The kidney is the organ most vulnerable to nephrotoxic drugs such as gentamicin. Nephrotoxicity is a rapid deterioration of kidney function due to various factors. Gentamicin causes nephrotoxicity, which was manifested by an increase in serum kidney biomarkers. Asparagus africanus is one of the ethnomedicinal plants used as traditional medicine for treating various ailments, including kidney disease in Ethiopian society. Thus, the aim of this study is to evaluate the nephroprotective effect of A. africanus root extract on gentamicin-induced nephrotoxicity. Using maceration techniques, 100 g of dried plant powder was extracted in 1 L of ethanol. The physicochemical screening of plant extracts revealed the presence of flavonoids, phenols, tannins, saponins, and steroids. The nephroprotective activity of A. africanus crude extract was evaluated on male Swiss albino mice. The crude ethanolic extract at 200 and 400 mg/kg doses showed strong nephroprotective effects by restoring biomarkers such as creatinine, uric acid, and blood urea nitrogen, which were damaged by gentamicin ( ) in a dose-dependent manner. The mice treated with higher doses (400 mg/kg) had a comparable nephroprotective effect compared to the positive control group (200 mg/kg silymarin; ). The histopathology of the control group showed normal glomeruli, normal parenchyma, distal convoluted, and no tubular damage. The toxicant-induced group showed damage to glomeruli and inflammatory infiltration. Therefore, A. africanus root extract has a nephroprotective activity by retarding the gentamicin toxicity in male Swiss albino mice.

Drug-induced liver injury (DILI) is one of the cumbersome health-related problems which render approximately 50% of liver failure and patients to receiving liver transplantation every year. Antituberculosis drugs such as isoniazid and rifampicin are potentially rendering hepatotoxicity. Ensete ventricosum (Welw.) Cheesman is an herbaceous perennial plant that contributes to the indigenous ethnomedicinal values for the society. This study aimed to investigate the hepatoprotective effect of corm of Ensete ventricosum (Welw.) Cheesman extracts against isoniazid and rifampicin induced hepatotoxicity in Swiss albino mice. The study was conducted on 30 Swiss albino mice randomly allocated into five groups. Group I, group II, group III, group IV, and group V were the groups in which mice were given distilled water, only isoniazid and rifampicin, isoniazid and rifampicin along with 200 mg/kg corm of Ensete ventricosum (Welw.) Cheesman extract, isoniazid and rifampicin along with 400 mg/kg corm of Ensete ventricosum (Welw.) Cheesman extract, and isoniazid and rifampicin along with silymarin per oral per day, respectively. On the 30th day of the experiment, mice were sacrificed after anesthetized, and blood was drawn for the liver function test, and the liver was also taken from each experimental mouse for histopathological evaluation. Data were entered into EpiData version 3.1 subsequently exported to SPSS version 25 for analysis by using one-way ANOVA. Plasma alanine aminotransferase (ALT) levels, aspartate aminotransferase (AST), alkaline phosphatase (ALP), and total bilirubin (TBIL) of group II mice were significantly ( $p<0.05$ ) elevated as compared to group I. The group of mice treated with a corm of Ensete ventricosum (Welw.) Cheesman at a dose of 400 mg/kg (group IV) and silymarin100 mg/kg (group V) showed a significant ( $p<0.05$ ) decrease in ALT, AST, ALP, and TBIL as compared to the group II. The liver section of group II showed a change in liver architecture; however, these deformities were not noticed in group IV mice. The result showed corm of Ensete ventricosum (Welw.) Cheesman extract has a very promising hepatoprotective potential against isoniazid and rifampicin induced liver injury.

