Background: Pharmaceuticals wastes are drugs and medicines that can no longer be used. The improper disposal of unused medicines is a growing problem throughout the world. This study assessed the pharmaceutical wastage rate and pharmaceutical waste management for the year 2015 to 2017 in the public health facility of Dessie, Ethiopia. Methodology: A cross-section study design was used to review logistic data retrospectively from health commodity management information systems and manual records in 8 health facilities. Health professionals’ (135) pharmaceutical waste management practices were assessed using the world health organization waste management checklist. Descriptive and inferential statistics were made using a statistical package for social sciences version 20. Result: Supplies were the leading class of pharmaceuticals with an overall wastage rate of 37.1%. Tablet and injectable constituted the highest class of pharmaceuticals dosage form with the overall wastage rate of 20.78% and 16.49%. The overall pharmaceutical wastage rate was 3.68% amounting to USD 159,762.66 and expiry (92.05%) was the major reason for wastage. The pharmaceutical wastage rate of health centers was nearly twofold higher than hospitals. Pharmaceutical waste management was practiced by 105 (77%; 95% CI; 69.9%, 84.9%) health professionals. Determinants of pharmaceutical waste management were being male (P value = 0.08, AOR = 3.72), receiving training (P value = 0.01, AOR = 4.34), writing label (P value = 0.02, AOR = 5.04), storage of segregated waste in dispensing unit (P value = 0.01, AOR = 0.72) and the presence of disposal plan (P value = 0.002, AOR = 16.93). Conclusions: Supplies and tablets constituted the highest wastage class of pharmaceuticals and dosage form. The pharmaceutical wastage rate was higher than the standard and increasing in successive years. Pharmaceutical waste management was not fully practiced. Appropriate inventory control and waste management are recommended.

Introduction: Diabetic foot ulcer is a serious and disabling complication of diabetes mellitus that consists of lesions in the deep tissues resulting in lower extremity amputations. The incidence of diabetic foot ulcers has increased due to an increased prevalence of diabetes mellitus. This study assessed the knowledge and practice of diabetic foot self-care among diabetic patients attending Dessie referral hospital. Methods: A facility-based explanatory sequential mixed method was used from April 03/2019 to May 09/2019. The quantitative method employed an institutional-based cross-sectional study design using a structured questionnaire. A simple random sampling technique was employed to select the study participants. Descriptive and inferential statistics were made using the statistical package for social sciences version 20. Then, a phenomenological study was employed among key informants and content analysis was performed. Results: Sixty-eight (19.8%) of patients with diabetes developed complication, among them 97 (28%) had foot ulcer. Nearly two-third (217 (61.3%): 95% CI (57.6– 68.3%)) and 134 (39%; 95% CI:34.3– 45.1%) of patients with diabetes had good knowledge and practice on diabetic foot self-care, respectively. Diabetic nephropathy ((AOR): 0.03, 95% CI (0.00– 0.27)) was associated with knowledge on foot self-care. Practice of foot self-care was associated with female ((AOR: 2.07, 95% CI (1.04– 4.12)), age 21– 30 ((AOR: 6.42, 95% CI (1.54– 26.8)), 31– 40 years ((AOR: 7.4, 95% CI (1.42– 39.05)), 41– 50 years ((AOR: 8.4, 95% CI (1.4– 50.6)), single ((AOR: 0.35, 95% CI (0.150– 0.81)), living in rural ((AOR: 0.31, 95% CI (0.18– 0.545)) and no comorbidity ((AOR: 0.406, 95% CI (0.18– 0.88)). Key informants were not compliant, confused and negligent to foot self-care. Conclusion: Nearly two-third and more than one-third of patients with diabetes had good knowledge and practice on diabetic foot self-care, respectively. Patients lack proper knowledge regarding self-care and how it is practiced. Patient education and proper management of diabetic foot ulcers are recommended to reduce, delay, or prevent complications.

Introduction: HIV/AIDS remains a public health concern affecting millions of people across the world. Although the health-related quality of life (HRQoL) of patients living with HIV has significantly improved after treatment, its chronicity makes the HRQoL uncertain. This study assessed factors associated with the health-related quality of life among people living with HIV/AIDS on HAART in North-East Ethiopia. Methods: An institutional-based cross-sectional study was conducted from March to April 2018, and systematic random sampling was used to select 235 participants who were on HAART. HRQoL was assessed using the Medical Outcomes Study HIV Health Survey. Descriptive and multiple linear regression analysis were computed using the statistical package for social sciences version 20. Results: The study revealed one-factor structure and had good overall internal consistency (78.5). Over one-third (42.6%; 95% CI; 36.2%, 48.9%) of participants had good HRQoL. The least HRQoL mean score was found for cognitive functioning 32.21(±19.78), followed by social functioning 40.58(±29.8). Factors associated with the overall HRQoL were 25–45 years of age (β = − 3.55, 95% CI;-6.54, -0.55), working in private sector (β = -5.66, 95% CI;-9.43, -1.88), government (β = -4.29, 95% CI;-7.83, -0.75) and self-employment (β = -8.86, 95% CI;-13.50, -4.21), 100–200 (β = − 4.84, 95% CI;-9.04, -0.63) and 201–350 CD4 at the time of diagnosis (β = − 7.45, 95% CI;-11.73, -3.16), 351–500 current CD4 level (β = 8.34, 95% CI;5.55, 11.41), 6–10 years of disease duration (β = -8.28, 95% CI;-12.51, -4.04), WHO stage II (β = -4.78, 95% CI;-8.52, -1.04) and III (β = 3.42, 95% CI;0.06, 6.79) during treatment initiation and not taking of Cotrimoxazole prophylaxis (β = -5.79, 95% CI;-8.34, -3.25). Conclusions: High proportion of participants had a poor HRQoL. Routine assessment and appropriate interventions at each visit is recommended to improve HRQoL.

