IntroductionAbdominal pregnancy is a rare form of ectopic pregnancy with very high maternal and fetal morbidity and mortality. A high index of suspicion is crucial for prompt diagnosis and management especially in low-resource countries.Case presentationA 32-year-old gravida III para II Amhara woman presented with shortness of breath and progressive abdominal distension and pain. An emergency laparotomy was performed with the impression of abdominal pregnancy. Intraoperatively, the fetus was seen in an intact amniotic sac in her abdomen, her uterus was ruptured at the fundus and the placenta was extensively adhered to the edge of the ruptured site. The patient and neonate progressed well and were discharged.ConclusionsTerm abdominal pregnancy is an extremely rare diagnosis and requires a high index of suspicion. The life-threatening complication is bleeding from the detached placental site. A thorough examination of the newborn is important to rule out congenital anomalies.

Background: Family planning is defined as the ability of couples or individuals to attain their desired number of children, spacing, and timing of their births with the use of contraceptive methods. Ethiopia is one of the most populated countries in Africa with a high fertility rate, a highly unmet need for family planning, and low contraceptive utilization.Objective: This study aims to assess modern contraceptive method utilization and associated factors among women of reproductive age in Gondar City, Northwest Ethiopia. Materials and Methods: A community-based cross-sectional study design was undertaken with 708 women in the reproductive age in Gondar City, using a structured questionnaire combined with face-to-face interviews. Descriptive analysis, binary, and multivariable logistic regression analyses were applied to analyze the data. Results: In this study, 41.2% of the respondents utilized modern contraceptive methods. Of the study participants, 52.1 % had good knowledge and 45.3% had a favorable attitude towards modern contraceptive methods. After adjusting for covariates, the odds of using modern contraceptive methods were 3.6 times, 4.7 times, 2.4 times, and 4 times higher among women of the age 20-24, 25-29, preparatory education, and degree holders, respectively. In addition, for the women having up to six desired children [AOR (Adjusted Odds Ratio) = 2.4 (95% CI: 1.1, 5.3)], a history of no-child death experience [AOR= 4.4 (95% CI: 1.03, 19.1)], good knowledge [AOR= 4.1 (95% CI: 2.7, 6.0)], and favorable attitude [AOR= 3.5 (95% CI: 2.4, 5.1)] were positively associated with modern contraceptive utilization. Conclusion:The majority of participants had good knowledge about, but the unfavorable attitude towards the utilization of modern contraceptive methods. Therefore, the authors recommended that special awareness creation with the help of health education interventions should be employed in the community.

Use of long-term herbivory studies in understanding the effects of livestock grazing on dwarf shrubs of arid zones of Africa is uncommon. Moreover, research has seldom focused on monitoring a 4-5 yr effect of herbivory at the level of individual plants. This study provided information on field-based experiments and simplified statistical modeling to test compensatory growth responses of individuals of the African dwarf shrub Indigofera spinosa in northwestern Kenya. From August 1986 to January 1990, we simulated livestock grazing during dry and wet seasons and over the full year, whereby plants were defoliated during both wet and dry seasons. Individuals of I. spinosa (n ϭ 480 plants) were subjected to one of five clipping intensities: unclipped control (0%), light (30%), moderate (50%), severe (70%), and very severe (90%) clipping; and defoliated of regrowth (i.e., new biomass). Our findings showed that rainfall, clipping regimes, and seasons of treatment influenced the compensatory growth response. Rainfall more than residual biomass influenced regrowth, while plants with greater residual biomass produced more regrowth than those with less. Optimum residual biomass was achieved under the 30% clipping level, while least was maintained under the 90% level. We separated compensatory growth response into under-and overcompensation. We showed that overcompensation occurred under some conditions but not in others. The shrub displayed relative overcompensation with a compensatory ratio (CR) Ͼ 1.0 for three continuous years with light clipping regime during the wet season defoliations (WSD). In two of five years there was overcompensation with the dry season defoliations (DSD), but undercompensation (CR Ͻ 1.0) with full-year defoliations (FYD). On average, under the moderate, severe, and very severe clipping regimes the plants had undercompensation. Patterns of change of cumulative regrowth and its derivative, relative growth rates (RGR), provided different compensatory responses. RGR was more positive at lower cumulative regrowth but gradually declined and became negative when cumulative regrowth was maximum. The exception was in WSD where RGR remained positive for three years. DSD by far achieved greater cumulative regrowth than WSD and FYD. However, compared to the controls, FYD (except under light regime) exactly overcompensated for total ''biomass budget'' while WSD overcompensated under all clipping regimes except very severe. DSD under the light and moderate regimes overcompensated by ϩ343.6% and by ϩ202.7%, respectively. The study showed that I. spinosa combines tolerance with compensatory growth response to cope with a wide array of herbivory and seasons of use. The shrub may be grazed under light regime during the wet and dry seasons as opposed to the full-year grazing which is unsustainable.

