Background
Anemia is a critical complication among hemodialysis patients, often leading to poor outcomes. This study aimed to assess anemia prevalence and identify predictors among hemodialysis patients at Felege Hiote Referral Hospital, Northwest Ethiopia, in 2022.


Research design and methods
A retrospective cohort study analyzed 410 hemodialysis patients from January 2018 to February 2022. Data was collected from medical records, entered using Epi-data Version 4.1, and analyzed with STATA Version 14. Kaplan-Meier survival curves assessed survival time, while Cox regression identified anemia predictors.


Results
Of 410 patients, 66 (16.1%) developed anemia, with an incidence rate of 7.9 per 100 person-years (95% CI: 3.1–13.5). Significant predictors included female sex (IRR: 1.5, p = 0.04), rural residence (IRR: 2.5, p = 0.01), low body mass index (IRR: 1.6, p = 0.02), and congestive heart failure (IRR: 6.9, p = 0.02).


Conclusions
Anemia prevalence among hemodialysis patients is high, with key predictors including gender, residence, body mass index, and comorbidities. Interventions targeting these factors, especially in rural areas, could reduce anemia incidence. Study limitations include single-center data, incomplete variables, and lack of causality.





KEYWORDS: Anemia, incidence, predictors of anemia, end stage kidney disease, hemodialysis

This study evaluated the antibacterial activity of medicinalplants (MPs) used to treat wounds. Methanol and ethyl acetatecrude extracts of four medicinal plants were examined for anti-bacterial efficacy against gram-positive and gram-negativeAmerican Type Culture Collection (ATCC) strains. Plant crudeextracts were produced using the maceration technique andanalyzed using qualitative phytochemical tests. The antibacter-ial properties of plant products were evaluated using the agardisc diffusion assay. The broth microdilution method was usedto determine the minimum inhibitory concentrations (MIC) andminimum bactericidal concentrations. The data were analyzedusing Analysis of Variance (ANOVA). The methanol extract ofRumex nervosus had the highest yield (21%). The methanolextracts of all tested MPs tested positive for alkaloids, phenolics,and tannins. The methanol and ethyl acetate extracts exhibiteda dose-dependent increase in the growth inhibition zoneagainst all ATCC. The methanol extract of Plantago lanceolatademonstrated the highest antibacterial activity (16.67 ± 1.15)against Staphylococcus epidermidis. S. aureus and S. epidermidisrecorded a relatively lower MIC (6.25 mg mL−1) from methanolextracts of P. lanceolata, while P. lanceolata and R. nervosusrecorded a lower MBC (25 mg mL−1) against S. aureus.
KEYWORDS: Antibacterial activity; inhibition zone; medicinal plants; MIC; phytochemical; wound

The groundwater level in the Chemoga watershed has been declining due to an increase in water demand, anthropogenicactivities, and climate change effects. This paper uses the WetSpass-MODFLOW coupling to evaluate the groundwater rechargein the Chemoga watershed. The MODFLOW groundwater flow simulation model is then used to simulate the hydraulic headdistribution based on these findings. The input data of WetSpass models are soil, land cover, topography, slope, and ground-water depth, as well as monthly meteorological characteristics (such as temperature, wind speed, and rainfall). The long-termspatial and temporal average annual precipitation of 1,453 mm is distributed as 169 mm (11.63%) groundwater recharge and879 mm (60.5%) surface runoff, while 405 mm (27.87%) is lost through evapotranspiration. In such seasonal variations, thegroundwater head due to the wet/summer stress period varied from 4 to 41 m. While in the dry/winter stress period ground-water head varied from 3.5 to 39.8 m, and also the groundwater head due to the annual stress period varied from 3.7 to 40 m.The findings are extensive and can be applied to water resource management and groundwater resource development in asustainable manner by safeguarding high groundwater recharge locations, and reevaluating allowable groundwater abstractionrates.Key words: ArcGis, Chemoga watershed, groundwater recharge, hydraulic head, MODFLOW, WetSpass-M model

