Point-of-Care Ultrasound to Assess Diaphragmatic Paralysis in Resource-Limited Setting: A Case Series.

Diaphragmatic dysfunction can arise from various factors, and Guillain-Barre syndrome, characterized by acute inflammatory polyradiculoneuropathy, is one such cause that may result in respiratory failure due to diaphragmatic paralysis. Prompt recognition and timely intervention, including airway protection and addressing the underlying pathology, are crucial for achieving optimal patient outcomes. Point-of-care ultrasound, specifically utilizing the M-mode function, can be employed for individuals displaying symptoms of diaphragmatic paralysis. This diagnostic approach is uncomplicated an effective tool for serial follow-up. In this context, we present a case series involving three patients with diaphragmatic paralysis in a limited-resource setting.

In-hospital outcome and its predictors among patients with acute cardiogenic pulmonary oedema at a tertiary hospital in Harar, Eastern Ethiopia: a retrospective cohort study.

Background: Acute cardiogenic pulmonary oedema is highly associated with poor in-hospital outcomes. This study aimed to determine the in-hospital outcome and its predictors among patients with acute cardiogenic pulmonary oedema at a tertiary hospital in Harar, Eastern Ethiopia, from May 1 to 20, 2023. Methods: A retrospective cohort study was employed among 204 patients with acute cardiogenic pulmonary oedema who were admitted between 1st May 2018 and 30th April 2023. The collected data were entered into Excel, and analysed using theSTATA software version 17. The hazard ratio with its 95% confidence interval was used and a P-value < 0.05 was considered a statistically significant association. Results: The overall mortality rate was 17.60 (95% CI: 11.59-26.72) per 1000 person-day observation with mean (±SD) time to death was 2.88 (±2.06) days. Age (AHR: 1.35; 95% CI: 1.04-1.74 for every 10 years), being smoker (AHR: 3.26; 95% CI: 1.05-10.10), having respiratory rate of ≥40 breaths per minute (AHR: 5.46; 95% CI: 1.71-17.45), and having anaemia (AHR: 4.35; 95% CI: 1.23-15.33) were significant predictors of in-hospital mortality. Conclusion: More than one in ten patients in this study died in the hospital. Therefore, special attention needs to be considered for patients with those predictors of in-hospital mortality.

Emergency department overcrowding and its associated factors at HARME medical emergency center in Eastern Ethiopia.

Introduction: Emergency department (ED) overcrowding has become a significant concern as it can lead to compromised patient care in emergency settings. Various tools have been used to evaluate overcrowding in ED. However, there is a lack of data regarding this issue in resource-limited countries, including Ethiopia. This study aimed to validate NEDOCS, assess level of ED overcrowding and identify associated factors at HARME Medical Emergency Center, located in Hiwot Fana Comprehensive Specialized Hospital, Harar, Ethiopia. Methods: A cross-sectional study was conducted at the HARME Medical Emergency Center, Hiwot Fana Comprehensive Specialized Hospital, involving a total of 899 patients during 120 sampling intervals. The area under the receiver operating characteristic curves (AUC) was calculated to evaluate the agreement between objective and subjective assessments of ED overcrowding. A multivariable logistic regression analysis was employed to identify factors associated with ED overcrowding and statistically significant association was declared using 95 % confidence level and a p-value < 0.05. Results: The interrater agreement showed a strong correlation with a Cohen's kappa (κ) of 0.80. The National Emergency Department Overcrowding Study Score demonstrated a strong association with subjective assessments from residents and case team nurses, with an AUC of 0.81 and 0.79, respectively. According to residents' perceptions, ED were considered overcrowded 65.8 % of the time. Factors significantly associated with ED overcrowding included waiting time for triage (AOR: 2.24; 95 % CI: 1.54-3.27), working time (AOR: 2.23; 95 % CI: 1.52-3.26), length of stay (AOR: 2.40; 95 % CI: 1.27-4.54), saturation level (AOR: 2.35; 95 % CI: 1.31-4.20), chronic illness (AOR: 2.19; 95 % CI: 1.37-3.53), and abnormal pulse rate (AOR: 1.52; 95 % CI: 1.06-2.16). Conclusion: The study revealed that ED were overcrowded approximately two-thirds of the time.

The Burden and Contributing Factors of Cardiogenic Pulmonary Edema Among Acute Heart Failure Patients Admitted to Tertiary Hospital, Eastern Ethiopia.

