Ethiopian Journal of Medical and Health Sciences

Gossypiboma, Mimicking a Mesenteric Tumour: A Case Report

2024-11-01T13:08:44+03:00

Gossypiboma refers to a retained surgical textile in body tissue and cavity after an operation. It is an
infrequent and potentially preventable post-operative complication due to medical error. The presence of
retained surgical material within the body tissue can incite an aseptic but fibroblastic reaction resulting in
the formation of a chronic granuloma, which may present in the form of a pseudo-tumour several months
to years after the surgical procedure.
We report the case of a 42-year-old woman who presented with a painless intra-abdominal mass one year
after undergoing myomectomy for symptomatic uterine fibroid in a private hospital. A presumptive
diagnosis of the mesenteric tumour was made on the basis of pre- and intra-operative findings. However,
the histopathological diagnosis confirmed a gossypiboma.
This case highlights the need to consider gossypiboma as a differential diagnosis in post-operative
patients presenting with intra-abdominal mass. The highly variable characteristics of this condition both
clinically and radiologically warrant a high index of suspicion, early recognition, and prompt surgical
intervention to reduce the morbidity and mortality associated with it.

Knowledge, Attitude, and Practice of Infection Prevention among Healthcare Providers at Hawassa University Comprehensive Specialized Hospital (HUCSH), Sidama Region

2025-02-05T17:58:28+03:00

Background: Healthcare-associated infections (HAIs) remain a critical global challenge, significantly
increasing patient morbidity and mortality. Healthcare providers' knowledge, attitudes, and practices
(KAP) toward infection prevention (IP) are pivotal in combating these infections. Despite its importance,
data on KAP among healthcare providers in Ethiopia are scarce. This study aimed to evaluate the KAP of
healthcare providers and examine associated factors at Hawassa University Comprehensive Specialized
Hospital.

Methods: A cross-sectional study was conducted from December 1 to December 15, 2024, involving
191 healthcare providers, yielding a 96.9% response rate. Data were collected using a structured
questionnaire, entered into EpiData, and analyzed in STATA. Multivariable logistic regression was
performed to identify factors influencing KAP, with findings reported as adjusted odds ratios (AOR) and
95% confidence intervals. Statistical significance was set at p < 0.05.
Results: Among participants, 72.8% demonstrated good IP knowledge [AOR = 18.21, 95% CI (2.54-
62.4)], with IP manuals at the workplace significantly enhancing knowledge AOR = 4.22, 95% CI (2.48-
9.68)]. Favourable attitudes toward IP were reported by 66.5%, influenced by sufficient PPE availability
[AOR = 3.12, 95% CI (1.65, 5.82)] and recent IP training [AOR = 1.89, 95% CI (1.12-3.95)]. Good IP
practices were observed in 60.8%, strongly associated with good knowledge [AOR = 3.50, 95% CI
(1.70-7.23)] and adequate PPE [AOR = 2.64, 95% CI (1.40-4.80)].

Conclusion: The findings highlight suboptimal IP KAP among healthcare providers, despite significant
associations with knowledge, training, and resources. Enhancing KAP requires addressing gaps in PPE
supply, IP manuals, and training programs. Institutional and policy-level interventions are imperative to
foster effective infection control practices.

Trends in Impacted Teeth among Patients at the Dental Center of Addis Ababa University, Ethiopia

2025-01-01T08:34:21+03:00

Background: An impacted tooth is a tooth that fails to erupt to the normal anatomic level in the oral
cavity within the expected time. There are local as well as systemic causes of teeth impaction. Impacted
teeth have the possibility of impinging nearby vital structures as well as predisposing patients to pain and
discomfort. Impaction of teeth can be partial or complete, soft tissue or bony. This study aimed to
determine patterns of impacted teeth among patients presented to the Dental and Maxillofacial Surgery
department of Addis Ababa University.

Methods: A cross-sectional descriptive study with retrospective data collection was done from
January 2019 to December 2021.

Results: A total of 184 patients (Female n=112, Male n=72) were included in the study. The mean age
was 26.5 and the age range was 10-84 years. The study result revealed that the occurrence of teeth
impaction was more common in females (60.86%) than males (39.4%). The mandibular third molar was
the most commonly impacted tooth, comprising 152(82.61%) of all impacted teeth. Among the third
molar impaction, 77 (50.65%) of the third molar impaction was mesioangular in position. The left
mandibular third molar was the most impacted tooth in both males and females 78(42.39%). Among the
patients with impacted canine in the majority (52.63%) of cases it was placed palatally. About 75% of
patients with impacted third molar presented with caries lesions, toothache, and discomfort as primary
indications for removal. Disimpaction by raising a flap was the mainstay of treatment and was done for
90% of the patients.

