Objective Hypertension is a major risk factor and precursor of myocardial infarction, chronic kidney disease, heart failure and premature death. These vascular events increased costs of hypertension management. Self-care Practices were recommended to control blood pressure among hypertensive patients. Therefore, the objective of this study is to assess predictors of self-care practices among hypertensive patients at Jimma University Specialized Hospital. Results A 341-hypertensive patients participated in the study. The mean age of the participants was 54.35 ± 12.48 years with range of 26 to 89 years. One hundred seventy-seven (51.9%) respondents were males and male to female ratio is 1.08. About 61.9% of respondents were adherent to medication usage and 30.5%, 44.9%, 88.3%, 93.5% and 56.9% of respondents were adherent to low salt diet, physical activity, non-alcohol drinking, nonsmoking and weight management respectively. Normal weight (AOR = 1.822, 95% CI 1.073–3.093) was independent predictor of medication usage whereas good self-efficacy (AOR = 2.584, 95% CI 1.477–4.521) and being female (AOR = 0.517, 95% CI 0.301–0.887) were independent predictor of low salt diet and physical activity respectively. Also being female (AOR = 3.626, 95% CI 1.211–10.851) was independent predictors of non-smoking.

Epilepsy is a chronic neurological disease with a variable therapeutic response. To design effective treatment strategies for epilepsy, it is important to understand treatment responses and predictive factors. However, limited data are available in Africa, including Ethiopia. The aim of this study was therefore to assess treatment response and identify prognostic predictors among patients with epilepsy at Jimma university medical center, Ethiopia. We conducted a retrospective cohort study of 404 newly diagnosed adult epilepsy patients receiving antiepileptic treatment between May 2010 and May 2015. Demographic, clinical, and outcome data were collected for all patients with a minimum follow-up of two years. Cox proportional hazards model was used to identify predictors of poor seizure remission. Overall, 261 (64.6%) of the patients achieved seizure remission for at least one year. High number of pre-treatment seizures (adjusted hazard ratios (AHR) = 0.64, 95% CI: 0.49–0.83) and poor adherence (AHR = 0.57, 95% CI: 0.44–0.75) were significant predictors of poor seizure remission. In conclusion, our study showed that only about two-thirds of patients had achieved seizure remission. The high number of pre-treatment seizures and non-adherence to antiepileptic medications were predictors of poor seizure remission. Patients with these characteristics should be given special attention.

Background Acute coronary syndrome (ACS) remains the leading cause of cardiovascular disease mortality and morbidity worldwide. While the management quality measures and clinical outcomes of patients with ACS have been evaluated widely in developed countries, inadequate data are available from sub-Saharan Africa countries. So, this study aimed to assess the clinical profiles, management quality indicators, and in-hospital outcomes of patients with ACS in Ethiopia. Methods A Prospective observational study was conducted at two tertiary hospitals in Ethiopia from March 2018 to November 2018. The primary outcome of the study was in-hospital mortality. Data were analyzed using SPSS version 23.0. Multivariable cox-regression was conducted to identify predictors of time to in-hospital mortality. Variable with p -value < 0.05 was considered statistically significant. Results Among 181 ACS patients enrolled, about (61%) were presented with ST-elevation myocardial infarction (STEMI). The mean age of the study participant was 55.8 ± 11.9 years and 62.4% were males. The use of guideline-directed medications within 24 h of hospitalization were sub-optimal (57%) [Dual antiplatelet (73%), statin (74%), beta-blocker (67%) and ACEI (61%)]. Only (7%) ACS patients received the percutaneous coronary intervention (PCI). Discharge aspirin and statin were high (> 90%) while other medications were sub-optimal (< 80%). The all-cause in-hospital mortality rate was 20.4% and the non-fatal MACE rate was 25%. Rural residence (AHR: 3.64, 95% CI: 1.81–7.29), symptom onset to hospital arrival > 12 h (AHR: 4.23, 95% CI: 1.28–13.81), and Cardiogenic shock (AHR: 7.20, 95% CI: 3.55–14.55) were independent predictors of time to in-hospital death among ACS patients. Conclusion In the present study, the use of guideline-directed in-hospital medications was sub-optimal. The overall in-hospital mortality rate was unacceptably high and highlights the urgent need for national quality-improvement focusing on timely initiation of evidence-based medications, reperfusion therapy, and strategies to reduce pre-hospital delay.

