Preoperative anxiety among adult patients undergoing elective surgery: a prospective survey at a general hospital in Ethiopia.

BackgroundMajor life changes are among factors that cause anxiety, and one of these changes is surgery. Hospitalization, regardless of disease, is known to provoke anxiety in the patient admitted for surgery. Anxiety is an unpleasant disturbing experience that involves way of thinking of tension, apprehension, uneasiness and high autonomic activity. Patients with high levels of anxiety require higher doses of anesthetic induction agents and recover poorly. The objective of this study was to investigate the prevalence of preoperative anxiety and its predictors among adult patients scheduled for elective surgery.MethodologyInstitutional based cross sectional study was conducted using interviewer administered structured questionnaire in Yirgalem zonal hospital in Ethiopia from November 1, to December 30, 2018 on 407 patients scheduled for elective surgery. The study included all patients with age greater than 18 years who were undergoing surgery. Patients with known anxiety disorder and unable to communicate were excluded from the study. State and trait anxiety inventory (STAI) measurement scale was used to assess preoperative anxiety. Statistical analysis was performed using SPSS version 22. Binary logistic regression analysis was performed to determine the predictors of preoperative anxiety. The strength of the association was presented using AOR with 95% confidence interval and p-value ResultsAmong a total of 402 patients enrolled in the study 228 (56.7%) were male. The prevalence of preoperative anxiety among scheduled patients for elective surgery was 47.0%. Having strong social support (AOR = .16 CI = 0.07, 0.34), harm from doctor or nurse mistake (AOR = 5.03, CI = 2.85, 8.89), unexpected result of operation (AOR = 3.03, CI = 1.73, 5.19), unable to recover (AOR = 2.96, CI = 1.18, 4.87), and need of blood transfusion (AOR = 2.76, CI = 1.65, 4.62) were significantly associated with preoperative anxiety.ConclusionIn the current study the prevalence of preoperative anxiety was high (47%). Having strong social support, unexpected result of operation, harm from doctor or nurse mistake, need of blood transfusion, and unable to recover were found to be statistically significant for preoperative anxiety. Patients need to be assessed regularly for anxiety during the preoperative visit

Massive megarectum secondary to constipation in institutionalized patient

Chronic constipation is a common cause of morbidity in the elderly and institutionalized population. It can be associated with significant morbidity and socioeconomical burden. Chronic resistance constipation can rarely be associated with megarectum. Herein, we present the case of a patient with physical and mental disability that presented with refractory constipation associated with extreme stool burden and a massive megarectum. We discuss chronic constipation in the elderly population, its etiologies and diagnostic work-up including surgical options. The management of chronic constipation with megarectum should be on a case-by-case basis

Trend analysis of extreme precipitation in the Northwestern Highlands of Ethiopia with a case study of Debre Markos

Understanding extreme precipitation is very important for Ethiopia, which is heavily dependent on low-productivity rainfed agriculture but lacks structural and non-structural water regulating and storage mechanisms. There has been an increasing concern about whether there is an increasing trend in extreme precipitation as the climate changes. Existing analysis of this region has been descriptive, without taking advantage of the advances in extreme value modeling. After reviewing the statistical methodology on extremes, this paper presents an analysis based on the generalized extreme value modeling with daily time series of precipitation records at Debre Markos in the Northwestern Highlands of Ethiopia. We found no strong evidence to reject the null hypothesis that there is no increasing trend in extreme precipitation at this location

Diabetic ketoacidosis among adult patients with diabetes mellitus admitted to emergency unit of Hawassa university comprehensive specialized hospital.

ObjectiveThis study was aimed to assess the prevalence and associated factors of diabetic ketoacidosis among adult patients admitted in emergency department of Hawassa university comprehensive specialized hospital. An institution based retrospective cross-sectional study design was conducted among 195 adult patients aged 16 years and above with known or previously unknown diabetes cases presented in the emergency unit.ResultIn our study from the total 195 patients medical record reviewed 78 (40%) developed DKA. Out of the total reviewed medical record 55 (28.2%) and 23 (11.8%) were with type-1 and type 2 diabetes mellitus respectively. From acute complication of diabetes, diabetic ketoacidosis was a leading cause 78 (77%) followed by hypoglycemia 14 (14%) and hyperosmolar hyperglycemic state (9%). During multiple logistic regression analysis age and hypertension were found to have significant association with diabetic ketoacidosis

Social Anxiety Disorder Among Undergraduate Students of Hawassa University, College of Medicine and Health Sciences, Ethiopia.

Introduction:Social anxiety disorder (SAD), also called social phobia, is an uncontrollable fear of social situations, which involve fear of observation or making contact with strangers. So, helping individuals with social anxiety, which is among the factors affecting mental health, can significantly influence a students' mental health and prevent other problems. Objective:The study aimed at assessing the magnitude of SAD and its determinants among undergraduate students of Hawassa University, College of Medicine and Health Sciences. Methods:An institution based cross-sectional study was conducted from April 1 to May 30, 2018, in Hawassa University, College of Medicine and Health Sciences. We selected participants by a stratified random sampling method, and we collected data independently from each stratum (department) using a 17 item self-rating Social Phobia Inventory (SPIN) scale to assess SAD. We performed multiple logistic regression analysis to find factors associated with SAD. Results:Out of 304 students, 293 completed the questionnaire, with a response rate of 96.3%. The mean age of the participants was 22.13 years with a standard deviation of ± 2.176, and 172 (58.7%) were males. The prevalence of SAD was 32.8%. Family history of mental illness (AOR=4.72, 95% CI (1.25, 17.74)), being a 3rd-year student (AOR=0.178, 95% CI (0.055, 0.57)) and being a 4th year student (AOR=0.15, 95% CI (0.049, 0.49)) were significantly associated with SAD. Conclusion:This study showed a high prevalence of SAD among medicine and health science students of Hawassa University. Therefore, the Ethiopian Ministry of Higher Education and university officials need to draw up a plan to reduce social phobia

Global Estimates of the Prevalence of Depression among Prisoners: A Systematic Review and Meta-analysis.

