Indications and Findings of Upper Gastrointestinal Endoscopy at a Tertiary Hospital in Ethiopia: A Cross-Sectional Study.

Background: Gastrointestinal disease is a significant global health problem. Symptoms related to digestive system diseases negatively affect quality of life and impose a significant economic impact. Upper gastrointestinal symptoms are common in the Ethiopian population, and the associated pathologies are diverse. Real-time endoscopic visualization of the upper gastrointestinal tract is crucial for diagnosis. However, local data on the indications for endoscopic evaluation and the common underlying pathologies are limited. This study aimed to assess the common indications and upper gastrointestinal endoscopic findings of patients presenting to Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia. Methods: A cross-sectional study was conducted by reviewing the complete records of patients who underwent upper gastrointestinal endoscopic evaluation between January 2012 and December 2019. A structured checklist was used to screen records for completeness. Data were analyzed using Statistical Package for the Social Sciences software version 25. Chi-square test was used to compare variables, with statistical significance set at P < 0.05. Results: A total of 5753 patients underwent complete upper gastrointestinal tract endoscopic evaluation during the study period. The median age of the patients was 37 years. Males accounted for 63.4% of the patients. Dyspepsia (27.8%) was the most common indication for upper gastrointestinal endoscopic evaluation, followed by upper gastrointestinal bleeding (17.1%), and screening for varices (16.8%). Esophageal varices (35.8%), gastritis (18.1%), and duodenal ulcers (10.6%) were the most common pathologies found on esophagus, stomach, and duodenum, respectively. Common upper gastrointestinal pathologies are predominant among males and patients in their third decade of life. Conclusion: Dyspepsia was the most common indication for endoscopic evaluation of the upper gastrointestinal tract. Esophageal varices were the most common pathological finding, followed by gastroesophageal reflux disease, gastritis, portal hypertensive gastropathy, duodenal ulcer, and hiatal hernia. Esophagogastroduodenoscopy remains a vital tool for the diagnosis of pathologies of the upper gastrointestinal tract.

Statistical Characterization and Modeling of Indoor RF-EMF Down-Link Exposure.

With the increasing use of wireless communication systems, assessment of exposure to radio-frequency electromagnetic field (RF-EMF) has now become very important due to the rise of public risk perception. Since people spend more than 70% of their daily time in indoor environments, including home, office, and car, the efforts devoted to indoor RF-EMF exposure assessment has also increased. However, assessment of indoor exposure to RF-EMF using a deterministic approach is challenging and time consuming task as it is affected by uncertainties due to the complexity of the indoor environment and furniture structure, existence of multiple reflection, refraction, diffraction and scattering, temporal variability of exposure, and existence of many obstructions with unknown dielectric properties. Moreover, it is also affected by the existence of uncontrolled factors that can influence the indoor RF-EMF exposure such as the constant movement of people and random movement of furniture and doors as people are working in the building. In this study, a statistical approach is utilized to characterize and model the total indoor RF-EMF down-link (DL) exposure from all cellular bands on each floor over the length of a wing since the significance of distance is very low between any two points on each floor in a wing and the variation of RF-EMF DL exposure is mainly influenced by the local indoor environment. Measurements were conducted in three buildings that are located within a few hundred meters vicinity of two base station sites supporting several cellular technologies (2G, 3G, 4G, and 5G). We apply the one-sample Kolmogorov-Smirnov test on the measurement data, and we prove that the indoor RF-EMF DL exposure on each floor over the length of a wing is a random process governed by a Gaussian distribution. We validate this proposition using leave-one-out cross validation technique. Consequently, we conclude that the indoor RF-EMF DL exposure on each floor over the length of a wing can be modeled by a Gaussian distribution and, therefore, can be characterized by the mean and the standard deviation parameters.

Child undernutrition and associated factors among children 6-23 months old in largely food insecure areas of rural Ethiopia.

