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Telila Mesfin,1 Nuri Haji,1 Fikadu Seyoume,2 Kenbon Seyoum,3 Eshetu Mesfin,4 Tsegaye Erdachew,5 Daniel Ayane,5 Gadisa Badasa,5 Moisan Soboka5 1Department of Medicine, Madda Walabu University Goba General Hospital, Goba, Ethiopia; 2Department of Pediatrics, Madda Walabu University Goba General Hospital, Goba, Ethiopia; 3Department of Midwifery, Madda Walabu University Goba General Hospital, Goba, Ethiopia; 4Department of Public Health, ICAP, Finfine, Oromia, Ethiopia; 5Department of Nursing, Madda Walabu University Goba General Hospital, Goba, EthiopiaCorrespondence: Telila Mesfin, Email telilamesfintadesse@gmail.comIntroduction: The term “disorders of sexual differentiation” refers to a variety of issues that result in the baby’s genitalia being underdeveloped or showing characteristics shared by both sexes. Normal sexual development in utero requires a precise and coordinated spatiotemporal sequence of numerous activating and suppressing factors. Inadequate development of the bipotential gonad into an ovary or a testis is one of the most frequent causes of genital ambiguity (partial gonadal dysgenesis). One in every 50,000 babies suffers from cloacal anomalies, which makes it one of the rarest congenital malformations. The supernumerary kidney is an extremely uncommon congenital abnormality with less than 100 cases reported in the literature.Case: We present five days old neonate admitted to the neonatal intensive care unit with a complaint of absence of anal orifice. The baby had not passed meconium within 48 hours after delivery, but the families later realized that meconium had been passing through the urethral orifice along with urine. The child was born to a 32-year-old para-four woman who claims to have been amenorrheic for the past nine months but could not recall her last regular period. On physical examination, the abdomen was grossly distended, and there was no anal opening other than just a dimple on the sacrococcygeal area, and the external genitalia appears female on inspection with labia majora well developed and no fusion.Conclusion: Disorder of sexual differentiation is a clinically diverse set of diseases that interferes with the proper differentiation and determination of sex in the embryo and fetus. One in 50,000 live births results in cloacal abnormalities, which are extremely uncommon. Less than 100 examples of the supernumerary kidney have been documented in the literature, making it an exceptionally rare congenital anomaly.Keywords: supernumerary kidneys, neonate, cloacal anomaly, ambiguous genitalia

Telila Mesfin,1 Kenbon Seyoum,2 Mesfin Tsegaye,1 Eshetu Mesfin,3 Geda Tilahun,1 Gela Atlie1 1School of Medicine, Madda Walabu University Goba General Hospital, Goba, Oromia, Ethiopia; 2Department of Midwifery, Madda Walabu University Goba General Hospital, Goba, Oromia, Ethiopia; 3Department of Public Health, ICAP, Finfine, Oromia, EthiopiaCorrespondence: Telila Mesfin, Tel +251931504321, Email telilamesfintadesse@gmail.comIntroduction: Phocomelia is an uncommon congenital condition in which the hand or foot are normal or almost normal but the proximal section of the limb – the humerus or femur, radius or tibia, ulna or fibula –_is missing or noticeably hypoplastic. It refers to how the patient’s limbs resemble marine creatures’ flippers and its prevalence is 0.62 in 100,000 births.Case: We present a 15-min-old male neonate born to a para-four mother who did not remember her LNMP but claimed to be amenorrheic for the past nine months. The mode of delivery was by cesarean section to extract alive neonate weighing 2.01 kg with APGAR scores of 5 and 6 at first and fifth minutes, respectively. The neonate did not cry and was resuscitated for five minutes. He was then transferred to neonatal intensive care unit for further management and investigations. His vital signs were pulse rate 160 beats per minute, respiratory rate 70 breaths per minute, temperature 33.4 degrees centigrade and saturation was 60% off oxygen. On HEENT anterior fontanelle measures 2 cm by 2 cm and has micrognathia and short neck. On the respiratory system, there were intercostal and subcostal retractions, labored breathing and grunting. On the musculoskeletal system there is bilateral upper extremity shortening, the right lower limb was normal in position and structure, the left leg rotated inward (bent in medially) at the knee joint and foot was normal in structure.Conclusion: Phocomelia is a rare congenital anomaly in which the hand or foot are directly attached to the trunk. Ultrasonography should be done as early as possible to identify fetal anomalies in order to plan subsequent management.Keywords: phocomelia, upper limb, ultrasonography, neonate

