Amezene Tadesse | Addis Ababa University (original) (raw)

Papers by Amezene Tadesse

Pan African Medical Journal, 2015

Introduction: infective endocarditis is an infection of the endocardial lining of the heart mainl... more Introduction: infective endocarditis is an infection of the endocardial lining of the heart mainly associated with congenital and rheumatic heart disease. Although it is a rare disease in children, it is associated with high morbidity and mortality; death due to infective endocarditis has been reported to be as high as 26% in sub-Saharan Africa. Methods: this was a retrospective review of routinely collected data from patient records. Results: a total of 40 children (71% female) with 41 episodes of infective endocarditis admitted to a general paediatric ward in Addis Ababa, Ethiopia between 2008 and 2013. Age ranged from 7 months to 14 years, with a median of 9 years (Inter quartile Range: 7-12 years). Rheumatic and congenital heart diseases were underlying risk factors in 49% and 51% of cases respectively. Congestive heart failure, systemic embolization and death occurred in 66%, 12% and 7.3% respectively. Death was associated with the occurrence of systemic embolization (P-value=0.03). Conclusion: rheumatic heart disease was an important predisposing factor for infective endocarditis in Ethiopian children. Late presentations of cases were evidenced by high proportion of complications such as congestive heart failure. A low rate of clinically evident systemic embolization in this study may be a reflection of the diagnostic challenges. High proportion of prior antibiotic intake might explain the cause of significant BCNE. Preventive measures like primary and secondary prophylaxis of rheumatic fever may decrease the associated morbidity and mortality. Early detection and referral of cases, awareness creation about indiscriminate use of antimicrobials, and proper history taking and documentation of information recommended.

Canadian Journal of Surgery

Research and Reports in Urology

Background: Posterior urethral valve (PUV) is the most common cause of congenital lower urinary t... more Background: Posterior urethral valve (PUV) is the most common cause of congenital lower urinary tract obstruction in boys. It is considered that early diagnosis and intervention have good outcomes in terms of renal function, though the varying extent of embryological insult requires these boys to remain in extended follow-up and care. Objective: To assess the renal outcome of patients following PUV ablation. Methods: This was a descriptive retrospective study. Data were collected from the operation logbooks of patients from 2015 to 2019 that had been admitted to the Tikur Anbessa Specialized Hospital pediatric surgery unit with a working diagnosis of PUV and had ablation done primarily or following diversion. Data were collected from January to April 2020 and analyzed using SPSS 25. P value≤0.05 was considered significant. Results: Seventy patients were analyzed and followed for 3 years for the development of postoperative chronic kidney disease (CKD) after PUV ablation. Postoperative CKD was found in 52.9% of patients and end-stage renal disease in 2.9%. Risk factors associated with postoperative CKD were the presence of preoperative and postoperative proteinuria, postoperative hypertension, and elevated nadir serum creatinine. Results also showed that a delay between the development of vesicostomy and ablation had a significant correlation with renal outcome. Elevated nadir serum creatinine, postoperative proteinuria, and delay between the development of vesicostomy and ablation were found to be independent risk factors of development of CKD. Conclusion: There was a high rate of CKD development in patients who had had ablation for PUV, which was comparable to other studies. Three variables were found to be independent risk factors for the progression of CKD, unlike other findings seen in low-and middle-income countries.

Ethiopian Journal of Health Sciences

BACKGROUND: Pediatric surgical emergency condition is a broad spectrum of surgical pathologies/di... more BACKGROUND: Pediatric surgical emergency condition is a broad spectrum of surgical pathologies/disorders occurring in pediatric age group requiring proper emergency surgical care as the only option of management to salvage life, avoid/minimize disability or palliation. The objective of this study is to analyze the pattern and outcome of pediatric surgical emergencies managed at Tikur Anbesa Hospital and the factors associated with outcome. METHODS: Retrospective analysis of medical records of patients was conducted to assess the pattern, outcome and factors associated with outcome of pediatric surgical emergencies admitted and managed at Tikur Anbesa Specialized Hospital, from January 1, 2015 to December 31, 2015. Data was checked for completeness and entered into SPSS version 20 for statistical analysis. RESULTS: A total of 454 patients' medical records were analyzed. The presentation was after 5 days of illness in 182(40%), and >3 days in 243(53.4%), while only 89(19.6%) of them come within 24 hours of the illness. The etiologies were abdominal/gastrointestinal emergencies 210(46.3%), foreign body in aero digestive system in 133(29.3%), urogenital surgical emergencies in 27(5.9%). The other causes include superficial and deep tissue abscess collections in 22(4.8%), trauma /injury related cases in 24(5.3%) and others in 38(8.4%) respectively while congenital malformations were only 57(12.6%) of the cases. Finally, 439(96.7%) were discharged cured or improved without major disabilities documented, while 9(2%) died. CONCLUSIONS: Delayed presentation, unstable condition on arrival, younger age group and the nature of underlying pathology could have contributed for the death, but this needs further study.

