Ethiopian Journal of Health Sciences最新文献

Background: Saint Paul's Hospital Millennium Medical College (SPHMMC) is one of Ethiopia's premier radiology training institutions. This study aimed to trace graduates of SPHMMC's radiology program and examined their career outcomes and perspectives on the training received.

Methods: A cross-sectional study design was employed, recruiting 78 participants. Data on employment status, career outcomes, job satisfaction, and perceptions regarding the program's strengths, weaknesses, and curriculum relevance were collected through a web-based questionnaire from May 31 to June 8, 2024. SPSS version 26 was used for data processing and analysis.

Results: The study revealed a high employment rate among SPHMMC radiology graduates, with 97% employed and 75% securing jobs within one month of graduation. Most graduates held permanent positions (86%) as radiology specialists, sub-specialists, and academicians. There was notable regional variation, with 65% working in Addis Ababa. Job satisfaction levels were 79% for radiology careers and 53% for current jobs. Satisfaction with the program overall and curriculum relevance was 69% and 96%, respectively.

Conclusions: High employment rates, and career and curriculum satisfaction levels might be reflective of the high market demand for radiologists in Ethiopia and the effectiveness of SPHMMC's radiology program in preparing graduates for professional careers. The regional disparity in radiologist distribution suggests underlying systemic issues that require further investigation.

Background: Radiology is an essential component of modern medicine and a rapidly evolving research field. The nature and dynamic of radiology research in Ethiopia remained largely unexplored This bibliometric scoping review was done to explore the current state of radiology research in Ethiopia.

Methods: Literature search was conducted using PubMed, Scopus, Embase, Web of Science, and Google Scholar from inception to June 15, 2024. Study screening, review, and selection were performed using EndNote Reference Manager. The key indicators assessed include publication trends, research themes, publication utility, contribution and collaboration of individuals and institutions, and journal metrics. Statistical analysis was done using R and VOS viewer software.

Results: Though low in volume, radiology research publication is increasing in Ethiopia, with 241 publications from 1968 to 2024, accounting for 0.03% of the global radiology research output. Top contributing institutions were Addis Ababa University, Jimma University, and St. Paul's Hospital Millennium Medical College. The studies were largely focused on case-reports, cross-sectional studies, and diagnostic imaging. Systematic reviews, meta-analyses, artificial intelligence and trials constituted only 3% of the studies. Most publications (96.7%) were done by academic institutions. Most frequently used journals were Ethiopian Medical Journal and Ethiopian Journal of Health Sciences, accounting for 29% and 15% of the total publications, respectively. Publications in Q1 journals was 12%. International collaboration was 7%, with the USA being the primary collaborator.

Conclusion: To elevate the quality and impact of radiology research in Ethiopia, it is crucial to adopt contemporary and robust research methodologies, align research topics with global trends and technological advancements, and foster enhanced collaboration and productivity within the research community.

Background: Tuberculosis (TB) remains the deadliest infectious disease globally, with the kidneys being the most frequently affected organ in the genitourinary system. Isolated prostate involvement by tuberculosis is rare and may mimic prostate cancer. This case report aims to highlight the diagnostic challenges and therapeutic responses associated with isolated prostate tuberculosis, particularly in the context of significantly elevated prostate-specific antigen (PSA) levels in a TB-endemic region.

Case presentation: A 69-year-old male was referred to Tikur Anbessa Specialized Hospital (TASH) with obstructive lower urinary tract symptoms (LUTS) lasting seven months. He had previously undergone transurethral resection of the prostate (TURP), with histopathological findings suggestive of benign prostatic hyperplasia (BPH). Further investigation revealed an extremely elevated PSA level of 1768 ng/ml. Magnetic Resonance Imaging (MRI} raised high suspicion for locally advanced prostate cancer; however, a repeat biopsy and histopathology ultimately diagnosed TB prostatitis. The patient responded successfully to anti-tuberculosis therapy.

