Introduction: Worse mental health outcomes appear to be related to COVID-19, as the virus is perceived to be severe. Pakistan, being a developing country; is badly affected due to limited resources, low literacy rate, spread misinformation related to COVID-19, and immense burden on health care. 

Aim: Our study aimed to analyze the fear and anxiety among Pakistan’s medical doctors and dental surgeons and also highlight the factors.

Methodology: This cross-sectional study included 493 participants. Ethical approval and consent were taken.  Data collected by circulating the validated online questionnaire and analyzed using SPSS 21 and results were expressed as frequency and percentages. Independent T-test was applied to check the fear and anxiety among medical doctors and dental surgeons

Results: The study included 270 dental surgeons and 223 medical doctors. Results demonstrated severe anxiety among both groups of participants with dental surgeons (56.3%) demonstrating greater anxiety and compared to medical doctors (43.6%). The factors contributing to anxiety include lack of health facilities in the country, the impact of the disease on the economy of the country, disease transmission to family, and thought of when the disease would be eradicated. Gender appeared to have a significant association with anxiety and fear scores (p< 0.05).

Conclusion: The study demonstrated severe fear and anxiety among Pakistan’s dental surgeons and medical doctors with no significant difference in anxiety and fear scores between the two groups of health care professionals. This concludes an equal level of anxiety among dental surgeons and medical doctors during the current pandemic.

Introduction/Aim:

Predicting the size of the parathyroid adenoma may be useful for the surgeon, hence the interest of finding a correlation between the biochemical parameters and the dimensions of the parathyroid adenoma.

Materials and methods:

A retrospective study was conducted over a 6-year period (2012-2017) on patients operated on for parathyroid adenoma and who had a biochemical assessment. The volume of the adenoma was estimated using its measured dimensions and a mathematical formula.

Results:

35 patients including 30 women and 5 men were operated for parathyroid adenoma. The mean age was 54 years. A correlation between the volume of the parathyroid adenoma and the values ??of preoperative PTH, calcium and phosphorus as well as the postoperative PTH were found. However, there was no correlation with intraoperative PTH or postoperative calcium

Conclusion:

Biochemical parameters can predict the size of a parathyroid adenoma.

Background: Studies from different settings demonstrated suboptimal proficiency in cardiac auscultation skills.

Objective: The purpose of this study was to assess proficiency in cardiac auscultation skills among a sample of pediatric residents in Addis Ababa University.

Methods: Five pediatric cardiac conditions namely, ventricular septal defect, atrial septal defect, patent ductus arteriosus, pulmonary valve stenosis and aortic valve regurgitation were selected and programmed on mannequins. After obtaining consent, residents auscultated the mannequins and wrote down their findings.   

Results: Twenty-nine residents participated in the study. Out of those, 17 (58.6%) were in their 1^st year of training, seven (24.1%) were in their 2^nd year of training and five (17.3%) in their 3^rd year. The mean percentage score for all residents in all the cardiac lesions was 31 ± 13% (range, 21 – 71%).  VSD was the most accurately identified lesion, with a mean score of 70 ± 24% (range, 0 – 100%). Aortic regurgitation was the least accurately identified lesion, with a mean score of 21 ± 20% (range, 0 – 67%). Year 3 residents significantly outperformed year I residents in accurately identifying findings of ASD (p= .006). The overall mean rank scores for all cardiac lesions combined; by year of residency were 13.24, 12.21, and 24.90, for year I, II, and III residents, respectively. Year III residents had significantly better overall mean rank scores.

Conclusion: Auscultation skills among pediatric residents were suboptimal. Therefore, those skills need to be reinforced and continuously evaluated in our pediatric residency training programs.

Abstract

Background: Mechanical Large Bowel Obstruction (MLBO) has been contributed significant burden of emergency admission.

Objective: To determine the magnitude of mechanical large bowel obstruction and outcome predictors for morbidity and mortality in Debre Tabor General Hospital Northcentral Ethiopia, 2020

Methods: Hospital-based cross-sectional study employed in Debre Tabor general hospital Northcentral Ethiopia. A medical review conducted on the medical chart from Jan1, 2016 to Dec31, 2019. The reviewed data checked manually for completeness, consistency, coded and entered to SPSS version 23 for data processing and analysis.  Binary logistic regression used to measure the association of each covariate with the outcome variable. In addition, factors that have an association with the outcome variables were taken into multivariable logistic regression analysis to control the potential confounders. The result of the final model expressed in terms of adjusted Odd Ratios (AOR) and 95% CI and statistical significance declared if the P-value is less than 0.05. 

Results: Mechanical Large bowel Obstruction (MLBO) was accounted 33.1 %( 135) of bowel obstruction. Majority of MLBO were males (N=129, 95.6%).The mean and median age were 56.56(SD=±14.58) and 58(IQR±18) respectively. Over all mean of hospital stay was 8.65 (SD±4.8) days and the media was 8(IQR±5) days. The leading etiologies of mechanical large bowel obstruction were sigmoid volvulus (N=124, 91.9%) and colorectal cancer (N=7, 5.2%). Overall complication rate was 21.5 %( N=29) and mortality rate was 8.9 %( N=12

Conclusion: Sigmoid volvulus was the most common cause of mechanical large bowel obstruction.

Aim: This study aimed at modeling a reliable and valid framework for building and measuring the health system workforce’s competence to lead, manage and govern.

