The Prevalence and Determinants of Inappropriate Oral Anticoagulant Use in Patients with Atrial Fibrillation, in Resource-Limited Setting.

Introduction: Anticoagulation treatment is routinely underused in patients with atrial fibrillation (AF), particularly in settings with limited resources. The current study is aimed at evaluating the appropriateness of oral anticoagulation treatment among AF patients at the Yekatit 12 Hospital Medical College (Y12HMC), Addis Ababa, Ethiopia. Methods: Institutional-based retrospective cross-sectional study conducted in Y12HMC from November 2019 to March 2020. During the study period, 256 patients' medical records were found; 231 of them met the eligibility criteria and were included in the study. The data were analyzed using SPSS version 25, descriptive statistics were used to summarize the data, and binary logistic regression was performed to identify predictors of inappropriate anticoagulation management. Results: The majority of study participants were males (55.8%), and over half of them (57.6%) had a nonvalvular type of AF. The majority of patients (61.9%) were receiving anticoagulant treatment, and of them, warfarin was prescribed to most of the study subjects (71.3%). Nearly half (47.6%) of the study participants had inappropriate anticoagulation treatment; among these, the majority of them (69.1%) were from a valvular type of AF. Patients with a valvular type of AF and having the diagnosis of congestive heart disease as comorbidity showed a statistically significant association towards inappropriate anticoagulation management. Conclusion: According to the study, a significant portion of AF patients received inappropriate anticoagulant treatment, which may play a significant role for the increased risk of stroke in these groups of patients. All of the inappropriate cases were due to failure to start anticoagulant treatment.

Post COVID-19 Vaccination Side Effects and Associated Factors Among Vaccinated Clients in Bahir Dar City, Ethiopia.

Introduction: The lack of local side effect profiles for vaccines could hinder vaccination uptake. Since all COVID-19 vaccines are brand-new medications, it is crucial to keep track of any safety related concern. Objective: This study is aimed to investigate post-vaccination side effects of COVID-19 vaccines and associated factors in Bahir Dar city. Method: An institutional-based cross-sectional study was conducted among vaccinated clients. A simple random and a systematic random sampling method were used to select the health facilities and the participants, respectively. Bi-variable and multivariable binary logistic regression analyses were executed with odds ratio at 95% confidence intervals at p < .05. Results: A total of 72(17.4%) participants reported at least one side effect following vaccination. The proportion prevalence was higher after the first dose than that of the second dose and the difference was also found to be statistically significant. In the multivariable logistic regression analysis female participants (AOR = 3.39, 95% CI = 1.53, 7.52), participants with a history of regular medication use (AOR = 3.34, 95% CI = 1.52, 7.33), participants aged 55 and above (AOR = 2.93, 95% CI = 1.23, 7.01), and participants who had taken only the first dose (AOR = 14.81, 95% CI = 6.40, 34.31) were more likely to develop side effects for COVID 19 vaccination compared to their counterparts. Conclusion: A significant number (17.4%) of participants reported at least one side effect following vaccination. Sex, medication, occupation, age, and type of vaccination dose were factors statistically associated with the reported side effects.

Knowledge of cardiovascular disease risk factors, practice, and barriers of community pharmacists on cardiovascular disease prevention in North West Ethiopia.

Background: In Ethiopia, there are no adequate studies made on the knowledge and practice of CVD and its risk factors among community pharmacists. Thus, this study aimed to assess knowledge of cardiovascular disease risk factors, practice, and barriers of community pharmacists on cardiovascular disease prevention. Methods: A Cross-sectional study was conducted on a total of 81 community pharmacists from the first march to May 30, 2020, at Gondar town. Data was entered to EPI-INFO 7 and exported to SPSS software for windows version 20 for analysis. The results are presented by using tables and figures. The chi-square test was applied to test the relationship between Knowledge and independent variables. P-value ≤ 0.05 was considered as statistical significance. Result: Of the participants, 45 (55.6%) of them were found knowledgeable about cardiovascular disease. On the other hand, only 18.5%, 77.8%, and 93.8% of the study participants respectively were aware of CVD risk factors like symptoms of heart disease, the connection of family history of heart disease, and the connection between old age and heart disease. Only 21% of the study participants had known the existence of HTN guidelines in Ethiopia. X2 statistical analysis showed that there was no statistically significant association between age (P = 0.82), gender (P = 0.661). Marital statuses (P > 0.50), number of years of practice (P = 0.796) and cardiovascular disease. The main barriers to the prevention of CVD for community pharmacists were, lack of time (18.5%), inability to identify targeted patients (65.4%), lack of knowledge (23%), and lack of communication (26%). Conclusion: The overall assessment of the pharmacists demonstrated that more than half of the participants were found knowledgeable. However, only a small proportion of the study participants had known about the existence of National guidelines for cardiovascular disease in particular and non-communicable disease in general. Therefore, the provision of government policy that will regulate their training, certification, and practice for CVD screening and as well as provide a framework of incentives are recommended.

