Incidence and predictors of early posttraumatic seizures among patients with moderate or severe traumatic brain injury in Northwest Ethiopia: an institution-based prospective study.

BACKGROUND: Early posttraumatic seizure (PTS) is a well-known complication of traumatic brain injury (TBI) that can induce the development of secondary brain injuries, including increased intracranial pressure, brain death, and metabolic crisis which may result in worse outcomes. It is also a well-recognized risk factor for the development of late post-traumatic seizure and epilepsy. This study was aimed to assess the incidence and predictors of PTS among patients with moderate or severe TBI admitted to Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia. METHODS AND SETTING: An institutional-based prospective follow-up study was conducted on 402 patients with TBI admitted to the neurologic unit from June 1, 2022 to January 30, 2023. A systematic sampling technique was employed. The incidence rate of occurrence of early PTS was calculated. Both bivariable and multivariable Cox proportional hazard regression was performed. The strength of the association was measured using adjusted hazard ratios with a 95% confidence interval and p-values < 0.05. RESULTS: The incidence rate of early PTS was 2.7 per 100 person-days observation. Early PTS was observed in 17.7% of TBI patients. Age 75 and above (AHR = 2.85, 95%CI: 1.58-5.39), severe TBI (AHR = 2.06, 95%CI: 1.03-3.71), epidural hematoma (AHR = 2.4, 95% CI: 1.28-4.57), brain contusion (AHR = 2.6, 95%CI: 1.07-4.09), surgical intervention (AHR = 1.7, 95%CI: 1.03-3.82), posttraumatic amnesia (AHR = 1.99, 95%CI: 1.08-3.48), history of comorbidities (AHR = 1.56, 95%CI: 1.08-3.86), and history of alcohol abuse (AHR = 3.1, 95%CI: 1.89-5.23) were potential predictors of early PTS. CONCLUSION: The incidence of early PTS was high. Since, early PTS can worsen secondary brain damage, knowing the predictors helps to provide an effective management plan for patients likely to develop early PTS and improve their outcome.

Evaluation of liver function biomarkers, blood pressure, and anthropometric parameters among chronic kidney disease patients: Laboratory-based cross-sectional study in Northwest Ethiopia.

Background: Chronic kidney disease (CKD) is a non-communicable disease leading to a progressive decline in kidney functions and complications like liver disorders. Serum levels of liver parameters such as aminotransferases and bilirubin are important biomarkers for the diagnosis of liver diseases. Studies on the effect of CKD with and without end-stage renal disease (ESRD) on the levels of liver biomarkers in Ethiopia are limited. Hence, this study aimed to assess liver biomarkers, blood pressure (BP) and anthropometric indices in CKD patients attending a renal clinic of Felege Hiwot Comprehensive Specialized Hospital(FHCSH) in Bahir Dar, Ethiopia. Method: A hospital-based cross-sectional study was conducted among 100 CKD patients attending the renal clinic of FHCSH in Bahir Dar, Ethiopia. Data were collected using a structured questionnaire through face-to-face interview. BP and anthropometric parameters were measured based on the standard procedures. About 5 ml of serum was used to analyzeliver parameter using automated chemistry analyzer. All data analyses such as independent sample t-testand one-way ANOVA were done using SPSS version 25.0. Besides, Pearson's correlation analysis and multiple linear regression were done to identify predictors of liver biomarkers in CKD patients. P-value< 0.05 were considered statistically significant. Results: The mean serum levels of AST and ALT were significantly lower in CKD patients under dialysis when compared to CKD patients with no dialysis (p < 0.05). These enzymes were positively and negatively correlated with eGFRand the severity of CKD, respectively. However, there were no significant differences in bilirubin level between different stages of CKD. There was also a significant increase (p < 0.05) in the levels of AST and ALT with BMI.There was also a significant rise of SBP and DBP in CKD patients under dialysis compared to CKD patients not in dialysis. Conclusion: Aminotransferases were significantly lower in CKD patients undergoing dialysis than in CKD patients not undergoing dialysis, warranting the need fora separate standard reference ranges or using other diagnostic criteria to diagnose liver comorbidities in CKD patients. The levels of AST and ALT in CKD patients were also significantly increased with BMI. Besides, BP was significantly elevated with the severity of CKD, indicating the more advanced the CKD is, the higher BP.

Incidence, time to occurrence and predictors of peripheral intravenous cannula-related complications among neonates and infants in Northwest Ethiopia: an institutional-based prospective study.

BACKGROUND: Peripheral intravenous cannulas (PIVC) are venous access devices commonly used for the administration of intravenous fluids, drugs, blood products, and parenteral nutrition. Despite its frequent use, it has complications that can seriously threaten patient safety, prolong hospital stays, and increases medical care costs. PIVC complications are associated with increased morbidity and reinsertion attempts are painful and anxiety-provoking for children and their parents. Therefore, this study was aimed to assess the incidence, time to occurrence and identify predictors for PIVC complications among infants admitted to Debre Tabor Comprehensive Specialized Hospital (DTCSH), Northwest Ethiopia. METHODS AND SETTING: An institutional-based prospective cohort study was conducted on 358 infants admitted to a neonatal intensive care unit and pediatric ward, DTCSH from January 1 to April 30, 2022. A systematic sampling technique was employed. RESULTS: The incidence rate of PIVC complication was 11.6 per 1000 person-hours observation. PIVC complication was observed in 56.4% (202) of PIVCs, of which infiltration (42.1%) was the most common complication followed by phlebitis (29.7%). The median time to complication was 46 h. Anatomical insertion site (AHR = 2.85, 95%CI: 1.63-6.27), admission unit (AHR = 1.88, 95%CI: 1.07-4.02), sickness (AHR = 0.24, 95% CI: 1.31-4.66), medication type (AHR = 2.04, 95%CI: 1.13-3.66), blood transfusion (AHR = 0.79, 95%CI: 0.02-0.99), clinical experience (AHR = 0.52, CI:0.26-0.84), and flushing (AHR = 0.71, 95%CI: 0.34-0.98) were potential predictors of PIVC complication. CONCLUSION: Knowing the predictor factors helps clinicians to provide effective care and to detect complications early.