Neonatal mortality is one of the major public health problems throughout the world and most notably in developing countries. There exist inconclusive findings on the effect of antenatal care visits on neonatal death worldwide. Thus, the aim of this systematic review and meta-analysis was to reveal the pooled effect of antenatal care visits on neonatal death. The present systematic review and meta-analysis was performed using published literature, which was accessed from national and international databases such as, Medline/PubMed, EMBASE, CINAHL, Cochrane Central library, Google Scholar, and HINARI. STATA/SE for windows version 13 software was used to calculate the pooled effect size with 95% confidence intervals (95% CI) of maternal antenatal care visits on neonatal death using the DerSimonian and Laird random effects meta-analysis (random effects model), and results were displayed using forest plot. Statistical heterogeneity was checked using the Cochran Q test (chi-squared statistic) and I2 test statistic and by visual examination of the forest plot. A total of 18 studies, which fulfilled the inclusion criteria, were included in the present systematic review and meta-analysis. The finding of the present systematic review and meta-analysis revealed that antenatal care visits decrease the risk of neonatal mortality [pooled effect size 0.66 (95% CI, 0.54, 0.80)]. Cochrane Q test (P < 0.001) revealed no significant heterogeneity among included studies, but I2 statistic revealed sizeable heterogeneity up to 80.5% (I2 = 80.5%). In the present meta-analysis traditional funnel plot, Egger’s weighted regression (P = 0.48) as well as Begg’s rank correlation statistic (P = 0.47) revealed no evidence of publication bias. The present systematic review and meta-analysis revealed that antenatal care visits were significantly associated with lower rates of neonatal death. The risk of neonatal death was significantly reduced by 34% among newborns delivered from mothers who had antenatal care visits. Thus, visiting antenatal care clinics during pregnancy is strongly recommended especially in resource-limited settings like countries of sub-Saharan Africa.

Background: The use of herbal medicine among pregnant women is increasing in many low- and high-income countries due to their cost-effectiveness in treatment and ease of access. Research findings across Ethiopia on the prevalence and predictors of herbal medicine use among pregnant women attending antenatal care are highly variable and inconsistent. Therefore, this systematic review and meta-analysis aims to estimate the overall prevalence of the use of herbal medicine and its predictors among pregnant women attending antenatal care in Ethiopia. Method: We searched articles in Medline (PubMed), EMBASE, HINARI, Google Scholar, Science Direct, Cochrane Library, and other sources. The study included a total of eight studies that reported the prevalence and predictors of herbal medicine use among pregnant women from different regions of Ethiopia. Cochrane Q test statistics and I² tests were used to assess heterogeneity. A random effect meta-analysis model was used to estimate the pooled prevalence. In addition, the association between risk factors and herbal medicine use in pregnant women attending antenatal care were examined. Results: A total of eight studies were included in this review. The pooled prevalence of herbal medicine use among pregnant women attending antenatal care in Ethiopia was 47.77% (95% CI: 28.00–67.55). Subgroup analysis by geographic regions has showed that the highest prevalence (57.49%;95% CI: 53.14, 61.85) was observed in Oromia Region and the lowest prevalence was observed in Addis Ababa (31.39%; 95% CI: 2.83, 79.96). The herbal medicines commonly consumed by women during pregnancy were ginger: 41.11% (95% CI: 25.90, 56.32), damakasse: 34.63% (95% CI: 17.68, 51.58), garlic: 32.98% (95% CI: 22.21, 43.76), tenaadam: 19.59% (95% CI: 7.54, 31.63) and eucalyptus: 4.71% (95% CI: 1.1, 8.26). Mothers’ previous history of self-medication (95% CI: 1.91, 51.35), illness during pregnancy (95% CI: 1.56, 23.91), employment status (95% CI: 3.89, 10.89), educational status (95% CI: 1.52, 2.68), and place of residence (95% CI: 1.86, 3.23) were predictors of herbal medicine use by women during pregnancy. Conclusion: In this study, about half of women attending antenatal care use herbal medicine and it is relatively high. The most commonly consumed herbal medicine during pregnancy was ginger followed by damakasse, garlic, tenaadam and eucalyptus. During pregnancy, it is not known that these most commonly consumed plant species have harmful fetal effects. However, many of the medicinal plant species are poorly studied, and it is not possible to rule out teratogenic effects. Teamwork between healthcare professionals and traditional practitioners to educate on the use of medicinal plants will encourage healthier pregnancies and better health for mothers and infants.

