Background: Informed consent is the process by which a patient learns about and understands the purpose, benefits, and potential risks of a medical or surgical intervention and then agrees to receive the treatment. It is a legally required process before performing any medical or surgical procedure. In most setups where surgical services are being provided, most components of informed consent are not always complete. The aim of this study is to assess the quality of informed consent among surgical patients admitted to the surgical ward of SPHMMC (St. Paul's Hospital Millennium Medical College) from March 4 to April 12, 2019, G.C. Methods and Materials: This is an institution-based prospective cross-sectional study done on patients admitted to the surgical ward of SPHMMC from March 4 to April 12, 2019, G.C. A total of 135 patients were selected by simple random sampling and were interviewed after their surgeries and before discharge. Results: The informed consent form does not have any of the essential components of surgical informed consent. Out of 135 respondents, only 8.1% of the patients received the minimum required components of informed consent (a good quality informed consent). 85.9% were told their diagnosis, 55.6% knew the benefits of the surgery, and 60.7% knew the consequences of not doing the surgery. Only 26.7% of respondents received explanations about the risk of the procedure. 44.4% of patients were told alternative options of treatment. Conclusion:The quality of informed consent is poor in the surgical ward of SPHMMC. The hospital administration (surgical department) should develop a protocol on the amount of information disclosed to patients before surgery and train all medical personnel.

BACKGROUND: A lipoma of the small bowel mesentery is a rare clinical entity. It rarely causes intestinal obstruction mainly due to volvulus.CASE: We report a case of a 25 years old male who presented with acute exacerbation of abdominal pain, nausea and vomiting. Plain abdominal x-ray showed complete small bowel obstruction. At laparotomy, there was small bowel volvulus with a big yellow mass as an axis. Enbloc resection and end-to-end ileal anastomosis was done.CONCLUSION; Mesenteric lipoma are rare. They should be considered in cases of long standing abdominal pain.

BACKGROUND: Inpatient mortality is among regularly collected data in Key performance indicators in the Ethiopian healthcare system, and it is generally reported to the Federal Ministry of Health and is used as one of inpatient services quality indicators. This study was undertaken to identify the magnitude, causes and pattern of mortalities among patients who are admitted and treated in surgical wards in Saint Paul Hospital Millennium Medical College for a period of three years.METHODS: A retrospective review was done on all patients admitted and died in the Department of Surgery in St. Paul's Hospital Millennium Medical College from January 1, 2016–Dec 30, 2018.RESULT: There were 10,259 admissions over three years and out of which there were 350 deaths between 2016-2018 making a crudemortality rate of 3.41 %. The commonest mode of admission was for emergency conditions, 195(62.7%). Out of emergency admissions, 139 mortalities were from general emergency surgery and 75 patients died from elective general surgery admissions. Eighty-four (26.9%) patients had comorbidity and the commonest comorbidity was anemia 21(25%). The commonest possible cause of death was multi-organ failure secondary to septic shock, 159(51%). Mortality rate patterns along the three years (2016, 2017, 2018) showed 3.34% (112/3360), 2.87% (102/3552) and 2.92% (98/3347) respectively.CONCLUSION: The mortality rate of this study is much higher than global rates, but still there is a significant difference from other developing countries and also other researches in this country. Pattern of mortality did not show any difference across years of the study period.

<p class="abstract"><strong>Background:</strong> Head injury is the leading cause of death and disability worldwide and has become one of the highest community health problems worldwide including Ethiopia. This study aims to assess the magnitude and factors affecting the outcome of head injury patients at Addis Ababa burn and emergency treatment Hospital from 01 January 2018 to 31 December 2019.</p><p class="abstract"><strong>Methods:</strong> A retrospective review was conducted on a patient who had a head injury and visited Addis Ababa burn and emergency treatment Hospital, from 01 January 2018 to 31 December 2019.  </p><p class="abstract"><strong>Results:</strong> There were 2163 head injury patients making the incidence of head injury 29.6%. The commonest cause of injury is road traffic accidents accounting for 89 (43.8%) and most patients sustained blunt injury 65 (32%).The commonest computed tomography (CT)-scan finding was intracerebral hemorrhage in 51 (25.1%) patients. Most head injury patients 112 (55.2%) stayed less than 1 week and the commonest complication was meningitis that occurred in 56 (27.6%) of patients. On presentation to hospital 90 (44.3%) had a mild type of traumatic brain injury. There is a significant correlation seen between gender, occupation, and severe traumatic brain injury (TBI) with the outcome of head injury (p&lt;0.05).</p><p class="abstract"><strong>Conclusions:</strong> Early diagnosis and interventions contributed to the good outcome of the patient. Establishing trauma centers at least in major cities can improve the outcome of head injury patients, by giving early treatment and using ambulances which are used for transportation of laboring mothers also might facilitate early referrals of patients to best centers.</p>

Thyroid surgery is frequently complicated by hematoma collection, nerve injury, hypothyroidism and rarely infections but persistent discharge from the gland is unusual. We report a case of persistent sinus discharge from the thyroid of the patient who underwent thyroidectomy 5 years back. The patient had persistent discharge from the wound site along with recurrent swelling all the years afterward. Fine needle aspiration cytology proved it was recurrent papillary cancer. Swab culture from discharge showed no growth. Completion thyroidectomy with functional lymph node dissection was done and specimen was not harbouring any foreign body and biopsy showed recurrent papillary cancer. Although post thyroidectomy sinus discharges are usually secondary to foreign body or chronic inflammation like tuberculosis, the tumour itself can be considered as a cause.

