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Hiwot Yisak,1 Dejen Gedamu,2 Amien Ewunetei3 1Department of Nutrition, Debre Tabor University, Debre Tabor, Ethiopia; 2Department of Statistics, Debre Tabor University, Debre Tabor, Ethiopia; 3Department of Pharmacy, Debre Tabor University, Debre Tabor, EthiopiaCorrespondence: Hiwot Yisak, Email hyisak@yahoo.comIntroduction: Despite being an excellent source of essential nutrients, whole cow’s milk poses risks for young children. This is mainly due to its association with adverse effects, including growth inhibition, delayed brain and motor development, and increased morbidity and mortality. The current study aimed to evaluate the occurrence of untimely introduction of whole cow milk, stunting and related factors among children below the age of 5 years.Methods: A community-centered survey was implemented on 806 mother–child matches. Expressive statistics such as frequency, magnitude, mean and standard deviation were computed. Multivariable logistic regression was done to discover independent determinants of the dependent variables. A p-value of < 0.05 was used to affirm significant association.Results: From the survey participant children 311 (39.2%) of them were stunted. About 453 (57.1%) of children were fed whole cow milk earlier than the age of one year. Mothers who are able to read and write were 49% less likely to initiate cow milk earlier than the age of one year with AOR = 0.51, 95% CI 0.33– 0.78. Not attending the growth monitoring and promotion service is a risk for untimely introduction of whole cow milk (AOR = 3.47, 95% CI 2.43– 4.94). Children who did not start consuming whole cow milk earlier than the age of one year were 54% less likely to be stunted than those who started consuming whole cow milk before the age of one year (AOR = 0.46, 95% CI 0.33– 0.65).Conclusion: More than half of the study participant children started consuming whole cow milk before the age of one year. Children who did not start consuming whole cow milk early were less likely to be stunted.Keywords: untimely initiation, whole cow milk, stunting, Ethiopia

Melkalem Mamuye Azanaw,1 Alemayehu Digssie Gebremariam,1 Fentaw Teshome Dagnaw,1 Hiwot Yisak,1 Getaneh Atikilt,1 Binyam Minuye,2 Melaku Tadege Engidaw,1 Desalegn Tesfa,1 Edgeit Abebe Zewde,3 Sofonyas Abebaw Tiruneh1 1Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia; 2Department of Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia; 3Department of Biomedical Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, EthiopiaCorrespondence: Melkalem Mamuye Azanaw Email Melkalem21@gmail.comIntroduction: Antenatal care (ANC) is a medical care and procedure carried out for pregnant women. Data on ANC visits can help policymakers show gaps in service provision. Therefore, this study assessed the factors associated with the number of ANC visits among women in rural Ethiopia.Methods: We included a total of 6611 women who gave birth within 5 years preceding the survey from the 2016 Ethiopian Demographic and Health Survey. A multi-level negative binomial regression analysis was employed to consider the hierarchical nature of the data. In the multivariable analysis, variables with a p-value < 0.05 were considered to be significantly associated with the number of ANC visits.Results: Overall, 27.3% (95% CI: 14.63, 15.76) of women had at least four ANC visits during pregnancy in rural Ethiopia. Among individual level factors, age group 25– 29 years (adjusted incidence rate ratio (AIRR)=1.13,95% CI:1.02,1.26), household rich wealth status (AIRR=1.17, 95% CI:1.04,1.31), women’s educational status (primary, AIRR=1.19,95% CI:1.08,1.32; secondary, AIRR= 1.30,95% CI:1.08,1.55; above secondary, AIRR=1.35, 95% CI:1.07,1.71), partner educational status (primary, AIRR=1.16, 95% CI:1.05,1.28; secondary, AIRR=1.22,95% CI:1.08,1.38), and autonomy to decision to their care (AIRR=1.25,95% CI:1.10,1.42) were positively associated factors whereas having a birth order of five or more (AIRR=0.80,95% CI: 0.69,0.94) was a negative associated with number of ANC visits. Among community-level variables, being in higher community level literacy (AIRR=1.35, 95% CI: 1.14, 1.59) and higher poverty level (AIRR=0.77, 95% CI: 0.64, 0.92) were significant factors with the number of ANC visits.Conclusions and Recommendations: Women’s age, wealth status, women’s educational status, partner educational status, autonomy to decision making in health care, and birth order were determinants of the number of ANC visits. Furthermore, poverty and literacy are also important factors at the community level. Addressing economic and educational interventions for rural women should be prioritized.Keywords: antenatal care, women, rural Ethiopia, multilevel negative binomial count analysis

