జర్నల్ ఆఫ్ క్లినికల్ రీసెర్చ్

Background: Patients undergoing major lower limb amputation sometimes have complicating underlying comorbidities that are likely to have significant influence on post-operative morbidity and mortality and long-term psychological status. This necessitates the healthcare system to plan for the amputees’ needs to achieve best outcomes.

So we aimed to determine the outcomes of major lower limb amputation among patients at our Hospital.

Methods: A retrospective cross-sectional study was conducted using medical records of 75 patients who underwent major lower limb amputation between 1st January 2016 and 31st December 2020 at St. Francis Hospital Nsambya. Variables including socio-demographic characteristics (age, sex), clinical factors (mean arterial pressure, random blood sugar, glycated hemoglobin), causes of amputation (trauma, neoplasms, diabetes mellitus, peripheral arterial disease, infections, congenital anomalies) and short-term outcomes (re-amputation, length of hospital stay, in-hospital mortality) were collected from patients' files. Intermediate outcomes (utilization of physiotherapy services) and long-term outcomes (prosthetic use, functional return and psychological status) were collected through phone calls.

Results: only 2(3%) underwent re-amputation. In-hospital mortality was 10.7% with deaths registered only among those aged ≥ 50 years. Average length of hospital stay was 12.8 ± 8.4 days. Physiotherapy utilization was 85.3% and it increased with older age (p=0.002). 16(26.2%) utilized prosthetics with majority being males. Majority (62.3%) of amputees had been able to return to work; 73.8% were still married. Psychological status score ranged from 4 to 10 with mean of 7.5 ± 1.7.

Conclusion: Majority of patients had gained full functionality with good utilization of physiotherapy services which are very key in improving amputees’ quality of life, thus the high psychological status scores. However, we found a low prosthetic uptake among our patients.

Background; Traumatic brain injury is one in all the foremost devastating kinds of injury, and it leads to varied degrees of paralysis, loss of consciousness, cognitive state and even death. Head trauma accounts for the bulk of trauma deaths. Traumatic brain injury is taken into account a ‘silent epidemic, as society is essentially unaware of the magnitude of this drawback.

Objective: To assess the Prevalence of traumatic brain injury/TBI and its prognosis among patients admitted to TASH emergency department, Addis Ababa, Ethiopia, 2018.

Method: Institutional based retrospective, cross sectional study was conducted at TASH, from May 23, 2018 to June 20, 2018, Addis Ababa Ethiopia. Data was recorded on structured check lists through reviewing of patient chart retrospectively. The quantitative data was entered by using SPSS version 20.

Results: A total of 129 records were analyzed. Prevalence of head injury is 27.7%. The gender distribution is 106 males to 23 females, making the male to female ratio 5.6:1. The most commonly affected age group was from 16-29 years old. A total of 47 (36.4%) of the TBI patients came from the urban area. The causes of the TBI were fall down accident in 15.5%, interpersonal violence in 31.7%, and Road Traffic Accident (RTA) in 48%.

Conclusion: The risk factors were the male gender, motorcycle riding, trading, extremes of age and active night and day (afternoon) time period. The incidence rate was much higher than in the developed countries, but could reduce with the use of crash helmets, EMS care, speed limits and safety/protective vehicular devices, with better rehabilitation centers.

Purpose: The novel coronavirus pneumonia (COVID-19) has been global threaten to public health. This paper provides perspective to the decision-making for public health control of the pandemic or the spread of epidemic. Methods: According to the WHO global reported database, we developed and used the number of cumulative cases, and the number of cumulative deaths to calculate and analyze rates of incidence, mortality, and fatality by country, with respect to the 30 highest outbreak (Top 30) countries. Results: As of December 31, 2020, of the global population of 7.585 billion, the cumulative number of reported cases was 81,475,053, and the cumulative number of deaths was 1,798,050. The incidence rate of COVID-19 was 1074.13 per 100,000 population, the mortality rate was 23.70 per 100,000, and the case fatality rate was 2.21%. Among the Top 30 countries, the five countries with the highest number of reported cumulative cases were, in rank, the United States (19,346,790 cases), India (10,266,674), Brazil (7,563,551), Russia (3,159,297) and France (2,556,708), and the five countries with the highest number of cumulative deaths were the United States (335,789 cases), Brazil (192,681), India (148,738), Mexico (123,845) and Italy (73,604). Globally, the countries with the highest incidence rate were, in rank, Andorra, Luxembourg, Montenegro, San Marino, and Czechia; the countries with the highest mortality rate were, in rank, San Marino, Belgium, Slovenia, Italy, and North Macedonia. The highest fatality rate was found in Yemen, Mexico, Montserrat, Isle of Man, and Ecuador, respectively. In China, 96,673 cases of COVID-19 and 4788 deaths were reported in 2020, ranking the 78th and the 43rd, respectively, in the world. The incidence rate and mortality rate were 6.90/105 and 0.34/105, respectively, ranking 207th and 188th in the world. The case fatality rate was 4.95%, ranking 11th in the world. Conclusion: The COVID-19 prevalence is still on the rise, and the turning points of incidence and mortality are not yet forecasted. Personal protection, anti-epidemic measures and efforts from public health personnel, medical professionals, biotechnology R and D personnel, effectiveness of the vaccination programs and the governments, are the important factors to determine the future prevalence of this coronavirus disease.

Introduction: Burn is an injury resulting from extreme temperature, chemicals or electricity. Fire-related burns are the most cause of death for children. Infants are at high risk consisting a global rate ranging from 3.0 to 4.9 deaths per 100 000 population.

Methodology: The study involved children aged between 2 to 9 years who were admitted due to burn injuries from January 2014 to December 2018. The hospital based study was conducted and data were collected by using medical records.

Results: The totals of 9125 were admitted during the period and surgical conditions accounted about 12% of total pediatric admissions. Among these 291 were enrolled with M: F 1.8:1. Scald was the common cause of burn in this population 213 (73%), children of 2yeas were the most affected group by 32.3% (94) and the mortality rate was 1.7%.

Conclusion: Majority of childhood burn injuries at this hospital are scald and most affected children with two years of age which give a needs of community based education of children and infant protection from burn injury.

Background: The authors discuss the components of clinical research and GCP training programs in successful medical education curricula and introduce a development of clinical research scale first time for evaluation in medical and clinical pharmacology clinical research practices.

Methods: “Retrospective descriptive research” method was preferred for data collection and classification. The study group consists of third grade medical students who volunteered to be evaluated. These students were asked to fill in the form, and the pool of statements was compiled. Literature screening and expression pools selected words, were converted into sentences with attitude expression. A 5-point Likert-type scale consisting of 12 items was prepared through the questionnaire study. The scale study with 150 students was included. Sample size was calculated in order to evaluate the correlation of item total score.

Results: The sample size was “very good” (KMO=0.864). Barlett’s test of shericity (p<0.001) was significant. Cronbach’s alpha value of the scale was 0.91. This value indicates that the scale degree is in "very good" for reliability, validity and sample size. This scale is suitable for correlation matrix factor analysis; the sample adequacy degree is "very good". The reliability coefficient of Guttman (rt=0.830) and Spearman-Brown (rsb=0.831), which represent the scale divided into two, were found.

Conclusion: These GCP trainings can be included in the curricula and newly developed scale was able to evaluate students' attitudes towards clinical research and can be used in future education.

Research registration: “Retrospective descriptive research”