https://repository.ju.edu.et//handle/123456789/9929 2026-04-17T11:23:33Z https://repository.ju.edu.et//handle/123456789/9939 Barriers to optimal nutritonal therapy for Critically ill patients admitted to jimma university Intensive care units Embaye Arefayne; Mennur A. Background: Critically ill patients in Intensive Care Units are at high risk of malnutrition which worsens morbidity and mortality by increasing the risk of infection, prolonging mechanical ventilation and impairing wound healing. Despite the importance of optimal nutritional therapy in improving outcomes, its delivery is hindered by numerous barriers particularly in low-resource settings like Jimma University Medical Center. This qualitative study explored these barriers faced by healthcare professionals in providing optimal nutritional therapy to critically ill patients in Jimma University Medical Center Intensive Care Units. Methods: Semi-structured interviews were conducted with 13 healthcare professionals (nurses, residents, and a consultant) from various Intensive care units departments at Jimma University Medical Center. The interviews were audio-recorded and the data were transcribed verbatim and translated into English. A thematic analysis was used to analyze the data. Thematic analysis was used to identify key themes related to these barriers. Results: The study revealed multifaceted barriers to optimal nutritional therapy. Seven key themes emerged from the analysis: clinical and patient-specific factors (e.g., cultural and religious practices, patient comorbidities); communication barriers (e.g., language differences between staff and patients); knowledge and training gaps among healthcare professionals (compounded by the lack of standardized protocols for nutritional assessment and administration); lack of interdisciplinary collaboration; organizational and resource-based barriers (e.g., shortages of enteral feeding pumps and specialized nutritional formulas); socioeconomic constraints; and workload and personal attitudes. Conclusion: This study underscores the complex interplay of barriers to optimal nutritional therapy in Jimma University Medical Center Intensive Care Units. Addressing these challenges requires a multifaceted approach including targeted training programs for healthcare professionals, improved resource allocation (e.g., dedicated nutrition support teams), enhanced interdisciplinary collaboration, culturally sensitive care and systemic reforms such as integrating nutrition support teams into ICU care. Implementing these strategies can enhance nutritional therapy delivery and improve patient outcomes in critical care settings. I 2025-02-01T00:00:00Z https://repository.ju.edu.et//handle/123456789/9938 Clinical Profile and Outcome of Road Traffic Accident Patients Presenting to JUMC Emergency Department, South West Ethiopia Elias Hundessa; Gemechis Melkamu Road Traffic Accidents are incidents on a way or street open to public traffic. They contribute a significant amount of morbidity and mortality among all age groups. More than Eighty percent of road traffic deaths occur in middle-income countries. It causes major public health problems in the world especially in developing countries like Ethiopia; even though it is the major public health problem studies done on this topic in the study area is limited. Objective This study aimed at assessing clinical pattern and outcome of Road Traffic Accident patients presenting, to emergency department of Jimma University Medical Center from September 1 to November, 2024. Methodology Hospital based cross sectional study design was employed among RTA patients visiting Jimma University Medical center over 3 month period which included 247 participants. The data was collected using pretested checklist and analyzed using SPSS version 27. Descriptive statistics and binary logistic regression were computed. Results were reported in narrative texts, frequency, tables, bar graphs, pie chart and cross tabulation. Result The age distribution of the respondents revealed that 47.0% (n = 116) were aged 15-29 years. The majority of the respondents were male, comprising 57.5% (n = 142). Patients injured at night were significantly more likely to die compared to those injured during the day (AOR = 5.706, 95% CI: 1.201–27.116, p = 0.029). The absence of per-hospital care significantly increased mortality risk (AOR = 12.837, 95% CI: 2.238–73.636, p = 0.004). Patients with preexisting medical conditions had a significantly higher likelihood of mortality (AOR = 6.648, 95% CI: 1.243–35.55, p = 0.027). The analysis demonstrated a strong correlation between injury severity and mortality: Moderate injuries increased the odds of death by 7 times compared to mild cases (AOR = 7.515, 95% CI: 1.560–36.192, p = 0.012).Severe injuries were associated with a dramatic increase in mortality risk, with an odds ratio of 44 (95% CI: 9.49–210.117, p = 0.001) Conclusion In conclusion, this study highlights the vulnerability of