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Background: People with type 2 diabetes mellitus who have clinical inertia often struggle to control their blood sugar levels and do not receive timely treatment intensification. Strict glycemic control has advantages, but many patients with diabetes are unable to reach their target blood sugar levels. The study's main objective was to determine the prevalence of clinical inertia in patients with type 2 diabetes at Debre Tabor Comprehensive Specialized Hospital(DTCSH) in Ethiopia., Methods: An institutional based, cross-sectional research design was used at Debre Tabor Comprehensive Specialized Hospital from November 20/2023 to January 30/2024. A structured questionnaire modified from various medical records and literatures were used to gather data. A logistic regression model was also employed after the Hosmer-Lemeshow goodness-of-fit test was checked to find contributing variables to clinical inertia. A threshold of p < 0.05 was considered statistically significant., Result: In total, 287 samples were included in the research. The occurrences of clinical inertia 31.4% (95%CI: 25.9 - 36.8) were obtained from 90 patients. Aged patients (AOR = 1.103; 95% CI, 1.034 - 1.176; P = 0.003), medication fee (AOR = 4.955; 95% CI, 1.284 - 14.127; P = 0.020), medication nonadherence (AOR = 4.345; 95% CI, 2.457 - 15.537; P = 0.001), increase number of medication (AOR = 4.205; 95% CI, 2.657- 6.655; P ≤ 0.001), poor glycemic control (AOR = 2.253; 95% CI, 1.673 - 3.033; P ≤ 0.001) were more likely to have clinical inertia., Conclusion: One-third of patients experienced clinical inertia. Age, glycemic control, medication non-adherence, treatment fee, and number of medications were found to be strongly correlated with clinical inertia. More precise knowledge of the clinical inertia and the associated therapies is necessary to tackle this issue more effectively., 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 © 2025 Dagnew, Wondm, Yitayew Tarekegn, Kassaw and Moges.)

Rational use of steroids is essential in the long term for improving patient safety. Systemic steroids are important in clinical treatment, but if they are misused, they might have negative effects. This study assessed systemic steroid use and its determinants at Debre Berhan University Hakim Gizawu Teaching Hospital (DBUHGTH), Ethiopia. A cross-sectional study was conducted among 210 admitted patients at the Medical ward of DBUHGTH. A simple random sampling method was used to recruit study participants. The data was collected from patient medical records and patient interviews using a structured data abstraction and patient interview format. Binary logistic regression was employed to identify the potential predictors of systemic steroid use. Finally, the results were interpreted and presented by tables, charts, and graphs. Most study participants were 142 (67.62%) male. The mean age of the participants was 44.94 (SD, 19.2) years. Prednisolone was mostly utilized drug 130 (42.07%), followed by hydrocortisone 81 (26.21%), beclomethasone 58 (18.77%), and dexamethasone 40 (12.94%). Respiratory disorders 112 (53.34%), meningitis 25 (11.91%), and rheumatoid arthritis 19 (9.05%) were the top three disease conditions in which steroids were used with the highest frequency. Most systemic steroids were administered orally, 130 (42.07%). Short-acting (hydrocortisone, beclomethasone) 139 (44.98%) were mostly used, followed by intermediate-acting steroids (prednisolone) 130 (42.07%). Study participants in the 18-40 age range were approximately 2.5 times more likely than those in the 65 + age group to be using systemic steroids (AOR = 2.5, 95% CI 2.86-6.07). Prednisolone was mostly utilized, followed by hydrocortisone, beclometasone, and dexamethasone drugs in the medical ward of DBUHGTH., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Medication discontinuation poses a significant challenge to the effectiveness of therapeutic interventions and overall patient treatment outcomes. Improving the pharmaceutical dosage forms' acceptability for patients, knowledge of proper ways for medication usage, and proper storage of medications play an indispensable role in enhancing patient safety. Thus the present study aimed to assess patients' preferences for pharmaceutical dosage forms, their knowledge of storage of medications, and factors associated with medication discontinuation among patients attending Red Cross pharmacies in Northwest Ethiopia. This multicenter cross-sectional study was conducted from January 16, 2024, to February 15, 2024. The collected data was entered into EpiData (version 4.6.0) and statistical analysis was carried out by exporting to STATA version 14. A p-value of less than 0.05 was statistically considered as significant. Among 388 study participants, more than half (54.4%) had a history of medication discontinuation and frequency of administration was the most contributing factor (39.4%). The common reason for study participants' dosage form preferences was the ease of use (62.1%), followed by high efficacy and safety (11.9%). Rural residency [AOR = 1.61; 95%CI: 1.03, 2.52], number of medications [AOR = 4.29; 95%CI: 2.03, 9.06], preference for the type of dosage forms [AOR = 5.86; 95% CI: 3.36, 10.21], and frequency of administration [AOR = 2.49; 95%CI: 1.55, 3.99] were factors significantly associated with medication discontinuation. The present study revealed that more than half of the study participants had a history of medication discontinuation.To reduce medication discontinuation and enhance the treatment outcome of patients, medical and pharmacy professionals should improve information concerning dosage forms and their acceptability for patients through ongoing patient education and training., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethical considerations: Ethical clearance for the present study was obtained from the Institutional Review Board of Debre Tabor University College of Health Sciences with reference number DTU/RES/305/24. Informed written consent was obtained from the participants. Throughout the study period, confidentiality was maintained. In addition, study participants were given education on how to take medications and the impact of medication discontinuation on their treatment outcome and we informed them that they should tell their healthcare practitioners about their preference for pharmaceutical dosage forms. All methods of this study were based on the declaration of Helsinki., (© 2024. The Author(s).)

