Background: Data regarding prolonged length of hospital stay (PLOS) and in-hospital mortality are paramount to evaluate efficiency and quality of surgical care as well as for rational resource utilization, allocation, and administration. Thus, PLOS and in-hospital mortality have been used as a surrogate indicator of satisfactory treatment outcome and efficient utilization of resources for a given health institution. However, there was a scarcity of data regarding these issues in Ethiopia. Therefore, this study aimed to assess treatment outcome, length of hospital stay, in-hospital mortality, and their determinants.Methods: Health facility-based prospective observational study was used for three consecutive months among adult patients hospitalized for the surgical case. Socio-demographic, clinical history, medication history, in-hospital complications, and overall treatment outcomes were collected from the medical charts’ of the patients, using a checklist from the day of admission to discharge. PLOS is defined as hospital stay > 75th percentile (≥33 days for the current study). To identify predictor variables for both PLOS and in-hospital mortality, multivariate logistic regression was performed atp-value < 0.05 using SPSS version 20. Written informed consent was sought and secured.Results: Of 269 study participants, 91.8% were improved and discharged. PLOS was recorded in 25.3%; at least 33 days of hospital stay. Overall in-hospital mortality was 4.8%; which is equal to an incidence rate of 0.00193 per person-days, 5.2% in-hospital sepsis, and 2.6% of Hospital-acquired pneumonia (HAP), during their hospital stay. After adjusting for other factors; female gender (p = 0.003), emergency admission (p = 0.015), presence of Poly-pharmacy (p = 0.017), and presence of sepsis (p = 0.006) were found to be independent predictors for in-hospital mortality. On top of this, female gender (p = 0.026), patients who was paid by government (p = 0.007), burn-related surgery (p = 0.049), presence of cancer (p = 0.027), > 2 antibiotic exposure (p < 0.0001), and waiting for surgery for > 7 days (p < 0.0001) were independent predictors for PLOS.Conclusion: In-hospital mortality rate was almost comparable to reports from developing countries, though it was higher than the developed countries. However, the length of hospital stay was extremely higher than that of reports from other parts of the world. Besides, different socio-demographic, health facility’s and patients’ clinical conditions (baseline and in-hospital complications) were identified as independent predictors for both in-hospital mortality and PLOS. Therefore, the clinician and stakeholders have to emphasize to avoid the modifiable factors to reduce in-hospital mortality and PLOS in the study area; to improve the quality of surgical care.

Background: Drug therapy problems (DTPs) are of major concern in health care because of the associated increased cost of treatment, morbidity, and mortality. Thus, clinical practice should constitute the mainstream practice of clinical pharmacy in every ward. However, nothing is known about DTPs and the role of clinical pharmacist in the surgical ward of Ethiopia (the neglected ward). Objective: To assess the prevalence of DTP among patients hospitalized at the surgical ward and the role of clinical pharmacists in their identification and resolution. Methods: Hospital-based prospective observational and interventional study design was used with daily patients’ chart review using a semi-structured questionnaire among hospitalized adult patients at the surgical ward. After identification of DTP, verbal communication was used as a means of intervention with the treating physician. Acceptance of clinical pharmacist’s intervention was considered only if a change was made to the patients’ medication order. To identify determinants of DTPs, multiple stepwise forward logistic regression analysis was done by SPSS version 20.0. Statistical significance was considered at p-value < 0.05. Written informed consent was sought and the data were secured. Results: The response rate was 97.1% (300) for the final analysis. The mean (±SD = standard deviation) age of the participants was 42.62 ± 18.29 with male (67%) predominance. DTP was identified in 76% of study participants. A total of 449 DTPs were identified, which equates with an average of 1.97 per patient. Dose too low 124/449 (27.6%) and dose too high 81/449 (18.0%) were found to be the most common types of DTPs. The intervention rate was 86.0% (196/228 per patients) and 86.2% (387/449 DTPs), with the acceptance rate of 85.2% (167/196 per patients) and 78% (302/387 per DTP) which mean (67.3%) 302/449 of the problems were fully resolved by the clinical pharmacist. Poly-pharmacy [AOR, 7.23; 95% CI, 2.29– 22.13: P-value < 0.001] and hospital stay > 20 days [AOR, 5.42; 95% CI, 2.74– 10.70; p < 0.001] were the only independent predictors for DTPs. Conclusion and Recommendation: This study identified a high prevalence of DTP which was independently predicted by the presence of poly-pharmacy and > 20 days of hospital stay. The rate of intervention provided and acceptance from the physician was high, which is one indicator that the role of clinical pharmacists in the identification and resolution of DTP was paramount in the surgery ward and should be implemented as a must not as optional.

