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Yodit Habtamu, 1 Kalkidan Admasu, 2 Mikiyas Tullu, 3 Woyenabeba Damene, 4 Addis Birhanu, 5 Teferra Beyero, 1 Addis Birhanu Tereda 6 1Department of Psychiatry, Eka Kotebe General Hospital, Addis Ababa, Ethiopia; 2Psychosocial and Rehabilitation Services Department, Eka Kotebe General Hospital, Addis Ababa, Ethiopia; 3Department of Psychiatry, College of Health Sciences, Kotebe Metropolitan University, Addis Ababa, Ethiopia; 4Research and Training Department, Eka Kotebe General Hospital, Addis Ababa, Ethiopia; 5Department of Public Health, College of Medicine, Jimma University, Jimma, Ethiopia; 6Department of Internal Medicine, Eka Kotebe General Hospital, Addis Ababa, EthiopiaCorrespondence: Yodit Habtamu Email yodita25yididya@yahoo.comBackground: The COVID-19 pandemic has resulted in many frontline health-care workers vulnerable to developing various mental health conditions. This study aimed to determine prevalence and associated factors of such conditions among frontline workers at Eka Kotebe National COVID-19 Treatment Center in Addis Ababa, Ethiopia.Methods: This institution-based cross-sectional study was conducted between May and June 2020 on 280 frontline workers. Mental health outcomes (depression, anxiety, insomnia, and posttraumatic stress disorder) were assessed using the Patient Health Questionnaire9, Generalized Anxiety Disorder 7 questionnaire, PTSD Checklist — civilian version, and Pittsburgh Sleep Quality Index. Responses were coded, entered into EpiData 3.1 and analyzed using SPSS 20. Associations between outcomes and independent variables were identified using bivariate and multivariate logistic regressions, statistical significance set at p< 0.05.Results: A total of 238 subjects participated in the study, with a response rate of 85%. Estimated prevalence was 31.1% (95% CI 24.8%– 37%) for anxiety, 27.3% (95% CI 21.8%– 32.4%) for depression, 16% (95% CI 11.3%– 21%) for PTSD, and 40.8% (95% CI 33.6%– 47.5%) for insomnia. Female sex (AOR 2.99, 95% CI 1.49– 5.97), being married, (AOR 13.2, 95% CI 3.42– 50.7), being single (AOR 11.5, 95% CI 3.38– 39.8), duration of exposure 1– 2 hours (AOR 0.29, 95% CI 0.14– 0.64), and assigned place of work (critical ward —AOR 2.26, 95% CI 1.03– 4.97; ICU — AOR 4.44, 95% CI 1.51– 13.05) were found to be significant predictors of depression.Conclusion: We found a high estimated prevalence of mental health outcomes. Sex, marital status, duration of exposure, and assigned place of work were found to be associated with depression.Keywords: COVID-19, depression, anxiety, PTSD, insomnia, frontline health-care workers, Eka Kotebe Hospital

The authors offer observation on utilizing tables, figures, charts and graphs to help understand the research presented in a simple manner but also engage and sustain the reader's interest. Topics discussed include benefits provided by the use of tables/figures/charts/graphs, general methodology of design and submission, and copyright issues of using material from government publications/public domain.

The author discusses the significance of referencing in research right from the conception of the study question until its delivery as a publication. Topics covered include the preparations that a writer should take when organizing the reference to avoid bias in his/her research/writing, how to weigh references in terms of their value to the paper, and rules when choosing appropriate references.

Introduction: The association of pulmonary hemosiderosis with celiac disease (Lane–Hamilton syndrome) is extremely rare. Case Details: A five-year-old female child presented with fever, cough, breathlessness, and pallor for 20 days, without any previous history of recurrent lower respiratory tract infections, tuberculosis, or cardiac disease. There was no history of pica, chronic diarrhea, bleeding, or personal or family history of repeated blood transfusions. She had tachycardia, tachypnea, severe pallor, stunting, rickets, and bilateral fine lung crepitations. Peripheral smear and blood indices revealed dimorphic anemia. Anti-tissue transglutaminase IgA antibody levels were high (>200 U/mL) and the upper gastrointestinal endoscopy with duodenal biopsy confirmed the diagnosis of celiac disease. The child was discharged on a gluten-free diet (GFD) and oral hematinic, but her dietary compliance was poor. Interestingly, the child had persistent bilateral pulmonary infiltrates, which was initially attributed to congestive cardiac failure (CCF), which persisted even despite treatment. HRCT chest revealed interstitial thickening and bilateral alveolar shadows and bronchoalveolar lavage showed a few inflammatory cells. The child was readmitted four times with similar complaints and was given packed red cell transfusions. In the fourth admission, a lung biopsy was done, which revealed extensive pulmonary hemosiderosis. The patient was given a course of oral steroids for 6 weeks, with a gluten-free diet, following which both the anemia and the pulmonary infiltrates resolved. Conclusion: Pulmonary hemosiderosis is an important cause of anemia in cases of celiac disease and may be misdiagnosed as CCF due to severe anemia. A strict GFD, with or without corticosteroids, can reverse the clinical and radiological picture. [ABSTRACT FROM AUTHOR]

