Medication-related problems among patients with cervical cancers at oncology centers of University of Gondar comprehensive specialized hospital: A hospital-based retrospective study.

INTRODUCTION: Though drugs play indispensable role in the treatment of cervical cancer, they are associated with medication-related problems (MRPs). Hence, the present study was aimed to investigate MRPs among patients with cervical cancer. METHODS: A hospital-based retrospective study was employed at the oncology center of University of Gondar Comprehensive Specialized Hospital. All patients with cervical cancer diagnosis from January 1, 2016 to December 31, 2020, were included. Stata version 16/MP for Windows was used for description and analysis. Logistic regression analysis was employed. RESULTS: A total of 124 patients with cervical cancer were included. Paclitaxel and cisplatin (69.4%) combination were the most widely used treatment regimen. MRPs were found in 59.7% patients, with a mean of 2.22 ± 1.13. Subtherapeutic dose (24.4%), the need for additional drug therapy (22.6%), and adverse drug reactions (22%) were the most prevalent MRPs. Being >50 years (adjusted odds ratio (AOR) = 15.37, 95% confidence interval (CI) = 2.25-105.09, p = 0.005), treated with ≥5 medications (AOR = 7.00, 95% CI = 2.65-18.49, p < 0.001), and being stage III (AOR = 15.43, 95% CI = 2.92-81.47, p = 0.001) and stage IV (AOR = 8.41, 95% CI = 1.35-52.44, p = 0.023) were independent predictors of MRPs. CONCLUSION: More than half of patients with cervical cancer had one or more MRPs. Being older, patients taking polypharmacy, stage III and IV patients were significantly associated with the development of MRPs. As most of the cervical patients experienced one or more MRPs, clinical pharmacy service should be strengthened to optimize drug therapy to reduce unwanted adverse events.

Management pattern and medication-related harms and its predictors in colorectal cancer patients: an institutional-based retrospective study.

Introduction: Data on colorectal cancer (CRC) patients' thorough management practices and medication-related harms (MRH) are scarce. This study's aim was to investigate the MRHs in patients receiving CRC chemotherapy at the comprehensive specialized hospital of the University of Gondar (UoGCSH). Methods: A registry-based retrospective cohort study was conducted on CRC patients at the UoGCSH during 2017-2021. From February to May 2022, medical records were reviewed using a pretested data collection tool to collect socio-demographic and disease-related characteristics, MRHs, and medication regimens. MRHs occurrence and adverse drug reactions (ADRs) severity were assessed using standard guidelines and protocols. Version 16/MP of STATA for Windows was used for the analysis. Independent predictors of MRHs were investigated using logistic regression analysis. A p-value ≤0.05 was used to determine an independent variable's statistical significance. Results: One hundred forty three CRC patients were included, with a mean age of 49.9 ± 14.5 years. About 32.9% and 33.6% had stage II and III cancer, respectively. Significant patients had co-morbidities (15.4%) and complications (13.3%). Fluorouracil (5-FU)-based regimens were given to more than half (56%) of the patients. MRHs were found in 53.1% of the patients, with a mean of 2.45 ± 1.37 MRHs. The most common MRHs were the need for additional drug therapy, sub-therapeutic dose, DDIs, and ADRs. Being on stage IV (AOR = 27.7, 95% CI = 3.85-199.38, p = 0.001), having co-morbidity (AOR = 7.42, 95% CI = 1.80-30.59, p = 0.018) and having complication (AOR = 11.04, 95% CI = 1.72-70.95, p = 0.011) and treated with five or more drugs (AOR = 2.54, 95% CI = 1.07-6.07, p = 0.035) were independent predictors of MRHs. Conclusion: A fluorouracil-based treatment regimen was most frequently used. MRHs were found in nearly half of CRC patients. Furthermore, MRHs were significantly associated with cancer stage, comorbidity and complication status, and the number of medications used. Because MRHs are common, improving clinical pharmacy services is critical for optimizing drug therapy in CRC patients.

Harnessing the potential of probiotics in the treatment of alcoholic liver disorders.

In the current scenario, prolonged consumption of alcohol across the globe is upsurging an appreciable number of patients with the risk of alcohol-associated liver diseases. According to the recent report, the gut-liver axis is crucial in the progression of alcohol-induced liver diseases, including steatosis, steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma. Despite several factors associated with alcoholic liver diseases, the complexity of the gut microflora and its great interaction with the liver have become a fascinating area for researchers due to the high exposure of the liver to free radicals, bacterial endotoxins, lipopolysaccharides, inflammatory markers, etc. Undoubtedly, alcohol-induced gut microbiota imbalance stimulates dysbiosis, disrupts the intestinal barrier function, and trigger immune as well as inflammatory responses which further aggravate hepatic injury. Since currently available drugs to mitigate liver disorders have significant side effects, hence, probiotics have been widely researched to alleviate alcohol-associated liver diseases and to improve liver health. A broad range of probiotic bacteria like Lactobacillus, Bifidobacteria, Escherichia coli, Sacchromyces, and Lactococcus are used to reduce or halt the progression of alcohol-associated liver diseases. Several underlying mechanisms, including alteration of the gut microbiome, modulation of intestinal barrier function and immune response, reduction in the level of endotoxins, and bacterial translocation, have been implicated through which probiotics can effectively suppress the occurrence of alcohol-induced liver disorders. This review addresses the therapeutic applications of probiotics in the treatment of alcohol-associated liver diseases. Novel insights into the mechanisms by which probiotics prevent alcohol-associated liver diseases have also been elaborated.

