Background: Intraocular Foreign Bodies (IOFBs) are one of the common causes of visual loss. Missed IOFBs can lead to devastating complications. Case Report: A 14-year-old boy presented with one-month history of vision loss in the right eye from an electric cable used to whip a cart-horse. He was treated with unspecified eye drops and intravenous antibiotics at peripheral facilities. At a Tertiary hospital, CT scan revealed panophthalmitis and IOFB with orbital extension. He was managed with evisceration and foreign body removal. Conclusion: A high index of suspicion and appropriate investigations help minimize complications in patients with IOFBs.
Background: Childhood illnesses are a leading cause of morbidity and mortality in Sub-Saharan Africa, where healthcare infrastructure and trained personnel are limited. MedBrain, a digital decision support system (DDSS), aims to enhance pediatric emergency care by supporting mid-level healthcare workers in low-resource settings. Objective: To evaluate MedBrain’s triage and diagnostic performance among children presenting with common acute conditions to the emergency departments of two large hospitals in Ethiopia. Methods: A prospective observational diagnostic accuracy study was conducted between July 2024 and April 2025 at St. Paul’s Hospital Millennium Medical College and Alert Comprehensive Specialized Hospital. MedBrain’s triage and diagnostic performance were compared against healthcare professionals’ triage and pediatricians’ top presumptive diagnoses as gold standards. Performance metrics included accuracy, sensitivity (Sn), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), likelihood ratios (LR+ and LR–), and Cohen’s Kappa for reliability. Diagnostic performance was assessed for MedBrain’s top three ranked diagnoses (Top 1: highest probability diagnosis; Top 2: top two diagnoses; Top 3: top three diagnoses). Results: Of 1,204 patients screened, 274 were excluded for conditions not yet represented in MedBrain’s database (including malaria), leaving 930 participants. Of which, most were infants (33.8%) and children under 5 (31.9%), with pneumonia (20.4%) the most common diagnosis. MedBrain achieved 72.2% triage agreement, with 3.7% over-triage and 24.2% under-triage. Total diagnostic accuracy was 84.1% (Top 1), 91.5% (Top 2), and 93.3% (Top 3), with Sn of 93.3% and PPV of 100%. For prevalent conditions (pneumonia, acute bronchitis, late-onset neonatal sepsis, acute gastroenteritis, bronchiolitis, and meningitis), accuracy exceeded 97.4%, and Sp and PPV were consistently perfect. Sn increased from 73.0–98.6% (Top 1) to ≥90–100% (Top 2–3).NPV increased from 97.1–99.9% (Top 1) to 98.9–100% (Top 2) and 99.2–100% (Top 3). LR– improved from 0.014–0.270 (Top 1) to 0–0.100 (Top 2) and 0–0.079 (Top 3). Similarly, Cohen’s Kappa rose from 0.830–0.993 (Top 1) to 0.943–1.000 (Top 2) and 0.955–1.000 (Top 3). Diagnostic failures were rare, highest for late-onset neonatal sepsis (0.8%), bronchiolitis (0.5%), and pneumonia (0.4%), and none for gastroenteritis. Conclusion: MedBrain demonstrated high diagnostic accuracy and reliability in Ethiopian pediatric emergency settings. Under-triage and limited disease coverage remain challenges, warranting further validation with expanded disease libraries and in diverse settings.
Introduction: Mineral bone disease (MBD) abnormalities are common complications in patients with chronic kidney disease (CKD). The MBD abnormalities are known to be associated with increased morbidity and mortality. In spite of their importance, there are limited data on CKD-MBD abnormalities in Ethiopia. This study looked in to the magnitude and determinants of biochemical CKD-MBD abnormalities among predialysis CKD patients. Methods: A cross-sectional study was conducted from July 1 to September 30, 2020 in Tikur Anbessa specialized hospital. One hundred patients who had had follow-up for at least 6 months with an estimated glomerular filtration rate (eGFR)<60ml/min/1.73m2 using CKD-EPI equation without race factor were included. Serum calcium, albumin, phosphorus and PTH levels were determined. Demographic and clinical data were collected using a structured questionnaire. IBM SPSS software version 26 was used for analysis. Descriptive statistics was used to describe the demographic and clinical data. Chi-square was used to identify correlations between the grouped variables. The analysis for comparison among three or more categories was done using one-way ANOVA and Tukey post hoc test. Linear correlation and multiple regression analysis were used to identify associations between clinical and biochemical findings. Results: Among the 100 patients included in this study; the median age was 58 years with IQR of 73. The male to female ratio was 2.7:1. Patients in stages 3a, 3b, 4 and 5 CKD accounted for 23%, 29%, 26% and 22%, respectively. The main causes of CKD were diabetes and hypertension. Among these patients, 31% had hyperphosphatemia, 36% had hypocalcemia, and 89% had hyperparathyroidism. The mean values of calcium in CKD stage 3a,3b,4 and 5 were 8.91, 8.81, 8.7 and 7.14mg/dl, respectively; where as those of serum phosphorus were 3.58, 3.83, 3.83 and 5.53mg/dl, respectively. The median values of PTH were 140.6, 137.2, 274.05 and 440.85Pg/ml, respectively. Estimated GFR correlated negatively with serum parathyroid hormone (PTH) level but correlated positively with serum calcium level. In addition, serum calcium level is inversely associated with diabetes and diastolic blood pressure whereas serum PTH is directly associated with diastolic blood pressure and female sex. Conclusion: Hypocalcemia, hyperparathyroidism, and hyperphosphatemia are common biochemical CKD-MBD abnormalities among predialysis CKD patients in the renal clinic of Tikur Anbessa specialized hospital. Monitoring for CKD-MBD should begin earlier and treatment should be initiated accordingly to improve patient outcome.
Background: There is a lack of research on imaging findings of acute headaches in Ethiopia. Most available studies for cross-reference are conducted in developed countries and do not consider clinical and epidemiologic factors unique to developing countries. This study aims to identify the most common radiologic findings in patients presenting with acute headaches and examine their relationship with sociodemographic and clinical variables in an Ethiopian context. Methodology: A cross-sectional study was adopted in this study. The brain MRI reports and files of 497 patients who were referred for the evaluation of acute headache (less than or equal to one-month duration) to Wudassie Diagnostic Center in Addis Ababa, Ethiopia, from January 2016 to September 2018 were analyzed. The demographic variables and the clinical data of the patients were correlated to the imaging findings. Data analysis was done using IBM SPSS Statistics for Windows Version 20.0. Results: 60.6% of the patients referred for the evaluation of acute headache had abnormal MRI findings. Nonspecific white matter lesions (which neither explain the reason for acute headache nor alter patient outcome and management) were the most frequently observed radiologic diagnosis (16%), followed by neoplasms (11.1%) and infections (7.7%). Tuberculoma was the most frequently diagnosed infectious cause. The majority of patients with comorbid illnesses (hypertension and HIV) had abnormal imaging findings. Age had a weak but significant positive correlation with abnormal imaging findings. Conclusion: The findings suggest that acute headaches are frequently associated with significant underlying pathologies, particularly in older patients and those with comorbidities such as HIV or hypertension. The prominence of tuberculoma among infectious causes reflects the influence of local epidemiological factors. These results highlight the importance of targeted imaging protocols to enhance diagnostic accuracy and optimize patient management in resource-limited healthcare settings.
