Tikur Anbessa Specialized Teaching Hospital Research Articles

Perceptions of readiness for interprofessional learning among Ethiopian medical residents at Addis Ababa University: a mixed methods study

BackgroundInterprofessional learning is an important approach to preparing residents for collaborative practice. Limited knowledge and readiness of residents for interprofessional learning is considered one of the barriers and challenges for applying Interprofessional learning. We aimed to assess the perceptions of readiness of medical residents for interprofessional learning in Ethiopia.MethodsWe conducted a parallel mixed-methods study design to assess the perceptions of readiness for interprofessional learning among internal medicine and neurology residents of Tikur Anbessa Specialized Teaching Hospital in Addis Ababa, Ethiopia, from May 1 to June 30, 2021. One hundred one residents were included in the quantitative arm of the study, using the Readiness for Interprofessional Learning Scale (RIPLS) tool. All internal medicine and neurology residents who consented and were available during the study period were included. SPSS/PC version 25 software packages for statistical analysis (SPSS) was used for statistical analysis. Descriptive statistics were summarized as mean and standard deviation for continuous data as well as frequencies and percentages to describe categorical variables. Data were presented in tables. In addition, qualitative interviews were undertaken with six residents to further explore residents’ knowledge and readiness for IPL. Data were analyzed using a six-step thematic analysis.ResultsOf the 101 residents surveyed, the majority of the study participants were male (74.3%). The total mean score of RIPLS was 96.7 ± 8.9. The teamwork and collaboration plus patient-centeredness sub-category of RIPLS got a higher score (total mean score: 59.3 ± 6.6 and 23.5 ± 2.5 respectively), whereas the professional identity sub-category got the lowest score (total mean score: 13.8 ± 4.7). Medical residents’ perceptions of readiness for interprofessional learning did not appear to be significantly influenced by their gender, age, year of professional experience before the postgraduate study, and department. Additionally, the qualitative interviews also revealed that interprofessional learning is generally understood as a relevant platform of learning by neurology and internal medicine residents.ConclusionsWe found high scores on RIPLS for internal medicine and neurology postgraduate residents, and interprofessional learning is generally accepted as an appropriate platform for learning by the participants, which both suggest readiness for interprofessional learning. This may facilitate the implementation of interprofessional learning in the postgraduate medical curriculum in our setting. We recommend medical education developers in Ethiopia consider incorporating interprofessional learning models into future curriculum design.

Post‐stroke dementia and its determinant factors among Ethiopian stroke survivors: A cross‐sectional study

AbstractBackgroundStroke and dementia convene risks for each other and share some of the same, largely modifiable, risk factors.MethodAdult stroke survivors, who visited the outpatient stroke clinic in Tikur Anbessa Specialized Teaching Hospital in Addis Ababa University, Ethiopia was assessed for cognitive decline. Beside Montreal Cognitive Assessment‐Basic (MOCA‐B) tool, functional recovery and depression were measured using modified Rankin Scale (mRS) and Patient Health Questionnaire (PHQ‐9).ResultFrom 67 stroke survivors (mean age: 52.1 ± 12.7 years, 40.3 % female, 25.3% illiterate, rural dwellers 32.8%, 37.3% stoke onset < 45‐year), 68.7% had cognitive impairment in at least one domain and 25.3% had dementia. Hospitalization [OR = 0.22 (0.06 ‐0.74)], right hemisphere stroke location [OR = 0.21 (0.06‐0.77)] and poor function recovery with mRS ³3 [OR = 1.4 (1.06‐1.74)] were independently associated with post stroke cognitive impairment and dementia.ConclusionThe frequency of post stroke dementia was high in Ethiopia and poor functional recovery negatively impact cognitive outcome.

Assessment of Serum Vitamin B12 and Folate Levels and Macrocytosis in Patients with Type 2 Diabetes Mellitus on Metformin Attending Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A Cross-Sectional Study.

