Implementation of structured trauma training for first-year surgical residents in Ethiopia: a novel pilot program in a low income country.

Purpose: Curricula for surgical residents should include training in trauma care; however, such training is absent in many low income countries. At the largest surgical training institution in Ethiopia, a trauma training program was developed, integrated into the existing surgical curriculum, and implemented. This study was conducted to evaluate the trainees' response to the new program.

Clinical predictors of therapeutic laparotomy in anterior abdominal stab injuries: a multicenter study from low-income institutions in Ethiopia.

Purpose: Despite the high incidence of abdominal stab injuries, the rate of nontherapeutic laparotomies and the predictors of therapeutic laparotomies have rarely been studied in low-income settings.

Methods: This multicenter retrospective study involved three of the largest academic medical centers in central Ethiopia. All patients who sustained an anterior abdominal stab injury and underwent exploratory laparotomy, regardless of the intraoperative findings, were included over the 3-year course of the study.

Validation of the Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) scoring system for the diagnosis of acute appendicitis among Ethiopian patients: a multi-institutional observational study.

Background: Acute appendicitis is the most common surgical emergency in Ethiopian clinical practice. Although a multitude of scoring systems have been used in clinical practice, none have been universally validated. The purpose of this study was to validate the Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) scoring system in the Ethiopian context.

Free intraperitoneal air in infected pancreatic necrosis with intraperitoneal rupture: A rare presentation of a complex diseases.

Key Clinical Message: Among the multitude of causes for acute abdomen patients presenting with free intraperitoneal air, one almost never finds infected pancreatic necrosis as one of the culprits. In patients with risk factors for acute pancreatitis presenting with generalized peritonitis with free intraperitoneal air, consideration should be given to this often deadly entity.

Abstract: Acute pancreatitis is a morbid acute abdominal pathology that has been increasing in incidence in recent years.

Nonmalignant tracheal stenosis: presentation, management and outcome in limited resources setting.

Background: Nonmalignant tracheal stenosis is a potentially life threatening conditions that develops as fibrotic healing from intubation, tracheostomy, caustic injury or chronic infection processes like tuberculosis. This is a report of our experience of its management with tracheostomy, rigid bronchoscopic dilation and surgery.

Methods: Retrospective study design was used.

Perioperative mortality of emergency and elective surgical patients in a low-income country: a single institution experience.

Background: The perioperative mortality rate is an indicator of access to safe anesthesia and surgery. Studies showed higher perioperative mortality rates among low- and middle-income countries. But the specific causes and factors contributing to perioperative death have not been adequately studied in the Ethiopian context.

Giant gastric GIST with fast-growing mass after intra-tumoral bleeding.

Only a few instances of giant gastrointestinal stromal tumors and even fewer cases of such tumors with intra-tumoral bleeding have ever been reported. This report represents a case with both giant size and intra-tumoral spontaneous hemorrhage. Here a 42-year-old male patient presented with abdominal pain and abdominal distention of 5-month duration.

"A breach in the protocol for no good reason": a surgical antimicrobial prophylaxis experience in an Ethiopian academic medical center.

Background: An appropriately administered surgical antimicrobial prophylaxis decreases the rate of surgical site infections. Although evidence-based clinical practice guidelines have been published on surgical antimicrobial prophylaxis, the rate of adherence to the protocol and the impact of extending antimicrobial prophylaxis postoperatively is yet to be well elucidated.

Method: A total of general surgery and vascular surgery patients with clean and clean contaminated wound undergoing elective surgical procedures were included in the study.

Totally intramyocardial bullet in a clinically stable patient: a successfully managed case from a low income country.

Intra-cardiac retained bullets rare entities in clinical practice owing to the high mortality associated with it. We present a case of a 26-year-old male patient presented 24 days after sustaining a bullet injury to the left side of the chest. Intra-operatively totally myocardial bullet was found within the right ventricle and extracted successfully.

Retroperitoneal necrotizing soft tissue infections: A case report and literature review.

Necrotizing soft tissue infections of the retroperitoneal is a rare disease identity. Here we present a 50-year-old male patient who underwent surgical exploration for retroperitoneal necrotizing soft tissue infection. Postoperatively, he was put on broad-spectrum antibiotics.

Delayed distal pancreatectomy for isolated complete pancreatic disruption secondary to "trivial" blunt abdominal injury: A case report and literature review.

Pancreatic injury is a formidable diagnostic and therapeutic challenge owing to its relative rarity. Most injuries are from motor vehicle related injuries in blunt trauma patients. We present a 22-year-old male patient presented after sustaining a kick to the abdomen.

Acute pain management in the trauma patient population: are we doing enough? A prospective observational study.

Purpose: There is a strong correlation between trauma and pain. Pain increases the rate of depression, posttraumatic stress disorder, and even mortality in trauma patients.

Methods: This institution-based, provider-blinded and patient-blinded, observational study was conducted among trauma patients treated at kur Anbessa Specialized Hospital.

Determinants of satisfaction and self-perceived proficiency of trainees in surgical residency programs at a single institution.

Background: We aimed to identify factors contributing to training program satisfaction and self-perceived proficiency of residents in 5 integrated surgical residency programs within the same referral institution.

Methods: We conducted a cross-sectional survey including all senior surgical residents in all integrated sub-specialty and general surgery residency programs at Tikur Anbessa Specialized Hospital (TASH) in Addis Ababa, Ethiopia. Training programs were assessed on 6 educational components including operative case volume and diversity, intra-operative hands-on training, morning teaching sessions, seminars, ward rounds, and research opportunities.

Cost-effectiveness of screening mammography in a low income country: a Markov simulation analysis.

Background: Breast cancer is the most common cancer diagnosed in women. Screening mammography is the only imaging screening study for breast cancer with a proven. mortality benefit.

Experience with modified radical mastectomy in a low-income country: a multi-center prospective observational study.

Background: Modified radical mastectomy is the procedure of choice in centers with little to no radiotherapy services. Studying the in-hospital outcome and complications associated with the procedure is important in low-income countries.

Methods: This is a multi-center prospective observational study involving all patients operated with modified radical mastectomy with curative intent.