COVID-19-related anxiety and knowledge toward its preventive measures among patients with chronic medical illness on follow-up in public hospitals of Bale, East Bale, and West Arsi zones, Ethiopia

Background: Coronavirus disease 2019, also known as 2019-nCoV cluster of acute respiratory illness with unknown causes, which occurred in Wuhan, Hubei Province, in China, was first reported to World Health Organization country office as of December 30, 2019. People with medical illness are at a higher risk for coronavirus disease, and the pandemic influences mental health and causes psychological problems, particularly in those with chronic medical illness. Hence, this study aimed to assess coronavirus disease 2019-related anxiety and the knowledge on its preventive measures among patients with medical illness on follow-up in public hospitals of Bale, East Bale, and Arsi zones Objective: To assess coronavirus disease 2019-related anxiety and knowledge toward coronavirus disease 2019 preventive measures among patients with chronic medical illness on follow-up in public hospitals of Bale, East Bale, and West Arsi zones. Methods: A hospital-based cross-sectional study was conducted in selected hospitals of Bale and West Arsi zones, Southeast Ethiopia. A total of 633 study participants were included in this study, and data were collected through an interviewer-administered questionnaire. A descriptive summary was computed. Bivariable and multivariable logistic regression analyses were carried out to identify the associated factors. Results: Overall, the prevalence of anxiety among chronic patients in this study was 6.3% (95% confidence interval: 4.6%–8.5%) and 420 (66.35%) had good knowledge on the preventive measures of coronavirus disease 2019. Factors significantly associated with anxiety among chronic patients were being educated (95% confidence interval: adjusted odds ratio = 0.26 (0.09–0.74)), being male (95% confidence interval: 2.69 (1.11–6.53)), and use of mask (95% confidence interval: 0.11 (0.05–0.26)). Conclusion: The prevalence of coronavirus disease 2019-related anxiety among chronic patients was high and being males, uneducated, and not using face mask was significantly associated with coronavirus disease 2019-related anxiety.

Pneumothorax in COVID-19 – A New Challenge

Background: Coronavirus disease 2019 mainly affect the lungs which can complicate into pneumothorax and require hospitalization. We aimed to discuss the presence of pneumothorax and its possible risk factors in vulnerable patients of COVID-19 to establish an effective preventive and therapeutic strategy for this fatal complication. Methods: This retrospective observational study included 30 admitted patients of COVID-19 associated pneumothorax. The patient’s data concerning demography, clinical manifestation, associated medical illness, point of onset of pneumothorax, mode of oxygenation with FiO2 and PEEP, radiological imaging, and outcome were extracted from their medical records. All collected data were tabulated, compiled, and analyzed to establish possible causality of pneumothorax. Results: All patients of the study group exhibited symptomatic presentations, 73% of patients had severe clinical conditions and 24 patients also had associated chronic medical illness. In our study pneumothorax developed 3rd week onwards after symptoms onset with a mean time of pneumothorax was found to be 23.96 days (23.96±8.06). At the point of diagnosis of pneumothorax, 22 patients were on non-invasive ventilation, 6 on high flow mask, and 2 patients on invasive ventilation, these patients required higher FiO2 (77.66%) and higher PEEP (10.83 cmH2O) to maintain PaO2 within normal range. All patients had raised COVID-related inflammatory markers viz. NLR, D-dimer, CRP, IL-6, and these markers showed a positive correlation with the duration of hospital stay in patients of pneumothorax. Conclusion: Pneumothorax can be suspected in COVID-19 infected patients having severe COVID-19 pneumonia of longer duration with assistant ventilation and raised inflammatory markers going to rapid worsening of symptoms.

How Did We Get Here?

It is important to understand how the addiction treatment industry began and how its beliefs and practices gradually evolved into today’s standards of care. The problems associated with alcohol and drug use have been around for millennia, but the notion of addiction as a chronic medical illness is a relatively new (twentieth-century) concept. Stigma and misunderstanding abound, and antiquated attitudes about addiction as a moral failing continue to marginalize and shame the people we are tasked with helping. The chapter addresses how current addiction treatment is designed and its involvement with both medical and physical elements.

