Background: Diabetes mellitus comprises a group of metabolic disorders that share the common feature of hyperglycemia. One-third of the global population of individuals with diabetes is estimated to have diabetic retinopathy.

Method: This institution based cross sectional study  was conducted at Menilik II Hospital from March 2022 to September 2022 GC. A complete eye exam was performed to reach a diagnosis by a retina specialist using a slit lamp microscope coupled with a 90D lens. Data were entered and analyzed using the Statistical Package for Social Science.

Results: In this study, a total of 222 diabetic patients were enrolled. There were 116 males (52.3%). Diabetic retinopathy was mild in 28 (12.6%), moderate in 58 (26.1%), severe in 23 (10.4%) and proliferative in 60 (27%) patients. Moderate and severe visual impairment was observed in 26 (15.1%) patients; 24 (14.2%) had mild visual impairment, and 53 (31.4%) patients were blind. Among the 163 diabetic retinopathy patients who had fasting blood sugar tests, 109 (66.9%) had poor glycemic control. Among the 56 diabetic retinopathy patients who had Hb A1c measurements, 89.5% had poor glycemic control.

Conclusion: Visual-threatening diabetic retinopathy is more common in patients with poorly controlled diabetes and requires multi-sectoral collaboration to decrease visual loss

Keywords: Diabetic retinopathy, Diabetic macular edema

Citation : Feleke F, Negussie D, Pattern of Diabetic Retinopathy in a Referral Hospital in Resource Limited setting; Institution Based Cross-sectional Study Ethiop Med  J 62 (3)  163-171

Submission date : 21 April 2024    Accepted: 7 June 2024  Published: 1 July 2024

Background: Prevalence and types of secondary glaucoma varies between countries. This study aims to determine the current clinical profile, proportion, and causes of various types of secondary glaucoma in newly diagnosed glaucoma patients at Menelik II Specialized Hospital.

Methods: This hospital-based cross-sectional descriptive study was conducted at a glaucoma clinic between May 1 and July 31, 2022. All newly diagnosed secondary glaucoma patients aged 18 years and above were included. A structured questionnaire comprising socio-demographic data, history, visual acuity, intraocular pressure, slit-lamp, gonioscopy, fundus examination findings, and finally, the diagnosis was used. Data management and analysis were done using SPSS version 26.

Results: Four hundred forty-nine newly diagnosed glaucoma patients visited the clinic during the study period. One hundred seventy-three (38.53%) patients were diagnosed to have secondary glaucoma. The leading causes of secondary glaucoma were found to be Pseudoexfoliative glaucoma (75.5%), followed by neovascular glaucoma (7%), uveitic glaucoma (6.7%), lens-induced glaucoma (5%), and miscellaneous causes (5.7%). Secondary glaucoma was a significant cause of visual morbidity, with 57.04% of eyes presenting with best corrected visual acuity of < 6/60, intraocular pressure > 30 mmHg in 45.3% of eyes, and 61.74% with a cup-to-disc ratio of ≥0.7.

Conclusion: The leading causes of secondary glaucoma were found to be Pseudoexfoliative glaucoma (75.5%), followed by neovascular glaucoma (7%), uveitic glaucoma (6.7%), lens-induced glaucoma (5%), and miscellaneous causes (5.7%). Secondary glaucoma is a significant cause of visual morbidity. Timely diagnosis and early and appropriate management are essential to prevent irreversible visual loss.

Keywords: Blindness, Clinical profile, Glaucoma, Neovascular glaucoma, Pseudoexfoliative glaucoma

Citation : Alemu AM, Gebrekidan GT Profile of Secondary Glaucoma in a Resource-Limited Setup: Institution-Based Cross-Sectional Study Ethiop Med  J 62 (3)  173 - 179

Submission date :  April 28, 2024   Accepted: June 25, 2024    Published: 01 July 2024

Abstract

Background: Frozen section is an intraoperative rapid diagnostic tool that could direct a patient's intra- or post-operative therapy. Given the importance of frozen section in the management of surgical patients and the lack of published research in Ethiopia, it is prudent to evaluate its efficacy in our setting.

