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Your search keyword '"Amezene Tadesse"' showing total 11 results
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11 results on '"Amezene Tadesse"'

1. Early Outcome of Laparotomy Wounds in Pediatric Patients in TASH, Addis Ababa, Ethiopia: A Six-Months Prospective Study

Author

Belachew Dejene, Abay Gosaye, Hana Getachew, Nichole Starr, Fisseha Temesgen, Miliard Derbew, Woubedil Kiflu, Tihitena Negussie, and Amezene Tadesse

Subjects
Male, medicine.medical_specialty, Multivariate analysis, medicine.medical_treatment, Global Surgery, Logistic regression, Pediatrics, Risk Factors, Laparotomy, medicine, Humans, Surgical Wound Infection, Wound dehiscence, Prospective Studies, Prospective cohort study, Preschool, Child, Evisceration (ophthalmology), Pediatric, business.industry, SSI, Mortality rate, Prevention, General Medicine, medicine.disease, Surgery, Malnutrition, Good Health and Well Being, Child, Preschool, Zero Hunger, Original Article, Patient Safety, Ethiopia, business
Abstract

BACKGROUND፡ Surgical Site Infection (SSI) and wound dehiscence are two early complications of laparotomy causing significant morbidity and mortality. This study was conducted to determine the prevalence and risk factors of SSI and wound dehiscence in pediatric surgical patients.METHODS: We performed a prospective observational study of all pediatric surgical patients who underwent laparotomy at Tikur Anbessa Specialized Hospital, Ethiopia, from December 2017 to May 2018. Data collected included demographics, operative indication, nutritional status, prophylactic antibiotics administration, and duration of operation. Primary outcome was SSI; secondary outcomes were hospital stay and other postoperative complications, including wound dehiscence and mortality. Data were analyzed using SPSS, Version 23. Fisher’s exact and Chi-squared tests used to report outcomes. Multivariable logistic regression was used to identify variables associated with SSI, wound dehiscence and other outcomes.RESULTS: Of 114 patients, median age was 46 months [range: 1day-13years]; 77(67.5 %) were males. Overall SSI rate was 21.05%. Nine (7.9%) developed wound dehiscence while 3(2.6%) had abdominal contents evisceration. Overall mortality rate was 2.6%. In multivariate analysis, prophylactic antibiotics administration (AOR=13.05, (p=0.006)), duration of procedure (AOR=8.62, (p=0.012)) and wound class (AOR=16.63, (p=0.034)) were independent risk factors for SSI while SSI was an independent predictor of prolonged hospital stay, >1 week (AOR=4.7, p=.003,) and of wound dehiscence (AOR=33. 96,p=0.003). Age (p=0.004) and malnutrition (p1 hour before surgery and operative time >2 hours are independent predictors of SSI.

Published
2021

2. Outcome of PUV Patients Following Ablation in a Tertiary Teaching Hospital in Addis Ababa, Ethiopia

Author

Tihitena Negussie Mammo, Belachew Dejene, Fisseha Temesgen, Woubedel Kiflu, Hiwote Girma Assefa, Hanna Getachew, and Amezene Tadesse

Subjects
Posterior urethral valve, medicine.medical_specialty, end-stage renal disease, business.industry, Research and Reports in Urology, Urology, primary ablation, Renal function, Retrospective cohort study, medicine.disease, urologic and male genital diseases, nadir serum creatinine, End stage renal disease, vesicostomy, Internal medicine, Pediatric surgery, Medicine, proteinuria, business, Urinary tract obstruction, Postoperative Hypertension, posterior urethral valve, chronic kidney disease, Kidney disease, Original Research
Abstract

Hiwote G Assefa,1 Hanna Getachew,2 Amezene Tadesse,2 Woubedel Kiflu,2 Fisseha Temesgen,2 Belachew Dejene,2 Tihitena Negussie Mammo2 1Department of Surgery, St Paul’s Hospital, Millennium Medical College, Addis Ababa, Ethiopia; 2Department of Surgery, Addis Ababa University School of Medicine, Addis Ababa, EthiopiaCorrespondence: Hiwote G Assefa; Tihitena Negussie Mammo Email hiwotesc@gmail.com; tihutin@yahoo.comBackground: Posterior urethral valve (PUV) is the most common cause of congenital lower urinary tract obstruction in boys. It is considered that early diagnosis and intervention have good outcomes in terms of renal function, though the varying extent of embryological insult requires these boys to remain in extended follow-up and care.Objective: To assess the renal outcome of patients following PUV ablation.Methods: This was a descriptive retrospective study. Data were collected from the operation logbooks of patients from 2015 to 2019 that had been admitted to the Tikur Anbessa Specialized Hospital pediatric surgery unit with a working diagnosis of PUV and had ablation done primarily or following diversion. Data were collected from January to April 2020 and analyzed using SPSS 25. P value≤ 0.05 was considered significant.Results: Seventy patients were analyzed and followed for 3 years for the development of postoperative chronic kidney disease (CKD) after PUV ablation. Postoperative CKD was found in 52.9% of patients and end-stage renal disease in 2.9%. Risk factors associated with postoperative CKD were the presence of preoperative and postoperative proteinuria, postoperative hypertension, and elevated nadir serum creatinine. Results also showed that a delay between the development of vesicostomy and ablation had a significant correlation with renal outcome. Elevated nadir serum creatinine, postoperative proteinuria, and delay between the development of vesicostomy and ablation were found to be independent risk factors of development of CKD.Conclusion: There was a high rate of CKD development in patients who had had ablation for PUV, which was comparable to other studies. Three variables were found to be independent risk factors for the progression of CKD, unlike other findings seen in low- and middle-income countries.Keywords: posterior urethral valve, primary ablation, vesicostomy, nadir serum creatinine, proteinuria, chronic kidney disease, end-stage renal disease

Published
2021

3. Incidence and Risk Factors of Thrombocytopenia in Neonates Admitted with Surgical Disorders to Neonatal Intensive Care Unit of Tikur Anbessa Specialized Hospital: A One-Year Observational Prospective Cohort Study from a Low-Income Country

Author

Tihitena Nigussie Mamo, Amezene Tadesse Robele, Belachew Dejene Wendemagegehu, Hana Abebe Gebre Selassie, Hanna Getachew Wolde Selassie, Fisseha Temesgen Gebru, and woubedel Kiflu Aklilu

Subjects
Pediatrics, medicine.medical_specialty, Neonatal intensive care unit, Neonatal sepsis, business.industry, Incidence (epidemiology), thrombocytopenia, Hematology, medicine.disease, Neonatal Thrombocytopenia, Sepsis, Journal of Blood Medicine, Informed consent, incidence, medicine, Chi-square test, risk factors, Observational study, Prospective cohort study, business, Original Research
Abstract

Background: Thrombocytopenia is one of the most common hematologic disorders affecting neonates who are admitted to the neonatal intensive care unit with a reported incidence of 18-35%. Several maternal, neonatal and perinatal factors contribute to the development of thrombocytopenia. This study is aimed to determine the incidence and associated risk factors of neonatal thrombocytopenia. Methods: An observational prospective cohort study was conducted and all neonates admitted to the neonatal intensive care unit of Tikur Anbessa Specialized Hospital with surgical disorders in the study period were included. Data was collected using a checklist and analysed by SPSS version 23. Chi square test and independent sample T- test were used to asses the association among different variables. Findings: A total of 210 neonates were included in the study out of which 56.2% were males. The incidence of thrombocytopenia in the study period was 55.8%. Among neonates with thrombocytopenia, 90.9% had a late onset thrombocytopenia and half of them were in the severe range (