Child malnutrition is the leading public health problem in Sub-Saharan Africa, resulting in poor health and economic losses. Ethiopia has one of the highest child undernutrition rates in the world that occurs to multifaceted factors, including food insecurity. Thus, we performed a cross-sectional study to assess the prevalence and risk factors for child undernutrition in largely food insecure areas of Ethiopia. Data were collected from 354 mother-child pairs from the Siraro district. Both bivariate and multivariate logistic regression was used for statistical analysis. Variables with a P-value of <0⋅05 in multivariate analysis were used to detect statistical significance at a 95 % confidence level. About 67 % of households are food insecure. The prevalence of stunting wasting and underweight were 42⋅7, 9⋅9 and 27⋅7 %, respectively. Female gender, higher age of the child (12-23 months v. 6-11 months), living in a household with five or more siblings, not getting therapeutic zinc supplement at least once, inadequate diet diversity, lack of growth monitoring service, and maternal own income increases the likelihood of child undernutrition. It can be concluded that child undernutrition is a severe public health problem in the study area. Improving primary healthcare services related to zinc supplementation, growth monitoring and promotion, and improving infant and child feeding practices can be considered as a strategy to address the problem.

Artificial Neural Network-Based Uplink Power Prediction From Multi-Floor Indoor Measurement Campaigns in 4G Networks.

Paving the path toward the fifth generation (5G) of wireless networks with a huge increase in the number of user equipment has strengthened public concerns on human exposure to radio-frequency electromagnetic fields (RF EMFs). This requires an assessment and monitoring of RF EMF exposure, in an almost continuous way. Particular interest goes to the uplink (UL) exposure, assessed through the transmission power of the mobile phone, due to its close proximity to the human body. However, the UL transmit (TX) power is not provided by the off-the-shelf modem and RF devices. In this context, we first conduct measurement campaigns in a multi-floor indoor environment using a drive test solution to record both downlink (DL) and UL connection parameters for Long Term Evolution (LTE) networks. Several usage services (including WhatsApp voice calls, WhatsApp video calls, and file uploading) are investigated in the measurement campaigns. Then, we propose an artificial neural network (ANN) model to estimate the UL TX power, by exploiting easily available parameters such as the DL connection indicators and the information related to an indoor environment. With those easy-accessed input features, the proposed ANN model is able to obtain an accurate estimation of UL TX power with a mean absolute error (MAE) of 1.487 dB.

Internal Medicine Residents' Perceptions of the Learning Environment of a Residency Training Program in Ethiopia: a Mixed Methods Study.

INTRODUCTION: The learning environment is an important determinant of the quality of medical education. Having a good learning climate leads to improved learning process, satisfaction with education, and helps achieve the goals of the curriculum. Assessment of the quality of learning environment helps with the identification of areas that need improvement. The aim of this study was to assess the learning environment of internal medicine training program in Ethiopia. METHODS: A mixed methods study using a cross-sectional survey using Postgraduate Hospital Educational Environment Measure and a qualitative study using a focus group discussion was done on internal medicine residents from December 2020 to May 2021. Comparison of quantitative data was done using Mann-Whitney U-Test and Kruskal-Wallis H-test. P-value <0.05 was considered statistically significant. RESULTS: A total of 100 residents participated in the study. The overall total mean score of the responses of the participants was 70.87 (±19.8) with mean perceptions of role autonomy, perceptions of teaching and perceptions of social support of 25.9 (±7.1), 27.1 (10.2) and 17.9 (±5.1), respectively. These values suggest the presence of plenty of problems in the program. Higher mean scores were reported by males and by earlier years of residency. Ten residents participated in the focus group discussion. Four recurring themes that negatively affect learning environment were identified and included excessive workload, inadequate teaching activity, non-conducive hospital physical environment and lack of diagnostic and therapeutic modalities. CONCLUSION: The internal medicine residency learning environment has many challenges that need immediate attention and follow-up.