Drug dose adjustment in patients with renal impairment attending a specialized referral hospital, Northwest Ethiopia.

Background: Numerous drugs and their metabolites are removed from the body through the kidney. Improper use of drugs in renal impaired patients may therefore, be harmful and have deleterious effects. Thus, this study was aimed at investigating drug dose adjustment in renal impaired patients attending a specialized hospital. Methods: A prospective cross-sectional study was performed at the medical ward in University of Gondar comprehensive specialized hospital from March to May 2018. During the study period, a total of 2100 patients were admitted to the general medical wards. We located and assessed 210 patient files, of which 189 patient files had complete notes. Based on our inclusion criteria, 105 patients had Crcl of ≥ 59 ml per min per 1.73 m2. Therefore, 84 patients fulfilled our inclusion criteria and were included in the final analysis. The collected data were entered into Epi Info version 7 and exported to the statistical package for the social sciences (SPSS) version 20 for statistical analysis. A chi-square test was applied to test the relationship between renal status and dosage adjustment. P-value ≤ 0.05 was considered as statistical significance. Since the number of co-morbidities and number of drugs prescribed was non-normally distributed using the Shapiro-Wilk test (P < 0.001), the spearman correlation test was used (r = 0.228, p = 0.037). Results: The mean age of study participants was 57 years with 57.1% male and 42.9% female. The highest number of renal impaired patients was in stage three 56(66.7%). The mean creatinine clearance (Crcl) was 41.8 ml/min (IQR 24.8-60.9), and the mean serum creatinine (Scr) value of 2.63 mg/dl (IQR 1.3-3.1). More than two third (76.2%) of the study participants had comorbidities. Eighty-four patients with 257 prescription entries were included in the study. Of which 75 prescription entries need a drug dose adjustment. The overall rate of inappropriate dose adjustment was 42.6% (32/75). Inappropriate dose adjustment was more common with vancomycin (14.3%) and ciprofloxacin (6%). Inappropriate drug dose adjustments were associated with patients having intermediate renal insufficiency (P < 0.002) and co-morbid conditions (P < 0.02). Conclusion: The present study demonstrated that inappropriate dose adjustment was common at University of Gondar comprehensive specialized hospital that needs great attention. Vancomycin and ciprofloxacin were the most frequently identified drugs that were inappropriately adjusted. Intermediate renal insufficiency and co-morbidities were statically significant with inappropriate dose adjustment.

Synergetic antibacterial activity of Vernonia auriculifera Hiern and Buddleja polystachya Fresen on selected human pathogenic bacteria.

Background: Medicinal plants have been used as traditional treatments for various human diseases for many years and they are still widely practiced throughout the world. Due to the long history of the practice, medicinal plants have become an integral part of the Ethiopian culture. This study aimed to evaluate the antibacterial activities of Vernonia auriculifera Hiern and Buddleja polystachya Fresen leaf extracts and their synergistic effect against some selected human pathogenic bacteria. Methods: Ethanol, methanol, and n-hexane crude extracts of Vernonia auriculifera, Buddleja polystachya, and a mixture of the two-plant respective of each solvent were evaluated against tested pathogenic bacteria using the agar well diffusion method; the inhibition zones were recorded in millimeters. Gentamycin was used as a positive control, while dimethyl sulfoxide served as a negative control. The minimum inhibitory concentration of the plant extracts against test bacteria was evaluated using two-fold broth dilution methods and then Minimum bactericidal concentration was determined by sub-culturing the test dilutions from minimum inhibitory concentration tubes onto fresh Muller Hinton Agar plates incubated at 37 °C for 24 h. Results: Maximum antibacterial inhibition zone was observed on methanol extracts of synergism against S. Typhimurium (ATCC 1333) (31.00 ± 1.73 mm) while, a minimum inhibition zone was observed on methanol extract of Buddleja polystachya, against E. coli (ATCC 35218) (5.67 ± 0.57). Minimum inhibitory concentration and minimum bactericidal concentration values of the crude extracts of Vernonia auriculifera, Buddleja polystachya, and their mixture lies between (3.125%-12.5%) and (6.25%-25%) respectively. The data were analyzed using the SPSS software package version 20 for windows. Conclusion: The present study revealed that ethanol and methanol extracts of Vernonia auriculifera and Buddleja polystachya possess significant inhibitory effects against tested pathogens and the antibacterial activity of both plants leaf extracts was greater than the activity of currently used antibiotics (Gentamycin) against some selected organisms.