Magnitude of Common Mental Disorder and Factors Associated Among People Living in Addis Ababa Ethiopia 2018: Community Based Cross Sectional Study

Background: Common mental disorders are a group of distress states manifesting with anxiety, depressive and unexplained somatic symptoms, affecting individuals in different age groups, causes suffering to the individuals, families and community.Objective: This study assessed the magnitude of Common mental disorder and associated factors among people living in Addis Ababa, Ethiopia.Methods: Community based cross sectional study design was conducted from November 1 to 30, 2018 among people living in Addis Ababa, Ethiopia. Multistage sampling technique was used to get a total of 755 samples. Common Mental Disorder was assessed through interview using Self-Reported questionnaire (SRQ-20). The collected data were coded, entered into EPI-Info 7 and analysed by using SPPS version 20. Descriptive, analytical statistical procedure; bivariate and multivariate binary logistic regressions with odds ratios and 95% confidence interval was employed. The statistical significance was accepted at p value < 0.05. Result: In this study a total of 723 study subjects were participated, with response rate of 95.7%.The prevalence of common mental disorders was 24.7% with [95%CI; 21.6 – 27.7]. Females (AOR=2.1; 95% CI; 1.39- 3.23), Divorced/widowed (AOR=2.55; 95% CI; 1.16- 5.59), daily labourers (AOR=2.52; 95% CI; 1.3- 4.88, chronic medical illness (AOR=4.5; 95% CI; 2.46- 8.24). are independent predictors of CMD and educational status (primary, secondary and diploma)was positively associated with CMD. in this study. Regarding education (primary, secondary and diploma) (AOR=0.34; 95% CI; 0.17-0.66)and (AOR=0.35; 95% CI; 0.19-0.67) has positively associated with common mental disorders.Conclusion: The prevalence of common mental disorders was found high. Female sex, marital status like Divorced/Widowed, daily labour workers and chronic medical illness were found to be independent predictors of CMD and educational status (primary, secondary school and diploma holders) was were found to be protective factors

Extensive Angiokeratomas of the Trunk-An Unsual Presentation of Fabry Disease

A 23 year old man presented with erythematous non-pruritic rash over his trunk since childhood. Family history was non-contributory, and he did not have any major or chronic medical illness in the past. There was no history suggestive of paresthesias, exertional dyspnea or focal neurological deficit.

Depression and the associated factors among traumatized patients admitted at University of Gondar and Felege-Hiwot comprehensive specialized hospital, Northwest, Ethiopia

Background Depression is the main factor of impairment in many areas of function that affects almost all age groups and which also influences on mental and physical health. However, it negatively impacts quality of life and social activities, research into depression and the associated factors among people with traumatized patients in low-and middle-income countries are limited. Therefore, the present study was aimed at identifying the magnitude and associated factors of depression among traumatized patients have a pivotal role for further intervention these vulnerable people. Methods An institutional-based cross-sectional study was conducted at Felege-Hiwot and the University of Gondar comprehensive specialized hospital from March 11/2020 to April 12/2020, by using a structured and semi-structured questionnaire. A systematic random sampling was used to recruit a total of 422 patients. The standard patient health questionnaire (PHQ-9) was used to identify the prevalence of depression by employing a face to face interview. Bivariate and multivariate logistic regression analysis was used to identify associated factors with depression. Statistical significance was declared on 95% of confidence interval at P ˂ 0.05. Results The prevalence of depression was found to be 37.2% with 95% (CI: 32.7–41.5%). In the multivariate logistic regression; being single (AOR = 2.36, 95%, CI: 1.31, 4.21), history of chronic medical illness (AOR = 3.79, 95%, CI: 1.19, 12.08), anxiety symptoms (AOR = 3.81, 95%, CI: 2.11, 6.85), poor and moderate social supports (AOR = 4.59, 95%, CI: 2.36, 8.91) and (AOR = 4.34, 95%, CI: 2.23, 8.45), respectively, and moderate perceived threat to life (AOR = 2.66, 95%, CI: 1.58, 4.47) were factors significantly associated with depression. Conclusion In this study revealed that depression among physical trauma patients was considerable too high. Being single, chronic medical illness, anxiety, poor and moderate social support, and moderate perceived stress were factors significantly associated with depression. The ministry of health and other concerned health organizations may find the current finding useful for early detection, prevention, and intervention strategies to minimize the factor of depression in trauma survivors.

Premature Babies and Associated Factors Among Births in Referral Hospitals of Amhara Region, Ethiopia: a Cross-sectional Study