Background: Despite cardiogenic pulmonary edema is the most common phenotype of acute heart failure (AHF), studies on its burden and associated factors are limited. This study aimed to assess the burden and contributing factors of cardiogenic pulmonary edema in patients with acute heart failure admitted to a tertiary hospital in eastern Ethiopia. Patients and Methods: An institution-based cross-sectional study was conducted on the medical records (n = 276) of patients with AHF between February 01, 2018, and January 31, 2023. A simple random sampling technique was used to select participants from the study population. Bivariable and multivariable logistic regression analyses were used to assess factors associated with the development of cardiogenic pulmonary edema. A P-value ≤0.05 was considered as statistically significant. Results: The prevalence of cardiogenic pulmonary edema was 47.8% in AHF patients. Rural residence (adjusted odds ratio (AOR),9.54), smoking (AOR,3.17), comorbidity (AOR,2.1), and underlying cardiovascular disease (ischemic heart disease, chronic rheumatic valvular heart disease, and hypertensive heart disease with AOR: 6.71, 8.47, and 12.07, respectively) were significantly associated with the development of cardiogenic pulmonary edema in patients with AHF. Conclusion: Nearly half of the patients with AHF had cardiogenic pulmonary edema. Being a rural dweller, cigarette smoking, comorbidities, and underlying cardiac illness were significantly associated with the development of cardiogenic pulmonary edema in patients with AHF.

Burden of lower respiratory infections and associated risk factors across regions in Ethiopia: a subnational analysis of the Global Burden of Diseases 2019 study.

OBJECTIVE: This analysis is to present the burden and trends of morbidity and mortality due to lower respiratory infections (LRIs), their contributing risk factors, and the disparity across administrative regions and cities from 1990 to 2019. DESIGN: This analysis used Global Burden of Disease 2019 framework to estimate morbidity and mortality outcomes of LRI and its contributing risk factors. The Global Burden of Disease study uses all available data sources and Cause of Death Ensemble model to estimate deaths from LRI and a meta-regression disease modelling technique to estimate LRI non-fatal outcomes with 95% uncertainty intervals (UI). STUDY SETTING: The study includes nine region states and two chartered cities of Ethiopia. OUTCOME MEASURES: We calculated incidence, death and years of life lost (YLLs) due to LRIs and contributing risk factors using all accessible data sources. We calculated 95% UIs for the point estimates. RESULTS: In 2019, LRIs incidence, death and YLLs among all age groups were 8313.7 (95% UI 7757.6-8918), 59.4 (95% UI 49.8-71.4) and 2404.5 (95% UI 2059.4-2833.3) per 100 000 people, respectively. From 1990, the corresponding decline rates were 39%, 61% and 76%, respectively. Children under the age of 5 years account for 20% of episodes, 42% of mortalities and 70% of the YLL of the total burden of LRIs in 2019. The mortality rate was significantly higher in predominantly pastoralist regions-Benishangul-Gumuz 101.8 (95% UI 84.0-121.7) and Afar 103.7 (95% UI 86.6-122.6). The Somali region showed the least decline in mortality rates. More than three-fourths of under-5 child deaths due to LRIs were attributed to malnutrition. Household air pollution from solid fuel attributed to nearly half of the risk factors for all age mortalities due to LRIs in the country. CONCLUSION: In Ethiopia, LRIs have reduced significantly across the regions over the years (except in elders), however, are still the third-leading cause of mortality, disproportionately affecting children younger than 5 years old and predominantly pastoralist regions. Interventions need to consider leading risk factors, targeted age groups and pastoralist and cross-border communities.

In-hospital mortality and length of stay of patients with hypertensive crisis treated at public hospitals in Harari Regional State, Eastern Ethiopia.

