Objective Epilepsy management especially in developing country is challenging. Seizures recurrence can be caused by both drug and non-drug related problems such as inadequate antiepileptic regimens, adverse drug reaction and poor adherence. Patient treatment satisfaction also affects the treatment out comes by improving medication adherence. This study aimed to assess drug therapy problems (DTPs) and treatment satisfaction among ambulatory epileptic patients at Tikur Anbessa Specialized Hospital. Methods A prospective cross-sectional study was conducted on 291 epileptic patients. Data was collected through patient interview and medical charts review. DTPs were identified based on the standard treatment guidelines and Micromedex® was used as drug interaction checker. Cipolle DTPs classification was used to classify the DTPs and Treatment Satisfaction with Medicine Questionnaire (SATMED-Q) was used to assess treatment satisfaction. Binary logistic regressions were utilized to identify the associated factors. Results Phenobarbital 195 (67%) and phenytoin 97 (33.3%) were the most frequently prescribed antiepileptic medications as monotherapy or combination therapy. Only 54 (18.6%) of the study participants had controlled seizure. DTP was found in 205(70.4%) of the study participants. From 352 DTPs identified, adverse drug reaction 146 (41.5%) was the leading DTPs followed by ineffective drugs 98 (27.8%) drug interaction 45 (12.8%) and inappropriate dose 42(11.9%). Headache, depression and epigastric pain were frequently reported adverse drug reaction. Among the study participants 167 (57.3%) were adherent to their medications. The number of medications taken by the patients had significant association with occurrence of DTPs, whereas source of medication and seizure free periods were found to have significant association with poor adherence. The global patient satisfaction was

Objective: Anti-epileptic drugs (AEDs) are the primary therapeutic modalities for epilepsy management. However, one-third of epileptic patients continue to experience seizure even with appropriate AED use. Patients with epilepsy are at increased risk for seizure-related injury and they have higher incidences of home, street and work accidents. There is a paucity of data on AED use pattern and treatment outcomes among patients with epilepsy in the tertiary hospitals of Ethiopia. Therefore, the aim of this study was to assess AED use pattern, treatment outcome, and prevalence of seizure-related injury among patients with epilepsy in Tikur Anbessa specialized Hospital (TASH), Ethiopia. Patients and Methods: An institution-based cross-sectional study was carried out on 291 patients with epilepsy attending the neurology clinic of TASH. A semi-structured questionnaire and data abstraction format were used to collect data through patient interview and medical chart review. Binary logistic regression was utilized to identify the associated factors of treatment outcome. Results: About 172 (59%) of the patients were taking a single AED, in which phenobarbital, 195 (67%), and phenytoin, 97 (33.3%), were the most frequently prescribed AEDs as monotherapy and combination therapy. Headache, depressed mood and epigastric pain were frequently reported as adverse drug reactions. Seizure-related injury was reported among 78 (26.8%) patients and head injury 15 (5.2%), desntal injury 15 (5.2%), soft tissue injury 14 (4.8%) and burns 10 (3.4%) were the commonest. About two-thirds (191, 65.6%) of the study participants had uncontrolled seizure. Medication adherence and multiple AEDs were significantly associated with treatment outcome. Conclusion: All the study participants were put on old generation AEDs with phenobarbital being the most frequently used. About two-thirds of the patients had uncontrolled seizure and seizure-related injury is still a serious concern among patients with epilepsy.

BackgroundPolyneuropathy is one of the commonest complications of long-standing diabetes. Progressive sensory loss can predispose patients to foot ulcer and the neuropathy oftentimes causes pain. The pain can significantly affect the quality of life of patients.ObjectivesTo describes the health-related quality of life of patients with type II diabetes mellitus suffering from painful diabetic peripheral neuropathy at two referral hospitals in Addis Ababa, Ethiopia, 2017.MethodsAn institution based cross sectional study with internal comparison was conducted among a sample of 220 type II diabetes mellitus patients in a 1:1 matched ratio of those with and without diabetes associated peripheral neuropathic pain. All were having regular follow up at two hospitals in Addis Ababa, Ethiopia. The Short Form (SF-36) health-related quality of life instrument was used to collect data on quality of life while basic socio-demographic and other disease specific features were collected using a structured questionnaire. Descriptive statistics was used to examine the mean scores of health related quality of life. Cronbach’s alpha coefficient and Pearson’s correlation coefficient were applied to estimate the internal consistency, and the level of agreement between the different domains of SF-36, respectively. To measure association between health related quality of life domains and explanatory variables, independent T-test and ANOVA were performed followed by multiple linear regression analyses.ResultsThe health related quality of life of type II diabetes mellitus patients with peripheral neuropathic pain was poorer than those without pain in all the eight domains and the two summary scores by SF-36 (p < 0.001). Higher mean score difference was observed in Mental Component Summary Score (MCS) (14.6) compared to Physical Component Score (PCS) (9.3). Among the eight domains, the largest mean difference was found with the physical one (39.1) followed by mental health (38.2) and physical functioning (30). Pain intensity had a statistically significant negative correlation with all domains as well as the two summary scores. Younger age, a higher level of education, being single, a higher monthly income, normal body mass index, HbA1c less than seven mmo/L, absence of other diabetic complications and taking only oral hypoglycemic agents were found to predict better health related quality of life.ConclusionThe presence of diabetic peripheral neuropathic pain was found to negatively influence the health-related quality of life of type II diabetic patients; the greatest impact being on the ‘role physical’ and ‘mental health’ domains. Older age, presence of diabetes related complications, longer duration of illness negatively influenced the health-related quality of life.