Published
2021

4. Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Author

Naomi Jane Wright, Andrew J.M. Leather, Niyi Ade-Ajayi, Nick Sevdalis, Justine Davies, Dan Poenaru, Emmanuel Ameh, Adesoji Ademuyiwa, Kokila Lakhoo, Emily Rose Smith, Abdel Douiri, Maria Elstad, Marcus Sim, Cristiana Riboni, Bruno Martinez-Leo, Melika Akhbari, Stephen Tabiri, Ashrarur Mitul, Dayang Anita Abdul Aziz, Camila Fachin, Alliance Niyukuri, Muhammad Arshad, Fowzia Ibrahim, Natalie Moitt, Mohamed Fahmy Doheim, Hannah Thompson, Harmony Ubhi, Isabelle Williams, Sophia Hashim, Godfrey Sama Philipo, Laura Herrera, Aayenah Yunus, Dominique Vervoort, Samuel Parker, Yousra-Imane Benaskeur, Osaid H. Alser, Nana Adofo-Ansong, Ahmad Alhamid, Hosni khairy Salem, Mahmoud Saleh, Safa Abdal Elrais, Sadi Abukhalaf, Patricia Shinondo, Ibrahim Nour, Emrah Aydin, Agota Vaitkiene, Kelly Naranjo, Andile Maqhawe Dube, Sodumisa Ngwenya, Mina A. Yacoub, Henang Kwasau, Gabriella Hyman, Shrouk Mahmoud Elghazaly, Ibrahim Al-Slaibi, Intisar Hisham, Helena Franco, Hana Arbab, Lubna Samad, Aqil Soomro, Muhammad Amjad Chaudhry, Safina Karim, Muhammad Adnan Khan Khattak, Shireen Anne Nah, Doris Mae Dimatatac, Candy SC Choo, Niveshni Maistry, Ashrarur Rahman Mitul, Samiul Hasan, Sabbir Karim, Hina Yousuf, Taimur Qureshi, Ibrahim Rabi Nour, Raed Nael Al-Taher, Osama Abdul Kareem Sarhan, Luis Garcia-Aparicio, Jordi Prat, Eva Blazquez-Gomez, Xavier Tarrado, Martí Iriondo, Paolo Bragagnini, Segundo Rite, Lars Hagander, Emma Svensson, Sheila Owusu, Alhassan Abdul-Mumin, Dominic Bagbio, Vijay Anand Ismavel, Ann Miriam, Shajin T, Marlene Anaya Dominguez, Monica Ivanov, Andreea Madalina Serban, Miliard Derbew, Mahmoud Elfiky, Maricarmen Olivos Perez, Marcia Abrunhosa Matias, Alexis P Arnaud, Ahmed Negida, Sebastian King, Mohamad Rafi Fazli, Nadia Hamidi, Souhem Touabti, Rossana Francisco Chipalavela, Pablo Lobos, Brendan Jones, Damir Ljuhar, Georg Singer, Annelien Cordonnier, Lorena Jáuregui, Zlatan Zvizdic, Janice Wong, Etienne St-Louis, Qiang Shu, Yang Lui, Catalina Correa, Lucie Pos, Elvyn Alcántara, Erick Féliz, Luis Enrique Zea-Salazar, Liza Ali, Matthieu Peycelon, Nzanzu Kipata Anatole, Cherno S. Jallow, Judith Lindert, Dhruv Ghosh, Cathline Freya Adhiwidjaja, Ahmad Khaleghnejad Tabari, Saran Lotfollahzadeh, Haidar Mohammad Mussein, Fabrizio Vatta, Noemi Pasqua, David Kihiko, Hetal Gohil, Ibrahim R. Nour, Muhammed Elhadi, Suad Ahmed Almada, Gilvydas Verkauskas, Toni Risteski, Alejandro Peñarrieta Daher, Oumaima Outani, James Hamill, Taiwo Lawal, Jack Mulu, Benjamin Yapo, Lily Saldaña, Beda Espineda, Krystian Toczewski, Eugene Tuyishime, Isaac Ndayishimiye, Enaam Raboe, Philip Hammond, Gregor Walker, Ivona Djordjevic, Milind Chitnis, Joonhyuk Son, Sanghoon Lee, Muaad Hussien, Sawazen Malik, Enas Musa Ismail, Ampaipan Boonthai, Nesrine Ben Hadj Dahman, Nigel Hall, Fabiola Ruth Castedo Camacho, Helena Sobrero, Marilyn Butler, Aliev Makhmud, Nathan Novotny, Ahmad G. Hammouri, Maisara Al-Rayyes, Bruce Bvulani, Qais Muraveji, Muhammad Yousuf Murzaie, Ajmal Sherzad, Sayed Aman Haidari, Abdul Baqi Monawar, Dr. Ahmad Zia Samadi, Jesh Thiessen, Ntakarutimana Venant, Sonia Inamuco Hospital, Niyonkuru Jérémie, Jean Claude Mbonicura, Butoyi Jean Marie Vianney, Amezene Tadesse, Samuel Negash, Charles A. Roberts, John N. Jabang, Abdoulie Bah, Kajali Camamra, Armandou Correa, Babucarr Sowe, A. Gai, Musa Jaiteh, Kwizera Jean Raymond, Jean Paul Mvukiyehe, Innocent Itangishaka, Emmanuel Kayibanda, Emery Manirambona, Joseph Lule, Ainhoa Costas-Chavarri, Ian Shyaka Gashugi, Albert Ndata, Georges Gasana, Yves Castar Nezerwa, Turatsinze Simeon, Jean De Dieu Muragijimana, Sakina Rashid, David Msuya, Joseph Elisante, Meghna Solanki, Emmanuel Manjira, Jay Lodhia, Mubashir Jusabani, Murad Tarmohamed, Sengua Koipapi, Touabti Souhem, Nabti Sara, Brahimi Sihem, Bouguermouh Dania, Iaiche Achour Toufik, Baghdadi Nour el islam Mounira, Alouani Habiba, Liliana Aragão, Victor Gonçalves, Marcelo Mauricio Lino Urquizo, Maria Florencia Varela, Pedro Mercado, Bonavia Horacio, Andrea Damiani, Carlos Mac, Daniel Putruele, Karen Liljesthrom, Marianela Bernaus, Cesar Jauri, Alejandrina Cripovich, Ezequiel Bianchin, Maria Gabriela Puig, Lorna Andreussi, Susana Iracelay, Dolores Marcos, Carina Herrera, Nelly Palacios, Romina Avile, Belen Serezo, Debora Montoya, Rodrigo Cepeda, Justo Vaquila, Sofficci Veronica, Liliana Pardo, Pelussi Valeria, Lapalma Julio, Aranda Diego Martin, Palazzi Lucio, Comba Gabriel, Depetrini Marianella, José Alfredo Calderón Arancibia, Enrique Huespe, Gabriela Natalia Losa, Elsa Arancibia Gutiérrez, Humberto Scherl, Daniel Emilio Gonzalez, Valentina Baistrocchi, Yanina Silva, Marcelo Galdeano, Pablo Medard, Ines Sueiras, Enrique Romero Manteola, Victor Hugo Defago, Carlos Mieres, Carlos Alberto, Fabio Cornelli, Marcelo Molina, Pablo Ravetta, Celeste Carolina Patiño Gonzalez, Maria Belen Dallegre, Maria Tatiana Szklarz, Marcos Federico Leyba, Nahuel Ignacio Rivarola, Maria Delia Charras, Adriana Morales, Paloma Caseb, Luzia Toselli, Carolina Millán, Maria del Carmen Junes, Oscar Di Siervi, Jose Gilardi, Soledad Simon, Carla Sofia Contreras, Nair Rojas, Lucia Beatriz Arnoletto, Otilia Eva Blain, Mauro Nicolas Bravo, Nancy Sanchez, Luciana Martina Herrera Pesara, Maria Eugenia Moreno, Carlos Ariel Sferco, Umama Huq, Tamanna Ferdousi, Abdullah Al-Mamun, Sadia