Journal of Pediatric Gastroenterology and Nutrition

Annals of African Surgery

Background: Anorectal malformations are among the most common congenital malformation seen in chi... more Background: Anorectal malformations are among the most common congenital malformation seen in children. There is paucity of data regarding the incidence and treatment outcome of this disease from Ethiopia. Methods: This is a retrospective review of patients treated for ARM at the TASH from March 2010-February 2014. Relevant statistical analysis was done and the results presented in tables and graphs. Results: Six patients (6%) presented at early neonatal age (before the age of 4 days) and 14 (14%) presented between 4 days and one month. A total of 57 associated congenital malformations were diagnosed in 44/99(44%) patients. The two most common type of ARM diagnosed among the female patients were rectovestibular fistula which occurred in 39/56 (70%) and

Journal of Pediatric Surgery Case Reports

The New England journal of medicine, Apr 19, 2018

Postlicensure evaluations have identified an association between rotavirus vaccination and intuss... more Postlicensure evaluations have identified an association between rotavirus vaccination and intussusception in several high- and middle-income countries. We assessed the association between monovalent human rotavirus vaccine and intussusception in lower-income sub-Saharan African countries. Using active surveillance, we enrolled patients from seven countries (Ethiopia, Ghana, Kenya, Malawi, Tanzania, Zambia, and Zimbabwe) who had intussusception that met international (Brighton Collaboration level 1) criteria. Rotavirus vaccination status was confirmed by review of the vaccine card or clinic records. The risk of intussusception within 1 to 7 days and 8 to 21 days after vaccination among infants 28 to 245 days of age was assessed by means of the self-controlled case-series method. Data on 717 infants who had intussusception and confirmed vaccination status were analyzed. One case occurred in the 1 to 7 days after dose 1, and 6 cases occurred in the 8 to 21 days after dose 1. Five case...

East and Central African Journal of Surgery

Background: Undescended testis is one of the commonest congenital malformations seen in boys. The... more Background: Undescended testis is one of the commonest congenital malformations seen in boys. The aim of this study is to evaluate the pattern of presentation, approach to diagnosis, treatment and follow up in Tikur Anbesa Specialized Hospital, a tertiary teaching hospital in Ethiopia. Methods-This is a retrospective cross sectional study of all boys with undescended testis operated in Tikur Anbesa Specialized Hospital between September 2012 and August 2014. Results: Of 82 boys operated within the study period, 66 boys with 78 undescended testes are studied. Twenty-six percent (17/66)came before the age of 2 years, while the majority of the study group, 50% (33/66), presented beyond 5 years of age. Of the 17 boys brought to the hospital before 2 years, only 41% (7/17) them were treated before the age of two years. The majority 89% (59/66) of the boys were treated after 2 years of age. Seventy-one testes of 78 [91%] were in the inguinal canal, 5 were intra-abdominal and 2 were absent. 46% (36/78) were on the left side, 29% (23/78) on the right side and the rest were bilateral. Among the 54 boys who had ultrasound examination, the ultrasound report is consistent with operative findings in 33 [61%]. Associated congenital malformations were found in 31.8% (21/66) of the boys. Hypospadia was the predominant malformation comprising 38% (8/21) of the total congenital malformations. Orchidopexy was done for 82% (64/78) of the total testes, orchiectomy was done for 9% (7/78) and biopsy was taken in 1 case. Among the total operated boys only 62% (41/66) were followed in our clinic; of those who had follow up 10% (4/41) testes atrophied and 1 [2%] testis retracted. Conclusion: Boys with undescended testes present and are treated late in Tikur Anbesa Hospital. As opposed to the literatures most of the undescended testes were found on the left side. Ultrasound examination cannot be the only mode of examination for undescended testes as it misses more than one third of the cases. Hypospadia is the commonest associated congenital malformation. Post operative follow up is very poor after treatment for undescended testes 12. G, AfrikaGasana, K.A. Mteta. Pattern of presentation and management of patients with undescended testis at Kilimanjaro Christian Medical Center, Tanzania. African journal of urology _ volume16, issue3, September 2012, Page 124-126.