Background: Globally, stroke appears as a major cause of preventable deaths and disabilities. In Ethiopia, the intra-hospital mortality of stroke is significant; however, epidemiologic data are scarce whether there is a difference in the overall survival time between hypertensive and non-hypertensive adult stroke patients admitted in specialized hospitals. This study was intended to determine the survival of stroke patients according to their hypertension status admitted in Ayder Comprehensive Specialized Hospital, Northern Ethiopia from March 1, 2012, to February 28, 2019. Methods and Findings: A hospital-based retrospective cohort study was conducted among all cohorts of confirmed first-ever stroke patients admitted in Ayder Comprehensive Specialized Hospital, Northern Ethiopia. Kaplan-Meier survival analysis was applied to estimate the survival probability of hypertensive and non-hypertensive first-ever stroke patients. Cox proportional hazards regression model was used to determine the adjusted hazard ratio of death for each main baseline predictor variable with 95% CI, and P-value <0.05 was used to declare statistical significance. The assumptions of the Cox proportional hazards regression model assessed by the global test, Schoenfeld residuals. There were 503 (323 were hypertensive, 180 Non-hypertensive) confirmed first, ever adult stroke patients, the overall median age of the patients was 65 years, IQR (53-75) years. Seventy-five (14.9%) of them were dead, with a median survival time of 48 days and 428 (85.1%) of them were censored. At any particular point in time, the hazard of death among hypertensive patients was two times higher than non-hypertensive patients, but this was not found to be a statistically significant (adjusted HR=2.13: 95% CI 0.66-6.81). Glasgow Coma Scale 3-8 at admission (adjusted HR=10.12; 95% CI 2.58-40.68), presence of stroke complications (adjusted HR=7.23; 95% CI 1.86-28.26) and borderline high total cholesterol level (adjusted HR=3.57; 95% CI 1.15-11.1) were the only independent predictors of intra-hospital patient mortality. Conclusion: The overall survival time difference between hypertensive and nonhypertensive first-ever adult stroke patients was not statistically significant. Early identification and treatment of stroke complications, co-morbidities along strict follow-up of comatose patients may improve the intra-hospital survival of stroke patients, and we also recommend community-based studies using a large sample size.

BackgroundMigraine headache is a neurologic disorder which mainly affects younger and productive segment of population. Migraine not only causes pain; but also affects quality of life in terms of low productivity and economic loss. The main aim of this study was to examine migraine-related disability, co-morbid depression, and relationship between the two.MethodsA cross-sectional study was conducted among migraineurs who visited two neurology referral clinics. The study was conducted between June 1st 2016 to December 30th2016. Migraine disability assessment score [MIDAS] and patient health questionnaire [PHQ-9] were used to assess disability and depression, respectively.ResultsA total of 70 patients participated in the study. Fifty-three (74.3%) of our study participants were women. Fifty one (72.9%) study participants were between age group 20–40 years. Migraine without aura was the most common subtype (70%); migraine with aura accounted for the other 28.6%. The mean (± SD) headache frequency and intensity was 23.4 ± 14.9 days and 7.4 ± 1.2 respectively. Major depressive disorder was common in this group (41.4%). The mean MIDAS and PHQ-9 scores were 46.7 ± 30 and 9.2 ± 4.4 respectively. More than two-thirds (74.3%) of our participants had severe disability. We found a statistically significant correlation between migraine-related disability and co morbid depression among our participants(r = 0.318, p-value = 0.007).ConclusionThe positive correlation observed between migraine-related disability and co-morbid depression warrant routine screening and treatment of disability and depression in migraineurs; In addition, the observed high degree of disability among our participants may indicate sub optimal treatment of these patients.