Laparotomy for Abdominal Injury Indication & Outcome of patients at a Teaching Hospital in Addis Ababa, Ethiopia

BACKGROUND: Abdominal injury is among the major causes of trauma admissions. The aim was to determine etiology, commonly injured organs, indication and outcome of patients with abdominal injuries requiring laparotomy.METHODS: A retrospective study of all adult patients who underwent laparotomy for abdominal injury at St. Paul’s Hospital Millennium Medical College was conducted from January 2014 to December 2016. The factors associated with outcome were identified with bivariate and multivariate logistic regressions.RESULTS: Laparotomy for abdominal injury was performed for 145 patients. Of these, 129 (89%) case records were retrieved. The male to female ratio was 6.2:1. The mean age was 29 years, and most of them were unemployed. Penetrating trauma was the commonest injury, stab (46, 35.7%) and Road Traffic Accidents (RTA) (27, 20.9%) being the leading causes. Extra-abdominal injuries were seen in 33.3% (46) of the cases. Hollow organs were commonly injured than solid organs. Small intestine (35, 43.8%) and Spleen (17, 34.7%) were the leading injured organs in penetrating and blunt respectively. The main procedure performed was repair of hollow and solid organ laceration/perforation (70,54.3%). The negative laparotomy rate was 4.6% (6). Complications were seen in 23(17.8%) patients, the commonest being irreversible shock (7,30.4%). The mortality rate was 8.5 %(11), and it was significantly associated with blunt abdominal injury (AOR=7.25; 95% CI 1.09-48.37; p=0.041) and systolic blood pressure<90mmHg (AOR=8.66; 95% CI 1.1-68.41; p=0.041).CONCLUSION: Stab and RTA were the commonest indications of laparotomy. The mortality was significantly associated with blunt abdominal injury and hypotension (SBP<90mmHg)

Intra-Abdominal Hydatid Cyst: Sociodemographics, Clinical Profiles, and Outcomes of Patients Operated on at a Tertiary Hospital in Addis Ababa, Ethiopia

Background. Hydatid cyst is caused by the tapeworm Echinococcus granulosus. The abdomen, specifically the liver, is the most common site affected. Objective. Determine the presentation patterns, types of surgical management, and outcomes of patients operated for intra-abdominal hydatid cyst (IAHC). Methodology. A retrospective descriptive study of patients admitted and operated for IAHC from September 1, 2011, to August 31, 2015. Results. Forty-two patients whose age ranged from 10 to 65 (mean of 37 years) were operated on. Females comprised 27 (64.3%) of the patients. The commonest presenting complaint was abdominal pain (41, 97.6%). Abdominal mass was documented in 23 (54.7%) cases. Abdominal ultrasound (AUS) and CT were the main imaging studies done on 38 (90.5%) and 24 (57.1%) patients, respectively. Cysts measuring more than 10 cm in diameter were the most common finding in both studies. Liver was the primary site involved, 30 (71.4%) cases, the right lobe being the main side, 73%. Thirty-eight (90.5%) patients underwent deroofing, evacuation, marsupialization, and omentoplasty (DEMO). There was no perioperative death, but 4 (9.5%) of the patients had post-op complications. Conclusion. Abdominal pain was the most common presenting complaint. AUS and CT remain the preferred imaging. DEMO was the most common surgery

Types and Indications of Colostomy and Determinants of Outcomes of Patients After Surgery

Background: Colostomy is one of the commonest life saving procedures done worldwide with an intention of either decompression of an obstructed colon or diversion of stool. Indications may vary from region to region. Attending morbidity and mortality is significant. the objective of this study was to Determine the common indications and types of colostomy, and outcomes of patients operated at SPHMMCMethods: A retrospective medical records of patients, operation log book and nursing records review was done in a two-year period between January 2011 and December 2013 at the College Teaching Hospital, St Paul’s Hospital Millennium Medical, Addis Ababa.Results: During the two years, 253 colostomies were done and 219(86.6%) cases used for analysis. Of these, 151(68.9%) were males. Age ranged from 15 to 85 years with a mean of 50.8. Most of the surgeries, 196(89.5%), were done for emergency conditions. The three most common indications were gangrenous sigmoid volvulus, 102(46.6%), colorectal cancers, 46(21.0%, and abdominal injuries, 28(12.8%). The commonest type of colostomy done was Hartman’s colostomy, 179(81.7.1%), gangrenous sigmoid volvulus being the predominant indication, 102(57%). Loop colostomy constituted 35(16%) of all the colostomies. Penetrating abdominal injuries was the main indication 15(42.9%). Overall, 157 complications were seen on 106(48.4%) patients. The most common complications were surgical site infection, 51(23.3%), hospital acquired pneumonia, (10.5%), and wound dehiscence, 17(7.8%). The mortality rate was 9.6% (21).Conclusion: Gangrenous sigmoid volvulus is the leading indication for colostomy. Mortality and morbidity rates are high. Aggressive resuscitation, early prompt operation and post op close follow-up should be emphasized.Keywords: Colostomy, Indication, Complication