Ethiopian Journal of Health Sciences

BACKGROUND: Failure to pass meconium by a full-term neonate within the first 24 hours should rais... more BACKGROUND: Failure to pass meconium by a full-term neonate within the first 24 hours should raise a suspicion of bowel obstruction. The objective of this study was to determine pattern of presentation, diagnosis and outcome of management of intestinal obstruction in the early neonatal period in the Neonatal Care Unit of Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia METHODS: Retrospective chart review of admitted cases from January 2011 to December 2013 was done. Data were entered into SPSS software version 20. Descriptive analysis of data were done at first; then cross tabulation of variables with chi-square tests were done RESULT: Fifty-one (41 males and 10 females) cases of neonatal intestinal obstructions were described. ARM was the most common type of intestinal obstruction followed by intestinal atresia and Hirschsprung's disease. Delayed diagnosis of cases was observed in 72%. Associated congenital anomalies were documented in 13 % of the cases. Death occurred in 20% of the cases. One or another form of infection accounted for 90% of the deaths. Neonatal sepsis and being unfit for anesthesia were determinants of mortality with p-value <0.02 and < 0.0007 respectively. CONCLUSION: Anorectal malformation is the commonest cause of early neonatal obstruction followed by small intestinal atresia and Hirschsprung's disease. Low number of associated anomalies has been reported. High rate of death due to preventable causes such as sepsis is observed. Delayed diagnosis of cases were also prevalent.

Emergency radiology, Jan 24, 2017

Despite advances in non-invasive radiological techniques for the treatment of intussusception, ma... more Despite advances in non-invasive radiological techniques for the treatment of intussusception, management of the entity still remains exclusively surgical in many developing countries, including Ethiopia. Fluoroscopic units are rare or mostly dysfunctional. Ultrasound scanners are more commonly available. Ultrasound-guided hydrostatic reduction (USGHR) was recently introduced to the main referral hospital in Ethiopia, and subsequently has been adopted as the initial management option for intussusception. The aim of this study was to evaluate our experience with USGHR in Ethiopia and measure the impact on patient care. A prospective study was conducted between July 2014 and August 2015 on all pediatric patients, with US-confirmed intussusception, at the Tikur Anbessa Specialized Teaching Hospital in Addis Ababa, Ethiopia. All patients, excluding those with signs of peritonitis, bowel ischemia, or symptoms lasting longer than 4 days, were selected to undergo USGHR. A total of 53 child...

Background: Undescended testis is one of the commonest congenital malformations seen in boys. The... more Background: Undescended testis is one of the commonest congenital malformations seen in boys. The aim of this study is to evaluate the pattern of presentation, approach to diagnosis, treatment and follow up in Tikur Anbesa Specialized Hospital, a tertiary teaching hospital in Ethiopia. Methods-This is a retrospective cross sectional study of all boys with undescended testis operated in Tikur Anbesa Specialized Hospital between September 2012 and August 2014. Results: Of 82 boys operated within the study period, 66 boys with 78 undescended testes are studied. Twenty-six percent (17/66)came before the age of 2 years, while the majority of the study group, 50% (33/66), presented beyond 5 years of age. Of the 17 boys brought to the hospital before 2 years, only 41% (7/17) them were treated before the age of two years. The majority 89% (59/66) of the boys were treated after 2 years of age. Seventy-one testes of 78 [91%] were in the inguinal canal, 5 were intra-abdominal and 2 were absent...

Ethiopian medical journal, 2014

Vitelline duct anomalies (VDA) are rare complications of persistent omphalomesentric duct or vite... more Vitelline duct anomalies (VDA) are rare complications of persistent omphalomesentric duct or vitelline duct connecting the developing embryo with the yolk sac. VDA can be asymptomatic (detected incidentally) or symptomatic, most common of which is Meckel's diverticulum. A patent vitelline duct is the. most common symptomatic presentation in African children and we present here a four day old neonate with patent vitelline duct with ileal prolapse. The neonate was operated with the patent vitelline duct and gangrenous ileum resected and end to end ileal anastomosis done.

