Objectives This study was designed to assess the role of chest radiography for the diagnosis of pneumonia and assess the association of clinical characteristics with radiologic findings and predictors of hospitalization among children with severe community acquired pneumonia. Methods A prospective study was conducted on 122 children between ages of 3 month and 14 years admitted to pediatric emergency unit with diagnosis of severe pneumonia from September 1st to November 30th, 2017. Eligible children were subjected to chest radiography which was read by two senior radiologists independently (R1 and R2). Disagreements between R1 and R2 were resolved by a third senior radiologist (R3). Level of agreement between radiologists was assessed using Cohen's kappa coefficient. Clinical and laboratory parameters which could explain the variability in the duration of hospital stay were assessed using a linear regression mode. Independent predictors were assessed using multiple linear regression. Results The median age of the cohort was 10.0 months (interquartile range (IQR): 6.75–24.0); 76 (62.3%) were male. Nearly half, 63 (51.6%) did not have radiologic evidence of pneumonia. There was low level of agreement between R1 and R2 in reporting consolidation (kappa=0.435, p-value≤0.001), haziness (kappa=0.375, p-value≤0.001), and infiltration (kappa=0.267, p-value=0.008). Children with higher recorded temperature were more likely to have radiologic abnormalities suggesting pneumonia (p-value=0.033). The median duration of hospitalization was 3 days (IQR: 1-4 days); 118 (96.7%) were discharged with improvement. Height-for-age z-score (Coef.=0.203, R2=0.041, p-value=0.027); and hemoglobin level (Coef.=-0.249, R2=0.062, p-value=0.006) explained 4.1% and 6.2% of the variability in the duration of hospital stay, respectively. Conclusion Radiologic evidence of pneumonia was absent in half of the children with severe pneumonia. There was low agreement between senior radiologists in reporting chest radiographic findings, potentially necessitating harmonization activities to uniformly implement the WHO guidelines in reading chest radiographs.

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Background: Tikur Anbessa specialized hospital (TASH) is Ethiopia’s largest tertiary teaching and referral hospital admitting and treating surgical patients under various specialties. This study aims to analyze the magnitude and pattern of surgical admissions to this facility. Methods: A five-year Cross sectional retrospective analysis was done on all adult surgical admissions to TASH from Sept. 2010 to Sept. 2015. Results: There were a total of 8,698 surgical admissions of which, 4471 (51.4%) were male and 4227 (48.5%) were female with male to female ratio of 1.06:1. Their age ranged from 13 to 95, with mean age being 38.8 ± 16.2 years. Three thousand two hundred twenty two (46.5%) patients were from Addis Ababa. Of all admissions, 4706 (54.1%) were elective ones of which obstructive uropathy, 997(21.1%), esophageal diseases, 716(15.2%) and Urolithiasis, 573(12.2%) respectively are the top three. The rest, 3992 (44.9%), were emergency admissions, the top three ones being trauma, 1435(35.9%), appendicitis 281(7%) and Intestinal obstruction, 190(4.7%) respectively. General surgical (gastrointestinal, endocrine and vascular) cases account for 3414 (39.25%) of all admissions followed by urosurgical cases, 2114 (25.31%), cardiothoracic surgical cases, 1942 (22.33%), and neurosurgical cases, 1139 (13.1%). There were a total of 280 deaths with an overall mortality rate of 4% of which, 3.2% were from elective admissions and 5.2% from emergency ones. Mortality rate was the highest among neurosurgical patients being 6.3% followed by 4.3%, 3.8% and 3.5% in cardiothoracic, general surgical and urosurgical cases respectively. Conclusions: The admission pattern indicates quite a big number and diversity of cases though the bed capacity is limited. There are significant number of cases that could be treated at other secondary level hospitals. Trauma is the leading cause of emergency admissions and significant cause of mortality. We recommend increasing the number of beds, organizing separate trauma center and admitting only cases requiring tertiary level care. Keywords: pattern of surgical diseases; surgical admissions; Tikur Anbessa Specialized Hospital

BACKGROUND: The international literature on physicians’ knowledge regarding radiation dosages and risks due to computed tomography showed a widespread underestimation of diagnostic radiation doses. Hence, the objective of this work is to assess the awareness of pediatric residents and medical interns about pediatric CT dose and possible risks.METHODS: A cross-sectional study was conducted on May/2016 among year I to year III pediatric residents and 2015/2016 year medical interns attaching Pediatrics Department during the study period in Tikur Anbessa Specialized Referral and Teaching Hospital. Data was collected by distributing standardized structured questionnaires. Finally, after the data was checked for clarity and completeness, it was analyzed by using SPSS software.RESULT: While the majority (76.3%) of the residents and interns knew that children were more sensitive to radiation than adults, 93.7% did not know that there is currently no annual dose limit set for medical exposure of patients. The majority of the respondents (81.3%) know the risk of cancer from CT scan, but most (60%) of the respondents did not know that many imaging facilities still use adult doses for pediatric patients. Furthermore, 18.8% thought that magnetic resonance imaging involves ionizing radiation, and 8.9% of the physicians associated ultrasound examinations with ionizingradiation.CONCLUSION : Within resident group, since the level of clinical experience did not affect the outcome, we recommend that formal education and training on awareness of radiation with special concern on pediatric population is mandatory especially for pediatric residents and pediatricians who are major caretakers of children.KEYWORDS: Computed tomography, radiation exposure, awareness of radiation, pediatric CT dose, possible risks of radiation.