Prevalence and determinants of anemia among children aged from 6 to 59 months in Liberia: a multilevel analysis of the 2019/20 Liberia demographic and health survey data

BackgroundAnemia is a serious worldwide public health issue that happens at any stage of life but primarily affects young kids and pregnant mothers. Although anemia has a significant impact on child health, its magnitude and associated factors in children aged 6–59 months have not been yet studied in Liberia. Therefore, the aim of this study was to identify the prevalence and determinants of anemia in children aged 6–59 months in Liberia.MethodsThe data was extracted from Liberia Demographic and Health Survey, conducted from October 2019 to February 2020. The sample was obtained using a stratified two-stage cluster sampling technique. An overall weighted sample of 2,524 kids aged 6–59 months was involved in the final analysis. We used Stata version 14 software for data extraction and analysis. A multilevel logistic regression model was employed to identify factors associated with anemia. Variables with a P-value of <0.2 in the bivariable logistic regression analysis were selected as candidates for multivariable analysis. In multivariable analysis, the adjusted odds ratios (AOR) with the 95% confidence interval (CI) were declared as the determinants of anemia.ResultsThe prevalence of anemia in children aged 6–59 months in Liberia was 70.8% [95% CI: 68.9%, 72.5%]. Of these, 3.4% were severe anemia, 38.3% were moderate anemia and 29.1% were mild anemia. Children aged 6–23 and 24–42 months, being stunted, children from households with unimproved toilet facilities, children from households with unimproved water sources, and lack of media (television) exposure were significantly associated with higher odds of anemia. However, using mosquito bed nets, living in the Northwestern and Northcentral region were significantly associated with lower odds of anemia among children 6–59 months.ConclusionIn this study, anemia in kids aged 6–59 months in Liberia was a main public health issue. Age of the child, stunting, toilet facility, water source, exposure to television, mosquito bed net use, and region were significant determinants of anemia. Therefore, it is better to provide intervention for the early detection and management of stunted children. Similarly, interventions should be strengthened to address unimproved water sources, unimproved toilet facilities, and lack of media exposure

Mycotoxins in Ethiopia : current status, implications to food safety and mitigation strategies

Mycotoxins are one of the most significant contributors to food losses in developing countries including Ethiopia, and became a recurring food safety challenge. Many studies have reported the occurrence of mycotoxins in food and food commodities in Ethiopia. Aflatoxins, ochratoxins, fumonisins, and deoxynivalenol are among the most hazardous mycotoxins produced by the different fungal species. Groundnut, cereals (maize, sorghum, Leff, wheat, barley, finger mullet), milk, coffee and beer are the food commodities contaminated by mycotoxins and reported in Ethiopia. Mycotoxins negatively affect household food safety, livelihood, productivity, and income and leads to significant costs and economic losses for the given country. Lack of awareness on the occurrence and risks of mycotoxins, poor agricultural and postharvest practices, undiversified diets, poor legislation and regulation expose populations to dietary mycotoxin. Therefore, this review documents the prevalence of mycotoxins in food and food commodities and discuss the implications in food safety and health, mitigation strategies, legislation and regulations in Ethiopia

Validation of a HACCP community-based infants' complementary food safety assurance method in cash crop producing communities in Gedeo zone, Southern Ethiopia

A method based on a hazard analysis critical control point (HACCP)-based standard operating procedure (SOP) has been developed and implemented in community-based (CB) production of complementary foods (CFs) in agrarian regions in rural Ethiopia. The objective of this study was to validate the method in another setup, more specifically in cash crop (coffee and khat) producing communities in Southern Ethiopia. A quasi-experimental study was employed for the method validation. Two villages in the Gedeo zone, Southern Ethiopia were selected and a total of 40 mother-child pairs, 20 in each village, were involved in the study. Sociodemographic data, knowledge, and complementary feeding practices were collected using pretested questionnaires. The training was given to each mother for 1 h about community-based CFs production and implementation of the method. Then, 30 CF samples were collected and the level of aflatoxins (AFB1, AFB2, AFG1, and AFG2) was determined using a validated method. The majority (77.5%) of the mothers understand the importance of complementary feeding and give it to their infants beyond 6 months. Nearly two-thirds (62.5%) of the mothers had knowledge about the health impacts of aflatoxins, but the remaining 37.5% lacked awareness about the health risks of aflatoxins. Mothers were very well-motivated for the training and they promised to implement the knowledge and skill gained from the training for improving the nutritional status of their children. Overall, 23.3% of the CFs were contaminated by aflatoxins. AFB1 and AFG1 were detected in 6.7 and 16.7% of the CF samples, respectively. In cash crop-producing communities around the country, the HACCP-based SOP is easily validated in CB CFs production. Therefore, a scaleup of the method at the national level and beyond is recommended

Prevalence and associated factors of hemorrhoids among adult patients visiting the surgical outpatient department in the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.