Ethiopian medical journal, 2015

Acquired tracheoesophageal fistulae can be diagnosed clinically by features such as cough elicite... more Acquired tracheoesophageal fistulae can be diagnosed clinically by features such as cough elicited by swallowing but symptoms can be mild. Here, we report a case of a foreign body induced trachea-esophageal fistula in a 2 year and 6 months old male child with a chronic cough who had long been misdiagnosed and mismanaged.

Ethiopian medical journal, 2016

Intussusception is one of the frequent causes of bowel obstruction in infants and toddlers (1). I... more Intussusception is one of the frequent causes of bowel obstruction in infants and toddlers (1). It involves invagination of a portion of intestine into another(2-4). The peak age of occurrence is between the age of 4 and 8 months. The aim of this study is to review the pattern of clinical presentation and seasonal variation of intussusception in our hospital, and to analyze the mode and outcomes of treatment. This is a four-year retrospective study of children aged 13 years and below who were admitted and treated for intussusception between January 2011 and December 2014 at the pediatric surgery unit of Tikur Anbesa Specialized Hospital (TAH) in Ethiopia. Information on the patients' demographic characteristics, clinical presentation, and month of occurrence as well as the operative findings and outcome were obtained from the pediatric surgery unit record book, patient charts, and the operating theatre registry. One hundred and thirty six cases of intussusception were admitted t...

Ethiopian medical journal, 2015

As one of the countries in Sub-Saharan Africa with a low physician to population ratio, Ethiopia ... more As one of the countries in Sub-Saharan Africa with a low physician to population ratio, Ethiopia has sought to mitigate the problem by increasing the number of students enrolling in the existing medical schools. This increase in enrolment was not accompanied by expansion of clinical training venues, which has resulted in less patient contact time for each student. As part of the solution to fill the gap simulation-based teaching was introduced. To describe the process of introducing Simulation based medical education (SBME) at Addis Ababa University College of Health Sciences, school of medicine. Two rounds of intensive training was given by John Hopkins in collaboration with Medical Education partner Initiative (MEPI). to the core clinical educators to introduce them the six-step model of curriculum development for medical education and standardized patient (SP) techniques with the ultimate aim of introducing SPs in the teaching and learning process for medical students. The traini...

Archivos Argentinos de Pediatria, 2016

Presentación de casos clínicos Resumen El blastoma pleuropulmonar es un tumor pulmonar raro de la... more Presentación de casos clínicos Resumen El blastoma pleuropulmonar es un tumor pulmonar raro de la infancia, que puede manifestarse con lesiones quísticas o sólidas, como un hallazgo radiológico o con clínica respiratoria. Presentamos el caso de un niño de 2 años de edad que consultó en su primer cuadro obstructivo con imagen sospechosa de malformación pulmonar en el lóbulo superior izquierdo en la radiografía y la tomografía de tórax. Se realizó cirugía, que evidenció una malformación quística en el segmento ápico posterior del lóbulo superior izquierdo. Recibimos el informe de anatomía patológica con diagnóstico de blastoma pleuropulmonar tipo I. Comenzó el seguimiento por Oncología e inició el tratamiento con ciclofosfamida y vincristina, con buena tolerancia. Actualmente, existe controversia acerca del manejo de los quistes pulmonares congénitos, y se inclina la balanza hacia la conducta quirúrgica debido a serias dificultades en diferenciar quistes pulmonares benignos del blastoma pleuropulmonar, sin la revisión histopatológica.

Ethiopian medical journal, 2012

This is a case report of a 7 years old female patient diagnosed to have secretory carcinoma of th... more This is a case report of a 7 years old female patient diagnosed to have secretory carcinoma of the breast and secondary axillary lymph nodes metastasis after she presented with compliant of left breast swelling that lasted for about 6 months. It is a rare (< 1%) type of breast carcinoma with distinct histologic features. Diagnosis of this carcinoma at fine needle aspiration cytology (FNAC) is quite difficult and it is not a particularly aggressive tumor with excellent prognosis even in the presence of metastasis. Axillary locoregional lymph node metastases are uncommon. Several authors, therefore, recommend a conservative and non-aggressive treatment as much as possible. In her case, modified radical mastectomy with level II axillary dissection was done without hormonal or chemotherapy. So far, the therapeutic approach tends to be fairly flexible.

