Analysis of Medical Malpractice Clams and Measures Proposed by the Health Professionals Ethics Federal Committee of Ethiopia: Review of the Three Years Proceedings

Background: Medical malpractice is professional negligence by a healthcare provider in which the treatment provided falls below the standard and causes injury or death to the patient. Objective: To describe the adverse medical events; claims and decisions taken by the Ethiopian Health professionals Ethics Committee at the Federal level. Methods: A three-year report of the Ethics Committee and relevant documents of proclamations and regulations were reviewed. Results: Between January 2011 and December 2013; the committee reviewed 60 complaints against health professionals. About one third of the complaints were filed by the patients and/or their families; about 32 by the police or court and the rest were filed by Addis Ababa health bureau; health professionals and other unrelate4d observers. Thirty-nine complaints were related to death of the patient and 15 complaints were about disability. Twenty-five of the claims were against Obstetric and Gynecology specialists and 9 were against general surgeons. The committee verified that 14 of the 60 claims had ethical breach and/or negligence (incompetence). The committee took reasonable time to review complaints and respond the concerned authorities. Conclusion: The study showed that of the total claims lower than a quarter (23.3) were proven beyond the benefit of doubt. More than 3/4 (76.7) of the complaints were wrong. Hospitals should lead in preventing patient injury. Creation of more awareness among Obstetrics and Gynecology specialists; General and Orthopaedic Surgeons about medical errors is needed and special training should be given to those joining these specialities

Utilization of Insecticide Treated Nets in Arbaminch Town and the Malarious Villages of Arbaminch Zuria District; Southern Ethiopia

Introduction:Malaria causes an overwhelmingly large number of cases and deaths round the globe every year.Insecticide treated nets (ITNs) have become important tools that provide a simple; but effective means of preventing malaria in highly endemic areas. Methods: A community-based cross-sectional study design was used to investigate possession; utilization; and factors affecting possession and utilization of ITNs in Arbaminch Town and the malarious villages of Arbaminch Zuria District; southern Ethiopia from 22nd January to 1st February 2007 on a sample of 454 households. Data were collected using structured; pretested; interviewer-administered questionnaire. Data entry and analysis was performed using SPSS 11.0 for windows. Univariate; bivariate and multivariate analyses were carried out. Results: The coverage for any net and ITN was 75.1and 58.8respectively; the utilization rate for any net and ITN by any member of the household the night prior to the study was 71and 73respectively. Both coverage and utilization were higher in rural areas than in urban areas. The proportion of pregnant women and children under five years who slept under ITNs the night preceding the study was 35and 40.3respectively. Education and income of head of households; place of residence of households and presence of high risk groups in the household were found to be predictors of net possession. Sex and income of head of households; and presence of radio in the households were predictors of utilization of nets by any household member. Education of head of households and place of residence of households were predictors of utilization of nets by high risk groups. Conclusions: A wide gap exists between coverage and utilization of ITNs. Use of ITNs by high risk groups is far below the Abuja target. Appropriate BCC interventions are required to narrow the gap between coverage and utilization of ITNs and to escalate use of ITNs by high-risk groups

Haemonchus contortus: in vitro and in vivo anthelmintic activity of aqueous and hydro-alcoholic extracts of Hedera helix.

In vitro anthelmintic activity of crude extracts of the ripe fruits of Hedera helix was investigated on eggs and adult nematode parasites Haemonchus contortus. Aqueous extract of H. helix was also evaluated for in vivo anthelmintic activity at dose of 1.13 and 2.25 g/kg in sheep artificially infected with H. contortus. ED(50) for egg hatch inhibition was 0.12 and 0.17 mg/ml for aqueous and hydro-alcoholic extracts, respectively. There was no statistically significant difference in the activity of the two extract types (p>0.05). Hydro-alcoholic extract showed better in vitro activity against adult parasites compared to the aqueous extract. Significant faecal egg count reduction (FECR) was detected in groups treated with both doses of H. helix (p<0.05) on day 2 post-treatment. On day 7 post-treatment significant reduction was detected only for higher dose of H. helix (p<0.05) while on day 14 post-treatment there was no significant FECR in both groups treated with H. helix. The percentage of larvae recovered from culturing faeces obtained from groups of sheep treated with lower and higher doses of H. helix was 47.52% and 36.07%, respectively, which was significantly lower than (p<0.05) that recovered from the control group (60%). Significant (p<0.05), dose dependent total worm count reduction (WCR) was observed for groups of sheep treated with H. helix. Increasing the dose of H. helix improved the efficacy against the male than the female parasites. Treatment with both doses of H. helix helped the animals maintain their packed cell volume (PCV) unlike the untreated control group. The overall findings of the current study indicated that H. helix has a potential anthelmintic benefit and further in vitro and in vivo evaluation of the different parts and fractions is needed to make use of this plant for therapeutic purposes.

In vitro and in vivo anthelmintic activity of crude extracts of Coriandrum sativum against Haemonchus contortus.

In vitro anthelmintic activities of crude aqueous and hydro-alcoholic extracts of the seeds of Coriandrum sativum (Apiaceae) were investigated on the egg and adult nematode parasite Haemonchus contortus. The aqueous extract of Coriandrum sativum was also investigated for in vivo anthelmintic activity in sheep infected with Haemonchus contortus. Both extract types of Coriandrum sativum inhibited hatching of eggs completely at a concentration less than 0.5 mg/ml. ED(50) of aqueous extract of Coriandrum sativum was 0.12 mg/ml while that of hydro-alcoholic extract was 0.18 mg/ml. There was no statistically significant difference between aqueous and hydro-alcoholic extracts (p>0.05). The hydro-alcoholic extract showed better in vitro activity against adult parasites than the aqueous one. For the in vivo study, 24 sheep artificially infected with Haemonchus contortus were randomly divided into four groups of six animals each. The first two groups were treated with crude aqueous extract of Coriandrum sativum at 0.45 and 0.9 g/kg dose levels, the third group with albendazole at 3.8 mg/kg and the last group was left untreated. Efficacy was tested by faecal egg count reduction (FECR) and total worm count reduction (TWCR). On day 2 post treatment, significant FECR was detected in groups treated with higher dose of Coriandrum sativum (p<0.05) and albendazole (p<0.001). On days 7 and 14 post treatment, significant FECR was not detected for both doses of Coriandrum sativum (p>0.05). Significant (p<0.05) TWCR was detected only for higher dose of Coriandrum sativum compared to the untreated group. Reduction in male worms was higher than female worms. Treatment with both doses of Coriandrum sativum did not help the animals improve or maintain their PCV while those treated with albendazole showed significant increase in PCV (p<0.05).

The clinical and genetic spectrum of spinocerebellar ataxia 14.

Spinocerebellar ataxia 14 (SCA14) is associated with missense mutations in the protein kinase C gamma gene (PRKCG), rather than a nucleotide repeat expansion. In this large-scale study of PRKCG in patients with ataxia, two new missense mutations, an in-frame deletion, and a possible splice site mutation were found and can now be added to the four previously described missense mutations. The genotype/phenotype correlations in these families are described.