Evaluation of Wound Healing Activity of 80% Methanol Root Crude Extract and Solvent Fractions of Stephania abyssinica (Dill. & A. Rich.) Walp. (Menispermaceae) in Mice.

Background: The root of Stephania abyssinica (Dill. and A. Rich.) Walp. (Menispermaceae) is traditionally used to treat wounds. Despite the fact that there have been in vitro studies and claims supporting wound healing, there has been no scientific data on the in vivo wound healing activities of the root of S. Abyssinica. Objective: The aim of the study was to evaluate the wound healing activity of 80% methanol root extract and solvent fractions of S. Abyssinica in mice. Methods: The roots of S. Abyssinica were air dried, ground and macerated by 80% methanol three times successively. The crude extract was fractionated by water, hexane and ethyl acetate separately. The acute dermal toxicity test was done by applying 2000 mg/kg of the 10% w/w crude extract. Wound healing activity of crude extract was evaluated on excision, incision and burn wound models, while the fractions were evaluated on excision wound model only. Results: In mice, an acute dermal toxicity test of 2000 mg/kg of the 10% w/w crude extract was found to be safe. The 10% w/w crude extract ointment (CEO) produced significant (p < 0.001) wound contraction from 4th to 16th post wounding days, and the 5% w/w CEO were significant (p < 0.01) wound contraction on 10th post wounding day as compared to simple ointment (SO) treated group on excision wound. On burn wound models, the CEO showed highly significant (p < 0.001) from the 6th post wounding days onwards. The tensile strength was increased significantly (p < 0.001) by the CEO treated mice as compared to the untreated group and SO group. Conclusion: The data obtained from this study showed 80% methanol crude extract, the aqueous and the 10% w/w ethyl acetate fraction possessed better wound healing activities, and decreased period of epithelialization.

The proportion of chronic kidney disease and its associated factors among adult diabetic patients at Tibebe Ghion Specialized Hospital, Bahir Dar, Ethiopia.

Background: Chronic kidney disease is defined as a progressive loss of kidney function occurring over several months to years. Programs to detect chronic kidney disease, linked to comprehensive primary and secondary Prevention strategies are rare in our country. This study aimed to assess the proportion of chronic kidney disease and its associated factors among adult diabetic patients. Methods: An institutional-based cross-sectional study design was used. Adult Diabetic Patients (≥18 years of age) coming to the medical outpatient clinic were considered as study participants and they were selected using a systematic random sampling technique. Data were checked for completeness, then entered into Epi Data 3.1, and exported to SPSS Version 24 for analysis. Descriptive statistics such as frequency, crosstab, and median were utilized. chronic kidney disease epidemiology collaboration equations for calculating estimated glomerular filtration rate Simple binary logistic regression was conducted to identify candidate variables for multiple binary logistic regression at a p-value of <0.2. Those variables whose P-value <0.05 in multiple binary logistic regression were considered as significantly associated variables with chronic kidney diseases. Result: A total of 329 individuals were participating in the study. Of which 199 (60.5%) were males. The median age of participants was 39 (IQR; 28: 56) years. Of the total participants, 125(38%) had no formal education. The proportion of chronic kidney disease was 16.7% (95% CI: 12.8%-21%), The study also found that older age (AOR = 3.02; 95%CI: 1.37, 6.69), pre-existing hypertension (AOR = 4.85; 95%CI: 2.07, 11.3), current systolic blood pressure ≥140mmHg (AOR = 6.33, 95%CI: 3.34, 11.99), and presence of Albuminuria (AOR = 2.98, 95%CI: 1.26, 7.09) were associated with chronic kidney disease. Conclusions: The proportion of CKD among diabetic patients in Tibebe Ghion Specialized Hospital was relatively high as compared to other studies. Health care professionals should consider strict follow-up for older age patients, patients with co-morbidities like hypertension, and for those patients with Albuminuria.

Knowledge, Attitude, and Practice Towards Face-Mask Use Amid the Coronavirus 2019 Pandemic Among Public Transport Drivers in Gondar Town, A Cross-Sectional Study.

