African Journal of Health Sciences and Medicine

The sensitivity of Chest CT for the diagnosis of COVID-19 pneu monia and imaging patterns as seen on Chest CT: a crossectional prospective study done in Addis Ababa, 2021

admin admin — Wed, 10 Jul 2024 00:00:00 +0200

Background: Coronavirus disease 2019 (COVID-19) is a respiratory illness caused by a novel coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). While the RT-PCR test is considered the gold standard for diagnosis, chest imaging plays an important adjunct role in diagnosing and assessing the severity of the disease, as well as identifying complications. Distinguishing COVID-19 from other infectious processes can be challenging; thus, recognizing typical imaging patterns and degrees of involvement is crucial for guiding treatment.

Objective: This study aimed to assess the sensitivity of chest CT scans in comparison to the standard RT-PCR for diagnosing COVID-19.

Method: A cross-sectional study was conducted using data collected from various diagnostic and treatment centers between July 1, 2021, and October 1, 2021. The chest CT scans of patients were reviewed, and a structured questionnaire was completed using a Google form. The data were exported and analyzed using SPSS version 26.

Results: Chest CT analysis revealed that 95.9% of cases exhibited bilateral involvement, with 51.3% showing a peripheral distribution. Among the typical chest CT patterns, ground-glass opacities (GGO) were observed in 157 (83%) cases, consolidation in 152 (80.4%), and broncho vascular thickening in 68 (35.4%). The mean chest CT severity score was 13.6 ± 6.2, with 95 patients (49.2%) scoring above 18 (indicating severe disease). A positive correlation was found between the CT severity score and both age and diabetes, with a p-value < 0.01. There was a high probability of severe disease on chest CT among patients with diabetes mellitus (AOR = 1.6, 95% CI: 0.4-6.8).

Conclusion: This study demonstrated that chest CT has a high sensitivity (82.9%) for diagnosing COVID-19 pneumonia. The predominant imaging features included ground-glass opacity, consolidation, and bronchovascular thickening, with a notable bilateral, basal, and peripheral distribution. Additionally, the study revealed a positive correlation between the chest CT severity score and both age and diabetes comorbidity.

Keywords: Chest CT, COVID-19, RT-PCR

Incidence of Diabetic Foot Ulcer and its Predictors among Diabetic Patients Attending in Gedeo Zone Hospitals, Southern Ethiopia, 2020/2021

admin admin — Wed, 26 Jun 2024 00:00:00 +0200

Background: The incidence of diabetic foot ulcer is increasing over previous decade with an increasing prevalence of diabetes mellitus. The previous study mainly focused on the prevalence of diabetic foot ulcer but unable to identify average time it takes for diabetic patients to develop DFU and difficult for early identification, prevention and treatment of the cause of diabetic foot ulcer. Objectives: To determine incidence of diabetic foot ulcer and its predictors among diabetes mellitus patients who were follow up at Gedeo zone hospitals, 2020/2021 GC. Materials and

Methods: Institution-based Prospective follow up study was conducted in Gedeo zone hospitals From Nov 8/2020 to Sep 25/2021, Simple random sampling technique was used to select the study participants. The data collection was daily checked for completeness and consistency and it was entered into EPI data version 3.2 data and exported to Stata version 16 for analysis. The Kaplan-Meier estimation method was used and Cox proportional hazard model was applied.

Results: A total of 208 patients were taken from 4 hospitals 1 referral hospital and 3 Primary hospitals. of the total of study participant diabetic foot ulcer was found to be 10.58%[6.40-14.76].Age greater than 55 years old [AHR=1.90; 95% CI: 1.56, 3.24], type II diabetes mellitus [AHR=3.02; 95% CI: 1.08, 5.40], Retinopathy [AHR=2.30; 95% CI: 1.43, 5.02], Nephropathy [AHR=3.56; 95% CI: 2.47, 5.70] were significantly associated with diabetic foot ulcer. Conclusion: This study concluded that 10.58% diabetic patients have foot ulcer. The main reasons to develop foot ulcer were being older age, retinopathy, and nephropathy were significantly associated with DFU.

Keywords: Incidence, Diabetic Foot Ulcer, Predictors, Diabetes Mellitus, Ethiopia

Prevalence of Pseudoexfoliation Syndrome and Related Ocular Man ifestations in Patients Scheduled for Cataract Surgery

admin admin — Tue, 25 Jun 2024 00:00:00 +0200

Background: Pseudoexfoliation syndrome is an age-related condition marked by the deposition of a distinct fibrillar extracellular material in the eyes and other organs. Affecting nearly 70 million people worldwide, it is linked to various ocular conditions and complications that can impact long-term visual outcomes.

Purpose: To determine the prevalence of pseudoexfoliation syndrome and ocular manifestations related to it among patients who were scheduled for cataract surgery.

Methods and material: Ahospital-based cross-sectional study was conducted on consecutive 222 patients aged ≥ 40 years who were scheduled for cataract surgery. A structured questionnaire and an abstraction formant for ocular examination were used to collect data. The collected data were coded and entered into SPSS version 25 for analysis. Both descriptive and inferential statistical analyses were performed to present the results.

Results: The prevalence of pseudoexfoliation syndrome was 38.7% (86/222) (95% CI, 32.3– 45.5). In comparison to patients without pseudoexfoliation, patient with pseudoexfoliation had a higher mean age (67.7 ± 11.2 vs. 61.2 ± 10.1: P< 0.001). Significant association were found with working conditions (P< 0.001) and sex (P = 0.008), with outdoor workers and males being more affected. The mean intraocular pressure was higher in eyes with pseudoexfoliation (17.16 ± 3.83 vs. 15.63 ± 2.96mmHg: P = 0.001) and mean pupillary diameter after dilation was smaller (5.72 ± 0.86 vs. 6.73 ± 0.9 mm: P<0.001). All 24 eyes with phacodonesis or subluxation had pseudoexfoliation syndrome (P>< 0.001).

