Ethiopian Journal of Health Sciences最新文献

Background: Congenital heart disease surgery is related to significant postoperative complications which have been associated with poor patient outcomes. However, the prevalence, predictors, and effect of complications on outcomes have only been evaluated in a few numbers of studies. This study aimed to assess the magnitude of postoperative complications after congenital heart surgery, their predictors, and the associations between complications and patient outcomes.

Methods: A retrospective, single-center cross-sectional study was done at the Cardiac Center of Ethiopia (CCE) on children who had undergone cardiac surgery between 2009 and 2022. All 919 pediatric patients aged below 18 years who had undergone congenital heart surgery were included in the study.

Result: Of the 919 patients who underwent surgery in the cardiac center of Ethiopia, Ventricular septal defect (VSD) was the most common diagnosis (41%) and VSD patch closure (39.4%) was the most common surgical procedure. The presence of at least one complication was identified in 39.5% of patients. Of all patients, 11.3% had cardiac, 23.1% had extra-cardiac complications, and 5.3%% had major complications. Higher age at diagnosis, lower weight at admission, cyanotic congenital heart disease, higher Risk adjustment for congenital heart surgery score (RACH-1 score), higher vasoactive inotropic score, Cardiopulmonary bypass use during surgery, higher cardiopulmonary bypass time, higher aortic cross-clamp time, higher duration of surgery, and the higher number of surgeries were associated with complications. The duration of mechanical ventilation, length of intensive care unit stays, and length of hospital stay was significantly prolonged in patients with complications.

Conclusion: Congenital heart disease surgeries pose a high risk of complications, and these complications are associated with poor patient outcomes in Ethiopia. Therefore, predicting complications based on risk factors and early detection and treatment is crucial to improve the patient's outcome.

Background: The digital competency of health professional educators is crucial for institutions to develop digital skill policies and initiatives, plan professional development, and integrate technology into teaching practices. However, the development of policies, initiatives, and professional development programs related to digital skills is limited in low and middle-income countries due to a lack of empirical evidence. This study seeks to evaluate the digital competency of health professional educators in Ethiopian medical education.

Methods: A survey was conducted at public Higher Education Institutions that provide health training programs in Ethiopia from April to September 2023 using the digital competency level assessment tool. Descriptive statistics were used to summarize the skill levels, and a chi-square test analysed the relationship between digital skills and various factors.

Results: This study involved 498 health professional educators from 16 institutions. Most were male and taught clinical science. Over half worked in research institutions and held academic positions as assistant professors or above. About 10% were beginners in digital skills, with over half at an explorer level. Only a small percentage were experts. The majority had low digital skill competency, with only 7.2% showing high competency. There was no significant association between digital skill competency and factors like the type of institutions, program, course type or academic rank.

Conclusions: There is a notable lack of digital skill competency among faculty members, with the majority lacking expertise in this area. Educators require guidance, collaborative encouragement, and knowledge exchange to enhance their digital competencies and effectively harness technology in their teaching.

Background: Knowledge about quality of life following brain trauma is necessary to improve public health programmes.

Methods: A cross-sectional study was conducted at Ghazi al-Hariri Surgical Specialties Hospital, Dr. Saad Al-Witry Neuroscience Hospital in the Baghdad governorate, and Baqubah General Hospital in the Diyala governorate from first January to the end of April 2022. The study's target population was patients aged 18 years and older with traumatic brain injury six to 12 months post-injury, Quality of life was evaluated by a structured questionnaire using the quality of life after brain injury (QOLIBRI) scale.

Results: A total of 225 participants were included. The highest proportion (52.9%) was within the age group of 18-29 years. The male-to-female ratio was 3.09:1. Road traffic accidents were the main cause of brain damage, affecting 67.6% and 52.7%, respectively. The average levels of satisfaction with thinking ability, emotions, independence, and social relationships were 56.9%, 52.9%, 42.2% and 43.6%, respectively. The average levels of dissatisfaction with feelings and physical activity were 48.4% and 53.8%, respectively.

