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Diriba Alemayehu Gadisa,1 Guye Betero Busawa,2 Esayas Tadesse Gebremariam,1 Gosaye Mekonen Tefera,1 Kefyalew Taye Belete,3 Getu Melesie Taye,1 Lemma Bose Meskele,1 Biruk Mosisa Gudeta,1 Belayneh Kefale Gelaw4 1Department of Pharmacy, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia; 2Department of Pharmacy, College of Medicine and Health Sciences, Bule Hora University, Bule Hora, Ethiopia; 3Department of Public Health, College of Medicine and Health Science, Ambo University, Ambo, Ethiopia; 4Department of Pharmacy, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, EthiopiaCorrespondence: Diriba Alemayehu GadisaDepartment of Pharmacy, College of Medicine and Health Sciences, Ambo University, P.O. Box 19, Ambo, EthiopiaTel +251915958190Email direalexphar@ymail.comBackground: Stroke is becoming a leading cause of death and adult disability in the developing world.Objective: The objective of the study was to assess the clinical characteristics, treatment outcomes, and its predictors among stroke patients admitted to Ambo University Referral Hospital (AURH), West Ethiopia.Methods: All 111 stroke patients hospitalized from April 2016 to May 2019 were included using a hospital-based retrospective study. Socio-demographic profile, past medication history, clinical presentation, drugs prescribed for comorbid condition and stroke treatment, and outcomes data were collected using data abstraction formats and results were summarized using both descriptive and inferential statistics.Key Findings: According to WHO clinical criteria, 89 (80.2%) were diagnosed with ischemic stroke, and 20 (18.0%) were diagnosed with hemorrhagic stroke. The majority of the patients 94 (84.7%) had at least one antecedent risk factor in which hypertension accounted for 44.1%. More than half, 69 (62.2%), of hospitalized stroke patients had good treatment outcomes while 42 (37.8%) had a poor outcome. The overall case-fatality rate was 18 (16.2%), 12 (13.5%) from ischemic stroke, and 6 (30.0%) from hemorrhagic stroke. Acetyl salicylic acid (ASA) with atorvastatin/simvastatin, 67 (73.5%) in ischemic stroke and 12 (60.0%) in hemorrhagic stroke, was the most frequent medications prescribed for stroke during admission while it was frequently prescribed for 48 (53.6%) of ischemic stroke and 10 (50.0%) of the hemorrhagic stroke on discharge. Overall, ceftriaxone + metronidazole 32 (28.8%) was frequently prescribed concomitant medications during admission. The major predictors identified for poor stroke outcomes were substance abuse (AOR=2.839, P=0.024) and have had not received any medication for stroke treatment during admission (AOR=12.503, P≤ 0.001).Conclusion: A significant number of the admitted stroke patients had poor treatment outcome in which the case-fatality rate was relatively high. Substance abuse and having not received medication for stroke were the significant predictors for poor treatment outcome. Hence, a well-established stroke unit setup at AURH is required for accurate diagnosis and management of stroke to overcome stroke-related mortality and/or poor treatment outcome.Keywords: stroke, predictors, outcomes, Ambo, Ethiopia

Gosaye Mekonen Tefera,1 Beshadu Bedada Feyisa,2 Getu Melesie Taye,3 Gurmu Tesfaye Umeta,1 Fekadu Negash Bereded,4 Hunduma Dinsa Ayeno,1 Diriba Alemayehu Gadisa,3 Tsegaye Melaku Kebede5 1Department of Pharmacy, Clinical Pharmacy Course Unit, Ambo University, Ambo, Ethiopia; 2Department of Public Health, Human Nutrition Course Unit, Ambo University, Ambo, Ethiopia; 3Department of Pharmacy, Pharmacology Course Unit, Ambo University, Ambo, Ethiopia; 4School of Medicine, Department of Surgery, Wachemo University, Hossana, Ethiopia; 5School of Pharmacy, Department of Clinical Pharmacy, Jimma University, Jimma, EthiopiaCorrespondence: Gosaye Mekonen Tefera Email Gosi2010pharma@gmail.comBackground: Surgical site infection (SSI) is the most prevalent in developing countries where 61– 90% of cases develop in-hospital. The study aimed to assess the correctness of antibiotic prophylaxis (AP) use, the incidence of in-hospital SSI, and its determinants.Patients and Methods: A 3-month hospital-based prospective observational study design was used on general surgery patients. The criteria for identification of SSI were performed based on the Center for Disease Control and Prevention’s (CDC’s) definition of SSI. The correctness of AP was performed based on the American Society of Health System Pharmacist 2013 guideline (ASHP). Multiple stepwise backward logistic regression analysis was used at p-value < 0.05 to predict SSI.Results: Of 269 adult patients, the type of admission was almost equal between emergency and elective surgery. The mean (± SD) age of the study participants was 41.95± 17.764. Only 19.7% of the study participants used AP correctly. The incidence rate of in-hospital SSI was 16.7% (45/269), which corresponds to 45/4736 or 9.5/1000 person-days. Independent predictors for SSI were American Society of Anesthesiology (ASA) class III–IV (p-value < 0.0001), patients with age-adjusted Charlson co-morbidity index (CCI) of ≥ 1 score (p value=0.008), and incorrect use of AP (p-value =0.025).Conclusion: Incorrect antibiotic prophylaxis use contributed to an increased risk of SSI, which needs urgent attention in the present study area.Keywords: antibiotic prophylaxis, surgical site infection, predictors, JUMC

