Introduction: Aspirin appeared as a medicine to deal with aches and inflammation, but due to its antiplatelet properties, it has evolved into a drug mainly used to avert cardiovascular disease. Regardless of its therapeutic uses, the limiting aspect for aspirin use has been its affiliation with gastrointestinal (GI) toxicity, classifying from acute mucosal damage to GI problems and death. Objective: The aim of this systematic review is to address the question regarding the ECA effect on the gastric mucosa. Methods: A systematic search of the literature was conducted in the PubMed electronic databases from April 10th to April 23rd, 2020. Eligibility has been set, and based on those criteria, initially a total of 637 results were obtained, from these 58 of them were not written in English. Then, 168 articles which were free from duplication were screened and all the included articles were RCTs published after 2000. Based on these, final number of articles included on this review was 6. Results: Data were obtained from 6 published articles which reported on 15,621 participants. The reports were from 3 different countries. Most of the studies revealed that enteric-coated aspirin (ECA) treatment was not an effective mechanism against GI protection. ECA administration with omeprazole can hugely reduce the incidence of endoscopic GI damage compared to the impact of ECA used alone. Even short-term administration of a low dose of ECA was significantly associated with an apparent small bowel injury. Conclusion: ECA treatment is not an effective mechanism against GI protection, and it is highly associated with small bowel injury. So the coating does not reduce risk of GI complications.

Purpose: Venous thromboembolism (VTE) is the most common preventable cause of hospitalization-associated mortality. In the absence of optimal prophylaxis and depending on the type of surgery and patient-related factors, the risk of developing VTE increases by 10% to 50%. We aimed to assess VTE risk and thromboprophylaxis among surgical patients hospitalized at surgical wards of Tikur Anbessa Specialized Hospital (TASH). Addis Ababa, Ethiopia. Materials and Methods: A retrospective cross-sectional study was conducted from September 1, 2018 to February 28, 2019. Data were collected using a pretested observational checklist which is prepared based on the VTE Caprini risk assessment model. Then, the collected data were checked for completeness and finally entered and analyzed using Statistical Package for Social Sciences (SPSS) version 25. Results: Out of 155 admitted patients, almost equal numbers of males (49.68%) and females (50.32%) participated in the study with a mean age of 41.87± 16.84 and an age range of 13 to 89 years. Undergoing major surgery, resting in bed for more than 3 days and having acute infections (including pneumonia) were the most frequently seen VTE risk factors. Most of the study participants (135, 87.10%) were at risk of developing VTE (> 1 Caprini risk score), and 47.11% were in the highest risk category (≥ 5 Caprini score). The maximum and minimum total risk scores were 19 and 1, respectively with a mean score of 4.53± 2.31. Among patients who were at risk of developing VTE and eligible for thromboprophylaxis, only 17.78% received thromboprophylaxis and two ineligible patients received prophylaxis. Parental unfractionated heparin twice or three times per day was the most widely used thromboprophylaxis regimen. A total of 29 (18.71%) patients had one or more contraindication(s) for thromboprophylaxis and three of them took prophylaxis despite the contraindications. Only 3 (1.93%) patients admitted to surgical wards developed VTE during hospitalization. Conclusion: As per the Caprini risk assessment model, the majority of surgical patients treated at TASH were at risk of developing VTE. However, thromboprophylaxis was underutilized. The incidence of VTE was 1.93% in our study.

Surgical site infections (SSIs) are infections that develop within 30 days after an operation or surveillance of surgical wound infection implementation within 90 days after surgery when an implant is placed. The objective of this study was to assess preoperative and postoperative antimicrobial use in St. Paul’s Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia. A hospital-based cross-sectional study was undertaken in surgery wards of SPHMMC for 4 months by reviewing 413 patients’ charts. All patients 13 years and older who were admitted and underwent different types of surgical procedures were included in the study. Epi info 7 was used for data entry, and then data were exported to Statistical Package for Social Sciences (SPSS) version 20.0 software for analysis. Descriptive analyses were computed and rate of SSI was calculated in this study. Moreover, bivariate analysis was done to examine the relationship between the outcome variable and predictor variables with a value of P < .2 retained for subsequent multivariate analyses using multiple logistic regressions. P value of <.05 was considered as statistically significant. Out of 413 patients, 152 (36.8%) were operated for general surgery, and the remaining were for other types of surgeries. Most of the patients, 196 (79.7%), were managed by a single surgical antibiotic agent, followed by 2 agents (20.3%) for surgical prophylaxis indication. Surgical site infections occurred in 46 (11.1%) patients before discharge from the hospital. In those patients who need treatment for SSIs, almost half of them (49.5%) received combination therapy of ceftriaxone and metronidazole. Emergency surgical cases were 2.647 times more likely to develop SSIs than the elective surgical cases (adjusted odds ratio [AOR] = 2.647; 95% confidence interval [CI] = 1.406-4.983; P = .003). Patients who did not receive antibiotic prophylaxis were 2.572 times more likely to develop SSIs compared to those who received antibiotic prophylaxis (AOR = 2.572; 95% CI = 1.02-6.485; P = .045). Clean-contaminated and contaminated types of wound were a protective factor against SSI in our study. This study indicated that most of the patients (72.1%) received surgical antimicrobial prophylaxis. The overall incidence rate of SSIs was 11.1% in the studied hospital. Ceftriaxone was the most commonly used drug. Being not receiving prophylaxis, wound class, and surgery types were significantly associated with the development of SSI.