BackgroundMetformin is the first-line drug in the treatment of type 2 diabetes mellitus. Monitoring vitamin B12 deficiency associated with long-term and high-dose therapy is not a common practice in many clinical settings in Ethiopia.ObjectiveThe study aimed to measure levels of serum vitamin B12 and folate and to assess the macrocytic status of type 2 diabetes mellitus patients on metformin.MethodsA cross-sectional study was conducted on 80 type 2 diabetes mellitus patients who had been on metformin for 5 months or more at the diabetic clinic of Tikur Anbessa Specialized Teaching Hospital. Serum vitamin B12 and folate levels were quantified by chemiluminescent immunoassays. Mean corpuscular volume was determined by complete blood count. Differences in vitamin B12 and folate levels and mean corpuscular volume between different groups were assessed using Kruskal–Wallis H and Mann–Whitney U tests.ResultsVitamin B12 and folate deficiency were documented in 5% and 23.8% of participants, respectively, and 6.2% of patients were macrocytic. Levels of vitamin B12 and folate in patients who had been on metformin >1,500 mg/day ≥4 years were significantly lower those who had been on metformin 1,000–1,500 mg/day and <1,000 mg/day <4 years, respectively.ConclusionLow serum vitamin B12 and folate levels and macrocytosis were found to be associated with prolonged metformin treatment.

Bacterial Profiles and Antimicrobial Susceptibility Pattern of Isolates from Inanimate Hospital Environments at Tikur Anbessa Specialized Teaching Hospital, Addis Ababa, Ethiopia.

IntroductionMicrobial contamination of the hospital environment plays an important role in the spread of healthcare-associated infections (HCAIs). This study was conducted to determine bacterial contamination, bacterial profiles, and antimicrobial susceptibility pattern of bacterial isolates from environmental surfaces and medical equipment.MethodsA cross-sectional study was conducted at Tikur Anbessa Specialized Hospital (TASH) from June to September 2018. A total of 164 inanimate surfaces located at intensive care units (ICUs) and operation theaters (OTs) were swabbed. All isolates were identified by using routine bacterial culture, Gram staining, and a panel of biochemical tests. For each identified bacteria, antibiogram profiles were determined by the Kirby–Bauer disk diffusion method according to the guidelines of the Clinical and Laboratory Standards Institute (CLSI).ResultsOut of the 164 swabbed samples, 141 (86%) were positive for bacterial growth. The predominant bacteria identified from OTs and ICUs were Staphylococci aureus (23% vs 11.5%), Acinetobacter baumannii (3.8% vs 17.5%) and coagulase-negative Staphylococcus (CoNS) (12.6% vs 2.7%) respectively. Linens were the most contaminated materials among items studied at the hospital (14.8%). Gram-positive bacteria (GPB) had significantly high resistance levels to penicillin (92.8%), cefoxitin (83.5%), and erythromycin (53.6%). On the other hand, Gram-negative bacteria (GNB) revealed the highest resistance levels to ampicillin (97.5%), ceftazidime (91.3%), ceftriaxone (91.3%), and aztreonam (90%). However, a low resistance level was recorded for amikacin (25%) followed by Ciprofloxacin (37.5%). Of the 63 S. aureus isolates, 54 (85.7%) were methicillin-resistant S. aureus (MRSA).ConclusionThe inanimate surfaces and commonly touched medical equipment within OTs and ICUs are reservoirs of potentially pathogenic bacteria that could predispose critically ill patients to acquire HCAIs. The proportions of the antimicrobial resistance profile of the isolates are much higher from studied clean inanimate environments.