Pan African Medical Journal, 2015

Introduction: infective endocarditis is an infection of the endocardial lining of the heart mainl... more Introduction: infective endocarditis is an infection of the endocardial lining of the heart mainly associated with congenital and rheumatic heart disease. Although it is a rare disease in children, it is associated with high morbidity and mortality; death due to infective endocarditis has been reported to be as high as 26% in sub-Saharan Africa. Methods: this was a retrospective review of routinely collected data from patient records. Results: a total of 40 children (71% female) with 41 episodes of infective endocarditis admitted to a general paediatric ward in Addis Ababa, Ethiopia between 2008 and 2013. Age ranged from 7 months to 14 years, with a median of 9 years (Inter quartile Range: 7-12 years). Rheumatic and congenital heart diseases were underlying risk factors in 49% and 51% of cases respectively. Congestive heart failure, systemic embolization and death occurred in 66%, 12% and 7.3% respectively. Death was associated with the occurrence of systemic embolization (P-value=0.03). Conclusion: rheumatic heart disease was an important predisposing factor for infective endocarditis in Ethiopian children. Late presentations of cases were evidenced by high proportion of complications such as congestive heart failure. A low rate of clinically evident systemic embolization in this study may be a reflection of the diagnostic challenges. High proportion of prior antibiotic intake might explain the cause of significant BCNE. Preventive measures like primary and secondary prophylaxis of rheumatic fever may decrease the associated morbidity and mortality. Early detection and referral of cases, awareness creation about indiscriminate use of antimicrobials, and proper history taking and documentation of information recommended.

Canadian Journal of Surgery

Research and Reports in Urology

Background: Posterior urethral valve (PUV) is the most common cause of congenital lower urinary t... more Background: Posterior urethral valve (PUV) is the most common cause of congenital lower urinary tract obstruction in boys. It is considered that early diagnosis and intervention have good outcomes in terms of renal function, though the varying extent of embryological insult requires these boys to remain in extended follow-up and care. Objective: To assess the renal outcome of patients following PUV ablation. Methods: This was a descriptive retrospective study. Data were collected from the operation logbooks of patients from 2015 to 2019 that had been admitted to the Tikur Anbessa Specialized Hospital pediatric surgery unit with a working diagnosis of PUV and had ablation done primarily or following diversion. Data were collected from January to April 2020 and analyzed using SPSS 25. P value≤0.05 was considered significant. Results: Seventy patients were analyzed and followed for 3 years for the development of postoperative chronic kidney disease (CKD) after PUV ablation. Postoperative CKD was found in 52.9% of patients and end-stage renal disease in 2.9%. Risk factors associated with postoperative CKD were the presence of preoperative and postoperative proteinuria, postoperative hypertension, and elevated nadir serum creatinine. Results also showed that a delay between the development of vesicostomy and ablation had a significant correlation with renal outcome. Elevated nadir serum creatinine, postoperative proteinuria, and delay between the development of vesicostomy and ablation were found to be independent risk factors of development of CKD. Conclusion: There was a high rate of CKD development in patients who had had ablation for PUV, which was comparable to other studies. Three variables were found to be independent risk factors for the progression of CKD, unlike other findings seen in low-and middle-income countries.

Ethiopian Journal of Health Sciences

BACKGROUND: Pediatric surgical emergency condition is a broad spectrum of surgical pathologies/di... more BACKGROUND: Pediatric surgical emergency condition is a broad spectrum of surgical pathologies/disorders occurring in pediatric age group requiring proper emergency surgical care as the only option of management to salvage life, avoid/minimize disability or palliation. The objective of this study is to analyze the pattern and outcome of pediatric surgical emergencies managed at Tikur Anbesa Hospital and the factors associated with outcome. METHODS: Retrospective analysis of medical records of patients was conducted to assess the pattern, outcome and factors associated with outcome of pediatric surgical emergencies admitted and managed at Tikur Anbesa Specialized Hospital, from January 1, 2015 to December 31, 2015. Data was checked for completeness and entered into SPSS version 20 for statistical analysis. RESULTS: A total of 454 patients' medical records were analyzed. The presentation was after 5 days of illness in 182(40%), and >3 days in 243(53.4%), while only 89(19.6%) of them come within 24 hours of the illness. The etiologies were abdominal/gastrointestinal emergencies 210(46.3%), foreign body in aero digestive system in 133(29.3%), urogenital surgical emergencies in 27(5.9%). The other causes include superficial and deep tissue abscess collections in 22(4.8%), trauma /injury related cases in 24(5.3%) and others in 38(8.4%) respectively while congenital malformations were only 57(12.6%) of the cases. Finally, 439(96.7%) were discharged cured or improved without major disabilities documented, while 9(2%) died. CONCLUSIONS: Delayed presentation, unstable condition on arrival, younger age group and the nature of underlying pathology could have contributed for the death, but this needs further study.

