bluuebunny/crossref_metadata_2025 huggingface dataset:
Total hip arthroplasty in patients with ankylosing spondylitis: challenges and midterm results
Authors: Eid Ahmed S. , Kotb Ahmed , Hashem Mohammed H.
Published: July 2024

Purpose

To assess the effectiveness of total hip arthroplasty (THA) in patients with ankylosing spondylitis (AS).

Introduction

The prevalence of hip disease in AS ranges from 19 to 36%, with 90% of patients affected bilaterally. Hip involvement in AS patients represents a substantial clinical challenge. While THA using cemented and cementless implants offers a valid treatment option, the complexities of AS-related osteoporosis, diminished spinopelvic mobility, reduced bone union, and femoral deformities necessitate tailored surgical strategies.

Patients and methods

This retrospective case series study involved 11 patients (equating to 20 hip joints). These patients were diagnosed with AS that affected their hips and underwent THA. The study spans from 2012 to 2018, with a minimum follow-up 5 years. The mean age at the time of operation was 25.2 ± 4.6 years and the mean duration of follow-up was 5.6 ± 0.6 yrs. Follow-up was assessed using Harris Hip Score (HHS) preoperatively, 6 months, 1 year, and at last follow-up postoperatively with a mean period of 6.4 (5–8) years.

Results

The mean preoperative HHS was 15.3 ± 6.6, while in the last follow-up, the mean HHS was 76.3 ± 4.2. The comparison between preoperative mean HHS and the last follow-up was highly significant. There were no postoperative complications except an iatrogenic fracture of the acetabulum.

Conclusion

AS is a painful and debilitating disease. THA in patients with AS causes a significant improvement in patient’s pain and function. THA is a definitive solution for the crippling fate of these patients with advanced hip OA.
Is it inevitable to have dynamic horizontal acromioclavicular joint instability with a single tightrope?
Authors: Arafa Mohamed S. , Ibrahim Mohamed , Lädermann Alexandre , Magdy Ahmed , Elkayal Engy S.
Published: July 2024

Background and purpose

Literature showed that single Tightrope fixation in acromioclavicular joint (ACJ) dislocation cases does not secure horizontal joint stability. A positive clinical cross-body adduction test is a usual outcome finding. We hypothesized that some cases might have some degree of horizontal stability, which might be confirmed with ultrasound examination.

Methods

This clinical study was performed on 27 patients who underwent single Tightrope application in acute ACJ dislocation. Patients were divided into group A which had an arthroscopic technique, and group B which had an open technique augmented with trans-ACJ fixation using two k-wires for 6 weeks. A clinical examination of the operated shoulders was done, and the results were compared with the sound shoulder examination in the same patient at the last 24 months postoperative follow-up visit. Besides, the results of the cross-body adduction test were correlated with ultrasound findings at the same visit. Records, operative details, and postoperative radiography were reviewed to assess if any factors would diminish the dynamic horizontal stability of the ACJ. Body mass index (BMI) was calculated per case.

Results

Group A had 17 patients (three patients had grade III dislocations, and 14 patients had grade V dislocations). Group B had 10 patients (four patients had grade III dislocations, and six patients had grade V dislocations). The clinical cross-body adduction test gave gross positive results in 14 patients out of group A patients while it gave gross positive results in six patients out of group B patients. Group A patients with negative results were 3, while group B patients with negative results were 4. By ultrasound, differences in horizontal translation of the clavicle within the ACJ in resting and cross-arm positions were more obvious in all operated shoulders than in all sound shoulders.

Conclusion

The less the Rockwood grading, the more potential to secure more horizontal stability. An open approach also gives more horizontal stability. With increased BMI, horizontal instability is usually masked. So, some factors may diminish, or mask clinical dynamic horizontal instability, which can be confirmed or rolled out with ultrasound usage.
Outcome of the surgical treatment of adolescent idiopathic scoliosis using the Scoliosis Research Society outcome questionnaire
Authors: Elashmawy Hany E.A. , Hassanin Ehab Y. , Abdellatif Mohammed S.E. , Ghorab Mohamed A.
Published: July 2024

Background

Adolescent idiopathic scoliosis (AIS) is a structural deformity of the spine. Posterior deformity correction represents the gold standard of the surgical treatment of AIS. The fixation technique was shifted from hybrid fixation to the all pedicle screw construct, which could produce superior deformity correction. Patient-oriented outcome questionnaires have become an important measure of the success of surgical correction. This study was conducted to assess the outcome of all pedicle screw constructs in treating AIS using the Scoliosis Research Society (SRS)-24 outcome questionnaire.

Patients and methods

Seventy-nine AIS patients were included with a minimum 2-year follow-up. Clinical and radiographic measurements were evaluated at preoperative, postoperative, and final follow-up periods. Complications and results of the SRS-24 questionnaire were analyzed. Sex, Lenke classification, levels of the lowest instrumented vertebra, curve magnitude, and percentage of curve correction were correlated with the SRS-24 questionnaire results.