Methods: A prospective diagnostic accuracy study was done on 39 samples from June 2022 to December 2022. Cases were selected based on suspicion of a neoplasm and where there was an indication to perform frozen section. Data analysis was conducted using SPSS version 23. Findings were demonstrated using text, charts and diagrams.

Results: The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of frozen section as opposed to histopathological diagnosis using paraffin-embedded samples was found to be 92.3%, 88% and 95.2%, 94.1%, 90.9%, respectively. The mean turnaround time for frozen section was found to be 23 minutes.

Conclusion: The accuracy, ability to detect true positive cases, and ability to exclude false-positive     cases of frozen section diagnosis in this research are consistent with most worldwide quality assurance data for frozen section. Despite its constraints, frozen section is a highly dependable method when carried out by experienced personnel, in the study context.

Keywords: Frozen section, Intra-operative Consultation, Accuracy, Sensitivity, Specificity, Ethiopia

Citation: Debebe M, Ergete W, Shiferaw B et al Practicality of Frozen Section at Tikur Anbessa Specialized Hospital: A Pilot Study Ethiop Med  J 62 (3)  181-188

Submission date : 23 February 2023    Accepted: 03 June 2023  Published: 01 July 2024

Background: A good number of patients with viral hepatitis are asymptomatic and detected as incidental findings. Early detection of the hemodynamic changes as well as prompt treatment is paramount to prevent the development of complications such as portal hypertension, liver cirrhosis and hepatocellular carcinoma. The congestive index (CI) of the portal vein has a high sensitivity and specificity in the diagnosis of hepatic fibrosis and portal hypertension and it is therefore imperative to assess these categories of patients using this index. The objective of this study is to compare the portal vein CI of patients with asymptomatic hepatitis B viral infection and normal individuals"

Methods and Patients : This is an institution-based case-control study comprising 112 cases with serological diagnosis of hepatitis B viral infection and 112 age and sex-matched controls that were seronegative for hepatitis B and C viral infection and had normal LFT parameters. The CI of the participants were obtained using duplex Doppler ultrasound, and the data obtained were analyzed using statistical package for social sciences (IBM SPSS version 23.0. Armonk, NY).

Result: 224 participants made of 112 cases and 112 age and sex-matched controls were evaluated. The age of the participants ranged from 18-63 years. 113 (50.4%) of the participants were males, while 111 (49.6%) were females. The mean value of the portal vein CI was 0.04±0.003cmS among controls and 0.06±0.01cmS among cases; however, the difference was not statistically significant (p 0.192). CI was noted to increase with age and was higher among the male gender, but the difference was also not significant statistically. Also, LFT parameters among the participants was higher in cases than the control and most were statistically significant except for ALP and AST.

Conclusion: The CI of the portal vein and LFT parameters were higher in cases than control and and it may therefore be a useful tool in the assessment of patients with hepatitis, particularly in symptomatic cases.

Background: : Catha edulis of the plant family Celastraceae is a mild stimulant plant known as Khat in Ethiopia. In Ethiopia, the history of Khat dates back to the 13th century, and communities produce and/or consume Khat leaves for social, religious, cultural and economic purposes. This study aimed to assess the association between Khat production and consumption on food security and dietary diversity among rural households in Ethiopia.

Method: A panel survey using quantitative methods was conducted in two regions of Ethiopia. Using an open Data Kit (ODK) a panel survey was conducted and analyzed applying a multivariable linear regression model.

Result: The likelihood of food insecurity was twice as high among non-Khat consumers and Khat producers compared to households who neither produce nor consume Khat, (AOR: 2.17 [95%CI: 1.25, 3.76], p<0.1. On average, households that produced and consumed Khat were 1.5 times more likely to have high dietary diversity (AOR: 1.51 [95%CI: 1.09, 2.08], p<0.01).

Conclusion: Although Khat is an important source of income for farmers throughout the year, our findings highlighted that Khat production and non-consumption were negatively associated with food security. The possible pathways of this association could be through the household subsistence farming and cash crop (Khat) interaction. Food security interventions should consider Khat production and consumption practices among households in Khat-producing and consuming areas of Ethiopia.

Keywords: Khat chewing; food security; Dietary diversity; QTR + EPI-2.