Journal of Pediatric Gastroenterology and Nutrition

Annals of African Surgery

Background: Anorectal malformations are among the most common congenital malformation seen in chi... more Background: Anorectal malformations are among the most common congenital malformation seen in children. There is paucity of data regarding the incidence and treatment outcome of this disease from Ethiopia. Methods: This is a retrospective review of patients treated for ARM at the TASH from March 2010-February 2014. Relevant statistical analysis was done and the results presented in tables and graphs. Results: Six patients (6%) presented at early neonatal age (before the age of 4 days) and 14 (14%) presented between 4 days and one month. A total of 57 associated congenital malformations were diagnosed in 44/99(44%) patients. The two most common type of ARM diagnosed among the female patients were rectovestibular fistula which occurred in 39/56 (70%) and

Journal of Pediatric Surgery Case Reports

The New England journal of medicine, Apr 19, 2018

Postlicensure evaluations have identified an association between rotavirus vaccination and intuss... more Postlicensure evaluations have identified an association between rotavirus vaccination and intussusception in several high- and middle-income countries. We assessed the association between monovalent human rotavirus vaccine and intussusception in lower-income sub-Saharan African countries. Using active surveillance, we enrolled patients from seven countries (Ethiopia, Ghana, Kenya, Malawi, Tanzania, Zambia, and Zimbabwe) who had intussusception that met international (Brighton Collaboration level 1) criteria. Rotavirus vaccination status was confirmed by review of the vaccine card or clinic records. The risk of intussusception within 1 to 7 days and 8 to 21 days after vaccination among infants 28 to 245 days of age was assessed by means of the self-controlled case-series method. Data on 717 infants who had intussusception and confirmed vaccination status were analyzed. One case occurred in the 1 to 7 days after dose 1, and 6 cases occurred in the 8 to 21 days after dose 1. Five case...

East and Central African Journal of Surgery

Background: Undescended testis is one of the commonest congenital malformations seen in boys. The... more Background: Undescended testis is one of the commonest congenital malformations seen in boys. The aim of this study is to evaluate the pattern of presentation, approach to diagnosis, treatment and follow up in Tikur Anbesa Specialized Hospital, a tertiary teaching hospital in Ethiopia. Methods-This is a retrospective cross sectional study of all boys with undescended testis operated in Tikur Anbesa Specialized Hospital between September 2012 and August 2014. Results: Of 82 boys operated within the study period, 66 boys with 78 undescended testes are studied. Twenty-six percent (17/66)came before the age of 2 years, while the majority of the study group, 50% (33/66), presented beyond 5 years of age. Of the 17 boys brought to the hospital before 2 years, only 41% (7/17) them were treated before the age of two years. The majority 89% (59/66) of the boys were treated after 2 years of age. Seventy-one testes of 78 [91%] were in the inguinal canal, 5 were intra-abdominal and 2 were absent. 46% (36/78) were on the left side, 29% (23/78) on the right side and the rest were bilateral. Among the 54 boys who had ultrasound examination, the ultrasound report is consistent with operative findings in 33 [61%]. Associated congenital malformations were found in 31.8% (21/66) of the boys. Hypospadia was the predominant malformation comprising 38% (8/21) of the total congenital malformations. Orchidopexy was done for 82% (64/78) of the total testes, orchiectomy was done for 9% (7/78) and biopsy was taken in 1 case. Among the total operated boys only 62% (41/66) were followed in our clinic; of those who had follow up 10% (4/41) testes atrophied and 1 [2%] testis retracted. Conclusion: Boys with undescended testes present and are treated late in Tikur Anbesa Hospital. As opposed to the literatures most of the undescended testes were found on the left side. Ultrasound examination cannot be the only mode of examination for undescended testes as it misses more than one third of the cases. Hypospadia is the commonest associated congenital malformation. Post operative follow up is very poor after treatment for undescended testes 12. G, AfrikaGasana, K.A. Mteta. Pattern of presentation and management of patients with undescended testis at Kilimanjaro Christian Medical Center, Tanzania. African journal of urology _ volume16, issue3, September 2012, Page 124-126.