Conclusion: Isolated prostate involvement by M. tuberculosis is rare, and extremely elevated PSA levels are unusual. Histopathological examination is a confirmatory test, but results can be falsely negative if a representative sample is not obtained. Therefore, a high degree of clinical suspicion, particularly in endemic areas, along with repeat biopsy, is crucial for accurate diagnosis.

Background: St. Paul's Hospital Millennium Medical College (SPHMMC) has offered radiology specialty training for a decade. To mark its 10th anniversary and assess the program's status, this study aimed to gather stakeholders' perspectives on its functioning.

Methods: The assessment was conducted from June 15 to July 5, 2024, using a stratified cross-sectional study design. A total of 211 participants were recruited through exhaustive sampling from alumni, faculty, students, referring physicians, and patients. Data were collected via web-based and paper-based questionnaires, where stakeholders rated the core functions of the SPHMMC radiology program (curriculum, teaching, research, and imaging practices) on a 5-point scale and provided additional feedback.

Results: Overall, 78% of stakeholders regarded the program's curriculum as highly relevant. However, teaching quality and research were viewed negatively, with only 19% and 11% of radiologists rating these aspects positively. Referring physicians considered radiology reports relevant (68%) but often found them incomplete and untimely (73%), with only 2% deemed timely. Over 80% of patients expressed dissatisfaction with the imaging services and were unwilling to recommend them.

Conclusions: While positive perceptions of the curriculum and imaging services suggest program strengths, the negative feedback on teaching and research quality indicates the need for improvements to maintain SPHMMC's commitment to quality education and services.

Background: Perianal fistula refers to an abnormal connection between the anal canal and the perianal skin or perineum. Magnetic Resonance Imaging (MRI) plays a crucial role in accurately characterizing perianal fistulas, which informs surgical strategies and helps minimize recurrence.

Methods: This cross-sectional study was conducted at a single diagnostic imaging center in Addis Ababa, utilizing retrospectively collected data from May 2023 to June 2024. All patients referred for suspected perianal fistulas were included. MRI scans were reviewed by a radiologist in body imaging fellowship and a body imaging subspecialist. Findings, along with sociodemographic data, were documented in a structured questionnaire and analyzed using SPSS.

Results: The study encompassed 304 primary fistula tracts in 276 patients, with 233 (84.4%) being male. Complex fistulas were identified in 83 patients (30.1%), 43 (15.6%) had secondary extensions, and 64 (27.1%) presented with abscess collections. The most common type of fistula, according to the Parks classification, was intersphincteric, observed in 263 cases (86.5%). The St. James University Hospital grades 1 and 2 were predominant, representing 176 (57.9%) and 62 (20.4%) of the cases, respectively. A significant association was found between complex fistulas, higher Parks grades, and the total length of the fistula tract.

Conclusion: This study elucidates MRI patterns of perianal fistulas, revealing that over one-third of patients had complex fistulas. This underscores the importance of preoperative MRI for effective surgical planning and reducing recurrence rates.

Background: Necrotizing soft tissue infection (NSTI) is one of the deadliest diseases among surgical infections. Prompt timely diagnosis and urgent surgical intervention with supportive care are cornerstones of patient management. This study aimed to assess patient outcomes and associated factors of adult patients diagnosed and surgically treated for NSTIs at Saint Paul's Hospital Millennium Medical College (SPHMMC), Ethiopia from January 2015 to December 2019.

Method: An institution-based cross-sectional study was conducted by reviewing medical records of patients treated for NSTIs at SPHMMC in the 5 years study period. A five-section survey instrument was developed, and the collected responses were cleaned and entered into Epi data (v3.1) and exported to SPSS (v.26). Statistical analysis of associated factors was done with binary logit regression model.

Result: Medical records of 110(84%) patients were retrieved and nine out of ten subjects were male with a median age of 42 years (IQR- 34-62yrs) The leading clinical presentations were painful swelling 96(87.3%), fever 79(71.8%) and foul-smelling discharge 62(56.4%). Five out of ten participants have known comorbidity and 9 out of 10 patients have specified predisposing events before their infection. The majority (86.3%) underwent surgical debridement and amputation was done for eighteen patients. The average length of hospital stay was 27 days (2 to 112 days range) with mortality rate of 20%. advanced age, shock at presentation, post-operative anemia, and infection involving the torso were significantly associated with poor patient outcomes.

