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Background Published coronavirus disease 2019 (COVID-19) reports suggest higher mortality with increasing age and comorbidities. Our study describes the clinical characteristics and outcomes for all intensive care unit (ICU) patients admitted across the Cleveland Clinic enterprise, a 10-hospital health care system in Northeast Ohio, serving more than 2.7 million people. Methods We analyzed the quality data registry for clinical characteristics and outcomes of all COVID-19-confirmed ICU admissions. Differences in outcomes from other health care systems and published cohorts from other parts of the world were delineated. Results Across our health care system, 495 COVID-19 patients were admitted from March 15 to June 1, 2020. Mean patient age was 67.3 years, 206 (41.6%) were females, and 289 (58.4%) were males. Mean Acute Physiology Score was 45.3, and mean Acute Physiology and Chronic Health Evaluation III score was 60.5. In total, 215 patients (43.3%) were intubated for a mean duration of 9.2 days. Mean ICU and hospital length of stay were 7.4 and 13.9 days, respectively, while mean ICU and hospital mortality rates were 18.4% and 23.8%. Conclusions Our health care system cohort is the fourth largest to be reported. Lower ICU and hospital mortality and length of stay were seen compared to most other published reports. Better preparedness and state-level control of the surge in COVID-19 infections are likely the reasons for these better outcomes. Future research is needed to further delineate differences in mortality and length of stay across health care systems and over time.

Background: Frailty is a multidimensional geriatric condition that increases vulnerability to stressors, increases the risk of negative health outcomes, and lowers quality of life in older people. However, little attention has been paid to frailty in developing countries, particularly in Ethiopia. Therefore, the aim of the study was to investigate the prevalence of frailty syndrome and the sociodemographic, lifestyle, and clinical factors associated with it., Methods: A community-based cross-sectional study design was conducted from April to June 2022. A total of 607 study participants were included using a single cluster sampling technique. The Tilburg frailty indicator, which is a self-reported schedule for assessment of frailty, required respondents to answer 'yes' or 'no' and the total attainable score ranged from 0 to 15. An individual with a score of ≥ 5 considered frail. Data were collected by interviewing the participants using a structured questionnaire, and the data collection tools were pre-tested before the actual data collection period to check for the accuracy of responses, language clarity, and appropriateness of the tools. Statistical analyses were performed using the binary logistic regression model., Results: More than half of the study participants were male, and the median age of the study participants was 70, with an age range of 60-95 years. The prevalence of frailty was 39% (CI 95%, 35.51-43.1). In the final multivariate analysis model, the following factors associated with frailty were obtained: older age (AOR = 6.26 CI (3.41-11.48), presence of two or more comorbidities (AOR = 6.05 CI (3.51-10.43), activity of daily life dependency (AOR = 4.12 CI (2.49-6.80), and depression (AOR = 2.68 CI (1.55-4.63) were found to be significant factors., Conclusion and Recommendations: Our study provides epidemiological characteristics and the risk factors of frailty in the study area. Efforts to promote physical, psychological, and social health in older adults are a core objective of health policy, especially for older adults aged 80 and above years, and those with two or more comorbidities., (© 2023. The Author(s).)

Background: stroke is a common cause of mortality and morbidity in low- and middle-income countries. It is a very sudden episode in the patients' lives and can lead to multiple psychosocial, social, and economic consequences, and psychiatric problems. poststroke depression is the most common and major neuropsychiatric consequence of stroke that affects one-third of stroke survivors. The aim of this study to assess the burden of depression and its predictors among stroke survivors with local version validated Patient Health Questionnaire., Methods: An institutional-based cross-sectional study was conducted among stroke patients at selected tertiary level hospitals. Data were collected by interview method using structured questionnaires, and patient medical record reviews and data were recruited by using consecutive sampling method. Bivariate and multivariable binary logistic regression model analysis was used with SPSS version 23 to identify factors associated with depression., Results: A total of one hundred eighty stroke patients participated in the study with a response rate of 88.2%. The overall prevalence of depression is 49.6% (95% CI: 42.8, 56.7). Occupation, marital status, level of education of stroke patients was significantly associated with post stroke depression with P < 0.05., Conclusion: The study findings presented that nearly half of the stroke patients suffered from post stroke depression. Post-stroke depression was strongly associated with patient occupation, marital status, and level of education There is urgent need for integration of screening for and management of post-stroke depression among stroke survivors., Competing Interests: The authors report no conflicts of disclosure in this work., (© 2021 The Authors.)