Outpatient parenteral antimicrobial therapy (OPAT) offers an alternative to inpatient (hospital bed-based) treatment of infections that require intravenous administration of antimicrobials. This meta-analysis aimed to summarise the evidence available from randomised controlled trials (RCTs) regarding the efficacy and safety of OPAT compared to inpatient parenteral antimicrobial therapy. We searched the Cochrane Library, MEDLINE, Embase, PubMed, and Web of Sciences databases for RCTs comparing outpatient versus inpatient parenteral antimicrobial therapy. We included studies without restrictions on language or publication year. Eligibility was reviewed independently by two assessors, and data extraction was cross validated. We evaluated bias risk via the Cochrane tool and determined the evidence certainty using GRADE. Meta-analysis was conducted using a random effects model. The protocol of this review was registered on PROSPERO (CRD42023460389). Thirteen RCTs, involving 1,310 participants were included. We found no difference in mortality (Risk Ratio [RR] 0.54, 95% Confidence Interval [CI] 0.23 to 1.26; P = 0.93), treatment failure (RR 1.0, CI 0.59 to 1.72; P = 0.99), adverse reaction related to antimicrobials (RR 0.89, CI 0.69 to 1.15; P = 0.38), and administration device (RR 0.58, CI 0.17 to 1.98; P = 0.87) between outpatient and inpatient parenteral antimicrobial therapy. The overall body of evidence had a low level of certainty. Existing evidence suggests OPAT is a safe and effective alternative to inpatient treatment. Further RCTs are warranted for a thorough comparison of inpatient and outpatient parenteral antimicrobial therapy with a high level of certainty.

Introduction: Inventory management is a complex process that accelerates the probability of stock-out and overstocking if not tracked properly. Classification of drugs based on their criticality, cost burden, and in combination is important to make inventory decisions and optimize the quality use of scarce resources. This study analyzed the pharmaceutical inventory management systems of Dessie Referral Hospital using the ABC-VEN matrix for the years 2013 to 2017. Methodology: Cross-sectional study design was used to review logistic data retrospectively from health commodity management information system and manual records. Data were collected from January 1– 20, 2018 in Dessie Referral Hospital. Results: In the five-year ABC-VEN analysis, 310 (17%), 368 (20.18%), and 1146 (62.83%) items were class A, B, and C, while 610 (34.56%), 1125 (63.74%), and 30 (1.7%) of pharmaceuticals were V, E, and N, respectively. Among these, 139 (7.88%) and 339 (19.21%) of AV and CV pharmaceuticals utilized 43.52% and 2.89% of annual drug expenditures, respectively. Category I, II, and III pharmaceuticals also accounted for 43.68%, 54.79%, and 1.53% of items with their respective USD drug expenditure of 2,268,405.64 (84.49%), 411,961.18 (15.34%), and 4483.97 (0.17%). The pharmaceutical inventory cost projected to be 1,619,351.79 USD in 2025 and total cost (β= 10.68, p = 0.001), class A (β= 8.68, p = 0.001), class B (β= 1.27, p = 0.007), class C (β= 0.72, p = 0.03), and E items (β= 6.08, p = 0.01) were statistically significant with inventory cost. Conclusion: A huge amount of budget is invested in class A and category I, which pinpoints the need for strict inventory control to prevent wastage and accumulation of capital in buffer stocks. ABC-VEN analysis should be routinely performed before initiation of any new procurement for efficient use of scarce resources.

Background: There are controversies on the causal role of H. pylori in duodenal ulceration. Helicobacter pylori are curved gram-negative microaerophilic bacteria found at the layer of gastric mucous or adherent to the epithelial lining of the stomach. It’s a public health significance bacteria starting from discovery, and the prevalence and severity of the infection varies considerably among populations. H. pylori are a risk for various diseases, while the extent of host response like gastric inflammation and the amount of acid secretion by parietal cells affects the outcome of infection. Method: Relevant literature were searched from databases such as Google Scholar, PubMed, Hinari, Web of Science, Scopus, and Science Direct. Result: The review evidence supports a strong causal relation between H. pylori infection and duodenal ulcer, as patients are more likely to be infected by virulent strains which later cause duodenal ulceration. Thus, eradication of H. pylori infection decreases the incidence of duodenal ulcers, and prevents its recurrence by reducing both basal gastrin release and acid secretion without affecting parietal cell sensitivity. On the other hand, some studies show that H. pylori infection is not associated with the development of duodenal ulcers and such a lack of association revealed that duodenal ulceration has different pathogenesis. Conclusion: Despite controversies observed in the causal role of H. pylori to duodenal ulceration by various studies, Hill criteria of causation proved the presence of a causal relation between H. pylori infection and duodenal ulcers. Other factors are also responsible for the development of duodenal ulcers and such factors are responsible for the differences in the prevalence of the diseases.