BackgroundPatients receiving anticoagulant drugs must be carefully screened for drug-related problems, as such medications, including warfarin have narrow therapeutic ranges and a high potential for complications. Thus, this study was designed to assess drug-related problems in the management of patients with deep vein thrombosis at Tikur Anbessa Specialized Hospital.MethodsA cross-sectional descriptive study involving retrospective chart review of adult patients with deep vein thrombosis was conducted from patients who visited the hospital from July 2012 to June 2013, using structured data collection format and this was complemented by key informant interview.ResultsThe study included 91 patients with venous thromboembolism. Fifty three (58.2 %) were females. Mean age was 38.6 (±13.76) years and more than 2/3 were below the age of 44 years. About 54 % of them presented with concurrent medical conditions and most commonly with cancer. Adjustment of warfarin dose up or down was done in increments of 16 to 100 % for recent subtherapeutic International Normalized Ratios, 16 to 50 % for therapeutic and 11 to 66 % for overtherapeutic International Normalized Ratios, with the mean of 36.5 (±18.03) based on the cumulative weekly dose of warfarin. There was significant linear relationship between percentage of dose change and consequent International Normalized Ratio values (R2 = 0.419; p = 0.000). Accordingly, more than 51 % of them presented with nontherapeutic International Normalized Ratio ranges following dose adjustment.ConclusionsThe most prevalent anticoagulation drug-related problems were subtherapeutic doses, overtherapeutic doses and potential drug interactions. Institutional validated decision support tools for dosing decisions during maintenance anticoagulation therapy should be developed and used accordingly in order to prevent recurrent and hemorrhagic complications and to improve clinical outcomes.

Purpose: Despite the increasing burden of metabolic syndrome (MS) and ischemic heart disease in sub-Saharan Africa, data on the prevalence of MS among patients with acute coronary syndrome (ACS) from the regions are limited. Hence, this study is aimed to evaluate the prevalence and impact of MS on 30-day all-cause mortality in patients hospitalized with ACS. Patients and Methods: We prospectively assessed 176 ACS patients, who were admitted to two tertiary hospitals in Ethiopia. MS was diagnosed based on a harmonized definition of MS. In-hospital major adverse cardiovascular events (MACE) and 30-day mortality were recorded. Multivariable cox-regression was used to identify predictors of 30-day mortality. Results: Among 176 ACS patients enrolled, 62 (35.2%) had MS. Majority of the patients (62.5%) were male with the mean age of 56±11.9 years. ACS patients with MS were older, presented with atypical symptoms, and they had history of hypertension, diabetes, dyslipidemia and coronary artery disease compared to those without MS. MS was also significantly associated with in-hospital MACE (30.6% vs 17.5%; p= 0.046) and 30-day mortality [adjusted hazard ratio (AHR) = 3.25, 95% CI=1.72-6.15]. The other significant predictors of 30-day mortality were pre-hospital delay >12h (HR= 4.32, 95% CI=1.68-11.100), killip class ≥2 (HR=10.7, 95% CI= 2.54-44.95), and ejection fraction <40 (HR= 2.59 95% CI=1.39-4.84). Conclusion:The prevalence of MS among patients with ACS in Ethiopia is high. MS was significantly associated with high in-hospital MACE and it was an independent predictor of 30-day mortality. Initiating appropriate strategies on MS prevention and timely diagnosis of MS components could decrease the burden of ACS and improve patient's outcome.