Stroke is the leading cause of adult disability worldwide, with 70 percent of survivors exhibiting residual impairments of the upper limb that require frequent in-person visits to rehabilitation clinic over several months. This study explored rehabilitation clinician's preferences for design features to be included in an mHealth-enabled app for post-stroke upper limb rehabilitation. Data were collected via online survey, sampling participants from Ethiopia ( n = 69) and the United States ( n = 75). Survey results indicated that Ethiopian and US rehabilitation clinicians have different opinions about the importance of design features that should be included in a stroke tele-rehabilitation system which are likely due to differences in culture, the availability of human and physical resources, and how the field of rehabilitation is organized and managed. Our results, thus, indicate that mHealth technologies must be tailored to the geographical and cultural context of the end users.

Background: Fall is a major public health problem and potentially disabling issue. A vast burden of visually impaired live in low-middle income countries particularly in Sub-Saharan Africa. Limited ability to detect environmental hazards puts visually impaired at a greater risk of falls and unintentional injuries. Falls among visually impaired is associated with considerable disability, health care cost, loss of independence, and socio-economic consequences. Ethiopia lacked estimates of fall among any vulnerable population, particularly among visually impaired people. Therefore, this study aimed to estimate the prevalence of falls and factors associated among adult people with medically diagnosed visual impairment in Ethiopia., Methods: An institutional-based cross-sectional study was conducted among visually impaired adults who attended the ophthalmology clinic at the University of Gondar comprehensive specialized hospital during the study period. Data were collected by interview method using structured questionnaires, patient medical record reviews, and physical measurements. Bivariate and multivariable binary logistic regression model analysis was used to identify factors associated with falls. Adjusted odds ratio with corresponding 95% confidence intervals were computed to show the strength of association., Results: A total of 328 adults medically diagnosed with visual impairment participated in the study (97.3% response rate). The age of the participants ranged from 25 to 89 years with a mean age of (56.46 ± 14.2 years). The overall cumulative prevalence of self-reported falls among adults with visual impairment was 26.8% with 95%CI (22.7, 32.4%). The major associated factors of fall identified by multivariate analysis were; visual impairment in both eye (AOR 3.21, 95% CI 1.11, 9.29), fear of falling: some concerned: (AOR, 4.12; 95%CI, 1.44, 11.76), very concerned fear (AOR 10.03; 95% CI, 3.03, 33.21), medications: (AOR 4.63; 95% CI 2.14, 10.00) and self-reported depression: (AOR 3.46; 95% CI 1.11, 10.79)., Conclusion: The result of this study indicates a moderate self-reported prevalence of fall among adult people with medically diagnosed visual impairment. Identifying sub-groups at risk of falls among visually impaired, modifiable risk factors, implementation of precaution measures to avoid fall and fall-related injuries, and most importantly measures that would reduce the fear of falls in visually impaired people deserves immediate attention.

Background: Diabetic sensory neuropathy is a common form of microvascular complication among diabetic patients. The swiftly growing population of people living with diabetes in Ethiopia and lack of elaborated scientific data on peripheral sensory neuropathy among diabetic population in Ethiopia prompted this work. This study was set out to assess the enormity and associated factors of peripheral sensory neuropathy among diabetes patients attending chronic illness clinic of Felege Hiwot Regional Referral Hospital, Bahr Dar, Northwest Ethiopia., Methods: An institution based cross-sectional study was conducted at Felege Hiwot Referral Hospital chronic illness clinic using Michigan neuropathy screening instrument tool for diabetic peripheral sensory neuropathy on 408 diabetic patients during 2016. Data were collected using interview, patient record review, anthropometric measurements and physical examination. Both bivariate and multivariate binary logistic regression was employed to identify factors associated with peripheral sensory neuropathy. Odds ratios with their 95% CI and P value less than 0.05 used to determine statistically significant associations., Results: A total of 368 patients were included with the mean age of 49 ± 14.3 years. The overall prevalence of Peripheral Sensory Neuropathy was found to be 52.2%. The major associated factors identified by multivariate analysis were age >50 years: AOR: 3.0 CI [1.11, 7.89]; overweight and obese: AOR: 7.3 CI [3.57, 14.99]; duration of DM: AOR: 3.4 CI [1.75, 6.60]; not involved in physical exercise: AOR: 4.8 CI [1.90, 7.89]; male gender: AOR: 2.4 CI [1.18, 5.05]., Conclusion: Almost half of the diabetic patients who attended Felege Hiwot regional referral hospital during study period were found to present with peripheral sensory neuropathy. Socio-demographic and bio characteristics like patients age, Body Mass Index, level of physical activity and marital status were significantly associated with diabetic peripheral sensory neuropathy.