Diuretic resistance in patients with heart failure: Clinical characteristics and predictors of outcome

Background: Our aim was to study the clinical characteristics and predictors of mortality in heart failure (HF) with diuretic resistance. Methods: We conducted a 5-year retrospective study on 119 HF patients with diuretic resistance at Tikur Anbessa Specialized Teaching Hospital. The primary endpoint was mortality. We compared baseline characteristics and assessed association in patients who received high-dose (≥120 mg) versus low-dose (

Effect of iron deficiency anemia on HbA1c in diabetic patients at Tikur Anbessa specialized teaching hospital, Addis Ababa Ethiopia

BackgroundHemoglobin A1C (HbA1c) is the predominant hemoglobin found in HbA1 fractions. A1c assay is the recommended assay for diagnosing diabetes and any condition that changes red cell turnover such as Iron deficiency Anemia (IDA), will lead to spurious A1C results. Therefore, the present study was aimed at determining the effect of IDA on HbA1c in diabetic patients attending Black Lion Specialized Teaching Hospital, Addis Ababa, Ethiopia.MethodsA facility based comparative cross sectional study was conducted on 174 diabetic patients (87 with IDA and 87 without IDA) from April to July 2016. Socio demographic data and clinical conditions were collected using structured questionnaire. Venous blood was collected for performing Complete blood count (CBC) using Cell dyn 1800 hematology analyzer; Serum ferritin, performed by COBAS INTEGRA 400/800 Chemistry analyzer and HbA1c tests, performed by COBAS C 111 analyzer. Data was analyzed using SPSS version 21 software. Pearson’s correlation, chi-square, and independent t-tests were calculated. The data was presented as mean ± SD. A P-value of < 0.05 was taken as statistically significant.ResultsMean hemoglobin (Hgb), hematocrit (HCT), Mean cell volume (MCV), mean cell hemoglobin (MCH), mean cell hemoglobin concentration (MCHC) were lower in IDA group compared to non-IDA diabetic patients. HbA1c (%) level was significantly lower in IDA group (6.18 ± 1.57) compared with the non-IDA diabetic patients (7.74 ± 1.81) (p < 0.05).ConclusionHbA1c is significantly lower in diabetic patients with IDA compared to the non-IDA diabetic patients. Therefore, the authors believe that monitoring these patients using only HbA1c could be misleading, hence physicians and health care providers should take this into account before making any therapeutic decision. Detailed examination including large number of participants employing advanced laboratory techniques is recommended.

Hypogonadism and associated risk factors in male patients with type 2 diabetes mellitus attending the diabetic clinic of Tikur Anbessa Specialized Teaching Hospital, Addis Ababa, Ethiopia

Background: A high prevalence of hypogonadism among men with type 2 diabetes mellitus (T2DM) has been reported worldwide. This in turn creates a substantial public health burden in terms of inadequ...

Prevalence of Autoimmune Hemolytic Anemia in Human Immunodeficiency Virus–Infected Anemic Adults: A Cross-Sectional Study at Tikur Anbessa Specialized Teaching Hospital From June 5, 2015, to September 10, 2015, Addis Ababa, Ethiopia

Prevalence of Autoimmune Hemolytic Anemia in Human Immunodeficiency Virus–Infected Anemic Adults: A Cross-Sectional Study at Tikur Anbessa Specialized Teaching Hospital From June 5, 2015, to September 10, 2015, Addis Ababa, Ethiopia

Implementing ultrasound-guided hydrostatic reduction of intussusception in a low-resource country in Sub-Saharan Africa: our initial experience in Ethiopia.

Despite advances in non-invasive radiological techniques for the treatment of intussusception, management of the entity still remains exclusively surgical in many developing countries, including Ethiopia. Fluoroscopic units are rare or mostly dysfunctional. Ultrasound scanners are more commonly available. Ultrasound-guided hydrostatic reduction (USGHR) was recently introduced to the main referral hospital in Ethiopia, and subsequently has been adopted as the initial management option for intussusception. The aim of this study was to evaluate our experience with USGHR in Ethiopia and measure the impact on patient care. A prospective study was conducted between July 2014 and August 2015 on all pediatric patients, with US-confirmed intussusception, at the Tikur Anbessa Specialized Teaching Hospital in Addis Ababa, Ethiopia. All patients, excluding those with signs of peritonitis, bowel ischemia, or symptoms lasting longer than 4days, were selected to undergo USGHR. A total of 53 children were diagnosed with intussusception, confirmed via ultrasound. Following exclusion criteria, USGHR was attempted in 47 of the patients. Forty-one of the 47 patients (87.2%) had successful reduction, resulting in a 77% overall rate of successful non-operative management in all patients with intussusception. The rate of operative reduction of intussusception decreased by 77% following the introduction of USGHR as the initial non-surgical intervention. Therefore, we believe USGHR should be fully implemented in our hospital, and recommend that this study serves as an example to other institutions in our country as well as in other developing countries facing similar challenges.

