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Biomedical subjects

M Shamebo

Publications and source records attributed to M Shamebo.

13 recordsLinked to original sources
PubMed1998

Clinical profile of Ethiopian patients with breast cancer.

This prospective study was designed to obtain information on demographic characteristics, clinical profile and problems related to early diagnosis and treatment of breast cancer in 72 Ethiopian patients. There were 62 females and 10 males, the female to male ratio being 6.2:1. The age range of the females was 21-82 (mean 41.8 +/- 12.8) years and that of the males' was 38-75 (mean 52.1 +/- 12.2) years. The time interval between the onset of breast-related symptoms to diagnosis varied from 2-108 (median 12) months. Infiltrating ductal and lobular carcinoma histologic types accounted for 85% and 11%, respectively, in 62 cases who had surgical biopsies. Surgery was performed in 46 cases out of whom only 21 cases received adjuvant treatment. Eighteen females refused mastectomy at some point before they came to our clinic with metastatic disease. After a median follow up duration of 36 (range 2-120) months, 29 cases were alive, 24 died and 19 were lost to follow up. The cause of death in 17 subjects (71%) was rapidly refilling pleural effusion and superimposed infection. Both females and males had similar clinical characteristics, except that, the males were older by 10 years. Moreover, the females in this series developed breast cancer at a younger age (72% were premenopausal) and 76% had advanced disease (Stages III and IV) at presentation, similar to females from other African countries. We suggest that the attitude of Ethiopian females towards breast cancer has to change through continuous but targeted public education.

Adult↗
PubMed1998

Deep venous thrombosis in a university teaching hospital, Addis Ababa, Ethiopia.

A five-year prospective study designed to obtain information on the demographic characteristics, risk factors and complications of deep venous thrombosis (DVT) in sixty six Ethiopians is reported. There were 44 females and 22 males with a female to male ratio of 2:1. Their age ranged between 13 and 80 (mean = 34 +/- 12.8) years. Fifty one subjects (77%) were below the age of 41 years. Sixty three cases (95%) presented with lower and three with upper limb DVT. In 26 females (40%) pregnancy and pregnancy-related conditions such as childbirth, abortions and Caesarean section were the risk factors for their DVT. Immobilisation was considered a risk factor in 12 cases (18%) and 12 other patients did not have an apparent risk factor for their DVT. Post-thrombotic syndrome was observed in 26% of the study population during the follow up period which ranged from two months to seven years (median = 1 year). Twelve per cent of the patients developed recurrent DVT and 9% had non-fatal pulmonary embolism. Venous thrombosis is common in Ethiopians and usually affects pregnant and young adults. The risk factors and complications observed were similar to those documented in the literature.

Adolescent↗
PubMed1996

Chronic lymphocytic leukaemia in Ethiopians.

One hundred and two cases of chronic lymphocytic leukaemia (CLL) were seen at the Tikur Anbessa (Black Lion) Hospital, in Addis Ababa, Ethiopia, from January 1982 to December 1994. The age range was 35-91 (mean 55.6 +/- 11.08) years. The male to female ratio was 3.6:1. The commonest symptoms were weakness, weight loss, fever and sweating. The commonest signs were lymphadenopathy, splenomegaly and hepatomegaly. Fifty six per cent had Rai stage III and IV, only three patients were in stage 0. Of those treated with chemotherapy, 22.0% and 48.8% achieved complete and partial remissions respectively. Twelve patients are still alive and on follow up for 2-138 (median 18) months, 69 are lost to follow up after 0-132 (median 3) months and 21 are dead 0.5-84 (median 2.8) months after diagnosis. Of those that died, 13 were in stage IV and five in stage III. The main causes of death were septicaemia of undetermined origin in eight and pneumonia in seven. Thus CLL is not a rare disease in this centre. Its presentations are similar to cases reported in the literature. Optimal treatment is not possible due to lack of chemotherapeutic agents and supportive care. Therefore, we suggest that referral centres be equipped for better management of CLL patients.

Adult↗
PubMed1996

Ocular manifestations of leukaemia in Ethiopians.

A prospective ophthalmic evaluation of 74 newly diagnosed and 34 old (on follow-up) leukaemic patients, carried out from March 1990 to December 1995 is described. Primary ocular involvement, that is leukaemic retinal infiltrates, were detected in 32% of the newly diagnosed. In contrast, none of the old leukaemic patients had this lesion. In 69% of the new and 21% of the old cases, secondary ocular manifestations of leukaemia were observed. The major secondary ocular manifestation of leukaemia in both groups was intra-retinal haemorrhage. A variety of miscellaneous ocular findings, such as cataract, pterygium, pingeculae, etc. were detected in 36% of all leukemics. These findings indicate the importance of a complete ophthalmologic evaluation in the diagnosis, follow-up and management of leukaemic patients.

Adolescent↗
PubMed1994

Acute leukaemias in adult Ethiopians in a teaching hospital.