Hypertensive crisis poses substantial cardiovascular morbidity and mortality. This study aimed to assess in-hospital mortality, length of stay (LOS), and their predictors among patients with hypertensive crisis treated at public hospitals in Harari Regional State, Eastern Ethiopia. An institutional-based retrospective cohort study was conducted from October 1 to 31, 2022. The medical records of 328 patients with hypertensive crisis treated at two public hospitals between September 1, 2017 and August 31, 2022 were reviewed. Cox proportional hazards regression and negative binomial regression were used to identify predictors of in-hospital mortality and LOS, respectively. The in-hospital mortality rate of patients with hypertensive crisis was 18.94 (95% confidence interval (CI): 12.08-29.70) per 1000 person-day observation. The median (interquartile range) LOS of these patients was 10 (4-120) hours. Age ≥65 years (adjusted hazard ratio (AHR): 3.30; 95% CI: 1.17- 9.33); increment in initial systolic blood pressure (AHR: 1.040; 95% CI: 1.014-1.066); and having acute brain-related damage (AHR: 4.02; 95% CI: 1.48-10.88) were predictors of in-hospital mortality. Rural residence (adjusted incident-rate ratio (IRR): 1.34; 95% CI: 1.03-1.75); having a history of medication discontinuation (adjusted IRR: 1.59; 95% CI: 1.16-2.18); comorbidity (adjusted IRR: 1.90; 95% CI: 1.49-2.43); acute brain-related damage (adjusted IRR: 13.32; 95% CI: 9.22-19.24), acute cardiac-related damage (adjusted IRR: 7.40; 95% CI: 4.90-11.16); and acute kidney injury (adjusted IRR: 7.64; 95% CI: 5.46-10.69) were predictors of LOS. Thus, it is necessary to develop strategies that allow early screening and follow-up of patients at risk.

Role of point of care ultrasound in the absence of radial pulse and unrecordable blood pressure during the assessment of shock: Case report.

INTRODUCTION: Point-of-care ultrasound (POCUS) has been an integral part of patient evaluation in the Emergency Department. It has been used increasingly for the evaluation of critically ill and trauma patients. CASE PRESENTATION: We report a case of 60-year-old male patient who presented to the Emergency department with flank pain and urinary symptoms suggesting pyelonephritis with unrecordable blood pressure indicating potential septic shock, but the absence of bilateral radial pulses triggered the use of POCUS which reveal bilateral radial artery occlusion. CASE DISCUSSION: Assessment of the peripheral pulses (usually radial pulse) is an important clue to estimate the systolic blood pressure with presence of a pulse correlating to a systolic SBP of ≥80 mmHg. this case report showed there was an absent peripheral radial and brachial pulse despite the patient appearing hemodynamically stable and no other signs of shock. By utilizing vascular POCUS, the patient's diagnosis completely changed. The use of POCUS led to an instant diagnosis and appropriate patient management. CONCLUSION: Point-of-Care ultrasound is a valuable diagnostic tool that can help narrow down differential diagnostics and guide early proper management and intervention.

Knowledge of Drug-Food Interactions Among Healthcare Professionals Working in Public Hospitals in Ethiopia.

Background: Drug-food interactions can result in unfavorable outcomes during the treatment of patients. Healthcare professionals (HCPs) should advise patients on drug-food interactions. Knowledge of such interactions is crucial to avoid their occurrence. However, there is no information regarding the knowledge of HCPs about drug-food interactions in Harari Regional State. Objective: To assess knowledge of drug-food interactions and associated factors among HCPs working in public hospitals in Harari Regional State, Eastern Ethiopia from April 15 to May 15, 2022. Methods: A cross-sectional study was conducted in public hospitals in Harari Regional State, Eastern Ethiopia, among 251 HCPs. After stratification was done based on profession (pharmacists, nurses, and doctors), the sample size was proportionally allocated for the respective groups. Data were collected using a standardized self-administered questionnaire, entered into Epi-Data 3.1 and analyzed using Statistical Package for Social Sciences 26.0. Descriptive statistics were used to summarize variables. Multivariable logistic regression was done to determine factors associated with knowledge of drug-food interactions. P < 0.05 was used to declare significant association. Results: Among the HCPs who completed the questionnaire, 56 (22.3%), 36 (14.3%), and 159 (63.3%) were doctors, pharmacists, and nurses, respectively. The majority of the HCPs were males (174 (69.3%)). The mean age of the HCPs was 27.6±3.8. The mean knowledge score±SD of the HCPs was 28.6±6.6 out of an overall score of 59. The HCPs poorly identified drug-food interactions and the correct administration time of drugs relative to meals. Being a pharmacist (AOR: 2.8, CI: 1.3-6.4, p-value=0.012), and working at a tertiary hospital (AOR: 3.9, CI: 2.1-7.3, p-value <0.001), were associated with higher knowledge of drug-food interactions. Conclusion: The HCPs in this study had inadequate knowledge of drug-food interactions. Thus, additional educational courses and training should be provided in order to improve knowledge regarding drug-food interaction.

Admission Pattern and Treatment Outcome in Pediatric Intensive Care Unit, Tertiary Hospital, Addis Ababa, Ethiopia.

