Search

Alemayehu Tegegne Tefera,1 Kaleab Habtemichael Gebreselassie,1 Feysel Hassen Issack,1 Ashenafi Aberra Buser,2 Ferid Ousman Mummed,1 Masresha Solomon Dino,1 Fitsum Gebreegziabher Gebrehiwot1 1Department of Surgery, Urology Unit, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia; 2Department of Radiology, St. Paul’s Hospital Millennium Medical College, Addis Ababa, EthiopiaCorrespondence: Kaleab Habtemichael Gebreselassie, Department of Surgery, Urology Unit, St. Paul’s Hospital Millennium Medical College, PO Box 59004, Addis Ababa, Ethiopia, Email Kaleab528@gmail.com; kaleab.habtemichael@sphmmc.edu.etAbstract: Supernumerary kidney is a rare anomaly of number where commonly a third extra kidney exists with its own collecting system, blood supply, and encapsulated parenchyma. However, an extremely rare and unique diagnosis of bilateral supernumerary kidneys is also reported in few instances where two extra kidneys exist on each side of the body. Parenchymal fusion and the presence of good excretory function make the supernumerary kidneys even rarer as many of the reported cases are rudimentary organs. We present a 35-year-old man with a sudden onset of agonizing right flank pain and tenderness. Radiologic assessment with computed tomography showed bilaterally fussed and malrotated supernumerary kidneys with an obstructive stone and good contrast uptake. The patient has four fully functional kidneys (two on each side) with their own arterial supply, venous drainage, collecting system and incompletely duplicated ureters bilaterally. An open pyelolithotomy is performed to relieve pain and hydronephrosis. The patient’s symptoms improved after surgery and during subsequent follow-up.Keywords: bilaterally fused supernumerary kidneys, supernumerary kidney, malrotation

Hepatic pregnancy, an exceedingly rare subtype of abdominal ectopic pregnancy, remains clinically challenging due to its infrequency, diverse presentations, and diagnostic difficulties. We report the clinical course, diagnostic journey and treatment of a woman with a primary hepatic pregnancy. The patient presented with acute pain in the right hypochondrium and vomiting. Imaging revealed a peripheral hypodense gestational sac within the right hepatic lobe containing a fetus with heart pulsations, as well as peritoneal fluid and pelvic collection. Following administration of mifepristone, the patient underwent a laparotomy, and expelled a developed fetus. Hepatic resection utilizing the Pringle maneuver was performed, and methotrexate was administered postoperatively. The patient had a stable recovery and vital signs and was discharged two days after surgery. This case highlights the diagnostic and management challenges of hepatic pregnancy, and emphasizes the need for heightened clinical suspicion and thorough evaluation. By sharing the experience, we aim to contribute insights to guide the diagnosis and management of similar cases., (© 2024 The Authors.)

Background: St. Paul's Hospital Millennium Medical College (SPHMMC) has offered radiology specialty training for a decade. To mark its 10th anniversary and assess the program's status, this study aimed to gather stakeholders' perspectives on its functioning., Methods: The assessment was conducted from June 15 to July 5, 2024, using a stratified cross-sectional study design. A total of 211 participants were recruited through exhaustive sampling from alumni, faculty, students, referring physicians, and patients. Data were collected via web-based and paper-based questionnaires, where stakeholders rated the core functions of the SPHMMC radiology program (curriculum, teaching, research, and imaging practices) on a 5-point scale and provided additional feedback., Results: Overall, 78% of stakeholders regarded the program's curriculum as highly relevant. However, teaching quality and research were viewed negatively, with only 19% and 11% of radiologists rating these aspects positively. Referring physicians considered radiology reports relevant (68%) but often found them incomplete and untimely (73%), with only 2% deemed timely. Over 80% of patients expressed dissatisfaction with the imaging services and were unwilling to recommend them., Conclusions: While positive perceptions of the curriculum and imaging services suggest program strengths, the negative feedback on teaching and research quality indicates the need for improvements to maintain SPHMMC's commitment to quality education and services., (© 2024 Kumlachew Abate Mekonen, et al.)

Background: Saint Paul's Hospital Millennium Medical College (SPHMMC) is one of Ethiopia's premier radiology training institutions. This study aimed to trace graduates of SPHMMC's radiology program and examined their career outcomes and perspectives on the training received., Methods: A cross-sectional study design was employed, recruiting 78 participants. Data on employment status, career outcomes, job satisfaction, and perceptions regarding the program's strengths, weaknesses, and curriculum relevance were collected through a web-based questionnaire from May 31 to June 8, 2024. SPSS version 26 was used for data processing and analysis., Results: The study revealed a high employment rate among SPHMMC radiology graduates, with 97% employed and 75% securing jobs within one month of graduation. Most graduates held permanent positions (86%) as radiology specialists, sub-specialists, and academicians. There was notable regional variation, with 65% working in Addis Ababa. Job satisfaction levels were 79% for radiology careers and 53% for current jobs. Satisfaction with the program overall and curriculum relevance was 69% and 96%, respectively., Conclusions: High employment rates, and career and curriculum satisfaction levels might be reflective of the high market demand for radiologists in Ethiopia and the effectiveness of SPHMMC's radiology program in preparing graduates for professional careers. The regional disparity in radiologist distribution suggests underlying systemic issues that require further investigation., (© 2024 Alemayehu Bedane, et al.)