The author offers insights on post-publication issues on original medical research papers in 2021. Topics discussed include replies to received letters to the editor on the published manuscript, the basis of a publication's prestige on a highly rated indexed journal like MEDLINE, and the website posting of the published article in portable document format (PDF). Also noted are the factors of journal and personal research impacts.

Introduction: There is a paucity of studies on the progression and outcome of Systemic Inflammatory Response Syndrome (SIRS) with its determinants. Aims and Objectives: To determine the predictors of the outcome and progression of pediatric sepsis and septic shock. Materials and Methods: Prospective observational study of children fulfilling criteria of SIRS and their progression to sepsis, severe sepsis, and septic shock (clinically and biochemically) was conducted at a tertiary care center. Results: Totally, 200 children were recruited over a period of 21 months (from February 2016 to October 2017). Most cases (80, 40%) were infants. Of the total, 188 (94%) cases were of an infective etiology (mostly respiratory system). Temperature and heart rate were the two commonest SIRS parameters which were deranged. Blood cultures were positive in only 25 (12.5%) cases. Out of the total 200 children, 108 progressed to sepsis, of which 26 progressed to severe sepsis, of which 22 progressed to septic shock. Abnormal leukocyte count, culture positivity and severe acute malnutrition were significantly associated with progression of SIRS patients to septic shock (P = 0.001, 0.00001 and 0.002, respectively). Factors associated with mortality were positive blood culture, multiorgan dysfunction, late hospital admissions, severe acute malnutrition, and requirement of supportive care (P values-<0.0001, <0.0001, 0.03, <0.0001 and <0.0001, respectively). Conclusions: SIRS can progress to septic shock if not identified early. The predictors of mortality were positive blood cultures, multiorgan dysfunction, late hospital admissions, severe acute malnutrition, and requirement of supportive care. The predictors of progression to septic shock were abnormal leukocyte count, culture positivity, and severe acute malnutrition. [ABSTRACT FROM AUTHOR]

The article offers information on the process of peer review and method for writing good reviews for original research papers. Topics discussed include comparison of the blinded and the open peer review, qualifications of a reviewer, training of reviewers, and attributes or characteristics of a good reviewer.

The author offers observation on research contribution of India on telemedicine. Topics discussed include findings of the study by P. K. Behera and colleagues, titled "Mapping and visualizing the research contribution of India on telemedicine: A scientometric study," role played by the Covid-19 pandemic in the popularity and acceptance of telemedicine, and applications for the use of telemedicine.

Byline: S. Vaidyanathan, M. Tullu, K. Lahiri, C. Deshmukh We report here a 2.5-year-old male child with community-acquired Pseudomonal sepsis showing the characteristic lesions of ecthyma gangrenosum. The child had [...]

Pulmonary arteriovenous malformations rarely present in childhood. Two cases are presented in this report. Both the cases presented clinically with cyanosis and clubbing without a cardiac murmur. The second case had cerebral abscess in addition. Both the cases underwent a contrast-enhanced echocardiography which suggested the presence of pulmonary arteriovenous malformations. The first case also underwent 99mTc radionuclide scan and pulmonary angiography. The cases are being reported for their characteristic clinical features and for emphasizing the role of non-invasive modalities like contrast-enhanced echocardiography and radionuclide scan in reaching the diagnosis. [ABSTRACT FROM AUTHOR]

Glanzmann's thrombasthenia (GT) is an uncommon cause of bleeding in children. We diagnosed two siblings as having GT on the basis of flow cytometric studies. Both had cutaneous bleedings and epistaxis since early childhood. Hematological investigations revealed prolonged bleeding time and a normal platelet count. Both the patients had absence of aggregation of platelets with the agonist adenosine diphosphate. Absence of the GPIIb/IIIa receptor was confirmed by flow cytometry. A short review of the disorder is presented. [ABSTRACT FROM AUTHOR]