Results

There were 59 females and 20 males. The mean age of the patients was 14.2 ± 2.5 years. According to Lenke classification, the majority of the curves were type 1 (57 patients), followed by type 5 (11 patients), type 2 (six patients), type 3 (three patients), type 6 (two patients), and no type 4. The mean preoperative major curve Cobb angle was 59.3 ± 9.045° and the mean postoperative Cobb angle was 5.82 ± 5.932°. The average score for SRS-24 was 4.17. The mean preoperative pain score was 3.29, which improved to 4.30 after at least 2 years of follow-up (P˂0.005). Statistically significant improvement was seen in the general self-image, function from back condition, and level of activity. After surgery, the mean score for self-image was 4.19, and for function was 3.55. The postoperative function was the lowest, while the postoperative satisfaction score was the best of all domains, with a mean score of 4.55. About 90% of patients were satisfied with the results of their surgical correction. Magnitude of curve and amount of correction did not significantly alter the SRS scores.

Conclusion

All pedicle screw construct is an efficient and safe method in AIS correction. The surgical treatment in our AIS patients has resulted in a perceived benefit in all domains of SRS-24 questionnaire.
A rare case report of inverse sciatic hernia unveiling as a lipoma
Authors: Pallikamattom Mathew Philip , T.V. Murali , Das Sheima R. , Thomas John
Published: July 2024

When a swelling arising in the gluteal region herniates into the pelvic cavity through the sciatic foramen, it is referred to as inverse or reverse sciatic hernia and is a rare occurrence. We present the case of a 62-year-old female who presented with swelling in the left gluteal region with features of sciatica and abdominal pain. Magnetic resonance imaging showed 27 cm × 22 cm × 9 cm soft tissue swelling arising from the gluteal region and inversely herniating into the pelvic cavity through the sciatic foramen. We were successful in delivering the tumor through a gluteal approach. Lipomatous tumors presenting as inverse sciatic hernia are a rare event.
Evaluation of mtDNA common deletion in esophageal squamous cell carcinoma
Authors: Ghadyani Fatemeh , Sharif Shahrbanoo , Morovvati Saeid
Published: July 2024

Background:

Mitochondrial defects are thought to play a role in cancer initiation and progression for a long time. Because of the absence of protective histones and an inefficiency in the DNA repair process, mitochondrial DNA is known to be prone to mutations. The deletion of 4977bp is one of the most common mutations in human cancers. This study aimed to investigate the relationship between 4977bp common deletion and Esophageal Squamous Cell Carcinoma Disease (SCC) to provide prognostic information.

Methods:

By using a PCR protocol, this study identified the 4977bp deletion of mtDNA. A PCR method was used on tumor samples from 41 squamous cell carcinoma patients and blood samples from 50 healthy individuals to detect DNA.

Results:

Among the 41 tumor samples (80.5%), 33 were found to have the 4977bp deletion, while none of the blood samples from healthy individuals contained it.

Conclusions:

It is shown that the deletion of 4977bp of mtDNA correlates significantly with SCC in this study. A 4977bp deletion could be used as an effective cancer screening indicator and biomarker for early diagnosis and prevention of cancer.
The access and invasiveness-based classification of medical procedures to clarify non-invasive from different forms of minimally invasive and open surgery
Authors: Whiteley Mark Steven , Davey Sienna Esme , Placzek Gabriel Mark
Published: July 2024

Background:

The rapid development of less invasive and traumatic medical procedures has resulted in a mixture of terms used to describe them, without any agreed definition for each. This is confusing to both medical professionals and patients and can lead to unrealistic patient expectations. The aim of this article is to show the current confused nomenclature and to suggest a new, simple classification based on access and invasiveness (AI) that can be applied to any medical procedure.

Methods:

We performed an online search for definitions for ‘non-invasive’, ‘non-surgical’, ‘minimally invasive’, ‘minimal access’, ‘pinhole’ and ‘keyhole’. We then searched peer-reviewed medical papers (PRMPs) and patient facing websites (PFWs) for the following index procedures, to see which of the original 6 terms were used to describe them: transvaginal ultrasound, sclerotherapy for leg veins, botulinum toxin injections, dermal fillers, endovenous thermal ablation and laparoscopic gall bladder removal.

Results:

We found a wide variety of definitions for each of the initial terms. In both PRMPs and PFWs, there were a variety of terms used for each index procedure (i.e.: transvaginal ultrasound, injections of sclerotherapy, botulinum toxin or dermal fillers being both ‘non-invasive’ and ‘minimally invasive’) showing confusion in the classification of procedures. We suggested the ‘AI classification’ based on access (A - none, B - natural orifice or C - penetrating an epithelial surface) and invasiveness (1 - none, 2 - surface damage, 3 - needle = <21G, 4 - cannula >21G but not a surgical trocar, 5 - surgical trocars or small incisions and 6 - incisions).

Conclusion:

The current confusion of terms used for procedures that are less invasive than the open surgical alternatives leads to confusion and possible false patient expectations. We have proposed an AI classification that can be applied easily to any procedure, giving a uniform classification for medical professionals and patients to understand.
Predictors of Insomnia and Sleep Abnormalities in Medical Students and Its Impact on Academic Performance
Authors: Aljafen Bandar N. , Alneseyan Ruwa A. , Bahr Mohamed H. , Abusrair Fatimah H. , Almutawa Amal A. , Almadeh Zahrah M. , Almozher Mona A. , Ahmed Sibeela R. , Muayqil Taim A.
Published: July 2024

Objectives:

This study aims to investigate predictors of insomnia and their prevalence among medical students from different levels, as well as the impact of insomnia on academic performance.

