Integrated Emergency and Obstetrics Surgery

TREATMENT OUTCOME AND ASSOCIATED FACTORS AMONG GYNECOLOGIC ONCOLOGY PATIENTS UNDERWENT SURGERY IN HIWOT FANA SPECIALIZED UNIVERSITY HOSPITAL, EASTERN ETHIOPIA

2024-12-31T07:39:36Z

TREATMENT OUTCOME AND ASSOCIATED FACTORS AMONG GYNECOLOGIC ONCOLOGY PATIENTS UNDERWENT SURGERY IN HIWOT FANA SPECIALIZED UNIVERSITY HOSPITAL, EASTERN ETHIOPIA Miressa Bekana (Dr); Dr. Maleade Birara( maternal fetal medicine subspecialist, Gynecologic Oncologist, Associate Professor); Dr Merga Dheresa (MPH, Associate Professor) Background: Gynecologic cancer is a common malignancy among women worldwide. It is associated with high morbidity and mortality especially in developing countries. Overall, there is no available information on the level of treatment outcome and associated factors among gynecologic oncology patients attending specialized healthcare in eastern Ethiopia in general and the study setting in particular. Objective:To determine treatment outcome and associated factors among gynecologic oncology patients underwent surgery in Hiwot Fana Specialized University Hospital, eastern Ethiopia from 01 July 2021 to 30 October2023. Data was collected from December 4 to 8, 2023 Method: Institution-based retrospective cross-sectional study will be conducted among all 132 gynecologic oncology patients underwent surgery in Hiwot Fana Speciallized University Hospital, eastern Ethiopia. Convenient sampling technique was used to enroll participant. Data was collected on sociodemographic characters, medical comorbidies, and treatement related factorsusing Structured checklists from the medical records of gynecologic oncology patients (patient cards/medical records, available post-surgical cancer follow-up charts and national gynecologic oncology registries. Data was entered using EpiData version 3.1 and analyzed using SPSS 27. Descriptive statistics was conducted to characterize the data/describe the participants and assess treatment outcome of gynecologic oncology patients underwent surgical therapy Result - A total of 133 Women diagnosed with gynecologiccancer who underwent surgery in hiwot fana specialized university hospital included in the study. Majority 75(56.5%) of patient who underwent oncology surgery was with diagnosed ovarian cancer.Forty four (44) 33.1% patient develops intraoperative complications. Hemorrhage requiring transfusion was the most common intraoperative complication accounting for 21.8%of the case. Postoperatively 19(15%) patients developed post-operative complications.majority 81(60.9) of patient have favorable outcome and discharged without intraoperative or post-operative complications, while 52(39.1%) of them developed either intraoperative or post-operative complicationsStage of the disease is associated with intraoperative complication with Pearson chi2 0.004 with advanced disease associated with increased intraoperative complication Conclusion -From this study we can conclude that intraoperative and post-operative morbidity and mortality associated with gynecologic oncology surgery is slightly higher than other low income countries and Capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention in this setup 70

PROPORTION AND RELATIVE FREQUENCY OF DIFFERENT TYPES OF GYNECOLOGIC CANCERS AT HIWOT FANA SPECIALIZED UNIVERSITY HOSPITAL, EASTERN ETHIOPIA.

