14 research outputs found
Anatomical branching patterns of the aortic arch in Ethiopia: An imaging-based study
Background: The aortic arch (AA) is a key anatomical vascular structure through which blood is distributed to the bodyâs organs. Knowledge of its branching patterns is important for surgical procedures. This study aimed to describe anatomical variations in the branching patterns of human AAs in patients who underwent chest contrastenhanced computed tomography. Methods: A retrospective study involving 630 chest contrastenhanced computed tomography scans from July 2018 to July 2019 was carried out at Ayder Comprehensive Specialized Hospital, Mekelle, Ethiopia. These images were reviewed for AA branching patterns and classified accordingly. Data were analyzed using SPSS version 21. Results: Of the 630 patients (364 males and 266 females), AA branching pattern variations were found in 35.2%: type II, 26%; type III, 6.5%; type V, 2.7%; the rest, 64.8%, had a normal (type I) AA branching pattern. The left vertebral artery and the aberrant right subclavian artery were also observed to originate directly from the AA. Conclusions: AA branching pattern variation types II, III, and V were found in our study. These findings could be vital during aortic instrumentation and surgical procedures of the head and neck in Ethiopia and globally
Under detection of depression in primary care settings in low and middle-income countries:a systematic review and meta-analysis
Background: Depression is one of the commonest mental disorders in primary care but is poorly identified. The objective of this review was to determine the level of detection of depression by primary care clinicians and its determinants in studies from low- to middle-income countries (LMICs). Methods: A systematic review and meta-analysis was conducted using PubMed, PsycINFO, MEDLINE, EMBASE, LILAC, and AJOL with no restriction of year of publication. Risk of bias within studies was evaluated with the Effective Public Health Practice Project (EPHPP). âGold standardâ diagnosis for the purposes of this review was based on the 9-item Patient Health Questionnaire (PHQ-9; cutoff scores of 5 and 10), other standard questionnaires and interview scales or expert diagnosis. Meta-analysis was conducted excluding studies on special populations. Analyses of pooled data were stratified by diagnostic approaches. Results: A total of 3159 non-duplicate publications were screened. Nine publications, 2 multi-country studies, and 7 single-country studies, making 12 country-level reports, were included. Overall methodological quality of the studies was good. Depression detection was 0.0% in four of the twelve reports and < 12% in another five. PHQ-9 was the main tool used: the pooled detection in two reports that used PHQ-9 at a cutoff point of 5 (combined sample size = 1426) was 3.9% (95% CI = 2.3%, 5.5%); in four reports that used PHQ-9 cutoff score of 10 (combined sample size = 5481), the pooled detection was 7.0% (95% CI = 3.9%, 10.2%). Severity of depression and suicidality were significantly associated with detection. Conclusions: While the use of screening tools is an important limitation, the extremely low detection of depression by primary care clinicians poses a serious threat to scaling up mental healthcare in LMICs. Interventions to improve detection should be prioritized. Systematic review registration: PROSPERO CRD42016039704
The psychosis treatment gap and its consequences in rural Ethiopia
Abstract
Background
The âtreatment gapâ (TG) for mental disorders, widely advocated by the WHO in low-and middle-income countries, is an important indicator of the extent to which a health system fails to meet the care needs of people with mental disorder at the population level. While there is limited research on the TG in these countries, there is even a greater paucity of studies looking at TG beyond a unidimensional understanding. This study explores several dimensions of the TG construct for people with psychosis in Sodo, a rural district in Ethiopia, and its implications for building a more holistic capacity for mental health services.
Method
The study was a cross-sectional survey of 300 adult participants with psychosis identified through community-based case detection and confirmed through subsequent structured clinical evaluations. The Butajira Treatment Gap Questionnaire (TGQ), a new customised tool with 83 items developed by the Ethiopia research team, was administered to evaluate several TG dimensions (access, adequacy and effectiveness of treatment, and impact/consequence of the treatment gap) across a range of provider types corresponding with the WHO pyramid service framework.
Results
Lifetime and current access gap for biomedical care were 41.8 and 59.9% respectively while the corresponding figures for faith and traditional healing (FTH) were 15.1 and 45.2%. Of those who had received biomedical care for their current episode, 71.7% did not receive minimally adequate care. Support from the community and non-governmental organisations (NGOs) were negligible. Those with education (Adj. OR: 2.1; 95% CI: 1.2, 3.8) and history of use of FTH (Adj. OR: 3.2; 95% CI: 1.9â5.4) were more likely to use biomedical care. Inadequate biomedical care was associated with increased lifetime risk of adverse experiences, such as history of restraint, homelessness, accidents and assaults.
