Prevalence and associated factors of symptomatic pelvic floor disorders among women living in Debre Tabor Town, Northwest Amhara, Ethiopia.

BACKGROUND: Pelvic floor disorders are a group of disorders affecting the pelvic floor that include clinically definable conditions such as pelvic organ prolapse, urinary incontinence and fecal incontinence. These conditions silently affect millions of women worldwide and related problems are not well disclosed by women due to associated social stigma or lack of access to services in developing countries. Thus, the magnitude and related burden of these conditions vary, and little is known about them. This study was conducted to assess the magnitude and associated factors of symptomatic pelvic floor disorders in Debre Tabor town, Northwest, Ethiopia, from May 30-July 30, 2020. METHOD: A community-based cross-sectional study was conducted on child bearing women (> 15 years) who resided in Debre Tabor Town from May 30-July 30, 2020. The participants were selected through multistage systematic random sampling. The data were collected via a structured questionnaire through face-to-face interviews, entered into Epi-info-7.2, and subsequently analyzed using SPSS version 20. The prevalence of pelvic floor disorders was presented along with the 95% CI. RESULTS: A total of 402 women participated in this study, 59 (14.7%; 95% CI; 11.4, 18.2) of whom reported one or more types of pelvic floor disorders. The most prevalently reported pelvic floor disorders were pelvic organ prolapse (13.9%; 95% CI: 10.9, 17.4), urinary incontinence (10.9%; 95% CI: 7.4, 9.2) and fecal incontinence (7.7%; 95% CI: 5.2, 10.2). Additionally, aging, multiparity and having early marriage (< 18 yrs.) were identified as potential risk factors associated with pelvic floor disorders. CONCLUSIONS: The prevalence of symptomatic pelvic floor disorders in the current study was high. Thus, early detection, preventive and treatment strategies should be considered. In addition, it is better to educate the community and women on the association of early marriage and multiparty with PFDs.

Prevalence and associated factors of maternal birth trauma following vaginal delivery at University of Gondar Comprehensive Specialized Hospital, North-West Ethiopia, 2022.

BACKGROUND: Maternal injury with any form of perineal trauma following vaginal delivery is very common which ranges globally from 16.2 to 90.4%. The frequency of Obstetric anal sphincter Injuries and the incidence of cervical laceration increases rapidly. However, in Ethiopia, there is limited evidence on the prevalence of maternal birth trauma and its determinant factors after vaginal delivery. OBJECTIVE: To assess the magnitude and associated factors of Maternal Birth Trauma after vaginal delivery at University of Gondar Comprehensive Specialized Hospital, Gondar, North-West Ethiopia, 2022. METHODS: An Institution based cross-sectional study was conducted among mothers with singleton vaginal delivery at University of Gondar Comprehensive Specialized Hospital from 9th May to 9th August 2022 among 424 study participants. Pre-tested semi-structured questioner was utilized. Epi-Data version 4.6 was used for data entry and exported to SPSS version 25 for data management and analysis. To identify the determinant factors, binary logistic regression model was fitted and variables with p-value < 0.2 were considered for the multivariable binary logistic regression analysis. In the multivariable binary logistic regression analysis, Variables with P-value < 0.05 were considered to have statistical significant association with the outcome variable. The Adjusted Odds Ratio (AOR) with 95% CI was reported to declare the statistical significance and strength of association between Maternal Birth Trauma and independent variables. RESULTS: A total of 424 mothers who delivered vaginally were included. The mean age of participants was 26.83 years (± 5.220 years). The proportion of birth trauma among mothers after vaginal delivery was47.4% (95%CI: 43.1, 51.7). Of different forms of perineal trauma, First degree tear in 42.8%, OASIs in 1.5% and Cervical laceration in 2.5% study participants. In the multivariable binary logistic regression analysis being primiparous (AOR = 3.00; 95%CI: 1.68, 5.38), Gestational age ≥ 39 weeks at delivery (AOR = 2.96; 95%CI: 1.57, 5.57), heavier birth weight (AOR = 12.3; 95%CI: 7.21, 40.1), bigger head circumference (AOR = 5.45; 95%CI: 2.62, 11.31), operative vaginal delivery (AOR = 6.59; 95%CI: 1.44, 30.03) and delivery without perineum and/or fetal head support (AOR = 6.30; 95%CI: 2.21, 17.94) were significantly associated with the presence of maternal birth trauma. CONCLUSION AND RECOMMENDATION: Maternal birth trauma following vaginal delivery was relatively high in this study. Prim parity, gestational age beyond 39 weeks at delivery, heavier birth weight, bigger head circumference, operative vaginal delivery and delivery without perineum and/or fetal head supported were factors affecting perineal outcome. The Ministry of Health of Ethiopia should provide regular interventional training as to reduce maternal birth trauma.