Introduction: Plants have formed the basis of traditional medicine (TM) systems, which have been used for thousands of years. According to reports, one-quarter of the commonly used medicines contain compounds isolated from plants. This study aims to identify and document the plants for ethno-pharmacological use by the indigenous communities of West Shoa Zone, Oromia region, Ethiopia. Methods: The cross-sectional study was conducted from November 2020 to November 2021 in West Shewa Zone, Oromia Region, Ethiopia. The ethnobotanical data was collected from Ejere District, Ada Berga District, Dandi District, Ambo District, Ambo Town, Toke Kutaye District, and Bako Tibe District. A descriptive statistical method (percentage and/or frequency) was employed to summarize ethnobotanical data. Moreover, the informant consensus factor was computed. Microsoft Excel spreadsheet software (Microsoft Corporation, 2016) and SPSS (version 25) were used to organize and analyze the data. Result: In the study area, a total of 51 families of medicinal plants with 108 Species were identified. Fabaceae 8 species, Asteraceae, Solanaceae and Lamiaceae each with 6 species and Cucurubitacieae 5 species were the frequently reported medicinal plants. The leaf (57.2%) was the most widely used medicinal plant parts, and oral administration (56.5%) was the most cited route of administration. In the present study, most of the medicinal plants were used fresh, which was (75%) and the most common disease the healers treated was gastrointestinal disease, followed by skin disease and febrile illness. The major threat to medicinal plants in the study area was agricultural expansion, which was reported by 30.6% of the respondents. The study area was rich in medicinal plants, Fabaceae which commonly used family. Conclusion: Most of the medication prepared by the traditional healers was taken orally and derived from the leaf part of the medicinal plant. Since this research is a preliminary study which will be used as a base for further study. The efficacy and safety of the medicinal plant claim should be studied in the future., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Beressa, Gadisa, Mammo, Umeta, Meskele, Gudeta and Taye.)

Objective: This study was aimed at assessing the prevalence of herbal drug use among pregnant women with access to modern medicine and associated factors in public health facilities in the west Shewa zone, Oromia regional state, Ethiopia., Design: A sequential mixed-method study approach was carried out among pregnant women and other stakeholders., Setting: This study was conducted at public health facilities, including 3 public hospitals and 20 health centres, in the west Shewa zone of Ethiopia., Participants: A systematically selected sample of 411 pregnant women was participated in the quantitative study. For the qualitative method, focus group discussions and in-depth interviews were conducted among pregnant women attending antenatal care and key informants using an interview guide until data saturation was achieved., Primary Outcome: For outcome variables, the respondents were asked if they used any herbal medicine during their current pregnancy. It was then recorded as 0=no and 1=yes., Results: The prevalence of herbal medicines was found to be 19.7%. The most commonly used herbal medicines were Zingiber officinale , Ocimum gratissimum , Eucalyptus globules , Allium sativum and Rutacha lepensis . Herbal medicine use during pregnancy was significantly associated with older maternal age (adjusted OR (AOR) 2.4, 95% CI 1.2 to 5.1), urban residence (AOR 2.3, 95% CI 1.3 to 3.7) and second trimester of pregnancy (AOR 2.3, 95% CI 1.3 to 4.5)., Conclusions: In this study, one in five pregnant women uses herbal medicine, which is relatively low. Sociodemographic factors and the duration of pregnancy affected the utilisation of herbal drugs during pregnancy. The most common herbals used by pregnant women were intended to treat minor disorders of pregnancy and medical disorders such as hypertension., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Phytolacca dodecandra (L' Herit), or 'Endod', is one of the widely known medicinal plants in Ethiopia. Berries of the endod have been used as a detergent for centuries. The present study was aimed to test the hepatoprotective effects of the plant against acetaminophen (APAP)-induced liver injury in rats. Mice of either sex were used for oral acute toxicity tests and APAP-induced lethality tests. Hepatoprotective experiments were done on male rats using 2 g/kg of APAP to induce liver damage. Liver enzymes, total bilirubin (TB), and lipid profile were determined. Liver tissues were also examined histopathologically to see a morphologic change in the control and experiment groups. The protective effect of the plant extract was also tested through sodium