Dr. Abebe Muche Moges

AbstractBackgroundCircle of Willis is the main structure that provides constant and regular blood flow to the brain, protects the brain from ischemia. Stroke has remained the second leading cause of death globally in the last fifteen years. It is the fifth leading cause of death in the United States. It is also the leading cause of serious adult disability. Interlinked problems related to ischemic stroke are become increasing nowadays. Strong evidence is needed about the pooled measure of association between the circle of Willis (COW) and ischemic stroke. Therefore, this systematic review and meta-analysis were intended to provide compressive and up to date evidence on the association between the variations of COW and ischemic stroke using the available studies.MethodsPubMed, Google Scholar, Science Direct, and Cochrane Library databases were systematically searched. All essential data were extracted using a standardized data extraction template. The heterogeneity across studies was assessed by using the Cochrane Q test statistic, I2test statistic, and P-values. A fixed-effect model was used to estimate the pooled effect of the measure association between COW and ischemic stroke.ResultsIn this meta-analysis, 2,718 participants were involved. The pooled measure of association between COW and ischemic stroke was 1.38 (95% CI 0.87, 2.19). Therefore, this indicated that the presence of any variation in COW was 1.38 times more likely to develop ischemic stroke as compared to the patent COW. The presence of hypoplasia/incompleteness in a posterior communicating artery (PcomA) [Pooled OR: 1.34 (95% CI 0.80, 2.25)] and anterior communicating artery (AcomA) [Pooled OR: 1.32 (95% CI 0.81, 2.19)] were a contributing factor for the development of ischemic stroke. Hypertension was the most common comorbid condition, followed by diabetes mellitus, smoking, coronary artery disease, and hyperlipidemia.ConclusionsThere was a non-significant positive association between COW variation and ischemic stroke in this meta-analysis.

Introduction Hemorrhoidal disease is a very common benign anorectal disease. It affects millions of people around the world, and represent a major medical and socioeconomic problem. However, studies that determine the magnitude and risk factors are limited. Therefore, the aim this study is to assess the prevalence and associated factors of hemorrhoid among adult patients visiting the surgical outpatient department at the University of Gondar Comprehensive Specialized Hospital (UoGCSH) Northwest Ethiopia. Methods An institution-based cross-sectional study was conducted from February to May 2020. A systematic random sampling technique was used to select a total of 403 participants. The data were collected then entered using EPI DATA version 3.1 and exported to the STATA 14 for analysis. Bivariable and multivariable logistic regression analysis were performed. Adjusted odds ratio (AOR) with 95% confidence interval was used as a measure of association. Variables having P-value < 0.05 from the multivariable analysis were considered to have a significant association with the outcome. Result Out of the 403 study participants, 13.1% (95%CI; 10.1, 16.8) had hemorrhoids. Constipation (AOR = 4.32, 95% CI; 2.20, 8.48) and BMI ≥25kg/m2 (AOR = 2.6, 95% CI; 1.08, 6.23) had a statistically significant association with hemorrhoid. Conclusion The overall prevalence of hemorrhoid was high and its prevalence was higher in male subjects. Constipation and being overweight were found to increase the odds of having hemorrhoids. Screening for early identification and intervention of hemorrhoids, especially for risk groups is better to be practiced by health professionals.

Background:Dental caries affects mastication, growth and development, and school attendance and has a long-term psychological effect on affected individuals. In developing countries, the prevalence of dental caries is increasing due to the growing consumption of sugary foods, poor tooth brushing habits, and a low level of awareness about dental caries. Even if there was a high prevalence of dental caries in sub-Saharan Africa, there is a paucity of data on the prevalence of dental caries in East Africa. Hence, this study aimed to determine the prevalence of dental caries and associated factors in East Africa.Methods:A systematic search of articles was conducted in MEDLINE, Scopus, and Google Scholar using all the synonyms of dental caries in published literature (until December 2020) in East Africa. Important data were extracted using a standardized data extraction form prepared in Excel. Stata software (version 14.0) was used to calculate the pooled prevalence of dental caries. Besides, subgroup analysis was done based on country and dentition type. Moreover, associated factors of dental caries were assessed and the overall effect was presented in the form of odds ratios. The quality of the included studies was evaluated using the Joanna Briggs Institute reviewers' manual.Results:The overall pooled prevalence of dental caries was found to be 45.7% (95% CI = 38.0–53.4). The pooled prevalence was high in Eritrea (65.2%, 95% CI = 49.2–81.1), followed by Sudan (57.8%, 95% CI = 36.0–79.7), and a low prevalence was found in Tanzania (30.7%, 95% CI = 21.5–39.9). Moreover, the subgroup analysis revealed a prevalence of 50% (95% CI = 38.4–62.1) in permanent dentition and 41.3% (95% CI = 33.5–49.2) in mixed dentition. The overall mean decayed, missed, and filled permanent (DMFT) and primary (dmft) teeth were 1.941 (95% CI = 1.561–2.322) and 2.237 (95% CI = 1.293–3.181), respectively. High DMFT scores were reported in Sudan (3.146, 95% CI = 1.050–5.242) and Uganda (2.876, 95% CI = 2.186–3.565). Being female (OR = 1.34, 95% CI = 1.24–1.46) and having poor tooth brushing habit (OR = 1.967, 95% CI = 1.67–2.33) were independent risk factors of dental caries.Conclusion:The overall prevalence of dental caries was comparatively high. Being female and poor oral health practice were independent risk factors of dental caries. The Ministry of Health of the member countries, along with dental associations of each country, ought to offer due attention to strengthen the oral health program in schools and primary health care centers and the implementation of school water fluoridation.