Reasons for modern contraceptives choice and long-acting reversible contraceptives early removal in Amhara Region, Northwest Ethiopia; qualitative approach.

BACKGROUND: Women use modern contraceptive methods, mainly either to limit or space pregnancy and both are not identical in their choices. One method may not best fit an individual's need irrespective of the time of spacing. Cognizant of this, the context with which women base in choice of contraceptives, their lived experiences in using, and factors for early removal/ discontinuation of long-acting reversible contraceptives (LARCs) are not much investigated in the study setting and our study aimed to bridge the gap through exploring the underlying reasons. METHOD: A phenomenological study design was used to explore sampled women's reasons and experiences. Reproductive-aged women (15-49 years) who removed long-acting methods in the past 6 months were included. A criterion sampling approach was employed to recruit study participants. Data was collected using an interview guide for in-depth (IDIs) and key informant interviews and were tape-recorded with interviewees' consent. Audio data were transcribed verbatim and translated into English. The data was first saved in plain text format and imported into Atlas.ti 7.0 software to facilitate coding and categorizing. The content analysis method was used to classify, organize data, and interpret the qualitative data according to key categories. RESULTS: Several misconceptions about contraceptives (e.g., implants are not appropriate for daily laborers, women who use contraceptives (such as injectables) can only bear girl-child, etc.) were reported by clients and health providers. These misconceptions might not have scientific merit but they are powerful enough to affect actual behaviors toward contraceptives, including early removal. The awareness, attitude, and use of contraceptives tend to be lower in rural areas. For premature removal of LARCs, side effects, and heavy menstrual bleeding, was the most commonly identified reason. The IUCD is the least preferred method and users said it is not comfortable during sex. CONCLUSION AND RECOMMENDATION: Our study found different reasons and misconceptions for modern contraceptive methods' non-use and discontinuation. Standardized counseling approaches like the REDI (Rapport Building, Exploration, Decision Making, and Implementation) framework should be implemented in the country consistently. Some of the concrete providers' conceptions should be well-studied considering contextual factors to bring scientific evidence.

Large Vesicovaginal Fistula After Vaginal Insertion of a Plastic Cap Healed with Two Weeks of Catheterization: A Case Report.

Vesicovaginal fistula (VVF) in developing countries is mainly associated with obstructed labor, iatrogenic injury during cesarean delivery, and hysterectomy. However, formation of VVF after foreign body insertion into the vagina is an extremely rare phenomenon. We report on an 18-year-old girl from rural northwest Ethiopia who presented with continuous leakage of urine for 2 months. She had inserted a plastic cap into her vagina 2 years prior for an unrevealed reason. A foreign body was found in her vagina, resulting in a large VVF. Removal of the foreign body was made under spinal anesthesia. She was catheterized for 14 days and the fistula closed spontaneously. Longstanding impaction of a foreign body in the vagina is associated with VVF formation. VVF resulting from a foreign body in young women could be closed with prolonged catheterization, even for large fistulas.

Zinc deficiency and associated factors among pregnant women's attending antenatal clinics in public health facilities of Konso Zone, Southern Ethiopia.

