Early post-stroke cognitive impairment and in-hospital predicting factors among stroke survivors in Ethiopia

BackgroundIn low-and middle-income countries, post-stroke cognitive impairment (PSCI) is the least investigated stroke complication that clinically is given little attention. Finding patients who are at high risk of having cognitive problems after a stroke could allow targeted follow-up and help with prognosis discussions, which would then contribute to improved treatment outcomes. The main aim of this study was to determine the incidence and predictors of PSCI among stroke survivors in Northwest Ethiopia.MethodsThe study was a multicenter prospective cohort study. The study participants were 403 stroke survivors who were alive on follow-up after 3 months of stroke onset at the neurology department of three hospitals in Northwest Ethiopia. To investigate the link between the outcome and the explanatory variables, analyses of bivariable and logistic multivariable regression were performed. A value of p of 0.05 or less was regarded as statistically significant, and data were presented as odds ratios and 95% confidence intervals.ResultsThe mean age of the participants was 61.3 years (SD = 0.7), 56% were females, the mean time from symptom onset to hospital arrival was 46 h (SD = 3.32), and the mean National Institute of Health Stroke Scale (NIHSS) score at admission was 14.79 (SD = 0.25). PSCI was observed in 122 patients (30.3%) after 90 days of stroke onset, that is, 83 (20.6%) of female and 39 (9.7%) of male stroke survivors. The result of multivariable logistic regression analysis revealed PSCI was independently associated with age (adjusted OR = 1.04, 95% CI = 1.061–1.981), women (AOR = 1.390, 95% CI = 1.221–2.690), admission modified Rankin scale (mRS) (AOR = 1.629, 95% CI = 1.381–2.037), moderate Glasgow coma scale (GCS) score (AOR = 1.149, 95% CI = 1.402–3.281), and poor GCS score (AOR = 1.632, 95% CI = 1.610–4.361) and stage one (AOR = 1.428, 95% CI = 1.198–2.922) and stage two hypertension (AOR = 1.255, 95% CI = 1.107–2.609).ConclusionNearly one-third of stroke survivors developed PSCI. Moreover, further research is needed with a larger sample size, showing a time trend and longer follow-up duration

Yield response of tef (Eragrostis tef) to nitrogen, phosphorus, potassium and sulphur under balanced fertilization on Vertisols in different agroecological zones of Ethiopia

Nutrient deficiency is a major constraint in tef (Eragrostis tef (Zucc.) Trotter) production in Ethiopia. In the past, a blanket recommendation of nitrogen (N) and phosphorus (P) fertilizers has been applied regardless of the diversity of agroecological zones and soil types. As crop responses declined with widespread deficiencies of nutrients, farmers have lost interest in applying the recommended fertilizer rates. The present study was conducted with the objective of quantifying the response of tef to different rates of N, P, potassium (K) and sulphur (S) fertilizers under balanced application of the nutrients other than the one under investigation. In each region, the same set of trials was implemented on farmers’ fields for three years. All trials were implemented on Vertisols across four agroecological zones (AEZs). The treatments were seven rates of N, six rates each of P and S and eight rates of K with a basal application of zinc (Zn) and boron (B). The results showed that the most limiting nutrient is N followed by P in each agroecological zone on the Vertisols. There was clear evidence of increases in grain yield with increasing rates of N and P, but the responses to K and S rates did not follow clear trends across AEZs. With balanced application of the other nutrients, 23–92 kg N ha−1 increased grain yield by 11–92%, while 10–40 kg P ha−1 increased yields by 12–33% over the control in the different AEZs. Based on results from dose–response models, it is concluded that the agronomic optimum rates for tef production are 69 kg N, 20 kg P, 30 kg K and 10 kg S ha−1 in the cool sub-moist mid-highlands and the tepid sub-humid mid highlands; 92 kg N, 30 kg P, 15 kg K and 10 kg S ha−1 in tepid moist mid highlands but 69 kg N, 10 kg P, 15 kg K and 10 kg S ha−1 in the tepid sub-moist mid highlands. On Vertisols not covered by this study, these recommendations should be subject to appropriate soil and plant analysis. We also recommend further studies on the nutrient requirement of tef on other soil types and AEZs

Systematic review on the frequency of occurrence in nerve branches and the side of the face involved in trigeminal neuralgia and its clinical implication