IntroductionAnemia remains a major public health problem for children in sub-Saharan Africa (SSA). Iron-rich foods consumption has a determinant role on the anemia status. Hence, this study aimed to determine the prevalence of good consumption of iron-rich foods and its associated factors among children aged 6–23 months in SSA.Materials and methodsThe recent Demographic and Health Survey data sets of thirty-five SSA countries were used. Data were analyzed using STATA/MP version 16.0 and all statistical analyses were done after weighting the data. A generalized linear mixed model using Poisson regression with robust error variance was used to determine factors associated with good consumption of iron-rich food. Association of variables was declared at a p-value of ≤0.05 and adjusted prevalence ratio (aPR) ratio with its 95% confidence interval (CI) was calculated for each variable.ResultsThe total weighted samples of 77,001 children aged 6–23 months were included. The prevalence of consumption of iron rich foods was 42.1% (95% CI: 41.78–42.48). Children with age of 12–17 (adjusted prevalence ratio (aPR) = 1.96, 95% CI: 1.89–2.04) and 18–23 months (aPR = 2.05, 95% CI: 1.97–2.14), who took drugs for intestinal parasites (aPR = 1.30, 95% CI: 1.26–1.34), with postnatal check within 2 months (aPR = 1.09, 95% CI: 1.06–1.13), and children from women with ANC visit of 1–3 (aPR = 1.31, 95% CI: 1.24–1.37) and ≥4 (aPR = 1.41, 95% CI: 1.34–1.48) had higher prevalence of good consumption of iron rich foods. Moreover, the prevalence of consumptions of iron rich foods was higher among children from; family with rich (aPR = 1.36, 95%CI: 1.30–1.42) and middle (aPR = 1.14 95% CI: 1.09–1.19) wealth index, and mother with media exposure (aPR = 1.26, 95%CI: 1.22–1.31).ConclusionThe prevalence of good consumption of iron-rich foods among children aged 6–23 months in SSA countries is low. Child factors, family factors, and community-level factors were significantly associated with consumption of iron rich foods. Strategies to increase the consumption of iron-rich foods during this critical stage of growth and development should be designed in SSA.

AbstractBackgroundCongenital anomaly is a partial or complete structural and/or functional defect during intrauterine life. Globally, major congenital anomalies account for 6% of all newborns among which about 94% of cases occurred in developing countries. In spite of its public health importance, very limited studies are reported in Ethiopia, and hardly any study in Arsi Zone.ObjectivesTo determine the predictors of congenital anomalies among newborns in Arsi Zone Public Hospitals, Southeast Ethiopia.MethodsA multi-center institutional-based case-control study was conducted in 418 (105 cases and 313 controls) of newborns in Arsi Zone Public Hospitals. Descriptive analysis, binary and multivariable logistic regressions were implemented.ResultsIn this study, women who have been drinking alcohol during pregnancy were 3.48 times more prone to have newborns with congenital anomalies than their counterparts (AOR = 3.48; 95% CI: 1.38, 8.74). The likelihood of having a newborn with congenital anomalies was six and four times higher for women who had a maternal illness (AOR = 6.10; 95%CI: 2.39, 15.57) and chewing khat during pregnancy (AOR = 4; 95%CI: 1.49, 10.65), respectively. Moreover, the lack of folic acid supplementation and pesticides during pregnancy were 3.25 and 4.76 times more likely to experience a newborn with congenital anomalies, respectively.ConclusionAlcohol drinking, maternal illness, khat chewing, and chemical exposure during pregnancy had a significant association with the occurrence of congenital anomalies. While, taking folic acid supplements had a protective effect. Health experts and the community should take these factors into consideration and act accordingly.