2024-12-24T06:30:11Z

PROPORTION AND RELATIVE FREQUENCY OF DIFFERENT TYPES OF GYNECOLOGIC CANCERS AT HIWOT FANA SPECIALIZED UNIVERSITY HOSPITAL, EASTERN ETHIOPIA. Elias Jemal (OBGYN Specialist, Gynecologic Oncology Fellow); Dr. Malede Birara PhD.; Dr. MergaDheresa (PhD) Background: Gynecologic cancer are among the common malignancy in women worldwide with high morbidity, disabilities and deaths in developing countries. Overall, there is no available information on the burdens, distributions, patterns, trendsand influencing factors among gynecologic oncology patients attending specialized healthcare in eastern Ethiopia in general and the study setting in particular. Objective:Assessment of proportion andrelative frequencyof different types of gynecologic cancers at Hiwot Fana Specialized University Hospital, eastern Ethiopia from 01 July 2021 to August 30, 2023. Data collected from December4 to7 , 2023. Method: Institutional based retrospective cross sectional chart review study was conducted after retrieval of medical record of 243 out of 286 patientsdiagnosed with gynecologic malignancy.Total number of cancer cases and number of female cancer patients over the study period were collected from registry at oncology treatment center, gynecology oncology clinic and 10 operation theatre registration bookand proportion of gynecological cancers was calculated. By using structured checklist information about sociodemographic information, reproductive and gyneclologic information, and medical and clinical information of patient with gynecological cancer was collectedand data was entered and analyzed using SPSS version 25. Descriptive statistics were conducted to characterize percentage and relative frequency distribution of different gynecologic cancers at Hiwot Fana Hospital. Result:From 1270 cancer cases diagnosed over two years of study period, 66.7%(850) are female.The number of gynaecologic cancer cases seen over the study period were 286, accounting for 33.64 % of female cancer cases and 22.52% of total oncology cases. The mean age of gynecological cancer patients were 50.9 ± 12.73(range 18 to 80) years. The highest number of cancer were diagnosed between the age of 51 to 60 years. Majority of the patients came from Oromia (39.1%) followed by Dire Dawa (25.1%). Cervical cancer accounted 44.4% of GCs, followed by ovarian cancer(34.6%% of cases). Uterine cancers is third making 13.2%%. The least frequent is vulvar cancer making 7.4% of gynaecological cancers Concussion: Gynecologic cancers make significant proportion of cancers in female at HFSUH and cervical cancer is the leading types of gynecologic malignancy.Approximately 80% of cancers were at advanced stage during presentation. Majority of patients were from Oromia. 57

CLINICL PROFILE AND OPERATIVE OUTCOME OF GALLSTONE DISEASE AMONG ADULT PATIENTS ADMITTED TO HIWOT FANA SPECIALIZED UNIVERSITY HOSPITAL AND JEGOL GENERAL HOSPITAL

2024-12-23T07:03:59Z

CLINICL PROFILE AND OPERATIVE OUTCOME OF GALLSTONE DISEASE AMONG ADULT PATIENTS ADMITTED TO HIWOT FANA SPECIALIZED UNIVERSITY HOSPITAL AND JEGOL GENERAL HOSPITAL Mohamed Muhumed(MD, General Surgery Resident); Dr. Mulat Asfaw (MD, Assi.Prof., General Surgery).; Mr. Mekonnen Sisay (BPharm, MSc, Assi. Prof.) Background. Gallstone disease (condition known as cholelithiasis) constitutes a significant health problem in developed countries. It is estimated that at least 20 million persons in the United States have gall stones and that approximately 1 million new cases of cholelithiasis develop each year. While thought to be uncommon in Africa, cholelithiasis is currently diagnosed significantly more frequently than would be expected from the previous studies. the prevalence of gallstone disease in Ethiopia is 5.2%. There is no study in Eastern part of Ethiopia, so this study will show us the gap that existing in our hospitals. This study assessed the magnitude and post-operative complications of this disease in Harar, Ethiopia. Methodology: - A retrospective cross-sectional study was employed by analyzing patient records from December 2017 to November 2021, at Department of General surgery, Hiwot Fana Specialized University Hospital and Jegol General Hospital, both in Harar. All the necessary data were collected from the patient’s charts and were collected by using pre-tested semi-structured checklist. Data entry was done using Epi Data version 3.1 and analysis was done using SPSS statistical software version 20. Bivariate analysis was used to Identify factors affecting Clinical profile and Operative outcome of Gallstone disease with cut point of 0.25, then factors found to be significant was processed in multivariate analysis to remove confounding factors statistical significance was declared for the p- value<0.05. Result: one hundred and eighty patients were enrolled in the study. Majority (83.8%) of the patients were in between 40-59 years of age. The chief complaint of most of the patients (77.2%) was right upper quadrant pain. Post-operative complications were reported in 13.3% of patients. In multivariate logistic regression analyses, acute cholecystitis (adjusted odds ratio (AOR), 14.3, 95% CI: 1.4-18.3), chronic cholecystitis (AOR, 32, 95% CI: 9.7 – 59.3), and comorbidity (AOR), 55.2,95% CI:42.1-67.9) were significantly associated with post-operative complications. No mortality was reported. Conclusion: Open surgery remains the dominant procedure used to treat symptomatic cholelithiasis at these two centers. Our findings revealed that open surgery is a safe and effective treatment for this disease in the absence of routine laparoscopic services. 44