Background. Emergence delirium is a common and serious postoperative complication in older surgical patients. It occurs at any time in the perioperative period, during or immediately following emergence from general anesthesia. Unfortunately, it is highly associated with postoperative complications such as a decrease in functional capacity, prolonged hospital stay, an increase in health care costs, and morbidity and mortality. The goal of this study was to determine the prevalence of emergence delirium and associated factors among older patients who underwent elective surgery in the teaching hospitals of Ethiopia at the postanesthesia care unit in 2021. Methods. A multicenter prospective observational study was conducted at the postanesthetic care unit in the four teaching hospitals of Ethiopia. Older surgical patients admitted to the postanesthesia care unit who underwent elective surgery in the four teaching hospitals of Ethiopia were selected by using simple random sampling. Pretested structured questionnaire was used to collect data. Data were entered into EpiData (version 4.6) and exported to the SPSS (version 25.0). Binary logistic regression was used to identify factors independently associated with the emergence delirium. Results. Out of 384 older patients included in the study, the prevalence of emergence delirium was 27.6%. Preoperative low hemoglobin levels (AOR: 2.0, 95% CI; 1.77-3.46), opioid (AOR: 8.0, 95% CI; 3.22-27.8), anticholinergic premedications (AOR: 8.5, 95% CI; 6.85-17.35), and postoperative pain (AOR: 3.10, 95 CI; 2.07-9.84) at PACU were independently associated with emergence delirium. Conclusion. The prevalence of emergence delirium was high among older patients who underwent elective surgery. Opioid and anticholinergic premedication, low preoperative hemoglobin, and the presence of postoperative pain were independently associated with the emergence delirium. Adequate preoperative optimization and postoperative analgesia may reduce the prevalence of emergence delirium.

Background: Stunting is a serious public health issue in Ethiopia. However, due to the scarcity of studies, little is known about the prevalence and predictors of stunting among children under the age of five in urban areas, especially those close to the capital city of the country (Addis Ababa). Thus, the aim of this study was to assess the prevalence of stunting and its predictors among children under the age of five in Lega Tafo Lega Dadi, Sheger City, Oromia, Ethiopia.Methods: A community-based cross-sectional study was conducted on 566 children under the age of five using a systematic random sampling technique. Data were collected through face-to-face interviews, structured questionnaires, and anthropometric measurements. Afterward, the data were entered into EpiData (version 4.7) and exported to SPSS 26 for analysis. Anthropometric indices were calculated using WHO Anthro software (version 3.2.2). Bivariate and multivariable logistic regression analyses were performed to identify candidate variables and associated factors, respectively. An adjusted odds ratio (AOR) and its 95% confidence interval (CI) were used to assess the strength and significance of the association. A p-value of <0.05 was considered statistically significant. The goodness-of-fit for the model was assessed using the Hosmer-Lemeshow test.Results: The prevalence of stunting was 18.9% (95% CI: 16, 22%) among under-five children in our study setting. Children whose mothers were daily laborers (AOR: 10.3), whose mothers’ education level was primary school (AOR: 4.3), whose fathers were daily laborers (AOR: 4), who were born into families with an average birth interval of ≤24 months (AOR: 7.9), who were from families with a size ≥5 (AOR: 7.3), who had a history of diarrhea (AOR: 6.3), who had meals ≤3 times per day (AOR: 13.9), who were underweight (AOR: 2.8), who were breastfed for less than 2 years (AOR: 5.6), who had low dietary diversity (AOR: 6.3), and who experienced food insecurity (AOR: 3.6) were identified as the predictors of stunting in under-five children.Conclusion: Approximately one-fifth of the under-five children were stunted in the study setting. Family occupational and educational status, average birth interval, family size, a history of diarrhea, meal frequency per day, underweight status, duration of breastfeeding, inadequate dietary diversity, and household food insecurity were all associated with stunting among the under-five children in the study setting.