Background: Knowledge of the clinical profile and outcomes of critically ill children admitted to Pediatric Intensive Care Unit (PICU) in developing countries aids with the identification of priorities and the resources needed to improve the outcome of critically ill patients. This study aimed to assess the admission pattern, outcomes, and associated factors of patients admitted to the PICU of St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia. Methods: Institutional-based cross-sectional study was done. Data was collected through chart abstraction from patients admitted to the PICU between January 2017 and December 2018. SPSS 20.0 was used to analyze the data. Descriptive statistics, cross-tabulations, and logistic regressions were used. Results: A total of 260 pediatric patients were analyzed. The mean age at admission was 48.13 ± 53.65 months, with M: F ratio of 1.4:1. The mean and median duration of PICU stay was 7.26 ±6.87 days, and 6.0 days respectively. The most commonly affected organ systems were the central nervous system (79, 33.2%) and respiratory system (55, 23.1%). Mechanical ventilation and admission after cardiopulmonary resuscitation (p < 0.001) were independent predictors of mortality. Infectious causes of illnesses were the leading causes of admission and death in the PICU. Conclusion: The mortality rate of our PICU was 21.1 %. In this study, post-cardiopulmonary resuscitation admission and use of mechanical ventilation were statistically significant predictors of mortality indicating the need for well equipping and staffing the PICU to improve the outcome of such critically sick patients.

Refining benthic macroinvertebrate kick sampling protocol for wadeable rivers and streams in Ethiopia.

Streams and rivers cover a larger proportion of the Earth's surface but are highly affected by human pressures. Conversely, bioassessment methods are in their infancy in developing countries such as Ethiopia. In this study, we compared 2- and 3-min macroinvertebrate kick samples at multiple locations for both riffle habitat (RH) and multihabitat (MH) approaches. The performance of each method was evaluated statistically using benthic macroinvertebrate metrics and diversity indices. Results of the Kruskal-Wallis analysis in this study showed no significant differences among methods tested in minimally impacted streams in Ethiopia and generally performed equally irrespective of the methods employed except for total abundances and Ephemeroptera abundances. Furthermore, multivariate analysis of the relative abundances of macroinvertebrate communities using analysis of similarity (ANOSIM), RELATE, non-metric multidimensional scaling (MDS), and classification strength-sampling method comparability (CS-SMC) indicated a high similarity in the macroinvertebrate communities recorded among all methods employed in this study area. However, the index of multivariate dispersion (IMD) test showed variations in relative abundances of macroinvertebrate communities among the methods. In summary, if the focus is not on rare taxa and the required information is not dependent on additional evidence provided by the use of lower taxonomic levels of identification (genus and species), the results of the present study support the use of the shorter 2-min RH kick sampling method for the bioassessment of wadeable rivers and streams in Ethiopia.

Treatment outcome and associated factors among patients admitted with acute poisoning in a tertiary hospital in Eastern Ethiopia: A cross-sectional study.

INTRODUCTION: Acute poisoning causes morbidity and mortality worldwide. There is scarce of information on acute poisoning in the study area. OBJECTIVE: To assess treatment outcome and the associated factors among patients admitted with acute poisoning at Hiwot Fana Comprehensive Specialized Hospital, Eastern Ethiopia. METHODS: A cross-sectional study was conducted. All acutely poisoned patients who had been admitted at the emergency department of Hiwot Fana Comprehensive Specialized Hospital from 1 January 2016 to 31 December 2020 who fulfilled the inclusion criteria of the study were included. Data were collected by review of medical records. Poor treatment outcome of acute poisoning was defined as the acutely poisoned patient was died, or survived with disability. Multivariate logistic regression analysis was used to determine factors associated with the outcome of acute poisoning. RESULT: A total of 175 patient's medical records were reviewed. Of these, 150 patient's medical records had complete information and were included in the final analysis. The majority of participants 89 (59.3%) were in the age group of 19-37 years. More than half of the participants 86 (57.3%) were females. Organophosphate was the most poisoning agent encountered in 62 cases. Acetaminophen was the predominant drug poisoning agent encountered in 10 participants. Among 30 patients managed with antidote, 18 patients were treated with atropine for organophosphate poisoning. Of all the poisoning cases admitted during the study period, 16.7% died. Participants who were poisoned by themselves were 2.4 times more likely to have poor treatment outcomes than those who were poisoned accidentally: 2.44 (95% confidence interval: 1.10-5.42). The odd of having poor treatment outcome in participants who were poisoned by drugs was 2.13 more likely: 2.13 (95% confidence interval: 1.21-3.32). CONCLUSION: Organophosphate was the predominant cause of acute poisoning encountered in 62 cases. The modes of poisoning and drug poisoning were significant risk factors associated with poor treatment outcomes of acute poisoning.