Methods:

This multicenter cross-sectional study was conducted on medical students of different levels at 37 medical colleges in Saudi Arabia from March 2020 to June 2020. An online survey was used for data collection. The survey included questions on the demographics of students and two scales: the Insomnia Severity Index (ISI) and the Pittsburgh Sleep Quality Index (PSQI). The Statistical Package for the Social Sciences Program was used to analyze the data, and demographics were represented using descriptive statistics. Associations were tested using either the Chi-square test, Pearson correlation, or Spearman’s correlation based on the types of variables. P <0.05 was considered significant.

Results:

The study included 2413 medical students; the mean ± standard deviation of the ISI and PSQI was 11.6 ± 6.2 and 8.4 ± 3.7, respectively. The ISI results showed that only 27% had no clinical insomnia, while 39% had subthreshold insomnia. The ISI was negatively and significantly associated with exercise (r = −0.49, P = 0.016), meals (r = −0.088, P = 0.0001), and drinking water (r = −0.057, P = 0.005). The negative predictors of poor sleep quality included study year (B = −0.106, P < 0.05) and water intake (B = −0.568, P < 0.01).

Conclusion:

A few proportions of medical students complained of moderate insomnia, and a lower proportion suffered severe insomnia. Lower academic performance was associated with insomnia and poor sleep quality. Various predictors of insomnia were identified; however, these predictors can be modified.
Case Report: Disseminated Tuberculosis After Kidney Transplantation
Authors: Hall Ashton D. , Huaman Moises A. , LaPorta Joseph C. , Luckett Keith M.
Published: July 2024

Tuberculosis (TB) can cause significant morbidity and mortality among solid organ transplant (SOT) recipients, including disseminated disease. Most TB cases after SOT occur in kidney transplant recipients, although data about TB in this population are sparse. Tuberculosis may present atypically in immunocompromised patients, underscoring why physicians must maintain high clinical suspicion when pertinent epidemiological risk factors are present, including birth or former residence in a country with endemic TB. We describe a unique case of disseminated TB in a 54-year-old Filipino woman who developed central nervous system tuberculoma, Pott’s disease, chorioretinitis, and a perinephric fluid collection after kidney transplantation. Despite being a preventable and curable disease, TB remains a relevant and challenging infection with complex diagnostic and treatment guidelines.
Subtle Sonographic Signs of Disseminated Tuberculosis: A Case Report and Narrative Literature Review
Authors: Hodson Daniel Z. , Kumwenda Tapiwa , Wallrauch Claudia , Rambiki Ethel , Tymchuk Christopher , Taccari Francesco , Heller Tom
Published: July 2024

Miliary tuberculosis is a form of disseminated tuberculosis that can be difficult to detect when the classic pattern is absent on chest radiograph and advanced cross-sectional imaging is not readily available. While the focused assessment with sonography for HIV-associated tuberculosis (FASH) protocol for extrapulmonary tuberculosis emphasizes easy-to-teach findings, experienced sonographers may detect additional, subtler signs that can aid in diagnosis. We report a case of a 20-year-old man with miliary tuberculosis diagnosed on computed tomography of the chest. We describe subtle sonographic signs of disseminated tuberculosis including subpleural irregularities and comet-tail artifacts, a bright liver pattern, peritoneal nodules, and a nonspecific sponge spleen pattern. We then discuss important differential diagnoses for each finding. Knowledge of subtle sonographic signs outside of the FASH protocol can aid clinicians in detecting disseminated tuberculosis, including the miliary form, when advanced imaging may not be available.
Abandonment at the Transition from Hospital to Home: Family Caregivers’ Experiences
Authors: Alireza Nikbakht-Nasrabadi  , Leila Mardanian-Dehkordi  , Fariba Taleghani
Published: July 2024

BACKGROUND፡ People with concurrent chronic conditions face different situations that lead to frequent transferring between the hospital and home. Despite the use of different strategies for improving transitional care, these transferring is associated with different challenges. This article aims to explore family caregivers’ experiences of transitional care in diabetes with concurrent chronic conditions.METHODS: This descriptive explorative study was done at university hospitals in two big cities (Isfahan and Tehran) of Iran. The data collection was conducted from November 2018 to February 2020 using deep, semi-structured, and face-to-face interviews which are focused on family caregivers’ experiences of transitional care. The researchers continued the sampling until the data saturation. Finally, 15 family caregivers were selected through purposive sampling. Data collection and data analysis were performed concurrently. Data were analyzed through the conventional content analysis method.RESULTS: Two main themes were identified: unsafe transition (unplanned discharge, inappropriate communication, lack of patient center care, and unavailable healthcare team) and erosive effort (financial burden, psychological stress, physical exhaustion, and lack of supportive sources).CONCLUSION: The findings point to the importance of designing a discharge plan and preparing family caregivers before being discharged by healthcare providers. It appears to be essential for health managers and policymakers to pay attention to safe transitional care planning. The establishment oftransitional care centers will help to ensure continuity of care. Future research focusing on the design and implementation of an appropriate transitional care model is recommended.
Congenital Pulmonary Airway Malformation (CPAM): A Case Report, Jimma University Medical Center, Southwest Ethiopia
Authors: Habtamu Sime  , Gersam Abera  , Abera Mengistu  , Sabona Lamessa
Published: July 2024