Clinical pattern and drug-related problems among colorectal cancer patients at oncology center in Ethiopia: A hospital-based study.

Objective: Despite the fact that cancer patients are highly susceptible to drug-related problems due to the effects of cytotoxic agents, data are limited due to a lack of studies on those patients. Hence, we aimed to investigate drug-related problems among patients diagnosed with colorectal cancer. Method: A registry-based cross-sectional study was conducted on colorectal cancer patients at the Felege Hiwot Comprehensive Specialized Hospital. Socio-demographic and disease-related characteristics, treatment regimens, and drug-related problems were recorded by reviewing medical records. Standard guidelines, protocols, and databases were used to evaluate the occurrence of drug-related problems and the severity of adverse drug reactions. For the analysis, Stata version 16/MP for Windows was used. Logistic regression analysis was employed to investigate the potential-associated factors of drug-related problems. A p-value ⩽ 0.05 was used to declare the statistical significance of each independent variable. Results: A total of 150 colorectal cancer patients were included, with a mean age of 51.4 ± 13.8 years. About 30% and 41.3% had stage II and stage III cancers, respectively. About three-quarters (73.8%) of the patients were given 5-fluorouracil-based combination regimens. The prevalence of drug-related problems was found to be 48.7%, with a mean of 2.12 ± 0.93 drug-related problems. In the Felege Hiwot Comprehensive Specialized Hospital, drug-drug interactions and adverse drug reactions were the most prevalent drug-related problems, which accounted for 50 (32.7%) and 49 (32%) cases, respectively. Being elderly (>50 years old) (p = 0.013), having co-morbidity (p = 0.001), and being on five or more medications (p = 0.002) were independent predictors of drug-related problems. Conclusion: Fluorouracil-based chemotherapy was the most frequently used treatment regimen. Almost, half of the colorectal cancer patients had one or more drug-related problems. About one-third of patients had adverse drug reactions and drug-drug interactions. Furthermore, age, co-morbidity status, and the number of medications used were significantly associated with drug-related problems. Clinical pharmacy services should be implemented to optimize drug therapy because the majority of colorectal cancer patients have one or more drug-related problems.

Evaluation of Antidiabetic and Antihyperlipidemic Activity of 80% Methanolic Extract of the Root of Solanum incanum Linnaeus (Solanaceae) in Mice.

Background: Conventional antidiabetic drugs are linked with a number of contraindications and untoward effects. The root decoction of Solanum incanum L. has traditionally been used to treat diabetes. However, its safety and efficacy have not been scientifically authenticated yet. Hence, the study was conducted in mice to corroborate its antidiabetic potential and safety profile. Methods: Using normoglycemic, oral glucose-loaded, and streptozotocin-induced diabetic mice models, the hypoglycemic and antihyperglycemic activities of 80% methanolic root extract were investigated. On streptozotocin-induced diabetic mice, the effect of the test extract on diabetic lipid profile and body weight was also investigated. Further, the in vitro α-amylase inhibition activity was assessed. Results: The test extract was safe at a limit test dose of 2 g/kg. Dose-dependent α-amylase inhibition activity was seen with peak percentage inhibition of 75.95% at 700 µg/mL. In normoglycemic mice, the plant extract showed statistically significant hypoglycemic activity at 200 and 400 mg/kg (P < 0.001) at 6 h and 4 and 6 h of treatment, respectively; in oral glucose-loaded mice, at both the test doses, the glucose level was also significantly dropped at 120 (P < 0.01) and 60 and 120 min (P < 0.001), respectively; whereas, in the third model, the test extract showed significant antihyperglycemic activity at 100 mg/kg (P < 0.05) on the 14th day and at 200 (P < 0.01) and 400 mg/kg (P < 0.001) on the 7th and 14th day of treatment. Similarly, following repeated administration of the test extract at 200 and 400 mg/kg, the body weight was significantly improved on the 14th day (P < 0.05) and on the 7th and 14th day (P < 0.01), respectively, while diabetic dyslipidemia after 14 days (P < 0.05). Conclusion: The study revealed that the test extract showed promising antihyperglycemic and antihyperlipidemic activity. Thus, the findings back up its use in Ethiopian remedies for diabetes.

Evaluation of In vivo antidiarrheal activity of hydro-methanolic extract of the root of Rumex nepalensis in Swiss Albino mice.

