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Background: The situation for patients with ostomy can be challenging, probably more in a resource‐constrained environment. Our objective was to evaluate quality of life (QoL) (using EQ5D‐5L) and stoma‐specific QoL (using Stoma QoL) in a high‐ and low‐income setting. Methods: In this cross‐sectional study from the Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, and South General Hospital (SGH), Stockholm, patients with a permanent or temporary ostomy at TASH (EthioPerm), (EthioTemp), and patients with ostomy at SGH (SweSto) were included in October 2022–January 2023. Results: Patients N = 66 were included in groups: EthioPerm N = 28, EthioTemp N = 17, and SweSto N = 21. In EthioTemp, 88% used homemade stoma bags. Although morbidity related to the nipple itself was similar in the groups, the overall score from Stoma QoL was significantly lower in EthioPerm, 48/100 than in SweSto, 74/100. Scores were significantly lower for pouch‐related problems and social interactions in Ethiopian patients. In EthioPerm, 71% of the patients worried that they were a burden to the people close to them compared to 14% in SweSto (p < 0.001). Leakage was over four times more common in EthioPerm than in SweSto. Mean overall EQ5D‐5L score was 18 percentage points lower than the national mean score in EthioPerm and 2 percentage points lower in SweSto. Conclusion: QoL was more affected in the Ethiopian study participants than in the Swedish, even when commercial stoma bags were available. The largest problems were leakage, embarrassment with social interactions, and pouch‐related problems. Trial registration: NCT05970458 Clinicaltrials.gov, https://clinicaltrials.gov/study/NCT05970458?locStr=Ethiopia&country=Ethiopia&distance=50&cond=Stoma%20Ileostomy&rank=1. [ABSTRACT FROM AUTHOR]

Abstract Background HIV infection has been modifying both the epidemiology and outcome of parasitic infections. Hence, this study was undertaken to determine the prevalence of intestinal parasitic infection among people with and without HIV infection and its association with diarrhea and CD4 T-cell count. Methods A cross-sectional study was conducted at Hawassa Teaching and Referral Hospital focusing on HIV positive individuals, who gave blood for CD4 T-cell count at their first enrolment and clients tested HIV negative from November, 2008 to March, 2009. Data on socio-demographic factors and diarrhea status were obtained by interviewing 378 consecutive participants (214 HIV positive and 164 HIV negative). Stool samples were collected from all study subjects and examined for parasites using direct, formol-ether and modified acid fast stain techniques. Results The prevalence of any intestinal parasitic infection was significantly higher among HIV positive participants. Specifically, rate of infection with Cryptosporidium, I. belli, and S. stercoralis were higher, particularly in those with CD4 count less than 200 cells/μL. Diarrhea was more frequent also at the same lower CD4 T-cell counts. Conclusion Immunodeficiency increased the risk of having opportunistic parasites and diarrhea. Therefore; raising patient immune status and screening at least for those treatable parasites is important.

Background: This study was done to identify risk factors that affect the morbidity and mortality of patients operated for a perforated peptic ulcer in a resource-limited setting., Methods: A two years (January 1, 2016 -December 30, 2018) retrospective cross-sectional study was done on patients admitted and operated for PPU at Yekatit 12 Hospital, Addis Ababa, Ethiopia., Results: A total of 93 patients were operated. The median age affected was 29 years (Range 15-75 years). Male to female ratio was 7.5:1. Chewing chat, smoking and alcohol use were seen in 22 (23.6%), 35(37.6%), and 34(36.5%), cases respectively. Only 23.6% gave previous history of dyspepsia. The median duration of illness was 48hours and the duodenal to gastric ulcer perforation ratio was 6.5:1. In majority of the cases (63.3%) the perforation diameter was =10mm (63.3%). Cellan-Jones repair of the perforations was done in 92.5% of cases. A total of 47 complications were seen in 25 cases. The total complications and mortality rates were 25(26.8%) and 6(6.5%) respectively. The most common postoperative complication was pneumonia (13.97%) followed by superficial surgical site infection (10.8%). Mortality rate was highest among patients >50yrs [AOR (95%CI) =2.4(230)]. Delayed presentation of >24 hours [AOR (95%CI) =4.3(1.4-13.5)] and a SBP =90mmhg [AOR (95%CI) =4.8(1-24)] were found to be significantly related with higher complication rate., Conclusions: Patients who presented early and immediate corrective measures were instituted had better outcomes while those seen late developed unfavorable out-come with significantly higher complications. Therefore, early detection and treatment of PPU is essential., (Copyright: © 2020 Nebyou Seyoum, et al.)