Sultana, Refoyez Mahmud, Khalid Mahmud, Fatema Sayeed, Alexander Svirsky, Denisse Sempertegui, Amalia Negrete, Araceli Teran, Mariana Sadagurschi, Nusret Popovic, Kenan Karavdic, Emir Milisic, Asmir Jonuzi, Amira Mesic, Sabina Terzic, Nejra Dendusic, Elna Biber, Anesa Sehic, Nada Zvizdic, Emina Letic, Adna Saracevic, Ajla Hamidovic, Nejra Selak, Dzan Horozic, Lamija Hukic, Amila Muhic, Nedim Vanis, Emir Sokolovic, Adnan Sabic, Karin Becker, Elis Novochadlo Klüppel, André Iván Bradley dos Santos Dias, Miguel Angelo Agulham, Cristiano Bischoff, Stella Sabbatini, Rachel Fernandes de Souza, Ana Beatriz Souza Machado, Juliana Werneck Raposo, Maria Lucia da Silva Augusto, Bianca M.R. Martins, Mariana de Souza Santos Ferreira, Darli Fernandes de Oliveira, Carla Silva dos Santos, Fernanda Ribeiro de Fernández y Alcázar, Érika Alves Dutra da Silva, Mariana Furtado, Horácio Tamada, Marília Silva Ferreira dos Santos, Thayná Lopes de Almeida, Susy Oliveira de Andrade, Antonio Cipriano Gurgel do Amaral, Lais Sartori Giovanoni, Kamila de Deus Passos Leles, Eduardo Corrêa Costa, Leticia Feldens, Luciano Ferraz Schopf, José Carlos Soares de Fraga, Felipe Colombo de Holanda, Paola Maria Brolin Santis Isolan, Julia Loyola Ferreira, Carla Luisa Bruxel, Danielle Lopes Teixeira Ferdinando, Fabricio Zottis Barcelos, Natalia Baseggio, Nicole Knorr Brenner, Rafael Trindade Deyl, Carolina Dure, Iuri Nunes Kist, Rafael Bueno Mazzuca, Sarah Bueno Motter, Yna Ramos, Cristine Suzana Trein, Bianca Rezende Rosa, Murilo de Assis Silva, Flavio Augusto Menin, Isabela Cristina Semensato Carloni, Juliana Antinarelli Norberto da Silva, Adriano Luis Gomes, Mariana Girão Tauffer, Paulo César Bassan Gonçalves, Geraldo Magela Nogueira Marques, Eliane Moriya, Carla Labonia, Ana Lucia Carrasco, Karine Furtado Meyer, Luiz Farion-Aguiar, Fernando Amado, Amanda Antunes, Elisângela Silva, Leila Telles, Giovana Almeida, Aluísio Augusto Belmino Gadelha, Flavia de Azevedo Belesa, Acimar Gonçalves da Cunha, Jr, Beatriz Souza Barros, Josiane Bernartt Zanellato, Patricia Guimarães, Karina Ilheu da Silva, Bianca Ribas, Cristina Reuter, Francis Tanise Casado, Mila Torii Correa Leite, Daniela Testoni, Ruth Guinsburg, Simone de Campos Vieira Abib, Edson Khodor Cury, Suely Dornellas do Nascimento, Arthur Almeida Aguiar, Rodrigo Melo Gallindo, Carolina Gonçalves Borges, Yang Liu, Cai Duote, Jinhu Wang, Zhigang Gao, Liang Liang, Wenjuan Luo, Xiaoxia Zhao, Rui Chen, Peng Wang, Yijiang Han, Ting Huang, Hu Donglai, Guo Xiaodong, Chen Junjie, Libin Zhu, Guowei Wu, Xiaozhou Bao, Haijing Li, Junying Lv, Zhongrong Li, Feng Yong, Zhou Chong Gao, Qiang Bai, Weibing Tang, Hua Xie, Jethishka Motee, Jianming Zhu, Gang Wen, Weiwei Ruan, Shungen Li, Lulu Chen, Shungen Huang, Zhibao Lv, Jinjing Lu, Liuming Huang, Mengnan Yu, Wang Dajia, Yu Zuo Bai, Luis Carlos Rincon, Juliana Mancera, Edgar Alzate Gallego, Laura Torres-Canchala, Nathalia Silva Beltrán, Ghordana Osorio Fory, Daniela Castaño Avila, Angelica Maria Forero Ladino, Juanita Gomez, Martha Jaramillo, Otto Morales, Beatriz Sanchez, Nestor Julien Tinoco Guzmán, Sergio Castañeda Espinosa, Osbaldo Prieto Vargas, Lina Maria Pardo, Eliana Toral, Freud Cáceres Aucatoma, Daniel Hinostroza, Santiago Valencia, Vicente Salinas, Enrique Landivar Cino, Gabriela Yulissa Ponce Fajardo, Miguel Astudillo, Virginia Garcia, Guillermo Muñoz, Leonardo Verduga, Ivan Verduga, Ericka Murillo, Elena Bucaram, Marisol Guayelema, Monica Marmol, Janina Sanchez, Carolina Vergara, Adriana Mena, Junior Velaña, Karla Salazar, Sandra Lara, Elena Chiriboga, Julian Silva, Dalia Gad, Doaa Samy, Menan Ahmed Elsadek, Hanan Mahmoud Mohammed, Mohamed Abouheba, Karim Osamy Ali, Hayssam Rashwan, Omar Moustafa Fawzy, Tarek mohamed Kamel, Rawan Nemer, Mohamed Abada Hassan, Eyad Hassan Falah, Dina Sobhy Abdelhady, Mostafa Zain, Eman Abouzeid Abouzeid Ibrahim, Omar Ossama Elsiraffy, Ahmed Aboelela, Eman mohamed Farag, Ahmed Mohamed Oshiba, Omar Sameh Emam, Alaa Mobarak Attia, Moustafa A. Laymouna, Islam Abdelmonem Ghorab, Mansour Mkayed Mohammed, Nourhan Akram Soliman, Khaled Abd elrahman Ghaly, Kareem Sadek, Mohamed Elsherbiny, Amr Saleh, Hesham Sheir, Tamer Wafa, Mohamed Abd Elmenam, Sherif Abdelmaksoud, Ahmed Reda, Islam Mansour, Mohamed Elzohiri, Basma Waseem, Mohamed Elewaily, Mohammed El-Ghazaly, Ahmad Elhattab, Amr Shalaby, Adham Elsaied, Ahmad Adawy, Mirna Sadek, Mahmoud Abdelfattah Ahmed, Mohamed Omar Herdan, Gena Mohamed Hamed Elassall, Azhar Arabi Mohammed, Mohammed Hamada Takrouney, Tarek Mohamed Essa, Ahmed Mokhtar Mahmoud, Alshaimaa M. Saad, Mariam Albatoul Nageh Fouly, Mahmoud abdelshakour Ibrahim, Mohammad Nageh, Mahmoud M. Saad, Helmy Badr, Mohamed Fayez Fouda, Ahmed Hassan Nofal, Hisham Almohamady, Mohamed Ahmed Arafa, Mohamed Amad, Mohamed Awad Mansour, Jennifer O'Connor, Zachary O'Connor, Nzanzu Anatole, Elysé Nkunzimana, Solomon Machemedze, Lemfuka Dieudonné, William Appeadu-Mensah, Theophilus Teddy Kojo Anyomih, Priscilla Alhassan, Francis A. Abantanga, Vishal Michael, Roshine Mary Koshy, Ankit Raj, Vijay Kumar, Sundeep PT, P Santosh Prabhu, Armin Vosoughi, Ali Farooq Al-Mayoof, Muhamed Jassim Fadhle, Ali Egab Joda, Hayder Nadhim Obaid Algabri, Sultan S. Abdelhamid, Hashem M. Al-Momani, Marzouq Amarin, Louay Y. Zaghlol, Nijmeh Nasser Alsaadi, Yasmeen Z. Qwaider, Hibah Qutishat, Ahmad Hasan Aliwisat, Esraa Arabiat, Isam