Amien Ewunetei,1 Hiwot Yisak,2 Belayneh Kefale1 1Department of Pharmacy, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia; 2Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, EthiopiaCorrespondence: Amien EwuneteiDepartment of Pharmacy, College of Health Sciences, Debre Tabor University, Debre Tabor, 272, EthiopiaTel +251913670582Email amienpeace@gmail.comIntroduction: Inappropriate drug utilization may reduce the best possible benefits of drug therapy, and patients may not be cured, they may be exposed to toxicity, and medications may be wasted. The aim of this study is to assess household-level drug utilization practices and their associated factors.Methods: A cross-sectional community-based study was conducted from January 15 to March 15, 2020. In total, 847 households selected by stratified multistage sampling were visited. Bivariate and multivariable analyses for association were carried out using a binary logistic regression model. The statistical significance of an association was confirmed at p< 0.05.Results: Of the total 847 households, 378 (44.6%) were found to store drugs at home at the time of datacollection. In the 371 households that allowed observation of the drugs stored, a mean of 2.51 (SD=1.68) drugs per household was found; 40.2% of stored medicines were not in use at the time of the study. The prevalences of medication hoarding, sharing, and allopathic self-medication were 20.4%, 26.3%, and 43.8%, respectively. Higher monthly income and the presence of a child aged under 5 years were significantly associated with drug hoarding. The presence of an elderly person aged above 65 years and the presence of a family member with chronic illness were significantly associated with drug hoarding and sharing. Families with higher educational status were less likely to hoard and share medicines. The presence of stored drugs at home was significantly associated with the practice of self-medication.Conclusion: A high prevalence of inappropriate drug utilization was observed. Factors such as the presence of a family member with chronic illness, elderly people, and children under 5, higher income, and the presence of stored drugs were significantly associated with inappropriate drug utilization. Families of higher educational status were less likely to hoard and share medicines.Keywords: drug storage, medication hoarding, drug sharing, self-medication, Ethiopia

Hiwot Yisak,1 Amien Ewunetei,2 Belayneh Kefale,2 Melkalem Mamuye,1 Fentaw Teshome,1 Birhanie Ambaw,1 Getachew Yideg Yitbarek3 1Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia; 2Department of Pharmacy, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia; 3Department of Biomedical Science, College of Health Sciences, Debre Tabor University, Debre Tabor, EthiopiaCorrespondence: Hiwot YisakDepartment of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, EthiopiaTel +251-91-372-8949Email hyisak@yahoo.comIntroduction: Vitamin D status is related to risks of influenza and respiratory tract infections. Vitamin D has direct antiviral effects primarily against enveloped viruses, and coronavirus is an enveloped virus. The 2019 coronavirus disease had a high mortality rate and impacted the whole population of the planet, with severe acute respiratory syndrome the principal cause of death. Vitamin D can adequately modulate and regulate the immune and oxidative response to infection with COVID-19. The goal of this systematic review was thus to summarize and decide if there were a link between vitamin D status and COVID-19 infection and prognosis.Methods: The protocol of this study is documented in the Prospero database and can be accessed with the protocol number CRD42020201283. PubMed and Google Scholar were used for a literature search from August 2020 to September 2020. We restricted the year of publication of reviewed articles to 2019– 2020, and the selected language was