BACKGROUND: Zinc is an essential mineral known to be important for the normal physiological functions of the immune system. It is one of the basic nutrients required during pregnancy for the normal development and growth of the fetus. However, Zinc deficiency during pregnancy causes irreversible effects on the newborn such as growth impairment, spontaneous abortion, congenital malformations and poor birth outcomes. Even though, the effect of Zinc deficiency is devastating during pregnancy, there is scarcity of evidence on Zinc deficiency and related factors among pregnant women in the current study area. OBJECTIVE: To assess Zinc deficiency and associated factors among pregnant women attending antenatal clinics in public health facilities of Konso Zone, Southern Ethiopia. METHODS: Institution based cross-sectional study was conducted among randomly selected 424 pregnant mothers. Data were collected using pre tested questionnaire (for interview part), and 5 blood sample was drawn for serum zinc level determination. Data were entered to Epi-Data version 3.1 software and exported to SPSS version 25 for analysis. Binary logistic regression analysis was computed and independent variables with a p-value ≤ 0.25 were included in multivariable analysis. Serum zinc level was determined using atomic absorption spectroscopy by applying clean and standard procedures in the laboratory. Finally adjusted odds ratio with 95% confidence level, P-value < 0.05 was used to identify significant factors for Zinc deficiency. RESULT: The prevalence of Zinc deficiency was found to be 128 (30.26%) with the mean serum zinc level of 0.56±0.12 g/dl. Age, 25-34 years [AOR 2.14 (1.19,3.82)], and 35-49 years [AOR 2.59 (1.15, 5.85)], type of occupation, farming [AOR 6.17 (1.36, 28.06)], lack of antenatal follow up during pregnancy [AOR 3.57 (1.05,12.14)], lack of freedom to purchase food items from market [AOR 3.61 (1.27, 10.27)], and inadequate knowledge on nutrition [AOR 3.10(1.58, 6.08)] were factors associated with Zinc deficiency. CONCLUSION: Zinc deficiency is a public health problem among pregnant mothers in the current study area. Improving maternal nutritional knowledge, motivating to have frequent antenatal follow up, and empowering to have financial freedom to purchase food items from market were the modifiable factors to reduce Zinc deficiency. Nutritional intervention that focused on improving nutritional knowledge and insuring access to Zinc sources food items should be delivered for pregnant mothers.

Undiagnosed hypertension and associated factors among adults in Debre Markos town, North-West Ethiopia: A community-based cross-sectional study.

Introduction: Globally, hypertension is an important risk factor for cardiovascular diseases and all-cause mortality. Despite this high public health burden, no community-based evidence regarding the magnitude and related factors of hypertension has been reported in the study area. Objective: The aim of this study was to determine the prevalence and associated factors of undiagnosed hypertension in Debre Markos town, North-West Ethiopia, 2020. Method: A community-based cross- sectional study design was conducted from January to March 2020. Socio-demographic and behavioral characteristics of the participants were collected using interviewer-administered semi-structured questionnaires. Physical measurements including body mass index, waist circumference, and blood pressure were collected using standardized measuring instruments. Statistical analysis was collected using SPSS version 21 software. Univariate logistic regression model was used to present the results. The p value less than 0.05 in a multivariable analysis was considered statistically significant at 95% confidence interval. Results: From a total of 630 samples, 600 participants, 270 (45%) males and 330 (55%) females with a mean age of 36.32 ± 12.48 years, were participated giving a response rate of 95.2%. The prevalence of undiagnosed hypertension among adults was 12.7%. Of these, 5.5% were males and 7.2% were females. Factors including age (above 60 years) (adjusted odds ratio = 2.92, 95% confidence interval (1.05, 8.06), p = 0.03), body mass index (overweight and obese) (adjusted odds ratio = 3.85, 95% confidence interval (2.16, 6.87), p < 0.01), fatty diet consumption (adjusted odds ratio = 1.88, 95% confidence interval (1.03, 3.42), p = 0.04), family history of hypertension (adjusted odds ratio = 2.21, 95% confidence interval (1.04, 4.69), p = 0.04) were significantly associated with hypertension. Conclusion: The prevalence of undiagnosed hypertension among adults was found to be remarkable. Therefore, a community-based health education and hypertension screening strategies are needed to prevent the problem early in life in Debre Markos town and the nation at large.

Magnitude and associated factors of adverse perinatal outcomes among women with oligohydramnios at 3rd trimester at University of Gondar comprehensive specialized hospital, North West Ethiopia.

