LECTURE NOTES 
                                       
                              For Health Officers 
                                       
                                       
                                       
                                        
                    Internal Medicine 
                                        
                                        
                                       
                                       
                                       
                                             
                                       
                                       
                                       
                                   Editors 
                           Getachew Tizazu, M.D.. 
                              Jimma University 
                        Tadesse Anteneh, M.D., M.P.H. 
                             Hawassa University 
                                       
                                    2006 
                                       
             In collaboration with the Ethiopia Public Health Training Initiative, The Carter Center, 
                 the Ethiopia Ministry of Health, and the Ethiopia Ministry of Education 
                                       
          
          
          
          
          
          
          
                                        
             Funded under USAID Cooperative Agreement No. 663-A-00-00-0358-00. 
                               
                               
          Produced in collaboration with the Ethiopia Public Health Training Initiative, The Carter 
            Center, the Ethiopia Ministry of Health, and the Ethiopia Ministry of Education. 
          
          
          
          
          
          
          
          
         Important Guidelines for Printing and Photocopying 
         Limited permission is granted free of charge to print or photocopy all pages of this 
         publication for educational, not-for-profit use by health care workers, students or 
         faculty. All copies must retain all author credits and copyright notices included in the 
         original document. Under no circumstances is it permissible to sell or distribute on a 
         commercial basis, or to claim authorship of, copies of material reproduced from this 
         publication.  
          
         ©2006 by Getachew Tizazu, Tadesse Anteneh, Yoseph Mamo, Zenebe Assefa, 
         Abere Bekela, Woldnecherkos Abebe, Fetih Mohammed, Tesfaye H/Tsion, 
         Girma Tesfaye, and Dejuma Yadeta 
          
         All rights reserved. Except as expressly provided above, no part of this publication may 
         be reproduced or transmitted in any form or by any means, electronic or mechanical, 
         including photocopying, recording, or by any information storage and retrieval system, 
         without written permission of the author or authors. 
          
          
          
          
          This material is intended for educational use only by practicing health care workers or 
                    students and faculty in a health care field. 
         
                                        
                                  PREFACE 
                                        
        Internal medicine is a vast and complicated field that is based on strong scientific and clinical 
        foundations. Moreover it is rapidly evolving and one needs periodic updating and catching up with the 
        state of the art knowledge.   
        Providing a comprehensive review of internal medicine is not only difficult but almost impossible, as 
        the field is vast and extensive. Despite this limitation, the authors have tried to provide a basic 
        framework for working knowledge of Internal medicine. Essential topics are included as much as 
        possible, and some chapters and topics are dealt extensively, such as Infectious diseases in general 
        and Acute febrile illnesses, Tuberculosis, and HIV/AIDS in particular, as these are known to be the 
        commonest causes of morbidity and mortality in developing countries, like ours.  
        Even though a number of individuals have contributed in the original document of this lecture note, as 
        more than 3 years have elapsed, most of the topics are reviewed, and some topics are completely 
        rewritten, to include new developments and the state of the art scientific knowledge. 
        This lecture note has been written primarily for Health officer students; however it can also be used by 
        medical students and all other health science students who deal with patients, who have medical 
        illnesses. 
                          Getachew Tizazu 
                                                               & 
                          Tadesse Anteneh  
         
         
         
         
         
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                       ACKNOWLEDGMENTS 
       
      The editors are very grateful to all the medical professionals from Jimma, Hawassa, and Haramaya 
      Universities, who have contributed in different ways to help develop this lecture note.  
      Our special thanks go to the contributing authors, who took time from their very tight schedules, to 
      prepare the draft lecture notes, in different topics. We sincerely appreciate the effort of the reviewers 
      who have given their valuable comments and inputs during the initial within University review, and the 
      subsequent joint reviews conducted at the Carter center, in Addis Ababa. 
      We are mostly indebted to Dr. Akilu Azaje, Assistant professor of Internal medicine, in the department 
      of Internal Medicine at the Medical faculty of Addis Ababa University, who has reviewed the first draft 
      lecture note, for his guidance and outstanding comments and valuable inputs. 
      We would like to thank Dr. Tekabe Abdosh, who reviewed some topics of this lecture note.  
      We also thank all the staff of the Carter center, Ethiopia for their hospitable hosting and assistance 
      during the development of the lecture note.  
      Last but not least our deepest gratitude extended to Ato Aklilu Mulugeta, for his tremendous effort, 
      close follow-up and contribution in facilitating the completion of this lecture note.  
               Getachew Tizazu, M.D. 
                & 
               Tadesse Anteneh, M.D. 
       
       
       
                                 
                                 
       
       
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