Ethiopian Journal of Health Sciences

BACKGROUND: Failure to pass meconium by a full-term neonate within the first 24 hours should rais... more BACKGROUND: Failure to pass meconium by a full-term neonate within the first 24 hours should raise a suspicion of bowel obstruction. The objective of this study was to determine pattern of presentation, diagnosis and outcome of management of intestinal obstruction in the early neonatal period in the Neonatal Care Unit of Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia METHODS: Retrospective chart review of admitted cases from January 2011 to December 2013 was done. Data were entered into SPSS software version 20. Descriptive analysis of data were done at first; then cross tabulation of variables with chi-square tests were done RESULT: Fifty-one (41 males and 10 females) cases of neonatal intestinal obstructions were described. ARM was the most common type of intestinal obstruction followed by intestinal atresia and Hirschsprung's disease. Delayed diagnosis of cases was observed in 72%. Associated congenital anomalies were documented in 13 % of the cases. Death occurred in 20% of the cases. One or another form of infection accounted for 90% of the deaths. Neonatal sepsis and being unfit for anesthesia were determinants of mortality with p-value <0.02 and < 0.0007 respectively. CONCLUSION: Anorectal malformation is the commonest cause of early neonatal obstruction followed by small intestinal atresia and Hirschsprung's disease. Low number of associated anomalies has been reported. High rate of death due to preventable causes such as sepsis is observed. Delayed diagnosis of cases were also prevalent.

Emergency radiology, Jan 24, 2017

Despite advances in non-invasive radiological techniques for the treatment of intussusception, ma... more Despite advances in non-invasive radiological techniques for the treatment of intussusception, management of the entity still remains exclusively surgical in many developing countries, including Ethiopia. Fluoroscopic units are rare or mostly dysfunctional. Ultrasound scanners are more commonly available. Ultrasound-guided hydrostatic reduction (USGHR) was recently introduced to the main referral hospital in Ethiopia, and subsequently has been adopted as the initial management option for intussusception. The aim of this study was to evaluate our experience with USGHR in Ethiopia and measure the impact on patient care. A prospective study was conducted between July 2014 and August 2015 on all pediatric patients, with US-confirmed intussusception, at the Tikur Anbessa Specialized Teaching Hospital in Addis Ababa, Ethiopia. All patients, excluding those with signs of peritonitis, bowel ischemia, or symptoms lasting longer than 4 days, were selected to undergo USGHR. A total of 53 child...

Background: Undescended testis is one of the commonest congenital malformations seen in boys. The... more Background: Undescended testis is one of the commonest congenital malformations seen in boys. The aim of this study is to evaluate the pattern of presentation, approach to diagnosis, treatment and follow up in Tikur Anbesa Specialized Hospital, a tertiary teaching hospital in Ethiopia. Methods-This is a retrospective cross sectional study of all boys with undescended testis operated in Tikur Anbesa Specialized Hospital between September 2012 and August 2014. Results: Of 82 boys operated within the study period, 66 boys with 78 undescended testes are studied. Twenty-six percent (17/66)came before the age of 2 years, while the majority of the study group, 50% (33/66), presented beyond 5 years of age. Of the 17 boys brought to the hospital before 2 years, only 41% (7/17) them were treated before the age of two years. The majority 89% (59/66) of the boys were treated after 2 years of age. Seventy-one testes of 78 [91%] were in the inguinal canal, 5 were intra-abdominal and 2 were absent...

Ethiopian medical journal, 2014

Vitelline duct anomalies (VDA) are rare complications of persistent omphalomesentric duct or vite... more Vitelline duct anomalies (VDA) are rare complications of persistent omphalomesentric duct or vitelline duct connecting the developing embryo with the yolk sac. VDA can be asymptomatic (detected incidentally) or symptomatic, most common of which is Meckel's diverticulum. A patent vitelline duct is the. most common symptomatic presentation in African children and we present here a four day old neonate with patent vitelline duct with ileal prolapse. The neonate was operated with the patent vitelline duct and gangrenous ileum resected and end to end ileal anastomosis done.