Conclusion: The most common type of impaction observed was third molar impaction, accounting for
82.61% of cases followed by maxillary canine impaction. Many patients sought treatments only after
experiencing signs and symptoms related to their impacted teeth. It is crucial to raise awareness about
early detection and management of impacted teeth to reduce the complexity of surgical procedures and
minimize potential complications.

The effect of combined oral contraceptive and hormonal implant on plasma glucose level and liver function in women: A cross-sectional study

2024-12-06T13:21:43+03:00

Background: Long-term use of combined oral contraceptives and implant contraceptives was associated
with some adverse metabolic effects, including effects on serum glucose, body weight, and liver
enzymes. However, recent epidemiological reports suggest a possible increased risk of diabetes and liver
disease among users. This study aims to assess the effect of hormonal implants and combined
oral contraceptives use on glucose metabolism and liver function among women who attend family
planning services.

Methods: An institution-based comparative cross-sectional study was conducted to assess the effect of
hormonal implant contraceptives and combined oral contraceptives on glucose metabolism and liver
function status among women of reproductive age from September 15- June 30, 2022. A total of 162
women (86 hormonal implant users, 26 combined oral contraceptive users, and 50 non-users) were
included in the study. A one-way analysis of variance was used to examine differences in outcomes.
Pearson correlation was used to identify the association between outcome variables and the duration of
implant use.

Results: The prevalence of diabetes among study participants in Leku General Hospital and Yirba
Primary Hospital of Sidama Region was 10.5% (95% CI: 6.2- 15.4%). The prevalence of diabetes was
11.6% (95% CI: 5.8-18.6), 11.5% (95% CI: 0-26.9), and 8% (95% CI: 2.0-16.0) among implant users,
combined oral contraceptives users and non-users, respectively. From Bonferroni's post-hoc analysis,
implant users had a significantly higher mean hip-to-waist ratio than non-users (p=0.024). Implant users
had significantly higher mean systolic blood pressure (p = 0.027) than combined oral contraceptive users.
Longer implant use was associated with lower ALT levels (p = 0.044 and r = -0.22).

Conclusion: Longer implant use was associated with lower ALT levels and higher waist-to-hip ratio

Dietary diversity and associated factors among HIV positive adults attending antiretroviral therapy clinics.

2025-03-07T06:37:32+03:00

Background: People Living with HIV are more likely to become malnourished due to reduced food intake, poor absorption of nutrients, and changes in the way the body uses nutrients it receives or has stored. Ethiopia is among the seriously affected countries in sub–Saharan Africa with more than 1.3 million people living with HIV. The aim of this study was to determine prevalence and associated factors of dietary diversity among adult HIV positives attending antiretroviral therapy clinics in Hawassa comprehensive specialized Hospital and Yirgalem General Hospital, Southern Ethiopia.

Method: An institutional based cross-sectional study was conducted from May 2022 to June, 2022. A total of 345 HIV patients attending ART clinic in Hawassa University comprehensive Specialize Hospital and Yirgalem General Hospital. Data were collected by six trained nurses using pre tested structured questionnaires and from patients’ medical record. Data entered and analyzed by SPSS version 20. Multi-variable logistic regression was used to determine factors associated with self-dietary diversity and significance declared at p-value ≤ 0.05.

Results: The mean age of the study participants was 39.5 (±9.02) years and most of them were female (61%). The prevalence of low dietary diversity was found to be 46.7%. Dietary diversity was statistically significantly associated with high income level [AOR = 0.48, 95% CI: (0.28, 0.83)], BMI [AOR = 0.19, 95% CI: (0.07, 0.55)] and nutritional counseling service [AOR = 7.89, 95% CI: (4.41, 14.15)].

Conclusion and recommendation: The findings indicate that adult HIV patients experience low dietary diversity. Factors such as income level, body mass index, and access to nutritional counseling significantly influence dietary diversity. It is imperative for the government and relevant stakeholders to enhance income-generating opportunities. Additionally, healthcare professionals at antiretroviral therapy clinics should intensify their nutritional counseling efforts to support improved dietary practices among adult HIV patients.

Association between Cook stove Use and Respiratory Illness in Rural Southern Ethiopia

2025-03-12T12:42:29+03:00

Background: The use of traditional fuelwood for cooking in developing countries poses significant
health risks, particularly for women who are primarily responsible for household activities. Indoor air
pollution (IAP) arising from the inefficient combustion of biomass fuels releases harmful pollutants,
including particulate matter (PM), which have been linked to various respiratory illnesses. Improved
cookstoves (ICS) offer a promising solution to reduce IAP and improve health outcomes. This study
aimed to assess the association between cookstove use and respiratory illness among women in Chencha
District, Gamo Zone.