Background: Adverse drug reactions are more prevalent in geriatric patients and are frequently associated with a range of polypharmacy-related issues as well as some physiological aging-related alterations. These affect the pharmacokinetic and pharmacodynamic properties of drugs. This study aimed to assess the magnitude of ADRs and their contributing factors among geriatric patients admitted at Comprehensive Specialized Hospitals of the Amhara Region., Methods: A multicenter prospective cohort study was carried out from May 2023 to August 2023 on geriatric patients admitted to four randomly selected comprehensive hospitals in the Amhara region. We used logistic regression to find the factors influencing the occurrence of ADRs. A P value of less than 0.05 was deemed statistically significant., Results: During the study's follow-up period, 373 patients in total were included. An incidence rate of 31.10% (95% CI: 26.38-35.82) was obtained from the identification of 121 ADRs in total. The organ most frequently affected by ADRs was the gastrointestinal tract (28.92%), followed by the cardiovascular system (19.01%), and the drug class most often implicated in ADRs was antibiotics (21.49%), then anticoagulants (12.40%). ADRs were substantially linked to being overweight (P < 0.001), having been hospitalized in the previous six months (P = 0.000), and hyperpolypharmacy (p = 0.047). 93.39% of all ADRs received the interventions. 85.12% of the adverse drug reactions were successfully resolved., Conclusions: This study found that over one-third of older people and individuals admitted to the hospital experienced ADRs. Overweight, hyperpolypharmacy, and patients who had previously been admitted during the preceding six months were significantly linked with the occurrence of ADRs. Improving the drug safety of elderly patients, particularly those who are admitted, should be a greater priority for healthcare professionals., Competing Interests: Declarations Ethics approval and consent to participate The ethical review committee of Debre Tabor University’s College of Health Science, Department of Pharmacy has approved ethical authorization with reference number 058/2023. A support letter was sent to each of the four comprehensive hospitals. The directors of those healthcare organizations were then asked to sign a letter approving the usage of patient records as a source of data. Participants were informed about the purpose and design of the study before data collection. Furthermore, they provided their official consent to participate in the research. Written informed consent was obtained from all the study participants. Patients’ medical registration numbers (MRNs) were swapped out for new codes during the data collecting and entry process. Besides, to protect its confidentiality, the gathered data was similarly kept in a locked cabinet and on a computer with a strong password. The study followed Helsinki legislation in terms of doing it in a properly anonymous and confidential manner. Consent for publication Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Background: Medication non-adherence is a significant public health concern in managing patients with chronic diseases, and community pharmacists are on the frontline in the management of chronic medications. Chronic diseases require lifelong pharmacotherapy and understanding the determinants of medication adherence has paramount importance to develop strategies that improve medication adherence and treatment outcomes. Thus, this study aimed to assess the magnitude of medication non-adherence and its contributing factors among patients with chronic diseases attending community pharmacies in South Gondar Zone, Northwest Ethiopia., Methods: A multicenter cross-sectional study was conducted at community pharmacies in South Gondar Zone from September 01 to October 30, 2023. Medication adherence was assessed using a structured questionnaire using the Adherence in Chronic Diseases Scale (ACDS). Statistical Package for Social Sciences (SPSS) version 25 was used for analysis. Association between the outcome variable and independent variables was performed using binary logistic regression and a p -value of <0.05 was considered statistically significant., Results: Among three hundred and eighty six (386) study participants recruited in this study, more than half of them 222 (57.51%, 95%CI: 52.4% - 62.5%) were low adherent to their medications. Concerning determinants of medication non-adherence; the presence of side effects (AOR =2.1, 95%CI=1.33-3.29), unable to get ever counseling from community pharmacists (AOR=2.3, 95%CI= 1.46-3.58), and poor about their medications (AOR=3.1, 95% CI= 1.96-4.82) were significantly associated with patients' non-adherence to medications., Conclusion: The medication adherence level in this study was suboptimal, with a significant proportion of the patients being non-adherent to their medications. The presence of side effects, unable to get ever counseling, and poor knowledge about their medications were statistically significant factors of poorer medication adherence. Hence, healthcare professionals, especially community pharmacists, have a crucial role in designing the schedule for health education concerning the needs of these patients in community pharmacy settings., 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 Moges, Dagnew, Wondm, Ferede, Yiblet, Almaw, Shumet Yimer, Tesfaw Addis, Zewdu and Dagnew.)