Background: Natural products have been utilized by human beings for thousands of years to relieve a variety of ailments, including diarrhea. Conventional antidiarrheal drugs are associated with multiple adverse effects and contraindications. Traditionally, Rumex nepalensis by crushing the root, mix with water and then drunk the juice is extensively used for treating diarrhea. However, no scientific research has been done yet to support its antidiarrheal efficacy and safety. Hence, the aim of the study was to evaluate the antidiarrheal activity and safety profile of the plant in mice. Methods: The hydro-methanolic extract was extracted through a cold maceration technique using 80% methanol. Castor oil-induced diarrheal, gastro-intestinal transit, and enteropooling models have been employed to assess the antidiarrheal activity of the test extract at doses of 100, 200, and 400 mg/kg. Results: The crude root extract caused no mortality at a single limit test dose of 2 g/kg throughout the first 24 h and for the rest of the 14 days. In a castor oil-induced diarrheal model, the hydro-methanolic extract markedly delayed the onset of diarrhea, reduced the weight of wet and total feces at 100 (P<.05), 200 (P<.01), and 400 mg/kg (P<.001) test doses. Meanwhile, at 200 (P<.01) and 400 mg/kg (P<.001) doses, the plant extract considerably lowered the weight and volume of intestinal contents. In the gastro-intestinal transit model, however, a dramatic inhibition in the charcoal meal travel was noticed at 100 (P<.05), 200 (P<.01), and 400 mg/kg (P<.001) test doses. The peak antidiarrheal index was exhibited at the highest dose of the test extract. Conclusion: The study speculated that Rumex nepalensis root extract possesses antidiarrheal activity, which could be owing to its inhibitory effect on both gastro-intestinal motility and fluid secretion.

Evaluation of the Antiulcer Activity of Methanolic Extract and Solvent Fractions of the Leaves of Calpurnia aurea (Ait.) Benth. (Fabaceae) in Rats.

Introduction: In Ethiopia, traditionally, the leaves of Calpurnia aurea have been utilized to treat peptic ulcer disease. Therefore, the objective of the present study was to examine the antiulcer activity of Calpurnia aurea hydromethanolic leaf extract and solvent fractions in rats. Methods: The ulcer-healing potential of the crude test extract was assessed in rats by adopting pyloric ligation-, acidified ethanol-, and acetic acid-induced ulcer methods; while, in solvent fractions, the acidified ethanol-induced ulcer model was used. In all models, three serial test doses (100, 200, and 400 mg/kg) were given and the antiulcer activity was investigated. Standard drugs like sucralfate (100 mg/kg), omeprazole (20 mg/kg), and cimetidine (100 mg/kg) have been used as a positive control; whereas distilled water (10 mL/kg) was used as the negative control. Parameters like ulcer index, total acidity, pH, gastric volume, and gastric mucin level were all measured. Results: In an acute toxicity study, the test extract at the limit test dose (2 g/kg) was safe following a single dose administration. In pyloric ligation-induced ulcers, the plant extract at 200 and 400 mg/kg significantly reduced the ulcer index, the volume of stomach secretion, and total acidity while raising gastric pH and mucus content (P < 0.05). Likewise, in the acidified ethanol- and acetic acid-induced ulcer models, the extract at both test doses (200 and 400 mg/kg) also displayed a substantial reduction (P < 0.05) in ulcer index. Among the fractions, the ethyl acetate fraction revealed remarkable cytoprotective activity at all test doses and the aqueous fraction at 400 mg/kg (P < 0.05). In contrast, the effect of chloroform fraction was found to be negligible. The peak ulcer inhibition was noted at 400 mg/kg of ethyl acetate fraction (52.4%). Conclusion: The study showed that the crude extract and solvent fractions possess remarkable antiulcer activity.

Management Practice and Drug Related Problems and Its Contributing Factors Among Cervical Cancer Patients at Oncologic Center in Ethiopia: A Hospital-Based Retrospective Study.

Introduction: In cervical cancer therapy, there is a high prevalence of drug-related problems (DRPs) due to the high toxicity and complexity of most antineoplastic regimens. However, there is a paucity of data about DRPs among patients with cervical cancer in Ethiopia. Hence, the present study was aimed at investigating management practices and DRPs among patients diagnosed with cervical cancer. Methods: A registry-based retrospective cohort study was employed among cervical cancer patients at the oncology center of Felege Hiwot Comprehensive Specialized Hospital (FHCSH). All patients with a histologically confirmed diagnosis of cervical cancer from January 2016 to December 2020 were included. Relevant information was recorded by reviewing medical records. The possibility of DRPs was evaluated by comparing with standard guidelines. Logistic regression analysis was employed. Results: A total of 184 cervical cancer patients were included, with a mean age of 50.2±10.7 years. A total of 216 DRPs were identified from 93 cervical cancer patients, translating to a prevalence of 50.5% and a mean of 2.32±1.11 DRPs per patient. ADR (27.3%), DDI (25%), and the need for additional drug therapy (22.2%) were the most prevalent DRPs. DRPs were associated with the presence of co-morbidity (AOR = 4.23, 95% CI = 1.78-10.05, p = 0.001), complications (AOR = 2.99, 95% CI = 1.28-6.99, p = 0.011), being treated with ≥5 medications (AOR = 5.1, 95% CI = 2.38-10.95, p < 0.001), being stage II (AOR = 0.14, 95% CI = 0.02-0.90, p = 0.038), and stage III (AOR = 0.04, 95% CI = 0.01-0.32, p = 0.003). Conclusion: Cisplatin-based chemotherapy was the frequently used therapeutic option. Co-morbidity and complication status, number of medication and stage of cancer were significantly associated with DRPs. The study highlights the need of clinical pharmacy services to optimize drug therapy and reduce DRPs.