Conclusion: Most patients with traumatic brain injury had average overall satisfaction with their thinking abilities, emotions, independence, and social relationships. Majority of them had an average level of discontent with their feelings and a low level of discontent with their physical activity.

Background: Bowel obstruction is a common surgical emergency worldwide. It may result into high morbidity or mortality whenever intervention is delayed. It affects all age groups. The most commonly seen etiologies of bowel obstruction are post-operative adhesions, neoplasm and hernia in that order. Intestinal knot syndrome is an extremely rare cause of intestinal obstruction, and when it occurs, it poses diagnostic challenges. We report a case of appendico-ileal knotting causing strangulated small bowel obstruction due to its rarity and diagnostic difficulty. Our objective is to discuss the clinical presentation and management of this rare cause of surgical emergency.

Case: A-72- year old man was seen at the emergency unit of our center with 4 days history of gradual onset of colicky abdominal pain with nausea and vomiting. He had a two-day history of constipation and a one-day history of fever. He was acutely illlooking and his vital signs were abnormal. Urgent abdominopelvic ultrasound and plain abdominal x-ray was performed and were suggestive of intestinal obstruction. He had emergency laparotomy, and intra-operatively appendico-ileal knotting was seen with gangrenous appendix and terminal ileum. This necessitated limited right hemicolectomy and ileo-colonic anastomosis. The patient was managed post-operatively and discharged on post-operative day 10.

Conclusion: Appendico-ileal knotting is a cause of small bowel obstruction although it is very rare. The diagnosis is commonly confirmed intra-operatively. There are reports of simple small bowel obstruction secondary to appendico-ileal knotting, but this case confirmed that it could also lead to strangulated intestinal obstruction.

Background: The fertility behavior of women is characterized by maternal age, birth spacing and order, and it impacts the health of women and children. Evidence on the factors associated with maternal high-risk fertility behavior is scant in Ethiopia. Thus, the aim of this study was to identify the factors associated with maternal high-risk fertility behavior in Hadiya Zone, Southern Ethiopia.

Methods: A facility-based cross-sectional study was conducted. Three hundred women of reproductive age admissions to public hospitals in the Hadiya Zone who gave birth in the five years preceding this study were selected using systematic random sampling. Face-to-face interviews were held to gather data using interviewer-administered questionnaires. Descriptive statistics and binary logistic regression models were used to analyze data. Statistical significance was assessed using odds ratios and 95% confidence intervals and declared at a p-value of less than 0.05.

Results: The overall proportion of maternal high-risk fertility behavior was 60.3%. Mother, who lived in rural areas (AOR = 4.85; 95% CI: 2.56, 9.19), had early marriage (AOR = 3.39; 95% CI: 1.87, 6.14) and had unplanned last pregnancy (AOR = 2.62; 95% CI: 1.28, 5.39) were more likely engaged in high-risk fertility patterns.

Conclusions: In the study area, there was a high overall proportion of married women engaging in high-risk fertility behavior. Mothers with early marriages, unplanned pregnancies, and rural residence were more likely engaged in high-risk fertility behaviors. Plans for interventions aimed at preventing maternal high-risk fertility behavior should center on expanding access to family planning services and ending the practice of early marriage by giving rural women extra care and attention.

Background: Ultraviolet Radiation (UVR) from the sun is a significant environmental component that impacts on human health. Excessive UVR exposure has immediate impacts like burning and tanning, as well as long-term consequences including skin damage, photo-aging, skin malignancies. The objective for this study is to determine the student's knowledge, attitude and practice regarding solar ultraviolet exposure in Karachi, Pakistan.

Methods: A cross-sectional study was done in Public Sector University; total 361 students were recruited through stratified cluster sampling from different colleges of university. Data collection was done by validated structured questionnaire. Logistic regression was used to determine the association of outcome variables with risk factors and p-value of <0.05 as a threshold of statistical analysis.