BackgroundPrison populations tend to be marginalized and disadvantaged of the rights and freedoms that other people in the community benefit from. Their separation from families, a narrow room and lack of privacy in the prison, violence between prisoners, and the uncertainty about the future result in psychological distress, for example, depression. The review has synthesized previous studies conducted on the topic and summarized to formulate recommendations for future prison health care services.MethodsWe systematically searched the databases: PubMed, Psych Info, and SCOPUS, as well as manual Google Scholar searches, were conducted to retrieve published literature globally. We have included observational studies, written in English language. Estimates were pooled using a random-effects model. The study protocol was registered in PROSPERO with protocol number CRD42020156108. Subgroup and sensitivity analysis was conducted, and heterogeneity across the studies was evaluated using Q and the I 2-test. Publication bias was assessed by inspection of the funnel plot and Egger's regression test.ResultA total of 1313 studies were initially identified through the electronic database; among these, a total of 73 full-text articles were retrieved for further appraisal. Further, 32 full-text articles were included in the final systematic review and meta-analysis. In this meta-analysis, the pooled prevalence of depression among prisoners was 36.9% (95% CI; 27.3-47.6). The pooled prevalence of depression among prisoners in the developing and developed countries was 39.2% and 33.1%, respectively. Moreover, the prevalence of depression was 19.1% and 54% for the studies that used diagnostic and screen tools to diagnose or screen depression, respectively. A leave-one-out analysis revealed that the pooled prevalence of depression among prisoners was not dependent on a single study removal or addition. Thus, the pooled prevalence of depression ranges between 35.3 and 38.0%.ConclusionThe prevalence of depression among prisoners was high. Therefore, regular and continuous screening of depressive symptoms for prisoners along with its appropriate management is highly recommended

Knowledge and practice on adequate sunlight exposure of infants among mothers attending EPI unit of Aleta Wondo Health Center, SNNPR, Ethiopia.

ObjectiveThe main objective of this study was to assess knowledge and practice of adequate sunlight exposure of infants among mothers attending EPI unit at Aleta Wondo Health Center, Sidama zone, SNNPR, Ethiopia. Institutional based descriptive cross sectional study design was used. 313 mothers who had under 1 year child and immunization follow-up were selected by simple random sampling technique using immunization registration book as sampling frame.ResultOut of 313 respondents identified for the study 98.03% (n = 307) were responded for the interview. From the total respondents 279 (90.9%) of respondents exposed their infants to sunlight but only 62 (22%) of them exposed adequately. From 307 mothers, 191 (62.2%) are knowledgeable about sunlight exposure and 91 (32.6%) of mothers had good practice of exposing their infants to sunlight

Patterns of common skin infections among children living with HIV/AIDS in Hawassa City, Ethiopia: a cross sectional study.

ObjectivesSkin disorders are the most common health problems seen among HIV positive patients. It presents with a variety of manifestations which can cause significant morbidity. This study was aimed to assess the prevalence of common skin problems among children living with HIV/AIDS at Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia, 2017/2018. Hospital based cross-sectional study was conducted among 125 children living with HIV/AIDS who were recruited through simple random sampling techniques from February to April 2017. Pre-tested, structured questionnaires were used to collect the data.ResultAmong a total of 125 study participants, 72 (57.6%) of the children were males and 97 (77.6%) were in the age range of 10-14 years. 90 (72%) of participants had different kinds of skin problems. Among those who had one kind of common skin infection, 53 (42.4%) were males. Viral skin infections that accounts 48 (53.3%), were the leading cause of skin infections followed by 43 (47.8%), 33(36.7%) and 22 (24.7%) fungal infections, inflammatory and bacterial skin infections respectively. Among all children who were taking ART, only 2.4% of the children had skin related side effects

Post-concussion syndrome among patients experiencing head injury attending emergency department of Hawassa University Comprehensive specialized hospital, Hawassa, southern Ethiopia.

IntroductionPost-concussion syndrome (PCS) is defined as the presence of 3 or more of the following signs and symptoms after experiencing head injury such as headache, dizziness, fatigue, irritability, insomnia, difficulty of concentration or memory difficulty. In Ethiopia, even though there was no research conducted on post-concussion syndrome, it is common health problems after experiencing head trauma that affect the productive age group, which directly or indirectly influences the development of the country.ObjectiveTo assess the prevalence and determinants of post-concussion syndrome among patients experiencing head injury attending emergency department of Hawassa University Comprehensive Specialized hospital, Hawassa, Southern Ethiopia.MethodsInstitution based cross sectional study was conducted from November 1, 2017 to March 30, 2018, in Hawassa University Comprehensive Specialized Hospital emergency department, Hawassa, Southern Ethiopia.ResultA total of 275 cases were interviewed during data collection period with response rate of 95.2%. More than half (55.7%) of patients were within age range of 25-34 and Majorities (55.6%) of patients were married. About two-fifths of study participants (41.5%) had at least three symptoms of post-concussion syndrome components. Headache and restlessness were the most symptoms occurring in varying severity while double vision and fatigue were less severe among others. Occupation, cause of injury and location of injury were significant determinants of post-concussion syndrome.ConclusionAbout 41.5% of study participants had at least three symptoms of PCS. Occupation, cause of injury and location of injury were significantly associated with the occurrence of PCS