Telila Mesfin,1 Gosaye Debele,2 Kenbon Seyoum,3 Sisay Dadi,4 Mesfin Tsegaye,1 Degefa Gomora,3 Chala Kene,3 Gudisa Tolosa1 1Department of Medicine, Madda Walabu University Goba General Hospital, Goba, Ethiopia; 2Department of Surgery, Madda Walabu University Goba General Hospital, Goba, Ethiopia; 3Department of Midwifery, Madda Walabu University Goba General Hospital, Goba, Ethiopia; 4Department of Internal Medicine, Madda Walabu University Goba General Hospital, Goba, EthiopiaCorrespondence: Telila Mesfin, Tel +251931504321, Email telilamesfintadesse@gmail.comIntroduction: Abscess of the tongue is a very rare disease that potentially compromises the airway. Acute tongue abscess symptoms include swelling or a lump in the deep tissues of the tongue, throbbing local pain, a discomfort that radiates to the ears, fever, difficulty swallowing, deliberate fixation of the tongue due to pain, and eventually, difficulties breathing.Case: This is a 50-year-old male patient who presented with a complaint of severe tongue pain and swelling of three days duration. Associated with this, he had pain while swallowing, difficulty opening his mouth, shortness of breath, and drooling saliva. Likewise, he had a high-grade fever and a global type of headache. On physical examination, there was significant tongue swelling on the left anterolateral area, fluctuant on palpation, and had erythematous border. After informed consent was taken the patient was transferred to the operation room with the diagnosis of tongue abscess. Subsequently, incision and drainage were done under general anesthesia, and about 30mL of thick pus was drained. The pocket was washed with normal saline and 2% hydrogen peroxide. The patient was transferred to the surgical ward with stable vital signs and had been on antibiotics. He was discharged after two days of hospital stay.Conclusion: Abscesses in the tongue are quite uncommon due to its rich vascular supply, lymphatic drainage, and saliva’s immunologic advantage. Thorough diagnosis and successful treatment of tongue abscess prevent potential airway compromise. Antibiotic treatment should cover gram-positive and gram-negative anaerobes.Keywords: tongue abscess, khat chewing, sonography

Telila Mesfin,1 Yohannes Tekalegn,2 Mudesir Aman,3 Girma Geta,4 Adugna Ketema,4 Fekata Defere,1 Dejene Girma,1 Mesfin Tsegaye,1 Takele Mengistu,1 Kenbon Seyoum4 1Department of Medicine, Madda Walabu University Goba General Hospital, Goba, Oromia, Ethiopia; 2Department of Public Health, Madda Walabu University Goba General Hospital, Goba, Oromia, Ethiopia; 3Department of Surgery, Madda Walabu University Goba General Hospital, Goba, Oromia, Ethiopia; 4Department of Midwifery, Madda Walabu University Goba General Hospital, Goba, Oromia, EthiopiaCorrespondence: Kenbon Seyoum, Tel +251915821035, Email kbseyoum8@gmail.comIntroduction: Foreign body ingestion causes a serious health problems like bleeding, abscess formation, septicemia, perforation, and obstruction of the esophagus, stomach and the intestine. In adults, foreign body ingestion is more common in the elderly, individuals with mental illness or who have an intellectual disability, alcohol poisoning, prison inmates, and drug traffickers.Case Presentation: We present a 22 year old male patient who presented with abdominal distension and vomiting of ingested matter of two to three episodes per day of one month duration. He is a known schizophrenic patient for the past three years and has been on follow up at a nearby hospital. He swallowed metallic nails in an attempt to kill himself. On abdominal examination there was distension, and epigastric tenderness. His plain abdominal x-ray showed multiple radiopaque foreign body in the stomach. Similarly, abdominal ultrasound showed thickened gastric wall and multiple linear foreign bodies in the stomach. Then, with the impression of gastric outlet obstruction secondary to foreign body in the stomach, laparotomy plus gastrotomy plus foreign body removal and repair were done under general anesthesia. Dilated stomach, palpable mass on distal stomach and first part of duodenum, and adhesion between stomach, abdominal wall and liver was found intra operatively.Conclusion: Passage of curved metal through the throat is a rare case. Mentally ill individuals need close follow up and physiological consultation.Keywords: foreign body ingestion, metal, Schizophrenia