Diabetes self-care activities are essential for achieving optimal glycemic control. However, little investigation has been conducted in Ethiopia to evaluate the relationship between the rate glycemic controland self-care activities among patients with type 2 diabetes mellitus (T2DM). Therefore, this study was conducted to assess self -care activities and their association with glycemic control among patients with T2DM in Northwest Ethiopia general hospitals. This multicenter cross-sectional study was conducted in Northwest Ethiopia general hospitals diabetic clinics. Diabetes self-care activities were measured using the Amharic version of the Summary of Diabetes Self-Care Activities (SDSCA-Amharic). Glycated hemoglobin (HbA1c) were used to assess the rate of glycemic control. A linear regression model was used to identify predictors of self-care activities and glycemic control. P-value of <  0.05 at 95% confidence interval (CI)  was considerd as statistically significant. Of 413 participants included in the final analysis, two-thirds (66.3%) had poor glycemic control, with a mean HbA1c of 7.94% (SD = 1.75). Blood glucose testing was the most important self-care activity domain for predicting better glycemic control [β=-0.36, 95% CI (-0.48, -0.24); P = 0.0001] followed by diet [β=-0.29, 95% CI (-0.39, -0.083); P = 0.0001], foot-care [β=-0.28, 95% CI (-0.3, -0.061); P = 0.003], and physical activity [β=-0.27, 95% CI (-0.29, -0.056); P = 0.004], respectively. Moreover, unable to read and write [β = 0.72, 95% CI (0.57, 3.8); P = 0.037], overweight [β = 0.32, 95% CI (0.011, 0.62); P = 0.042], obesity [β = 0.67, 95% CI (0.39, 0.94); P = 0.0001], and low level of medication adherence [β = 0.7, 95% CI (0.39, 1.1); P = 0.0001] were significant predictors of poor glycemic control.       Previous diabetes education [β=-0.88, 95% CI (-1.2, -0.57); P=0.0001] was a significant predictor of good glycemic control. The prevalence of poor glycemic control and poor self-care activities were high among patients with T2DM. Self-care activities were independent predictors of glycemic control among patients with T2DM. Therefore, management interventions for patients with T2DM should focus on improving self-care activities and other predictor variables., (© 2024. The Author(s).)