Background: Although there are limited studies, recent data are lacking to determine the prevalence of eye problems in Ethiopia accurately and there is no scientific evidence of such study in Sekela Woreda. The purpose of this study was to determine the prevalence of visual impairment among school children in Sekela Woreda, Ethiopia. Methods: The study design was a community-based analytical cross-sectional with a multi-stage cluster random sampling technique from September to November 2016.Visual acuity was tested using Snellen’s “E” chart while color vision was tested using Ishihara chart. The data were analyzed using SPSS version 20 software, and binary logistic regression was used to identify factors associated with visual impairment. Results: A total of 875 participants, 466 (53.3%) males and 409 (46.7%) females, with an age range of 8–18 years were screened for visual acuity and color vision deficiency. The prevalence of visual impairment (visual acuity ⩽ 6/12) in “either eye” was 70 (8.0%). Among these, 37 (52.9%) were males and 33 (41.1%) were females. The prevalence of low vision (visual acuity ) and blindness (visual acuity < 3/60) in “either eye” were 28 (3.2%) and 10 (1.1%), respectively. Thirty two (3.7%) had mild visual impairment . The prevalence of color vision deficiency was 36 (4.1%). Among these, 27 (3%) were males and 9 (1.1%) were females. The variables age (adjusted odds ratio (95% confidence interval) = 1.14 (1.01–1.28) and color blindness (adjusted odds ratio (95% confidence interval) = 3.93(1.69–9.09) were significantly associated with visual impairment. Conclusion: The prevalence of blindness and low vision in school children were higher than the national prevalence in Ethiopia. Increasing age and color defective vision were factors associated with the children’s visual impairment. The Woreda health office ought to work with responsible stakeholders to tackle the situation in early childhood.

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Background: Heart failure is the cumulative and progressive result of conditions that cause structural defects and functional abnormalities in the heart. It is affects at least 26 million people worldwide and is increasing in prevalence especially among hemodialysis patients with severe renal failure. Objective: To assess the incidence and predictors of congestive heart failure among hemodialysis patients at Felege Hiote Referral Hospital, Northwest Ethiopia. Methods: This institutionally based retrospective cohort study was undertaken among 205 hemodialysis patients of Felege Hiote Referral Hospital from January 1, 2016 to February 29, 2020. All eligible hemodialysis patients who fulfilled the inclusion criteria were included in the study. Data were entered using Epi-data Version 4.1 and analyzed using STATA Version 14. The survival time of hemodialysis patients was estimated using the Kaplan-Meier survival curve, and the survival time between different categorical variables was compared using the log rank test. Both bivariable and multivariable Cox-proportional hazard regression models were fitted to identify independent predictors of congestive heart failure among hemodialysis patients. Results: Among a cohort of 205 hemodialysis patients at Felege Hiote Referral Hospital, 12 (5.9%) developed congestive heart failure during the follow-up time. The overall congestive heart failure incidence rate was 2.9 per 100 person-years (PY) with 95% CI. The total time allotted to follow up the study participants was 4968 PY. Using multivariable Cox-regression analysis, we found that male sex, rural residence, no formal education, low body mass index (<18.5), presence of comorbidity, and anemia during dialysis initiation significantly increased the risk of heart failure. Conclusion: In this study, we found a high rate of congestive heart failure among hemodialysis patients. Factors significantly linked with increased risk of heart failure included male sex, rural residence, no education, low body mass index (<18.5), presence of comorbidity, and anemia during dialysis initiation. Early screening and treatment for heart failure are highly recommended at hemodialysis follow-up for patients with the above risk factors.