BACKGROUND፡ Congenital pulmonary airway malformation is a very rare congenital cystic lung disease that presents in 0.004% of all pregnancies and constitutes <25% of all congenital pulmonary anomalies in children. Respiratory distress is a major concern in these patients.CASE DETAILS: Here in, we report an 8 month old girl presenting with exacerbation of fast breathing of three days duration. Chest X-ray showed hyper lucent right lung with significant shift of mediastinum to the left side, flattening of the diaphragm on the right side and compression of the left lung. Computed tomography scan of the chest revealed multiseptated cystic mass on the right lung measuring 8.9cm by 6.9cm. After receiving treatment for pneumonia, surgical excision of the mass was performed and biopsy showed congenital pulmonary airway malformation type1. The infant died on 40th postoperative dayfrom uncontrolled hospital acquired infection.CONCLUSION: When a child has respiratory distress, congenital pulmonary airway malformation could be considered after common pathologies are ruled out. Surgical excision, which is the treatment of choice, is recommended to make a definite diagnosis and exclude hidden malignancies.
Physical Violence and Associated Factors among Women of Reproductive Age in Gedeo Zone, Southern Ethiopia
Authors: Siraneh Zemenu Yohannes Kassa , Abebaw Abeje  , Tebeje Ashegu  , Nebiha Hadra
Published: July 2024

BACKGROUND፡ Physical violence against women of reproductive age is a significant public health problem worldwide. This study aimed to assess physical violence and associated factors among women of reproductive age.METHOD: A community-based cross-sectional study design was implemented from August 1 to September 30, 2018, including women of reproductive age in Gedeo Zone Southern Ethiopia. A stratified, two-stage cluster sampling technique was used. Finally, the study population was selected from the respective source population using a simple random sampling technique. Data were checked, coded, and entered Epi data version 3.1 and exported to SPSS version 20 for analysis. The wealth index was computed using the principal component analysis. Bivariate and multivariable analyses were computed to identify the determinants of physical violence among women of reproductive age.RESULTS: Experiencing at least one type of physical violence among women of reproductive age was 14.7% (95%CI: 11.7, 17.4). Study participants whose spouse had any habit (AOR: 3.56; 95%CI: 1.75, 7.25) and whose spouse had watched pornography counterpart ((AOR: 1.58; 95%CI: 1.02, 3.17) had significantly higher odds of experiencing physical violence among women of reproductive age. Spouses had any habit like alcohol drinking, chat chewing, cigarette smoking, and seeing pornography significantly increased physical violence among reproductive-age women. Therefore, the responsible stakeholders should work on the means to the spouse can alleviate any form of habit like alcohol drinking, chat chewing, cigarette smoking, and seeing pornography could decrease physical violence in women of reproductive age.
Clinical Presentation of Retinoblastoma in Ethiopia: A Case of Jimma University Medical Center Pediatric Oncology Unit, Southwest Ethiopia
Authors: Diriba Fufa Hordofa  , Kumale Tolesa Daba  , Aemero Abateneh Mengesha
Published: July 2024

BACKGROUND፡ Retinoblastoma (RB) is one of the most curable childhood cancers if early detected and treated. Late presentation complicates the management of RB results in dismal treatment outcome. Objective: The aim of this study is to report the clinical presentation pattern of retinoblastoma patients seen at Jimma University Medical center (JUMC).METHODS: The study was a retrospective review of retinoblastoma cases managed at JUMC between August 2016 and July 2020.RESULTS: Among pediatric oncology cases registered retinoblastoma, accounting 8.5 % (36/423) of all childhood cancer patients in the study period, 29 (90.6%) of them had unilateral retinoblastoma and 3(9.4%) of them had bilateral retinoblastoma. The average age at presentation for bilateral and unilateral retinoblastoma patients was 17 (range 3-30) months and 37.5 months (range 8-84) respectively. The first symptom observed by the family was leukocoria in 21 (65.6%) of the patients but 24(75%) of the patients presented with advanced stage (proptosis and fungating orbital mass) of the disease. The longest and the shortest lag time of presentation from the first symptom was 17 months and 2 weeks respectively with the mean lag time of 1.4 months in bilateral and 6 months in unilateralcases. Clinically, the majority of the eyes 24/35(68.6%) were extraocular tumors involving orbital tissues at presentation.CONCLUSION: Most of retinoblastoma patients presented at advanced stage of the disease and presented very late after the family observed the disease. Early detection strategies must be designed by the government and responsible stakeholders in mitigating the effects of late presentation.
Prevalence and Predictors of Hypocalcaemia among Adolescent Girls in Rural Public Secondary Schools in South-South Nigeria
Authors: Iyabo Oyibo  , Patrick Gold Oyibo  , Blessing Osie-Efetie
Published: July 2024