Background: Most patients with cancer have comorbid conditions that necessitate advanced medical treatment. Polypharmacy (PP) and potentially inappropriate medicine (PIM) use is common among older adult patients with cancer. Not much research has been conducted on PP and PIM use among older adult patients with cancer in Ethiopian oncology centers. Therefore, this study aimed to evaluate the prevalence and determinants of PP and PIM use among older adults with cancer in Northwest Ethiopia oncology centers using the American Geriatrics Society (AGS) 2019 updated Beers criteria., Methods: This multicenter cross-sectional study was conducted among older adult patients with cancer from July 15-December 30, 2023 in Northwest Ethiopian oncology centers. The use of at least one drug included in the 2019 Beers criteria revisions was classified as potentially inappropriate medication use. To identify the factors influencing PP and PIM use, logistic regression analysis was performed., Results: Of the 310 samples aproched, 305(98.4% response rate) participated in the study. The prevalence of PP and PIM use were 70.2% (95% CI 64.9-75.1) and 63.0% (95% CI 57.4-68.8) respectively. Being female AOR:3.6; 95% CI:1.7-7.8; p =  0. 001, advanced age [(70-74 years) AOR:3.9; 95% CI:1.2-6.7; p =  0.046 and ≥75 years AOR:3.8; 95% CI:1.7-8.4; p =  0.0028], abnormal body weight (underweight AOR:5.5; 95% CI:1.5-9.6; p =  0.019, overweight AOR:5.1; 95% CI:1.5-7.3; p = 0.01 and obese AOR:5.6; 95% CI:1.5-9.3; p = 0.021) and comorbidities AOR:3.5; 95% CI:1.7-8.3; p =  0.0032 were statistically significant factors for PP. Advanced age [(70-74 years) AOR:5.5; 95% CI:1.4-9.8; p =  0.015 and ≥75 years AOR:3.3; 95% CI:1.5-7.1; p = 0.002)] and polypharmacy; AOR:7; 95% CI:3.4-9.4; p = 0.001 were statistically significant factors for PIM use., Conclusion: Polypharmacy and potentially inappropriate medicine use were prevalent among older adult patients with cancer. Ensuring safe medicines prescription practices for older patients with cancer requires understanding the issue, stopping unwarranted treatment, and replacing it with less toxic, age-appropriate medicines., Competing Interests: No potential conflict of interest was reported by the author(s)., (© 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)

Background: Non-adherence to medication in patients with cardiovascular disease continues to be a main cause of suboptimal management, increased morbidity and mortality, and increased healthcare expenses. The present study assessed the level of medication adherence and its determinants of cardiovascular disease patients., Methods: An institutional-based multicenter cross-sectional study was conducted with patients with cardiovascular disease in Northwest Ethiopian teaching hospitals. The level of medication adherence was evaluated using a standardized questionnaire of the Adherence in Chronic Disease Scale (ACDS). To find determinants of the level of medication adherence, an ordinal logistic regression model was employed. Statistics were significant when P ≤ 0.05 at a 95% confidence interval (CI)., Results: In the end, 336 participants were included in the research. According to this study, one-third of patients had low medication adherence, half had medium adherence, and one-fifth had high medication adherence. Elderly patients [adjusted odds ratio (AOR) = 2.691; 95% confidence interval (CI), 1.704-4.251; P < 0.000], marital status (AOR = 1.921; 95% CI, 1.214-3.039; P = 0.005), alcoholic patients (AOR = 2.782; 95% CI, 1.745-4.435; P < 0.000), Patients without physical activity (AOR = 1.987; 95% CI 1.251-3.156; P = 0.004), non health insurances (AOR = 1.593; 95% CI 1.003-2.529; P = 0.049), sever Charles comorbidity index (AOR = 2.486; 95% CI 1.103-5.604; P = 0.028), patients with polypharmacy (AOR = 2.998 (1.817-4.947) P < 0.000) and, manypolypharmacy (AOR = 3.031 (1.331-6.898) P = 0.008) were more likely to have low medication adherence., Conclusion: The current study concluded that one-third of study participants had low medication adherence. Older age, marital status, drinker, physical inactivity, drug source, comorbidity, and polypharmacy all contributed to the low level of medication adherence. To improve patients with cardiovascular disease's adherence to their medications, intervention is necessary., 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 Dagnew, Wondm, Dagnew, Yimer, Wondmkun and Moges.)