PurposeThe purpose of this systematic review is to answer the focused question, “What is the commonly affected nerve branch and the side of the face involved in trigeminal neuralgia?”Types of studies reviewedThis systematic review included studies reporting commonly affected trigeminal nerve branches and the side of the face involved in trigeminal neuralgia. To find the potential studies published, the authors utilized specific search databases such as PubMed, and Google scholar.ResultsAmong 132 published studies, the authors selected only 11 to be included for this systematic review. The sample size ranged from 50 to 43,518 study subjects. This review identified that the mandibular branches of the trigeminal nerve were the most affected, followed by the maxillary branch. The review also identified that the right side of the face was predominantly affected.Conclusion and practical implicationsThe authors of this review identified a higher occurrence of trigeminal neuralgia in the mandibular division of the nerve, commonly affected on the right side of the face. Further prospective-based research and meta-analysis are required to validate the commonly occurring trigeminal nerve branch and sidedness of the face involved with its clinical implications in trigeminal neuralgia

Medication regimen complexity and its association with adherence and blood pressure control among hypertensive patients at selected hospitals of South Gondar Zone: A hospital based cross sectional study.

IntroductionDespite the availability of effective antihypertensive medications, blood pressure (BP) control is suboptimal. High medication regimen complexity index (MRCI) is known to reduce adherence and may be the reason for poor BP control. However, there is no data in the present study areas. Hence, the aim of this study was to assess MRCI and its association with adherence and BP control among hypertensive patients at selected hospitals of South Gondar Zone.MethodsA hospital based cross sectional study was conducted from December 1, 2020 to February 30, 2021 at selected hospitals of South Gondar Zone. Medication regimen complexity and adherence was evaluated using 65-item validated tool called MRCI (Text removed at time of retraction. See retraction notice for more information.). Multivariable logistic regression analysis was done to determine the association between predictive and outcome variables.ResultsAbout 3.3% of participants were classified as having high HTN specific MRCI whereas 34.75% of participants were classified as having high patient level MRCI. (Text removed at time of retraction. See retraction notice for more information.) Being illiterate, and having low HTN MRCI were more likely to have controlled BP in adjusted analyses. On the contrary, (Text removed at time of retraction. See retraction notice for more information.) not having health insurance, and having lower monthly income were less likely to have controlled BP.ConclusionA considerable proportion of patients had high MRCI. Having low HTN MRCI was more likely to have controlled BP. Simplification of a complex medication regimen for patients with HTN should be sought by physicians and pharmacists to improve BP control

Attitude and level of COVID-19 vaccination and its determinants among patients with chronic disease visiting Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia: A cross-sectional study

Introduction Coronavirus disease is a fatal viral disease caused by severe acute respiratory syndrome coronavirus 2. This study was aimed to assess the attitude, level of COVID-19 vaccine uptake, and its determinants among patients with chronic diseases visiting Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia. Methods An institutional-based cross-sectional study was conducted among 422 randomly selected patients with chronic disease visiting Debre Tabor Comprehensive Specialized Hospital from February 1 to March 30, 2022. Bivariable and multivariable binary logistic regression analyses were done to identify associations between dependent and independent variables. Results Among all participants, only 29.6% of patients were vaccinated with any of the COVID-19 vaccines at least one dose. Age from 31 to 40 years (AOR = 6.26, 95% CI: 2.69–14.56), attended collage and above (AOR = 6.3, 95% CI: 1.37, 28.68), positive attitude towards COVID-19 vaccine (AOR = 9.07, 95% CI: 4.51–18.22), good knowledge (AOR = 7.63, 95% CI: 1.08–16.85), history of COVID-19 (AOR = 4.33, 95% CI: 1.85–10.17), family history of COVID-19 (AOR = 3.99, 95% CI = 1.89–8.48), ever been tested for COVID-19 (AOR = 0.33, 95% CI: 0.15–0.74) were determinant factors for COVID-19 vaccine uptake. Conclusion COVID-19 vaccine uptake among patients with chronic disease was very low. The main reasons for not being vaccinated were doubts about vaccine efficacy, the vaccine may cause disease by itself, and fear of adverse effects. Therefore, different stakeholders should enforce vaccine uptake and awareness creation

Attitude and level of COVID-19 vaccination and its determinants among patients with chronic disease visiting Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia: A cross-sectional study.