Bsisu, Raghad M. Murshidi, Mohammad S. Jabaiti, Ziad A. Bataineh, Husam Aldean Abuhayyeh, Thekraiat M. Al Quran, Faris J. Abu Za'nouneh, Mohanad Mutasem Alebbini, Hamzah Abullah Qudah, Omar Ghazi Hussein, Amir M.I. Murad, Justin Z. Amarin, Haya H. Suradi, Sayel H. Alzraikat, Rand Y. Omari, Bashar M. Matour, Layana Al-Halbouni, Rajai O. Zurikat, Ahmad H. Yanis, Sara Al Hussein, Ali Shoubaki, Waleed H. Ghanem, Kuria David, Soita Wycliffe Chitiavi, Moraa Mose, Robert Mugo, James Ndungu, Timothy Mwai, Swaleh Shahbal, Janan Malik, Nirav Chauhan, Francisa Syovata, Kevin Ochieng, Polycarp Omendo Liyenzero, Syeda Ra'ana Hussain, Stanley Mugambi, Roseline Ochieng, Ebtesam Othman Abdulsalam Elkhazmi, Ala Khaled, Aya Albozidi, Manal Ben Enbaya, Mala Elgammudi, Enas Soula, Wegden ibrahim almabrouk Khalel, Yasmine Ali Elhajjaji, Nouriyah Ali Alwaggaa, Sumayyah Ghayth, Dafer abdulhakim .S. Zreeg, Sara Abobaker Tantush, Fatma Bibas, Tesneem Layas, Randa Alamen M Sharif, Wesal Omar F. Saied Aljadidi, Ahmed Tarek, Hazem Ahmed, Kamila Almabrouk Mohammed Essamilghi, Mabroka Alfoghi, Ma'aly A. Abuhlega, Saddam Arrmali, Fatima Mousa Abduljawad, Hasan Mustafa Alosta, Abdulsalam Abuajaila, Fakereldeen Abdelmutalib, Fatma Bashir, Inas Almengar, Mohammad hasan Annajjar, Abdelaziz Deyab, Fathi Elzowawi, Yousef Krayem, Weam Drah, Asma Meftah, Abobaker Mohammed, Lina Ali Arrmalli, Hajir Aljaboo, Abdallah Elayeb, Mohamed Altomi, Ahmed Altaweel, Mohamed Tumi, Hana Milad Bazozi, Aisha Shaklawoon, Mohammed Meftah Alglaib, Abdullahn Abdousalam Elkaloush, Sara Trainba, Hisham Swessi, Ali Alnaeri, Aya Essam Shnishah, Hamassat Mustufa, Sondas Ali Gargum, Sara Ali Tarniba, Hawa Ahmed Shalluf, Hajer Ali Shokri, Taher L. Sarkaz, Osama Tababa, Ahmed Elhadi, Vesna Cvetanovska Naunova, Laze Jovcheski, Marjan Kamilovski, Aleksandra Gavrilovska-Brzanov, Zarina Abdul Latiff, Siti Farhan Moh Pauzi, Marjmin Osman, Felicia Lim, Ainal Huda Abu Bakar, Azrina SK Zaman, Shareena Ishak, Rufinah Teo, Dr. Tammy Teoh Han Qi, Mohd Yusran Bin Othman, Dato' Dr Zakaria bin Zahari, Zulfitri bin Md Hassan, Cheah Hui Shan, Abhirrami Lechmiannandan, Hafatin Fairos bt Tamaddun, Mohd Fitri Shukri bin Mohamed Adanan, Mohd Yusof bin Abdullah, Wang Junyi, Mohd. Tarmizi Mohd Nor, Wan Ruzaimie Noor, Mohd Razin bin Hassan, Noor Fa'izatul Rahil Ambok Dalek, Hidayah Hayati binti Hashim, Ahmad Zulhisyam bin Zarwawi, V Muthualhagi M Vellusamy, Quah Soong Yuen, Hemasutha a/p Kannessan, Najua binti Ramli, Ahmad Shafiee bin Bujarimin, Jessmine Anntinea, Anthony Dass, Hazlina Mohd. Khalid, Nur Atiqah binti Mohd Hanifah, Keily Wong Yue Jyun, Rahilah binti Abd Razak, Nur Atifah binti Mohd Naim, Siti Nur Aien binti Hamid Hamzah, Cristian R. Zalles Vidal, Eduardo Bracho Blanchet, Roberto Dávila Perez, Emilio Fernandez Portilla, Raúl Villegas Silva, Daniel Ibarra, Antonio Calderon Moore, Cesar Carrasco-Ortega, Monica Noguez Castillo, Dorihela Herappe Mellado, Guillermo Yanowsky Reyes, Luis Fernando Gonzalez Cortez, Rafael Santana Ortiz, Jamie Orozco Perez, Jorge Román Corona C.Rivera, Juan Jose Cardenas Ruiz Velasco, Moises Quiles Corona, Christian Peña Padilla, Lucina Bobadilla Morales, Alfredo Corona Rivera, Izabel Maryalexandra Rios Flores, Cristian Irela Aranda Sánchez, Gabriela Ambriz-González, Nestor Martínez Hernández Magro, Francisco Javier León Frutos, José de Jesús Cárdenas Barón, Alejandro González Ojeda, Jessica Yarza Fernández, Juan Domingo Porras, Pastor Aguirre-Lopez, Vicente Sánchez Paredes, Arturo Montalvo Marin, Jose Manuel Diaz Gomez, Lorenzo Juvencio Caamal, David Bulnes Mendizabal, Pablo Sanchez Valladares, Humberto Garcia Martinez, Opeoluwa Adesanya, Moses Olanrewaju, Rilwan Adegboyega, Nurudeen Abdulraheem, Anuoluwapo Aremo, Florence Dedeke, Anyanwu Lofty-John Chukwuemeka, Mohammad Aminu Mohammad, Abdullahi Lawalbarau, Nwokoro Collins, Ogundele Ibukunolu, Amo Shonubi, Oluwaseun Ladipo-Ajayi, Olumide Abiodun Elebute, Justina Seyi-Olajide, Felix Alakaloko, George Ihediwa, Kayode Olayade, Christopher Bode, Olakayode Ogundoyin, Dare I. Olulana, Ifeanyichukwu Kelvin Egbuchulem, Felix O. Kumolalo, Ikechukwu Ulasi, Uchechukwu Obiora Ezomike, Sebastian Okwuchukwu Ekenze, Elochukwu Perpetua Nwankwo, Emmanuel Ifeanyi Nwangwu, Isaac Chukwu, Christopher Chim Amah, Nene Elsie Obianyo, Omolara Williams, Roland Iheanyichukwu Osuoji, Omolara Moronkeji Faboya, Olalekan Temitope Ajai, Moruf Adekunle Abdulsalam, Titiloye Hannah Agboola, Bolarinwa Bolanle Temilade, Maryrose Osazuwa, Morayo Monsurat Salawu, Eze Chukwuemeka Ejinkeonye, Mariya Mukhtar Yola, Amsa B. Mairami, Adekunle T. Otuneye, Matthias Igoche, Adebayo Gbenga Tanimola, Emmanuel Akinlabi Ajao, Efeturi Agelebe, Samson Olori, Philip Mari Mshelbwala, Olabisi Osagie, Adewale Oyinloye, Auwal M Abubakar, Lateef Oyebanji, Ibrahim Shehu, Cyril Cletus, Ahmed Bamanga, Faruk Suleiman, Sani Adamu, David C.Nwosu, Yahya S.Alkali, Iliya Jalo, Aliu Rasaki, Yusuf T.Sambo, Kalakwa A.Mohammed, Abubakar M.Ballah, Victor Modekwe, Okechukwu Hyginus Ekwunife, Ugochukwu S Ezidiegwu, Andrew N Osuigwe, Jideofor O Ugwu, Chuka A Ugwunne, Nadeem Akhter, Mudassir Fayaz Gondal, Rafee Raza, Ali Raza Chaudary, Hassan Ali, Muhammad Umar Nisar, Muhammad Umer Jamal, Ghuri Shankar Pandit, Uzma Mumtaz, Muhammad Bin Amjad, Nabila Talat, Wajeeh ur Rehman, Muhammad Saleem, Muhammad Bilal Mirza, Imran Hashim, Naveed Haider, Soban