BACKGROUND፡ Adolescent girls are at risk of developing skeletal inadequacy due to an imbalance between calcium intake and high requirements of calcium during this period of increased modeling and skeletal consolidation. This study assessed the prevalence and predictors of hypocalcaemia among adolescent girls in rural public secondary schools in south-south Nigeria.METHODS: This was a cross-sectional study conducted to assess the prevalence and predictors of hypocalcaemia among 238 adolescent girls selected by a multi-stage sampling technique. Data was collected using a semi-structured questionnaire which was interviewer-administered. Descriptive and inferential analysis of data collected was carried out using the IBM SPSS version 22 software.RESULTS: Over half (53.3%) and 75.2% of the participants were in their late adolescence period (17-19 years) and belonged to the lower social class level. Over one-quarter (30.7%) of the participants had hypocalcaemia. Participants who were in their mid-adolescence period (14-16 years) (OR= 2.38; 95% CI: 1.23-4.57), who skipped lunch (OR= 2.92; 95% CI: 1.35-6.34), who skipped breakfast (OR=3.60; 95% CI: 1.65-7.83) and were in senior secondary 1 class (OR=4.76; 95% CI: 1.21 18.75) had 2, 3, 4, and 5 times higher likelihood respectively of having hypocalcaemia. Participants who consume milk daily, who consume milk weekly and who had normal weight had 81.0%, 60.0% and 72.0% decreased odds respectively of having hypocalcaemia.CONCLUSION: The study brings to the fore a high prevalence of hypocalcaemia among the participants. Educational interventions targeted at parents to support adolescent girls to take calciumsupplements and calcium-rich meals should be implemented.
COVID-19 in WHO African Region: Account and Correlation of Epidemiological Indices with Some Selected Health-related Metrics
Authors: Henshaw Uchechi Okoroiwu  , Christopher Ogar Ogar  , Dennis Akongfe Abunimye  , Ifeyinwa Maryann Okafor  , Ikenna Kingsley Uchendu
Published: July 2024

BACKGROUND፡ The coronavirus disease 2019 (COVID-19) is a highly contagious and pathogenic viral disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Since it was first reported in Wuhan, China, it has spread across the continents. The study is aimed at describing epidemiological indices of COVID-19 as reported by the World Health Organization and to examine correlations with some country specific measures of general health status.METHODS: Data from the WHO African region were extracted from World Health Organization, Global Health Security Index, Worldometer and World Bank databases, as at September 8, 2020. Other epidemiological indices were computed for the various countries. Epidemiological indices of COVID-19 were correlated with some selected health related metrics: Global Health Security index (GHSI) and current health expenditure (CHE). Pearson correlation was used to access the relationship between the health-related metrics and epidemiological indices.RESULTS: Forty-seven (47) countries belonging to the WHO African region were evaluated. A total of 1,086,499 confirmed cases and 23,213 deaths were recorded giving a fatality rate of 2.1%. South Africa recorded the highest cumulative confirmed cases as well as deaths (Cases: 639,362; Deaths: 15,004) while Seychelles (Cases:135) and Eritrea/Seychelles (Deaths:0) had the least cumulative cases and deaths (135;0 and 330;0), respectively. South Africa recorded the highest attack rate (1127.67/100,000) while Republic of Tanzania recorded the least attack rate (0.78/100,000). The highest case fatality rate/ratio was observed in Chad (7.60%) while the least value was observed in Seychelles (0.0%). France was the most common country involved in travel history of index cases. Sporadic transmission was recorded in 3 countries, 9 countries had cluster of cases while the rest had community transmission. The first WHO African region country to record COVID 19 case was Algeria, while Comoros was the last. Significant positive correlation was found between COVID-19 case number/deaths and Global Health Security Index.CONCLUSION: The WHO African region has had its own share of the pandemic with all the countries being affected. The trio of cluster cases, sporadic and community transmission were recorded with majority being community transmission.
The Association between Diet Quality Scores with Sleep Quality among Employees: A Cross-Sectional Study
Authors: Hossein Bavi Behbahani  , Fatemeh Borazjani  , Leila Sheikhi  , Rezvan Amiri  , Kambiz Ahmadi Angali  , Sudabeh Basak Nejad  , Mahsa Samadani
Published: July 2024

BACKGROUND: Numerous factors such as nutrition and diet can affect the quality of sleep of people, especially employees. The aim of this study was to investigate the relationship between university employees' sleep quality and their dietary quality scores (HEI, DII and DASH score).MATERIALS AND METHODS: This cross-sectional study was performed on 211 employees with a mean age of 38.75±11.31. Nutritional status of individuals was determined through the Food Frequency Questionnaire (FFQ) and to assess sleep quality, the Pittsburgh Sleep Quality Index (PSQI) was used. The quality of sleep decreases with increasing Pittsburgh index score. The calculated dietary quality scores include DASH Index, Healthy Nutrition Index (HEI) and Diet Inflammation Index (DII).RESULTS: The results of this study after adjusting for confounding showed a significant positive relationship between DASH diet score and sleep duration (p<0.001). There was a significant negative relationship between HEI score and total score of PSQI (P = 0.003). Also, HEI score had a significant positive relationship with sleep duration in the unmodified and modified models (p <0.001), and a significant negative relationship was seen in unadjusted and modified model between DII score and sleep duration (p <0.001).CONCLUSION: It can be concluded that with increasing the diet quality in employees, the sleep quality also increases. This was the first study in south of Iran that examined the quality of sleep and diet of employees and the result of this study can affect the general health and improve the quality of foods consumed by employees.
Impact of COVID-19 on Surgical Volume: Single-Center Experience from Addis Ababa, Ethiopia
Authors: Yonas Ademe  , Abraham Genetu  , Tsegazeab Laeke  , Mulat Taye  , Abebe Bekele
Published: July 2024

