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Sintayehu Asrat Beyene,1 Nahom Tadesse Bogale,1 Binyam Mohammedbirhan Berhe,2 Demis Degu Teshome3 1General Surgery Unit, Department of Surgery, Jigjiga University Sheik Hassen Yabare Comprehensive Specialized Hospital, Jigjiga, Ethiopia; 2Department of Pathology, Jigjiga University Sheik Hassen Yabare Comprehensive Specialized Hospital, Jigjiga, Ethiopia; 3Department of Obstetrics and Gynecology, Jigjiga University Sheik Hassen Yabare Comprehensive Specialized Hospital, Jigjiga, EthiopiaCorrespondence: Sintayehu Asrat Beyene; Nahom Tadesse Bogale, Email sintayehubeyene54@gmail.com; Tadnahi2@gmail.comIntroduction: Endometriosis is a disease condition characterized by the presence of endometrial glands and stroma outside the uterine cavity and musculature. It affects 7– 10% of women of reproductive age and usually involves pelvic organs. The common symptoms include dysmenorrhea, menorrhagia, pelvic pain, dyspareunia, and infertility. Umbilical endometriosis is the rarest form of extra-pelvic endometriosis.Case Presentation: A 32-year-old Para II mother presented with umbilical swelling and pain that worsened during the menses of 2 months. She had two caesarean scars, both transverse Pfannenstein incisions. There was a dark blue, firm to hard 2× 3 cm umbilical mass on physical examination. Laboratory results are normal. Ultrasound of the abdomen showed umbilical mass with homogeneous echotexture measuring 2 cm × 3 cm with an irregular border and hypoechoic texture. An excisional biopsy was performed and a biopsy showed umbilical endometriosis.Discussion: Primary umbilical endometriosis is a disorder first described by Villar in 1886, and among all cases of extra-genital involvement of endometriosis, primary umbilical endometriosis accounts for 0.5– 1%. The usual presentation of primary umbilical endometriosis is typically the presence of a discrete bluish-purple mass in the umbilicus, which becomes swollen, painful, and bleeds concomitantly with the menstrual cycle. Ultrasound and other imaging techniques help in making diagnoses, and the diagnosis is confirmed by cytological examination. The management of umbilical endometriosis involves surgical excision and reconstruction of the umbilicus.Conclusion: Umbilical endometriosis is an uncommon form of extra-pelvic endometriosis. There is a wide differential diagnosis for swellings of the abdominal wall; however, it should be suspected in any female patient of reproductive age with an umbilical lesion that becomes more painful and swollen during her menstrual period. Appropriate clinical examination and workup are helpful to make a diagnosis and do a surgical excision.Keywords: endometriosis, umbilical nodules, umbilical hernia, abdominal wall scar, caesareans section

Nahom Tadesse Bogale,1 Sintayew Asrat Beyene,1 Dawit Zerihun Desta,1 Eyob Hailu Tessema,1 Sebsbie Admas Birhanie2 1General Surgery Unit, Department of Surgery, Jigjiga University Sheik Hassen Yabare Comprehensive Specialized Hospital, Jigjiga, Ethiopia; 2Department of Radiology, Jigjiga University Sheik Hassen Yabare Comprehensive Specialized Hospital, Jigjiga, EthiopiaCorrespondence: Nahom Tadesse Bogale; Sintayew Asrat Beyene, General Surgery Unit, Department of Surgery, Jigjiga University Sheik Hassen Yabare Comprehensive Specialized Hospital, PO Box: 26217/1000, Jigjiga, Ethiopia, Tel +251910182949, Email tadnahi2@gmail.com; sintayehubeyene54@gmail.comIntroduction: Colonic volvulus is an unusual cause of intestinal obstruction in pregnant women. Cecal volvulus, second only to sigmoid volvulus, accounts for 1– 2% of all cases of intestinal obstruction. Due to its infrequent occurrence, only a few articles have documented its diagnosis and management among pregnant women, and we assume this to be the first reported case in Ethiopia, as per the authors’ knowledge.Case Presentation: A 26-year-old Gravida 3, Para 2 mother who has had amenorrhea for the last five months presents with a complaint of upper abdominal cramps with associated vomiting, which is bilious, upper abdominal distension, and obstipation of five-hour duration. Her vital signs were in the normal range, and she had upper abdominal tenderness. Plain abdominal radiography suggested a cecal volvulus and exploratory laparotomy, a right hemicolectomy, and end-to-side ileotransverse