COVID-19 Prevention Practices and Associated Factors among Diabetes and HIV/AIDS Clients in South-Wollo Zone, Ethiopia: A Health Facility-Based Cross-Sectional Study.

BACKGROUND: Coronavirus-2019 (COVID-19) is affecting many people. Chronic patients are highly vulnerable to contracting an infection. Most people recover within a week, but chronic patients can face severe illness or death. The increasing of cases, complications, and mortality demands compulsory preventive measures. Therefore, this study was designed to identify major preventive practices and associated factors. METHODS: A facility-based cross-sectional study was employed from November to December 2020 among diabetics and HIV/AIDS follow-up clients in Dessie referral hospital. Data were entered into EpiData manager 4.6.0 version and exported to Statistical Package for Social Science (SPSS) version 25.0 for data cleaning and analysis. Logistic regression analysis was done and an adjusted odds ratio (AOR) with its 95% confidence interval (CI) was used for determining the strength of association. RESULTS: Data were collected from 426 participants with a mean age of 46.54 years. The overall poor prevention practice rate of COVID-19 among diabetic and HIV/AIDS follow-up clients was 68.8% 95% CI (64.6-72.8%). Factors significantly associated with poor prevention practice were femaleness (AOR; 1.61; 95% CI; 1.03-2.51), illiterate [AOR; 2.59; 95% CI; 1.33-5.09]), family size greater than four (AOR; 2.06; 95% CI; 1.32-3.23), absence of health professional in the household (AOR; 1.79; 95% CI; 1.13-2.84), not having health insurance (AOR; 1.85; 95% CI; 1.18-2.89) and urban residence (AOR; 0.38; 95% CI; 0.18-0.79). CONCLUSION: The overall proportion of prevention practice towards COVID-19 among diabetic and HIV/AIDS follow-up clients was poor. Illiteracy, having a family size greater than four, not having health professionals in the household, not having health insurance and urban residency were associated with poor prevention practices. Therefore, continuous health educations about good preventive behavioral practice should be enhanced by the health professionals.

Water, sanitation, and hygiene conditions and prevalence of intestinal parasitosis among primary school children in Dessie City, Ethiopia.

BACKGROUND: Intestinal parasitosis is a major public health problem that affects the health of primary school children in low- and middle-income countries where water, sanitation, and hygiene (WASH) conditions are deficient. Since there is a paucity of information on the prevalence and associated factors of this problem among primary school children in Dessie City in Ethiopia, this study was designed to address these gaps. METHODS: A school-based cross-sectional study was conducted among 407 stratified-sampled primary school children in five primary schools at Dessie City from April to June 2018. Data were collected using a pretested structured questionnaire, an observation checklist and laboratory analysis of stool samples. Stool specimen from each study participant was collected using clean, properly labeled and leak-proof stool cup. A portion of stool from each study participant collected sample was processed using saline wet mount technique and examined by microscope. The remaining specimens were preserved with 10% formalin and transported to Dessie Comprehensive Specialized Hospital laboratory to be processed by using formol-ether concentration technique. Then, slide smears were prepared from each processed stool specimen and finally, it was microscopically examined with 10x as well as 40x objectives for the presence or absence of intestinal parasites. Factors significantly associated with intestinal parasitosis were determined using binary logistic regression model at 95% CI (confidence interval). Thus, bivariate (COR [crude odds ratio]) and multivariable (AOR [adjusted odds ratio]) logistic regression analyses were carried out. From the multivariable analysis, variables having a p-value of less than 0.05 were declared as factors significantly associated with intestinal parasitosis among primary school children. MAIN FINDINGS: The overall prevalence of intestinal parasitosis was found to be 16.0% (95% CI: 12.5-19.4%), of these, 50.8% were positive for protozoa, 32.2% for helminth infections and 16.9% for double co-infections. Entamoeba histolytica was the most prevalent parasite (29.2%), followed by Giardia lamblia (21.5%), Ascaris lumbricoides (18.5%), Hymenolepis nana (9.2%) and Enterobius vermicularis (4.6%). Prevalence rates were similar among government (16.3%) and private (15.7%) school children. Water consumption was less than 5 liters per capita per day in 4 of the 5 schools. Thirty-eight (9.3%) of primary school students reported that they practiced open defecation. About two-thirds (285, 70.0%) said they always washed their hands after defecation. Mother's education (illiterate) (AOR = 3.3; 95% CI: 1.20-9.37), father's education (illiterate) (AOR = 3.9; 95% CI: 1.40-10.82), fathers who could read and write (AOR = 3.3; 95% CI: 1.25-7.86), handwashing before meal (sometimes) (AOR = 2.2; 95% CI: 1.11-4.17) and poor knowledge of WASH (AOR = 9.3; 95% CI: 2.17-16.70) were statistically associated with presence of intestinal parasitic infections. CONCLUSION: We concluded that the prevalence of intestinal parasitosis in the study area among Grades 4-8 primary school children had public health significance. Factors significantly associated with intestinal parasitosis among primary school children's were illiterate mothers and fathers, irregular handwashing of children before meals, and poor knowledge of WASH. Health education to improve students' WASH knowledge and mass deworming for parasites are recommended as preventive measures; and improvements to the quality of WASH facilities in primary schools are strongly recommended to support these measures.

