ABSTRACT
Background:Globally, preventionand repair of obstetric fistula remains a challenge, Ethiopia is one of the high-burden countries that constitute to the high fistula belt in the world. Methods:Cross sectional study was conducted from1st April 2018 to 1stMay2018 on women who had undergone obstetric fistula repair from 1stJanuary 2013 to 30th December 2017. Systematicsampling technique was applied to select a total of 385 study participants. Data were collected by reviewing clients’ cards using pre-tested questionnaire. Binary and multivariate logistic regression was conducted using SPSS version 21.0 statistical software.Results:The magnitude of fistula repair failure was 35.3%. Women weighing <50 kgs (AOR=3.43,95% CI: 1.89, 6.23), home delivery (AOR=2.40, 95%CI: 1.38, 4.18), labour for >2 days (AOR=3.22, 95%CI: 1.75,5.91), >3 cm width of fistula (AOR=2.30, 95%CI:1.27, 4.17), grade three fistula (AOR=3.26, 95%CI: 1.29, 8.27), grade four fistula (AOR=9.76, 95%CI: 3.71, 25.67), complete destruction of bladder neck (AOR=2.70, 95%CI: 1.07, 6.66) and post operation infection (AOR=2.98, 95%CI: 1.56, 5.70) were associated factors with fistula repair failure at p value <0.05.Conclusions:Caution should be taken for obstetric fistula repairing women who presented with less than 50 kg, home delivered, greater than two days labour, greater than 3 cm width of fistula, grade 3 and 4 fistulas, complete destruction of the bladder neck and post-operative infection.
ABSTRACT
Background: Despite improved antimicrobial therapy and multiple options for drainage of infected pleural space, thoracic empyema (TE) continues to cause significant morbidity and mortality. The objectives of this study were to assess the causes and treatment outcome of patients with thoracic empyema. Methods: Patients aged ⥠13year with TE who were admitted to Gondar University Teaching Hospital, Northwest Ethiopia, from Nov 1999 to Dec 2007 were included. Retrospectively, medical records were reviewed and demographic and clinical data were collected. Results: Records of 81 patients were analyzed; majority (82%) were below the age 50 year. The mean duration of symptoms prior to presentation and hospital stay was 97.4 and 38days, respectively. HIV/AIDS was detected in 60%. Causes of empyema were pulmonary tuberculosis (56%), pneumonia (36%) and lung abscess (7%). Closed chest tube was inserted in 86% of cases and was successful in 93% of them. Case-fatality was 12% and poor outcome occurred in 26%. Conclusions: Early identification of TE and aggressive management with antibiotics or antituberculosis, drainage with chest tube, and surgical treatment when closed tube drainage fails is recommended to improve the high mortality and morbidity