English. Studies that used secondary data, feedback, or analysis of reviews were removed. To assess the standard of studies included, the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method was used.Results: Of the nine studies reviewed, seven (77.8%) showed that COVID-19 infection, prognosis, and mortality were correlated with vitamin D status.Conclusion: Most of the articles reviewed showed that blood vitamin D status can determine the risk of being infected with COVID-19, seriousness of COVID-19, and mortality from COVID-19. Therefore, maintaining appropriate levels of Vitamin D through supplementation or natural methods, eg, sunlight on the skin, is recommended for the public to be able to cope with the pandemic.Keywords: COVID-19, vitamin D, prognosis, infection, mortality

Hiwot Yisak,1 Melaku Tadege,1 Birhanie Ambaw,1 Amien Ewunetei2 1Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia; 2Department of Pharmacy, College of Health Sciences, Debre Tabor University, Debre Tabor, EthiopiaCorrespondence: Hiwot Yisak Tel +251-913728949Email hyisak@yahoo.comBackground: Underweight, wasting, and stunting are the commonest nutritional disorders among children, especially in developing countries. The aim of this study was to assess the prevalence and determinant factors of underweight, wasting, and stunting among school-age children in 2019.Methods: A cross-sectional study was conducted in the five special districts of South Gondar Zone, among 314 school-age children. WHO AnthroPlus software was used to build Z-scores from anthropometric measurement. The data were analyzed by SPSS Version 20. The degrees of association were assessed using adjusted odds ratio (AOR) and 95% confidence interval during multivariable logistic regression. A P-value less than 0.05 was considered to be statistically significant.Results: Of the total study participants, 232 (77.3%) were from public schools. The mean±standard deviation (SD) of height of children was 132.9± 9.8 cm, and the mean±SD weight of children was 27.7± 5.8 kg. The prevalence of stunting, wasting, and underweight was 11%, 6.3%, and 11.4%, respectively. Students who ate their breakfast rarely were 8-times more likely to be underweight than those who ate their breakfast always (AOR=7.9, 95% CI=4.8– 14.8). Those who were sick in the past 2 weeks were more likely to be underweight than their counterparts (AOR=7.3, 95% CI=2.8– 14.4). Those who never consume milk or milk products were 6.5 (AOR=6.5, 95% CI=1.7– 23) times more likely to be stunted than those who consumed this always. Sickness in the past 2 weeks prior to data collection was significantly associated with thinness (AOR=6 0.9, 95% CI=4.1– 10.1).Conclusion: The overall prevalence of wasting, stunting, and underweight was a mild public health problem in the study area.Keywords: wasting, stunting, underweight, school-age children, South Gondar, Ethiopia

Hiwot Yisak,1 Birhanie Ambaw,1 Zebader Walle,2 Banchiayehu Alebachew,2 Amien Ewunetei3 1Department of Public Health Nutrition, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia; 2Department of Health Service and Management, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia; 3Department of Pharmacy, College of Health Science, Debre Tabor University, Debre Tabor, EthiopiaCorrespondence: Hiwot Yisak Email hyisak@yahoo.comIntroduction: Minimum acceptable diet is a composite indicator of minimum dietary diversity and minimum meal frequency. World Health Organization’s newborn child feeding and HIV guidelines suggestbeginning complementary nourishments at six months, and breastfeeding for HIV-exposed children. HIV infected mothers may be more sensitive on feeding practices to protect their children from contracting the disease. On the other hand, HIV infection is associated with higher risk food insecurity which may affect feeding practices of children. But in Ethiopia, there is lack of evidence on extent of minimum acceptable diet of HIV-exposed children. Therefore, the objective of this study was to assess minimum acceptable diet and associated factors among HIV-exposed 6– 24 months aged children.Methods: An institution-based cross-sectional study was conducted in health institutions of Debre Tabor town. The study was conducted on 287 mother-child pairs attending antiretroviral therapy (ART) and prevention of mother-to-child transmission (PMTCT) at public health facilities. Descriptive statistics like frequency, proportions, mean and standard deviation were computed. Multi-variable logistic regression was run to identify independent predictors of the outcome variable (minimum acceptable diet). A p-value < 0.05 was used to declare statistical significance.Results: About 76% (95% CI: 70.8– 80.8) and 58.2% (95% CI: 53.0– 68.3) children were fed with appropriate meal frequency and recommended dietary diversity, respectively. One hundred (34.8%) (95% CI: 29.3– 40.4) of children were fed a minimum acceptable diet and 59.9% (95% CI: 54.0– 65.9) of children consumed iron rich or fortified food. Out of the total, 203 (71.0%) (95% CI: 66.1– 76.2) of the mothers had good knowledge on minimum dietary diversity and meal frequency feeding practices. In multi-variable logistic regression poor knowledge with AOR = 0.32, 95% CI: 0.17– 0.58, maternal workload with AOR = 0.38, 95% CI: 0.19– 0.75 and inadequate information about child feeding from health care providers with AOR = 0.46, 95% CI: 0.26– 0.81 were statistically significant predictors of minimum acceptable diet.Conclusion: The study revealed that the proportion of children who received minimal acceptable diet was lower than that of WHO recommendation for good practice. Knowledge, maternal workload and information related to complementary feeding were associated with low minimum acceptable diet.Keywords: minimum acceptable diet, minimum dietary diversity, meal frequency, HIV-exposed children, Ethiopia

Hiwot Yisak,1 Rishah Elmneh,2 Wubet Taklual,1 Amien Ewunetei,3 Belayneh Kefale4 1Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara, Ethiopia; 2Department of Supply Chain, Distribution and Sales, Julphar Pharmaceuticals Plc, Addis Ababa, Ethiopia; 3Department of Pharmacology, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara, Ethiopia; 4Department of Clinical Pharmacy, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara, EthiopiaCorrespondence: Hiwot YisakDepartment of Public Health, College of Health Sciences, Debre Tabor University, PO Box 272, Debre Tabor, Amhara, EthiopiaTel +251 913728949Email hyisak@yahoo.comBackground: Globally, pre-school children are the most at-risk population groups for vitamin A deficiency (VAD). The 2009 World Health Organization (WHO) report stated that one-third (190 million) of pre-school children worldwide are deficient in vitamin A. Both clinical and subclinical VAD have been a long-standing problem in developing countries. In Ethiopia, VAD was recognized as a public health problem 4– 5 decades before. Since then, researches conducted in other parts of the country still showed varied and high prevalence, which is 2– 8 times higher than WHO cut-off points. This community-based study was therefore conducted on pre-school children of rural kebeles in Farta district to determine the prevalence of clinical VAD (Bitot’s spot and night blindness) and associated factors.Methods: A community-based cross-sectional mixed quantitative and qualitative study was conducted. Randomly selected 588 pre-school children participated in the study. The clinical aspect of the study investigated the presence of Bitot’s spots on the children’s eye with the aid of a magnifying loop and torch. Data on the history of night blindness were obtained from mothers/caregivers by using WHO standard questions. The qualitative study data were obtained via a key informant interview with the mothers/caregivers whose child has clinical VAD. Quantitative data were entered using Epi Data statistical software and analysed by using SPSS version 20 statistical software package. A bivariable logistic regression was employed, and variables that showed significant association with clinical VAD (P < 0.2) were entered a multivariable logistic regression model to identify independent predictors of clinical VAD.Results: The prevalence of Bitot’s spot and night blindness was 0.8% and 1.2%, respectively. Pre-school children who were from highland (AOR: 3.71; 95% CI: 1.01– 13.68), a mother having antenatal care (ANC) visit during pregnancy of a child (AOR: 8.63; 95% CI: 2.58– 28.79), family monthly income (AOR: 8.63; 95% CI: 2.58– 28.79) and handwashing frequency were found to be determinants of VAD (p < 0.05).Conclusion: Clinical vitamin A deficiency in the study area is of public health concern because the prevalence of Bitot’s and night blindness was above the WHO threshold level. Accordingly, effective preventive measures should be designed to reduce VAD prevalence.Keywords: clinical vitamin A deficiency, Bitot’s spots, night blindness, Farta district

