Ischemic stroke as the first clinical manifestation of an initially undiagnosed case of Takayasu arteritis in a young woman from Ethiopia: A case report.

Takayasu arteritis (TAK) is a rare large-vessel vasculitis of unknown etiology that leads to arterial wall thickening, stenosis, and occlusion, which may complicate cerebrovascular ischemic events. Ischemic stroke is a potentially devastating complication of TAK at a young age, but the occurrence is still rarely reported in Ethiopia. Although it occurs late in the course of the condition, it may be the initial presentation and suggest an unfavorable prognosis. Herein, we address the case of a 25-year-old woman who presented to a university hospital while on follow-up after 2 years of stroke with deterioration in clinical symptoms, absent brachial artery pulses, and unrecordable blood pressure in both arms. At the time of admission in 2021, the contrast brain computed tomography scan revealed an ischemic infarction in the right middle cerebral artery territory. However, the etiology of the stroke could not be defined at that time due to ambiguity in the clinical picture and the inability of clinicians to incorporate TAK into the differential diagnosis, resulting in a delay in the early diagnosis of the case. Two years later, in 2023, she underwent computed tomography angiography and was diagnosed to have TAK based on American College of Rheumatology criteria, with Numano type IIb angiographic extent of disease, ischemic stroke, and stage II systemic hypertension. The patient was treated by a field of experts. This case highlights the need to consider TAK in the differential diagnosis of stroke in young patients in the absence of traditional risk factors; appropriate tests should be performed to confirm or rule out this diagnosis, and management should be modified accordingly.

Length of stay and its associated factors among adult patients who visit Emergency Department of University Hospital, Eastern Ethiopia.

Objectives: This study was aimed to assess the length of stay and its associated factors among adult patients who visited Emergency Department of Hiwot Fana Specialized University Hospital, Eastern Ethiopia. Method: A hospital-based cross-sectional study was conducted among 400 adult patients who visit the Emergency Department. Systematic random sampling technique and an interviewer-administered data collection method was used. Data analyses were done using STATA version 16. Bivariable and multivariable logistic regression analysis was used to control the potential confounders. The analysis outputs were presented using an odds ratio with a corresponding 95% confidence interval (CI). Independent variables were defined as statistically significant at p-values <0.05 in the final model. Result: A total of 169 [42.25% (95% CI: 37.5%-47.0%)] patients stayed longer than 24 h in the Emergency Department. We identified factors significantly associated with length of stay in ED include: patients treated at orange triage type (adjusted odds ratio (AOR) = 0.267; 95% CI: 0.13-0.53), laboratory request (AOR: 3.05; 95% CI: 1.49-6.23), radiological requests (AOR: 1.80; 95% CI: 1.05-3.07), and diagnosed with medical condition (AOR: 2.27; 95% CI: 1.21-4.26). Conclusion: A significant number of patients stay longer in the Emergency Department. Evaluation of the clinical diagnosis, diagnostic investigations, and organizational factors is essential to reduce the length of stay in the Emergency Department.

Epidemiology and causes of intestinal obstruction in Ethiopia: A systematic review.

Objective: This systematic review was aimed to address the prevalence and causes of intestinal obstruction in Ethiopia. Methods: Systematic searches were conducted on PubMed, EMBASE, CINAHL, Scopus, African Journals Online, HINARI, and other supplementary sources, including Google Scholar. We conducted methodological quality assessments for the articles by employing a critical appraisal checklist of Joanna Briggs Institute. Results: The reported prevalence of intestinal obstruction in Ethiopia ranges from 18.6% to 50.7% among patients with acute abdomen. However, the prevalence varies from 4.3% to 34.6% among total surgical admissions. The leading causes of small intestinal obstruction were small bowel volvulus, intussusception, and adhesion. Sigmoid volvulus was the most commonly reported cause of large intestine obstruction, followed by colonic cancer. Conclusion: The highest reported prevalence of intestinal obstruction in Ethiopia was 50.7% among patients with acute abdomen and 34.6% among surgical admissions. Small intestine volvulus and sigmoid volvulus were the common causes of small and large bowel obstructions, respectively. Therefore, clinicians have to consider the common causes during the diagnosis and management of intestinal obstruction.

Diabetes Concordant Comorbidities and Associated Factors Among Adult Diabetic Out-Patients at Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia: a Cross-Sectional Study.

BACKGROUND: Nowadays diabetic comorbidities constitute a major public health problem in Ethiopian context. However, there is a dearth in epidemiology and risk factors of diabetic comorbidity in Ethiopia, particularly in the study setting. Therefore, this study was conducted to determine the prevalence and identify factors associated with concordant diabetic comorbidities among diabetic out-patients at Hiwot Fana Specialized University Hospital (HFSUH), EasternEthiopia. METHODOLOGY: A hospital-based cross-sectional study was conducted by reviewing medical record charts of adult diabetic outpatients. Bivariable and multivariable logistic regression analysis was carried out by using STATA version 16.0. To measure the strength of association an Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was used. Moreover, variables with p-value ≤ 0.05 were considered as statistically significant with the outcome variable. RESULTS: In this study, it is found that the overall prevalence of concordant comorbidity among adult diabetic out-patients was 55.8% (95% CI: 50.3-61.3). Moreover, more than two-third of patients, 72.73% were diagnosed for type two diabetic mellitus (T2DM). Among specified comorbidities about 42.3% were hypertension, 21.63% were obesity, and 13% were multi-morbidity. Age ≥ 55 years (AOR: 7.52, 95% CI: 1.24, 45.75), T2DM (AOR: 9.01, 95% CI: 1.50, 54.04), 2-5 years duration of treatments (AOR: 0.23, 95 CI: 0.078, 0.691), and poor glycemic control (AOR: 4.4 1, 95% CI: 2.34, 8.32) were factors significantly associated with concordant diabetic comorbidity. CONCLUSION: From the study conducted, the higher prevalence of concordant comorbidity among diabetic patients was investigated. Furthermore, older in age, T2DM, prolonged duration of treatment, and poor glycemic control were factors associated with diabetic comorbidities. Early detection and appropriate treatment of diabetic comorbidities are very important for better patient's quality of life and functionality.