Lumbar disc degeneration is defined as the wear and tear of lumbar intervertebral disc, and it is mainly occurring at L3-L4 and L4-S1 vertebrae. Lumbar disc degeneration may lead to disc bulging, osteophytes, loss of disc space, and compression and irritation of the adjacent nerve root. Clinical presentations associated with lumbar disc degeneration and lumbosacral nerve lesion are discogenic pain, radical pain, muscular weakness, and cutaneous. Discogenic pain is usually felt in the lumbar region, or sometimes, it may feel in the buttocks, down to the upper thighs, and it is typically presented with sudden forced flexion and/or rotational moment. Radical pain, muscular weakness, and sensory defects associated with lumbosacral nerve lesions are distributed on lower extremities, the buttock, lower abdomen, and groin region. A lumbosacral plexus lesion presents different symptoms in the territories of the lumbar and sacral nerves. Patients with lumbar plexus lesion clinically present with weakness of hip flexion, knee extension, thigh adduction, and sensory loss in the lower abdomen, inguinal region, and over the entire medial, lateral, and anterior surfaces of the thigh and the medial lower leg, while sacral plexus lesion presents clinical symptoms at nerve fibers destined for the sciatic nerve, common peroneal nerve, and pudendal nerve. Weakness of ankle inversion, plantar flexion, and foot drop are the main clinical manifestations of the sacral plexus lesion area. Numbness and decreased sensation are also present along the anterolateral calf and dorsum of the foot. On examination, foot eversion is usually stronger than foot dorsiflexion. The patients may also present with pain and difficulty of bowel movements, sexual dysfunction assessments, and loss of cutaneous sensation in the areas of the anal canal, anus, labia major, labia minor, clitoris, penis, and scrotum.

Introduction: social interaction impairments are the main feature of individuals diagnosed with autism spectrum disorder (ASD), making it a significant area of concern for both the children affected and their families. This study aimed to investigate the underlying factor structures of social interaction impairments in children diagnosed with autism spectrum disorder at autism centers in Addis Ababa, Ethiopia. Methods: a cross-sectional study was conducted among 145 children diagnosed with autism spectrum disorder. Various traits of social interaction impairments associated with autism were measured using the Autism Treatment Evaluation Checklist. A principal component analysis (PCA) employing a varimax rotation was used to identify the underlying factor structures of social interaction impairments. Results: six-factor structures of social interaction impairments were identified: challenges in interpersonal relationships and affection (eigenvalue: 4.99, variance: 13.437%), emotional insensitivity (eigenvalue: 1.714, variance: 11.837), poor gesture and attention (eigenvalue: 1.648, variance: 10.652), social withdrawal (eigenvalue: 1.40, variance: 8.932), behavioral resistance (eigenvalue: 1.270, variance: 8.011), and limited sharing (eigenvalue: 1.044, variance: 6.771). These factors accounted for approximately 60% of the total variance. Conclusion: the social interaction impairments in autism are multidimensional, presented in six distinct patterns. It is important to consider these patterns when supporting children with autism spectrum disorder.

Background: Individuals with autism spectrum disorder (ASD) have a wide range of challenges related to sensory and cognitive awareness. In Ethiopia, the increasing prevalence of ASD underscores the need for a comprehensive understanding of the associated challenges and impairments, an area that has not been studied so far. Objective: The objective of this study was to investigate the underlying patterns of sensory and cognitive awareness impairments in children diagnosed with ASD at autism centers in Addis Ababa, Ethiopia. Methods: An institution-based cross-sectional study was conducted at the Nehemia Autism Center and the Nia Foundation in Addis Ababa, Ethiopia. The study included children aged 4 to 16 years who had a confirmed diagnosis of ASD. A total of 145 study participants involved in this study. Study subjects were identified in collaboration with staff and caregivers. Caregivers of the study subjects were approached by trained data collectors, and written informed consent was obtained. The sensory/cognitive awareness subscale of the Autism Treatment Evaluation Checklist (ATEC) was administered to caregivers. This questionnaire tool has been validated for the autism population in Ethiopia. A face‒to-face interview was conducted. Data analysis was conducted IBM SPSS Version 22 Statistical Software. Principal component analysis with varimax rotation was employed to examine the patterns of sensory and cognitive awareness impairments. The numbers of principal components and factors to be retained were determined by examining the Eigenvalues and scree plot. Eigenvalues greater than 1 were used. The variable composition of each factor was examined by analyzing the factor loadings in the rotated component matrix. High variable loadings above 0.3 were considered for each factor. Results: This study revealed five patterns of sensory and cognitive awareness impairments in children diagnosed with ASD. Pattern 1, limitation in social engagement and exploration (α = 0.822); Pattern 2 challenges in emotional awareness and cognitive responsiveness (α = 0.743); Pattern 3 challenges in story comprehension and creativity (α = 0.62); Pattern 4 difficulties in social reciprocity and reward (α = 0.34); and Pattern 5 trouble with focus and attention (α = 0.12). All of these patterns accounted for 60% of the total variance. Conclusion: In this study, five patterns of sensory and cognitive awareness impairments were identified. Clinicians and therapists may need to consider these patterns for more personalized and effective support of children with ASD.