Abstract Objective To assess factors associated treatment outcomes of acute post streptococcal glomerular nephritis among patients less than 18 years old in Mekelle City Public Hospitals. Results About 334 medical records c of children with acute post streptococcal glomerular nephritis were revised during the study period. Of these 244 (73.1%) had a positive outcome. acute post streptococcal glomerular nephritis was found to be statically significant associated with age

Teff [ Eragrostis tef (Zuccagni) Trotter] is a cereal grain originating in Ethiopia as a staple food for millions of people. Its grain is a gluten-free superfood and got acceptance as a medicinal ingredient. Therefore, it is worthwhile to determine the antioxidative activities and L-ascorbic acid contents of teff grain and its baked food (injera). This study aimed to determine the ascorbic acid contents and antioxidant activities in the aqueous extract of the white and brown teff grains and their injera samples using iodimetric titration and UV-Vis spectrophotometric methods, respectively. The ascorbic acid contents in the white and brown teff ranged from 67.9-112.6 mg/100 g and 69.2-117.2 mg/100 g, respectively, and those in injera of the selected teff samples ranged from 30.5-32.9 mg/100 g and 37.3-43.0 mg/100 g, respectively. The antioxidant activities ranged from 1.26-7.04  μ mol AAE/g for the white teff grains, 1.44-6.29  μ mol AAE/g for the brown teff grains, 1.81-2.47  μ mol AAE/g for white teff injera, and 3.89-4.86  μ mol AAE/g for the brown teff injera samples. Findings of the present study have revealed that white teff and brown teff grains and their injera were found to have a higher content of ascorbic acid than commonly consumed grains and vegetables. No significant difference ( α  = 0.05) has been observed between the two varieties of teff grains with respect to the ascorbic acid content and antioxidant activities. However, there was a statistically significant difference ( α  = 0.05) in the ascorbic acid content and antioxidant activities between the teff grains and their injera samples. Therefore, this study indicated that teff grains and injera are rich in ascorbic acid content and antioxidant activities as compared to other cereal grains and are very crucial for human nutrition and health., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2023 Hagos Yisak et al.)

Objective: Undernutrition contributes to decreased physical and cognitive functional status, higher healthcare consumption, premature institutionalisation and increased mortality. So, the objective of this study was to determine the pooled prevalence and factors associated with undernutrition among older adults in Ethiopia., Design: Systematic review and meta-analysis was used. Articles that presented original data on undernutrition using body mass index (BMI) were included. We made an inclusive literature search from PubMed, Medline and Google Scholar. The I 2 test was used to examine the heterogeneity of the studies considered in this meta-analysis. Stata software V.14 and METANDI command were used., Setting: Studies conducted in Ethiopia were included., Participants: Eight independent studies were eligible and enrolled for final analysis., Outcome: Prevalence and determinants of undernutrition. A selection of publications, data extraction and reported results for the review was designed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines., Results: A total of eight unique studies were enrolled for final analysis. The pooled prevalence of undernutrition was 20.53% (95% CI 17.39% to 23.67%). The study revealed that males had lesser odds of being undernutrition with AOR 0.17 (95% CI 0.15 to 0.20). Older adults in the age range of 65-74 years were less likely to be undernourished as compared with those whose age was above 85 years with Adjusted Odds Ratio (AOR) 022 (95% CI 0.22 to 0.25). Older adults who were depressed had higher odds of undernutrition as compared with their counterparts with AOR 1.27 (95% CI 1.19 to 1.37). However, older adults from households with