Background. Coronavirus disease (COVID-19) is a highly communicable virus that continues to interrupt livelihoods, predominantly those of low-income segments of society. For the prevention of respiratory infections like the current COVID-19 outbreak, face masks are considered an effective approach.Objective. This study intended to assess the knowledge, attitude, and practice of public transport drivers towards face mask use amid the COVID-19 pandemic in Gondar, Ethiopia.Methods. A cross-sectional study was conducted among 412 public transport drivers in Gondar town from July to September 2021. The study subjects were recruited using a simple random sampling technique after proportionally allocating the sample size from the total number of public transport drivers, and finally, study subjects were selected using the convenience sampling method to select the participant drivers working in Gondar Town. The data were collected by face-to-face interview administered questioners and an on-the-spot observational checklist.Results. A total of 412 public transport drivers have participated in the study. The mean age of the respondents was 32.75 years (±8.75 years). The majority of the participants were Bajaj drivers 193 (46.84%). Among the responders, 114 (27.67%) of them use radio to gather information about the pandemic and 50 (12.14%) of them had reported being caught by COVID-19. Meanwhile, only 32 (7.77%) were vaccinated against COVID-19. Drivers that had a diploma level of education were found to be 87.7% less knowledgeable than degree holders (AOR .123, 95% CI = .026, .573). Respondents that had good knowledge about COVID-19 and face masks were found to have 1.7 times more positive attitudes than those that had poor knowledge (AOR = 1.728, 95% CI = 1.150, 2.596). drivers whose family members have ever been caught by COVID-19 were found 2 times more likely to use face masks whenever they are working/driving (AOR = 2.173, 95% CI = 1.015, 4.652) than their counterparts.Conclusion. This study revealed a very low Knowledge, attitude, and practice of face mask use among public transport drivers in Gondar town. Periodic reinforcement and training programs are needed for all public transport drivers in each level for proper understanding and adherence to COVID-19 prevention protocols and the use of face masks.

Compliance of Private Pharmacy Retail Outlets to Narcotic Drug Regulations in Ethiopia: A Cross-Sectional and Simulated Client Study Method.

BACKGROUND: Inappropriate use of narcotic drugs is a growing worldwide health challenge. The problem is even worse in Sub-Saharan Africa where organized supply chain regulations on dispensing and stock management are poor for controlling these global challenges. METHODS: A mixed method, descriptive cross-sectional and simulated client study design was used from September 10, 2020 to November 26, 2020 to assess the extent of utilization and compliance of narcotic drug dispensing in private pharmacy retail outlets of Gondar and Bahir Dar town of Amhara region, Ethiopia. A total of 107 private pharmacy outlets were on duty. But in simulated study, purposive sampling is a method that prioritizes study units having the data of interest. RESULTS: A total of 107 private pharmacy retails outlets were included in the survey. The average compliance to the controlled prescription regulation of Ethiopia in all pharmacy outlets (107) of the five drugs were calculated and found to be poor, 23.9% (SD = 18.3%). Compliance to strong narcotics is extremely low, 3.3 % for pethidine and 8% for morphine. Religion of the professionals has significant association with compliance to the prescription of narcotic drugs (p < .001). DISCUSSION: In the era of narcotic epidemics, as a result of growing global inappropriate use of controlled drugs, the finding of this study gives an insight for a serious and strict regulation in managing and controlling the overall distribution of the narcotic drugs. CONCLUSIONS: The compliance of the private retail pharmacies of Ethiopia to the regulation of controlled drugs is low.

Pharmacological evaluation of medicinal plants with antidiabetic activities in Ethiopia: A review.

