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Background: Neural tube defects are common group of central nervous system anomalies of complex etiology and major public health importance worldwide. The occurrence of multiple neural tube defects, however, is an extremely rare event and has never been reported in Ethiopia so far. This study gives an insight into how the embryogenesis, management, and postoperative complications of multiple neural tube defects differ from the ordinary single neural tube defects on the basis of up-to-date existing literature.Case Presentation: This paper highlights a case of an 8 days old female black race Ethiopian neonate who was brought by her mother with the chief complaint of lower back and lower neck swelling since birth. The findings were a 5 × 4 × 5 cm sized ulcerated placode at the mid-lumbosacral area and a 1.5 × 1.5 × 1 cm sized fluctuant, nontender, transilluminating mass with overlying unruptured defect dysplastic skin at the cervicothoracic junction. With a diagnosis of multiple neural tube defects secondary to unruptured cervicothoracic meningocele and ruptured lumbosacral myelomeningocele, single-stage repair of the defects was done with good outcome.Conclusion: There is insufficient evidence as to the exact mechanism of development of multiple neural tube defects. Similarly, whether patients with multiple neural tube defects had increased risk of post repair hydrocephalus compared with patients who have single neural tube defect is unknown. Hence, more research on the embryogenesis, management, and long-term outcome of multiple neural tube defects in particular and single neural tube defects in general should be done to better help patients with this costly and crippling problem. Lastly, the practice of folic acid supplementation is very low in resource-limited countries such as Ethiopia and, hence, should be improved. [ABSTRACT FROM AUTHOR]

Medicines are one of the critical elements of a well-functioning healthcare system, but their expiry remains one of the significant challenges in the healthcare sector. This study aims in assessing the extent of the issue and identifying the expired medicine types and their underlying causes in some selected public health facilities of Arsi Zone, Oromia Regional State, Ethiopia. This study is a mixed-method, which includes both quantitative and qualitative components. The quantitative research was undertaken by retrospective data extraction of recorded medicines as expired for the specified period. At the same time, the qualitative part is a facility-based cross-sectional survey study with self-administered questionnaires and semi-structured in-depth interviews engaging the health professionals of study facilities to explore the reasons for the expiration of medicines. Fifteen health facilities were selected from the study zone. The total monetary value of expired medicines in the studied health facilities during 2017-2019 was 185,938.86 USD. In the same period, all study facilities received medicines worth 2,425,882.64 USD, resulting in an expiry rate of 7.66%. The top classes of wasted medicines through expiry in terms of value were anti-infectives (35.51%) and medicines for central nervous system (CNS) disorders (20.48%). In comparison, by dosage forms, nearly half were solid dosage forms (48.81%), followed by liquid dosage forms (41.82%). Delivery of near expiry date medicines by Ethiopia's Pharmaceuticals Supply Agency (PSA), lack of a system to exchange nearly expired medicines between facilities, and presence of overstocked medicines due to improper forecasting of need were the common perceived factors contributing to the expiry of medicines. Thus, the Policymakers should make decisions to reduce the contributing factors of medicines expiry to reduce wastage of medicines and promote appropriate utilization of finite resources. [ABSTRACT FROM AUTHOR]

Background: Central nervous system (CNS) toxicities from regimens containing efavirenz are the main reasons for non-adherence, switch and discontinuation of antiretroviral therapy (ART). We aimed to assess prevalence of CNS adverse events and associated factors among HIV patients taking efavirenz-based regimens at the University of Gondar Comprehensive and Specialized Hospital (UoGCSH), Northwest Ethiopia. Methods: A hospital-based cross-sectional study was conducted from March 15 to May 15, 2018 on 345 patients living with HIV who were taking efavirenz-based regimens. Information on sociodemographic and clinical characteristics was taken from medical records and patient interview. Binary logistic regression analysis was done to determine association. Statistical significance was declared at P value of ≤ 0.05. Results: About 52.8% of participants experienced CNS adverse events. Vivid dreams, confusion, insomnia and somnolence were the most frequently reported adverse events. Most of the CNS adverse events occurred in the first year of treatment initiation and resolved within 1– 4 weeks. Age, economic status, CD4 count, disease stage, presence of comorbidities and concurrent use of other medication had a significant association with the occurrence of CNS adverse events. Conclusion: More than half of HIV patients taking efavirenz-based regimens at UoGCSH experienced CNS adverse events. Health-care providers should give attention to patients on efavirenz therapy to monitor for CNS adverse events, especially for patients who have low CD4 count, advanced disease, comorbidities, low income and are older in age. [ABSTRACT FROM AUTHOR]

The article presents a study that investigates the pattern and predictors of mortality of HIV/AIDS patients with neurologic manifestations. It is given that medical records of 347 patients admitted to Tikur Anbesa Hospital, Ethiopia, from September 2002 to August 2009 were analyzed. It is found that central nervous system (CNS) opportunistic infections were the major causes of neurological manifestations of HIV/AIDS.