Background: Oligohydramnios is a pregnancy condition characterized by low volume of amniotic fluid. Based on ultrasound measurement, it is defined as a single maximum vertical pocket of liquor less than 2 cm or summation of four quadrants vertical pockets of liquor measurement less than 5 cm. It is associated with multiple adverse perinatal outcomes (APO) and complicates 0.5%-5% of pregnancies. Objective: To assess magnitude and associated factors of adverse perinatal outcome among women with oligohydramnios at 3rd trimester at University of Gondar Comprehensive Specialized Hospital, North West Ethiopia. Methods: Institution based cross-sectional study was employed from April 1 to September 30, 2021 in which 264 participants were involved. All women with oligohydramnios at 3rd trimester who meet the inclusion criteria were included. Semi- structured questionnaire was used for data collection after Pre-tested. Collected data was checked for completeness; clarity then coded and entered using Epi data version 4.6.0.2 then exported to STATA version 14.1 for analysis. Result: The magnitude of APO was 46.6% (95%CI: 40.5-52.7%). Null parity [AOR = 2.2, 95%CI (1.2-4.2)], presence of hypertensive disorders of pregnancy (HDP) [AOR = 4.9, 95%CI (2.0-12.1)] and presence of intrauterine growth restriction (IUGR) [AOR = 8.4, 95%CI (3.5-20.2)] were found to be predictors of APO. Conclusion: Third trimester oligohydramnios is associated with APO. The presence of HDP, IUGR and being nulliparous were predictors of APO.

Adherence to diabetes self-care management and associated factors among people with diabetes in Gamo Gofa Zone public health hospitals.

INTRODUCTION: Adherence to diabetes self-care management is a lifestyle modification for people with diabetes which includes; medication, dietary practice and regular physical activity. The objective of this study was to assess the adherence to diabetes self-care management and associated factors among people with diabetes in Gamo Gofa Zone, Southern, Ethiopia, 2018. METHODS: Institutional-based cross-sectional study design with a systematic random sampling technique was conducted. A total 635 diabetic participants were involved in this study. Data were collected using structured interviewer administered questionnaire. Data were analyzed using SPSS version 21. Descriptive statistics were employed to describe the study population in relation to the relevant variables. Binary and multivariable logistic regression was conducted to identify factors associated with the outcome variables. P-value < 0.05 with 95% confidence interval was used to declare statistical significance. RESULTS: The prevalence of good adherence toward diabetes self-care management was 341 (53.7%), (95% confidence interval = 46.09, 61.31). Regarding diabetes self-care practices, poor adherence had been detected in blood sugar measurement practice, dietary feeding practice, physical exercise and eye examination practice. The multivariable analysis indicated that government workers [adjusted odds ratio = 2.74 (1.03, 7.30)], training on diabetes self-care practice [adjusted odds ratio = 3.13 (1.89, 5.16)], diabetes' association membership [adjusted odds ratio = 1.59 (1.01, 2.50)], having personal glucometer at home [adjusted odds ratio = 2.70 (1.37, 5.33)], duration of diabetic illness >10 years [adjusted odds ratio = 9.59 (3.99, 23.05)] and people with diabetes who were not developing complication [adjusted odds ratio = 1.54 (1.01, 2.33)] were significantly associated with good adherence to diabetes self-care management practice. CONCLUSION: Significant number of diabetes patients had poor adherence to diabetes self-care practice. Special focus should be given to farmers with diabetes, those with diabetic complication and for those with duration of diabetes less than 10 years. Periodical training should be given for people with diabetes on dietary feeding, physical exercise and eye examination practice.

Incidence and determinants of adverse outcomes among women who were managed for eclampsia in the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.