Background. Antituberculosis drugs are antimicrobial agents important for treating a communicable disease called tuberculosis. Despite their importance, antituberculosis drugs such as isoniazid and rifampicin have severe adverse effects like nephrotoxicity with acute renal failures. Ensete ventricosum (Welw.) Cheesman is a nutritional herbaceous perennial plant, and it has indigenous ethnomedicinal values for the society. This study aimed to evaluate the protective role of the Ensete ventricosum (Welw.) Cheesman corm extract (EVCE) against nephrotoxicity induced by isoniazid and rifampicin in mice. Methods. The present study was conducted on thirty Swiss albino mice randomly allocated into five groups. Group-I (only distilled water), Group-II (only isoniazid 75 mg/kg and rifampicin150 mg/kg), Group-III (isoniazid and rifampicin along with 200 mg/kg EVCE), Group-IV (isoniazid and rifampicin along with 400 mg/kg EVCE), and Group-V (isoniazid and rifampicin along with silymarin) were treated for thirty days. At the end of the study, the experimental animals were sacrificed after being injected with anesthetic drug, blood was drawn for a kidney function test, and the kidney was also taken from each experimental animal for histopathological evaluation. Data were entered and analyzed by using one-way ANOVA of SPSS version 25. Results and Conclusion. Serum levels of creatinine, blood urea nitrogen (BUN), and uric acid of the Group-II mice were significantly ( ) elevated, and serum levels of total proteins and albumin of Group-II mice were significantly ( ) decreased as compared to Group-I. The group of mice treated with an EVCE reinstated those derangements. The kidney section of Group-II mice showed an abnormality in kidney structure; however, these deformities were not detectable in group-IV mice. The EVCE has sufficient nephroprotective potential against antituberculosis drug-induced kidney injury.

Background: The nature of COVID-19 transmission creates significant risks in surgical departments owing to the close contact of medical staff with patients, the limited physical environment of the operating room and recovery room, the possibility of shared surgical equipment and challenges in the delivery of surgical care in all surgical departments. Globally, studies have reported that the effects of the pandemic on surgical departments are profound, potentially long-lasting and extensive. To manage these effects, different local guidelines and recommendations have been developed, with potential differences in their effectiveness and implementation. Therefore, harmonized and effective national/international guidelines for specific surgical departments during perioperative periods are pertinent to curtail the infection, and will inevitably need to be adapted for consistent and sustainable implementation by all medical staff. The pattern of surgical patient care during the COVID-19 pandemic at Jimma Medical Center (JMC), Ethiopia, has not been explored yet. The present study aimed to describe the pattern of perioperative surgical patient care, equipment handling and operating room management during the COVID-19 pandemic at JMC. Methods: A cross-sectional study was conducted to describe the pattern of perioperative surgical patient care, equipment handling and operating room management during the COVID-19 pandemic at JMC, using five-point Likert scales (0, not at all; 1, rarely; 2, sometimes; 3, most of the time; 4, frequently). A total of 90 respondents [35 patients (five patients from each of seven surgical departments) and 55 healthcare providers (six professionals from each of nine units, including the center of sterility room and anesthesia)] who were available during the study period, selected by a convenience sampling technique with multistage clustering, participated in the study. Data were collected using a structured questionnaire via direct observation and face-to-face interviews with patients undergoing surgery, healthcare providers and hospital administrators, against the standard surgical patient care guidelines. The collected data were manually checked for missing values and outliers, cleared, entered into EpiData (v4.3.1) and exported to SPSS (v22) for analysis. The mean score of practice was compared among different disciplines by applying the unpaired t-test. The findings of the study were reported using tables and narration. A p-value of less than 0.05 was declared as statistically significant. Results: Despite the surgical care practice having changed during the COVID-19 pandemic in all service domains, it is not implemented consistently among different surgical departments owing to different barriers (lack of training on the updated guidelines and financial constraints). The majority of surgical staff were implementing the use of preventive measures against COVID-19, while they were practiced less among patients. The guidelines for surgical practice during the preoperative phase were well applied, especially screening patients by different methods and the application of telemedicine to reduce physical contacts. But, against guidelines, elective patients were planned and underwent surgery, especially in the general surgery department. The implementation of recommended guidelines in the center of sterility room in handling surgical equipment was not very different before and during the pandemic. The extent of practice for anesthesia care, operating room management and postoperative care in the recovery room also changed, and the guidelines were sometimes applied. Conclusion and Recommendations: Although perioperative surgical care practice differed before and during the pandemic, the standard guidelines were inconsistently implemented among surgical departments. The implementation of recommended guidelines in the center of sterility room in handling surgical equipment was not very different before and during the pandemic. Thus, the authors developed safe surgical care guidelines throughout the different domains (infection prevention and PPE use; preoperative care, intraoperative care, operating room management, anesthesia care, equipment handling process and postoperative care) for all disciplines and shared them with all staff. We recommend that all surgical staff should access these guidelines and strictly adhere to them for surgical service during the pandemic.