Background. Malnutrition is the major public health problem over the world. Developing countries are highly affected. Asian and Sub-Saharan African countries, including Ethiopia, contribute the highest of all. The main aim of this study was to assess the prevalence of undernutrition and its associated factors among children below five years of age.Methods. Community-based cross-sectional survey was conducted on 342 study participants. Simple random sampling technique was used to select sampling kebeles and study units. Weight and height were measured using calibrated instruments. The data were entered into EpiData version 3.1 software and calculated using SPSS version 20.0 statistical software and/or World Health Organization Anthro software with aid of Stat/Transfer.Results. Overall prevalence of undernutrition was 35.5%, of which 85 (24.9%), 38 (11.1%), and 49 (14.3%) were stunting, wasting, and underweight, respectively. Male children were more affected in both severe and moderate nutritional problems compared to female children. The finding showed that 27 (7.9%) had severe stunting, 15 (4.4%) had severe wasting, and 11 (3.2%) had severe underweight, respectively.Conclusion. Undernutrition was high in Bure town among children below five years of age. Male sex, maternal educational status, low household income, preterm babies, absence of antenatal follow-up, diarrhea, and respiratory infections within one-month duration were factors affecting undernutrition.

Background Recurrent diabetic ketoacidosis in patients with known diabetes mellitus remains a relevant problem in pediatrics with an incidence of 1–10% per patient. Children may die because of cerebral edema and had a significant mortality (24%) and morbidity (35%). Objective We assessed the incidence and predictors of diabetic ketoacidosis among diabetes children at East and West Gojjam zone referral hospitals, North West Ethiopia, 2019. Methods An institution-based retrospective follow up study was conducted on children who were registered from January 1, 2014, to January 1, 2019. Epi data version 3.1 & Stata 14 were used for data entering and analysis respectively. Result Out of 354 children included in the study, 207 (58.5%) developed diabetic ketoacidosis. The overall incidence rate of diabetic ketoacidosis was 2.27/100 children/month of observation. Age < 5 years (AHR: 3.52, 95% CI (2.25, 5.49), non-adherence (AHR: 1.54, 95% CI (1.11, 2.14), inappropriate insulin storage (AHR: 1.36, 95% CI (1.008, 1.85), presence of upper respiratory tract infections during diabetic ketoacidosis diagnose (AHR: 2.22, 95% CI (1.11, 4.45) and preceding gastroenteritis (AHR: 2.18, 95% CI (1.07, 4.44) were significant predictors. Conclusion Age < 5 years old, non-adherence, inappropriate insulin placement at home, preceding gastroenteritis, and presence of upper respiratory tract infections at the time of diabetic ketoacidosis development were significant predictors. Hence, assessing and close monitoring as well as strengthened diabetic education should be given for the above predictors.

Background Breast cancer is one of the common global health concerns that affects2.1 million women each year and causes the highest number of cancer-related morbidity and mortality among women. The objective of this study was to determine the mortality rate and its predictors among breast cancer patients at the referral hospitals, in northwest Ethiopia. Methods A retrospective follow-up study was conducted on breast cancer patients registered between February 01, 2015 and February 28, 2018. They were selected by simple random sampling using computer-generated method and followed until February 29, 2020, in Amhara region referral hospital. A pre-tested data extraction checklist was used to collect data from the registration book and patient medical records. The collected data were entered into Epi-Data version 3.1 and exported to STATA version 14 for analysis. The mortality rate by person-year observation was computed. The Kaplan-Meier survival curve with the log-rank test was used to estimate the survival probabilities of the patients. Bivariate and multivariate Cox regression model was used to identify predictors of mortality. Results The overall mortality rate of breast cancer was 16.9 per 100 person-years observation. The median survival time was 38.3 (IQR: 26.23, 49.4) months. Independent predictors of breast cancer mortality was; Clinical stage IV and stage III (aHR:10.44,95% CI: 8.02,11.93 and aHR: 9.43, 95% CI: 6.29,11.03respectively), number of positive lymph node in the category of 10 and more and number of positive lymph node within the category of 4–9 (aHR:12.58, 95%CI: 5.2, 30.46 and aHR: 4.78, 95% CI: 2.19, 10.43respectively), co-morbidities (aHR:1.5, 95%CI: 1.01,2.21), Postmenopausal (aHR:2.03,95% CI: 1.37, 3), histologic grade III (aHR:2.12, 95% CI: 1.26,3.55) and not received hormonal therapy (aHR: 2.19, 95%CI: 1.52,3.15) were independent predictors of mortality. Conclusion The overall mortality rate was 16.9 per 100 person-years. The finding was higher compared to high-income countries. Advanced clinical stage, co-morbidities, menopausal status, and hormonal therapy are the significant predictors of mortality. Early detection and treatment of breast cancer is needed to reduce the mortality rate.