poor wealth indexes were two times more likely to be undernourished as compared with those who were from rich households., Conclusion: The burden of undernutrition in Ethiopia is significant. The limitation of the current study was that all included studies were observational, mainly cross-sectional., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Understanding the epidemiological dynamics of disease control, as well as the effectiveness, compliance, and success of the vaccination program requires an understanding of the local population's knowledge, attitude, and practice regarding the Corona Virus Disease of 2019 (COVID-19) vaccine. Thus, the objective of this study was to assess knowledge, attitude, and practice toward COVID-19 vaccination and associated factors among the general public., Methods: A cross-sectional study was conducted in the South Gondar Zone, among residents above the age of 18 years. The study used objective measures and the constructs of the Health Belief Model. Binary logistic regression was used and the result of the final model was presented in terms of adjusted odds ratio (AOR) and 95% confidence intervals (CI), and statistical significance was taken and considered at a P -value < 0.05., Results: The study was conducted on 1,111 study participants. The mean age is 30.83 ± 7.106. About 575 (51.8%) of the respondents have good knowledge about the COVID-19 vaccination and 43.4% have a positive attitude toward COVID-19 vaccination. About 361 (32.5%) of the respondents were willing to take the vaccine if it is available and 113 (10.2%) of them were vaccinated. Participants with a positive attitude and good knowledge, those with a secondary level of education AOR = 5.70, 95% CI (2.60-12.60), those with a monthly income of >2,000 birr AOR = 6.30, 95% CI (2.50-15.60), those having a television (TV), and those who use Facebook AOR = 17.70, 95% CI (10.10-30.90) had a higher level of acceptance of COVID-19 vaccination. The Health Belief Model's constructs of perceived susceptibility AOR = 1.53, 95% CI (1.26-1.85), perceived benefit AOR = 1.49, 95% CI (1.28-1.75), and cues to action AOR = 0.54, 95% CI (0.45-0.65) were all linked to COVID-19 vaccine acceptability., Conclusion: The level of acceptance of COVID-19 vaccination is much lower. Having a positive attitude score and good knowledge score, level of education, monthly income, presence of TV, the use of Facebook, and knowing the means of transmission of COVID-19 increase the level of acceptance of COVID-19 vaccination., 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 © 2022 Yisak, Ambaw, Belay, Desalegn, Getie, Asrat, Guangul, Seid, Zewde, Assefa and Ewunetei.)

There is no ultraviolet visible (UV-Vis) spectrophotometric method for the direct determination of total sugars in the aqueous extract of teff grain samples. Therefore, the objective of this study was to develop a green UV-Vis spectrophotometric method to determine total sugars in the aqueous extract of white teff, brown teff, white rice, and red wheat grain samples. The calibration curve was established in the range of 20.11-7,907 mg/L using sucrose as a standard with R 2  = 0.9996. The limit of detection and limit of quantification were 4.4 and 14.6 mg/L, respectively. The relative standard deviation (6.9%) of the method for the sucrose standard was within the acceptable range indicating that the method is precise. The amount of total sugars determined in the white teff (5.48-9.44% (w/w), brown teff (6.17-10.32% (w/w)), white rice (3.19% (w/w)), and red wheat (9.22% (w/w)) grain samples was comparable with other reported cereal grains. Furthermore, the accuracy of the developed analytical method was also evaluated by spiking the known amount of the sucrose standard solution to the white teff, brown teff, white rice, and red wheat sample extracts, and percentage recoveries found were in the acceptable range (85 ± 2 - 105 ± 4%) with an average recovery of 93%, confirming that the new green method is quantitatively reproducible. Hence, a fast, simple, inexpensive, widely used, selective, sensitive, precise, and accurate green UV-Vis method was developed and validated for the direct determination of total sugars in the aqueous extract of teff, white rice, and red wheat grain samples., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Hagos Yisak et al.)