Eighty-two consecutive cases of acute leukaemias in adult Ethiopians were admitted to the Tikur Anbessa (Black Lion) Hospital, a teaching and referral hospital in Addis Abeba, Ethiopia, from January 1982 to December 1992. These cases were studied to describe the clinical and haematological findings, response to therapy and prognosis. The age range was 13-78 (mean 29.6) years. The male to female ratio was 1.6:1. Acute myeloblastic (AML) and acute lymphoblastic (ALL) leukaemias occurred in 53.7% and 46.3%, respectively. The commonest symptoms were anaemia, fever and bleeding tendencies. The commonest signs were pallor, fever, sternal tenderness and purpura. Splenomegaly was more commonly seen in ALL patients. The haematological findings were anaemia (mean Hgb 6.35 g%), leucocytosis (mean WBC count 88,507/mm3) and thrombocytopenia (mean platelet count 31,700/mm3). Of the patients eligible for evaluation treated with chemotherapeutic agents, only 38.4% of ALL and 6.2% of AML achieved complete remission. Twenty-seven patients with ALL died from one day to 84 (median 1.0) months after diagnosis. Ten are lost to follow-up from two weeks to 36 (median 2.5) months, one is still alive 40 months after diagnosis. Thirty-nine of the AML patients died from one day to nine (median 0.3) months after diagnosis. Five are lost to follow-up from two weeks to two and a half (median 2.0) months. The causes of death were sepsis and bleeding, separately or in combination. Increasing numbers of acute leukaemia patients are being referred to this centre. Therefore, attempts should be made to equip it for the treatment of such cases.

Acute Disease↗
PubMed1992

Multiple myeloma in Ethiopians: analysis of 22 cases.

Twenty-two cases of multiple myeloma were seen in the Department of Internal Medicine, Tikur Anbessa (Black Lion) Hospital, a teaching and referral hospital in Addis Abeba, Ethiopia, from January 1983 to December 1990. The age range was 38 to 76 (mean +/- SD = 51.5 +/- 12.2) years; a third were in the fifth decade. The male:female ratio was 1.75:1. The common clinical findings were bone pain in 20 (91%), bone tenderness in 15 (68%), anaemia in 14 (64%) and spinal cord compression in 8 (36%). The erythrocyte sedimentation rate (ESR) was raised in 21. Serum protein was raised in 17 (77%) and hyperglobulinaemia was seen in 20 (91%). Serum uric acid, blood urea nitrogen (BUN) and calcium were elevated in 10, 8 and 5 patients respectively, Bence-Jones proteinuria and albuminuria were each found in 9 patients. All patients had radiological abnormalities; 9 had a combination of lytic lesions, osteoporosis and pathological fractures (41%). Ten patients presented in clinical stage III. Four patients are being followed after 3-84 (median 40.5) months; eight were lost to follow-up 1-8 (median 2.0) months after diagnosis. Ten patients have died after 1-55 (median 11) months. Multiple myeloma is not uncommon in Ethiopians. Except for a lower age at presentation, the clinical, haematological, biochemical, and radiological findings, and the response to therapy, are similar to those reported elsewhere.

Adult↗
PubMed1991

Chronic idiopathic thrombocytopenic purpura (ITP) in adult Ethiopians: clinical findings and response to therapy.

Between January 1982 and December 1989, thirty four cases of chronic idiopathic thrombocytopenic purpura (ITP) were seen in adult Ethiopians in the Department of Internal Medicine in-patient and haematology referral clinic, of Tikur Anbessa teaching hospital. Twenty three were females and eleven males; female to male ratio of 2.1:1. The age range was 13-57 years, with a mean of 24.9 years. The commonest manifestations were: purpura, epistaxis, gum-bleeding and menorrhagia. The duration of symptoms ranged from one month to over ten years (median 4.5 months). The platelet counts ranged from 4000/mm3 to 77,000/mm3 (mean - 19,200/mm3), haemoglobin 3.01 to 15.4 gm/dl (mean - 8.2 gm/dl). Four (11.8%) patients were not treated; of these, one went into spontaneous remission. Thirty patients (88.2%) were treated with prednisolone 1.0 to 1.5 mg/kg/day orally. Of these, 7 (23.3%) had excellent, 2 (6.7%) good, 6 (20%) fair, and 15 (50%) had poor responses. Ten patients had splenectomy with 5 (50%) excellent 2 (20%) good, 2 (20%) fair and 1 (10%) poor response. One patient with refractory ITP was treated with immunosuppressive drugs and had an excellent response. Fifteen patients are alive and on followup 3-122 months (median 33 months) after diagnosis, fifteen are lost after followup of 1-66 months (median 9 months) and four have died 1-18 months (median 2 months) after diagnosis. Chronic ITP is frequently seen in adult Ethiopians, its clinical features and response to therapy are similar to those reported in the literature.

Adolescent↗
PubMed1990

Human immunodeficiency virus (HIV) infection in patients with lymphoid neoplasia.

