double-blind, randomized clinical trial was conducted on 158 patients with ureteral stones, with 79 in each group: the prophylaxis cefazolin group (Group A) and the placebo group (Group B). The patients were referred to Imam Hassan Hospital in Bojnurd, Iran. The standard technique of TUL operation was performed using a pneumatic lithoclast and a semirigid 9/8/Fr ureteroscope. The bacterial isolates were identified through growth on EMB agar and blood agar. Antimicrobial sensitivity testing (AST) was carried out by disc diffusion technique.

Top of Form

RESULTS: According to our results, 157 patients were eligible for analysis; 79 patients in Group A and 78 patients in Group B. Flank pain and urinary complaints were the most common symptoms. Our findings indicate that cefazolin prophylaxis did not show any significant differences in preventing postoperative infection between the two groups. E. coli accounted for eight 10.1% (8/79) Group A and 9% (7/78) in Group B, respectively. The results of AST for the 15 E. coli strains revealed a high rate of antibiotic resistance against ampicillin (73.3%).

CONCLUSION: Our findings indicate that prophylactic antibiotic administration does not demonstrate effectiveness in reducing the infection rate following TUL surgery. Antibiotic prophylaxis is not recommended considering the potential adverse effects, cost implications, risk of antibiotic resistance, and lack of efficacy.

Effectiveness of Aerobic, Resistance, and Combined Training for Hypertensive Patients: A Randomized Controlled Trial

Addis Alemayehu, Getu Teferi — Thu, 07 Dec 2023 00:00:00 +0000

BACKGROUND: Physical exercise is a well-established method for managing blood pressure (BP). The purpose of this study was to compare the effectiveness of aerobic, resistance, and a combination of both aerobic plus resistance training on BP, body composition (BC), and cardiorespiratory fitness (CRF) among hypertensive patients.

METHODS: The total population was sixty hypertensive patients; of these, forty-eight male adults (45.28 ± 7.44, years); with a sedentary lifestyle were randomized to one of the three exercise interventions or a control group. Subjects in all three exercise groups had an equal total exercise time (60 minutes), which included 10-15 minutes of warming up and dynamic stretching, 10-15 minutes of cooling down and static stretching and 30- 40 minutes for the main workout. Data were presented as mean (standard deviation, SD) or mean change with 95% confidence intervals (CI).

RESULTS: All three-intervention trainings showed improvement in BP, CRF, and BC. However, the most effective intervention training was combined training. Combined training resulted in significant reductions in body composition, resting heart rate (RHR) and, BP: body weight -7.92 kg, BMI -5.96 kg/m2, SBP -17.75mmHg, DBP -12.5 mmHg, RHR -8.17 bpm, and percent body fat (%BF) -6.49%. The aerobic training group only increased VO2max 12.44 ml/kg/m.

CONCLUSION: Compared to aerobic or resistance training alone, a 12-week of combination exercise may offer more comprehensive advantages for those at a higher risk for hypertension.

Development of a Hospital-Stakeholder Collaboration Tool Using Mixed Methods to Assess Stakeholder Perspectives for Hospital Service Improvement

Thu, 07 Dec 2023 00:00:00 +0000

BACKGROUND: The purpose of this study was to develop the Hospital-Stakeholder Collaboration (HSC) Tool and Hospital Performance Factor (HPF) Tool to explore stakeholder perception and value for hospital service improvement.

METHODS: This exploratory mixed-method study involved three steps: initial tool development (Step 1), validity testing (Step 2), and module development (Step 3). In Step 1, qualitative data collection through literature reviews, focus group discussions, and interviews with hospital management experts led to the creation of the preliminary tools. Step 2 involved qualitative analysis by a 5-member expert panel, followed by quantitative analysis with 36 respondents for validity (Pearson correlation, α = 0.05) and reliability (Cronbach’s Alpha, α = 0.6) tests. Step 3 encompassed the final module development.

RESULTS: The HSC tool contains 6 domains and the HPF tool contains 4 perspectives. The 6 HSC domains were: 1) stakeholder identification, 2) interactive dialogue, 3) commitment, 4) planning, 5) implementation, 6) change in action and behavior. The 4 HPF perspectives were: 1) stakeholder perspective, 2) financial perspective, 3) internal business process, and 4) staff and organizational capacity. The values of the HSC tool validity and reliability tests were around 0,0046 and around 0,995, respectively. Additionally, the values of the HPF tool validity and reliability tests were around 0,0062 and around 0,995, respectively.

CONCLUSION: This study offers a practical tool for needs assessment for the improvement of service by analyzing direct feedback from hospital stakeholders and measuring hospital performance factors.

Comparing Resection and Primary Anastomosis versus Hartmann’s Stoma on the Mortality and Morbidity of Gangrenous Sigmoid Volvulus: Systematic Review and Meta-Analysis

Atalel Fentahun Awedew, Zelalem Asefa, Biruktawit Destaw Enkoye — Thu, 07 Dec 2023 00:00:00 +0000

BACKGROUND: Gangrenous sigmoid volvulus has a significant impact on morbidity and mortality. This study was conducted to compare sigmoid resection and primary anastomosis (RPA) with sigmoid resection and end colostomy (Hartmann’s procedure) for gangrenous sigmoid volvulus.

METHODS: A systematic review and meta-analysis study design was employed to summarize retrospective cohort, prospective cohort, and randomised control trial studies published from inception to march 31, 2023. Searching was performed on Medline, CINAHAL, Web of Science, Google Scholar, the Cochrane Library, and ClinicalTrials.gov to locate eligible articles. Data searching, selection and screening, quality assessment of the included articles, and data extraction were done by two separate reviewers. RevMan 5.4 software with a fixed-effect Mantel-Haenszel model and Stata version 14 were used to analyze the data. The protocol registered on PROSPERO registration website (CRD42023413367).

RESULTS: Ten cohort studies and one randomised control trial with 724 patients were found; all of them were rated as being of moderate quality. The overall mortality after RPA was 15% (95%CI: 11-19%), and after Hartmann’s procedure it was 19% (95%CI: 15-23%). Resection and primary anastomosis (RPA) for gangrenous sigmoid volvulus had slightly lower mortality rate than stoma (OR=0.98(95%CI: 0.68-1.42), p=0.07, I²=43%), which had no statistically significant difference. Resection and primary anastomosis (RPA) had a slightly higher morbidity rate than Hartmann’s procedure (OR=1.01(95%CI: 0.66-1.55), p=0.30, I²=18%), which had no statistically significant difference.

CONCLUSION: Sigmoid resection and primary anastomosis (RPA) and Hartmann’s procedure had no significant differences in mortality and morbidity for the treatment of gangrenous sigmoid volvulus. Choice of the intervention for gangrenous sigmoid volvulus should be individualized with consideration of different detrimental factors.

Dilated Cardiomyopathy as a Rare Presentation of Multisystem Inflammatory Syndrome in Children (MIS-C): A Case Report

Vipulkumar V. Gandhi, Komal Chopra — Thu, 07 Dec 2023 00:00:00 +0000

Multisystem inflammatory syndrome in children (MIS-C) is a rare post-infectious complication associated with COVID-19. This case report presents a detailed account of a paediatric patient diagnosed with MIS-C who developed dilated cardiomyopathy as a significant complication. This report aims to enhance our understanding of the rare potential cardiovascular implications of MIS-C and highlights the importance of prompt recognition and management.

List of reviewers for 2023 issues

Yibeltal Siraneh — Thu, 07 Dec 2023 00:00:00 +0000

List of reviewers for the last 6 issues and 2 special issues published in 2023.