BACKGROUND፡ The COVID-19 pandemic has caused substantial disruptions to surgical-care delivery mainly due to diversion of available resources from surgical to COVID-19 care, reduced flow of patients, supply-chain interruptions and social distancing and restriction measures. The purpose of this study was to understand the impact of the pandemic on surgical volume in our hospital.METHODS: A descriptive cross-sectional study was done at Tikur Anbessa Specialized Hospital. A 2- year data was collected from March 2019 up to March 2021 from the operation theatre registration books. The data registry at the admission records office was also reviewed to extract the number pf patients on the elective surgery waiting list. Data were recorded, analyzed and reported using SPSS software package 26.RESULTS: The findings showed that there was a significant drop in surgical volume during the COVID-19 era. Surgical volume has dropped by 19% for emergency and by 32% for elective surgeries. COVID-19 test positivity of patients was identified as the single most important reason for elective operation cancellation during the first wave of the pandemic, contributing to as high as 85% of the reasons.
CONCLUSION: The outcome of our study showed that COVID-19 has adversely affected elective and emergency surgical volume in our institution. This has also led to a dramatic increase in the surgical waiting list load. We recommend immediate surgical systems strengthening measures to re-build the surgical care ecosystem significantly affected by COVID-19. Surgical and anesthesia systems strengthening should be an integral part of pandemic preparedness and management.
Spontaneously Arrested Bilateral Primary Congenital Glaucoma: A Case Report From Ethiopia
Authors: Kalkidan S. Alayu  , Menen A. Shibeshi  , Abiye M. Alemu
Published: July 2024

BACKGROUND: Primary congenital glaucoma is potentially blinding condition characterized by elevated intraocular pressure and optic disc cupping. It is typically bilateral and usually manifest in the first year of life. Spontaneously arrested primary congenital glaucoma can occur, but it is very rare.CASE REPORT: A 32-year-old male patient from North Shewa presented to the department of ophthalmology, Menelik II Hospital with deterioration of vision. On examination he had large corneas with horizontal diameter of 14 mm, increased axial length, faint corneal stromal opacity and Haab's striae of both eyes. Anterior chamber angles were wide open. His intraocular pressure, optic nerve head appearance and visual field in both eyes were normal. He had subluxated dense cataract of the right eye.CONCLUSION: Late presentation with sequelae of primary congenital glaucoma without optic neuropathy is possible. Regular follow-up of spontaneously arrested congenital glaucoma and scleral fixation of intraocular lens is recommended.
Increasing Burden of Acute Hepatitis A among Ethiopian Children, Adolescents, and Young adults: A Change in Epidemiological Pattern and Need for Hepatitis A Vaccine
Authors: Abate Bane  , Amir Sultan  , Rabia Ahmed
Published: July 2024

BACKGROUND: Hepatitis A is a vaccine-preventable, feco-oral infection due to poor sanitary conditions. It is predominantly acquired during early childhood and results in lasting acquired protective immunity. However, it results in severe disease which can end up in acute fulminant hepatitis and hepatic failure when acquired during adolescence and adulthood. The prevalence of acute hepatitis A is increasing among children, adolescents, and young adults from higher-income households. They acquire this infection at a later age when they are exposed for the first time to contaminated food and drinks after being brought up in a relatively clean environment. This calls for the introduction of the Hepatitis A vaccine in Ethiopia; possibly as part of the Expanded Program on Immunization (EPI).METHODS: Socio-demographic and clinical data were collected from patients who were diagnosed to have hepatitis A infection at Adera Medical Center in 2020.RESULTS: This study showed that clinical acute hepatitis A is becoming common among children, adolescents, and young adults from relatively high-income families. Among patients with acute hepatitis, 89% were from middle and high-income families.CONCLUSIONS: There is a need for the incorporation of hepatitis A vaccine in the Ethiopian EPI program.
Electrocardiographic Changes and Serum Troponin Levels in Patients with Acute Stroke: A Prospective Cross-Sectional Study
Authors: Etedal Ahmed A. Ibrahim  , Salma Mohmed Taha  , Khabab Abbasher Hussien Mohamed Ahmed  , Mazin S. Haroun  , Mohammed Eltahier Abdalla Omer
Published: July 2024

BACKGROUND: Electrocardiographic changes and elevated serum troponin are frequent findings in acute stroke. They may reflect what is known as the neurogenic myocardial injury. The aim of this study is to determine the electrocardiographic changes and serum troponin level in acute stroke patients and to correlate these changes to the anatomical location and pathological type of the stroke.METHODS: A prospective cross-sectional study was conducted at the National Center of Neurological Science, from January to December 2019. Non-probability sampling with total coverage was considered. 50 patients with acute stroke were included in the study. Data were analyzed by using (SPSS) version 25. Standardized ECG was performed in the first hours of admission. 2 samples from each patient were obtained for serum troponin with at least 8 hours apart.RESULTS: All patients had wide variants of ECG changes. But tachycardia was the most frequent one identified in 54% of patients (n=50). Half of them were found to have an anterior circulation stroke. 14% of patients (n=50) have positive troponin; ECG changes are identified in all patients who represent positive troponin 100% (7 patients). Moreover, anterior circulation stroke was recognized in all patients with a positive troponin I marker.CONCLUSION: This study suggests that ECG abnormalities in patients with acute stroke are very common, especially tachycardia. The site of the lesion appears to play a major factor as a cause of the genesis of arrhythmia. Serum troponin elevation may play a role in diagnosing neurocardiogenic injury; nevertheless, ECG appears to be more sensitive and familial.
The Effect of Teff Seed on Hematological Findings and Anthropometric Measurements
Authors: Eftal Geçgil Demir  , Nadide Gizem Tarakçı  , Ruken Aslınur Samancı  , Merve Cambaz  , Şeymanur Bilici  , Dilara Tuygan  , Büşra Çalık  , Ayşe Sümeyye Çiftçi
Published: July 2024