young males, passengers, and pedestrians in RTAs, emphasizing the interplay of socio-demographic, clinical, and systemic factors. Higher mortality rate was found and the contributing factors require collaborative efforts from policy makers, communities and health care providers to reduce the burden of RTA in Ethiopia. Addressing gaps in pre-hospital care, safety compliance, and infrastructure is critical to reducing morbidity and mortality in resource-limited settings 2025-02-01T00:00:00Z https://repository.ju.edu.et//handle/123456789/9937 Clinical profile and outcome of patients diagnosed with Guillian barre syndrome at jumc Addis Ketema; Menur Abrar Background: Guillain-Barré Syndrome (GBS) is a severe neurological disorder with significant morbidity and mortality. This study aimed to assess the clinical characteristics, epidemiology, and outcomes of GBS patients at Jimma Medical Center (JMC) in Ethiopia. Methods: A retrospective and prospective study was conducted on GBS patients admitted to JMC between 2017 and 2024. Data on socio-demographics, clinical presentation, diagnostic findings, management, and outcomes were analyzed using descriptive statistics and survival analysis. Results: A total of 75 GBS patients were admitted, with a median age of 31 years (IQR: 24–42), and 66.7% were male. Most patients (76%) resided in rural areas. Antecedent events were identified in 56%, primarily upper respiratory tract infections (29.3%). The median time from symptom onset to admission was 5 days (IQR: 3–7). Ascending muscle weakness (85.3%) was the most common presentation, and 29.3% had respiratory muscle involvement. ICU admission was required in 50.7% of cases, and 25.3% needed mechanical ventilation. Only 2.7% received IV immunoglobulin, while the majority received supportive care. The in-hospital mortality rate was 18.7%, with significantly lower survival among mechanically ventilated patients (p = 0.021). Conclusions: GBS imposes a substantial burden at JMC, with high ICU admission and mortality rates. Limited access to immunotherapy and advanced care contributes to poor outcomes. Early diagnosis, improved supportive care, and increased awareness are essential for better management of GBS in Ethiopia and similar low-resource settings 2025-02-01T00:00:00Z https://repository.ju.edu.et//handle/123456789/9933 Clinical profile and outcome of st- segment Elevation myocardial infarction patients presented To jimma university medical center, jimma, Southwest Ethiopia: a two year retrospective study Abreham Assefa; Gelaw Hailemariam Background: ST-segment elevation myocardial infarction (STEMI) is one of the most deadly kinds of acute coronary syndrome (ACS), accounting for one of the leading causes of mortality worldwide. STEMI continues to raise internationally, with a major impact on low and middle-income countries, particularly Africa, due to inadequate healthcare infrastructure and patients' late presentation. Despite the expansion of the disease magnitude, clinical profile and outcome of STEMI is not thoroughly investigated in resource constraint settings like Ethiopia. Objective: The study was conducted to assess the clinical profile and outcome of patients presented with ST segment elevation myocardial infarction at JUMC. Method: A retrospective cross-sectional study design was conducted from STEMI patient’s medical chart record that fulfill the inclusion criteria using a structured questioner to assess the clinical profile and outcome at JUMC from November 1, 2022 to December 31, 2024. The collected data were checked, entered and analyzed using SPSS software version 27 and P-value less than 0.05 was considered as statistically significant. Result: A total of 73 patients were diagnosed with STEMI and met the inclusion criteria and included in the study. The M: F ratio was 3.88:1, with 58 (79.5%) being male. The median age was 60 years (IQR 45-70). A total of 62 patients out of 73, or 84.9% of the total, reported having chest pain. The average duration between the onset of symptoms and hospital presentation was 91.33 hours (3.8 days). Approximately 67 patients (91.8%) had echocardiography performed and 8.2% of patients had LVEF <30%. Every patient received dual antiplatelet (aspirin and clopidogrel), and 12.3% of patients received thrombolytic therapy. The in-hospital mortality was 13.7%. Predictors of in hospital mortality in JUMC were killip class (P=0.016) and major arrhythmias (P=0.04). Conclusion: The medical management of patients with STEMI was in accordance with international guidelines, even though only nine patients received thrombolytic and none received PCI. STEMI patients have a delayed presentation to the hospital from the onset of symptoms, and their risk profiles are comparable to those of the developed world, but their mortality rates are higher. Having an arrhythmia and higher killip class were found to be independent predictors of in-hospital mortality at Jimma University Medical Center 2025-02-01T00:00:00Z