Methods: A cross-sectional study was conducted in March 2020 among 513 women in the Chencha
Zuriya district. Eight kebeles were selected, four from communities using improved cookstoves and four
from non-user communities. Households within each kebele were selected using systematic random
sampling, with proportional allocation based on population size. Trained health professionals conducted
face-to-face interviews, and data analysis was performed using SPSS version 21. The prevalence of
respiratory illness was determined, and various socio-economic and household factors, including
cookstove use, were analyzed for their association with respiratory illness.

Results: The overall prevalence of respiratory illness was 33.5% (172/513) [95% CI: 29.5–37.6]. Nonusers of improved cook stoves had significantly higher rates of respiratory illness (55.2%) compared to
users (12.6%) (AOR = 2.97; 95% CI: 1.15–7.67). Women with no formal education had significantly
higher odds of respiratory illness compared to those with secondary education or above (AOR = 5.24;
95% CI: 2.69–10.20). Households with more than five members also had significantly higher odds of
respiratory illness (AOR = 2.50; 95% CI: 1.37–4.56). Inadequate cooking facilities, such as stoves
without chimneys (AOR = 5.16; 95% CI: 1.93–13.81) and homes without permanent roof ventilation
(AOR = 6.37; 95% CI: 1.70–23.82), were strongly associated with respiratory illness. However,
crowding and time spent in the kitchen did not show a significant adjusted association.

Conclusion: This study highlights the significant role of improved cook stove use, education, and household conditions in the prevalence of respiratory illness among women in rural Ethiopia. The use of
improved cookstoves and inadequate household ventilation were key contributors to respiratory health
issues. Interventions to promote improved cooking technologies, better household infrastructure, and
educational initiatives are crucial in mitigating respiratory illnesses in rural Ethiopian communities.

Molecular Analysis of Mutations in the PD-L1 and PD-1 Genes in Squamous Cell Carcinoma of the Cervix

2025-01-17T19:10:25+03:00

Background: Understanding the type, frequency, and location of mutations in the programmed death receptor-1 ligand (PD-L1) and programmed death receptor-1 (PD-1) genes in cervical cancer is essential for advancing our knowledge of the underlying mechanisms of gene mutation in the disease. This understanding is crucial for developing targeted therapies, improving early detection techniques, and providing individualized treatment plans for those affected by cervical cancer. This study aimed to determine mutations in PD-L1 and PD-1 genes in Squamous Cell Carcinoma of the Cervix.

Methods: This retrospective study employed a total of twenty formalin-fixed, paraffin-embedded tissue blocks of cervical cancer. The Nucleic Acid Amplification Technique was used, including DNA extraction and Polymerase Chain Reaction for DNA sequencing. The amplified fragments were sequenced using a genetic analyzer 3130xl sequencer. Kapelan Bio-Imaging Solutions software version 2.7.2 was used to measure the length of the PD-L1 and PD-1 isoforms. Data were presented as simple frequency and percentage using an Excel spreadsheet.

Results: The photomicrograph of the benign cervical cancer showed rounded to oval structures with layers of stratified squamous epithelial cells with distinct nuclei and no signs of dysplasia. In contrast, the photomicrograph of the malignant cervical cancer tissue showed dysplasia, nuclear polymorphism, increased nucleo-cytoplasmic ratio, and disorganized tissue architecture. Single nucleotide polymorphisms (SNPs) and functional mutation occurred along PD-L1 and PD1 genes respectively. Transversion mutation occurred in 37.5% of SNPs along the PD-L1 gene, while transition mutation occurred in 62.5% of SNPs along the PD-L1 gene. Missense mutation recorded 100% occurrence in the
PD-L1 gene, while the PD-1 gene had 80% silent mutation and 20% missense mutation respectively.

Conclusion: Mutations were found in both PD-L1 and PD-1 genes in cervical cancer cells, with a greater number of mutations in the PD-L1 gene compared to the PD-1 gene, providing potential therapeutic targets for PD-1/PD-L1 inhibitors. As PD-1/PD-L1 blockade therapy is expected to become a prominent cancer immunotherapy technique soon, targeting PD-1 or PD-L1 in cancer immunotherapy may effectively induce long-lasting anticancer immune responses with reduced toxicity in various cancers, particularly cervical cancer.

The Top Ten Cancer Burdens at Hawassa University's Comprehensive Specialized Hospital from 2013 to 2019

2025-01-15T13:57:22+03:00

Background: Cancer remains a leading cause of morbidity and mortality globally, posing significant public health challenges across various demographics. This study evaluates the epidemiology of the ten most prevalent cancers at Hawassa University’s Comprehensive Specialized Hospital (HURCSH) from 2013 to 2019.

