Background: Clinical guidelines are systematically proven statements that help physicians to make healthcare decisions for specific medical conditions. Non-adherence to clinical guidelines is believed to contribute significantly to poor delivery of clinical care, and hence poor clinical outcomes. This study aimed at investigating adherence of doctors to hypertension clinical guidelines in public Teaching Hospitals, Addis Ababa, Ethiopia.
Methods: A Facility based descriptive cross-sectional study was conducted from November 2017 to March 2018 on a sample of 217 doctors. Adherence of doctors to hypertension guidelines was measured through the modified JNC7, and 8 adherence tool. Descriptive statistics was used to summarize the data (mean, standard deviation, median) and analyzed by frequency tables. Chi square test was used to determine the association among categorized variables. Logistic regression analysis was used to determine the relationship between adherence to hypertension guidelines and the explanatory variables. All statistical tests were considered statistically significant when p value < 0.05.
Results: Of the 204 participants, 75.9% (155/204) were aware of the major hypertension treatment guidelines. PHGA score among male and female physicians was 34.9% and 20.6% respectively. In this study, the overall physicians’ hypertension guideline adherence mean score was 54.7% with a standard deviation ±17.8. Only 28.1% of the physicians score 70% and above. The chi square test shows that there is statistical significant difference between males and females regarding PHGA score (χ2(1, N = 203) = 4.437, P < 0.05) and OR=0.484, 95% CI: (0.257, 0.913). This study showed that male physicians and female physicians were almost equally likely to adhere the guideline.
Conclusion: The overall adherence of physicians to hypertension treatment guidelines was very low. This study highlights how a gap in clinical governance contributes to low adherence to clinical guidelines. Establishing regular clinical audit, issuing regulations to enforce the use of updated guidelines, along with introducing training programs in hospitals and continuous assessment to the practicing physicians are suggested as crucial interventions. Considerable efforts to build clinical governance in Ethiopia are required.

Background: Occurrence of infective endocarditis is infrequent in pediatric population especially neonates and is associated with high morbidity and mortality if not managed timely.
Case: A term extramural female baby born with a setting of Rh incompatibility required umbilical venous access for exchange level hyperbilirubinemia.Two days following which baby developed features of sepsis, shock and respiratory failure and pneumothorax requiring mechanical ventilation and chest drain insertion. Baby also had gangrene of big toe tip. Sepsis screen was positive, Echocardiography revealed structurally normal heart with vegetations over tricuspid valve. Serial blood culture grown growth of methicillin sensitive staphylococcus aureus.
Management: Baby diagnosed as having infective endocarditis according to modified Duke criteria. She was managed with ventilator care and supportive measures, empirically started on Meropenem vancomycin and later clindamycin added according to culture and sensitivity report. Antibiotics given for a total of 4 weeks. Follow up ECHO was normal. Baby discharged with stable vitals and on breastfeeds.
Conclusion: Early diagnosis and appropriate treatment can result in positive outcome in this rare disease.

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Intra-cerebral hemorrhage is one of the most disabling forms of stroke even though it accounts for only 15% of all strokes [1,2]. According to researches and reports, only 20 % gain functional independence while 33% patients with intracerebral hemorrhage do not survive [3]. Thus new modalities of investigation for medical and surgical interventions have to be studied and implemented upon to prevent high rate of morbidity and mortality

Background: Heart failure is the leading cause of death in cardiovascular diseases. Various factors that caused cardiac hypertrophy and pathological remodeling are the core mechanism of heart failure. Recent evidence suggested that RORs play protective roles against cardiac hypertrophy. However, it's not clear whether RORα/γ agonist SR1078 has a therapeutic effect on cardiac hypertrophy.
Methods: Norepinephrine induced neonatal rat ventricular myocytes (NRVMs) were treated with or without SR1078. mRNA levels of ANP and BNP were detected by qRT-PCR, size of NRVMs was demonstrated by immunofluorescent staining, and RNA sequencing was performed to identify the differentially expressed genes. Differentially expressed genes were defined as FDR≤ 0.001 and a fold change ≥ 2. KEGG analysis was utilized to analyze the metabolic pathways involved.
Results: SR1078 can repress norepinephrine induced ANP and BNP mRNA levels and reverse cardiac hypertrophy in NRVMs. Venn diagram demonstrated that there were 79 differentially expressed genes. KEGG analysis showed that thyroid hormone signaling was enriched in these genes. RXRα, Pln, and Ncoa2 were significantly and differentially expressed genes in thyroid hormone signaling and were further confirmed by qRT-PCR.
Conclusion: RORα/γ agonist SR1078 has a potential therapeutic role in cardiac hypertrophy and could reverse hypertrophy through thyroid hormone signaling.