Results: Most of the students were appropriate knowledge (71%), positive attitude (51%) and safe practice (54%) regarding ultraviolet solar exposure. Almost half (69%) of participants were used sun protective agents. After adjustment of covariate, female gender (OR 2.20 (95% CI 1.29-4.07) (p-value 0.004), significantly associated with in-appropriate knowledge, third year students (OR 2.93 (95% CI 1.01-8.95) p-value 0.048) were significantly associated with negative attitude. Age group 18-21 years (OR 1.75(95% CI 1.43-5.31) p-value 0.003) were significantly associated with un-safe practice regarding solar ultraviolet exposure harmful effects.

Conclusion: This study found that knowledge level was appropriate but attitude and practice level need to improve for prevention of harmful effects of solar ultra violet ray exposure. The study encourages students to be more aware of sun protection behavior in order to avoid the long-term effects of sun exposure.

Background: Osteopetrosis is a rare inherited disease caused by a lack of osteoclastic bone resorption, resulting in increased bone mass with insufficient mechanical strength. Patients usually present with complications such as pathologic fractures, cranial neuropathies, and bone marrow failure. Diagnosis is based on suggestive clinical and imaging findings, with genetic testing to confirm diagnosis and identify the subtype.

Case presentation: The patient is an eight-year-old girl who came to our hospital with complaints of bilateral arm swelling and visual disturbances for four years and a history of fracture of the left lower extremity two years before presentation. Physical examination revealed nontender bilateral arm swelling and a shorter left leg. The laboratory tests were within normal limits. A skeletal radiograph showed typical radiographic features of osteopetrosis.

Conclusion: It is important to consider osteopetrosis in patients presenting with pathologic fractures and cranial neuropathies. Typical imaging findings can provide rapid diagnosis in severe cases.

Background: Oral and Maxillofacial region is an area that is prone to multitude of disease conditions of developmental nature or acquired which require surgical intervention on many occasions. The aim of this study was to assess the pattern, indications, and types of major oral and maxillofacial surgical procedures carried out at Addis Ababa university Maxillofacial Surgery affiliate hospitals.

Methods: A retrospective study was conducted on all patients who had undergone oral and maxillofacial surgeries under general anesthesia at Yekatit 12 Hospital Medical College and Saint Peter Specialized Hospital in a period of 3 years from January 2017 to December 2019. Descriptive statistics such as biodata, indication and type of surgery were recorded and analyzed using the Epi info version 7 software.

Results: A total of 689 patients with oral and maxillofacial conditions were managed during the study period. The male to female ratio was 2.48:1, and the mean age of patients was 29.05 years with standard deviation of ±15.5. The predominant indications for surgery were traumatic conditions (50.71%, n=354), followed by neoplastic conditions (18.7%, n=129)). Open reduction and internal fixation were the most common (43.7%, n=313) surgical procedure performed.

Conclusions: The field of oral and maxillofacial surgery in our climes is a relatively new one. However, it is evolving, and its relevance is growing. With the observed relatively high frequency of traumatic conditions, especially among younger populations, efforts geared at prevention and adequate preparedness for proper surgical management of such patients should be commenced.

Background: Retained surgical items (RSIs) constitute a rare complication arising after surgical procedures. Their occurrence may be averted through diligent precautionary measures. Perioperative counting of equipment and materials is the most common method of screening for RSIs. Subsequent confirmation of the diagnosis can be achieved through clinical examination and imaging studies.

Case: We report a case of successful hysteroscopic identification and retrieval of gauze inadvertently left within the uterine cavity, after a cesarean section two years back. The patient was later diagnosed with RSIs during routine evaluation for secondary subfertility and vaginal discharge.

Conclusions: Despite the relatively low incidence of RSIs, they represent a significant and preventable source of patient harm, carrying the potential for fatal outcomes and resulting in substantial medical and legal expenditures.