Objectives: The objectives of this study were to assess the prevalence and determinants of undernutrition among older adults aged 65 years in the south Gondar Zone, Ethiopia, in 2020., Design: A community-based cross-sectional study., Setting: The study was conducted from 1 October to 15 December 2020, in the South Gondar Zone, Ethiopia. Study participants were selected by systematic random sampling. A pretested and structured questionnaire adapted from different literature was used to collect data. Anthropometric measurements were taken following the standard procedure., Participants: A total of 290 older adults aged greater than or equal to 65 years of age were included in the study., Data Analysis: Descriptive and summary statistics were employed. Multiple logistic regression was fitted to identify determinants of undernutrition. ORs and their 95% CIs were computed to determine the level of significance., Outcome Measures: Undernutrition was assessed by using Body Mass Index and Mini Nutritional Assessment (MNA) tool., Results: The prevalence of undernutrition was 27.6% (95% CI 22.4 to 32.8), and 2.1% (95% CI 0.7 to 3.8) of the study participants were overweight. Based on the MNA tool, 29.7% (95% CI 24.5 to 35.2) of the study participants were undernourished and 61.7% (95% CI 55.5 to 67.2) were at risk of undernourishment. Rural residence adjusted OR (aOR)=10.3 (95% CI 3.6 to 29.4), inability to read and write aOR=3.5 (95% CI 1.6 to 7.6), decrease in food intake aOR=13.5 (95% CI 6.1 to 29.5) and household monthly income of less than US$35.6 aOR=4.3 (95% CI 1.9 to 9.4) were significantly and independently associated with undernutrition., Conclusion: The level of undernutrition among older adults in the study area was high, making it an important public health burden. The determinants of undernutrition were a place of residence, educational status, food intake and monthly income., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Infection with Helicobacter pylori is one of the most frequent chronic bacterial illnesses in humans. Pregnant mothers are the populations most vulnerable to H. pylori infection. The objective of this study was to assess the prevalence of H. pylori infection and associated factors among pregnant mothers having antenatal care at Debre Tabor General Hospital, Debre Tabor, Ethiopia, 2021., Methods and Materials: Institutional based cross-sectional study design was conducted on 290 pregnant women. The stool antigen test is used to detect the active presence of the H. pylori antigen in the feces. Bivariate and multivariable logistic regression analyses were carried out to assess potential factors responsible for H. pylori infection. Variables associated with the prevalence of H. pylori infection with ( p -value < 0.05) were considered statistically significant., Results: The prevalence of H. pylori infection was 17.9%, with 95% (CI: 13.4%-22.3%). In all, 65.4% of H. pylori infection positive mothers had gastrointestinal problems and developed symptoms like abdominal cramp and diarrhea 1 (1.92%), loss of appetite 10 (19.23%), hiccups 9 (17.31%), abdominal pain which worsens when the stomach is empty 19 (36.54%), indigestion, and frequent heart burn 13 (25%) during the present pregnancy. Lesser frequency of handwashing practice AOR = 3.09, 95% CI (1.14-8.34), use of soap for handwashing AOR = 0.44, 95% CI (0.19-0.98), eating unwashed vegetables and fruits AOR = 2.279, 95% CI (1.03-5.04), and not being anemic AOR = 0.268, 95% CI (0.10- 0.71), were significantly associated with H. pylori infection., Conclusions: This study shows that the prevalence of H. pylori infection among pregnant women was low compared with that of the general population. Although in the lower prevalence, the level of anemia was strongly associated with the prevalence of H. pylori infection. This implies that H. pylori infection is a public health problem.

Objectives: Elective surgical case cancelation is a common problem and can cause prolonged wait times, harm to patients, and is a waste of scarce resources. Reasons for cancelations are complex and change place to place because they are related to patients, organizational issues, and clinical staff. So, this study is aimed to assess the magnitude and causes of the case cancelation among elective surgical cases in a general hospital., Methods: A cross-sectional prospective study design was conducted on 221 patients scheduled for elective surgery from March 1 to May 30 2019 G.C. All consecutive elective surgical cases scheduled during the study period were included in the study. Data were collected using prepared and pretested questionnaire and entered in the SPSS version 20 for analysis purpose., Results: During the study, 221 patients were scheduled for elective surgical operations, among these 150 (67.9%) patients were operated on the planned date of surgery whereas 71 (32.1%) operations were canceled. The decision for the cancelation was done by the anesthetist due to preoperative coexisting disease findings and inadequate preparation of the patient for the intended operations were 33 (46.5%) followed by administrative-related issues which account 26 (36.6%)., Conclusion: Cancelation of elective surgical procedures on the day of surgery was high in this study due to different reasons. Cancelation can be minimized if all the responsible bodies can communicate early regard to the patient., 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.)