Cost of Illness of Breast Cancer Patients on Chemotherapy in Addis Ababa Public Hospitals, the Case of Tikur Anbessa Specialized Teaching Hospital-Cross-Sectional Types of Study

Background: Breast cancer is the most commonly diagnosed cancer and the second most leading cause of death next to cervical cancer in Ethiopia. An economic burden of breast cancer is a considerable issue in most middle and low income countries, especially in Ethiopia, where there is high out-of-pocket expenditure for health. Objectives: To estimate Economic burden of breast cancer patients on chemotherapy attending at Tikur Anbessa Specialized Teaching Hospital (TASH) and to determine Predictors for variation in patient related cost of breast cancer patients on chemotherapy. Methods: The Cost of illness study on 349 breast cancer cases was carried out at Tikur Anbessa Specialized Teaching Hospital (TASH) using cross sectional study design. A Simple random sampling method was used to select study participants. As a semi-structured questionnaire was used to collect data, mean, median and standard deviation were used to calculate direct cost indirect cost and companion side costs. Multiple linear regression analysis was employed to analyze the separate effects of the various predictor variables on cost of treatment. Results: The average outpatient direct cost at Tikur Anbessa Specialized Teaching Hospital for breast cancer on chemo-therapy was 24953.45 ETB ($1188.26) SD (=24874.77{$1184.51}). Direct medical cost comprised the largest part (mean=18753.41 ETB (893.02 USD) (SD=18860.95 ETB) $898.14). Mean expenses for non-prescribed remedies was, 6200.00 birr ($295.24), takes the lion share of direct nonmedical cost followed by expense for transportation (mean=3568.31 ETB {$169.92). Conclusion: This study shows that the financial burden of breast cancer is substantial and overwhelming for both patients and their families. Outpatient treatment cost was found to be dependent on number of employed household members, number of facility visited. Longer duration of inpatient hospital stay and stages of breast cancer is associated with inpatient cost and indirect cost.

The revenue generated from clinical chemistry and hematology laboratory services as determined using activity-based costing (ABC) model.

Background The rapid and continuous growth of health care cost aggravates the frequently low priority and less attention given in financing laboratory services. The poorest countries have the highest out-of-pocket spending as a percentage of income. Higher charges might provide a greater potential for revenue. If fees raise quality sufficiently, it can enhance usage. Therefore, estimating the revenue generated from laboratory services could help in capacity building and improved quality service provision.Methods Panel study design was used to determine revenue generated from clinical chemistry and hematology services at Tikur Anbessa Specialized Teaching Hospital, Addis Ababa, Ethiopia. Activity-Based Costing (ABC) model was used to determine the true cost of tests performed from October 2011 to December 2011 in the hospital. The principle of Activity-based Costing is that activities consume resources and activities consumed by services which incur the costs and hence service takes the cost of resources. All resources with costs are aggregated with the established casual relationships. The process maps designed was restructured in consultation with the senior staffs working and/or supervising the laboratory and pretested checklists were used for observation. Moreover, office documents, receipts and service bills were used while collecting data. The amount of revenue collected from services was compared with the cost of each subsequent test and the profitability or return on investment (ROI) of services was calculated. Data were collected, entered, cleaned, and analyzed using Microsoft Excel 2007 software program and Statistical Software Package for Social Sciences version 19 (SPSS). Paired sample t test was used to compare the price and cost of each test. P-value less than 0.05 were considered as statistically significant.ResultA total of 25,654 specimens were analyzed during 3 months of regular working hours. The total numbers of clinical chemistry and hematology tests performed during the study period were 45,959 (66.1 %) and 23,570 (33.9 %), respectively. Only 274, 386 (25.3 %) Ethiopian Birr (ETB) was recovered from the total cost of 1,086,008.09 ETB incurred on clinical chemistry and hematology laboratory tests. The result showed that, about 133,821 (12.32 %) ETB was revenue not collected from out-of-pocket payments that was paid for the services as a result of under pricing. The result showed that 18 out of 20 laboratory tests were under priced. The cost burden related to free Anti Retro-viral Therapy (ART) services was 285,979.82 (26.3 %) ETB.ConclusionThe cost per test estimated was significantly different to the existing price. About 90 % of the tests were under priced. This information could warn the hospital to reconsider resetting prices of these tests profitability ration less than 1. The revenue collected could help to build capacity, upscale quality, and sustainable service delivery.