Background: Chemotherapy-induced anemia (CIA) is a hematologic complication that frequently affects patients with cancer undergoing chemotherapy. It is associated with worse treatment outcomes, higher rates of morbidity and mortality, worse quality of life, and higher healthcare costs. The incidence and predictors of CIA in Ethiopia, particularly in Northwest Ethiopian oncology centers, are poorly understood. This study was conducted at Northwest Ethiopian oncology centers to evaluate the incidence and determinants of chemotherapy-induced anemia in adult patients with cancer undergoing chemotherapy., Methods: This 3-year hospital-based retrospective follow-up study included adult patients with cancer receiving chemotherapy between 2019 and 2021 at two oncology centers in Northwest Ethiopia. Data were collected from October to December 2021. A binary logistic regression model was used to select variables and determine the Crude Odds Ratio (COR). Variables with P -value < 0.2 were entered into the multivariable logistic regression and Adjusted odds ratio (AOR) with 95% Confidence intervals (CI) for variables with P -value < 0.05 were estimated to show determinants of chemotherapy-induced anemia among cancer patients who received chemotherapy., Results: A total of 402 patients were included in the final analysis. The overall incidence of CIA was 75.4% (95% CI 70.7, 79.8). Older age [AOR = 1.8, 95% CI (1.4-3.5); P = 0.043], hematologic cancer [AOR = 3.7, 95% CI (3.2-5.7), P = 0.021], obesity [AOR = 3.4, 95% CI (2.3-6.9); P = 0.028], ≥6 chemotherapy cycles [AOR = 3.8, 95% CI (3.2-5.1), P = 0.019], cancer metastasis to bone [AOR = 2.9, 95% CI (1.2-4.7), P = 0.025] were statistically significant predictors of chemotherapy-induced anemia., Conclusion: Chemotherapy-induced anemia persisted in a significant percentage of cancer patients. Chemotherapy-induced anemia developed in three-quarters of patients undergoing chemotherapy. Chemotherapy-induced anemia was significantly associated with older age, hematologic malignancy, obesity, a greater number of chemotherapy cycles, and cancer metastasis to bone. To lower the risk of morbidity related to anemia, patients with chemotherapy-induced anemia should be regularly evaluated and treated with appropriate treatment., 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 Wondm, Dagnew, Gubae, Tesfaye and Tamene.)

Objective: The study was conducted to assess potential drug-drug interactions (PDDIs) and its determinants among patients with cancer receiving chemotherapy., Design and Setting: An institutional-based cross-sectional study was used. This study was conducted from 1 June 2021 to 15 December 2021, in Northwest Ethiopia oncology centres., Participants: All eligible patients with cancer received a combination of chemotherapy., Outcomes: The prevalence and severity of PDDIs were evaluated using three drug interaction databases. Characteristics of participants were presented, arranged and summarised using descriptive statistics. The predictors and outcome variables were examined using logistic regression. The cut-off point was a p value of 0.05., Results: Of 422 patients included in the study, 304 patients were exposed to at least one PDDI with a prevalence of 72.1% (95 % CI: 68% to 76%) using three drug interaction databases. There were varied reports of the severity of PDDI among databases, but the test agreement using the kappa index was 0.57 (95% CI: 0.52 to 0.62, p=0.0001) which is interpreted as a moderate agreement among three databases. Patients aged ≥50 years old had the risk to be exposed to PDDI by odds of 3.1 times (adjusted OR (AOR)=3.1, 95% CI (1.8 to 5.3); p=0.001) as compared with patients <50 years old. Similarly, patients with polypharmacy and comorbidity were more likely to be exposed to PDDI than their counterparts (AOR=2.4, 95% CI (1.4 to 4.1); p=0.002 and AOR=1.9, 95% CI (1.1 to 3.4); p=0.02, respectively)., Conclusion: The main finding of this study is the high prevalence of PDDI, signifying the need for strict patient monitoring for PDDIs among patients with cancer receiving chemotherapy. We suggest the use of at least three drug databases for quality screening. Patients with an age ≥50 years old, polypharmacy and comorbidity were significantly associated with PDDIs. The establishment of oncology clinical pharmacists and computerised reminder mechanisms for PDDIs through drug utilisation review is suggested., 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.)