Evaluation of antibiotic prescribing patterns among inpatients using World Health Organization indicators: A cross-sectional study.

Objective: Even though antibiotic resistance is one of the most serious threats to global public health, it is becoming more common due to inappropriate antibiotic prescribing patterns. Thus, the purpose of this study is to assess antibiotic prescribing patterns among inpatients at an Ethiopian comprehensive specialized hospital. Methods: An institutional-based cross-sectional study was used. During the study period, data were collected from the charts of admitted patients in selected wards of Debre Tabor comprehensive specialized hospital. The World Health Organization's developed questionnaire and conventional antibiotic prescribing indicators were used to assess rational drug usage, with an emphasis on antibiotic prescribing trends. The data were analyzed using SPSS 25.0 statistical software. Results: For 861 patients admitted to medical and pediatric wards, a total of 1444 antibiotics were prescribed. Overall, 60.6% of inpatients were prescribed at least one antibiotic, with an average (mean ± SD) number of antibiotics prescribed per patient of 1.7 ± 1.6. During their hospital stay, patients were given antibiotics for an average (mean ± SD) of 6.4 ± 2.7 days. Furthermore, 83.3% of antibiotics were prescribed for therapeutic purposes, whereas 100% were provided for empiric purposes. Ceftriaxone was the most commonly administered antibiotic in the study settings (49.2%). During the study period, Debre Tabor comprehensive specialized hospital had access to 67.5% of key antibiotics. Conclusion: The antibiotic prescribing pattern in our study diverged from the World Health Organization-recommended guidelines. Furthermore, all antibiotics were given without a culture or sensitivity test in every case. Setting up an antibiotic stewardship program, introducing antibiotic use based on culture and sensitivity tests, and adopting institutional guidelines could all help to address this issue.

Glinus lotoides linn. Seed extract as antidiabetic agent: In vitro and in vivo anti-glucolipotoxicity efficacy in Type-II diabetes mellitus.

Background: Diabetes, especially type-II, prevailed despite recent medical advances. An edible G. lotoides (GL) seed is sold in Ethiopian traditional market such as 'Merkato' and used in folkloric medicine to treat diabetes. But to date not scientifically proven in this optic. As a result, this study set out to validate this claim. Methods: Following G. lotoides seed has been extracted, its antidiabetic efficacy was initially validated in vitro before in vivo investigation. The in vitro activity was probed by employing carbohydrate and lipid metabolizing enzymes inhibition assay. Based on this fact, the in vivo antidiabetic efficacy was conducted in normoglycemic, oral glucose-loaded and streptozotocin (150 mg/kg)-nicotinamide (65 mg/kg)-elicited type II diabetic rats. Results: The extract's LD50 was found to be greater than 2 g/kg. In vitro tests pill up evidence that seed extract foils carbohydrate and lipid metabolizing enzyme activities (p < 0.001). On the other hand, seed extract significantly abridged blood glucose in normoglycaemic rats markedly (p < 0.05-0.001). The highest dose exhibited the strongest glucose tolerance effect, with a maximum slaying (41.1%) in glucose-loaded rats' plasma glucose (p < 0.001). All doses of the extract ameliorate blood glucose levels significantly in diabetic rats after 4 weeks of therapy (p < 0.05-0.001). Likewise, all test doses tempered harmful lipides in diabetic rats markedly (p < 0.05-0.001). But HDL (p < 0.01-0.001) and body weight losses (p < 0.05-0.001) were rectified. Conclusion: In consequence, our data unveils the safety and glucolipotoxicity inhibition potential of G. lotoides seed extract, authenticating the traditional standpoint that it might be converted into a viable anti-diabetic lead upon subsequent investigations.

Prevalence and Associated Risk Factors of Endoparasites among Under-Five Children in Debre Tabor Comprehensive Specialized Hospital, Debre Tabor, Northwest Ethiopia: A Cross-Sectional Study.