Diabetes mellitus is a serious, chronic disease that occurs either when the pancreas does not produce enough insulin, or when the body can't effectively use insulin. Herbal medicines have been commonly used by diabetic patients for the treatment of diabetes mellitus. To include findings from different studies, publications related to in vivo and invitro antidiabetic activities of medicinal plants in Ethiopia were searched from different databases, such as Web of Science, Google Scholar, Medline, Scopus, and PubMed, using English key terms. Different medicinal plant parts were used experimentally for antidiabetic effects in Ethiopia. Among these, leaves (69%) were the most commonly investigated medicinal plant parts followed by roots (14%) and seeds (7%). Most of the investigations were completed with hydro-methanolic extracts to obtain a higher percentage of yield. Medicinal plants such as Thymus schemperi R, Thymus vulgaris L, Hagenia abyssinica, Aloe megalacantha baker, Aloe moticola Reyonolds, Aloe pulecherrima Gilbert & sebseb, Bersama abyssinica fresen, and Rubus Erlangeri Engl have shown in vitro α-amylase inhibitory activity. However, only Hagenia abyssinica, Thymus schemperi R, and Thymus vulgaris L have exhibited α-glucosidase inhibitory activity. Likewise, only the extract of Aloe pulecherrima Gilbert & sebseb posses' maltase and sucrose inhibitory activity. In vivo antidiabetic activity were conducted for the extract of medicinal plants such as A. remota, S. rebaudiani, T. schemperi, T. vulgaris, H. abyssinica, C. aurea, D. stramonium, A. megalacantha, A. moticola, A.integrifolia, A. pulecherrima, B. grandiflorum, B. abyssinica, P. schimperiana, M. stenopetala, C. aure, J. schimperiana, T. brownie, C. macrostachys, I. spicata, O. integrifolia, C. abyssinica, R. Erlangeri, L. culinaris, A. camperi, A. polystachyus, A. ilicifalius, C. tomentosa, and C. Edulis. This review gives collective evidence on the potential antidiabetic activities of medicinal plants in Ethiopia. Moreover, further studies are recommended to substantiate the use of these medicinal plants as an antidiabetic agent.

Assessment of lifestyle changes during coronavirus disease 2019 pandemic in Gondar town, Northwest Ethiopia.

BACKGROUND: Coronavirus disease 2019 has had a global effect on people's lifestyles. Many people have developed irregular eating patterns and become physically inactive, which leads to an aggravation of lifestyle-related diseases and unhealthier lifestyles; these, subsequently raise the severity of coronavirus disease 2019. This study aimed to assess lifestyle changes during coronavirus disease 2019 pandemic in Gondar town, North West, Ethiopia. METHOD: Community-based cross-sectional study design was conducted among households at Gondar town from June to August 2021. The study participants were selected by a systematic random sampling technique from proportionally allocated kebeles. Data were collected using face-to-face interview techniques and were entered and analyzed by using a statistical package for the social sciences version 24; P-values < 0.05 were considered as statistically significant. RESULT: Overall, 348 study participants were included in the study. Among those respondents, 52.3% (182) were female study participants and the mean age of the respondents was 30.95±14.4. In this study, there was a significant decrement in non-homemade food from 20.4% to 13.4% at (P = <0.001). Concerning water intake, 11.5% (40) of respondents consumed ≥8 cups/day before the coronavirus disease 2019 pandemic, and the percentage increased to 14.7% (51) during the coronavirus disease 2019 pandemic (p = 0.01). Of the participants, 46% participants were reported never engaging in any physical activity before the coronavirus pandemic, and the percentage decreased to 29.9% during the pandemic (P = 0.002). The respondents also exhibited increment tension in large from 4.9% to 22.7% before and during the coronavirus disease 2019 pandemic, respectively. Furthermore, about 6.3% of the study participants slept badly before the coronavirus disease 2019 pandemics and the effects of sleeping badly and restlessly increased to 25.9% during the coronavirus disease 2019 pandemic (P = <0.001). CONCLUSION: The current study demonstrates that there is a noticeable alteration in food consumption, food choices, regular mealtime, sleeping habits, mental exhaustion, and practice of physical activity.

COVID-19 vaccine hesitancy among health professionals in a tertiary care center at the University of Gondar Specialized Hospital, Ethiopia: A cross-sectional study.

BACKGROUND: COVID-19 is a highly communicable disease that can be transmitted from animal-to-human and human-to-human contacts. It is still now a major global threat for which vaccination remains the ultimate solution to protect it, especially healthcare professionals are the first frontiers to fight against the COVID-19 virus which makes them at higher risk of this disease. Therefore, to reduce the spread of COVID-19, we need to improve the acceptance of COVID-19 vaccines is crucial. The aim of this study was to assess the vaccine hesitancy of the COVID-19 vaccine among health professionals who worked at the University of Gondar Specialized Hospital. METHODS: A cross-sectional survey was conducted between 1 May and 10 June 2021. And the data were analyzed using Statistical Package for Social Sciences version 26. A chi-square test was conducted and to assess the associations between socio-demographic characteristics, perceived risk of COVID-19, attitude, and acceptance of COVID-19 vaccine, a p-value of less than 0.05 was considered to declare statistical significance. RESULTS: We surveyed 319 health professionals with a response rate of 67.87%. Of these, 74.9% (239) were male, and 81.2% (259) of health professionals were perceived exposed to COVID-19 without testing. 87.7% of respondents would like to vaccinate their parents. 66.2% (208) of them have accepted the COVID-19 vaccine. 54.85% (175) of health professionals had a good attitude and 45.8% (146) of health professionals were received the first-round COVID-19 vaccine. CONCLUSION: This study showed that more than 60% of health professionals had good acceptance of COVID-19 vaccination during the pandemic period. Regarding vaccine safety profile may reduce the vaccination in the future. To increase vaccine uptake in response to the COVID-19 pandemic, COVID-19 vaccination programs should be redesigned to remove barriers to vaccine acceptance. Knowledge and attitude toward the COVID-19 vaccine should be promoted.

