Major Intraoperative Complications of Cholecystectomy in a Teaching Hospital, Addis Ababa, Ethiopia

Background: Gall stone disease is one of the commonly handled surgical pathologies by a General Surgeon. Major intra operative complications are less commonly encountered in experienced hands. The rate may increase in a teaching hospital where Residents are allowed to operate. Therefore it was with this assumption that a study was carried to assess the incidence and contributing factors for the complications in a tertiary teaching hospital.Methods: A retrospective chart and operation log book review was done in a two -year period between January 2009 and December 2010 in St Paul’s teaching hospital, AA, Ethiopia.Results: A total of 645 cholecystectomy, 588(91.2%) open and 57(8.8%) laparoscopic, were done in the study period. Females comprised 80.9% of the patients. The average age of the patients was 42.8 years with a range of 18 to 80. Major surgical complications were seen in 19(2.9%) patients but adequate information was found for 16 patients only with a retrievalrate of 84.2 %. Of the 16 patients 14(87.5%) were female. Thirteen  patients had open cholecystectomy and the rest 3 patients had  laparoscopic cholecystectomy. Accordingly the rate for open  cholecystectomy was 13/588(2.21%), and that of laparoscopic surgery3/57(5.26%). Twelve (92.3%) of the complicated cases in open   cholecystectomy were done by residents alone. The rate of complications for the consultants in open surgery was 0.2% and that of the residents 6.0%. The odd that patients operated by residents will develop IBDI was 6.25 times higher than that of the seniors. There is statistically significantassociation between seniority and major surgical complications(X2= 11.91, P=0.001).Conclusions: The incidence of major complications of cholecystectomy is unacceptably high in this study. Almost all complications occurred in the hands of residents which show that experience matters. Therefore it is our recommendation that residents should not be left alone until they get reasonable experience in the field

Opinion dynamics with varying susceptibility to persuasion

A long line of work in social psychology has studied variations in people's susceptibility to persuasion -- the extent to which they are willing to modify their opinions on a topic. This body of literature suggests an interesting perspective on theoretical models of opinion formation by interacting parties in a network: in addition to considering interventions that directly modify people's intrinsic opinions, it is also natural to consider interventions that modify people's susceptibility to persuasion. In this work, we adopt a popular model for social opinion dynamics, and we formalize the opinion maximization and minimization problems where interventions happen at the level of susceptibility. We show that modeling interventions at the level of susceptibility lead to an interesting family of new questions in network opinion dynamics. We find that the questions are quite different depending on whether there is an overall budget constraining the number of agents we can target or not. We give a polynomial-time algorithm for finding the optimal target-set to optimize the sum of opinions when there are no budget constraints on the size of the target-set. We show that this problem is NP-hard when there is a budget, and that the objective function is neither submodular nor supermodular. Finally, we propose a heuristic for the budgeted opinion optimization and show its efficacy at finding target-sets that optimize the sum of opinions compared on real world networks, including a Twitter network with real opinion estimates

The patterns of surgical thyroid diseases and operative treatment in Gondar College of Medical Sciences, north-west Ethiopia

Background: Goitre is defiied as enlargement of the thyroid gland that normally weighs 25-30g.Methods: This was a retrospective review aimed at determining the incidence, pattern, pathology, ostoperative complications of 137 cases of goitre operated at the Gondar College of Medical sciences, Ethiopia, over a period of four years were reviewed.Results: The female to male ratio was 5:2 and the mean age of patients as 32.3 years. The mean duration of illness was 9.1 years. The commonest reasons for seeking medical attention were bulk of the mass (82%), rapid growth (9.5%) and compressive symptoms (2.9%). The goitre size was grade I11 and above in 83.1% of the patients. There were 14 (10.2%) thyroid carcinomas. Follicular carcinoma was the most common type of malignancy. Thyroiditis and toxic goitres were seen in 8 and 5 of the patients respectively. Subtotal thyroideaomy and lobectomywere the commonest procedures done. A total of 36 post-thyroidectomy complications occurred in 20 patients. Eight patients developed airway obstruction six of them requiring tracheostomy. Eleven patients (8%) had blood transfusion. The postoperative mortality was 1.5%.Conclusion: The pattern of goitre was found to be similar to other reports and post tracheostomy complications in the acceptable range.Key Words: Goitre, thyroid, pattern, thyroidectomy, post thyroidectomy complication

Solar Radiation Estimation Using Data Mining Techniques for Remote Areas-A Case Study in Ethiopia

High quality of solar radiation data is essential for solar resource assessment. For remote areas this is a challenge, as often only satellite data with low spatial resolution are available. This paper presents an interpolation method based on topographic data in digital elevation model format to improve the resolution of solar radiation maps. The refinement is performed with a data mining method based on first-order Sugeno type Adaptive Neuro-Fuzzy Inference System. The training set contains topographic characteristics such as terrain aspect, slope and elevation which may influence the solar radiation distribution. An efficient sampling method is proposed to obtain representative training sets from digital elevation model data. The proposed geographic information system based approach makes this method reproducible and adaptable for any region. A case study is presented on the remote Amhara region in North Shewa, Ethiopia. Results are shown for interpolation of solar radiation data from 10 km x 10 km to a resolution of 1 km x 1 km and are validated with data from the PVGIS and SWERA projects

Geospatial forecast model for tsetse-transmitted animal trypanosomosis in Ethiopia