BACKGROUND: The incidence of eclampsia and its adverse maternal outcomes are very high in developing countries, particularly in Subsaharan African Countries. Identifying predictors for adverse maternal outcomes of eclampsia has paramount importance for helping health care providers to optimize their management outcomes. Therefore, this study aimed to assess the incidence of adverse maternal outcomes of eclampsia and its determinant factors. METHODS: A retrospective follow-up study design was applied. The data were extracted from patient charts using a structured, pre-tested, questionnaire. Descriptive analyses (frequencies, means, and standard deviation) were calculated, and bi-variable and multivariable logistic regression models were used to testing the association between independent variables and an outcome variable. After the data were coded and entered into Epi-Info Version 7.2 Software, the data were analyzed using STATA Version 14 Statistical Software. RESULTS: The magnitude of eclampsia was 5.36 per 1000 pregnancies (95% CI: 4.72, 6.10). The incidence of adverse maternal outcomes in eclamptic mothers was 53.7% (95% CI: 47.02, 60.24%). After adjusting for covariates maternal age 30-34, AOR 5.4 [95% CI = 1.02, 28.6]; age above 34, AOR 10.5 [95% CI = 1.3, 88.6]; gravidity 2-4, AOR 0.3 [95% CI = 0.1, 0.9]; 10 or more convulsions, AOR 4.6 [95% CI = 1.4, 14.9]; mild pyrexia, AOR 20.4 [95% CI = 3.7, 112.7]; moderate pyrexia, AOR 14.6 [95% CI = 1.7125.1]; platelet count below 50,000 cells/mm3, AOR 34.9 [95% CI = 3.6, 336.2]; platelet count between 50,000 and 99,000 cells/mm3, AOR 24.5 [95%CI = 5.4111.6]; and stillbirth of the current pregnancy, AOR 23.2 [95%CI = 2.1257.5] were strong predictors of adverse maternal outcomes in eclamptic mothers. CONCLUSIONS: The incidence of adverse maternal outcomes of eclampsia was found to be high compared to similar studies discussed in this study. This study recommends early identification of patients with the risk factors (having many convulsions, high body temperature, low platelet count, patient age above 30 years, and 2-4 pregnancies), strengthening the referral system, and advocation of research on the area of adverse maternal outcomes and thereby encourage evidence-based medicine.

Live ascaris in urinary bladder: a case report.

INTRODUCTION: Ascaris in urinary bladder is an extremely rare phenomenon. It may occur after fistula formation between urinary and gastrointestinal tract or by retrograde migration of adult worm, and is associated with complications. CASE PRESENTATION: A 47-year-old Amhara woman from rural northwest Ethiopia presented with a complaint of difficulty to fully evacuate her bladder of 1 year duration. Ultrasonography showed thickened bladder wall with echo debris. There were also thickened bowel and fluid-filled loops of intestine adjacent to urinary bladder. On cystoscopy examination, there was live ascaris swimming inside the bladder. Enterovesical fistula was entertained and explorative laparotomy performed. Findings confirmed presence of iliovesical fistula. The fistula was divided and the continuity of the intestine restored. The inflammatory mass was subjected to histopathology study and turned out to be benign inflammatory reaction. She was also given antihelminthics. Postoperatively, her course was uneventful, and she was discharged cured. CONCLUSION: Though it is extremely rare to have urinary symptoms from ascariasis, it is important to have a high index of suspicion for all possibilities.

Knowledge, attitude and preventive practice towards COVID-19 and associated factors among outpatient service visitors at Debre Markos compressive specialized hospital, north-west Ethiopia, 2020.

BACKGROUND: COVID-19 is an emerging infectious disease which is a major public health problem worldwide. Given the serious threats imposed by COVID-19 and the absence of vaccines until August 2020, preventive measures play an essential role in reducing infection rates and controlling its spread. This shows the necessity of public adherence for preventive and control measures, which is affected by their knowledge, attitudes, and practices. OBJECTIVE: This study aimed to determine knowledge, attitude, and practice (KAP) towards COVID-19 and associated factors among outpatient service visitors, Debre Markos compressive specialized hospital, north-west,Ethiopia. METHOD: Institutional-based cross-sectional study design with a systematic random sampling technique was conducted from July to August 2020. Among a total of 404 participants, 398 were recruited. Data were collected using a structured questionnaire. The data was edited, coded, and entered into Epi data version 4.6 and exported to SPSS-25 for analysis. Bivariable and multivariable logistic regression models were employed to identify factors associated with KAP. A p-value of <0.05 was considered statistically significant. RESULT: The prevalence of poor knowledge, attitude and practice among the outpatient service visitors were 27.1%, 30.7% and 44%, respectively. The mean age of the participants was 33.4 ±10.9 years. Variables like; educational status, ''can't read and write" [AOR = 3.76, 95% CI (1.36-10.42), P = 0.01], read and write [AOR = 5.90, 95% CI (2.39-14.98), P = 0.01], rural residence [AOR = 3.04, 95% CI (1.43-6.46), P = 0.01] and having no television [AOR = 0.8, 95% CI (0.79-0.89), P = 0.03] were significantly associated with poor knowledge. While, educational status of "can't read and write", [AOR = 6.71, 95% CI (2.78-16.16), P = 0.01] and rural residence [AOR = 2.03, 95% CI (1.14-3.61), P = 0.02] were significantly associated with poor attitude. Additionally, poor knowledge, [AOR = 22.73, 95% CI (10.5-49.21), P = 0.01], rural residence [AOR = 2.08, 95% CI (1.08-4.88), P = 0.04] and having no television [AOR = 2.24, 95% CI (1.05-4.79), P = 0.01] were significantly associated with poor practice. CONCLUSION: In this study, knowledge, attitude, and practice among outpatient service visitors was poor which needs targeted health education and interventions from the health professional to enhance their knowledge, attitude, and practice towards COVID-19. In parallel with this, special attention should be given for the rural community and for those with an educational status of can't read and write.