Conclusion and Recommendation: This study revealed a high prevalence of pseudoexfoliation syndrome (38.7%) among cataract patients. The condition was significantly associated with older age, working outdoors, male sex, higher intraocular pressure, poor pupillary dilation, and the presence of phacodonesis or subluxated lenses. Population-based studies are recommended to evaluate the prevalence of pseudoexfoliation in the general population, and further studies on cataract surgical outcomes in patients with pseudoexfoliation are recommended.

Keywords: Cataract, Hawassa, Ethiopia, Pseudoexfoliation syndrome

Short term Outcomes of Patients with Decompensated Cirrhosis on Follow up at Tikur Anbessa Specialized Hospital: a 1-Year Retrospective Cohort Study

admin admin — Wed, 10 Jul 2024 00:00:00 +0200

Background: Cirrhosis is the leading cause of liver-related mortality worldwide, with the highest age-standardized death rates found in low-income countries, particularly in Sub-Saharan Africa. In Ethiopia, studies evaluating the short-term outcomes of patients with chronic liver diseases, especially decompensated cirrhosis, are limited.

Objectives: This study aimed to assess the short-term outcomes of patients with decompensated cirrhosis at Tikur Anbessa Specialized Hospital and to identify the prevalence and factors associated with poor outcomes among these patients.

Methods: A retrospective cohort study was conducted over one year, including data from medical records of 110 patients with decompensated cirrhosis admitted to the emergency department, intensive care unit, medical wards, or seen as outpa tients at the Gastroenterology clinic from March 2020 to March 2021. Participants were selected consecutively using a convenience sampling technique. Chi-square statistics and binary logistic regression were employed to examine associations between categorical variables, while the Cox proportional hazard model assessed the probability of poor outcomes. Statistical significance was set at P < 0.05.

Results: Among the 110 participants, 82 (74.5%) were male, with a mean age of 40.35 (± 13.5) years. The median duration of known chronic liver disease was 20.5 months (IQR 33). Chronic hepatitis B infection was the most common etiology of cirrhosis (46.36%), followed by alcohol-related cirrhosis (24.55%) and cryptogenic cirrhosis (20.9%). The prevalence of poor outcomes—defined as readmission, variceal bleeding, hepatic encephalopathy, spontaneous bacterial peritonitis, and/or death—was 16.3%, 14.4%, and 22% at 1, 3, and 6 months, respectively. Sixty-one hospital admissions were documented, with 49 (44.5%) participants admitted at the index visit. Upper GI bleeding, hepatic encephalopathy, and hepatocellular carcinoma were the leading causes of hospitalization. During the study, 16 (14.54%) participants died in the hospital. Chronic HBV infection significantly contributed to poor outcomes [AOR=4.4; 95% CI: 1.15-16.93]. Age over 40 years was associated with upper GI bleeding [AOR=2.8; 95% CI: 0.76-5.44], but not with other complications of portal hypertension.

Conclusion: Chronic HBV infection was the predominant etiology of cirrhosis and a strong predictor of poor outcomes. Age over 40 was significantly linked to upper GI bleeding, while hepatic encephalopathy and upper GI bleeding predicted hospitalization. Enhancing access to HBV vaccines and treatments could improve overall prognosis. A national multicenter study is recommended to further investigate the outcomes of cirrhosis patients, focusing on specific causes and treatments to identify predictors of poor outcomes.

Keywords: Chronic liver disease, Decompensated cirrhosis

Efficacy and safety of erector spinae plane block for postoperative analgesia after surgery: An Umbrella review protocol

admin admin — Tue, 04 Jun 2024 00:00:00 +0200

Background: Poorly managed postoperative pain after thoraco-abdominal surgery has several consequences in the postoperative period. The postoper ative pain after thoraco-abdominal surgery has been managed with systemic opioids and different regional anesthesia techniques. The opioid-based analgesics and landmark techniques have undesirable consequences; regional analgesia tech nique with ultrasound requires resources and expertise, while erector spinae plane block is a new technique with minimal side effects and is easy to administer. However, the quality of evidence on its efficacy is still uncertain and needs further investigation.

Objective: This systematic review aimed to provide the quality of evidence on the efficacy and safety of erector spinae block after surgery.

Method: A comprehensive search was conducted in PubMed/Medline, Cochrane, Science Direct, CINHAL, and LILACS without date and language restrictions. All randomized trials comparing the efficacy of wound infiltration for postoperative pain management after cesarean section were included while observational studies and reviews were excluded. The data was extracted with two independent authors in a customized format. The methodological quality of the included studies was evaluated using a Measurement Tool to assess systematic Reviews (AMSTAR). The overall quality of the evidence was determined by GRADEpro software. The systematic review was conducted in line with the preferred Reporting Items of systematic review and meta-analysis (PRISMA).

Discussion: The incidence of postoperative pain after thoraco-abdominal surgery is very high, which has a severe impact on the patient, family, healthcare providers, and healthcare delivery. This systematic review aimed to provide quality evidence on the efficacy and safety of landmark and ultrasound-assisted erector spinae plane block technique for postoperative pain management after surgery.

Keywords: Analgesia, Erector spinae, Paravertebral, Postoperative