Precision agriculture technologies (PATs) transform crop production by enabling more sustainable and efcient agriculturalpractices. Tese technologies utilize data-driven approaches to optimize the management of crops, soil, and resources, thusenhancing both productivity and environmental sustainability. Tis article reviewed the application of PATs for sustainable cropproduction and environmental sustainability around the globe. Key components of PAT include remote sensing, GPS-guidedequipment, variable rate technology (VRT), and Internet of Tings (IoT) devices. Remote sensing and drones deliver high-resolution imagery and data, enabling precise monitoring of crop health, soil conditions, and pest activity. GPS-guided machineryensures accurate planting, fertilizing, and harvesting, which reduces waste and enhances efciency. VRToptimizes resource use byallowing farmers to apply inputs such as water, fertilizers, and pesticides at varying rates across a feld based on real-time data andspecifc crop requirements. Tis reduces over-application and minimizes environmental impact, such as nutrient runof andgreenhouse gas emissions. IoT devices and sensors provide continuous monitoring of environmental conditions and crop status,enabling timely and informed decision-making. Te application of PAT contributes signifcantly to environmental sustainabilityby promoting practices that conserve water, reduce chemical usage, and enhance soil health. By enhancing the precision ofagricultural operations, these technologies reduce the environmental impact of farming, while simultaneously boosting cropyields and proftability. As the global demand for food increases, precision agriculture ofers a promising pathway to achievingsustainable crop production and ensuring long-term environmental health.Keywords: environmental sustainability; precision agriculture technologies; precision farming; sustainable crop production

Background: Armed conflicts significantly disrupt healthcare systems, leading to infrastructure destruction, shortages of medical supplies, and reduced access to essential health services. The Amhara region has experienced prolonged conflict, raising concerns about its impact on healthcare delivery. Understanding the extent of these disruptions is crucial for informing policy responses and humanitarian interventions.
Objectives: This systematic review and meta-analysis aimed to assess the impact of armed conflict on healthcare delivery in the Amhara region.
Study design: Systematic review and meta-analysis.
Methods: Conducted between June 1 and July 10, 2024, this meta-analysis followed PRISMA guidelines. A comprehensive search was performed across PubMed/MEDLINE, EMBASE, CINAHL, Google Scholar, ScienceDirect, and the Cochrane Library. Eligible studies included English-language observational studies and grey literature addressing healthcare disruptions, infrastructure damage, and health crises. Data were analyzed using STATA Version 14, and study quality was assessed using a modified Newcastle-Ottawa Scale.
Results: Twelve studies, encompassing 12,037,279 participants, were included. The pooled prevalence of health impacts was 76.71 % (95 % CI: 76.63-76.78). The conflict rendered 60 % of healthcare facilities nonfunctional, disrupted medical supplies for 70 % of the population, and reduced service availability by 80 %. Chronic disease management, mental health services, maternal care, and immunization programs experienced significant declines. Subgroup analyses indicated a higher prevalence of health impacts in studies published after 2022 (70.72 %) compared to those published before 2022 (28.35 %).
Conclusion: Armed conflict in the Amhara region has severely disrupted healthcare services, leading to facility closures, medical supply shortages, and significant declines in essential health services. Urgent interventions are required to restore healthcare infrastructure and services.

Keywords: Amhara; Armed conflict; Meta-analysis; Prevalence; Systematic review.

Introduction: One of the main complications for stroke patients is aspiration pneumonia, which is an acute lunginfection brought on by the entry of endogenous flora and various bodily substances from the gastrointestinaltract into the respiratory system. Aspiration pneumonia following a stroke was linked to older age, gender,dysarthria, denture use, cerebral atrophy, and basal ganglia-infarcted foci. Despite improvements in care, theepidemiological and prognostic effects of pneumonia associated with stroke are increasing mortality andmorbidity.Objective: To assess the pooled prevalence of aspiration pneumonia among stroke patients in Ethiopia.Methods: Several databases, including PubMed/MEDLINE, EMBASE, Scopus, Google Scholar, African JournalsOnline (AJOL), grey literature, and articles from the repository of Ethiopian universities, were examined to findavailable articles. The data were extracted and sorted in Microsoft Excel and exported to STATA/MP 17.0 foranalysis. The Newcastle-Ottawa (NOS) was employed to assess each study’s qualities. A weighted inverse vari-ance random-effects model with a 95 % confidence interval was used to examine the pooled prevalence ofaspiration pneumonia. The Galbraith plot and funnel plot were used to evaluate heterogeneity and publicationbias, respectively. To identify the possible cause of heterogeneity, subgroup analysis and meta-regression wereperformed. P-values less than 0.05 were considered statistically significant.Result: The pooled prevalence of aspiration pneumonia among stroke patients in Ethiopia was 31.65 % (95 % CI:25.30–38.01). Visual examination of the Galbraith plot reveals the presence of significant heterogeneity (I2 =96.55 %, p < 0.001). Studies conducted in Addis Ababa and Harar revealed the highest prevalence of aspirationpneumonia: 37.67 % (95 % CI: 31.56, 43.78). Similarly, articles carried out before 2020 and studies done usingcross-sectional study design revealed the highest proportion of aspiration pneumonia: 32.97 % (95 % CI: 24.96,40.98) and 36.75 (95 % CI: 32.11, 41.38), respectively.Conclusion: Nearly one-third of stroke patients developed aspiration pneumonia. The highest prevalence wasreported in Addis Ababa and Harar regions. As a result, early detection, treatment, and control of stroke areadvisable to prevent the occurrence of aspiration pneumonia.
Keywords: Aspiration pneumonia, Stroke, Cerebrovascular accident, Systematic review, Meta-analysis, Ethiopia