Menstrual related discomfort and associated factors among undergraduate students in Ambo University, Central Ethiopia.

BACKGROUND: Menstruation is a natural phenomenon which is an indicator of women's health that occurs throughout the reproductive years of every female. This phenomenon is unique to the females and governed by the girl's general health condition, genetic, socioeconomic, and nutritional factors. Although it is a normal physiological process, most females experience some degree of pain and discomfort in their menstruation period. Even though there are limited studies so far reported about the issue in some other parts of the country, there is no scientific evidence in the present study area. OBJECTIVE: To assess menstrual-associated discomfort and associated factors among undergraduate students in Ambo University, Central Ethiopia, 2018. METHODS: Institution-based cross-sectional study was conducted at Ambo University from 30 March to 30 April 2018. Stratified sampling technique was used and 748 study participants were randomly selected from faculties using a multi-stage sampling procedure. Only data from 713 study participants were entered into EpiData 3.1 and analyzed using SPSS version 20.0 software. Logistic regression was used to associate factors with menstrual-associated discomfort. All statistical tests were considered as significant at a p-value of < 0.05. RESULT: The prevalence of menstrual-associated discomfort was found to be 68.6%. The variables age (Being younger) (adjusted odds ratio = 3.9 (95% confidence interval: 1.28, 11.78)), Tigire ethnicity (adjusted odds ratio = 2.4 (95% confidence interval: 1.02, 5.75)), unmarried (adjusted odds ratio = 2.1 (95% confidence interval: 1.21, 3.76)), smokers (adjusted odds ratio = 2.2 (95% confidence interval: 1.12, 4.29)), drinking caffeine (adjusted odds ratio = 1.8 (95% confidence interval: 1.17, 2.74)), amount of flow (adjusted odds ratio = 2.4 (95% confidence interval: 1.28, 4.62)), and duration of pain (adjusted odds ratio = 4.2 (95% confidence interval: 1.93, 9.29)) were significantly associated with menstrual-associated discomfort. CONCLUSION: This study revealed that majority of the participants was experienced with menstrual-associated discomfort. As the tendency of smoking cigarettes, drinking caffeine, and amount of flow is increased, menstrual associated discomfort is increased. Therefore, specific plan of action and support is urgently needed in order to enlighten and treat menstrual-associated discomfort.

Cataract and associated factors among adults visiting ophthalmic clinic at Debre Markos comprehensive specialized hospital, northwest Ethiopia, 2020.

INTRODUCTION: Globally, it is estimated that 2.2 billion people have a visual impairment, of which around 65.2 million is due to cataract. Cataract is the leading cause of preventable blindness worldwide, with the greatest burden found in low-income countries. That is providing recent epidemiological data is very crucial to design intervention measures. The aim of this study was to assess the magnitude and associated factors of cataract among adults visiting ophthalmic clinic, Debre Markos comprehensive specialized hospital, Northwest Ethiopia, 2020. METHODS: The sample size was calculated using single population formula and determined to be 174. All adult participants aged ⩾40 were the source population and those fulfilling the inclusion criteria were the study population. An institutional-based cross-sectional study design using a systematic random sampling technique was conducted from July to August, 2020. Semi-structured questionnaires and patients' card were used to collect data. Data were entered into epi-data version 4.6 and the analysis was conducted using SPSS-25 software. Data were presented using graphs, tables and texts. Bivariable and multivariable binary logistic regression models were used to identify factors associated with cataract. Adjusted odds ratio with corresponding 95% confidence interval was computed to show the strength of association. A p-value < 0.05 was considered statistically significant. RESULT: From a total of 174 samples, 158 participated, giving a response rate of 90.8%. The prevalence of cataract was found to be 90 (57%). The variables-age 60-69 years (adjusted odds ratio = 6.667, 95% confidence interval: (1.662, 13.101)); age 70-79 years (adjusted odds ratio = 9.583, 95% confidence interval: (2.840, 32.342)), and single marital status (adjusted odds ratio = 2.945, 95% confidence interval: (1.241, 6.989))-had a significant association with cataract. CONCLUSION: The prevalence of cataract was found to be very high, which needs immediate intervention. Older age and single marital status were found to be significantly associated with cataract prevalence.