Background: To confirm effective preventive practice and reduce the risk of COVID-19 data on knowledge, attitude, and preventive practices (KAP) are essential. Therefore, the current study was designed to evaluate the KAP of COVID-19 among people with hypertension (HTN) and/or diabetes mellitus (DM) attending public health facilities in Ambo town. Patients and Methods: Institutional-based cross-sectional study design was done among patients with HTN and/or DM from June 2020 to September 2020 at Ambo University Referral Hospital (AURH) and Ambo General Hospital (AGH). To identify the associated factors with poor practice and knowledge, logistic regression analyses were used. Results: The mean age of the study respondents was 44.6 years (± 9.84) of which the majority were male 235 (55.6%) and 159 (37.59%) of the participants had good knowledge. Concerning attitude, 335 (79.2%) have strongly believed that DM and HTN patients were more at risk of death because of COVID-19. Only 44 (10.4%) of them had a good level of COVID-19 prevention practice measures. Patients who use the source of information daily were 54.4% less likely to have poor knowledge about COVID-19 than those who use it weekly. Participants with no formal education were 3 times more likely to have poor COVID-19 prevention practice than those who were with formal education, and participants who have poor knowledge about COVID-19 were 2 times more likely to have poor COVID-19 prevention practice than those who have knowledge. Conclusion: The prevalence of poor knowledge about COVID-19 was low, and only less than ¾ of the participants strongly believed COVID-19 as a serious disease. A small percentage of participants had a good level of COVID-19 prevention practice. Good knowledge had an association with a good level of prevention practice. So, health sectors should work to increase accessibility of COVID-19 information.

There have been few studies evaluating the efficacy of knowledge-transfer methods for livestock owners in developing countries, and to the authors' knowledge no published work is available that evaluates the effect of knowledge-transfer interventions on the education of working equid users. A cluster-randomised controlled trial (c-RCT) was used to evaluate and compare the effectiveness of three knowledge-transfer interventions on knowledge-change about equid health amongst rural Ethiopian working equid users. Groups were exposed to either; an audio programme, a village meeting or a diagrammatic handout, all of which addressed identical learning objectives, and were compared to a control group which received no intervention. Thirty-two villages were randomly selected and interventions randomly assigned. All participants in a village received the same intervention. Knowledge levels were assessed by questionnaire administration. Data analysis included comparison of baseline data between intervention groups followed by multilevel linear regression models (allowing for clustering of individuals within village) to evaluate the change in knowledge between the different knowledge-transfer interventions. A total of 516 randomly selected participants completed the pre-intervention questionnaire, 504 of whom undertook the post-dissemination questionnaire, a follow up response rate of 98%. All interventions significantly improved the overall 'change in knowledge' score on the questionnaire compared to the control, with the diagrammatic handout (coefficient (coef) 9.5, S.E.=0.6) and the village meeting (coef 9.7, S.E.=0.6) having a significantly greater impact than the audio programme (coef 4.8, S.E.=0.6). Covariates that were different at baseline, and which were also significant in the final model, were age and pre-intervention score. Although they had a minimal effect on the intervention coefficients there was a significant interaction between age and intervention. This study should aid the design of education materials for adult learning for working equid users and other groups in developing countries.