Hameed, Ayesha Saleem, Sohail Dogar, Muhammad Sharif, Muhammad Kashif Bashir, Fatima Naumeri, Zarqa Rani, Muath A.M. Baniowda, Basheer Ba'baa', Majd Yousef Mohammed Hassan, Ammar Darwish, Abrar Shaheen Sehwiel, Mohammed Shehada, Abrar ghassan Balousha, Yara Ajrami, Ainaa Ata Mohammad Alzamari, Bashar Yaghi, Hasan Subhi Hasan Abu Al-saleem, Mervat Sufian Abu Farha, Mohammad Omar Mohammad Abdelhafez, Firas Anaya, Asef belal Qadomi, Abd Al-Naser Bany Odi, Muath Abdelrahem Fuad Assi, Fadwa Sharabati, Ahmad Abueideh, Doha mustafa saleh Beshtawi, Hasan Arafat, Lara Zahi Adel Khatatba, Safa' Jamal Abatli, Hiba Al-Tammam, Dania Jaber, Yara Imad Omar Kayed, Ali Abdelhay Abumunshar, Rami Anwar Misk, Asmahan Mohammad Suliman Alzeer, Mutassem Sharabati, Ihsan Ghazzawi, Osama Majed Darras, Mahmoud M.Qabaja, Ma'alem sameer Hajajreh, Yasmeen Ahmad Samarah, Dua Hasan Yaghi, Moradallah Asad Fahmi Qunaibi, Abdelrazzaq Abu Mayaleh, Sharehan Joubeh, Annan Ebeido, Samer Adawi, Ihda Adawi, Mohammad Omar Ibrahim Alqor, Ahmad Samih Arar, Hadeel Awad, Fawzi Abu-Nejmah, Osaid Shaher Shabana, Firas Alqarajeh, Tareq Z. Alzughayyar, Jomana Madieh, Mahmoud Fuad Sbaih, Raghad mohammad abdu Alkareem, Raghad abdullateef Lahlooh, Yasmeen Adly Halabi, Wisam Baker, Tasneem Fathi Hasan Almusleh, Abdulraheem Adnan Abdulraheem Tahyneh, Yazid yousef mahmoud Atatri, Najlaa Abu Jamie, Nasrallah Ashraf Al Massry, Walaa Lubbad, Ayoub A.Nemer, Mohammed Alser, Aya Azmi Shehda Salha, Khaled Alnahhal, Aya Mahmoud Elmzyyen, Amir Talat Sheda Ghabayen, Abdulwhhab Ayman Abu Alamrain, Samar H. Al-Shwaikh, Omar Adly Elshaer, Nureddin Shaheen, Jehad Fares, Hisham Dalloul, Anas Qawwash, Mustafa abu Jayyab, Dina Ayman Ashour, Ahmad Ashraf Shaheen, Samy Rafat Ramadan Naim, Eman Abu Shiha, Nagham Mohammed Al Dammagh, Walaa Almadhoun, Ashraf Ayman Al-Salhi, Abdalkarim Yhya Hammato, Jamal Mohammed Salim, Doaa Khalil Hasanain, Soha Marwan Salem Alwadia, Ismail Nassar, Hala M. Al-Attar, Haya Abdulnasser Ali Alshaikhkhalil, Yasmin Mohammed Khalil Abu Jamie, Yara shareef Ashour, Sharif S. Alijla, Mohamed Anwer El Tallaa, Adham Ashraf Abuattaya, Bisan D.M. Wishah, MOHAMMED A.M. ALDIRAWI, Ahmed S Darwish, Sulaiman T. Alzerei, Nidal Wishah, Sharif Alijla, Isidora Garcia, Marlene Diaz Echegaray, Veronica Raquel Cañapataña Sahuanay, Fernando Trigoso Mori, Jackelyne Alvarado Zelada, Juan Jose Salinas Barreto, Porfirio Rivera Altamirano, Cesar Torres Miranda, Rocio Anicama Elias, Julio Rivera Alvarez, Juan Pedro Vasquez Matos, Fernando Ayque Rosas, Jesmarina Ledesma Peraza, Andrea Gutarra Palomino, Stephany Vega Centen, Victor Casquero, María Rosa Ortiz Argomedo, Francisco Lapouble, Genaro Llap Unchón, Florangel Patricia Delgado Malaga, Luis Ortega Sotelo, Segundo Gamboa Kcomt, Araceli Villalba Villalba, Nancy Rossana Mendoza Leon, Loreley Raquel Cardenas Alva, Maria Susana Loo Neyra, Cathy Lee Alanguia Chipana, Cintya Maria de Jesus Torres Picón, Natalia Huaytalla Quiroz, Danny Dominguez, Carlos Segura Calle, Jenny Arauco, Luis Ormeño Calderón, Ximena Ghilardi Silva, Miriam Daniela Fernandez Wilson, Joan Elizabeth Gutierrez Maldonado, Cesar Diaz Leon, Waldo Berrocal Anaya, Patricia Chavez Galvez, Prince Pamela Aguilar Gargurevich, Flor de Maria Diaz Castañeda, Carmen Guisse, Erika Ramos Paredes, Jose Luis Apaza Leon, Faye Aguilar Aguilar, Raul Ramirez De La Cruz, Lenny Flores Carbajal, Carlos Mendoza Chiroque, Gladys Johana Sulca Cruzado, Natalia Tovar Gutierrez, Jennifer Sotelo Sanchez, Carolina Paz Soldan, Karina Hernández Córdova, Edgar Fernando Delgado Quinteros, Luz Mery Brito Quevedo, Juan Jose Mendoza Oviedo, Angel Samanez Obeso, Patricia Paredes Espinoza, Johann de Guzman, Raisa Yu, Vlad Cosoreanu, Sebastian Ionescu, Aurel Mironescu, Lucian Vida, Adrian Papa, Roxana Verdeata, Bogdan Gavrila, Liviu Muntean, Marija Lukac, Miona Stojanovic, Djordje Toplicic, Milan Slavkovic, Andjelka Slavkovi, Dragoljub Zivanovic, Ana Kostic, Maja Raicevic, Delphine Nkuliza, Daniel Sidler, Corné de Vos, Elmarie vd Merwe, David Tasker, Omar Khamag, Cecilia Rengura, Thozama Siyotula, Uzair Jooma, Dirk von Delft, Marion Arnold, Hansraj Mangray, Shamaman Harilal, Sanele Madziba, Naveen Wijekoon, Tharanga Gamage, Benedict Paul Bright, Alaa Abdulrahman, Ola Ahmed Abdulmjeed Mohammed, Mohammed Salah, Ahmad Elian Abu Ajwa, Mohammed Morjan, Mohammad Mohannad Batal, Vivian Faks, Mohamad Bassel Mouti, Ahmadfateh Assi, Ahmad Al-Mouakeh, Ahmad Sankari Tarabishi, Ziad Aljarad, Aos Alhamid, Jiraporn Khorana, Wannisa Poocharoen, Sirima Liukitithara, Anan Sriniworn, Wasun Nuntasunti, Monawat Ngerncham, Ratiyaporn Phannua, Kanokrat Thaiwatcharamas, Patchareeporn Tanming, Lassaad Sahnoun, Nahla Kchiche, Roua Abdelmoumen, Egemen Eroğlu, Mehmet Ali Ozen, Hatice Sonay Yalçın Cömert, Mustafa İmamoğlu, Haluk Sarıhan, Şebnem Kader, Mehmet Mutlu, Yakup Aslan, Ahmet Beşir, Şükran Geze, Bahanur Çekiç, Ali Yalcinkaya, Kaan Sönmez, Ramazan Karabulut, Zafer Türkyılmaz, Kıvanç Şeref, Merve Altın, Merve Aykut, M.Eren Akan, Melisa Erdem, Ebru Ergenekon, Canan Türkyılmaz, Elif Keleş, Ali Canözer, Aslı Öztürk Yeniay, Elif Eren, İlknur Banlı Cesur, Zerrin Özçelik, Gökmen Kurt, Mustafa Kurthan Mert, Hatice Kaya, Müge Çelik, Suleyman Cuneyt Karakus, Nazile Erturk, Alev Suzen, Nilay Hakan, Fatih Akova, Mehmet Pasaoglu, Shukurali Eshkabilov, Rustam Z. Yuldashev, Dekhkonboev Avazjon Abdunomonovich, Aliev Makhmudjan