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

Performance Evaluation of Grade Separation Within the Selected Major Intersection in Addis Ababa City

Urban City Traffic Management introduced various remedies to decongest traffic and to reduce the severity of accidents, such as providing traffic signal controls at the intersecting roads at different levels, or grade separating the traffic movement towards different directions. One type of grade separation is Road Underpass or Flyover. The construction of Road Underpass or Flyover poses some doubts whether it is effective or ineffective from the point of view of the travelers or motorists. It is for this reason that this research sought to evaluate the performance and effectiveness of the Road Underpass structure on traffic flow at the major intersection, specifically the Wellosefer intersection in Addis Ababa City. The primary data used the existing traffic volume recorded between 7:00 AM – 6:00 PM from Monday to Friday. While the secondary data obtained from the Consulting Office 'before' the improvement of Wellosefer intersection, including the previous study, which served as the control analysis for the research. From these data, the analyses provided results on vehicle travel time and delay for a case 'before' and 'after' improvement of the intersection. SIDRA Software was used to analyze the traffic conditions of the intersection. Based on the findings of the study, a case 'before' Improvement of Wellosefer Unsignalized T-Intersection indicated an average delay of vehicles of about 535.7 seconds and a travel time of vehicles of about 574.7 seconds. On the other hand, in a case 'after' Improvement of Wellosefer intersection, three alternatives considered; such as 1) Signalized T-Intersection, 2) Roundabout and 3) Road Underpass with Roundabout at the upper level. The results of the first alternative showed the Signalized T-intersection indicated an average delay and travel time of 344.3 seconds and 365.0 seconds, respectively. It means, there could be a reduction of 15.4% in average delay if signalized intersection implemented. The second alternative, a case of Roundabout using the same traffic data at current condition, the results indicated the motorists and commuters would be experiencing an average delay of about 355.8 seconds and average travel time of 390.0 seconds. The third alternative considering Road Underpass with Roundabout at the upper level, the results revealed that there was a significant reduction in an average delay of vehicles of about 42% from the Unsignalized T-Intersection. Comparing this result with the Signalized intersection using the same traffic data, showed that there was a significant decrease in average delay. Therefore, the findings of the study, a combination of Road Underpass and Roundabout at the upper level as in the case of Wellosefer intersection performed well than the other traffic control design alternatives