Background: Premature birth remains a serious public health problem in developing countries including Ethiopia. Ethiopia is one of the country with highest preterm birth rate in Africa. However, there is limited evidences on the prevalence and associated factors of premature birth. Therefore, this study was aimed to assess the prevalence and associated factors of premature birth among newborns delivered in Amhara region referral hospitals, Northern Ethiopia.Methods: A hospital-based cross-sectional study was undertaken from February 23rd to April 23rd, 2020, in the Amhara region. A total of 482 mother-newborn pairs were included in this study. The data were collected by interviewing the mothers and reviewing their charts using a structured and pretested questionnaire. The outcome variable was preterm birth. Data were entered using Epi-data version 4.6 and analyzed using STATA software (version 14). Bivariable and multivariable logistic regression models were done for the factors associated with premature birth. Results: In this study, the prevalence of premature birth was 11.41%(95% CI: 8.9, 14.6%). In multivariable logistig regression model; maternal age < 20 years (Adjusted odds ratio (AOR) = 7.8: 95% CI 2.3 – 26 ), preeclampsia (AOR = 5: 95% CI 2.3 – 11 ), premature rupture of membrane (AOR=3.9: 95%CI 1.6- 9.0), chronic medical illness (AOR=4.6:95% CI2.1-10), and history of stillbirth (AOR = 2.7: 95% CI 1.1-7.3) were significantly associated with preterm birth.Conclusion: The finding of this study showed that the burden of premature birth is a public health concern among newborns delivered in Amhara region referral hospitals. Maternal age less than 20 years, preeclampsia, premature rupture of membrane, chronic medical illness, and history of stillbirth were factors associated with preterm birth. Therefore, efforts have to be made to reduce the burden of prematurity, and for early detection and management of preeclampsia. Premature rupture of membrane, and chronic medical illness. Obstetric care providers should give due attention to women with an age of less than 20 years and a history of stillbirth.

The Selective SIK2 Inhibitor ARN-3236 Produces Strong Antidepressant-Like Efficacy in Mice via the Hippocampal CRTC1-CREB-BDNF Pathway

Depression is a widespread chronic medical illness affecting thoughts, mood, and physical health. However, the limited and delayed therapeutic efficacy of monoaminergic drugs has led to intensive research efforts to develop novel antidepressants. ARN-3236 is the first potent and selective inhibitor of salt-inducible kinase 2 (SIK2). In this study, a multidisciplinary approach was used to explore the antidepressant-like actions of ARN-3236 in mice. Chronic social defeat stress (CSDS) and chronic unpredictable mild stress (CUMS) models of depression, various behavioral tests, high performance liquid chromatography-tandem mass spectrometry, stereotactic infusion, viral-mediated gene transfer, western blotting, co-immunoprecipitation and immunofluorescence were used together. It was found that ARN-3236 could penetrate the blood-brain barrier. Repeated ARN-3236 administration induced significant antidepressant-like effects in both the CSDS and CUMS models of depression, accompanied with fully preventing the stress-enhanced SIK2 expression and cytoplasmic translocation of cyclic adenosine monophosphate response element binding protein (CREB)-regulated transcription coactivator 1 (CRTC1) in the hippocampus. ARN-3236 treatment also completely reversed the down-regulating effects of CSDS and CUMS on the hippocampal brain-derived neurotrophic factor (BDNF) system and neurogenesis. Moreover, we demonstrated that the hippocampal CRTC1-CREB-BDNF pathway mediated the antidepressant-like efficacy of ARN-3236. Collectively, ARN-3236 possesses strong protecting effects against chronic stress, and could be a novel antidepressant beyond monoaminergic drugs.

Knowledge, attitude, and practice of healthcare workers toward COVID-19 and its prevention in Ethiopia: A multicenter study

Background: An emerging respiratory disease abbreviated as coronavirus disease 2019 was first reported in December 2019 in Wuhan city of China. The virus is zoonotic and tends to be transmitted between animals to humans and humans to humans. The major route of transmission of coronavirus disease 2019 is droplet and close contact. The Ethiopian Ministry of Health has initiated training for health care workers at a different level. Thus, the main objective of this study is to assess the knowledge, attitudes, and practices of health workers in Ethiopia toward coronavirus disease 2019 and its prevention techniques. Method: An institution-based multicenter cross-sectional study was conducted in each of eight teaching and referral hospitals. A total of 422 Ethiopian healthcare workers were selected for the assessment of knowledge, attitude, and practice toward coronavirus disease 2019. Data were collected using a structured questionnaire. A logistic regression model was used to identify factors associated with the attitude and knowledge of healthcare workers toward coronavirus disease 2019 at a significance level of p < 0.05. Result: Three hundred ninety-seven healthcare workers participated in the study, with a response rate of 94%. Among these, 88.2% and 94.7% of respondents had good knowledge and positive attitudes, respectively. A respondent with a history of chronic medical illness (odds ratio: 0.193, 95% confidence interval: 0.063–0.593), social media, telecommunication, and television/radio as a source of information were significantly associated with knowledge (odds ratio: 3.4, 95% confidence interval: 1.5–7.4, OR: 4.3, 95% confidence interval: 1.3–14.3 and odds ratio: 3.2, 95% confidence interval: 1.4–7.2). In addition, respondents with a history of chronic medical illness were significantly associated with a negative attitude toward coronavirus disease 2019. Conclusion: The knowledge and attitude were good while; the practice was relatively low. Sources of information such as social media, telecommunication, and television/radio were positively associated with healthcare workers' knowledge about coronavirus disease 2019.