Determinants of acute respiratory infection (ARI) among under-five children in rural areas of Legambo District, South Wollo Zone, Ethiopia: A matched case-control study.

BACKGROUND: Acute respiratory infection (ARI) leads to morbidity and mortality among under-fivechildren in developing countries, especially in rural settings. ARI ranks among the top 10 diseases in under-five children in Legambo District, South Wollo Zone, Ethiopia. The aim of this study was to evaluate determinant factors for ARI in Legambo District in 2019. MATERIALS AND METHODS: A community-based matched case-control study was conducted, involving 139 cases and 278 controls under 5 years of age, from mid-January to mid-February 2019. Data were collected using a structured questionnaire. Bivariate and multivariable conditional logistic regression analyses were performed. From the multivariable conditional logistic regression analysis, variables with a significance level of p < 0.05 were taken as significantly associated with ARI among under-five children. RESULT: ARI among children under 5 years of age was significantly associated with age of the mother/caregiver being ≥35 years, occupation of mother/caregiver being housewife, the family being of medium wealth status, the type of stove used in the house, carrying the child while preparing food, absence of windows in the house, and nutritional status of the child. CONCLUSION: The occurrence of ARI could be reduced by improving economic status, stove use, and nutrition of children, and by increasing community awareness regarding indoor air pollution and ventilation.

Electrocardiography Interpretation Competency of Medical Interns: Experience from Two Ethiopian Medical Schools.

BACKGROUND: Electrocardiography (ECG) is the graphical display of electrical potential differences of an electric field originating in the heart. Interpretation of ECG is a core clinical skill in the department of emergency medicine. The main aim of this survey was to assess competency of ECG interpretation among 2018 graduating class medical students in Addis Ababa University and Haramaya University. Methodology. A cross-sectional survey was conducted on medical interns at Addis Ababa University and Haramaya University. Data had been collected from October 01, 2018, to October 30, 2018, by using structured questionnaires. Data were entered, cleaned, edited, and analyzed by using SPSS version 25.0 statistical software. Descriptive statistics, cross-tabs, chi-squared test, Mann-Whitney U test, and binary logistic regression were utilized. RESULTS: Two-hundred and two graduating medical students were involved on this survey, out of which 61.3% (95% CI 56.3-66.3%) and 32.75% (95% CI 28.25-37.25) were able to correctly interpret the primary ECG parameters and the arrest rhythm of ECG abnormalities, respectively. The ability to detect from common emergency ECG abnormalities of anterioseptal ST segment elevation myocardial infraction, atrial fibrillation, and first-degree atrioventricular block was 42.6%, 39.1%, and 32.1%, respectively. CONCLUSION: This survey showed graduating medical students had low competency in ECG interpretations.

Behcet's Disease with Upper GI Bleeding.

Introduction. Behcet's disease is a multisystem disease. In sub-Saharan Africa, the prevalence of this disease is not known, with only one case report from Ethiopia. Case Presentation. We describe a case of a 29-year-old Ethiopian male who presented to the emergency room of Tikur Anbessa specialized hospital with 4 days history of back pain, recurrent history of oral and genital ulcers, right eye blindness, chronic cerebral vein thrombosis, gastrointestinal bleeding, aortic aneurysm with dissection, and positive pathergy test. He is retrospectively diagnosed with Behcet's disease according to both the International Criteria for Behcet's Disease (ICBD) and the International Study Group (ISG) consensus. Conclusion. Even if Behcet's disease is rare in sub-Saharan Africa, it is important to know the clinical presentation for timely diagnosis and urgent management.