Background: Radiology is an essential component of modern medicine and a rapidly evolving research field. The nature and dynamic of radiology research in Ethiopia remained largely unexplored This bibliometric scoping review was done to explore the current state of radiology research in Ethiopia., Methods: Literature search was conducted using PubMed, Scopus, Embase, Web of Science, and Google Scholar from inception to June 15, 2024. Study screening, review, and selection were performed using EndNote Reference Manager. The key indicators assessed include publication trends, research themes, publication utility, contribution and collaboration of individuals and institutions, and journal metrics. Statistical analysis was done using R and VOS viewer software., Results: Though low in volume, radiology research publication is increasing in Ethiopia, with 241 publications from 1968 to 2024, accounting for 0.03% of the global radiology research output. Top contributing institutions were Addis Ababa University, Jimma University, and St. Paul's Hospital Millennium Medical College. The studies were largely focused on case-reports, cross-sectional studies, and diagnostic imaging. Systematic reviews, meta-analyses, artificial intelligence and trials constituted only 3% of the studies. Most publications (96.7%) were done by academic institutions. Most frequently used journals were Ethiopian Medical Journal and Ethiopian Journal of Health Sciences, accounting for 29% and 15% of the total publications, respectively. Publications in Q1 journals was 12%. International collaboration was 7%, with the USA being the primary collaborator., Conclusion: To elevate the quality and impact of radiology research in Ethiopia, it is crucial to adopt contemporary and robust research methodologies, align research topics with global trends and technological advancements, and foster enhanced collaboration and productivity within the research community., (© 2024 Ashenafi Aberra Buser, et al.)

Background: Perianal fistula refers to an abnormal connection between the anal canal and the perianal skin or perineum. Magnetic Resonance Imaging (MRI) plays a crucial role in accurately characterizing perianal fistulas, which informs surgical strategies and helps minimize recurrence., Methods: This cross-sectional study was conducted at a single diagnostic imaging center in Addis Ababa, utilizing retrospectively collected data from May 2023 to June 2024. All patients referred for suspected perianal fistulas were included. MRI scans were reviewed by a radiologist in body imaging fellowship and a body imaging subspecialist. Findings, along with sociodemographic data, were documented in a structured questionnaire and analyzed using SPSS., Results: The study encompassed 304 primary fistula tracts in 276 patients, with 233 (84.4%) being male. Complex fistulas were identified in 83 patients (30.1%), 43 (15.6%) had secondary extensions, and 64 (27.1%) presented with abscess collections. The most common type of fistula, according to the Parks classification, was intersphincteric, observed in 263 cases (86.5%). The St. James University Hospital grades 1 and 2 were predominant, representing 176 (57.9%) and 62 (20.4%) of the cases, respectively. A significant association was found between complex fistulas, higher Parks grades, and the total length of the fistula tract., Conclusion: This study elucidates MRI patterns of perianal fistulas, revealing that over one-third of patients had complex fistulas. This underscores the importance of preoperative MRI for effective surgical planning and reducing recurrence rates., (© 2024 Semira Abrar Issa, et al.)

Background: Prostate cancer is a leading cause of cancer-related mortality among men, second only to lung cancer. Prostate magnetic resonance imaging (MRI) utilizing the Prostate Imaging and Reporting Data System (PI-RADS) v2.1 scoring system effectively stratifies patients by risk and correlates significantly with histopathological outcomes. This study aimed to assess the positive predictive value (PPV) of high-grade PI-RADS v2.1 MRI findings and their correlation with histopathological results from biopsies in patients visiting the interventional radiology unit at St. Paul's Hospital Millennium Medical College (SPHMMC)., Methods: A facility-based cross-sectional study was conducted involving patients referred to the SPHMMC interventional radiology unit with high-grade PI-RADS v2.1 MRI findings who underwent TRUS-guided prostate biopsy between January 2023 and April 2024., Results: Among 105 patients, the PPV was 94.5% for a PI-RADS v2.1 score of 5 and 51.5% for a score of 4. These findings underscore the predictive power of high-grade PI-RADS scores, particularly for score 5 lesions, aiding clinicians in decision-making for further investigations and treatment. Significant correlations were observed between MRI characteristics-such as ill-defined margins, larger size, and extraprostatic extension- and high-grade PI-RADS scores in the peripheral zone (p<0.01)., Conclusion: High-grade PI-RADS v2.1 scores exhibit strong positive predictive value for detecting prostate cancer, emphasizing the essential role of multiparametric MRI in diagnosis. Integrating multiparametric MRI findings with clinical and laboratory data can further enhance patient care and outcomes., (© 2024 Abdudin Heru Mehammed, et al.)