Muslimovich, Azad Patel, Chisengo Kapihya, Nicholas Ensar, Ramesh M Nataraja, Mithila Sivasubramaniam, Matthew Jones, Warwick Teague, Sharman Tan Tanny, Gordon Thomas, Kiera Roberts, Soundappan Sannappa Venkatraman, Holger Till, Manon Pigeolet, Martine Dassonville, Anas Shikha, Win Sabai Phyu Win, Zahidah Adlynee Haji Ahmad, Léamarie Meloche-Dumas, Louise Caouette-Laberge, Dickens St-Vil, Ann Aspirot, Nelson Piché, Shahrzad Joharifard, Nadia Safa, Jean-Martin Laberge, Sherif Emil, Pramod Puligandla, Kenneth Shaw, Hussein Wissanji, Eileen Duggan, Elena Guadagno, Maria Consuelo Puentes, Paola Osses Leal, Carolina Mendez Benavente, Michal Rygl, Barbora Trojanová, Klára Berková, Tereza Racková, Ladislav Planka, Jan Škvařil, Radek Štichhauer, Shahad Sabti, Alex Macdonald, Nordeen Bouhadiba, Dorothy Kufeji, Caroline Pardy, Simon Mccluney, Alireza Keshtgar, Rebecca Roberts, Hannah Rhodes, Kate Burns, Robin Garrett-Cox, Kat Ford, Hannah Cornwall, Krithi Ravi, Felicity Arthur, Paul Losty, Tony Lander, Ingo Jester, Suren Arul, Oliver Gee, Giampiero Soccorso, Michael Singh, Max Pachl, Benjamin Martin, Afnan Alzubair, Arun Kelay, Jonathan Sutcliffe, Thomas Middleton, Amy Hughes Thomas, Merina Kurian, Fraser Cameron, Jayaram Sivaraj, Mark C Thomas, Dean Rex, Ceri Jones, Kate Bradshaw, Arnaud Bonnard, Xavier Delforge, Camille Duchesne, Caroline Le Gall, Coralie Defert, Samia Laraqui Hossini, Florent Guerin, Géraldine Hery, Virginie Fouquet-Languillat, Jules Kohaut, Aline Broch, Thomas Blanc, Luke Harper, Thomas Delefortrie, Quentin Ballouhey, Laurent Fourcade, Céline Grosos, Benoit Parmentier, Guillaume Levard, Maria Giovanna Grella, Mariette Renaux Petel, Lucie Grynberg, Olivier Abbo, Sofia Mouttalib, Mélodie Juricic, Aurelien Scalabre, Elodie Haraux, Anke Rissmann, Hardy Krause, Peter Goebel, Ludwig Patzer, Udo Rolle, Andrea Schmedding, Alexandra Antunez-Mora, Bernd Tillig, Sylvester von Bismarck, Patricia Reis Barbosa, Christian Knorr, Domitille Stark, Marco Brunero, Luigi Avolio, Francesco Manni, Matilde Molinelli, Marinella Guazzotti, Alessandro Raffaele, Piero Giovanni Romano, Silvia Cavaiuolo, Gian Battista Parigi, Laszlo Juhasz, Anna Rieth, Arunas Strumila, Rūta Dagilytė, Arunas Liubsys, Pranas Gurskas, Dalius Malcius, Agne Mikneviciute, Asta Vinskaite, Vidmantas Barauskas, Liam Vierboom, Timothy Hall, Spencer Beasley, Lucy Goddard, Mark Stringer, Naveen Weeratunga, Stephen Adams, Jitoko Cama, Marilyn Wong, Sridharan Jayaratnam, Askar Kukkady, Udaya Samarakkody, Sylwester Gerus, Dariusz Patkowski, Agnieszka Wolny, Tomasz Koszutski, Szymon Tobor, Marta Osowicka, Piotr Czauderna, Dariusz Wyrzykowski, Hanna Garnier, Stefan Anzelewicz, Osowicka Marta, Agata Knurowska, Alicja Weiszewsk, Andrzej Grabowski, Wojciech Korlacki, Michal Pasierbek, Przemyslaw Wolak, Aneta Piotrowska, Anna Roszkiewicz, Piotr Kalicińsk, Agata Trypens, Grzegorz Kowalewsk, David Sigalet, Amer Alsaied, Mansour Ali, Ameen Alsaggaf, Alaa Ghallab, Yazeed Owiwi, Ali Zeinelabdeen, Mohamed Fayez, Ahmed Atta, Mazen Zidan, Asaad saleh Radwan, Hanin Shalaby, Reem Abdelbaqi, Khalid Alattas, Yar Kano, Omar Sindi, Abdullah Alshehri, Tariq Altokhais, Fahad Alturki, Mohammad Almosaibli, Dasha Krisanova, Wisam Abbas, Hee-Beom Yang, Hyun-Young Kim, Joong Kee Youn, Jae Hee Chung, Seok Hyeon Cho, In ji Hwang, Ju yeon Lee, Eung song Song, Jenny Arboleda, Mercedes Ruiz de Temiño Bravo, Alexander Siles Hinojosa, Miriam García, Isabel Casal Beloy, Detlef Oliu San Miguel, Maria Elena Molina Vazquez, Verónica Alonso, Alberto Sanchez, Oscar Gomez, Isabel Carrillo, Tomas Wester, Carmen Mesas Burgos, Martin Salö, Erik Omling, Niclas Rudolfson, Christina Granéli, Helena Arnadóttir, Emma Grottling, Kate Abrahamsson, Vladimir Gatzinsky, Michaela Dellenmark Blom, Daniel Borbonet, Paul Puglia, Vinicio Jimenez Morejon, Gaston Acuna, Mario Moraes, Jonathan Chan, Pavan Brahmamdam, Alan Tom, Karen Sherer, Brandy Gonzales, Aaron Cunningham, Sanjay Krishnaswami, Reto Baertschiger, Mary Leech, Regan Williams, Lauren Camp, Ankush Gosain, Maria Mora, Bailey D. Lyttle, Jeremy Chang, Lydia McColl Makepeace, Kathryn L Fowler, Sara Mansfield, Erica Hodgman, Chukwubinyelum Amaechi, Alana Beres, Mark N. Pernik, Luke J. Dosselman, Murad Almasri, Sunil Jain, Varun Modi, Marianelly Fernandez Ferrer, John Coon, Joann Gonzalez, Medhavi Honhar, Nensi Ruzgar, Griffin Coghill, Sarah Ullrich, Maija Cheung, Katrine Løfberg, Jodie Greenberg, Kate Davenport, Samir Gadepalli, Sarah Fox, Stephanie Johnson, Mercedes Pilkington, April Hamilton, Nicole Lin, Juan Sola, Yang Yao, Jenna Kylene Davis, Monica Langer, Jonathan Vacek, Fizan Abdullah, Julie Khlevner, William Middlesworth, Marc Levitt, Hira Ahmad, Sabina M Siddiqui, Alex Bowder, Terry Derks, Afua Amoabin Amoabin, Brooke Pinar, Frank Owusu-Sekyere, Benmanseur Saousen, Rasika Naidoo, Azra Karamustafic, Danielle Paula de Oliveira, Jerhy Andrade, Antonín Šafus, Jason Langley, Alexandra Wilke, Corazone Deya, Habib Mansour Murtadi, Mindaugas Berzanskis, Nwachukwu Calistus, Olalekan S. Ajiboye, Michael Felix, Osagie O Olabisi, Seçil Erçin, Teymursha Muradi, Stephen S. Burks, Sergio Lerma, Jillian Jacobson, Calin Calancea, Rafael Valerio-Vazquez, Guigui Sikwete, Owusu Sekyere, Akhona Mbonisweni, Shahnoor Syed, Cho Seok Hyeon, Fatemeh Pajouhandeh, Sheba Mary Pognaa Kunfah, Global PaedSurg Research Collaboration, and Tıp Fakültesi