Bladder rupture due to urogenital tract trauma caused by ox horn injury in a patient with pelvic organ prolapse: a case report.

INTRODUCTION: Genitourinary tract trauma caused by ox horn injury in the presence of pelvic organ prolapse (POP) is an extremely rare phenomenon and associated with devastating morbidity. CASE PRESENTATION: A 50-year-old multiparous postmenopausal woman from rural northwest Ethiopia presented with the primary complaint of urinary incontinence 6 days after she suffered ox horn injury to her prolapsed genitalia. She had stage 3 pelvic organ prolapse with the leading point being the cervix. The anterior vaginal and posterior bladder walls were disrupted with visible draining of the left ureter. The wound was dirty and edematous with whitish discharge. She was admitted to the urogynecology ward and provided with wound care until the infection subsided. Apical prolapse suspension was performed using right sacrospinous fixation, and bladder repair was carried out 6 weeks following the prolapse suspension. She recovered well and was continent when discharged. CONCLUSION: Ox horn injury involving the female lower urogenital tract in the presence of POP is extremely rare. Late presentation after sustaining injury is associated with increased risk of morbidity and long hospital stay, and treatment requires multistage surgery.

Modern Contraceptive Method Utilization and Associated Factors Among Women of Reproductive Age in Gondar City, Northwest Ethiopia.

BACKGROUND: Family planning is defined as the ability of couples or individuals to attain their desired number of children, spacing, and timing of their births with the use of contraceptive methods. Ethiopia is one of the most populated countries in Africa with a high fertility rate, a highly unmet need for family planning, and low contraceptive utilization. OBJECTIVE: This study aims to assess modern contraceptive method utilization and associated factors among women of reproductive age in Gondar City, Northwest Ethiopia. MATERIALS AND METHODS: A community-based cross-sectional study design was undertaken with 708 women in the reproductive age in Gondar City, using a structured questionnaire combined with face-to-face interviews. Descriptive analysis, binary, and multivariable logistic regression analyses were applied to analyze the data. RESULTS: In this study, 41.2% of the respondents utilized modern contraceptive methods. Of the study participants, 52.1 % had good knowledge and 45.3% had a favorable attitude towards modern contraceptive methods. After adjusting for covariates, the odds of using modern contraceptive methods were 3.6 times, 4.7 times, 2.4 times, and 4 times higher among women of the age 20-24, 25-29, preparatory education, and degree holders, respectively. In addition, for the women having up to six desired children [AOR (Adjusted Odds Ratio) = 2.4 (95% CI: 1.1, 5.3)], a history of no-child death experience [AOR= 4.4 (95% CI: 1.03, 19.1)], good knowledge [AOR= 4.1 (95% CI: 2.7, 6.0)], and favorable attitude [AOR= 3.5 (95% CI: 2.4, 5.1)] were positively associated with modern contraceptive utilization. CONCLUSION: The majority of participants had good knowledge about, but the unfavorable attitude towards the utilization of modern contraceptive methods. Therefore, the authors recommended that special awareness creation with the help of health education interventions should be employed in the community.

Patients with chronic kidney disease are not well adhered to dietary recommendations: a cross-sectional study.