colon anastomosis was performed. The postoperative course was uneventful.Discussion: The cecal volvulus is an axial twist of the cecum, segment of the terminal ileum, and ascending colon along its mesentery, resulting in closed-loop obstruction with early vascular compromise and ischemia. It requires an anatomic prerequisite, which makes the cecum hypermobile, unlike the sigmoid volvulus. Diagnosis is challenging in pregnant women, as there are many differential diagnoses and a reluctance to request radiological imaging.Conclusion: A high index of suspicion is of paramount importance whenever a pregnant woman comes with a complaint of persistent abdominal cramps and obstipation. Early diagnosis and management are crucial to improve patients’ outcome. Plain abdominal radiography is the safest option of imaging modality in low-resource areas where magnetic resonance imaging (MRI) is not available during pregnancy whenever intestinal obstruction is considered. Right hemicolectomy is the preferred surgical option.Keywords: Cecal volvulus, intestinal obstruction, pregnancy, right hemicolectomy

Selamwit Gidey,1 Dawit Seyoum Gebremariam,1 Marta Yemane Hadush,1 Amanuel Berhe,1 Tedros Hailu Abay,1 Araya Abrha Medhanyie,2 Selemawit Asfaw Beyene,2 Tadele Tesfean Abraha,2 Yibrah Berhe Zelelow3 1Department of Pediatrics and Child Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 2School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 3Department of Obstetrics and Gynecology, College of Health Sciences, Mekelle University, Mekelle, EthiopiaCorrespondence: Dawit Seyoum Gebremariam, Department of Pediatrics and Child Health, Ayder Comprehensive Specialized Hospital, College of Health Science, P.O. Box: 1871, Mekelle, Tigray, Ethiopia, Tel +251911731454, Email dgseyoum@yahoo.comBackground: Kangaroo mother care is a proven intervention shown to be effective in reducing neonatal mortality among low-birth-weight infants. The paucity of evidence regarding the practice at home can be highlighted. This study aimed to assess the practice and outcome of kangaroo mother care at home among mothers having low-birth-weight infants discharged from two hospitals in Mekelle, Tigray, Ethiopia.Methods: A prospective cohort study was conducted among 101 paired mothers and low-birth-weight neonates discharged from Ayder and Mekelle Hospitals. Non-probability purposive sampling was used to select 101 infants. Data were collected from patient charts in both hospitals using interviewer-administered structured questionnaire, anthropometric measurements and were then analyzed using SPSS version 20. Characteristics were analyzed using descriptive statistics. Bivariate analysis was used, and variables with p-value < 0.25 were exported to multivariable logistic regression and statistical significance was set at a p-value < 0.05.Results: Kangaroo mother care was continued at home in 99% of the infants. Three of the 101 infants died before the age of 4 months with a possible cause of death from respiratory failure. Exclusive breastfeeding was provided for 67% of the infants, and it was higher in infants who started kangaroo mother care within 24 hours of life (AOR 3.8, 95% CI 1.07– 13.25). Malnutrition was higher in those with birth weight < 1500 grams (AOR 7.3,95% CI 1.63– 32.59); small for gestational age (AOR 4.8,95% CI 1.41– 16.31) and those provided kangaroo mother care for < 8 hours per day (AOR 4.5,95% CI 1.40– 16.31).Conclusion: Early initiation and prolonged duration of kangaroo mother care were associated with increased exclusive breastfeeding practice and decreased incidence of malnutrition. Kangaroo mother care should be promoted at the community level.Keywords: low birth weight, kangaroo mother care, malnutrition, exclusive breastfeeding