Many endoparasites are still considered neglected tropical illnesses. The term "endoparasites" refers to infections caused by both helminths and protozoa. In many places in Ethiopia, particularly Debre Tabor, epidemiological data on the prevalence and associated variables of endoparasites among under-five children is unavailable. Thus, the aim of this study was to gather baseline data on the prevalence of endoparasites and their associated variables among under-five children who visited the Debre Tabor comprehensive specialized hospital in Northwest Ethiopia. A hospital-based quantitative cross-sectional study was used. The study was carried out from May 1 to November 30, 2021. Study participants were selected by a systematic sampling technique. The stool specimen was examined for the presence of different stages of intestinal parasites (adult, trophozoite, larvae, cysts, and ova) using direct wet mount, modified formal-ether sedimentation, and modified Ziehl-Neelsen methods. The IBM SPSS statistical package (version 23) was used to enter and analyze the collected data. The data was summarized using frequency tables and a bar chart. The adjusted odds ratio and p value <0.05 were used to declare the final association. In the present study, a total of 258 under-five children and their mothers/guardians were involved in the study, with a response rate of 100%. More than half of the respondents, 137 (53.10%), were females, and 159 (61.63%) were in the age group of 24 to 59 months. The overall prevalence of one or more endoparasites among under-five children was 45 (17.44%). Multivariate logistic regression analysis showed that health supervision, child food freshness, regular trimming of fingernails, and children's playground cleanliness were significantly associated with childhood endoparasites. The present study demonstrated a higher prevalence of endoparasites among under-five children. Health supervision, child food freshness, regular trimming of fingernails, and children's playground cleanliness were significantly associated with endoparasites. Thus, strengthening health education about food, personal, and environmental hygiene for both children and their mothers/guardians is crucial.

Antimalarial Efficacy of Hydromethanolic Root Extract and Solvent Fractions of Urtica simensis Hochst. ex. A. Rich. (Urticaceae): An Experimental Study on Plasmodium berghei-Infected Mice.

Background: Despite modern therapeutic armamentariums, malaria remains a 21st century public health menace. The issue of combating malaria is the ever-growing resistance to high-tech medications in which novel phytomedicines are highly demanding, a rapidly expanding research avenue. In Ethiopian folklore medicine, Urtica simensis has been used to treat malaria by drinking its juice after the dry roots have been mashed and combined with water. Hitherto, no in vivo study has been reported in the literature so far. To substantiate this folkloric claim, the present work herein was done. Methods: An acute oral toxicity study was conducted as per the standard protocol. To rule out, the extract's inherent potential effects on bodyweight, basal body To, and PCV changes were tracked for two weeks. A four-day suppressive model and a curative assay model were utilized to investigate the antimalarial activity of the plant. Percent parasitemia suppression, packed cell volume, mean survival date, bodyweight, and rectal body temperature were used to determine antimalarial activity. Result: An acute toxicity study reveals that Urtica simensis was atoxic at a dose of 2000 mg/kg. It also affirms that U. simensis is free from intrinsic potential effects of interfering with bodyweight, temperature, and packed cell volume evolution. Both crude extract and its solvent fractions at all test doses exerted significant (P < 0.001) inhibition of parasitemia as compared to the control group. CF400 mg/kg provided the greatest chemosuppressive effect (79.24%). In a curative experiment, crude extract and CF were able to prevent the cardinal indications of P. berghei-induced malaria, such as weight loss, hypothermia, parasitemia, and anemia. Both crude extracts and their solvent fractions prolong survival dates. Conclusion: The antimalarial activity of the crude extract and its solvent fractions was promising, confirming previous assertions. As a result, more research studies into chemical entities may be required.

Effects of Undernutrition and Predictors on the Survival Status of HIV-Positive Children after Started Antiretroviral Therapy (ART) in Northwest Ethiopia.

Malnutrition and human immunodeficiency virus/acquired immunodeficiency syndrome have complex and multidirectional relationships. Ethiopia is one of the countries hardest hit by the HIV epidemic as well as malnutrition. This study was aimed at assessing the effects of undernutrition on the survival status of HIV-positive children who received HIV/AIDS care in Northwest Ethiopia. Materials and Methods. A facility-based retrospective follow-up was conducted from January 1, 2009, to December 31, 2020. The data was entered into EpiData version 4.2.0. Then, the entered data was exported to STATA 14 software for further analysis, and the Kaplan-Meier survival curve was used to estimate survival time after the initiation of ART. The Bivariable and multivariable Cox regression analyses were conducted to identify predictors of mortality associated with undernutrition. Results. The mean (±SD) age of participant children was found 118.4 (±38.24) months. The overall mortality rate in this study was determined as 5.4 per 100 child-years (95% CI: 3.6, 5.8). Children with CD4 cell counts below the threshold [AHR = 1.6; 95% CI (1.19, 7.85)], advanced WHO clinical stages (III and IV) HIV [AHR = 4.5; 95% CI (2.80, 8.40)], and being severe stunting at the beginning [AHR = 2.9; 95% CI (1.80, 6.40)] were significantly associated with mortality of HIV-positive children. Conclusion. The findings of the current study indicated that HIV-positive children on ART had a high rate of mortality. Baseline undernutrition has the mortality of children who had CD4 counts below a threshold, advanced WHO HIV clinical staging (III and IV), and being severe stunting (HAZ ≤ -3 Z score) which were found to be independent predictors for mortality of undernourished HIV.