Availability of Essential Antidotes and the Role of Community Pharmacists in the Management of Acute Poisoning: A Cross-Sectional Study in Ethiopia.

BACKGROUND: Morbidity and mortality related to acute poisoning is a major public health issue in both developing and developed countries. Community pharmacists have a crucial role in ensuring drug availability, increasing drug safety, counseling patients, overdose risk reduction and management, and provision of appropriate drug information. This study aimed to assess the availability of necessary antidotes in community pharmacies in Gondar and Bahir-Dar cities, Ethiopia, and the role of community pharmacists in the management of acute poisoning. METHODS: A cross-sectional survey was conducted in Gondar and Bahir-Dar cities. A self-administered, structured questionnaire was used for data collection and Statistical Package for Social Sciences (SPSS) version 24.0 was used for data analysis. Chi-square analysis was computed to identify the associated factors with a confidence interval of 95% and a P value less than .05 was used as a cut-point for statistical significance. RESULTS: Out of 101 community pharmacies invited to participate in the study, 80 of them completed the survey with a response rate of 79.2%. The overall mean antidote availability score was .59 (SD = .837), which falls within the definition of Poor availability. None of the pharmacies had kept all of the antidotes, and the maximum number of an antidote kept by a single pharmacy was 7 out of nineteen essential antidotes surveyed. The most commonly reported reason for the unavailability of essential antidotes was stock was not ordered (56.3%) followed by stock ordered but not delivered from suppliers (wholesalers) (20.0%). More than 3 fourth of the respondents (83.8%) had poor knowledge about the antidotes for the common poisonings. CONCLUSION: There was a significantly very low availability of essential antidotes in the community pharmacies. Strategies should be implemented to improve pharmacist's knowledge about antidotes, and management of poisoning emergencies through on-job training and provision of reference materials.

Effect of Crude Leaves Extract of Bersama abyssinica on Blood Glucose Level and Serum Lipid Level of Streptozotocin-Induced Diabetic Mice: Evidence for in vivo Antidiabetic Activity.

BACKGROUND: Diabetes mellitus is one of the major and common metabolic and chronic disorders in the world. Several medicinal plants have been used globally for the management of diabetes mellitus. The current study aimed to study the antihyperglycemic and antihyperlipidemic effects of Bersama abyssinica. METHODS: Antidiabetic effect of 80% methanolic crude extract of Bersama abyssinica was studied in a repeated dose-treated STZ-induced diabetic mice model. The activities of Bersama abyssinica on serum lipid level and body weight were investigated on STZ-induced diabetic mice. Data were analyzed using one-way ANOVA and were significant when the p-value was less than 0.05. RESULTS: All doses of the crude 80% methanolic extract of Bersama abyssinica (100 mg/kg, 200 mg/kg, and 400 mg/kg) exhibited a noticeable BGL reduction when compared with baseline blood glucose level and diabetic control on the 7th and 14th days of administration. Moreover, higher dose of the extract (at 400 mg/kg) significantly (p < 0.001, 54.3%) decreased the BGL in STZ-induced diabetic mice. The maximum decrement in fasting BGL was achieved at the 14th days: 34.92%, 41.10%, 54.30%, and 59.66%, respectively for BAC 100 mg/kg, BAC 200 mg/kg, BAC 400 mg/kg, and GLC 5 mg/kg treated groups. Bersama abyssinica also displayed a significant (p < 0.05) improvement of serum lipid levels and body weight. CONCLUSION: Bersama abyssinica crude extract exhibited a significant antidiabetic effect and prevented body weight loss in streptozotocin-induced diabetic mice. The finding also confirmed the valuable biochemical activity of Bersama abyssinica by improving serum lipid levels.

Evaluation of patients' knowledge of warfarin at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.