BACKGROUND: The low incidence of diseases such as celiac, anemia, osteoporosis, and obesity in Ethiopia has aroused interest in the study of teff. The primary objective of this study was to determine the effect of regular consumption of teff seeds on hematological findings and anthropometric measurements in overweight and obese individuals. The secondary objective was to compare these effects of teff seeds with the Mediterranean diet.METHODS: In our study, planned as a cohort study, 28 participants followed the teff seed-containing diet (n=14) and the Mediterranean diet (n=14) for 3 months. To determine nutritional status, a 72-h recall was taken. Anthropometric measurements and hematological findings were recorded at the beginning and end of the study.RESULTS: There was a significant decrease in fasting blood glucose, cholesterol, LDL, and HDL levels in the teff group (p<0.05). The increase in total protein levels in the teff group was significantly higher than in the Mediterranean diet group (p=0.05). With increased intake of carbohydrates (g) in the teff group, fasting blood glucose levels decreased significantly. There was no significant difference between the two groups regarding anthropometric measurements.CONCLUSION: It has been found that the teff seed has no predominance over anthropometric measurements, as compared to the Mediterranean diet, and that it is more effective in improving hematological findings related to obesity. There is a need for more comprehensive studies that also address physical activity, the different types of teff seeds available, and include increased participant numbers.
Imaging Findings of Concomitant Pulmonary and Central Nervous System Sarcoidosis: A Case Report
Authors: Tewodros Endale Balcha  , Abebe Mekonnen Woldeyohannes  , Azmera Gissila Aboye
Published: July 2024

BACKGROUND: Sarcoidosis is a multisystem idiopathic granulomatous disorder characterized by the development of noncaseating infiltrative granulomas in various body organs. The central nervous system (CNS) is one of the sites to be affected by sarcoidosis. We present a case of sarcoidosis with concomitant involvement of lung and CNS with emphasis on neuroimaging findings.CASE: A 45-year-old Ethiopian male patient was sent to our radiology department at Tikur Anbessa Specialized Hospital for chest computed tomography (CT) and brain Magnetic resonance imaging (MRI) evaluation for an indication of panhypopituitarism, nasal congestion, and decreased vision. The chest CT reveals the perilymphatic distribution of multiple soft tissue attenuating pulmonary nodules which is a pattern seen in sarcoidosis. The brain MRI also revealed thickening and gadolinium enhancement of hypothalamus/optic chiasm which is also a common site of involvement in neurosarcoidosis. The nasal biopsy finding of granulomatous inflammation with the above imaging findings supports the diagnosis of sarcoidosis.CONCLUSION: As sarcoidosis is a systemic disease that can affect any organ in the body, multimodality imaging is important in the diagnosis of sarcoidosis. Brain MRI with gadolinium contrast is a preferred imaging modality that can assess different patterns and areas of CNS involvement in sarcoidosis.
Factors Associated with the Extent of Coronary Artery Disease and the Attained Outcome of Percutaneous Coronary Intervention at Gesund Cardiac and Medical Center, Addis Ababa, Ethiopia
Authors: Bekele Alemayehu Shashu  , Ararso Baru
Published: July 2024

BACKGROUND: In Ethiopia, objective evidences showing pathologic features and clinical characteristics predicting the extent of coronary artery disease are scanty. The present study is aimed at assessing factors associated with the extent of coronary artery disease and the attained outcomes in patients undergoing percutaneous coronary intervention.METHODS: A retrospective observational study of 197 patients that have undergone percutaneous coronary intervention was undertaken. Data were entered using Epi data version 4.2 and exported to Statistical Package for Social Science version 25 for analysis. Descriptive statistics such as frequencies and percentages were used to summarize the findings. Logistic regression was carried out to test the association between dependent and independent variables.RESULTS: The mean age of the study participants was 58.6 with standard deviation (SD) of 11.5 and male to female ratio of 4.2. The majority, [110 (55.8%)], had ST segment elevation myocardial infarction. Nearly two-third of the study participants had documented heart failure. Dyslipidemia [AOR 4.2(95%; CI:1.29-14.00)] and left ventricular hypertrophy [AOR 4.1(95%; CI:1.38-12.40)] were associated with extent of coronary artery disease on adjusted analysis. In the large majority, 169 patients (85.8%), thrombolysis in myocardial infarction 3 flow grade was achieved.Conclusion: Dyslipidemia and left ventricular hypertrophy predicted multi-vessel coronary artery disease. There is a high frequency of post myocardial infarction heart failure, underscoring the need for centers of excellence and implementation of health education programs targeting the importance of primary prevention and timely revascularization. The success rate of percutasneous coronary intervention at Gesund Cardiac and Medical Center is praiseworthy.
Comparison of Topical Oxygen with Vacuum Assisted Closure in Wound Healing in a Low Resource Setting
Authors: Ansari Tariq Akhtar , Barik Sitanshu , Meena Pradeep , Arora Shobha
Published: July 2024