Methods: A cross-sectional survey was conducted in three zones of Amhara regional state, Ethiopia. Eight-hundred-thirteen participants were recruited from 32 health facilities. The data were collected using a structured self-rated questionnaire. Data analysis techniques such as factor analysis, composite reliability and average variance extraction were applied. Factor analysis was unlocked to assemble the relationship among latent factors extracted, items rated and error variances observed. Latent factors were extracted using Eigenvalue greater than 1 as a cut of point. Latent factors were labeled considering the contents of the items clustered within them. Latent factors labeled, items rated and error variances observed were assembled to develop competence building and measuring framework. Its reliability and validity were tested using composite reliability and average variance extraction respectively.

Results: A four-factor framework for building and measuring the health system workforce’s competence to lead, manage and govern was resulted. The factors extracted were labeled as compliance with principles, strategic sensitivity, system building, and contextual thoughtfulness. These explained 68.434% of the total variability. Composite reliability and average variance extraction for all factors were .807 and greater, and .512 and greater, respectively.

Conclusions: Compliance with principles, strategic sensitivity, system building, and contextual thoughtfulness are dimensions that affect competence to lead, manage and govern, which, in turn, influence the health system performance and health outcomes. This model has implications for training, evaluation, and research.

Aims/Purpose: The management of breast carcinoma in Nigeria still poses a big challenge as a large proportion of the patients present at an advanced stage. This study aims to determine the pattern of post-treatment metastasis in a tertiary hospital in Nigeria

Methods: A five-year retrospective review of records of breast cancer patients seen between January 2013 and December 2017 was conducted. Relevant information was extracted and analyzed using statistical package for social science software 21.

Results: A total of 292 patients with carcinoma of the breast were seen at the University of Benin Teaching Hospital. Of these, 113(38.7%) developed metastases post-treatment with taxane-based therapy within 2 years of follow-up. Most of the patients were aged 30-59years (77.4%). Majority had moderately differentiated carcinoma (62.8%). The pattern of metastases was commonly to the loco-regional sites (39.5%), bone (16.9%), lungs (10.6%), brain (6.3%) and liver (4.4%) while multiple sites were (15.0%) and of these, 51.3% developed the metastasis within 10 – 12months. Within a period of 2 years, 60.2% had stable disease.

Conclusion: Our study showed loco-regional site as the commonest metastatic sub-site in this region with bony metastasis being the commonest distant spread. These occur commonly within the first one year post-treatment. Careful evaluation of these sites during follow-up is advocated to ensure early detection and appropriate management. This study also showed a significant survival of patients at 2 years following taxane-based therapy. We therefore advocate that taxane-based therapy should be the main stay of patients with breast cancer. 

 Pneumonia is a major cause of morbiddity and mortaiity in low and middel income countries.The aim of this study  was to determin the magnitude of  community acquired pneumonia(CAP) among hospital treated  adult patients at Tikur Anbessa Specilized hospital (TASH)

Methods: This is a register based retrospective CAP study aimed to determine the magnitude of CAP treated at TASH over the last two years. Data was collected using a structured checklist. Data analysis was conducted by use of SPSS.

Result: A total of 104 Patients with clinically suspected and radiologically confirmed patients with CAP were included in the analysis. 55 (54%) were males. All of the patients had at least one co morbidity with CAP.  CAP makes 1.19 % (104/8673) of all patients managed as in patient.  Indication for admission by CURB-65 criteria was only 28% (29/104). On average patients were on IV antibiotics for 8 days with average LOS of 10.8 days before discharge.16 % were started on anti-TB. Most of them 97% (101/104) managed in the general wards and none of them were bacteremic. Sputum culture was done for only 8 %. 86 % (89/104) survived to discharge and 14 % (15/104) died in the hospital. 10.5% readmitted within 30 days.

Conclusion:This study demonstrated that only few of inpatient managed cases were due to CAP. The main indication for admission was presence of comorbidity. This is a baseline study that could be used for further prospective study to characterize all aspects of CAP in TASH.

Abstract

Introduction

Asthma is a major public health problem globally affecting 339 million people with 300,000 deaths annually. African Severe Asthma Program (ASAP) was a multi-country prospective cohort study designed to characterize severe asthma in three African countries Ethiopia, Uganda and Kenya.  In this study, we describe the baseline characteristics and disease severity among asthmatics enrolled in the Ethiopia site.

Methods

Analysis of baseline ASAP data of asthmatics from Tikur Anbessa Specialized Hospital (TASH), who visited the facility from August 2016 to May 2018, were included.  Asthma was diagnosed based on symptoms and spirometry. Baseline demographic and clinical data were collected using a structured questionnaire. Standardized research tools were used to assess asthma severity, asthma control and asthma quality of life. 

Results

A total of 419 asthmatic patients were enrolled in the study; the mean age for the group was 52 ± 8 years and 58.2 % were female. The majority of participants, 365 (87.2%), had a prior diagnosis of asthma with a median (IQR) age at first diagnosis of 29 (IQR: 22 - 36) years. A family history of asthma was present in 149 (35.6%) subjects. Current or previous cigarette smoking was reported in 8.6% of participants. Overall, 93.8% of the participants reported uncontrolled asthma symptoms (ACQ >1.5). More than half of the patients, had severe persistent asthma and 35% presented with one or more comorbidities.

Conclusions

In Ethiopia, asthmatics can be characterized as predominantly female with late onset disease, with poor control  and associated comorbidity.