Introduction: The increasing prevalence of diabetes mellites (DM), especially type 2 diabetes mellitus, presents significant challenges for healthcare systems. Effective blood glucose management is essential for preventing serious complications, and telehealth offers a promising approach to improve patient engagement and adherence. The effectiveness of telehealth on blood glucose management should be investigated. The evaluated metric for diabetes management plans in this study was the change in blood glucose levels, specifically HbA1c, as an indicator of glycemic control. The impact of telehealth interventions on these outcomes was analyzed across various patient groups. This review conducts a comprehensive analysis of the current literature to offer insights that can guide clinical practices and inform policymakers about the advantages of telehealth in managing diabetes.
Methods: In this study, several evidence-based databases and relevant clinical trial registries were searched to evaluate the effects of telehealth on blood glucose management among patients with diabetes. The included studies were randomized controlled trials that compared telehealth with traditional in-person management. Microsoft Excel was used to extract and sort the data before it was exported to STATA/MP 17.0 for analysis. A weighted inverse variance random-effects model with a 95% confidence interval was employed to pool the data. Egger's test and Cochrane I2 statistics were used to assess publication bias and heterogeneity, respectively.
Result: This review identified six randomized controlled trials (RCTs) involving a total of 3,995 patients, with 2,022 in the telehealth intervention group and 1,973 in the control group, conducted across the USA, Asia, and Europe. The analysis showed a significant improvement in blood glucose control for patients using telehealth, evidenced by a Standard Mean Difference (SMD) of 0.20 (95% CI: 0.10-0.29; p < 0.001), with USA studies reflecting the highest SMD of 0.24 and diabetic veterans showing an even greater SMD of 0.41.
Conclusion and recommendations: This study demonstrates that telehealth interventions significantly enhance blood glucose management among patients with diabetes. The findings highlight the need for healthcare systems to prioritize telehealth integration into diabetes management protocols while developing tailored interventions to meet the diverse needs of various patient populations.

Keywords: Blood glucose; Diabetes mellitus; HbA1c; Meta-analysis; Systematic review; Telehealth.

Abstract
Unemployment, particularly graduate unemployment, brings a huge impact on the community. Thus, the fundamental purpose of the study was to examine the socioeconomic challenges of graduate unemployment in the community. To do this, descriptive research with a cross-sectional design was used to reckon the socioeconomic challenges of graduate unemployment in the community, and a mixed research approach was employed. Accordingly, 279 survey respondents, 6 unemployed graduates, 5 parents of job seekers for the interview, six discussants, and 3 key informants were selected by employed stratified, simple random, and purposive sampling methods. The data which are obtained from survey questionnaires were analyzed through descriptive statistics, while qualitative data were analyzed by narration and thematic. Hereof, the findings depict that families of jobseekers and their community members have faced economic and social-related troubles. Thus, it brings economic bankruptcy, family strain, menanced for social security, and young students have low interest in education because of the presence of graduate unemployment.




Keywords: Communiy, family, socioeconomic effects, unemployment

This study systematically assessed the concentrations of selected metals and the proximate composition of milk samples collected from six locations: Agerie Milk Cooperative, Andassa Livestock Research Center, Tekelehymanot Monastery, the College of Agriculture and Environmental Sciences, Bahir Dar Dairy Cooperative, and households in Keble-7, Bahir Dar city. Proximate composition, including moisture, ash, protein, and fat, was determined using the Kjeldahl digestion and Gerber methods, while metal analysis was performed using the Inductively Coupled Plasma Optical Emission Spectroscopy technique. The findings revealed significant variations (P

Objectives: This study aimed to assess the prevalence and risk factors of intestinal schistosomiasis in students atBochesa Elementary School in the wetlands of Lake Ziway.Methods: A cross-sectional study of 384 students was conducted in May 2016. Intestinal schistosomiasis wasexamined using the Kato-Katz technique. For the association between the prevalence of intestinal schistosomiasisand categorical variables, the chi-square (𝜒2 ) test was used. A binary logistic regression was applied.Results: The overall prevalence of intestinal schistosomiasis was 25.52%. Males were more infected (17.45%)than women (8.07%), and the difference was significant (𝜒2 = 17.756; P