Attitudes Toward Neurosurgery in a Low-Income Country: A Qualitative Study

To adapt a study exploring the needs of neurosurgery patients in a tertiary care hospital in Canada to examine, for the first time, the perspectives of neurosurgery patients in a low-income country with limited health care resources. Semistructured interviews were conducted with 25 neurosurgery patients at Tikur Anbessa Specialized Teaching Hospital in Addis Ababa, Ethiopia. Interviews were conducted in Amharic or Oromo, translated into English, and subjected to modified thematic analysis. The following 5 themes emerged: 1) With limited resources, many patients did not seek information outside of that obtained during the clinical encounter. 2) Patients valued direct verbal communication and deferred to the surgeon's authority. 3) Religion played an instrumental role in patient attitudes toward surgery. 4) Most patients did not feel anxious about surgery. 5) A few patients did not inform family members about their medical condition. Qualitative research methodology in neurosurgery can be successfully adapted from resource-abundant to resource-poor contexts. In low-income countries, patients are faced with limited options for self-education and self-empowerment, and fatalistic and paternalistic attitudes may be prevalent. Local cultural values and expectations can influence practice differently than they do in resource-rich countries.

Incidence of Road Traffic Injury and Associated Factors among Patients Visiting the Emergency Department of Tikur Anbessa Specialized Teaching Hospital, Addis Ababa, Ethiopia.

Background. Road traffic injuries are a major public health issue. The problem is increasing in Africa. Objective. To assess the incidence of road traffic injury and associated factors among patients visiting the emergency department of Tikur Anbessa Specialized Teaching Hospital, Addis Ababa, Ethiopia. Methods. Institutional based cross-sectional study design was conducted. A total of 356 systematically selected study subjects were included in the study. Bivariate and multivariate logistic regressions were performed to identify associated factors with road traffic injury. Odds ratios with 95% confidence interval were computed to determine the level of significance. Results. The incidence of road traffic injury in the emergency department of Tikur Anbessa Specialized Teaching Hospital was 36.8%. Being a farmer (AOR = 3.3; 95% CI = 1.06–10.13), conflict with family members (AOR = 7.7; 95% CI = 3.49–8.84), financial problem (AOR = 9.91; 95% CI = 4.79–6.48), psychological problem (AOR = 17.58; 95% CI = 7.70–12.14), and alcohol use (AOR = 2.98; 95% CI = 1.61–5.27) were independently associated with road traffic injury. Conclusion and Recommendation. In this study the incidence of road traffic injury was high. Alcohol is one of the most significant factors associated with Road Traffic Injury. Thus urgent education on the effect of alcohol is recommended.