Diabetic Ketoacidosis (DKA) is the most common and yet potentially life-threatening acute complication of diabetes that progresses rapidly to death and requires immediate medical intervention. To assess the DKA management and treatment outcome/in-hospital mortality and its predictors among hospitalized patients with DKA at the Medical ward of Shashemene Referral Hospital (SRH). A retrospective study was conducted at the Medical Ward of SRH from 01 February 2015 to 31 January 2017. A systematic random sampling technique was used to select study subjects based on the inclusion criteria. Thus, of 236 reviewed charts, only 225 patients with DKA fulfilled inclusion criteria. Treatment outcome was considered good for patients who have shown improvement at discharge, while poor for patients who left against medical advice or died in the hospital. Logistic regression analysis was done to determine independent predictors for treatment outcome/in-hospital mortality using SPSS version 20 with statistical significant at P ⩽ .05. Of 225 patients with DKA, 124 (55.1%) were male. Regular insulin was prescribed to all patients and antibiotics were administered to 87 (38.7%). Potassium supplementation was given only for 28 (12.4%). Non-adherence to insulin treatment (n = 91; 40.4%) and infection (n = 66; 29.3%) were the principal DKA precipitating factors. Even though 73.8% of hospitalized patients with DKA have shown good treatment outcomes, DKA contributed 12% in-hospital mortality. The result of multivariate logistic regression analysis shown that hypoglycemia is the only independent predictor for in-hospital mortality[P = .03]. Moreover, the independent predictors for poor DKA treatment outcome were found to be smoker [P = .04], Urinary tract infection (UTI) relative to other co-morbid condition [P < .001], severe hypokalemia which increase risk of poor treatment outcome by around 4 times [P = .02], and use of Metronidazole as a concurrent medication relative to other concurrent medication [P = .03]. There was a high in-hospital mortality rate due to correctable causes. This mortality is unacceptable as it was majorly related to the poor practice of potassium supplementation and hypoglycemia due to insulin. Thus, clinicians and stakeholders should have to focus on modifiable factors (hypokalemia, UTI, and hypoglycemia) to reduce poor treatment outcome/in-hospital mortality.

Background: Acute poisoning is a common reason for visiting the emergency department (ED) worldwide. However, little is known about this issue in the western part of Ethiopia. This study was carried out to determine the prevalence, predictors, and treatment outcome of acute poisoning at the ED of western Ethiopia. Patients and Methods: A hospital record-based retrospective study design was conducted on all patients admitted to the ED of the two hospitals between 01 January 2018 to 17 March 2019. Socio-demographic, clinical presentation, medication history, poisoning characteristics, time to hospital arrival, treatment given, and outcome of treatment were collected. All collected data were analyzed using SPSS Version 20. Backward multiple logistic regression analysis at p-value ≤ 0.05 tested the predictor for treatment outcome. Results: The prevalence of acute poisoning was 134/7883 (1.7%) per ED admissions. The mean ±SD age of the study participants was 23.90± 10.606 with female to male ratio of 1:1.06. The most vulnerable patients to poisoning were individuals in the age range of 18 to 29 years 68/134 (50.7%) for both genders. Moreover, the most common poisoning agent was organophosphate 72/134 (53.7%). Besides, intentional poisoning was the most common 103/134 (76.9%) manner of poisoning with family disharmony 37/103 (35.9%) as the common reason. The case fatality rate of acute poisoning in the two hospitals was 2/134 (1.5%). The mean ±SD length of hospital stay was 1.86 ± 0.943. The independent predictors of poor treatment outcome of acute poisoning were age ≥ 35 years [p-value= 0.049], female gender [p-value= 0.027], and hospital stay of > 48 hours [p-value= 0.035]. Conclusion: The prevalence of acute poisoning in western Ethiopia is higher than the ever-reported data in Ethiopia. Thus, stakeholders should have to pay more attention to prevention and control strategies and appropriate handling of agrochemical substances to minimize their negative effects on this productive age group.