Conclusion: Surgical management of NSTIs has favorable result and patient presentation and anatomical location of the lesion determine patient outcome.

Prolonged hospital stays in Nigerian teaching hospitals pose a significant challenge to patient care and hospital management, exacerbated by socio-economic and systemic factors. This case study report looked at the multifaceted role of medical social workers in addressing these challenges, focusing on their efforts in providing psychosocial support, coordinating care, and advocating for patients within a strained healthcare system. This case-study highlights the impact of resource constraints and inadequate hospital practices on patient outcomes, emphasizing the psychological toll on patients and their families. It underscores the critical role of medical social workers as they navigate complex healthcare landscapes to mitigate the adverse effects of extended hospitalizations. This calls for a comprehensive approach to address these systemic issues, including policy reforms, increased healthcare funding, and strategic improvements in hospital administration. Hence the urgency of systemic change to ensure a more resilient and compassionate healthcare environment for all Nigerians.

Background: Osteoporosis is a bone disease caused by decrease in bone mineral density (BMD). Quantitative computed tomography (QCT) has proven to be an effective tool to measure the BMD of the lumbar spine. Therefore, the objective of the study is to investigate the impact of intravenous contrast media (CM) on BMD of lumbar spine measured by QCT.

Methods: This is a prospective study and included a total of 141 patients (females: 71, males: 70) referred for contrast enhanced computed tomography (CECT) abdomen. First, the plain scan of abdomen was done. Contrast media was injected intravenously followed by acquisition of arterial and portovenous phase (PV) of abdomen. Plain, arterial and PV phases axial CT images were loaded on Philips BMD analysis application. A circular region of interest (ROI) measuring 30-40 mm² was placed at all five lumbar vertebrae (L1-L5) and value of BMD was obtained in mg/cm³.

Results: Paired t-test was used to compare BMD in plain, arterial and PV phase. There was significant difference (p <0.05) in BMD (L1-L5) between plain (110.86±36.61 mg/cm³), arterial (117.04±37.95 mg/cm³) and PV phase (127.52±40.9 mg/cm³). The study also noted significant difference between males and females in BMD of lumbar spine (L1-L5) for plain and CECT abdomen (p <0.05).

Conclusion: The BMD was highest for PV phase of the CECT abdomen. Therefore, the study concludes that BMD values are highly influenced by intravenous contrast media injections.

Background: Due to resource constraints, advanced spinal stabilization methods such as pedicle screws are unavailable at our center. Adeolu's technique, which employs low-cost and readily available vertical struts and spinal process wires, has been used as an adjunct in treating various spinal conditions to achieve rigid spinal constructs. This study evaluates the long-term clinical outcomes of this technique.

Methods: Nineteen patients treated with Adeolu's technique were prospectively followed to assess clinical outcomes. Primary outcomes included symptom reduction, absence of adverse events or need for re-intervention, and radiological evidence of stabilization and unrestricted mobilization. Secondary outcomes included back pain intensity, implant-related complications (rotation, migration, back-out, fracture), wound infection, worsening neurological status, and need for implant removal Data were analyzed using SPSS with simple descriptive statistics.

Results: The average follow-up period was 4.1 years (Range: 0.1 - 9.0 years). Patients' ages ranged from 20 to 81 years (Mean: 48.5). Indications for surgery included lumbar spondylosis (7, 36.8%), spinal trauma with unstable fractures (4, 21.1%), spinal tumors (4, 21.1%), and Pott's disease (4, 21.1%). All patients achieved satisfactory primary outcomes. Implant rotation was observed in 4 patients (21.1%), and implant migration in 1 patient (5.3%), requiring removal. Superficial surgical site infection occurred in 2 patients (10.5%). No implant fractures, deep infections, or worsening neurological status were noted.

Conclusion: Adeolu's technique is effective for a range of spinal pathologies, with favorable long-term clinical outcomes.