The aims of this study were to develop a geographic information systems (GIS) forecast and risk assessment model for cyclically transmitted trypanosomosis in Ethiopia by matching features in the environment to available information on the preferences and limits of tolerance of the parasite and its vector, and validate and further develop the GIS model using data from current and historical prevalence survey data and habitat microenvironment studies from trypanosomosis endemic areas. Results indicate that GIS model developed for parasitic diseases based on growing degree day (GDD) concept can be applied to tsetse-transmitted trypanosomosis. GIS for animal trypanosomosis was created using Food and Agriculture Organization – Crop Production System Zones (FAO-CPSZ) database and Normalized Difference Vegetation Index (NDVI) and maximum temperature (Tmax) from the Global Land 1km dataset. The two datasets used to determine the risk of tsetse flies and consequently animal trypanosomosis in Ethiopia indicated the magnitude of the disease and possible expansion of the “fly belt” in the future. The GIS model indicated the distribution and importance of tsetse-transmitted trypanosomosis in Ethiopia. Spatial and statistical analysis verified the use of GDD concept and climate forecast system that was developed to determine the suitability of a given environment for the proliferation of a biotype, in this case tsetse and trypanosomes. Results presented here indicate the importance of GDD and the two climatic variables (NDVI and Tmax) in the development of forecast model for tsetse-transmitted trypanosomosis in Ethiopia. Key words/phrases: Ethiopia, GIS, NDVI, Tmax, trypanosomosis SINET: Ethiopian Journal of Science Vol.27(1) 2004: 1-

Survey of Safety Practices among Hospital Laboratories in Oromia Regional State, Ethiopia

Background: Unsafe working practices, working environments, disposable waste products, and chemicals in clinical laboratories contribute to infectious and non-infectious hazards. Staffs, the community, and patients are less safe. Furthermore, such practices compromise the quality of laboratory services. We conducted a study to describe safety practices in public hospital laboratories of Oromia Regional State, Ethiopia.Method: Randomly selected ten public hospital laboratories in Oromia Regional State were studied from Oct 2011- Feb 2012. Self-administered structured questionnaire and observation checklists were used for data collection. The respondents were heads of the laboratories, senior technicians, and safety officers. The questionnaire addressed biosafety label, microbial hazards, chemical hazards, physical/mechanical hazards, personal protective equipment, first aid kits and waste disposal system. The data was analyzed using descriptive analysis with SPSS version16 statistical software.Result: All of the respondents reported none of the hospital laboratories were labeled with the appropriate safety label and safety symbols. These respondents also reported they may contain organisms grouped under risk group IV in the absence of microbiological safety cabinets. Overall, the respondents reported that there were poor safety regulations or standards in their laboratories. There were higher risks of microbial, chemical and physical/mechanical hazards.Conclusion: Laboratory safety in public hospitals of Oromia Regional State is below the standard. The laboratory workers are at high risk of combined physical, chemical and microbial hazards. Prompt recognition of the problem and immediate action is mandatory to ensure safe working environment in health laboratories.Keywords: laboratory safety, district hospital, Oromia Regio

The Ethiopian dairy sector with focus on traditional butter: A review

Ethiopia is believed to have the largest cattle population in Africa. The total annual milk production from cattle has been estimated at 3.5 billion liters from 11.38 million dairy cows. As a result, cow’s milk is the focus of milk processing in Ethiopia. In Ethiopia, the base of milk processing is fermented milk (Ergo) with no defined starter cultures used to initiate fermentation. The main reasons reported for the use of fermented milk as a base of processing are the small volume of milk produced per day, better shelflife of fermented milk, consumer preference and type of available milk processing materials. The success of dairy development to a large extent depends on market for the product combined with other dairy infrastructure and availability of small-scale processing facilities to manufacture high quality dairy products. In Ethiopia, only 6.6 % of the total milk produced in the country is marketed as liquid milk and the remaining 48.8 % and 44.6 % of produced milk is used for home consumption and processing, respectively. Out of the 44.6 % of milk allocated for household processing, 75 % and 25 % go to butter and Ethiopian cottage cheese production, respectively. Thus, the products could be easily transported to market place, and fetch better prices or returns. The microbiological information on traditional butter is not fully available in Ethiopia. However, the available previous research works conducted in Ethiopia revealed that the microbial count of butter is generally above the acceptable limits set for quality butter. The presence of bacteria in butter reduces the keeping quality of the product and certain bacteria with their associated enzymes and toxins may even survive high temperature and create public health hazards. The potential sources of butter microbial contamination are raw materials, air, water and equipment, which usually occur during processing, packaging and storage of finished product. Therefore, all precautions should be taken to avoid contamination of butter and public health hazards.&nbsp

Seroprevalence of contagious caprine pleuropneumonia in Borana and Guji lowlands, Southern Ethiopia

A multistage cross sectional serological study and questionnaire survey were conducted on contagious caprine pleuropneumonia in selected districts of Borana and Guji lowlands, Southern Ethiopia, to determine the prevalence of the disease and identify risk factors associated with the occurrence of the disease. A total of 900 sera samples were collected and tested using Complement Fixation Test (CFT). Questionnaire surveys were conducted with 69 randomly selected households. Out of the 900 goat sera samples tested, 119 (13.2%) were seropositive for CCPP, giving an overall seroprevalence of 13.2 % (95% CI=11.0%-15.4%) in the study areas. A seroprevalence of 18.3% (95% CI=14.3%-22.7%), 11.7% (95% CI=8%-15.2%) and 9.7% (95% CI=6.3%-12.6%) were recorded in Liban, Teltale and Moyale districts respectively. The seroprevalence recorded in Liban district was significantly different from that of Moyale district (