Background: In clinical settings all across the world, including Ethiopia, the irrational use of antibiotics to treat acute diarrhea is common. The main causes of resistance are antibiotic abuse, misuse, and underuse, and among infectious diseases, antibiotic overuse is pervasive in diarrheal infections around the world. As a result, the primary goal of this study was to evaluate antibiotic use patterns for the treatment of acute diarrheal diseases at Debre Tabor Comprehensive Specialized Hospital in North-West Ethiopia., Methodology: A retrospective cross-sectional study was conducted to assess the antibiotic utilization pattern used to treat acute diarrheal illness, taken from the record cards of 243 patients who received treatment for acute diarrheal illness, employing structured questions from September 1 to September 30, 2022. The results are displayed using percentages and frequency distributions in tables along with figures., Results: A total of 243 patients were involved, 134 (55.1%) of whom were male and 134 (55.1%) were under the age of five. Out of the 103 cases of acute watery diarrhea, 83 received antibiotics that were given improperly. Additionally, 88 individuals had bloody diarrhea diagnoses, but 58 of them received the currently administered antibiotics. Amoxicillin and co-trimoxazole were the most frequently prescribed medications, with 193 (79.5%) of the 243 cases of patients receiving some form of antibiotic., Conclusion: The results of the study revealed that there is inappropriate antibiotic use in acute diarrheal disease at Debre Tabor Comprehensive Specialized Hospital, which might be the cause for the overall increase in antimicrobial resistance as well as the associated costs of treatment. The finding is helpful as evidence for prescribers' inappropriate use of antibiotics for the treatment of acute diarrheal sickness., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors. Published by Elsevier Ltd.)

In the current scenario, prolonged consumption of alcohol across the globe is upsurging an appreciable number of patients with the risk of alcohol-associated liver diseases. According to the recent report, the gut-liver axis is crucial in the progression of alcohol-induced liver diseases, including steatosis, steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma. Despite several factors associated with alcoholic liver diseases, the complexity of the gut microflora and its great interaction with the liver have become a fascinating area for researchers due to the high exposure of the liver to free radicals, bacterial endotoxins, lipopolysaccharides, inflammatory markers, etc. Undoubtedly, alcohol-induced gut microbiota imbalance stimulates dysbiosis, disrupts the intestinal barrier function, and trigger immune as well as inflammatory responses which further aggravate hepatic injury. Since currently available drugs to mitigate liver disorders have significant side effects, hence, probiotics have been widely researched to alleviate alcohol-associated liver diseases and to improve liver health. A broad range of probiotic bacteria like Lactobacillus , Bifidobacteria , Escherichia coli , Sacchromyces , and Lactococcus are used to reduce or halt the progression of alcohol-associated liver diseases. Several underlying mechanisms, including alteration of the gut microbiome, modulation of intestinal barrier function and immune response, reduction in the level of endotoxins, and bacterial translocation, have been implicated through which probiotics can effectively suppress the occurrence of alcohol-induced liver disorders. This review addresses the therapeutic applications of probiotics in the treatment of alcohol-associated liver diseases. Novel insights into the mechanisms by which probiotics prevent alcohol-associated liver diseases have also been elaborated., 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 © 2023 Mishra, Singh, Molla, Yimer, Dinda, Chandra, Singh, Dagnew, Assefa and Ewunetie.)

Background: Even though numerous conventional anti-diarrheal agents are available, the inherent toxicities of the drugs urge the search for alternative drugs that are safe and effective., Objective: To evaluate the in-vivo anti-diarrheal activity of crude extract and solvent fractions of Rhamnus prinoides leaves., Materials and Methods: The Rhamnus prinoides leaves were macerated using absolute methanol and then fractionated using solvents of different polarity indexes. For in-vivo antidiarrheal activity evaluation of the crude extract and solvent fraction, castor oil-induced diarrhea, castor oil-induced anti-enteropolling, and intestinal transit models were used. One-way analysis of variance was used to analyze the data, followed by a Tukey post-test. The standard and negative control groups were treated with loperamide and 2% tween 80 respectively., Results: A significant (p˂0.01) reduction in the frequency of wet stools and watery content of diarrhea, intestinal motility, intestinal fluid accumulation, and delaying the onset of diarrhea as compared with controls were observed in mice treated with 200 mg/kg and 400 mg/kg methanol crude extract. However the effect increased dose-dependently, and the 400 mg/kg methanol crude extract produced a comparable effect with the standard drug in all models. Amongst the solvent fractions, n-BF significantly delayed the time of diarrheal onset and reduced the frequency of defecation, and intestinal motility at doses of 200 mg/kg and 400 mg/kg. Furthermore, the maximum percentage inhibition of intestinal fluid accumulation was observed in mice treated with 400 mg/kg n-butanol extract (p˂0.01; 61.05%)., Conclusions: The results of this study showed that crude extract and solvent fractions of Rhamnus prinoides leaves showed a significant anti-diarrheal activity which supports its traditional use as a diarrhea treatment., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