Background: Self-care practice is crucial for the prevention and management of Hypertension. Poorly controlled hypertension leads to cardiovascular complication as well as organ damage. Despite the availability of several effective pharmacologic and non-pharmacologic therapies, hypertension control remains suboptimal. Self-care practices allow hypertensive patients to have improved quality of life by avoiding complication and decrease health care expenditure.Objective: we assessed self-care practice and its associated factors among Hypertensive Follow up patients at East Gojjam Zone public hospitals, Northwest Ethiopia, 2020.Methods: Institution based cross sectional study was conducted by both quantitative and qualitative methods from October 1-30, 2020. Epi data version 3.1 and SPSS version 25.0 were used for data entry and for analysis respectively. Descriptive statistics and binary logistic regression analysis was employed. Adjusted odds ratios were used to ascertain effect sizes for any association between the dependent and associated variables while signi cance level at p value of 0.05 was determined using 95% con dence intervals.Result: Out of 480 patients included in the study 51% have Poor self-care practices. About 44.6%, 92.5%, 82.8%, 62.5% of respondents were poor adherent to antihypertensive medications, low diet quality, poor practiced to physical activity, poor practice to weight management respectively. Some of the respondents 3.3%, 9.8% were smokers and were alcohol drinkers respectively. Educational status who cannot read and write (AOR=3.153, 95% CI: 1.674-5.939), no co morbidity (AOR = 0.418, 95% CI: 0.263-0.663), uncontrolled blood pressure status (AOR = 2.141, 95% CI: 1.271-3.609), poor social support status (AOR = 2.587, 95% CI: 1.544-4.334) and unfavorable attitude (AOR= 3.193, showed signi cant statistical association with poor self-care practice. Conclusion:The level of hypertension self-care practices found to be low. Therefore, education towards hypertension self-care practices should be strengthened for patients living with hypertension. Special attention should be given to patients with low educational level that cannot read and write, patients with co morbidity, uncontrolled state of hypertension, poor social support and those with unfavorable attitude towards hypertension management modalities.

Background: Each year 15 million preterm babies are born. Pre-term birth complications account for 35% of the estimated 3.1 million global neonatal deaths and are the second leading cause of death in children less than 5 years aged.Objective: we assessed the magnitude of preterm birth admissions, immediate outcomes and their predictors in Debre Markos Referral Hospital, North West, Ethiopia, 2019. Methodology: An institutional based retrospective cross- sectional study design was conducted among 212 neonates registered from January 1, 2014, to January 1, 2019. Data was entered using Epidata version 3.1 and exported to SPSS version 20 for analysis. Bivariable and multivariable logistic regressional analysis were done. Variables with p value <0.05 in multivariate analysis were declared as statistically significant at a 95% confidence interval. Results: Out of 212 neonates involved in the study, 27.8% were preterm birth admissions. From this 36.3% of neonates was died before discharge. In the final multivariate analysis hypertension during pregnancy was significantly associated for preterm admissions (P= 0.013, AOR= 4.464, 95% CI: (1.375, 14.498)) and being extreme low and very low birth weight (P= 0.005, AOR= 2.107, 95% CI: (0.023, 0.508)) and those with low APGAR score (P= 0.016, AOR= 3.113, 95% CI: (0.019, 0.669)) was significantly associated with death before discharge. Conclusion: Preterm admissions accounted for a significant percentage of neonatal admissions with significant death outcomes. Maternal medical problems like hypertension during pregnancy, premature rupture of membrane had significant association for preterm admissions. Also, being extreme low weight and very low weight baby, low APGAR score had significant association with death outcome of preterm neonates. Therefor, strategies should be designed to prevent preterm birth and their complications. Special attention should be given for pregnant mothers having medical problems especially hypertension. Furthermore, health institutions should have organised ANC follow up for regular screening of pregnant mothers for medical and obstetric complications.