Background: The aim of this pilot study is to obtain preliminary results comparing topical oxygen therapy (TOT) and vacuum assisted closure (VAC)  in terms of its ability to accelerate wound healing.Methods: This non-randomised prospective study included patients with age 16-50 years, wound size ≥ 16cm2 and present below knee joint within  seven days of occurrence. Bates-Jensen wound assessment tool (BWAT) was used for evaluation at 8-day interval along with percent area reduction  at final follow up.Results: Mean number of cycles required in VAC and TOT group were 1.97 (range 1-3) and 2.1 (range 1-3) (each cycle of 5 days) per patient  respectively. Percent area reduction was significantly higher in the VAC group (34±9.7%) than TOT (11.3±3.8%) group at final follow up (p<0.05). TOT  patients had better improvement in epithelialization compared to VAC at last follow up. More extensive debridement was needed in patients of TOT  than VAC. There was no significant difference between final score in both groups.Conclusion: TOT appears to be comparable to well-established VAC in treatment of fresh traumatic wounds below the knee joint.  Further large scale,  multicentric and randomised studies comparing both these modalities of treatment should be the way forward.
Barriers and Challenges to Self-Care among Older Adults with Knee Osteoarthritis: A Qualitative Study
Authors: Kooranian Faranak , ParsaYekta Zohreh , Rassouli Maryam
Published: July 2024

Background: Knee osteoarthritis (KOA) is a chronic disease causing disability in older adults. Self-care is an effective strategy for KOA management  in older adults and clinicians have shown increased interest regarding the challenges of self-care activities in these patients.The present study aimed  to explore the perception of older adults' patients with KOA regarding barriers and challenges faced in their self-care management.   
Methods: In this qualitative study, data were collected using purposeful sampling and in-depth semi-structured interviews with 22 older adults with  KOA, their first-degree caregivers, and medical team members in Mashhad, northeast Iran, from April to December 2020. All the interviews were  transcribed verbatim. Interviews continued until reaching data saturation. All interviews were recorded. Data analysis was done using conventional  content analysis according to the technique described by Graneheim and Lundman. The MAXQDA (Version 10) was used to organize, code, and  manage the data.
Findings: Three main themes (confusion, confrontation with increasing stresses, and social rupture) were emerged as the barriers and challenges  to self-care among older adults with KOA.
Conclusion: The results of this study provide a broad range of context-specific of barriers and challenges to selfcare among older adults with KOA,  which can be used for designing and implementing appropriate interventions to improve self-care in these patients.
Trends and Challenges in Access to Essential Medicines in Ethiopia and the Contributions of Local Pharmaceutical Production
Authors: Marew Tesfa , Richmond Frances J. , Belete Anteneh , Gebre-Mariam Tsige
Published: July 2024

Decades ago, the United Nations declared that access to essential medicines was a key element of universal human rights. Accordingly, member  states have been striving to address this issue through strategic policies and programs. Strengthening local pharmaceutical production has been a  pivotal strategy adopted by many developing countries including Ethiopia. The government of Ethiopia identified local pharmaceutical production  as a key industrial sector and has been implementing a ten-years strategic plan to improve capabilities and attract investment. Such support is  needed because local production could satisfy only 15 to 20% of the national demand, typically from a limited portfolio of medicines in conventional  dosage forms.The increasing prevalence of chronic diseases has accentuated the need for a more sustainable supply to reduce reliance on imports  and increase access to essential medicines. A full understanding of the structure, constraints and complexities of the Ethiopian pharmaceutical  market structure is vital to direct effective policies, target most impactful investments and exploit opportunities for leapfrogging. Hence, the  purpose of this review was to assess the trends and challenges in access to essential medicines and local pharmaceutical production in Ethiopia.  Literature search through major databases and review of policy documents and performance reports from relevant sector institutions were made to  extract information for the review.
Knowledge and Practice about Glasgow Coma Scale Assessment among Nurses Working in Adult Intensive Care Units of Federal Public Hospitals in Addis Ababa, Ethiopia: A Cross-Sectional Study
Authors: Andualem Habtamu , Beyene Temesgen , Tuli Wagari
Published: July 2024

Background: The Glasgow Coma Scale is a dependable and objective neurological assessment instrument used for determining and recording a  patient's level of consciousness. Therefore, the knowledge, practice, and factors affecting Glasgow coma scale evaluation among nurses working in  adult intensive care units of federally administered hospitals in Addis Ababa, Ethiopia, were investigated.
Methods:From April 4 to 24, 2020, 121 Adult Intensive Care Unit nurses at Ethiopian federal hospitals participated in an institutional-based cross-  sectional survey with a standardized selfadministered questionnaire. The information was entered into Epidata version 3.1 and then exported to  SPSS version 25.0 for analysis. Bivariable and multivariable logistic regressions were used to examine the relationships between independent and dependent variables.
Result: According to this study, nurses working in the Adult Intensive Care Unit of federal hospitals in Addis Ababa, Ethiopia, had poor knowledge  (51.2%) and poor practice (62%) of the Glasgow Coma Scale's basic theoretical notions and competencies. Furthermore, the education and gender of  nurses were linked to their level of knowledge and clinical practice. Being a male and having a master's degree were both significantly linked  with knowledge(AOR = 4.13, 95% CI: (1.87–9.1)), (AOR=7.4, 95% CI: (1.4-38)) and practice (AOR = 2.7, 95% CI: (1.2–6)), (AOR = 10.4, 95% CI: (2.0–53))  respectively.
Conclusion: The findings from this study showed that nurses had poor knowledge and application of practice-related clinical scenarios on the  Glasgow Coma Scale.