IntroductionHemorrhoidal disease is a very common benign anorectal disease. It affects millions of people around the world, and represent a major medical and socioeconomic problem. However, studies that determine the magnitude and risk factors are limited. Therefore, the aim this study is to assess the prevalence and associated factors of hemorrhoid among adult patients visiting the surgical outpatient department at the University of Gondar Comprehensive Specialized Hospital (UoGCSH) Northwest Ethiopia.MethodsAn institution-based cross-sectional study was conducted from February to May 2020. A systematic random sampling technique was used to select a total of 403 participants. The data were collected then entered using EPI DATA version 3.1 and exported to the STATA 14 for analysis. Bivariable and multivariable logistic regression analysis were performed. Adjusted odds ratio (AOR) with 95% confidence interval was used as a measure of association. Variables having P-value ResultOut of the 403 study participants, 13.1% (95%CI; 10.1, 16.8) had hemorrhoids. Constipation (AOR = 4.32, 95% CI; 2.20, 8.48) and BMI ≥25kg/m2 (AOR = 2.6, 95% CI; 1.08, 6.23) had a statistically significant association with hemorrhoid.ConclusionThe overall prevalence of hemorrhoid was high and its prevalence was higher in male subjects. Constipation and being overweight were found to increase the odds of having hemorrhoids. Screening for early identification and intervention of hemorrhoids, especially for risk groups is better to be practiced by health professionals

Total aflatoxins in complementary foods produced at community levels using locally available ingredients in Ethiopia

This study was conducted to determine the occurrence and levels of total aflatoxins in complementary foods (CFs) and their ingredients. A total of 126 samples collected from 20 Districts from Amhara, Tigray, Oromia, and Southern Nations Nationalities and Peoples (SNNP) regions were analysed for levels of total aflatoxins using enzyme linked immunosorbent assay (ELISA). Aflatoxins were detected in 62 out of 66 pre-milling samples with mean range of 0.3-9.9 mu g/kg. Aflatoxins were also detected in 19 out of 20 post-production CFs and in all of the one-month stored CFs at households and grain banks, with a mean range of 0.5-8.0, 3.6-11.3, and 0.2-12.4 mu g/kg, respectively. Overall, 3 out of 126 samples exceeded the maximum limit (10 mu g/kg). Although most aflatoxin levels were below the maximum limit and thus considered to be safe for consumption, more effort should be implemented to reduce contamination, as these CFs are intended for consumption by young children

Identification, validation and cross-species transferability of novel Lavandula EST-SSRs

Main conclusion: We identified and characterized EST-SSRs with strong discrimination power against L. angustifolia and L. x intermedia species. The markers also showed considerable cross-species transferability rate into six related Lavandula species. Lavenders (Lavandula) are important economical crops grown around the globe for essential oil production. In an attempt to develop genetic markers for these plants, we analyzed over 13,000 unigenes developed from L. angustifolia and L. x intermedia EST databases, and identified 3,459 simple sequence repeats (SSR), which were dominated by trinucleotides (41.2%) and dinucleotides (31.45%). Approximately 19% of the unigenes contained at least one SSR marker, over 60% of which were localized in the UTRs. Only 252 EST-SSRs were 18 bp or longer from which 31 loci were validated, and 24 amplified discrete fragments with 85% polymorphism in L. x intermedia and L. angustifolia. The average number of alleles in L. x intermedia and L. angustifolia were 3.42 and 3.71 per marker with average PIC values of 0.47 and 0.52, respectively. These values suggest a moderate to strong level of informativeness for the markers, with some loci producing unique fingerprints. The cross-species transferability rate of the markers ranges in 50 to 100% across eight species. The utility of these markers was assessed in eight Lavandula species and 15 L. angustifolia and L. x intermedia cultivars, and the dendrogram deduced from their similarity indexes successfully delineated the species into their respective sections and the cultivars into their respective species. These markers have potential for application in fingerprinting, diversity studies and marker-assisted breeding of Lavandula. [This is a post-peer-review, pre-copyedit version of an article published in Planta. The final authenticated version is available online at: http://dx.doi.org/10.1007/s00425-014-2226-8].Arts and Sciences, Irving K. Barber School of (Okanagan)Biology, Department of (Okanagan)ReviewedFacult

EST-SSR analysis and cross-species transferability study in Lavandula

The genus Lavandula comprises of several economically important lavender species that are mainly cultivated worldwide for essential oil production. Identification of lavender species and their cultivars has been a huge bottleneck in lavender industries due to lack of appropriate identification mechanisms. Recent advances in modern technologies would help to address these identification issues through development of potential molecular markers, including simple sequence repeats (SSRs). SSRs can be developed from specific species, and can be potentially used for related species, which lack the source sequences to develop species-specific SSRs. Here, we describe the guidelines and steps of identifying and analyzing SSRs from expressed sequence tag (EST) sequences of lavender species. We also detail the validation procedures of selected EST-SSRs in distinguishing source (donor) species as well as related species.Arts and Sciences, Irving K. Barber School of (Okanagan)Non UBCBiology, Department of (Okanagan)ReviewedFacult