BackgroundRecurrent diabetic ketoacidosis in patients with already diagnosed diabetic mellitus remains a relevant problem in pediatric with an incidence of 1–10% per patient. Children may die due to cerebral edema and had a significant mortality (24%) and morbidity (35%).ObjectiveWe assess incidence and predictors of diabetic ketoacidosis among diabetic children at East and West Gojjam zone referral hospitals, North West Ethiopia, 2019.MethodsAn institution-based retrospective follow up study was conducted on children who were registered from January 1, 2014, to January 1, 2019. Epi data version 3.1 & Stata 14 were used for data entering and analysis respectively.ResultA total of 354 children were included from this 207(58.5%) had diabetic ketoacidosis. The overall incidence rate of diabetic ketoacidosis was 2.27/100 children/month of observation. Age < 5 years (AHR: 3.52, 95% CI (2.25, 5.49), non-adherence (AHR: 1.54, 95% CI (1.11, 2.14), inappropriate insulin storage (AHR: 1.36, 95% CI (1.008, 1.85), presence of upper respiratory tract infections during diabetic ketoacidosis diagnose (AHR: 2.22, 95% CI (1.11, 4.45) and preceding gastroenteritis (AHR: 2.18, 95% CI (1.07, 4.44) were significant predictors.Conclusion and recommendationage < 5 years old, non-adherence, inappropriate insulin placement at home, Preceding gastroenteritis and presence of upper respiratory tract infections at the time of diabetic ketoacidosis development were significant predictors. Hence, assessing and close monitoring as well as strengthened diabetic education should be given for the above predictors.

Background: Each year 15 million preterm babies are born. Pre-term birth complications account for 35% of the estimated 3.1 million global neonatal deaths and are the second leading cause of death in children less than 5 years aged.Objective: we assessed the magnitude of preterm birth admissions, immediate outcomes and their predictors in Debre Markos Referral Hospital, North West, Ethiopia, 2019. Methodology: An institutional based retrospective cross- sectional study design was conducted. Bivariable and multivariable logistic regression analysis were done. Variables with p value <0.05 in multivariate analysis were declared as statistically significant at a 95% confidence interval. Results: Out of 212 neonates involved in the study, 27.8% were preterm birth admissions. From this 36.3% of neonates was died before discharge. Hypertension during pregnancy was significantly associated with preterm admissions (P= 0.013, AOR= 4.464, 95% CI: (1.375, 14.498)) and being extreme low and very low birth weight (P= 0.005, AOR= 2.107, 95% CI: (0.023, 0.508)), and those preterm babies with low APGAR score (P= 0.016, AOR= 3.113, 95% CI: (0.019, 0.669)) were significantly associated with death before discharge. Conclusion: Preterm admissions accounted for a significant percentage of neonatal admissions with significant death outcomes. Maternal medical problems like hypertension during pregnancy was significantly associated with preterm admissions. Also, preterm babies with extreme low birth weight and very low birth weight, low APGAR score were significantly associated with death outcome. Therefore, strategies should be designed to prevent preterm birth and their complications.