Knowledge and adherence to Antiretroviral Therapy among adult people living with HIV/AIDS at Tikur Anbessa Specialized Hospital, Ethiopia

Background: Adherence to antiretroviral therapy (ART) is necessary to achieve best virological response, lower the risk of drug resistance, and reduce morbidity and mortality. The objectives of the current study were to assess the extent of knowledge of patients on treatment plan and regimen, determine the rate of adherence and identify factors related to non-adherence to ART. Methods: A cross-sectional study was conducted at Tikur Anbessa Specialized Teaching Hospital, Addis Ababa, Ethiopia, using data from both semi-structured interview (self-report) and ART database (pharmacy refill) during the months of March and April 2013 using a total 350 participants. Results: The results indicated that 33% of the participants had good knowledge on the treatment plan and regimen. Using self-report and pharmacy refill record, 79.1% and 72.9% respectively showed adherence rate of ≥95%. Younger people were found to be less likely to adhere to ART (AOR [95%] = 0.51 [0.30, 0.85]) using pharmacy refill record. Risk factors for ART non-adherence using self-report were use of memory aids (AOR [95%] = 3.46 [1.72, 6.98]), treatment satisfaction (AOR [95%] = 2.33 [1.22, 4.07]), taking co-medication (AOR [95%] = 0.56 [0.32, 0.98]), and regimen switch (AOR [95%] = 0.41 [0.19, 0.85]). Whereas using pharmacy refill record risk factors were, knowledge on treatment plan and regimen (AOR [95%] = 2.50 [1.39, 4.51]), use of memory aids (AOR [95%] = 2.71 [1.34, 5.47]), treatment satisfaction (AOR [95%] = 3.78 [1.47, 9.71]), and regimen switch (AOR [95%] = 0.50 [0.27, 0.92]). Conclusion: Older age, good knowledge on treatment plan and regimen, use of memory aids, treatment satisfaction, and not having co-medications and regimen switch showed more adherence to ART.

Impairment of Liver Function Tests and Lipid Profiles in Type 2 Diabetic Patients Treated at the Diabetic Center in Tikur Anbessa Specialized Teaching Hospital (Tasth), Addis Ababa, Ethiopia

Background: The liver is an insulin- sensitive organ. Insulin resistance is recognized as a pathological factor in the development of liver function impairment and in Non-Alcoholic Fatty Liver Disease (NAFLD). Studies on liver function abnormalities in type 2 diabetic patients in Ethiopia are lacking. In this study we assess liver function tests in patients with type 2 diabetes mellitus and we examine factors associated with these biochemical changes. Methods: A cross-sectional study was conducted on type 2 diabetic patients. 0ut of 100 randomly selected diabetic patients, 80 individuals fulfilled the criteria set up for inclusion, while 20 were excluded. Analysis was carried out to compare liver function tests and lipid profiles of the patients with 60 non-diabetic control individuals. Results: Mean values of liver function tests (ALT,AST,ALP,TP,Bilirubin)and lipid profiles (TC,LDL,HDL,TAG ) were significantly higher in diabetic patients compared with the non-diabetic controls (P<0.05). In contrast, total protein and high density lipoprotein concentrations in diabetic patients were lower compared with non-diabetic control group (P<0.01). Overall , 22 patients (25%) had at least one or more abnormal liver function tests and lipid profiles. 39 patients (48.75%), 62 patients (77.5%), 47 patients (58.75%), 52(65%) patients had abnormal total serum Cholesterol, LDL, TAG, and HDL levels ,respectively. The liver function and lipid profile tests among different anti diabetic on taking groups of the study patients were not statically significant at p value <0.05. Conclusion: Elevated parameters were greater among persons with type2 diabetic patients. There is less association between liver function impairments with the anti diabetic drugs the patients on taking. known to have type 2 diabetes appears to be relatively low, accounting for 23% of people with the diabetes (3). In 2011, 14.7 million adults in Africa were estimated to have diabetes, with a regional prevalence of 3.8%. The highest prevalence of diabetes in the Africa Region is in the island of Reunion (16.3%), followed by Seychelles (12.4%), Botswana (11.1%) and Gabon (10.6%). Some of Africa's most populous countries also have the highest number of people with diabetes, with Nigeria having the largest number of diabetes (3.0 million), followed by South Africa (1.9 million), Ethiopia (has an estimated 1.4 million adults ,with a prevalence of 3.45% in the adult population). The top six countries with the highest number of people with diabetes make up just over half of the total number of diabetes in Africa (4-10).