The Urticaceae family contains 54 genera and more than 2000 species that can be found in tropical, subtropical, and temperate climates all over the world. This family includes the largest genus in the world, Urtica , which is also known as stinging nettle. Stinging hairs are present on the lower surface of the leaves and beneath the stems of Urtica simensis , also known as the stinging nettle, herbal nettle that is dioecious, upright, and unbranched. For the treatment of conditions like gastritis, heart disease, diabetes, gonorrhea, and malaria, people employ various portions of Urtica simensis in a variety of ways in traditional medicine. The Urtica simensis leaves are rich in variety of active secondary phytochemical constituents including terpenoids, saponins, tannins, flavonoids, steroids, alkaloids, polyphenols, sterols, oxalate, and ascorbic acid (vitamin C). According to different reports, it possesses a variety of pharmacological properties, including antioxidant, antiproliferative, antidiabetic, cardioprotective, antiulcer, antibacterial, and antifungal actions. The current review summarizes published and unpublished information about the ethnobotanical, phytochemical, ethnopharmacological, and toxicological reports of Urtica simensis and summarizes all the research work carried out on this plant to provide updated information for future work., Competing Interests: The authors report no conflicts of interest in this work., (© 2023 Tadesse et al.)

Objective: Drug-drug interactions are of major concern due to links to untoward drug effects, hospitalizations, and serious health impacts. Elderly patients are more predisposed to drug interactions than younger patients. The present study aimed to find out the prevalence of drug-drug interactions at North West Ethiopian compressive specialized hospitals' Internal Medicine wards., Methods: From 30 April to 30 July 2021 GC, a multicenter prospective observational study was conducted at north Ethiopian specialized hospitals. Data was collected by using a structured questionnaire adapted from different literature and medical records at the North West Ethiopian Comprehensive Specialized Hospitals' Internal Medicine wards during the study period. Thereafter checked the completeness of the collected data was checked drug-drug interactions by using Medscape. Epi data version 4.6.2 software was used as data clearance and STATA version 14.1 was used for further data analysis., Result: A total of 389 subjects participated in the study of which more than half (55.53%) of them were female with a mean (SD) age of 68.9 ± 7.46 years. A total of 641 drug-drug interactions were detected in this investigation of which, 225(35.1%) were major, 299(46.6%) were significant interactions, and 117(18.3%) were minor interactions. Hospital stay (AOR = 5.95 CI: 3.49-10.12), retire (AOR = 6.71 CI: 1.26-35.78), 5-9 drugs (AOR = 5.30 CI: 2.91-9.67) and more than 10 drugs (AOR = 8.03 CI: 2.47-26.07) were important risk factors for drug-drug interactions., Conclusion: The findings of this study suggest that drug-drug interactions were high among hospitalized elderly patients. The presence of polypharmacy, to be retired, and hospital stayed were all found to be strongly linked with drug-drug interactions., Competing 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: Improper utilization of antibiotics harms the patient, the public, and the economy. The overuse of injections is one of the key factors in the irrational use of medicines. However, little is known about intravenous (IV) to peroral (PO) conversion practice in the Ethiopian healthcare setting, specifically in the Northwest part of Ethiopia., Objective: To assess antibiotics IV to PO conversion practice and its associated factors at the internal medicine ward of the University of Gondar Comprehensive and Specialized Hospital (UOGCSH)., Method: A prospective observational study was conducted on 324 study participants who were admitted to the University of Gondar Specialized Hospital from October 3 to November 14, 2021. A systematic random sampling technique was employed to select the study participants. Stata version 14.2 was used for the analysis. Descriptive statistics result was presented using mean and standard deviation. Logistic regression analysis was done to determine the association between independent variables and dependent variables. The association between independent variables and dependent variables was tested at 95% CI and P value≤ 0.05 was considered statistical significance., Result: A total of 324 study participants were included in the study, and the mean age of the patients was 41.4 ± 18.6. Of the 324 study participants, 63.3% were male. The most frequently prescribed antibiotics used for empiric treatment were ceftriaxone (45.4%), followed by metronidazole (33.2%), and cloxacillin (11.4%). A total of 34.5.57% of patients who took antibiotics were converted to PO antibiotics. The most frequently converted type of conversion practice was sequential (23.1%), followed by the switch type of conversion (7.4%). Tachypnea, unavailability of medication, higher temperature, hospital stay greater than 10.78-days, and the presence of comorbidity were predictors of IV medications not being converted to PO medications., Conclusion: Intravenous to peroral conversion practice was infrequent. The most frequently applied conversion practice was sequential type conversion practice, followed by switch type of conversion practice. IV to PO conversion practice was significantly associated with tachypnea, unavailability of medication, higher temperature, hospital stay greater than 10.78-days, and comorbidity. Awareness of IV to PO conversion practice and short-term training for healthcare teams is vital for better antibiotic conversion practice., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Getachew Yitayew Tarekegn et al.)