Background: Appendiceal mass is one of the complications of acute appendicitis. The management of patients with appendiceal mass is controversial and different treatment options have been suggested., Objective: The objective of this study was to assess the results of conservative management of patients with appendiceal mass followed by interval appendicecomy., Methods: The study was a retrospective analysis of 73 medical records of patients with appendiceal mass who were managed conservatively between March 2007 and February 2014., Results: Fifty patients were males and 23 patients were females making the male to female ratio of 2.2:1. The mean age was 29.6 ± 6.3 years (range 12-68 years). The maximum incidence was in the 3rd decade. Forty one (55.8%) of the patients presented one week or more after the onset of their illness. Abdominal pain, right lower quadrant (RLQ) direct and rebound tenderness were observed in all patients. Mass was detected in the RLQ in 84.9% of the patients. Sixty five patients (89%) responded to conservative treatment and these patients were discharged after a mean hospital stay of 6.5 1.5 days (range 3-12 days). Interval appendicectomy was done for 58 patients 8-16 weeks after successful conservative management. The mean hospital stay after interval appendicectomy was 3.5 ± 0.5 days with a range of 2-5 days. One patient (1.7%) had a wound infection. There were no deaths., Conclusion: Initial non-operative management of appendiceal mass was successful in most cases and the complication rate after interval appendicecomy seems lower than with early operative treatment.

Background: Acute appendicitis is the most common cause of acute abdomen in children. The rate of appendicular perforation may be related to duration from the onset of symptom presentation to treatment., Objective: To describe the clinical characteristics and assess symptom duration as a risk factor for perforation in children with acute appendicitis. PATENTS AND METHODS: A retrospective analysis of medical records of 322 children under 15 years of ages with intraoperative diagnosis of acute appendicitis between the periods of September 2006 and August 2010., Results: Acute appendicitis accounted for 87.5% of all cases of acute abdomen during the study period. Two hundred patients were boys and 122 patients were girls giving male to female ratio of 1.6:1. The mean and median ages were 10.4 and 11 years respectively. The youngest patient was 3 years old. The peak age range was 10-14 years. The most common presenting symptoms were abdominal pain (100%), anorexia (85.1%), vomiting (83.9%), and fever (82.3%). Right lower quadrant tenderness was the leading physical finding observed in 83.9% of patients. The mean duration of symptoms in children with non-perforated appendicitis was 2.5 days whereas the mean duration of symptoms in children with perforated appendicitis was 5.2 days. The mean length of hospital stay in children with non-perforated appendicitis was 3.6 days whereas the mean length of hospital stay in children with perforated appendicitis was 8.4 days. Leucocytosis was observed in 74.5% of children and the mean leucocyte count was 13150/mm3. The incidences of perforation if symptoms were present for less than 24 hours, 24-48 hours and more than 48 hours were 4.1%, 10.2%, and 45.3%, respectively. Postoperative wound infection was observed in 1.9% and 31% of children with non-perforated and perforated appendicitis, respectively. Two children died in the hospital., Conclusion: Acute appendicitis was the commonest cause of acute abdomen in children. It was more prevalent in children aged 10-14 years. The commonest presenting symptoms and signs were abdominal pain, anorexia, vomiting, and fever and right lower quadrant tenderness. The risk of perforation is directly proportional to the duration of illness at presentation. Perforated appendicitis was associated with increased morbidity, mortality and prolonged hospital stay.