Background: There is no fluorescence spectroscopic method for the determination of trigonelline and theobromine in green coffee beans. Therefore, the objective of this study was to develop a new fluorescence spectroscopic method to determine the alkaloids simultaneously in the aqueous extract of green coffee beans., Results: The calibration curves were linear in the range 2-6, 1-6, 1-5 mg/L for caffeine, theobromine and trigonelline, respectively, with R 2  ≥ 0.9987. The limit of detection and limit of quantification were 2, 6 and 7 µg/L and 40, 20 and 20 µg/L for caffeine, theobromine and trigonelline, respectively. Caffeine and trigonelline exhibited well separated fluorescence excitation spectra and therefore the two alkaloids were selectively quantified in the aqueous extract of green coffee. While theobromine showed overlapping fluorescence excitation spectra with caffeine and hence theobromine could not be determined in the aqueous extract of green coffee beans. The amount of caffeine and trigonelline in the three samples of green coffee beans were found to be 0.95-1.10 and 1.00-1.10% (w/w), respectively. The relative standard deviations (RSD ≤ 4%) of the method for the three compounds of interest were of very good. The accuracy of the developed analytical method was evaluated by spiking standard caffeine and trigonelline to green coffee beans and the average recoveries were 99 ± 2% for both the alkaloids., Conclusions: A fast, sensitive and reliable fluorescence method for the simultaneous determination of caffeine and trigonelline in the aqueous extract of green coffee beans was developed and validated. The developed method reflected an effective performance to the direct determination of the two alkaloids in the aqueous extract of green coffee beans.

Background: Under nutrition is one of the major causes of health problems among children under five years old in Ethiopia. Though the problem of under nutrition has decreased in the country, it is still continuing as one of the major causes of mortality of children under five. Studies have shown that the magnitude and related factors of under nutrition are varied in different agro-ecological settings of the country. Thus it is indispensable to assess the nature of the problem at community level. The objective of this study was to assess the extent of under nutrition and related factors among children under five years in Haramaya district, eastern Ethiopia., Methods: A community based cross sectional study was conducted in Haramaya district from December 1, 2012 to January 30, 2013 and Multi-stage stratified systematic random sampling technique was used to select the study subjects. A total of 791 study subjects were included in the study. Data were collected using face-to-face interview and anthropometric measurements. World Health Organization (WHO) Anthro software was used to convert nutritional data indices from anthropometric measurement into Z-scores, and Multivariate logistic regression model with an enter method was used to determine the predictors of under nutrition., Results: The study indicated that prevalence of stunting, wasting and underweight among children under five years old were 45.8%, 10.7 % and 21 % respectively. Children in rural Kebeles with Adjusted odd ratio (AOR) =2.45, 95% CI(1.25-6.66), children who were 6 and above birth order (AOR =1.992, 95% CI( 1.05-3.77)), and children who were used to live with households having two and more under five children (AOR = 1.81, 95% CI( 1.19-2.7)) were more stunted than their counterparts. Children in the lowland Kebeles, (AOR = 3.29, 95% CI( 1.2-8.8)) and children having diarrhea, (AOR = 2.48, 95% CI(1.28-4.78)); mothers with Body mass index (BMI) < 18.5 (AOR = 2.17, 95% CI(1.17-3.81)); mothers who did not have ANC visit during pregnancy (AOR = 3.47, 95% CI (1.49-7.8) ) and with birth order of 4 to 5 children (AOR = 3.08, 95% CI (1.11-8.5)), were more likely to be underweight than their counterparts. Moreover, male children (AOR = 2.37, 95% CI (1.19-4.7)), children who were served food with family (AOR = 2.3, 95% CI (1.14- 4.9)), children who had fever, (AOR = 2.9, 95% CI (1.16-7.2)), were more likely to be wasted than their counterparts., Conclusions: This study indicated that nearly half of the children under five years in the study area were stunted. Thus, a large number of children had poor nutritional history or growth failure. Furthermore, underweight and wasting were significantly high. The problem can be addressed by targeting children since their early ages and by conducting tailored nutrition education to mothers or caretakers to improve the nutritional status of their children.