Subjects
Male, Pediatrics, medicine.medical_specialty, Adolescent, Gastrointestinal Diseases, Psychological intervention, Disease, Global Health, Specialties, Surgical, Congenital Abnormalities, Cohort Studies, medicine, Humans, Prospective Studies, Prospective cohort study, Child, Developing Countries, business.industry, Gastroschisis, Developed Countries, Intestinal atresia, Infant, Newborn, Gestational age, Congenital diaphragmatic hernia, Infant, Articles, General Medicine, medicine.disease, Gastrointestinal Tract, Atresia, Child, Preschool, Female, business
Abstract

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p

Published
2020

5. Heteropagus (parasitic) twins

Author

Amezene Tadesse, Miliard Derbew, Tihitena Negussie Mammo, Samuel Negash, Hanna Getachew, and Belachew Dejene

Subjects
Parasitic twin, medicine.medical_specialty, business.industry, lcsh:RJ1-570, lcsh:Surgery, lcsh:Pediatrics, lcsh:RD1-811, medicine.disease, Surgery, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, Pediatrics, Perinatology and Child Health, medicine, Heteropagus, business, 030217 neurology & neurosurgery
Abstract

Heteropagus (parasitic) twin is a type of conjoined twinning in which a partially formed defective twin is attached to an otherwise normal twin. It is an extremely rare anomaly. In this paper, we describe five cases we encountered over the past 9 years. Except one, all presented early within a few days of birth. None of them shared an organ but two had bony/visceral connections. All surgeries were successful, and we only encountered wound complications. To the best of our knowledge this is the largest compilation of original cases in a parasitic twin report. Keywords: Conjoined twin, Parasitic twin, Heteropagus twin, Ethiopia

Published
2018

6. Trends in Retention and Decay of Basic Surgical Skills: Evidence from Addis Ababa University, Ethiopia: A Prospective Case–Control Cohort Study

Author

Abebe Bekele, Naod Firdu, Amezene Tadesse, Mulat Taye, and Sahlu Wondimu

Subjects
medicine.medical_specialty, Students, Medical, Time Factors, Universities, education, Standardized test, 030230 surgery, Random Allocation, 03 medical and health sciences, 0302 clinical medicine, Internship, medicine, Surgical skills, Humans, Prospective Studies, business.industry, Suture Techniques, Clinical Clerkship, Retention, Psychology, Vascular surgery, Surgical Instruments, Cardiothoracic surgery, Case-Control Studies, 030220 oncology & carcinogenesis, Cohort, Physical therapy, Surgical instrument, Surgery, Clinical Competence, Ethiopia, business, Cohort study
Abstract

While prior studies have evaluated surgical skills simulation and retention in highly resourced environments, there is paucity of data on the retention of surgical skills taught in simulation laboratory to undergraduate students, and virtually none from low-resource settings. We aimed to evaluate the trends in retention/decay of surgical skills among medical students in Ethiopia and determine whether regular intervention in the form of intermittent skills testing can aid retention. Forty-four final year medical students were randomly divided into two cohorts of 22 students each. All 44 were trained in surgical instrument identification, simple interrupted suturing and one-handed knot tying. A previously validated, standardized assessment was performed before training, immediately after training, and then at 6 weeks, 3 months, 6 months and 1 year for cohort 1, and before training, immediately after training, and at 6 months and 1 year for cohort 2. All areas learned were tested for general decay. The baseline mean scores of surgical skills were 3.8/30 for instrument identification, 3.3/15 for one-handed knot tying, and 1.35/15 for suturing. At the end of the training, mean scores improved to 26.6/30, 11.2/15 and 11.1/15 (instrument identification +599% and +772%, knot tying +447% and +417%, suturing +237% and +260%, respectively, for Cohort I and II). At 6 months and 1 year, there was a significant drop in all the three areas tested, especially in knot tying and suturing. There was no statistically significant difference between the two cohorts. While our surgical skills course is an effective means to teach surgical skills to medical students, there is significant decay in abilities after 6 months. Conducting regular assessments does not appear to have any effect in helping students retain these skills. We recommend such surgical skills training be conducted at appropriate intervals, such as just before internship, to prepare student for active surgical practice.

Published
2018
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7. Trends and Outcomes of Emergency Pediatric Surgical Admissions from a Tertiary Hospital in Ethiopia

Author

Muluwork Teferra, Temesgen Firomsa, and Amezene Tadesse

Subjects
Male, medicine.medical_specialty, 030231 tropical medicine, Pediatric surgery, Pediatrics, Medical Records, Tertiary Care Centers, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, 030212 general & internal medicine, Surgical emergency, Pediatric surgery, Emergency Surgery, Ethiopia, Child, Abscess, Emergency Surgery, Pediatric Emergency Medicine, Genitourinary system, business.industry, Medical record, General Medicine, medicine.disease, Hospitalization, Treatment Outcome, Child, Preschool, General Surgery, Emergency medicine, Etiology, Female, Original Article, Ethiopia, Emergencies, Presentation (obstetrics), Foreign body, business
Abstract

BACKGROUND : Pediatric surgical emergency condition is a broad spectrum of surgical pathologies/disorders occurring in pediatric age group requiring proper emergency surgical care as the only option of management to salvage life, avoid/minimize disability or palliation. The objective of this study is to analyze the pattern and outcome of pediatric surgical emergencies managed at Tikur Anbesa Hospital and the factors associated with outcome. METHODS : Retrospective analysis of medical records of patients was conducted to assess the pattern, outcome and factors associated with outcome of pediatric surgical emergencies admitted and managed at Tikur Anbesa Specialized Hospital, from January 1, 2015 to December 31, 2015. Data was checked for completeness and entered into SPSS version 20 for statistical analysis. RESULTS : A total of 454 patients’ medical records were analyzed. The presentation was after 5 days of illness in 182(40%), and >3 days in 243(53.4%), while only 89(19.6%) of them come within 24 hours of the illness. The etiologies were abdominal/gastrointestinal emergencies 210(46.3%), foreign body in aero digestive system in 133(29.3%), urogenital surgical emergencies in 27(5.9%). The other causes include superficial and deep tissue abscess collections in 22(4.8%), trauma /injury related cases in 24(5.3%) and others in 38(8.4%) respectively while congenital malformations were only 57(12.6%) of the cases. Finally, 439(96.7%) were discharged cured or improved without major disabilities documented, while 9(2%) died. CONCLUSIONS : Delayed presentation, unstable condition on arrival, younger age group and the nature of underlying pathology could have contributed for the death, but this needs further study. KEYWORDS : Pediatric surgery, Emergency Surgery, Ethiopia

Published
2018

8. Risk Factors Associated With Increased Mortality From Intussusception in African Infants

Author

Richard Omore, Jacqueline E. Tate, Evans M. Mpabalwani, George E. Armah, Bothwell Mbuwayesango, Bhavin Jani, Bagrey Ngwira, Amezene Tadesse, Talia Pindyck, Umesh D. Parashar, and Jason M. Mwenda

Subjects
Male, Pediatrics, medicine.medical_specialty, Multivariate analysis, medicine.medical_treatment, Black People, Logistic regression, Article, 03 medical and health sciences, 0302 clinical medicine, Sex Factors, Risk Factors, 030225 pediatrics, Intussusception (medical disorder), Abdomen, Odds Ratio, Medicine, Humans, Hospital Mortality, Socioeconomic status, Africa South of the Sahara, business.industry, Gastroenterology, Infant, Enema, Odds ratio, medicine.disease, Confidence interval, Bowel obstruction, Hospitalization, Intestines, Socioeconomic Factors, Population Surveillance, Pediatrics, Perinatology and Child Health, Multivariate Analysis, 030211 gastroenterology & hepatology, Female, business, Intussusception
Abstract