Background: Leadership is the ability to influence the attitudes, beliefs, and abilities of employees to achieve organisational goals. It is crucial for the successes or failures of organisational performance. Healthcare organizations need effective leadership to manage the health service delivery reforms efficiently and effectively. However, there was no adequate evidence on the current status of the healthcare leaders to make evidence-based decisions. Therefore, this study aims to assess the effectiveness of healthcare leadership and associated factors among managers working at public health institutions in Addis Ababa, Ethiopia., Methods: Institution-based cross-sectional study triangulated with the qualitative study was employed from 01 April to 01 June 2021. A total sample of 844 healthcare managers were used to assess their leadership effectiveness. Multi-stage sampling followed by a simple random sampling technique was used to select the participants. Binary logistic regression model was fitted to identify the factors associated with healthcare leadership effectiveness. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and p-value less than 0.05 during multivariable logistic regression were used to declare the factors associated with the outcome variable. We conducted key informant interviews (KIIs) to explore the views of healthcare managers on their leadership practices, mainly on vision creation, developing followership and implementing vision. We also tape-recorded the KIIs and then transcribed word by word and finally translated it into English. We conducted a thematic analysis to supplement the quantitative findings., Results: In this study, 46.8% (95% CI: 43.4 -50.2) of the participants had effective healthcare leadership practices. Emotional intelligence (AOR = 7.86; 95% CI; 4.56, 13.56), democratic managers (AOR = 4.01, 95% CI; 1.98, 8.14), master or above education (AOR = 5.1; 95% CI; 2.07, 12.61) and work experience (AOR = 3.44, 95% CI; 1.24, 9.55) were positively associated with healthcare effective leadership. The challenges in healthcare leadership were mainly associated with lack of leadership knowledge and skills. In addition, autocratic leaders negatively influenced managers ability to work closely with the staffs and affected employee's motivation. On the contrary, emotionally intelligent managers were effective on employee handling, providing chance to talk, understanding their feelings and needs., Conclusion: Healthcare managers had low capacity on vision creation, implementation and developing followership, particularly the ability of vision creation was very low. Lack of leadership knowledge and skills and frequent use of autocratic leadership were the challenges for healthcare leadership effectiveness. This could also negatively influence organisational performances, managers' ability to work closely with the staffs and reduced employee's motivation. Therefore, strengthening emotional intelligence and empowering managers will be very helpful to improve leading health cares., (© 2022. The Author(s).)

Background: Common mental disorders are a group of distress states manifesting with anxiety, depressive and unexplained somatic symptoms, affecting individuals in different age groups, causes suffering to the individuals, families and community., Objective: This study assessed the magnitude of Common mental disorder and associated factors among people living in Addis Ababa, Ethiopia., Methods: Community based cross sectional study design was conducted from November 1 to 30, 2018 among people living in Addis Ababa, Ethiopia. Multistage sampling technique was used to get a total of 755 samples. Common Mental Disorder was assessed through interview using Self-Reported questionnaire (SRQ-20). The collected data were coded, entered into EPI-Info 7 and analysed by using SPPS version 20. Descriptive, analytical statistical procedure; bivariate and multivariate binary logistic regressions with odds ratios and 95% confidence interval was employed. The statistical significance was accepted at p value < 0.05., Result: In this study a total of 723 study subjects were participated, with response rate of 95.7%.The prevalence of common mental disorders was 24.7% with [95%CI; 21.6 - 27.7]. Females (AOR=2.1; 95% CI; 1.39- 3.23), Divorced/widowed (AOR=2.55; 95% CI; 1.16- 5.59), daily labourers (AOR=2.52; 95% CI; 1.3- 4.88, chronic medical illness (AOR=4.5; 95% CI; 2.46- 8.24). are independent predictors of CMD and educational status (primary, secondary and diploma) was positively associated with CMD. in this study. Regarding education (primary, secondary and diploma) (AOR=0.34; 95% CI; 0.17-0.66) and (AOR=0.35; 95% CI; 0.19-0.67) has positively associated with common mental disorders., Conclusion: The prevalence of common mental disorders was found high. Female sex, marital status like Divorced/Widowed, daily labour workers and chronic medical illness were found to be independent predictors of CMD and educational status (primary, secondary school and diploma holders) was were found to be protective factors., (© 2022. The Author(s).)