pentobarbital (SPB)-induced sleeping time. A significant increase in serum levels of liver enzymes, TB, low-density lipoprotein (LDL), and triglycerides (TGs) was seen from oral administration of 2 g/kg APAP. Total cholesterol (TC) and high-density lipoprotein (HDL) levels were decreased. Serum levels of all parameters were reversed to normal after administration of silymarin 100 mg/kg and, 100, 200, and 400 mg/kg doses of the extract. A significant dose-dependent hepatoprotective effect of Phytolacca dodecandra Methanol Root Extract (PDME) was seen in terms of LDL. Histopathological investigations and SPB-induced sleeping time confirmed the findings of biochemical analysis. The findings of the present study indicate that PDME protected the liver from APAP injury., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: Internet addiction (IA) is causing academic failure, decreased concentration ability, and a negative affective state. In Ethiopia, studies conducted on IA were limited; therefore, this study aimed to assess its prevalence and risk factors among medicine and health science (MHS) students of Ambo University., Materials and Methods: This study was a cross-sectional study and included MHS students of Ambo University from July 15 to August 15, 2021. Data were collected using a self-administered questionnaire after receiving informed consent from study participants. The results were analyzed using the statistical software for social sciences version 24. Bivariate and multivariate logistic regressions were performed to explore the relationship between IA and dependent variables., Results: Of the 253 participants who participated in the study, 201 (79%) were found to have an IA. Having one's own computer, Internet access at home and an email account were 2 times more risky to develop IA compared to their counterparts with AOR = 2.615 (95% CI = 1.118-5.956) with a P value of .022, AOR = 2.154 (95% CI = 1.054-4.405) with a P value of .35 and (=2.154 (95% CI = 1.054-4.405 with a P value of .035 respectively. Additionally, those who use the Internet for news were 2.5 times more likely to develop IA compared to those who do not (AOR = 2.551 (95% CI = 1.225-5.349) with a P -value of .013). The use of the Internet for scientific research and education reduces IA by 0.7 times (AOR = 0.323 (95% CI = 0.120-0.868) with a P value of .025)., Conclusions: The prevalence of IA was found to be high in this study. Therefore, strategies are needed to minimize the prevalence of this problem., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)

Background: Diabetic Ketoacidosis (DKA) is the most common and yet potentially life-threatening acute complication of diabetes that progresses rapidly to death and requires immediate medical intervention., Objective: To assess the DKA management and treatment outcome/in-hospital mortality and its predictors among hospitalized patients with DKA at the Medical ward of Shashemene Referral Hospital (SRH)., Method: A retrospective study was conducted at the Medical Ward of SRH from 01 February 2015 to 31 January 2017. A systematic random sampling technique was used to select study subjects based on the inclusion criteria. Thus, of 236 reviewed charts, only 225 patients with DKA fulfilled inclusion criteria. Treatment outcome was considered good for patients who have shown improvement at discharge, while poor for patients who left against medical advice or died in the hospital. Logistic regression analysis was done to determine independent predictors for treatment outcome/in-hospital mortality using SPSS version 20 with statistical significant at P  ⩽ .05., Results: Of 225 patients with DKA, 124 (55.1%) were male. Regular insulin was prescribed to all patients and antibiotics were administered to 87 (38.7%). Potassium supplementation was given only for 28 (12.4%). Non-adherence to insulin treatment (n = 91; 40.4%) and infection (n = 66; 29.3%) were the principal DKA precipitating factors. Even though 73.8% of hospitalized patients with DKA have shown good treatment outcomes, DKA contributed 12% in-hospital mortality. The result of multivariate logistic regression analysis shown that hypoglycemia is the only independent predictor for in-hospital mortality[ P  = .03]. Moreover, the independent predictors for poor DKA treatment outcome were found to be smoker [ P  = .04], Urinary tract infection (UTI) relative to other co-morbid condition [ P  < .001], severe hypokalemia which increase risk of poor treatment outcome by around 4 times [ P  = .02], and use of Metronidazole as a concurrent medication relative to other concurrent medication [ P  = .03]., Conclusion: There was a high in-hospital mortality rate due to correctable causes. This mortality is unacceptable as it was majorly related to the poor practice of potassium supplementation and hypoglycemia due to insulin. Thus, clinicians and stakeholders should have to focus on modifiable factors (hypokalemia, UTI, and hypoglycemia) to reduce poor treatment outcome/in-hospital mortality., Competing Interests: Declaration of Conflicting Interests:The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2021.)