Ethiopian medical journal, 2015

Acquired tracheoesophageal fistulae can be diagnosed clinically by features such as cough elicite... more Acquired tracheoesophageal fistulae can be diagnosed clinically by features such as cough elicited by swallowing but symptoms can be mild. Here, we report a case of a foreign body induced trachea-esophageal fistula in a 2 year and 6 months old male child with a chronic cough who had long been misdiagnosed and mismanaged.

Ethiopian medical journal, 2016

Intussusception is one of the frequent causes of bowel obstruction in infants and toddlers (1). I... more Intussusception is one of the frequent causes of bowel obstruction in infants and toddlers (1). It involves invagination of a portion of intestine into another(2-4). The peak age of occurrence is between the age of 4 and 8 months. The aim of this study is to review the pattern of clinical presentation and seasonal variation of intussusception in our hospital, and to analyze the mode and outcomes of treatment. This is a four-year retrospective study of children aged 13 years and below who were admitted and treated for intussusception between January 2011 and December 2014 at the pediatric surgery unit of Tikur Anbesa Specialized Hospital (TAH) in Ethiopia. Information on the patients' demographic characteristics, clinical presentation, and month of occurrence as well as the operative findings and outcome were obtained from the pediatric surgery unit record book, patient charts, and the operating theatre registry. One hundred and thirty six cases of intussusception were admitted t...

Ethiopian medical journal, 2015

As one of the countries in Sub-Saharan Africa with a low physician to population ratio, Ethiopia ... more As one of the countries in Sub-Saharan Africa with a low physician to population ratio, Ethiopia has sought to mitigate the problem by increasing the number of students enrolling in the existing medical schools. This increase in enrolment was not accompanied by expansion of clinical training venues, which has resulted in less patient contact time for each student. As part of the solution to fill the gap simulation-based teaching was introduced. To describe the process of introducing Simulation based medical education (SBME) at Addis Ababa University College of Health Sciences, school of medicine. Two rounds of intensive training was given by John Hopkins in collaboration with Medical Education partner Initiative (MEPI). to the core clinical educators to introduce them the six-step model of curriculum development for medical education and standardized patient (SP) techniques with the ultimate aim of introducing SPs in the teaching and learning process for medical students. The traini...

Archivos Argentinos de Pediatria, 2016

Presentación de casos clínicos Resumen El blastoma pleuropulmonar es un tumor pulmonar raro de la... more Presentación de casos clínicos Resumen El blastoma pleuropulmonar es un tumor pulmonar raro de la infancia, que puede manifestarse con lesiones quísticas o sólidas, como un hallazgo radiológico o con clínica respiratoria. Presentamos el caso de un niño de 2 años de edad que consultó en su primer cuadro obstructivo con imagen sospechosa de malformación pulmonar en el lóbulo superior izquierdo en la radiografía y la tomografía de tórax. Se realizó cirugía, que evidenció una malformación quística en el segmento ápico posterior del lóbulo superior izquierdo. Recibimos el informe de anatomía patológica con diagnóstico de blastoma pleuropulmonar tipo I. Comenzó el seguimiento por Oncología e inició el tratamiento con ciclofosfamida y vincristina, con buena tolerancia. Actualmente, existe controversia acerca del manejo de los quistes pulmonares congénitos, y se inclina la balanza hacia la conducta quirúrgica debido a serias dificultades en diferenciar quistes pulmonares benignos del blastoma pleuropulmonar, sin la revisión histopatológica.

Ethiopian medical journal, 2012

This is a case report of a 7 years old female patient diagnosed to have secretory carcinoma of th... more This is a case report of a 7 years old female patient diagnosed to have secretory carcinoma of the breast and secondary axillary lymph nodes metastasis after she presented with compliant of left breast swelling that lasted for about 6 months. It is a rare (< 1%) type of breast carcinoma with distinct histologic features. Diagnosis of this carcinoma at fine needle aspiration cytology (FNAC) is quite difficult and it is not a particularly aggressive tumor with excellent prognosis even in the presence of metastasis. Axillary locoregional lymph node metastases are uncommon. Several authors, therefore, recommend a conservative and non-aggressive treatment as much as possible. In her case, modified radical mastectomy with level II axillary dissection was done without hormonal or chemotherapy. So far, the therapeutic approach tends to be fairly flexible.