Communication skills of physicians during patient interaction in an in-patient setting at Tikur Anbessa Specialized Teaching Hospital (TASH), Addis Ababa, Ethiopia, 2009

Background: Physician-patient relationship is foremost among the numerous qualities needed for sound patient care. In the Ethiopian clinical setting, a vast majority of patients complain that physicians do not interact with them properly. Objective: Assess behavior of physicians (verbal and nonverbal) when interacting with patients. Methods: Randomly selected physicians were observed in doctor-patient interactions in an inpatient setting using a standardized check list at Tikur Anbessa Hospital in November, 2009.Mean comparison of total scores of each category as well as mean interaction and biomedical exam times were made using Pearson’s Chi square, and Student’s T test. Results: 211 interactions were observed. 22.7% were consultants, 49.7% were residents and 26.5% were interns. Mean total score of observed behavior ranged from poor to satisfactory across category and showed statistically significant variations. Average interaction time was 7.87 minutes while average biomedical exam time was 5.05 minutes. The means showed a significant variation (p=0.001 at 95% CI). Conclusion: The study has shown that there is a reasonable ground to suggest that physician-patient interaction has deficiencies. Due attention should be given to improve communication skills of physicians.

Pattern of acute adult poisoning at Tikur Anbessa specialized teaching hospital, a retrospective study, Ethiopia

Acute poisoning continues to be an important public health problem. Medical records of 116 adult patients presented to Tikur Anbessa Specialized University Hospital from January 2007 to December 2008 were reviewed retrospectively. Females outnumbered males. Mean age was 21 years. Most (96.5%) were intentional self-harm poisonings. Household cleansing agents were the leading causes of poisoning (43.1%) followed by organophosphate (21.6%) and phenobarbitone (10.3%). Loss of consciousness, vomiting and epigastric pain were the common presenting features accounting 46.2%, 23.8% and 22.5%, respectively. A total of 13(11.2%) patients had already known mental illness and 12 of them poisoned by using their own medications. Among 65 patients who reported their reason of poisoning, temporary quarrel (57%) and emotional disturbance (26%) were frequently cited. The case fatality rate was 8.6%. Death was most occurred by organophosphate (5/25) and phenobarbitone poisoning (3/12). Awareness on proper handling of chemicals and prescribed agents should be forwarded to users of these agents. Majority of patients poisoned for intentional self-harm purposes so that linkage of suicidal patients to appropriate mental health service is recommended. The availability of psychiatry consultation in the hospital is also recommended.

Pediatric Residents' and Medical Interns' Awareness about Pediatric Ionizing Radiation Dose from Computed Tomography and Its Associated Risks in Tertiary Hospital in Ethiopia.

The international literature on physicians' knowledge regarding radiation dosages and risks due to computed tomography showed a widespread underestimation of diagnostic radiation doses. Hence, the objective of this work is to assess the awareness of pediatric residents and medical interns about pediatric CT dose and possible risks. A cross-sectional study was conducted on May/2016 among year I to year III pediatric residents and 2015/2016 year medical interns attaching Pediatrics Department during the study period in Tikur Anbessa Specialized Referral and Teaching Hospital. Data was collected by distributing standardized structured questionnaires. Finally, after the data was checked for clarity and completeness, it was analyzed by using SPSS software. While the majority (76.3%) of the residents and interns knew that children were more sensitive to radiation than adults, 93.7% did not know that there is currently no annual dose limit set for medical exposure of patients. The majority of the respondents (81.3%) know the risk of cancer from CT scan, but most (60%) of the respondents did not know that many imaging facilities still use adult doses for pediatric patients. Furthermore, 18.8% thought that magnetic resonance imaging involves ionizing radiation, and 8.9% of the physicians associated ultrasound examinations with ionizing radiation. Within resident group, since the level of clinical experience did not affect the outcome, we recommend that formal education and training on awareness of radiation with special concern on pediatric population is mandatory especially for pediatric residents and pediatricians who are major caretakers of children.