Background: Lumbar puncture is a difficult medical skill and used by anesthetists for administering local anesthetics to the subarachnoid space. Prior knowledge of how far the needle needs to be inserted from skin to the subarachnoid space distance (SSD) has a paramount role to guide spinal needle placement and reduce complications related to lumbar puncture. Therefore, we aimed to determine the depth of spinal needle insertion and its associated factors among patients who underwent surgery under spinal anesthesia. Methods: An institutional based cross-sectional study design was conducted among 274 patients who underwent surgery under spinal anesthesia. Following very successful lumbar puncture procedure, the distance from skin entry point to the tip of the spinal needle was measured. The data were entered into an Epi data version 4.3.1 and exported to SPSS software version 20 for analysis. Descriptive analysis, simple linear and multiple linear regression analysis were used. Then, in order to assess the correlation of depth of spinal needle insertion with other independent variables Pearson’s correlation coefficient (r) was applied. Results: Two hundred seventy four patients comprising 112 (40.8%) male and 162 (59.1%) female were included in the study with a mean height, weight and body mass index (BMI) of 1.63 m, 62.9 kg, and 23.9 kg/m2 respectively. The mean distance from skin to the subarachnoid space was 5.13 ± 0.69 cm ranging from 3.5 to 7.1 cm. Pregnancy, weight and BMI had statistically significant effect on the mean SSD (p < 0.001, p < 0.001 and p = 0.014) respectively. Conclusions: The distance from the skin to the subarachnoid space was differed among individuals. The SSD was affected by individuals’ pregnancy status, BMI and weight. Hence, to minimize complications, these factors should be taken into consideration at the time of spinal needle insertion.

BACKGROUND፡ A trauma to the skull in the area of the pterion usually causes rupture of the middle meningeal artery leading to life- threatening epidural hematoma. The objective of the study is to assess the prevalence of different types of pterion and to determine its location using valuable bony landmarks.METHODS: On 90 dry adult human skulls of unknown sex, age and nationality the distance of different landmarks from pterion was measured using stainless steel sliding Vernier caliper. The data were analyzed using SPSS version-20 and an independent ttest analysis was implemented. A value of P< 0.05 was considered as statistically significant.Results: A higher occurrence of sphenoparietal type of pterion with the absence of frontotemporal type was noted. About 23% and 77% of the suture types are found to be unilateral and bilateral, respectively. There was a statistically significant difference between right and left sides of the skull in distances from the center of pterion to frontozygomatic suture, root of zygomatic arch, inion and in central thickness pterion.CONCLUSION: This study showed that the most prevalent type of pterion is sphenoparietal, and revealed asymmetry in the distances from center of pterion to frontozygomatic suture, root of zygomatic arch and inion, and its central thickness. Such findings could offer worthy information about the type and location of pterion, which could be relevant to anatomists, neurosurgeons, forensic medicine specialist and anthropologists.

Background: Fontanel can be defined as a space where two or more sutures meet. There are six fontanels in the newborn skull, namely anterior, posterior, two mastoid, and two sphenoid fontanels. The anterior fontanel is the most important for clinical evaluation. In Ethiopia, there is a paucity of information regarding the size of anterior fontanel dimensions . Thus, this study aimed to determine and compare the average values of the length and width of the anterior fontanel and to identify the factors that affect the dimensions. Method: An institution-based cross-sectional study was conducted on three hundred eighty-four healthy and term newborns. A systematic sampling technique was used to select study subjects. The data were collected using interviewer-administered questionnaire by interviewing the mothers of the neonates. The examination included assessment of the length and width of the anterior fontanel, birth weight, and head circumference. Socio-demographic, pregnancy, and labor variables were also recorded. Descriptive analysis, simple linear and multiple linear regression analysis were applied to analyze the data. Result: The mean length and width of the anterior fontanel was 3.07 ± 0.69 cm and 2.92 ± 0.61 cm, respectively. Cesarean mode of delivery (ABC (Adjusted B-Coefficient) = 0.09, 95% CI: 0.002, 0.18)), being daily laborer (ABC = -0.23, 95% CI: - 0.41, -0.05), width of anterior fontanel (ABC = 0.91, 95% CI: 0.84, 0.98), and head circumference (ABC = 0.03, 95% CI: 0.001, 0.050) were independently associated with length of anterior fontanel. Age of the newborn (ABC= 0.01, 95% CI: 0.008, 0.02) was associated with width of the anterior fontanel. Conclusion: At birth, the mean length of the anterior fontanel was larger than the mean width of the anterior fontanel. This study provides an insight on the mean length and width anterior fontanel for term neonates in the study area. which can serve as a baseline for future larger sample size studies to set reference values for the area.. Keywords: Length of anterior fontanel, width of anterior fontanel, comparison, newborns.

