Epidemiology and Outcomes of Critical Illness and Novel Predictors of Mortality in an Ethiopian Medical Intensive Care Unit.

Low- and middle-income countries (LMICs) bear most of the global burden of critical illness. Managing this burden requires improved understanding of epidemiology and outcomes in LMIC intensive care units (ICUs), including LMIC-specific mortality prediction scores. This study was a retrospective observational study at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia, examining all consecutive medical ICU admissions from June 2014 to April 2015. The primary outcome was ICU mortality; secondary outcomes were prolonged ICU stay and prolonged mechanical ventilation. ICU mortality prediction models were created using multivariable logistic regression and compared with the Mortality Probability Model-II (MPM-II). Associations with secondary outcomes were examined with multivariable logistic regression. There were 198 admissions during the study period; mortality was 35%. Age, shock on admission, mechanical ventilation, human immunodeficiency virus, and Glasgow Coma Scale ≤8 were associated with ICU mortality. The receiver operating characteristic curve for this 5-factor model had an AUC of 0.8205 versus 0.7468 for MPM-II, favoring the simplified new model. Mechanical ventilation and lack of shock were associated with prolonged ICU stays. Mortality in an LMIC medical ICU was high. This study examines an LMIC medical ICU population, showing a simplified prediction model may predict mortality as well as complex models.

OPEN WINDOW THORACOSTOMY, STILL AN OPTION IN THE MANAGEMENT OF CHRONIC EMPYEMA: EXPERIENCE FROM AYDER REFERRAL HOSPITAL.

OBJECTIVE: Chronic empyema is a serious problem and is often difficult to manage. Its incidence has dropped worldwide, but continues to pose health problems in low and middle income countries. This study has been conducted to assess the outcome of open thoracic window in patients with neglected chronic thoracic empyemain Ethiopian patients. METHODS: A six-year (June 2008 to October 2014) retrospective study was conducted on thirty five patients (ten females and twenty five males, age ranging from 30-70 years). Open window thoracostomy was performed on these patients for chronic empyema with residual lung tissue and with or without bronchopleural fistula who failed to respond to the conventional methods of treatment. RESULTS: The etiology was primary empyema in 16 patients, post-traumatic in 12 patients, and post-thoracotomy in seven patients. Spontaneous closure was achieved in 12 patients; simple closure was done on 18 patients; and closure with muscle flap in five patients. In all patients, the cavity cleared from secretions in two to three weeks and the residual space narrowed in seven to nine months. All patients gained weight following the surgery. CONCLUSION: Our result has revealed that open thoracic window is still an alternative method for the treatment of chronic empyema when the conventional method of treatment fails.

Squamous cell carcinoma of the esophagus presenting with features of intracranial space occupying lesion.

We are reporting on a rare case of a male patient with squamous cell carcinoma (SCC) of the esophagus presented itself clinically as a pure intracranial space occupying lesion with symptoms of abnormal body movement, hemiplegia and failure to communicate.

Gender-besed violence among high school students in north west Ethiopia.

BACKGROUND: Gender-based violence exists in all societies and individual woman experience it in every social and economic group. Different studies in Africa have showed that there are significant percentages of females that have suffered from the violence. Most societies encourage manifestation of manliness through violence in workplace, among friends and in the community as a whole. OBJECTIVE: The study tried to see the prevalence of Gender-based Violence and the various patterns and correlates of Gender-Based Violence among female high-school students, Northwest Ethiopia. METHODOLOGY: This study is a cross--sectional study done on 367 female high--school students who were given self-administered questionnaires to assess the prevalence of gender-based violence against these students in Dabat High school. RESULT: This study showed 11.4% of the students have started sexual intercourse and of these, 33.3% were raped cases. Twenty percent (20.4%) from the total of 367 students have survived attempted rape. In addition 44% of the students were sexually harassed. Among the study participants considerable proportion are mainly responsible for the housework. Around 8% of the students have undergone Female Genital Mutilation. CONCLUSION: Generally, the prevalence of gender-based violence is high in Dabat High-School, Northwest Ethiopia and attention should be given by policy-makers and law enforcing bodies to adequately address the problem.