Unusual presentation of rectal carcinoma in a young woman

Advanced rectal carcinoma usually presents with rectal bleeding, tenesmus or alteration in bowel habits. Secondary deposits in the inguinal lymphnode is generally an indication of advanced disease. We report unusual presentation of advanced rectal carcinoma in a 23 year-old female patient who came presenting with symptoms of left inguinal lymphadenopathy and left leg swelling. There were no symptoms related to local effects of rectal carcinoma. First the patient was treated as a case of deep venous thrombosis. Fine needle aspiration biopsy provided the first clue to the nature of disease. To the best of our knowledge such unusual presentation of advanced rectal carcinoma has never been reported in Ethiopia. Rectal carcinoma should be considered in the list of secondary adenocarcinoma in the inguinal lymphnodes.     

A Three Year Retrospective Study on Seroprevalence of Syphilis among Pregnant Women at Gondar University Teaching Hospital,Ethiopia

Background

Sexually transmitted infections (STIs) are a serious public health problem in low income countries, including Ethiopia. Syphilis caused by Treponema pallidum remains a major cause of reproductive morbidity and poor pregnancy outcomes in low income countries. Stillbirth, perinatal death, serious neonatal infection and low-birth weight babies are common among seropositive mothers.

Objective

To assess the seroprevalence of syphilis and risk factor correlates of this infection at Gondar University Teaching Hospital, Ethiopia.

Methods

The study was done on 2385 pregnant women attending the antenatal care clinic (ANC) from January 2009 to December 2011. Data was abstracted from the antenatal care clinic medical database. Chi-square test was used, using SPSS version 16 and significance level was chosen at 0.05 level with a two-tailed test.

Results

Of the total, 69(2. 9%) of pregnant women were confirmed as seropositive for syphilis. Pregnant women with an age group of 21–25 years of old were the most seropositive (3.4%), followed by 26–30 years of old (3.1%). The prevalence of syphilis infection was 3.2% in urban and 2.2% in rural pregnant women. Relatively high prevalence of syphilis infection were identified among students (4.2%) followed by governmental employees (3.8%).

Conclusion

The seroprevalence of syphilis among pregnant women attending ANC is declining. However, syphilis is more prevalent in the young and urban pregnant women. Emphasis on education to young people on STI risk behavioral change and partner follow up and notification for exposure to syphilis and treatment should be given.     

Factors related to the use of antenatal care services in Ethiopia: Application of the zero-inflated negative binomial model

The major causes for poor health in developing countries are inadequate access and under-use of modern health care services. The objective of this study was to identify and examine factors related to the use of antenatal care services using the 2011 Ethiopia Demographic and Health Survey data. The number of antenatal care visits during the last pregnancy by mothers aged 15 to 49 years (n = 7,737) was analyzed. More than 55% of the mothers did not use antenatal care (ANC) services, while more than 22% of the women used antenatal care services less than four times. More than half of the women (52%) who had access to health services had at least four antenatal care visits. The zero-inflated negative binomial model was found to be more appropriate for analyzing the data. Place of residence, age of mothers, woman’s educational level, employment status, mass media exposure, religion, and access to health services were significantly associated with the use of antenatal care services. Accordingly, there should be progress toward a health-education program that enables more women to utilize ANC services, with the program targeting women in rural areas, uneducated women, and mothers with higher birth orders through appropriate media.     

Prevalence of onchocercal skin disease and infection among workers of coffee plantation farms in Teppi,southwestern Ethiopia

In June 1996, a study on the economic impacts of onchocercal skin disease was initiated in southwestern Ethiopia. We made parasitological and clinicoepidemiological investigations among 1619 workers of a coffee plantation firm in Teppi, south-western Ethiopia. Sixty percent of the workers were included in the study. The prevalence of onchocercal skin disease (OSD) was 85.3%. Severe OSD (SOSD) was found in 17.3% of the study subjects. This was 1/5 of all OSD cases. The overall nodule carrier rate was 44.2%, which differed significantly by age classes from a rate of 12.3% to 73.0%. This rate varied by sex, 51.7% in males and 22.6% in females. Microfilarial carrier rate (MFCR) was 77.6%. This rate did not vary neither with severity of disease nor with presence or absence of pruritus or onchodermatitis. Mean microfilarial count was determined to be 38.1 per mg of skin snip or 44.4 per mg of infected skin snips. The geometric mean of microfilarial load per infected skin was 23.8. The community microfilarial load (CMFL) was estimated to be 14.0 per mg skin snip. The study showed that SOSD is prevalent in Teppi and affects a substantial number of the working population. An intervention program is called for.     

Sonographic diagnosis of hypertrophic pyloric stenosis: preliminary experience

The value of ultrasound diagnosis for suspicion of infantile hypertrophic pyloric stenosis (HPS) was assessed in three consecutive years using ultrasound measurement of pyloric muscle thickness (PMT), pyloric diameter (PD) and pyloric length (PL) in Tikur Anbessa Hospital which is a tertiary referral and teaching hospital. Among all patients 39 patients (36 males and 3 females) had Infantile Hypertrophic Pyloric Stenosis confirmed by surgery, with male to female ratio of 12:1. Ultrasound correctly diagnosed all of the cases. Sixty- six patients were negative by Ultrasound, Barium meal studies and clinical follow up. The mean Pyloric Muscle Thickness (4.46 Vs 1.81), Pyloric Length (19.1 Vs 11.55) and Pyloric Diameter (14.05 Vs 8.4) between patients with and with out pyloric stenosis were significantly different (p < 0.05). A PMT of 3 mm and above was observed in all cases of HPS, and was never observed in the absence of HPS (100% sensitivity and specificity). A pyloric muscle thickness of 3 mm and above is recommended as a diagnostic cutoff and upper gastrointestinal series (UGIS) can be reserved for those who might fall in the grey zone (i.e. PMT of 2-3 mm).     

Extensive subcutaneous soft tissue calcification in a neonate following hypothermia: case report

A ten-hour old newborn found in the street where a dog was savaging him, was brought to Black Lion Hospital in 1998. The history, physical findings and radiological features suggested widespread subcutaneous fat necrosis, which later became calcified. Although this is a rare condition, medical workers need to be aware of the possibility of this self-limiting disease, which may occur in abandoned and hypothermic neonates.