BackgroundOligohydramnios is a pregnancy condition characterized by low volume of amniotic fluid. Based on ultrasound measurement, it is defined as a single maximum vertical pocket of liquor less than 2 cm or summation of four quadrants vertical pockets of liquor measurement less than 5 cm. It is associated with multiple adverse perinatal outcomes (APO) and complicates 0.5%–5% of pregnancies.ObjectiveTo assess magnitude and associated factors of adverse perinatal outcome among women with oligohydramnios at 3rd trimester at University of Gondar Comprehensive Specialized Hospital, North West EthiopiaMethodsInstitution based cross-sectional study was employed from April 1 to September 30, 2021 in which 264 participants were involved. All women with oligohydramnios at 3rd trimester who meet the inclusion criteria were included. Semi- structured questionnaire was used for data collection after Pre-tested. Collected data was checked for completeness; clarity then coded and entered using Epi data version 4.6.0.2 then exported to STATA version 14.1 for analysis.ResultThe magnitude of APO was 46.6% (95%CI: 40.5–52.7%). Null parity [AOR =  2.2, 95%CI (1.2–4.2)], presence of hypertensive disorders of pregnancy (HDP) [AOR = 4.9, 95%CI (2.0–12.1)] and presence of intrauterine growth restriction (IUGR) [AOR = 8.4, 95%CI (3.5–20.2)] were found to be predictors of APO.ConclusionThird trimester oligohydramnios is associated with APO. The presence of HDP, IUGR and being nulliparous were predictors of APO.

Background The incidence of eclampsia and its adverse maternal outcomes are very high in developing countries, particularly in Subsaharan African Countries. Identifying predictors for adverse maternal outcomes of eclampsia has paramount importance for helping health care providers to optimize their management outcomes. Therefore, this study aimed to assess the incidence of adverse maternal outcomes of eclampsia and its determinant factors. Methods A retrospective follow-up study design was applied. The data were extracted from patient charts using a structured, pre-tested, questionnaire. Descriptive analyses (frequencies, means, and standard deviation) were calculated, and bi-variable and multivariable logistic regression models were used to testing the association between independent variables and an outcome variable. After the data were coded and entered into Epi-Info Version 7.2 Software, the data were analyzed using STATA Version 14 Statistical Software. Results The magnitude of eclampsia was 5.36 per 1000 pregnancies (95% CI: 4.72, 6.10). The incidence of adverse maternal outcomes in eclamptic mothers was 53.7% (95% CI: 47.02, 60.24%). After adjusting for covariates maternal age 30–34, AOR 5.4 [95% CI = 1.02, 28.6]; age above 34, AOR 10.5 [95% CI = 1.3, 88.6]; gravidity 2–4, AOR 0.3 [95% CI = 0.1, 0.9]; 10 or more convulsions, AOR 4.6 [95% CI = 1.4, 14.9]; mild pyrexia, AOR 20.4 [95% CI = 3.7, 112.7]; moderate pyrexia, AOR 14.6 [95% CI = 1.7125.1]; platelet count below 50,000 cells/mm3, AOR 34.9 [95% CI = 3.6, 336.2]; platelet count between 50,000 and 99,000 cells/mm3, AOR 24.5 [95%CI = 5.4111.6]; and stillbirth of the current pregnancy, AOR 23.2 [95%CI = 2.1257.5] were strong predictors of adverse maternal outcomes in eclamptic mothers. Conclusions The incidence of adverse maternal outcomes of eclampsia was found to be high compared to similar studies discussed in this study. This study recommends early identification of patients with the risk factors (having many convulsions, high body temperature, low platelet count, patient age above 30 years, and 2–4 pregnancies), strengthening the referral system, and advocation of research on the area of adverse maternal outcomes and thereby encourage evidence-based medicine.