Abstract Background Oral diseases are a public health concern with a significant impact on the quality of life of individuals. Children with special needs face significant challenges in carrying out oral hygiene due to their disability, and they are more prone to poor oral health and illnesses. This study assessed dental health problems and treatment-seeking behaviors of special needs school students in Amhara region, Ethiopia. Methods An institution-based cross-sectional study was conducted from November 2020 to April 2021, in eight special needs schools located in the Amhara Regional State, Ethiopia. A total of 443 randomly selected special needs students were included. Data were collected using a structured interview-administered questionnaire. Bivariable and multivariable logistic regression models were fitted to identify factors associated with oral health problems and treatment-seeking behavior. A p-value of less than 0.05 was used to declare statistical significance. Results The prevalence of self-reported dental health problems and treatment-seeking behaviors among special needs school students was 46.1% (95% CI: 41.4%, 50.7%) and 60.3% (95% CI: 53.4%, 66.8%), respectively. Place of residence, grade level, religious affiliation, years lived with disability, and knowledge of dental health-related risk behaviors were associated with dental health problems. Whereas, place of residence, being hearing impaired, and having prior information about dental health problems were associated with dental treatment-seeking behavior. Conclusions A significant number of special needs students reported dental problems and about 40% of them did not seek dental treatment. Oral hygiene practice and access to dental care services are important in the prevention of dental problems. Hence, oral hygiene promotion programs focusing on oral hygiene practice and dental treatment services are needed in special needs schools. It is also strongly suggested to incorporate oral health related information in health-related academic lessons to enhance optimum oral health among special needs students.

Background: Oral health care is the most common unmet need among individuals with a disability. Individuals with a disability may have compromised oral health needs due to neglect from parents, socioeconomic problems, and communication barriers. In Ethiopia, there is a lack of data on oral health status of the hearing-impaired population. Therefore, this study aimed to assess the oral health status of hearing-impaired students in the Amhara region, Ethiopia. Methods: A cross-sectional study was conducted from November 2020 to April 2021 on hearing-impaired students in Amhara region, Ethiopia. Data were collected using a pretested interview administered questionnaire and clinical examination. Oral cavity was evaluated using the simplified oral hygiene index, decayed, missed and filled teeth, and community periodontal index. Data analysis was done using SPSS 26.0, and logistic regression analysis was done to identify the risk factors of dental caries and periodontal disease. Results: A total of 149 hearing impaired students with an age range of 7-30 years were involved in the study. The prevalence of periodontal disease and dental caries was 22.8% (95% CI: 16.8, 30.4) and 38.9% (95% CI; 32.2, 46.9), respectively. Being grade 1-4 student (AOR = 3.94, 95%: 1.16, 13.38), lack of formal education (AOR = 4.98, 95% CI: 1.00, 24.65), dental caries (AOR = 2.51, 95% CI: 1.08, 5.08) and bleeding on probing (AOR = 9.98, 95% CI: 3.69, 26.64) were statistically significant with periodontal disease. Grade level, parents' support during brushing, oral health status, and medication intake were independent factors for dental caries. Conclusion: In the present study, a significant number of hearing-impaired students had periodontal disease and dental caries. School oral health programs and caregivers assisted oral hygiene practices are essential to combat oral health problems in hearing-impaired students. Moreover, a nationwide prospective study with a large sample size will be required to reflect the oral health status of hearing-impaired individuals in the country. Keywords: DMFT; dental caries; hearing impairment; oral health status; periodontal disease.

