Stoma-related complications and quality-of-life assessment: A cross-sectional study with patients from Ethiopia and Sweden.

BACKGROUND: The situation for patients with ostomy can be challenging, probably more in a resource-constrained environment. Our objective was to evaluate quality of life (QoL) (using EQ5D-5L) and stoma-specific QoL (using Stoma QoL) in a high- and low-income setting. METHODS: In this cross-sectional study from the Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, and South General Hospital (SGH), Stockholm, patients with a permanent or temporary ostomy at TASH (EthioPerm), (EthioTemp), and patients with ostomy at SGH (SweSto) were included in October 2022-January 2023. RESULTS: Patients N = 66 were included in groups: EthioPerm N = 28, EthioTemp N = 17, and SweSto N = 21. In EthioTemp, 88% used homemade stoma bags. Although morbidity related to the nipple itself was similar in the groups, the overall score from Stoma QoL was significantly lower in EthioPerm, 48/100 than in SweSto, 74/100. Scores were significantly lower for pouch-related problems and social interactions in Ethiopian patients. In EthioPerm, 71% of the patients worried that they were a burden to the people close to them compared to 14% in SweSto (p < 0.001). Leakage was over four times more common in EthioPerm than in SweSto. Mean overall EQ5D-5L score was 18 percentage points lower than the national mean score in EthioPerm and 2 percentage points lower in SweSto. CONCLUSION: QoL was more affected in the Ethiopian study participants than in the Swedish, even when commercial stoma bags were available. The largest problems were leakage, embarrassment with social interactions, and pouch-related problems. TRIAL REGISTRATION: NCT05970458 Clinicaltrials.gov, https://clinicaltrials.gov/study/NCT05970458?locStr=Ethiopia&country=Ethiopia&distance=50&cond=Stoma%20Ileostomy&rank=1.

Pediatric Residents' and Medical Interns' Awareness about Pediatric Ionizing Radiation Dose from Computed Tomography and Its Associated Risks in Tertiary Hospital in Ethiopia.

BACKGROUND: The international literature on physicians' knowledge regarding radiation dosages and risks due to computed tomography showed a widespread underestimation of diagnostic radiation doses. Hence, the objective of this work is to assess the awareness of pediatric residents and medical interns about pediatric CT dose and possible risks. METHODS: A cross-sectional study was conducted on May/2016 among year I to year III pediatric residents and 2015/2016 year medical interns attaching Pediatrics Department during the study period in Tikur Anbessa Specialized Referral and Teaching Hospital. Data was collected by distributing standardized structured questionnaires. Finally, after the data was checked for clarity and completeness, it was analyzed by using SPSS software. RESULT: While the majority (76.3%) of the residents and interns knew that children were more sensitive to radiation than adults, 93.7% did not know that there is currently no annual dose limit set for medical exposure of patients. The majority of the respondents (81.3%) know the risk of cancer from CT scan, but most (60%) of the respondents did not know that many imaging facilities still use adult doses for pediatric patients. Furthermore, 18.8% thought that magnetic resonance imaging involves ionizing radiation, and 8.9% of the physicians associated ultrasound examinations with ionizing radiation. CONCLUSION: Within resident group, since the level of clinical experience did not affect the outcome, we recommend that formal education and training on awareness of radiation with special concern on pediatric population is mandatory especially for pediatric residents and pediatricians who are major caretakers of children.

Laparascopic cholecstectomy at Myungsung Christian Medical Center, Ethiopia: a five-years experience.

BACKGROUND: Laparoscopic cholecystectomy is a recent entry in the treatment of gall bladder disease in Ethiopia mainly in private hospitals of the capital city, Addis Ababa, and is slowly gaining acceptance. Like all new techniques, it has generated considerable controversy and debate on its merits over the traditional open operation. OBJECTIVE: The aim of this study was to review our experience of laparoscopic cholecystectomy at Myungsung Christian Medical in, Ethiopia MATERIAL AND METHODS: A hospital based retrospective cross sectional analysis was conducted in Myungsung Christian Medical Center, Addis Ababa, Ethiopia. Patients' medical records and operation theater registers of 681 patients for whom laparoscopic cholecystectomy were done for symptomatic and complicated cholelithiasis, between January 2005 and December 2009 were analyzed using computer based statistical software SPSS version 11.0. Difference in proportions were examined using Chi-square test with its conventional criterion for statistical significance (p < 0.05). RESULTS: The female to male ratio was 6.6:1 with mean age of 44.4 [Standard Deviation, 0.53] years. Of the six hundred eighty-one patients admitted and planned for laparoscopic cholecystectomy, 661 (97.1%) patients completed the procedure successfully (p < 0.0001) and the procedure was converted to open surgery in 20 (2.9%) for various reasons. Mean duration of operation and hospital stay were 58.9 +/- 18.2 [SD] minutes and 36.9 +/- 10.9 [SD] hours respectively. Postoperative mortality and complication rate were 0.15% and 2.94% respectively. CONCLUSION: LC is safe and effective procedure even in difficult cholelithasis (p < 0.0001), in addition the merit of laparoscopic cholecstectomy include fast recovery, minimal tissue trauma, less postoperative hospital stay (p < 0.0001). Hence, LC could be practiced by general surgeons working in third world countries.