Kebede Dinsa, Beshea Gelana Deressa, Waju Beyene Salgedo Department of Health Policy and Management, Jimma University, Jimma, Oromia, EthiopiaCorrespondence: Beshea Gelana Deressa, Department of health policy and management, Jimma University, Jimma, Oromia, Ethiopia, Tel +251 921833996, Email tuniriyabesha@gmail.comBackground: The difference in nursing care quality by institution has implications for both the organization and its clients. Though disparities in patient satisfaction, which is an interpersonal patient outcome with nursing care, have been reported between public and private hospitals, there has been little research on the study area.Objective: To compare the level of patients’ satisfaction towards nursing care services among adult inpatients at Jimma Medical Center, and Oda Hulle hospital Jimma, southwest Ethiopia 2021.Methods: A comparative cross-sectional study design was used among 431 patients of Jimma medical center and Oda Hulle hospital from May 3 to July 3, 2021, using a systematic random sampling technique. The Newcastle scale of satisfaction was used to collect data, which was then entered into Epidata 4.6 and exported to SPSS version 26 for analysis. We used descriptive and logistic regression analysis.Results: Patient satisfaction at public and private hospitals was reported 54.2% (95% CI: 52.9– 59.3) and 57.1% (95% CI: 55.2– 61.7), respectively. In public hospital, the patient satisfaction was affected by being in the age group of 41– 50 years (P = 0.006, AOR = 3), duration of stay in the ward (P = 0.002, AOR = 0.42,), cleanliness of the ward (P = 0.018, AOR = 1.8,), and admission history (P = 0.049, AOR = 0.60,). In private hospital (Oda Hulle), the patient satisfaction was affected by history of admission (P = 0.035, OR = 0.456), ward space (p = 0.007, AOR = 2.8), the perceived capacity of nurses (P = 0.002, AOR = 5.8) to pharmacy services (P = 0.032, AOR = 2.3,).Conclusion: Relatively the patient satisfaction towards nursing care in public hospital was lower compared to the private hospital, though no statistical difference (p = 0.225) observed. Illness history, cleanliness of the ward, Nurses make adequate visits and get their support when needed, Adequacy of ward space, the perceived capacity of nurses, and Access to pharmacy services were positively associated with patient satisfaction.Keywords: nursing care, patients’ satisfaction, public–private, service quality

Marta Yemane Hadush,1 Dawit Seyoum Gebremariam,1 Selemawit Asfaw Beyene,2 Tedros Hailu Abay,1 Amanuel Hadgu Berhe,1 Yibrah Berhe Zelelew,1 Tirhas Asmelash,3 Fisseha Ashebir,3 Samson Yohannes Amare,4 Znabu Hadush,2 Araya Abrha Medhanyie2 1School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 2School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 3Tigray regional health bureau, Mekelle, Ethiopia; 4School of Computing, Mekelle University, Mekelle, EthiopiaCorrespondence: Marta Yemane Hadush, Email marsec112@yahoo.comBackground: Kangaroo mother care (KMC) is an evidence-based approach to reducing morbidity and mortality in low-birth-weight and preterm newborns. Barriers for KMC and its effective practice at a larger scale are highly affected by contextual factors. The purpose of this study is to explore barriers and enablers in the community and health facilities for implementation and continuation of KMC.Methods: This formative study employed a qualitative exploratory approach using focus group discussions and in-depth interviews in five zones of Tigray region, Northern Ethiopia. A total of 16 focus group discussions and 46 in-depth interviews were conducted with health workers and community members. The whole process of data collection took an iterative approach. An inductive thematic analysis was done by going through the transcribed data using ATLAS.ti software.Results: The current study found that problems of infrastructure and equipment for KMC practice, shortage of staff, and absence of trained health workers as the most frequently mentioned barriers by health workers. Low level of awareness, lack of support, mother being responsible for the rest of the family, holding babies in the front being traditionally unacceptable, and preference of incubators for better care of small babies were among the barriers identified in the community. Presence of community health workers and the positive attitude of the community towards them, as well as antenatal and postnatal care were among the favorable conditions for the implementation of KMC at health facilities and continuation of KMC at home.Conclusion: Empowering health workers through training to identify preterm and low-birth-weight babies, to do follow-ups after discharge, and creating awareness in the community to change the perception of kangaroo mother care are necessary.Keywords: kangaroo mother care, KMC, implementation research, low birth weight, Ethiopia, newborn care, preterm birth, KMC implementation, enablers and barriers to KMC