Abstract Background Periodontal disease is the most common oral health problem among individuals living with disabilities. Any physical impairment and/or mental handicap can compromise the capability to perform oral health care. Individuals with poor oral hygiene practice were prone to dental caries, periodontal disease, and upper respiratory tract infections. Despite the high prevalence of disabled people in Ethiopia, data are scarce about their periodontal status. The aim of this study was to determine the prevalence and determinant factors of periodontal disease among students living with disability in the Amhara region. Methods A school-based cross-sectional study was done on eight special needs schools in Amhara regional state from November 30, 2020, to April 10, 2021. A simple random sampling technique using a computer random generator was employed to recruit the study participants. The participants were interviewed for sociodemographic characteristics, oral hygiene practice, type of disability, and medical condition through a pre-tested semi-structured questionnaire. The periodontal status of the participants was evaluated using the community periodontal index (CPI). Data entry was done using the Epi-data and analyzed using SPSS 26. Binary logistic regression analysis was used to identify the predictors of periodontal disease at a 5% level of significance. Results A total of 443 study participants were involved with a mean age of 15.84 ± 3.882. Among these, 27.5% (95%CI 23.4–32.0) had a periodontal pocket depth of ≥ 4 mm, and 56.7% had bleeding on probing. The prevalence of periodontal disease was higher in participants with poor oral health status (52.2%), dental caries (34.8%), class-2 malocclusion (46.1%), and low monthly income (30.4%), visually impaired (30%), and mentally disorder (29.9%). Age of above 18 years (AOR = 3.41, 95%CI 1.40, 8.28), low family monthly income (AOR = 2.21; 95%CI 1.22, 4.03), malocclusion (AOR = 1.59, 95%CI 1.01, 2.54), poor oral health status (AOR = 9.41; 95%CI 4.92, 17.98), and dental caries (AOR = 1.85, 95%CI 1.21, 2.82) were independent predictors of periodontal disease. Conclusions A substantial amount of disabled school students in the study area had periodontal disease. The study found that there was a statistically significant association between age, family monthly income, malocclusion, oral health status, and dental caries with periodontal disease. The implementation of school oral health programs has a great benefit for the oral health status of disabled school students.

AbstractObjectivesPeople living with disability are more vulnerable to dental caries and have a high decayed, missed, and filled permanent teeth (DMFT) index and untreated dental disease than nondisabled individuals. In Ethiopia, there is a dearth of information on the oral health status of the disabled population. Hence, this study aimed to determine the prevalence of dental caries and its predictors among special needs school students in the Amhara region, Ethiopia.MethodsAn institution‐based cross‐sectional study was done on special needs school students in the Amhara region from November 2020 to April 2021. The study participants were recruited using a simple random sampling technique using a computer random generator. Data collection was done using the World Health Organization oral health survey tool. Data entry was done using Epi‐data 4.6 and analyzed using SPSS 26. A logistic regression model was used to identify the possible predictors of dental caries.ResultsFour hundred and forty‐three students with a mean age of 15.8 ± 3.8 were included in the study. The prevalence of dental caries was 41.5% (95% confidence interval [CI]: 36.3, 46.0) in permanent dentition with a mean DMFT score of 1.3 ± 1.6. The prevalence of dental caries in primary dentition was 23.1% (95% CI: 11.9, 32.1) with a mean decayed, missed, and filled primary teeth (dmft) score of 1.9 ± 0.2.Being 7–12 years old (adjusted odds ratios [AOR] = 3.6, 95% CI: 1.6, 8.3), lower grade level (AOR = 2.4, 95% CI:1.3,4.4), poor oral hygiene status (AOR = 2.5, 95% CI: 1.3, 4.8), and lack of parental support during tooth brushing (AOR = 2.2, 95% CI: 1.2, 4.1) were independent predictors of dental caries.ConclusionsA significant amount of special needs school students in the study area had dental caries. Age, grade level, oral hygiene status, and lack of parent support during tooth brushing were independent predictors of dental caries.

Background:Cardiothoracic ratio (CTR) is the common way for the measurement of heart size, diagnosis of heart disease, and screening of cardiomegaly. The aim of the study was to assess CTR and the factors altering its measurement. Materials and Methods:Institution-based cross-sectional study was conducted among adult patients coming for a chest x-ray at Gambi Teaching General Hospital. A total of 250 adult study subjects selected by a systematic random sampling method were included in our study. Thesociodemographic and radiographicdata were collected using a pre-tested standardized questionnaire and measurements and analyzed using SPSS version-21. One-way ANOVA followed by Tukey post hoc test was implemented and P<0.05 was considered as statistically significant. Results:The average values of CTR, transverse cardiac diameter (TCD), and transverse thoracic diameter (TTD) were 46.08 ± 3.34%, 12.53 ± 1.63 cm, and 27.05 ± 2.24 cm, respectively. The average values of male TCD and TTD were significantly greater than the mean values of female TCD and TTD (P=0.000) and the reverse holds true for the CTR. TCD and TTD values increased withage and level of monthly income. In all age groups, the CTR was less than 50%. Conclusion:The CTR of females was greater than the males (P> 0.05) and compared with other African studies. Age, monthly income, and occupation of the study subjects appeared to alter the values of TCD, TTD, and CTR. Further research on the association between CTR and anthropometric measurements should beconducted. Keywords: Cardiothoracic ratio, radiograph, transverse cardiac diameter, transverse thoracic diameter