Antidiabetic Activity of Hydromethanolic Extract of Crude Dorstenia barnimiana Root: Validation of In Vitro and In Vivo Antidiabetic and Antidyslipidemic Activity.

BACKGROUND: Despite modern therapeutic armamentaria, DM remains a 21st-century public health menace. Novel phytomedicines are a rapidly expanding focus of research. The juice of Dorstenia barnimiana roots has long been used for the treatment of diabetes mellitus in traditional Ethiopian medicine, but its efficacy has not been supported by in vitro or in vivo scientific study. To investigate this, the present work was performed. METHODS: In this experimental study, simple random sampling was applied. Healthy male mice were used in normoglycemic and oral glucose-tolerance test (OGTT) models. Streptozotocin (IP, 150 mg/kg)-administered diabetic male mice were utilized. Animals were randomly divided into five groups of six each. Group I received 10 mL/kg distilled water, groups II-IV received 100 (DB100), 200 (DB200), and 400 (DB400) mg/kg crude extract, respectively, and group V received glibenclamide 5 mg/kg. A sham group (group VI) was added that received 10 mL/kg distilled water. All treatments were given orally. FBG, serum-lipid profiles, and body-weight changes were then measured. In vitro α-amylase inhibitory activity was also evaluated. RESULTS: The doses were atoxic up to 2,000 mg/kg. There was α-amylase inhibition activity of 67.52% at 500 µg/mL with an IC50 of 4.595 µg/mL. The OGTT revealed an antihyperglycemic effect of the crude extract. This was not attributed to a hypoglycemic side effect. In the diabetic mouse model, it shrank FBG levels remarkably. There were also significant reductions in serum TC, TGs, VLDL-C, and LDL-C. Nevertheless, HDL-C and body-weight levels returned. CONCLUSION: The present study confirmed the safety and promising in vivo antidiabetic and antidyslipidemic activity of D. barnimiana, thus corroborating the traditional claim.

Incidence and Predictors of Pulmonary Tuberculosis among Children Who Received Antiretroviral Therapy (ART), Northwest Ethiopia: A Multicenter Historical Cohorts Study 2009-2019.

The human immune deficiency virus (HIV) is the strongest risk factor for endogenous reactivation of pulmonary tuberculosis (PTB) through target reduction of CD4, T-lymphocytes, and cellular immune function. Almost one-third of deaths among people living with HIV are attributed to tuberculosis. Despite this evidence, in Ethiopia, information is scarce and meager regarding PTB incidence after ART initiated for seropositive children. Methods. Facility-based multicenter historical cohort was conducted among 721 seropositive children after initiating ART from January 1, 2009, to December 31, 2019. Data from the records of children were extracted using a standardized checklist. The collected data were entered using Epi-Data version 4.2 and exported to STATA (SE) R-14 version statistical soft wares for further analysis. Bivariable and multivariable Cox regression analyses were conducted to identify predictors of PTB incidence. Results. Seven hundred twenty-one (N = 721) seropositive children were included with a mean (±SD) age of 118.4 ± 38.24 months. During the follow-up periods, 63 (15.2%) participants developed new cases of TB; majority (61/63, 96.8%) of them were PTB. The overall incidence rate and the median (±IQR) time of PTB reported were determined as 5.86 per 100 child years (95% CI: 4.58, 7.5) and 17.8 (±11) months, respectively. At baseline, children being severely stunted (AHR = 2.9 : 95% CI, 1.2-7.8, P=0.03), with Hgb ≤10 mg/dl (AHR = 4.0; 95% CI, 2.1-8.1, P=0.001), and not given isoniazid and cotrimoxazole preventive therapy (AHR = 2.4; 95% CI: 1.2; 5.1, P=0.001) (AHR = 2.5; 95% CI, 1.4-4.7, P=0.021) were significantly associated with PTB incidence. Conclusion. A high incidence rate of PTB was observed in our study as compared with the previous finding in Ethiopia. Cases at baseline not taking IPT and CPT, being severely stunted, and having low hemoglobin (≤10 mg/dl) levels were found to be at higher risk of developing PTB.

Patients' satisfaction with outpatient pharmacy services and associated factors in Debre Tabor comprehensive specialized hospital, Northwest Ethiopia: A cross-sectional study.