OBJECTIVE: The study was to assess the knowledge of warfarin in patients using the validated anticoagulation knowledge assessment questionnaire and to evaluate the predictors of the level of knowledge among outpatients receiving warfarin at the Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. METHODS: It was a prospective cross-sectional study carried out from October 2019-January 2020. During the study period a total 401 of them were included in the study. Anticoagulation Knowledge Assessment questionnaire has 29 question items, a single patient should answer at least 21 of the question to be considered as knowledgeable about his/her medication. The data was exported into SPSS version 25 and a one way ANOVA and post hoc were conducted. RESULTS: The mean age of the study participants were 36 years old (SD ± 11.83), which was ranges from 18 to 82 and majority of the participants were females (69.6%). Almost in one-third of the participants (35.7%), the reasons for warfarin therapy were Chronic Rheumatic Valvular Heart Disease. The overall AKA mean ± SD score of the respondents was 7.4 (±2.6) that ranges from 2 to 22. From those only (4.2%) of the study participants had succeeds the passing score. Educational level and the duration of warfarin therapy were independent predictors towards patient's warfarin knowledge. CONCLUSION: The overall patient's knowledge about warfarin treatment was poor when it was compared to most other studies. The longer duration of warfarin therapy and advanced educational level showed favored relationship towards better warfarin knowledge of the study participants.

Impact of objectively-measured sleep duration on cardiometabolic health: A systematic review of recent evidence.

Cardiometabolic disease is a spectrum of diseases including, cardiovascular diseases, and metabolic syndrome. It is the leading cause of morbidity and mortality worldwide, with premature deaths being preventable. Currently, sleep has emerged as a potential target for cardiometabolic disease prevention. Several epidemiological studies have provided ample evidence that objectively measured short sleep duration increases the risk of cardiometabolic disease. However, the findings are inconsistent, and few studies measure sleep duration on cardiometabolic profiles objectively. Therefore, in this review, we focused on the recently published literature that explored the association between objectively measured sleep duration and cardiometabolic profiles (cardiovascular diseases, type 2 diabetes mellitus, and metabolic syndrome), seeking more insights regarding the applicability and, in turn, the impact of objectively measured sleep duration on cardiometabolic health, which is relatively understudied. We retrieved the information manually from PubMed, Google Scholar, HINARI, and the Cochrane Library from 2015 to 2022 using appropriate search terms, we included 49 articles. In this review, we found a strong relationship between objectively measured sleep duration and the risk of cardiometabolic disease, indicating that objectively measured short sleep durations increase cardiometabolic risks. In general, the association between objectively measured sleep duration and increased cardiometabolic risks (CMR) has been well-documented in higher-income countries. Several studies found that longer sleep duration was associated with a more favorable cardiometabolic profile in early adolescence, independent of other risk factors. On the other hand, objectively measured short sleep duration is associated with adverse cardiometabolic health outcomes such as coronary heart disease, hypertension, type 2 diabetes mellitus, and metabolic syndrome.

Availability and Utilization of the WHO-Recommended Lifesaving Medicines for Under-Five Children at University of Gondar Comprehensive Specialized Hospital, Amhara Region, Ethiopia.

According to the World Health Organization report, 5.4 million under-five children died, which is similar to under-five mortality rate of 39 deaths per 1000 live births. This rate is higher in sub-Saharan Africa with 76 deaths per 1000 live births. More than 1 out of every 2 deaths is because of diseases that can be managed with drug of low-cost and high quality. Institutional-based cross-sectional survey was conducted from January to February 2021, at the University of Gondar Comprehensive Specialized Hospital. Statistical Package for the Social Sciences software version 24 was used for data analysis. The results were presented using Figures, tables, and texts according to the nature of the data. The overall average availability of priority medicines was 75% on the day of visit and the average stock-out duration in the last 6 months was 23.85 days. Availability and utilization of priority medicines for the management of antiretroviral infections, Vitamin A deficiency, malaria, and diarrheal cases were high, whereas availability and utilization of suggested medication for neonatal sepsis were very low. A significant proportion of priority diseases was managed by non-priority medications. Medicines supply sources of the country, ministry of health, policymakers as well as facility managers should work in collaboration toward ensuring sustainable and consistent availability of priority medicines through the country. Continues in-service training of healthcare professionals is also mandatory to update themselves with newly developed guidelines, standards, and recommendations.