A peptic ulcer is described as the rupture of the mucosal integrity of the stomach, the duodenum, and, in certain cases, the lower esophagus as a result of contact with chloridopeptic secretions. The two most common kinds of peptic ulcer disorders are referred to as "gastric ulcer" and "duodenal ulcer." The name is derived from the location of the ulceration. Despite the promise of a wide range of antiulcer treatments, these therapies are associated with several adverse reactions, including hypersensitivity, arrhythmia, impotence, gynecomastia, galactorrhea, hematological abnormalities, and kidney disease, which are intolerable for many patients. Nowadays, there is a lot of emphasis on finding new and innovative agents. As a result, herbal medicines are commonly utilized in circumstances when drugs are used for long periods and are also cost-efficient, effective, and readily available. In this review paper, a total of 82 medicinal plants have been identified and reported for their use in the treatment of peptic ulcer disease. The majority of these medicinal plants are widely used throughout Ethiopia. However, only the safety and efficacy of Plantago lanceolata, Osyris quadripartita, Rumex nepalensis, Cordia africana, Croton macrostachyus , and Urtica simensis have been scientifically studied in animal models. Despite this, many medicinal plants' pharmacological effects and chemistry have not been well studied scientifically. As a result, further bioactive compound characterization, efficacy, mechanism of action evaluation, and toxicity evaluation of medicinal plants should be carried out. A study that can improve the documentation of indigenous knowledge and contribute to drug development and future self-reliance is also recommended., Competing Interests: The authors report no conflicts of interest in this work., (© 2022 Tadesse et al.)

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., Competing Interests: The authors report no conflicts of interest in this work., (© 2022 Yiblet et al.)

Background: Drug therapy in the elderly needs an emphasis on age-related changes in drug pharmacokinetics and pharmacodynamics profile. Hospitalized elderly patients are at risk of more than one disease and polypharmacy associated with these; they are at risk of drug-related problems. This study aimed to assess the role of clinical pharmacy on identifying and resolution of drug-related problems among elderly patients admitted to medical ward of Northwest Ethiopia comprehensive specialized hospitals. Methods : A multicenter prospective observational study was conducted. A systematic sampling technique was used. The identified drug-related problem was recorded and classified using Cipolle, and adverse drug reaction was assessed using Naranjo algorithm of adverse drug reaction probability scale, and Medscape was used for drug-drug interaction. Data were analyzed by using STATA software version 14.1. Logistic regression was used, and results were reported as odds ratios (ORs) with 95% Confidence intervals with P  value < 0.05 statistically significant. Result : A total of 389 study participants were included in the study. About 266 (68.4%) of the participants had at least a single drug-related problem. About 503 drug-related problems were identified with a mean of 1.32 (CI: 1.27-1.36) drug-related problem per patient. The three-leading categories of drug-related problems were dose too high 108 (21.5%), nonadherence 105 (20.9%), and adverse drug reaction 96 (19.1%). Alcohol use (AOR = 2.2, 95CI%: 1.23-3.94), source of the drug (AOR = 2.85, 95CI%: 1.63-4.98), length of hospitalization (AOR = 2.32, 95CI%: 1.37-3.95), number of comorbidities (AOR = 1.48, 95CI%: 1.09-1.99), and polypharmacy (AOR = 3.06, 95CI%: 1.72-5.46) were important risk factors for drug-related problems. From the intervention provided, 84.7% were accepted by prescribers. Among the total drug-related problems 67.4% of the problem was totally solved. Conclusion : This study revealed that DRPs were high among elderly patients admitted to medical ward of Northwest Ethiopia. Comorbidity, length of hospitalization, ploy-pharmacy, payer, and alcohol drinker were more likely to developed drug-related problems. Treatment optimizations were also done by clinical pharmacists and interventions were well accepted by prescribers., Competing Interests: The authors declare that they have not any conflict of interest, (Copyright © 2022 Samuel Berihun Dagnew et al.)