IntroductionCoronavirus disease is a fatal viral disease caused by severe acute respiratory syndrome coronavirus 2. This study was aimed to assess the attitude, level of COVID-19 vaccine uptake, and its determinants among patients with chronic diseases visiting Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia.MethodsAn institutional-based cross-sectional study was conducted among 422 randomly selected patients with chronic disease visiting Debre Tabor Comprehensive Specialized Hospital from February 1 to March 30, 2022. Bivariable and multivariable binary logistic regression analyses were done to identify associations between dependent and independent variables.ResultsAmong all participants, only 29.6% of patients were vaccinated with any of the COVID-19 vaccines at least one dose. Age from 31 to 40 years (AOR = 6.26, 95% CI: 2.69-14.56), attended collage and above (AOR = 6.3, 95% CI: 1.37, 28.68), positive attitude towards COVID-19 vaccine (AOR = 9.07, 95% CI: 4.51-18.22), good knowledge (AOR = 7.63, 95% CI: 1.08-16.85), history of COVID-19 (AOR = 4.33, 95% CI: 1.85-10.17), family history of COVID-19 (AOR = 3.99, 95% CI = 1.89-8.48), ever been tested for COVID-19 (AOR = 0.33, 95% CI: 0.15-0.74) were determinant factors for COVID-19 vaccine uptake.ConclusionCOVID-19 vaccine uptake among patients with chronic disease was very low. The main reasons for not being vaccinated were doubts about vaccine efficacy, the vaccine may cause disease by itself, and fear of adverse effects. Therefore, different stakeholders should enforce vaccine uptake and awareness creation

Incidence and predictors of early posttraumatic seizures among patients with moderate or severe traumatic brain injury in Northwest Ethiopia: an institution-based prospective study

Abstract Background Early posttraumatic seizure (PTS) is a well-known complication of traumatic brain injury (TBI) that can induce the development of secondary brain injuries, including increased intracranial pressure, brain death, and metabolic crisis which may result in worse outcomes. It is also a well-recognized risk factor for the development of late post-traumatic seizure and epilepsy. This study was aimed to assess the incidence and predictors of PTS among patients with moderate or severe TBI admitted to Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia. Methods and setting An institutional-based prospective follow-up study was conducted on 402 patients with TBI admitted to the neurologic unit from June 1, 2022 to January 30, 2023. A systematic sampling technique was employed. The incidence rate of occurrence of early PTS was calculated. Both bivariable and multivariable Cox proportional hazard regression was performed. The strength of the association was measured using adjusted hazard ratios with a 95% confidence interval and p-values < 0.05. Results The incidence rate of early PTS was 2.7 per 100 person-days observation. Early PTS was observed in 17.7% of TBI patients. Age 75 and above (AHR = 2.85, 95%CI: 1.58–5.39), severe TBI (AHR = 2.06, 95%CI: 1.03–3.71), epidural hematoma (AHR = 2.4, 95% CI: 1.28–4.57), brain contusion (AHR = 2.6, 95%CI: 1.07–4.09), surgical intervention (AHR = 1.7, 95%CI: 1.03–3.82), posttraumatic amnesia (AHR = 1.99, 95%CI: 1.08–3.48), history of comorbidities (AHR = 1.56, 95%CI: 1.08–3.86), and history of alcohol abuse (AHR = 3.1, 95%CI: 1.89–5.23) were potential predictors of early PTS. Conclusion The incidence of early PTS was high. Since, early PTS can worsen secondary brain damage, knowing the predictors helps to provide an effective management plan for patients likely to develop early PTS and improve their outcome

Attitude towards COVID-19 vaccine among patients with chronic disease visiting in Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia, 2022.

Attitude towards COVID-19 vaccine among patients with chronic disease visiting in Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia, 2022.</p

Determinant factors of COVID-19 vaccine uptake among patients with chronic disease visiting Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia, 2022.

Determinant factors of COVID-19 vaccine uptake among patients with chronic disease visiting Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia, 2022.</p

Knowledge towards COVID-19 vaccine among patients with chronic disease visiting Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia, 2022.

Knowledge towards COVID-19 vaccine among patients with chronic disease visiting Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia, 2022.</p