BACKGROUND: Thyroid disease is a common disorder of the endocrine system worldwide. It is a common problem in developing countries, including Ethiopia. The aim of this study was to determine the burden and the pattern of thyroid disease in St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia.METHODS: A retrospective review of patients’ medical records over a two-year period, January 2013-december 2014, was done. OR log books, and individual patient medical records was used for the review. Data was analyzed with SPSS version 20.RESULTS: A total of 2201 general surgical operations were done in a two-year period. Of these, 250(11%) were for thyroid surgery. Records of 222(88.8%) patients were found and used for analysis. Females accounted for 91.4% with F: M ratio of 10.7:1. The common mode of presentations were anterior neck swelling (91.4%) and toxic (29.7%) and pressure symptoms(19.4%). The common physical findings identified were multi nodular goiter (57.2%), diffuse goiter (23.9%) and solitary nodule (5.8%). FNAC showed that Nodular colloid goiter was common diagnosis (68.5%). Neoplasms accounted for 15.9% of the diagnosis; of this follicular neoplasm make (54%) and papillary cancer (20%). Functionally, hyperthyroid goiter 28.8% and euthyroid goiters (64 %). Transient hypocalcaemia (3.2%) and hoarseness of voice (1.8%) were the commonest complications. There was no postoperative mortality.CONCLUSION: Hyperthyroidism and neoplasms make significant proportions of the patients. Follicular neoplasm is the commonest tumor. Morbidity and mortality rates are comparable to the literature.

Background Breast cancer is the most common cancer among women worldwide and in Ethiopia. Even though there are scattered studies in Ethiopia, no study has attempted to establish systematic knowledge in the area. Hence, we reviewed studies that examined the epidemiology, clinical and histological characteristics, and management of breast cancer in Ethiopia. Methods We searched PubMed, Google Scholar, and Science Direct without other restrictions from November 1, 2021, until June 20, 2022. The search keywords included various aspects of breast cancer, including epidemiology, clinical presentation, histological and molecular subtypes, and management. We followed the Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA) guideline to identify, search, extract articles, and report this systematic review. The protocol was registered in PROSPERO, ID: CRD42023403320. Results of the initial 883 studies identified, 20 studies included with 31,831 participants. from 20 included articles, 3 were community-based and 17 were hospital-based. In most reviewed studies, breast cancer is the most common cancer among women of Ethiopia. The most typical presenting symptom was a breast lump affecting the right breast. Most patients presented at a late stage and they are premenopausal age group. The commonest histology type is ductal carcinoma, that the most prevalent receptor was estrogen receptor positive, and the most common molecular subtype was Luminal A in pathology samples. Conclusion Breast cancer incidence is rising, and it accounts for the major cancer burden in the country. There is a need for additional awareness-raising and health education because delayed presentation are critical problems throughout Ethiopia. For planning and monitoring cancer patterns, comprehensive demographic and clinical data from a population or facility-based registry are needed in the regions.

Background Breast abscess is a prevalent cause of morbidity in women occurring in 0.4% to 11% of patients after mastitis. The majority are benign, but worrisome etiologies such as inflammatory cancer and concomitant immune-compromising diseases should be addressed when a non-lactating patient presents with a breast abscess. The problem is high among women in developing countries (1). The purpose of this study is to assess the magnitude, clinical presentation, and treatment of breast abscess patients at a tertiary hospital. Methodology A descriptive cross-sectional study was conducted on all patients treated for breast abscesses from September 2015 to August 2020. A retrospective review of the clinical records was performed to collect data on sociodemographic, clinical, and management data using a data extraction form. The collected data were then cleaned and entered into SPSS for analysis. Results Two hundred and nine patients were included in this study over 5 years and lactational breast abscess (LBA) is more prevalent,182 (87.1%) than non-lactational breast abscess (NLBA), 27 (12.9%). Bilateral breast abscesses occurred in 16 (7.7%) patients. Patients presented at a median duration of 11 days and had been breastfeeding for 2 or more months. A spontaneously ruptured abscess was detected in, 30 (14.4%) of the patients. Comorbidities identified include diabetes mellitus (DM) in, 24 (11.5%), Hypertension in, 7 (3.3%), HIV in, 5 (2.4%) of patients. All women were treated with Incision and Drainage and had a median volume of 60 mL of pus drained. Following surgery, all patients were given ceftriaxone in the immediate post-operative days and either cloxacillin,167 (80.3%), or Augmentin,41 (19.7%) antibiotics p on discharge. Follow-up data were available for 201 (96.1%) patients and the recurrence rate was 5.8%. Conclusions and Recommendations Lactational breast abscesses are more common than non-lactational breast abscesses, particularly in primiparas. DM is the most common comorbidity in non-lactational breast abscesses and health-seeking behavior should be improved given the delayed presentation.