Methods: A retrospective cross-sectional study was conducted among all cancer patients treated at Hawassa University Comprehensive Specialized Hospital (HUCSH) between 2013 and 2019. A thorough review of medical records in both the oncology and pathology units was performed. Descriptive statistics and trend analyses were conducted using SPSS version 20, with results presented in tables and graphs.

Results: During the study period, a total of 4,658 new cancer cases were registered, with complete records available for 3,002 cases. The ten most common cancers accounted for 2,162 cases (72.1%). Breast cancer was the most prevalent, comprising 559 cases (25.9%), followed by cervical cancer with 385 cases (17.8%), gastric cancer with 257 cases (11.9%), esophageal cancer with 245 cases (11.3%), and colorectal cancer with 204 cases (9.4%). There was a notable predominance of cases among females, with a male-to-female ratio of 1:2.1. Many cancers peaked in individuals aged between 30 to 59 years. Alarmingly, there was a marked increase in cancer cases over the seven-year period, especially after 2016.

Conclusion: Burden of cancer is raising time to time, it is crucial to establish awareness, improve screening programs, and promote healthier lifestyle choices to mitigate the public health impact of cancer in Ethiopia. This study underscores the need for strengthened healthcare policies and resource allocation to effectively address the growing cancer burden.

Patterns and outcomes of chest injury among adult patients treated at Hawassa university comprehensive specialized hospital, Hawassa sidama, Ethiopia:

2024-08-10T15:55:56+03:00

Introduction: Trauma is a major global health concern, causing 4.4 million deaths annually, with
thoracic injuries accounting for 25% of deaths. Developing countries disproportionately bear these
deaths due to inadequate post-trauma measures.

Methods: Retrospective chart review study was conducted at Hawassa University Comprehensive
Specialized Hospital among 111 chest injury patients from August 01/2021 to August 31/2023. Data
were collected using structured questionnaires from the trauma registry, 24-hour reports, and patient
charts and collected by trained nurses. The collected data were entered, cleaned, edited, and analyzed
using SPSS version 25.0 statistical software.

Results: A total of 111 chest injury patients’ charts were included in the analysis. About threefourths (74.77%) were males, and 28 (25.23%) were females. Blunt trauma (77.5%, n = 86) was the
most common type of injury, with road traffic crashes (59.5%, n = 66) being the most common
mechanism. Rib fracture (n = 39, 35.14%) was the most common injury, followed by hemothorax (n =
37, 33.33%), hemopneumothorax (n = 32, 28.83%), and flail chest (n = 18, 16.22%). On univariate
analysis, comorbidity (P <0.001), blunt mechanism (P = 0.039), hemopneumothorax (P = 0.006), flail
chest (P = 0.021), pulmonary contusion (P = 0.014), development of complication (P <0.001), and
extra thoracic injuries (P = 0.013) were associated with mortality.

Conclusion: This study found that one in ten chest injury patients died in a hospital, with road traffic accidents being the main cause. Most patients sustained blunt chest injuries and death was associated with chronic diseases, hemopneumothorax, multiple injuries, and complications.

Health System Responsiveness and Associated Factors Among Outpatients in Primary Healthcare in Boricha District

2025-03-05T19:26:28+03:00

Background: Health system responsiveness is a crucial component for improving public health. While previous studies did not considered factors like; type of patients, physical disability, type of illness, and community-based health insurance membership. This study aimed to assess health system responsiveness and its associated factors among outpatients in primary healthcare settings in Boricha District, Ethiopia.

Methods: An institution-based cross-sectional quantitative study was conducted from April 1 to 30, 2024. Data were collected through structured and pretested questionnaires administered by interviewers. Multivariable binary logistic regression analysis was used to identify factors associated with overall responsiveness. Adjusted odds ratios with their corresponding 95% confidence intervals were used to determine factors associated with responsiveness, with a significance level of p<.05.

Results: The overall responsiveness was 57.7% with confidentiality rated highest. Males were 2.5 times more likely to have good HSR than females, and the odds of acceptable overall responsiveness among outpatients who visited hospital care were 2.5 times higher than those in a health center. Patients with perceived good health status and non-members of community-based health insurance showed higher responsiveness than their counter parts by 5 and 7 folds, respectively. Similarly, patients who were repeated visitor had 3.8 times more likely to have acceptable HSR compared to those who were new visitor. And, patients with chronic illness had 4 times more likely to have acceptable responsiveness than their counter parts. The likelihood of the acceptable overall responsiveness among patients treated by traditional healers was 3 times higher.

Conclusion: The overall responsiveness in primary healthcare facilities in the district was 57.7%. It was affected by gender, the type of health facility, subjective health status, type of patients, type of illness, the use of traditional medicines, and membership in community-based health insurance schemes.