PREVALENCE OF NEURAL TUBE DEFECT AND ASSOCIATED FACTOR AMONG PREGNANT WOMEN DELIVERED OR ABORTED AT HIWOT FANA COMPREHENSIVE SPECIALIZED UNIVERSITY HOSPITAL, EASTERN ETHIOPIA

2024-12-23T07:00:43Z

PREVALENCE OF NEURAL TUBE DEFECT AND ASSOCIATED FACTOR AMONG PREGNANT WOMEN DELIVERED OR ABORTED AT HIWOT FANA COMPREHENSIVE SPECIALIZED UNIVERSITY HOSPITAL, EASTERN ETHIOPIA Ibsa Usmail (MD); Dr. Semir Sultan (MD, Assistant Prof. of OBGYN); Dr. Kadir Teji (PHD, Associate Prof. of Public health) Background: Several congenital malformations affect developing fetuses, among which Neural tube defect (NTD) is most common potentially preventable cause of perinatal morbidity and mortality. Worldwide, around 10% of infant mortalities are due to nervous system defects. It was estimated that approximately 300,000 babies are born each year. It remains a major problem in developing countries in eastern parts of Ethiopia there is very limited published data regarding the prevalence and associated factors Objective: To determine prevalence of neural tube defect and associated factor among pregnant women delivered or aborted at Hiwot fana comprehensive specialized university hospital from September 01- October 31, 2021. Methods: A Hospital-based cross-sectional study was employed and sampling technique was used to select study participants. Data processing and analysis was done using Epidata 4.6 and using SPSS statistical software version 25. Bivariate analysis was performed to assess the factors associated neural tube defect. Multivariable logistic regression was used to assess strength of association between each independent variable with outcome variable. The significance of association between dependent and independent variables was declared using odds ratio with 95% confidence interval and P-value <0.05. Results: The magnitude of NTD among mothers delivered or aborted at HFUSH were 45(7.1%, CI (5.2, 9.3). The predictors of neural tube defects were having history of stillbirths [AOR=2.77(1.00, 7.66)], drink alcohol during preganancy [AOR=10.27(1.98, 53.16)], consangious marriege [AOR=5.97(2.07, 17.02)], exposed to radiation during pregnancy [AOR=6.84(1.42, 32.9)]. Conclusion:The magnitude of NTD among mothers delivered or aborted at HFUSH were high. Predictors of NTD were being rural residence, parity of between two and five, having history of still birth, having history of early neonatal death, not having history of COC use, drug use during pregnancy, coffee intake during pregnancy, drink Alcohol during pregnancy, consanguinity, exposure to radiation during pregnancy, having passive smoker, and exposure to toxin chemicals during pregnancy. So, the Ministry of health and Harari Regional Health Bureau should work together on advocacy and designing for initiation of preconception care services and implement the new ANC visit recommended by World Health Organization by 2016. The Physician or health care provider should be conscious when order x-ray without sheild and prescribe drug during pregnancy. The pregnant mother should also counseled about the impact of drinking alcohol and exposure to chemical toxin on the pregnancy. 71