INTRODUCTION: By measuring patients' satisfaction, providers can gain insight into several elements of health care services, including the effectiveness of their care and the level of empathy they exhibit. The aim of this study was to assess patient satisfaction with pharmaceutical services and associated factors in public hospitals located in Northwestern Ethiopia. METHODS: An institution-based quantitative cross-sectional study was used. The study was carried out in an outpatient pharmacy from January 1-June 30, 2021. Participants were selected by a systematic sampling technique. The IBM SPSS statistical package (version 23) was used to enter and analyze the collected data. The findings were presented using descriptive statistical methods. To find factors linked to satisfaction, binary logistic regression was used. RESULTS: The final analysis included a total of 401 samples. More than half of the participants (229, or 55.1%) were female. The overall mean score of satisfaction was 30.6 out of a maximum of 100 scores. By taking this mean score as a cut-off point, 204 (50.9%) of the study participants had satisfaction with the outpatient pharmacists' service. Participants' responses scored on the uncomfortable and inconvenient waiting areas [AOR = 0.31; 95%CI, (0.13, 0.49)] were found to be negatively associated with the level of patients' satisfaction. Also, the unavailability of medications [AOR = 0.12; 95%CI, (0.02, 0.37)] was negatively associated with the respondent satisfaction. Uncomfortable and inconvenient private counseling areas [AOR = 1.37; 95%CI, (0.79, 4.42)] showed a negative association with their satisfaction. CONCLUSION: Patients' satisfaction levels with pharmacy service were found to be greater than 50%. The socio-demographic characteristics of patients have no association with their level of satisfaction, but their perception of uncomfortable private counseling areas and waiting areas was negatively associated with their satisfaction.

Hydromethanolic Crude Extract of the Leaf of Urtica simensis Hochst. ex. A. Rich. (Urticaceae) Acquires Appreciable Antiulcer Effect: Validation for In Vivo Antiulcer Activity.

BACKGROUND: Urtica simensis has been used for the treatment of peptic ulcer disease in Ethiopian folkloric medicine by drinking its juice after boiling the semicrushed leaf. To our latest understanding, no in vivo study was available regarding its antiulcer activity. The present study was done to appraise the ulcer-protective and ulcer healing activity of hydromethanolic crude extract of leaf of U. simensis in rats. METHODS: Preliminary qualitative phytochemical screening and oral acute toxicity were carried out using a standard protocol. To validate U. simensis in vivo antiulcer potential pyloric ligature, cold restraint stress and acetic acid-induced ulcer models were employed. The extracts (100, 200, and 400 mg per kg of body weight per day), standard treatment (omeprazole 20 mg/kg/day), and vehicle (distilled water 10 ml/kg/day) were given to treatment, positive, and negative controls by oral gavage, respectively. Parameters were then evaluated accordingly after the humane scarification of rats. RESULTS: Any sign of toxicity was not observed in the oral acute toxicity test. The crude extracts exerted a significant (P < 0.05) inhibition of ulcer risk compared to the negative control. In the pylorus ligation-induced ulcer model, its antisecretory activity was in a dose-dependent manner. The highest gastroprotective effect (67.68%) was exhibited by the 400 mg/kg/day dose of 80% methanolic crude extract. Regarding the chronic ulcer model, treatment at a dosage of 100, 200, and 400 mg/kg/day cures ulcers by 33.54%, 58.33%, and 67.07%, respectively, as compared to the negative control groups remarkably. CONCLUSION: The findings of the present study confirmed the safety and a promising in vivo ulcer healing and antiulcerogenic activity of U. simensis, thus supporting the traditional claim. In-depth investigations on the plant, however, are highly recommended.

Knowledge, Attitude, and Practice of Healthcare Providers Toward Novel Coronavirus 19 During the First Months of the Pandemic: A Systematic Review.

Introduction: Coronavirus disease (COVID-19) is a highly contagious viral infection that has spread to every corner of the world. Lack of knowledge among healthcare providers (HCPs) about diseases such as COVID-19 may delay the diagnosis, disease spread, and produce poor infection control practices. Hence, this systematic review aimed to summarize the knowledge, attitudes, and practices (KAP) of HCPs toward COVID-19 during the first months of the pandemic. Methods: A systematic review was conducted according the PRISMA guidelines, and the protocol was registered on PROSPERO (CRD42020191742). A relevant article search was performed on EMBASE, PubMed, CINAHL, Scopus, and the Google Scholar database. The methodological quality of studies was assessed using the Newcastle-Ottawa Quality Assessment Scale. The median percentage of HCPs with good KAP was computed. Results: Twenty studies involving 12,072 HCPs were included in the review process. Median percentages of 75.8% (IQR: 69.3-87.7%), 74.6% (IQR: 54.4-74.6), and 79.8% (IQR: 67.0-79.8%) of HCPs had good knowledge, and positive attitude and practice, respectively. Although the reported risk factors were inconsistent among studies, age, gender, level of education, experience, infection prevention training, and sources of information were associated with knowledge of HCPs. In addition, being elderly, having a high level of education, absence of chronic illness, and good knowledge and practice were significantly associated with the attitude of HCPs. Further, types of profession, experience, age, level of education, use of personnel protective equipment, and gender were significantly associated with the practice of HCPs. Conclusions: Approximately, three-fourths of HCPs had good knowledge, attitudes, and practices toward COVID-19 during the first months of the pandemic, although the percentage of HCPs was inconsistent in different study settings. In addition, associated factors of KAP were inconsistent among studies; hence, stake holders should target locally identified risk factors to design relevant education packages and infection prevention training to halt the rapid transmission of COVID-19. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020191742, identifier: CRD42020191742.