OBJECTIVES Morbidity and mortality from intussusception, the leading cause of bowel obstruction in infants, is higher in Africa than in other regions of the world, but the reasons have not been well examined. We sought to identify risk and protective factors associated with death or intestinal resection following intussusception. METHODS Infants with intussusception from 7 sub-Saharan African countries (Ethiopia, Ghana, Kenya, Malawi, Tanzania, Zambia, and Zimbabwe) were enrolled through active, hospital-based surveillance from February 2012 to December 2016. We examined demographic, clinical, and socioeconomic factors associated with death or intestinal resection following intussusception, using multivariable logistic regression. RESULTS A total of 1017 infants

Published
2019

9. Hypospadias Repair in Ethiopia: A Five Year Review

Author

Hanna Getachew, Belachew Dejene, Samuel Negash, Tihitena Negussie Mammo, Teamir Negussie, Amezene Tadesse, and Miliard Derbew

Subjects
Male, medicine.medical_specialty, Adolescent, Urethroplasty, medicine.medical_treatment, Penis, urethra, hypospadias, repair, Ethiopia, Surgical Flaps, Postoperative Complications, Pediatric surgery, medicine, Hypospadias repair, Humans, hypospadias, Child, Glans, Retrospective Studies, business.industry, Infant, General Medicine, Plastic Surgery Procedures, medicine.disease, Meatal stenosis, Surgery, Treatment Outcome, Urethra, medicine.anatomical_structure, Hypospadias, Child, Preschool, repair, Original Article, Ethiopia, urethra, business, Penis, Follow-Up Studies
Abstract

BACKGROUND: Hypospadias repair is one of the problematic issues in pediatric surgery. As a result of the multiple complications following the procedure, a variety of techniques have been used and newer methods continue to emerge. There is still controversy regarding the best method of repair. We aimed to determine the outcome of surgery and factors contributing to unfavorable outcomes in children with hypospadias.MATERIALS AND METHODS: This is a retrospective review undertaken from September 2009 to August 2014. The research was conducted at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. All children who underwent hypospadias repair and had regular follow-up were included in the study.RESULTS: A total of 202 boys aged less than 13 years were assessed. Most surgeries (80.3%) were performed in children older than 18 months. Transverse incised plate urethroplasty (TIP) was frequently performed for distal hypospadias (71.2 %), while transverse ventral preputal flap (TVPF) was the most common procedure done for proximal hypospadias (62.8 %). Overall success rate for first surgery was 55.9 %. There was a high rate of major post-operative complications (44.1%) of which urethrocutaneous fistula (UCF) was the most common (31.2%) followed by meatal stenosis and glans breakdown (7.4 % each). These complications were found to be higher in those who were operated at a later age and those with proximal hypospadias (p=0.03 and p=0.01 respectively). There was also a significant difference among the type of procedures with TIP and TVPF having the least complications (p

Published
2019

10. Management of undescended testes: a retrospective study from a tertiary hospital in Ethiopia

Author

T Nigussie, B Dejene, Miliard Derbew, Amezene Tadesse, H Getachew, and M Gama

Subjects
Pediatrics, medicine.medical_specialty, medicine.diagnostic_test, business.industry, Cross-sectional study, 030232 urology & nephrology, Retrospective cohort study, Creative commons, Inguinal canal, Teaching hospital, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Biopsy, Medicine, Presentation (obstetrics), business, After treatment
Abstract

Background: Undescended testis is one of the commonest congenital malformations seen in boys. The aim of this study is to evaluate the pattern of presentation, approach to diagnosis, treatment and follow up in Tikur Anbesa Specialized Hospital, a tertiary teaching hospital in Ethiopia. Methods: This is a retrospective cross sectional study of all boys with undescended testis operated in Tikur Anbesa Specialized Hospital between September 2012 and August 2014. Results: Of 82 boys operated within the study period, 66 boys with 78 undescended testes are studied. Twenty-six percent (17/66)came before the age of 2 years, while the majority of the study group, 50% (33/66), presented beyond 5 years of age. Of the 17 boys brought to the hospital before 2 years, only 41% (7/17) them were treated before the age of two years. The majority 89% (59/66) of the boys were treated after 2 years of age. Seventy-one testes of 78 [91%] were in the inguinal canal, 5 were intra-abdominal and 2 were absent. 46% (36/78) were on the left side, 29% (23/78) on the right side and the rest were bilateral. Among the 54 boys who had ultrasound examination, the ultrasound report is consistent with operative findings in 33 [61%]. Associated congenital malformations were found in 31.8% (21/66) of the boys. Hypospadia was the predominant malformation comprising 38% (8/21) of the total congenital malformations. Orchidopexy was done for 82% (64/78) of the total testes, orchiectomy was done for 9% (7/78) and biopsy was taken in 1 case. Among the total operated boys only 62% (41/66) were followed in our clinic; of those who had follow up 10% (4/41) testes atrophied and 1 [2%] testis retracted. Conclusion: Boys with undescended testes present and are treated late in Tikur Anbesa Hospital. As opposed to the literatures most of the undescended testes were found on the left side. Ultrasound examination cannot be the only mode of examination for undescended testes as it misses more than one third of the cases. Hypospadia is the commonest associated congenital malformation. Post operative follow up is very poor after treatment for undescended testes https://dx.doi.org/10.4314/ecajs.v22i1.10 This work is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source (including a link to the formal publication), provide a link to the Creative Commons license, and indicate if changes were made.

Published
2017

11. Implementing ultrasound-guided hydrostatic reduction of intussusception in a low-resource country in Sub-Saharan Africa: our initial experience in Ethiopia

Author

Amezene Tadesse, Jonathan Zember, Samuel Sisay, Eyasu Wakjira, Yocabel Gorfu, Kassa Darge, Daniel Zewdneh, and Tesfaye Kebede

Subjects
Male, medicine.medical_specialty, Sub saharan, Referral, Low resource, Developing country, Dysfunctional family, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Intussusception (medical disorder), medicine, Humans, Radiology, Nuclear Medicine and imaging, Prospective Studies, Prospective cohort study, Intensive care medicine, Child, Ultrasonography, Interventional, business.industry, General surgery, Infant, medicine.disease, Cross-Sectional Studies, Treatment Outcome, 030220 oncology & carcinogenesis, Radiological weapon, Child, Preschool, Emergency Medicine, Female, Ethiopia, business, Intussusception
Abstract

Despite advances in non-invasive radiological techniques for the treatment of intussusception, management of the entity still remains exclusively surgical in many developing countries, including Ethiopia. Fluoroscopic units are rare or mostly dysfunctional. Ultrasound scanners are more commonly available. Ultrasound-guided hydrostatic reduction (USGHR) was recently introduced to the main referral hospital in Ethiopia, and subsequently has been adopted as the initial management option for intussusception. The aim of this study was to evaluate our experience with USGHR in Ethiopia and measure the impact on patient care. A prospective study was conducted between July 2014 and August 2015 on all pediatric patients, with US-confirmed intussusception, at the Tikur Anbessa Specialized Teaching Hospital in Addis Ababa, Ethiopia. All patients, excluding those with signs of peritonitis, bowel ischemia, or symptoms lasting longer than 4 days, were selected to undergo USGHR. A total of 53 children were diagnosed with intussusception, confirmed via ultrasound. Following exclusion criteria, USGHR was attempted in 47 of the patients. Forty-one of the 47 patients (87.2%) had successful reduction, resulting in a 77% overall rate of successful non-operative management in all patients with intussusception. The rate of operative reduction of intussusception decreased by 77% following the introduction of USGHR as the initial non-surgical intervention. Therefore, we believe USGHR should be fully implemented in our hospital, and recommend that this study serves as an example to other institutions in our country as well as in other developing countries facing similar challenges.

Published
2017

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