Herbal medicine use for the management of COVID-19: A review article.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause pandemic of coronavirus disease 2019 (COVID-19). For many thousands of years, herbal products and dietary plants have been prescribed for various diseases by traditional healers. Thus, the aim of this review is to present main herbal products, their source, characteristics, and potential antiviral actions concerning COVID-19. Publications on herbal products related to antiviral effects were searched from different databases, such as Web of Science, Google Scholar, Medline, Scopus, and PubMed, until August 2021, using English key terms. According to different studies, there are so many important medicinal plants with antiviral activity, which can be used for viral infections or can be prescribed as supportive treatment. lack of information on the safety profile and amount of dose for different diseases is some of the limitations of medicinal plants. herbal medicine can interfere with COVID-19 pathogenesis by inhibiting SARS-CoV-2 replication and entry to host cells. Some of the antiviral medicinal plant species are citrus Spp., orange (C. Sinensis), Allium sativum, Allium cepa, Mentha piperita, and nigella sativa are the most desirable herbal drink or fruit that can introduce effective adjuvant components in COVID-19 management.

Complementary and alternative medicine use and its associated factors among hypertensive patients in Debre Tabor General Hospital, Ethiopia.

BACKGROUND: Hypertensive patients have been using complementary and alternative medicine (CAM) to meet their primary healthcare needs within Ethiopia. The use of plant-based medicine is not only common rather it is also a culturally accredited practice, among the people of Ethiopia. However, studies conducted on the prevalence and correlates of herbal medicine (HM) use among hypertensive patients are lacking. Thus, this study aimed to assess CAM use and its associated factors among hypertensive patients. METHODS: An institutional-based cross-sectional study was conducted on 450 hypertensive patients, visiting the hypertensive care service of Debre Tabor General Hospital from November 1 to December 28, 2020. Interview-guided self-administered questionnaires were used for data collection. Statistical Package for the Social Sciences (SPSS) software version 24.0 was used for data analysis. Univariate and multivariate logistic regression was computed to identify associated factors of CAM use (age, sex, religion, residence, marital status, educational level, monthly income, presence of HTN complication, duration of HTN, and family history of HTN). RESULTS: Out of the 450 hypertensive patients, 275 (67.8%) participants used complementary and alternative medicine. Herbal medicines used among hypertensive patients were M. stenoptela 105 (62.9%), O. lamiifolium 81 (48.5%), C. aurea 62 (37.1%), R. nepalensis 44 (26.3%), M. piperata 36 (21.6%), H. abyssinica 24 (14.4%), T. schimperi 19 (11.4%), R. abyssinicus 15 (9.0%), and T. foenumgraecum 9 (5.4%). Majority of CAM users 202 (73.5) did not discuss with health professionals about their CAM use. Families and friends 91 (33.1%) were the frontline source of information about CAM use. In a multivariate analysis, female gender patients over 45 years old, rural residence, higher educational level, high average monthly income, presence of complications, greater than 5 years duration of hypertension (HTN), and having a family history of HTN were the independent predictors of CAM use. CONCLUSION: The prevalence of CAM use among hypertensive patients was high 275 (67.8%). Factors associated with CAM use are similar to those observed in previous studies, but further research is required to further clarify the opportunities and challenges correlated to CAM use in Ethiopia.

SARS-CoV-2 and diabetes: A potential therapeutic effect of dipeptidyl peptidase 4 inhibitors in diabetic patients diagnosed with COVID-19.

COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 and has become an urgent economic and health challenge. Dipeptidyl peptidase 4 (DPP4), also mentioned as a cluster of differentiation 26 (CD26) is a serine exopeptidase found in two arrangements: a soluble form (sDPP-4) and a plasma membrane-bound form. Because other coronaviruses enter the cells by binding to DPP-4, it has been speculated that DPP-4 inhibitors may exert activity against COVID-19. Therefore, this review aimed to summarize the potential therapeutic effect of dipeptidyl peptidase 4 inhibitors in diabetic patients diagnosed with COVID-19. To include different studies, publications related to Dipeptidyl peptidase-4 inhibitor use and clinical outcomes from COVID-19 were searched from the databases such as Web of Science, PubMed, Medline, Elsevier, Google Scholar, and SCOPUS, via English key terms. A direct engrossment of DPP4 in COVID-19 needs to be elucidated, there is also evidence confirming that DPP4 inhibitors exert anti-fibrotic and modulate inflammation activity. Thus, the use of DPP-4 inhibitors could reduce mortality due to COVID-19 or improve the progression of COVID-19; this evidence may support the management of diabetic patients diagnosed with COVID-19; however more well-designed investigation is urgently required.