Fourty-four patients with lymphoid neoplasia 37 males and 7 females aged 15 to 75 years, were seen in the Department of Internal Medicine, Tikur Anbessa (Black Lion) Hospital, Addis Ababa, Ethiopia, between January and December 1988. Twenty-seven (61.4%) had non-Hodgkin's lymphoma, eleven (25%) Hodgkin's disease and six (13.6%) chronic lymphocytic leukaemia. Six (22.2%) of the non-Hodgkin's lymphoma one, (9.1%) of the Hodgkin's disease and none of the chronic lymphocytic leukaemia cases had positive enzyme linked immunosorbent assay (ELISA) and Western Blot tests for human immunodeficiency virus (HIV) infection. Of the 6 non-Hodgkin's lymphoma patients with HIV infection, five had extra-nodal involvement--four of the gastrointestinal tract, including the oropharynx, and one of the cervix uteri. Four of these six had clinically advanced disease at the time of presentation and histologically three patients had intermediate and three high grade malignancy. Two of the patients have died within two months of diagnosis, one is lost to follow up, and three patients are still alive and well 12 to 46 months after diagnosis. The HIV positive patient with Hodgkin's disease had stage IV E disease involving the pancreas with mixed cellularity histology, and died seven months after diagnosis. Diffuse, aggressive non-Hodgkin's lymphoma and possibly atypical aggressive Hodgkin's disease, may be indicator diseases for AIDS in HIV seropositive individuals.

Adolescent↗
PubMed1990

Leukaemia in adult Ethiopians.

The pattern of leukaemias in adult Ethiopians admitted to Tikur Anbessa (Black Lion) Hospital, a teaching and referral hospital in Addis Ababa, Ethiopia, from January 1982 to December 1987 [corrected] is analyzed. There were a total of 7969 medical admissions, of which 180 (2.3%) were for leukaemia. The age range was 14 to 80 years, with a mean of 37.6 years. The male:female ratio was 2.3:1. The commonest type of leukaemia was chronic myeloid leukaemia (CML) 57.8%, acute leukaemias and chronic lymphatic leukaemia (CLL) accounted for 21.1% each. Of the acute leukaemias, 53.3% were lymphoblastic (ALL) while 46.7% were acute myeloblastic (AML). Most patients came from Addis Ababa (30.6%) and Shoa (28.9%) regions. The overall incidence of leukaemia in Addis Ababa population was estimated at 1.95 +/- 0.79/100,000/year at 95% confidence interval. The purpose of this study is to attempt a detailed description of leukaemias in Ethiopian patients and compare the findings with similar studies from other countries. Leukaemias are commoner than previously thought, and warrant further study in the community so that management, especially of acute forms, can be improved.

Adult↗
PubMed1989

Angio-immunoblastic lymphadenopathy with dysproteinaemia in an Ethiopian: case report and literature review.

A thirty year-old man with angio-immunoblastic lymphadenopathy (AILD) is presented. This is the first case recorded from Ethiopia, and few have been reported elsewhere in Africa. The patient presented with generalized lymphadenopathy, fever, weight loss, pruritus, skin rashes, anaemia, hepatomegaly and pulmonary infiltrates. Lymph node histology was typical of AILD. The available literature on this relatively new pathologic entity reveals that little is known about the nature of AILD, and since there is no established therapy, an individualized approach to management is advisable.

Adult↗
PubMed1982

Dialysis induced hypoxemia.

We investigated the mechanism by which hypoxemia is produced in patients on dialysis by studying changes in neutrophil count, blood gases and pulmonary function in a patient with only trace amounts of circulating C3 associated with Type II mesangiocapillary glomerulonephritis and a control group of 6 patients with normal C3 levels during a 4 hour hemodialysis. Fifteen minutes after the start of dialysis the neutrophil count fell to 13% of pre-dialysis values in the control group while it only fell to 71% in the study patient. A further fall to 47% occurred in the patient at 30 minutes. A drop in PaO2 by 15% of initial values occurred at 15 and 30 minutes in the controls and the patient respectively matching the trend of fall in the neutrophil count. PaCO2 fell sharply across the dialysis membrane with reciprocol changes in the dialysis bath. Alveolar oxygen tension showed a significant reduction starting at 15 minutes correlating with the reduction in PaO2. The A-a O2 gradient was not altered significantly. These data strongly suggest that the principal mechanism leading to hypoxemia during dialysis is hypoventilation resulting from CO2 loss into the dialysis bath. Complement mediated pulmonary leucostasis may play a secondary role in inducing a quicker fall in PaO2 in the early part of dialysis.

Adolescent↗
PubMedDate not supplied

Blood pressure variation among Ethiopians on the Simien Plateau.

This report presents information on determinants of blood pressure variation in a rural sample of 263 Ethiopian highlanders 14-86 years of age, resident at 3530 m on the Simien Plateau. Mean systolic and diastolic blood pressures for males and females were 109/ 75 and 106/73, respectively, and there were no age differences. These findings confirmed that men and women can have low normal blood pressure throughout adulthood. Blood pressures increased with increasing body mass index (BMI) among adult males, although the mean BMI of 19.1 kg/m2 was low compared with US values. This illustrates that BMI variation may be associated with blood pressure variation in men even at low mean values of both. Blood pressure did not vary with adult haemoglobin concentration.

Adolescent↗