Dove Press is a member of the Open Access Initiative, specializing in peer reviewed Medical Journals. View articlesor submit your research for publishing

Introduction. In Ethiopia, different medicinal plants have been claimed and used to treat diarrheal diseases. However, these claimed effects for most medicinal plants have not been scientifically verified. One of such plants in Ethiopian folkloric medicine is Moringa stenopetala, which is usually consumed as a vegetable in southern Ethiopia. Thus, this study aimed to evaluate the antidiarrheal and antisecretory effects of 80% methanolic leaf extract of Moringa stenopetala in different mice models. Method. Using Swiss albino mice, castor oil-induced diarrhea, charcoal meal-based gastrointestinal motility, and castor oil-induced secretion models were employed to assess antidiarrheal activity. In all of the test models, animals were randomly assigned into five groups consisting of six animals in each group. Group I received 0.5 ml of the vehicle (2% tween-80), while group II was treated with standard drug (3 mg/kg loperamide) in the respective models, whereas groups III to V received 150, 300, and 450 mg/kg of the methanolic leaf extracts of Moringa stenopetala. Onset, frequency, consistency, and weight of stool (diarrhea) were recorded, and different parameters and percentage proportions were calculated. Data were analyzed using one-way ANOVA followed by Tukey’s test, and < 0.05 was considered statistically significant at 95% confidence of interval. Result. In the castor oil-induced diarrheal model, the percentage inhibition of diarrhea was 48.5, 58.6, and 60% for the respective doses of 150, 300, and 450 mg/kg of the extract. And, the extract showed a 36.8, 54.4, and 55.9% reduction of peristalsis in charcoal meal-based gastrointestinal motility test compared to the negative control group. Moreover, in the antisecretory assay, the 150, 300, and 450 mg/kg doses of MEMS inhibited fluid contents of the stool by 11.5, 54.54, and 61.82%, respectively, relative to the vehicle-treated group. Conclusion. The findings revealed that the 80% methanolic leaf extract of Moringa stenopetala extract has shown antidiarrheal activity.

Purpose: Benzathine penicillin G (BPG) monthly administration is the most effective method for secondary prophylaxis against acute rheumatic fever (ARF). BPG’s efficacy largely depends on adherence to treatment. This study was aimed at assessing adherence to BPG prophylaxis and its determinants among adult patients with rheumatic heart disease. Patients and Methods: An institutional cross-sectional study design was used. One hundred and forty-five patients receiving monthly BPG at the Adult Cardiac Clinic of Tikur Anbessa Specialized Hospital (TASH) were interviewed. Their 1-year BPG prophylaxis administration record was also reviewed. The rate of adherence to BPG injection was determined by calculating the percentage of the administered drug from the total expected doses. Data were entered and analyzed using Statistical Package for Social Sciences (SPSS) software version 25. Both descriptive and logistic regression analyses were computed to describe different variables and assess factors associated with adherence, respectively. A p-value < 0.05 was used to declare association. Results: Among a total of 145 study participants involved, the majority (76.6%) of them had been receiving BPG for the last 10 years. The average adherence rate to monthly BPG injection was 80.60% with a range of 0% to 100%. However, only 101 (69.7%) of participants were taking ≥ 80% of their prescribed monthly BPG prophylaxis doses. Study participants with informal education 1.10 (0.023– 46.96) and secondary school education 0.89 (0.10– 8.11) were more and less likely to adhere to BPG injection, respectively, when compared with those who attended higher education programs. The regression analysis showed patients who were not admitted to the hospital (AOR: 26.22; CI: 2.55– 269.70; p=0.006) and once admitted patients (AOR: 50.08; CI: 2.87– 873.77; p=0.007) were more likely to adhere to their BPG injections than those admitted twice or more. The study participants who waited until the next appointment were also less adherent (AOR: 0.02; CI: 0.00– 0.13; p=0.000) than those who went a few days later for receiving the missed/late dose. Conclusion: The adherence rate to BPG injection among RHD patients was found to be high (80.60%). Patients’ admission status and their action on missed and/or late doses were found to be important determinants of adherence in this study.