Treatment Outcome of Epileptic Patients Receiving Antiepileptic Drugs in Ethiopia: A Systematic Review and Meta-Analysis.

BACKGROUND: The prevalence and incidence rate of epilepsy were found to be higher in low- and middle-income countries. Uncontrolled epilepsy has a high risk of disability, stigma, discrimination, human rights violations, and premature death. The available studies of controlled seizure in Ethiopia have showed inconsistent results which calls for systematic review and meta-analysis. Therefore, this review intended to show the pooled prevalence of controlled seizure among people with epilepsy receiving antiepileptic drugs at outpatient department. METHODS: A systematic literature search was conducted using PubMed/Medline, Science Direct, PsycINFO, Hinnarri databases, and Google Scholar for grey literatures. Data were extracted with structured format prepared using Microsoft Excel and exported to Stata/MP 16.0 software for analyses. The I 2 test was used to check the heterogeneity between primary studies with a corresponding 95% confidence interval (CI). RESULTS: A total of 23 primary studies were included in the review showing the pooled prevalence of controlled seizure to be 46% (95% CI: 35, 56). A subgroup analysis of the primary studies showed a considerable variation in magnitude of seizure freedom by study regions, age groups, and seizure-free period. The highest prevalence was found in Addis Ababa 52% (95% CI: 29, 75), pediatric patients 77% (95% CI: 71, 83), and a seizure-free period of less than six months 58% (95% CI: 32, 83). On the other hand, the lowest prevalence of controlled seizure was found in Tigray 27% (95% CI: 11, 65), adult patients 43% (95% CI: 32, 54), and a seizure-free period of six or more 41% (95% CI: 32, 51). Higher frequency of seizure before treatment (2.23, 95% CI: 1.15, 3.31) and medication nonadherence (2.7, 95% CI: 1.25, 4.15) had statistically significant association with uncontrolled seizure. CONCLUSION: In this review, the prevalence of controlled seizure was found to be low. This warrants that clinicians should give more focus to epileptic patients regarding monitoring and evaluation of treatment outcome of epilepsy and factors that affect seizure control in routine clinical services. The use of standardized definition of controlled seizure, designing strategies to identify pharmacoresistant epilepsy and its treatment, and increasing medication adherence are recommended in Ethiopia. The review protocol has been registered with PROSPERO registration number CRD42021215302.

Surgical Site Infections and Prophylaxis Antibiotic Use in the Surgical Ward of Public Hospital in Western Ethiopia: A Hospital-Based Retrospective Cross-Sectional Study.

OBJECTIVE: Surgical site infection (SSI) is one of the leading causes of hospital-acquired infection among hospitalized patients. It causes significant health problems and results in an extended length of hospital stay, increased cost, and increased patient morbidity and mortality. To prevent the development of SSI, surgical antibiotic prophylaxis (SAP) administration before surgery is an evidence-based practice. Therefore, this study aimed to assess the prevalence of SSIs and surgical antibiotic prophylaxis practice, and identifying the gap in practicing prophylactic surgical antibiotic use. METHODS: A retrospective cross-sectional study design was conducted on randomly selected 281 participants who fulfilled the inclusion criteria. Appropriateness of surgical antibiotic prophylaxis was assessed by clinical pharmacists based on the standard treatment guideline. Descriptive and multivariate logistic regression analyses were performed in SPSS version 25. Statistical significance was set at p <0.05. RESULTS: The overall prevalence of SSI was 19.6% (95% CI: 19-20.2). Majority of surgical patients (88.6%) got surgical antibiotic prophylaxis. Ceftriaxone and metronidazole (45.4%), and ceftriaxone (33.3%) were the most frequently used prophylactic antibiotics. Presence of comorbidity (AOR=9.18, 95% CI: 5.17-17.9, p<0.001), contaminated (AOR=6.01, 95% CI: 1.77-16.8, p=0.019) and dirty (AOR=7.20, 95% CI: 1.23-12.1, p=0.029) wound classes, devoid of prophylactic antibiotics (AOR=6.63, 95% CI: 0.89-19.3, p=0.006), the timing of prophylactic antibiotic administration between 1 hour and 2 hours before incision (AOR=8.2, 95% CI: 4.34-18.1, p=0.001), and 48 hours duration of surgical antimicrobial prophylaxis (AOR=7.20, 95% CI: 1.23-28.17, p=0.027) were significantly associated with the development of SSIs. CONCLUSION: The prevalence of SSI was relatively high despite most surgical patients were given prophylactic antibiotics. The presence of comorbidity, contaminated and dirty wound classes, devoid of prophylactic antibiotics, administering prophylactic antibiotics between 1 hour and 2 hours before incision, and 48 hours duration of surgical antibiotic prophylaxis were significantly associated with SSIs.