Citation : Wondafrash B, Grown, chewed and omnipresent, Catha edulis plant in Ethiopia, Its Livelihood Implica tion on Rural Households. Community Based Cohort Nutrition Study. Ethiop Med  J 62 (3) 197-204

Submission date : 14 November 2023   Accepted: 25 June 2024  Published: 30 June 2024

Background: Metabolic syndrome (MetS) is characterized by a cluster of cardiovascular risk factors and has an impact on the prevalence of chronic kidney diseases (CKD). We aimed to investigate the association between CKD and peripheral arterial diseases (PAD) in MetS patients.

Patients and Methods: This retrospective record review was performed among patients with and without MetS over seven months. MetS was defined according to NCEP ATPIII criteria, PAD was diagnosed by an ankle-brachial index (ABI) <0.9 and confirmed by angiography. Subjects were categorized on the basis of estimated Glomerular filtration rate (eGFR). The ANOVA test was applied to compare the three classes of eGFR. Boxplots were used to compare kidney biological parameters between males and females, MetS abnormalities and association of PAD with CKD.

Results:  From 342 patients, 56.40% were females, 77.8% with MetS, and 17.3% with PAD, 79.9% diabetics, 50.9% hypertensives, and 37.1% with dyslipidemia. The mean age was 61.56±17.30 years. Significant differences (p<0.05) were highlighted for age, anthropometric characteristics, diabetes, dyslipidemia, hypertension, PAD, family history and biochemical parameters. High levels of uric acid, albuminemia, micro-albuminuria and caliciumia in MetS patients were observed in both genders. These parameters increased with number of MetS components. CRP levels and lipid profile were significantly higher (p<0.05) in CKD patients. The prevalence of PAD in patients without CKD was 10.16% vs. 47.45 % in subjects with CKD.

Conclusion: The coexistence of CKD and PAD was associated with MetS abnormalities and an inflammatory state, suggesting that the control of metabolic disorders may form part of the preventive measures for PAD and CKD.

Keywords: CKD, Peripheral arterial disease, Metabolic syndrome, eGFR, Ankle-brachial index.

Citation: Bouragba I, Diaf M, The Relationship Between Kidney Function and Peripheral Artery Diseases in Patients with Metabolic Syndrome In a Resource Limited Setup: A Retrospective Record Review Ethiop Med  J 62 (3)205-215 

Submission date : February 22, 2023  Accepted: June 12, 2023  Published: 01 July 2024

Background: The mortality due to COVID-19 in low-income settings has been grossly underestimated. The gap in the estimated deaths as the cause of COVID-19 and observed deaths in Africa requires further investigation. Hence, we aimed to assess the socio-demographic characteristics, clinical and laboratory profiles of patients who died from COVID-19 at the treatment centers in the Oromia region, Ethiopia. 

Method: A retrospective chart review was conducted from all health facilities that reported more than ten COVID-19 deaths from April 2020 to November 2021 in Oromia. CSPro Data Entry and STATA version 14 were used for data entry and analysis, respectively.

Result: Of the 594 COVID-19 deaths reported during the study period, 454 (76.4%) were captured in nine health facilities. Of the 454 participants, 288 (63.4%) were men and 192 (42.3%) were over 60 years. Cough and shortness of breath were the most prevalent symptoms. Cough and shortness of breath were the most prevalent symptoms. Upon presentation, 394 (97.28%) exhibited tachypnea, 78 (27.56%) had a fever, and 366 (84.92%) had oxygen saturation levels below 92%. At least one comorbidity was present in 60% of the individuals. The median length of stay in the facility before death was five days (IQR 2–8). Common laboratory tests include complete blood counts, renal function and liver function tests. In 35(15%) of cases, the estimated glomerular filtration rate was <30 ml/min/1.73 m2. Neutrophilia was in 83.9% of cases, lymphocytosis in 2.6% and elevated creatinine in 35%. Chest X-ray was the frequently used imaging modality with opacity was the most common finding. Antibiotics and steroids were administered primarily.

Conclusion: Most of the cases had comorbidity and were older aged. However, a quarter of patients were less than 45 years and two-fifths of patients had no known comorbidity. Strengthening vaccine acceptance across all age groups has paramount importance in preventing the severity of disease and death.