BACKGROUND: Nutrition and dietary patterns are modifiable factors that can be utilized to prevent or slow the progression of Chronic kidney disease (CKD). Adherence to current dietary recommendations can reduce the incidence, or slow the progression of CKD and reduce mortality. The objectives of this study was to compare the dietary nutrient intake of CKD patients (CKD above stage 3 including hemodialysis) to dietary recommendations and to assess the correlations of those dietary nutrient intakes with each other and with chosen laboratory measurements. METHODS: A hospital-based cross-sectional study was conducted among 100 patients with CKD. A consecutive 7 days dietary record supplemented with interviews for data completion was used to assess dietary intake. Recent clinical laboratory measurements were obtained from patients' medical records. The obtained dietary data were analyzed by the Ethiopian food composition database and the nutrisurvey software. Dietary energy and nutrients intake were compared with recommendations for CKD patients. RESULTS: The dietary energy intake (DEI) of almost all patients was below recommended levels. The average Dietary protein intake (DPI) was above the recommended levels (0.95 ± 0.27 g/kg/day) for about 60% of the respondents. Besides, 38% and only two of the respondents had their dietary phosphorus and potassium intakes above recommended levels, respectively. Estimated Glomerular filtration rate (eGFR) was positively correlated with both total and animal protein intakes while blood levels of creatinine and urea were negatively correlated with animal protein intake. CONCLUSION: Patients with CKD are not well adhered to dietary recommendations and some nutrients showed correlation with chosen clinical laboratory measurements. Besides, DEI and DPI were below and above recommended levels, respectively, for most patients. Besides, more than one-third of the participants had phosphorus intakes above recommendation. These non-optimal dietary nutrient intakes may contribute to fast clinical deterioration and mortality.

Prevalence of color blindness among school children in three primary schools of Gish -Abay town district, Amhara regional state, north-west Ethiopia.

BACKGROUND: Although there are limited studies, recent data are lacking to accurately determine the magnitude of color blindness in Ethiopia and there is no evidence of such a study in Gish Abay town district. The purpose of thie study was to assess the prevalence of color blindness among school children in Gish Abaya town district, Ethiopia. METHODS: The study used a community-based analytical cross-sectional study design with multistage cluster random sampling technique from September to October 2016. Three primary schools were selected randomly in the district of Gish Abay town district. Ishihara color plates (24 -edition) was used for color vision test and Snellen' tumbling 'E' chart was used for visual acuity test. The data was analyzed using Statistical Package for Social Sciences (SPSS) version 20 statistical software and binary logistic regression was used to identify factors associated with color blindness. RESULTS: Among a total of 854 subjects, 850 participants with age range of 8-18 years were screened for color vision test giving a response rate of 99.53%. Among the participants, 452 (53.2%) were males and 398 (46.8%) were females. There were 36 (4.24%) cases of impaired color vision. Among these, 27 (3.18%) were males and 9 (1.06%) were females. Out of 36 cases of color blindness, 15 (1.77%) were deutan, 7 (0.82%) were protan and 14(1.65%) were unclassified (both deutan and protan forms). The variables; sex adjusted odds ratio (AOR [95% Confidence Interval] =3.19 [1.45; 6.98], p-value = 0.004); and visual impairment (AOR [95% CI] =4.15 [1.77; 9.75], p-value = 0.001) were significantly associated with color impairment. CONCLUSION: The prevalence of childhood color blindness in Gish Abay town district was relatively similar with other studies in Ethiopia. Sex and visual impairment are factors found to be related with the children's color blindness. Periodical eye examination at the time of school admission is recommended to adjust the children's occupation early in life.

Term abdominal pregnancy: a case report.

INTRODUCTION: Abdominal pregnancy is a rare form of ectopic pregnancy with very high maternal and fetal morbidity and mortality. A high index of suspicion is crucial for prompt diagnosis and management especially in low-resource countries. CASE PRESENTATION: A 32-year-old gravida III para II Amhara woman presented with shortness of breath and progressive abdominal distension and pain. An emergency laparotomy was performed with the impression of abdominal pregnancy. Intraoperatively, the fetus was seen in an intact amniotic sac in her abdomen, her uterus was ruptured at the fundus and the placenta was extensively adhered to the edge of the ruptured site. The patient and neonate progressed well and were discharged. CONCLUSIONS: Term abdominal pregnancy is an extremely rare diagnosis and requires a high index of suspicion. The life-threatening complication is bleeding from the detached placental site. A thorough examination of the newborn is important to rule out congenital anomalies.