Conclusion
This is the first study of its kind. Viewing TG not as a unidimensional, but as a complex, multi-dimensional construct, offers a more realistic and holistic understanding of health beliefs, help-seeking behaviors, and need for care. The reconceptualized multidimensional TG construct could assist mental health services capacity building advocacy and policy efforts and allow community and NGOs play a larger role in supporting mental healthcare
Effect of Khat (Catha edulis Forsk) on Neurobehavioral Functions: Systematic review and Meta analysis
Abstract Background: Khat (Catha edulis forks, family: celastraceae) is a plant grown in East-Africa and the south west of the Arabian Peninsula. People uses for its pleasant stimulant effect of physical activity, consciousness, motor and mental functions as well as its anti-fatigue action. Although there is a rich body of research available regarding the effect of acute and chronic khat dosing in animal models, research on the behavioral and cognitive effects of khat in human subjects is not extensive and several of the available studies have been done only in the context of observational and single-case studies. Objective: To determine the level of evidence of toxicity of Khat (Catha edulis Forsk) on Neurobehavioral Functions. Methods: Key words representing major broad subject areas including: Khat, learning memory, working memory, cognitive flexibility, motor activities and other psychological disorders were used to search in the electronic databases. Randomized controlled trials (RCTs) and Cross sectional study investigating the effect of khat on neurobehavioral were included. Studies involving human participants reporting behavioral change and the experimental animal models were included in the present systemic review. Meta analysis was conducted to examine the effect of khat on neurobehavioral functions. Quality assessment was performed using the PEDro scale with subsequent data extraction. Result: Out of the 260 studies, eight studies met inclusion criteria for this review. Of these, four studies were included in the meta-analysis. Meta-analysis results suggested that there were significant difference between khat exposed and control group for the neurobehavioral changes. The Pedro score was 6, meeting the cut off score for high quality. Conclusion: Although a number of studies regarding the current topic is limited, there is the high quality of evidenced that khat (Catha edulis) induced neurobehavioral changes. Key words: Khat, learning memory, working memory, cognitive flexibility, motor activities, psychological disorders Introduction Khat (Catha edulis, family: Celastraceae) is a plant grown in East-Africa (mainly in Somalia, Kenya, Djibuti, Yemen and Ethiopia) and the south west of the Arabian Peninsula. In these countries the chewing of khat is very common; it is consumed as qat and kat in Yemen; chat in Ethiopia; miraa, kijiti, gomba, mbachu or veve in Kenya; and as mairungi in Ugand
Role of Melatonin in Cancer Treatment
Abstract Melatonin is a methoxyindole synthesized and secreted principally by the pineal gland at night under normal environmental conditions. The endogenous rhythm of secretion is generated by the suprachiasmatic nuclei and entrained to the light/dark cycle. The primary physiological function of melatonin, whose secretion adjusts tonight length, is to convey information concerning the daily cycle of light and darkness to body physiology. It is secreted during darkness and plays a key role in various physiological responses, including regulation of circadian rhythms, sleep homeostasis, retinal neuromodulation and vasomotor responses. Melatonin also enhances the antioxidant potential of the cell by stimulating the synthesis of antioxidant enzymes, including superoxide dismutase, glutathione peroxidase and glutathione reductase, and by augmenting glutathione levels. Melatonin plays a role in mammary cancer by down-regulating some of the pituitary and gonadal hormones that control mammary gland development and which are also responsible for the growth of hormone-dependent mammary tumors. Furthermore, melatonin could act directly on tumoral cells, as a naturally occurring antiestrogen, thereby influencing their proliferative rate. Key words: Melatonin; Mammary cancer; pineal gland; suprachiasmatic nuclei Introduction Melatonin is an indolic hormone mainly secreted by the pineal gland. Secondary sources are retina, gut, skin, platelets, bone marrow and probably other structures, whose systemic contribution is insignificant. This aspect and the fact that it lightens the frog skin by contracting melanophores led to the naming of this molecule as Melatoni
Hematological responses to iron-folate supplementation and its determinants in pregnant women attending antenatal cares in Mekelle City, Ethiopia.
OBJECTIVE:To characterize anemia and evaluate hematological responses to universal iron-folic acid (IFA) supplementation in Ethiopian pregnant women. METHOD:A hospital- based prospective follow up study was done between December 2016 and June 2017. Hematological profiles were measured in pregnant women before and after a minimum of one-month IFA supplementation. Mean values and abnormal proportions of hematological profiles were compared before and after supplementation using paired t-test and McNemar test, respectively. Univariate and multivariate analysis were used to analyze the association between independent variables and poor treatment responses. RESULT:Lack of adequate hemoglobin response was found in 48.5%(95/196) of the participants. Prevalence of anemia and low hematocrit value were decreased significantly after IFA supplementation (p = 0.002, and p = 0.001, respectively). Normocytic hypochromic anemia was the commonest form of anemia found in this study followed by normocytic normochromic anemia. There was no statistically significant association between poor hemoglobin responses and all studied factors such as educational level, household size, parity, recent illness, stage of pregnancy, coffee consumption, and duration of iron treatment. CONCLUSION:Our study revealed poor hemoglobin responses in nearly half of the study participants and a high proportion of anemias morphologically atypical of iron deficiency anemia. There is a need to consider anemia attributable to etiologies other than an iron deficiency in anemia intervention programs
Prevalence of substance abuse among regular degree health science students in Sheba University College in Mekelle Town, Tigray - Ethiopia
Background: Substance abuse (SA) refers to the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs. The most common substances which are usually abused are alcohol and tobacco. Herein, we assessed the prevalence of SA among regular degree health science students of the Sheba University College (SUC). Materials and Methods: A cross-sectional survey was carried out among 1076 SUC students using self-administered structured questionnaire. The simple sampling technique was used to select students. Descriptive statistics, bivariate, and multivariate analysis were done. Results: The overall prevalence of âever used substanceâ for at least one was 45.5%. The most commonly used drugs in descending order were alcohol (25.1%), cigarette (11.4%), and khat (9.2%). Male participants, urban setting, peer pressure, personal pleasure, and academic dissatisfaction and pocket money were highly associated with SA. Conclusion: This study showed a lower magnitude (45.6% ever use and 21% still using) of SA among studentsâ compared to other studies. Even if a considerable decrease in SA among study subjects, the creation of awareness and health education should be continued to fully combat the problem of abuse
High burden of neural tube defects in Tigray, Northern Ethiopia: Hospital-based study.
INTRODUCTION:Neural tube defects are the major causes of fetal loss and considerable disabilities in infants. Currently, there is no significant research on the incidence of Neural tube defects in the Tigray region of Ethiopia. OBJECTIVE:To determine the incidence and clinical pattern of the Neural Tube Defects. METHODS:A hospital-based cross-sectional study was conducted from October 2016 to June 2017. All pregnancy outcomes were examined for any externally visible birth defects and neurological integrity by trained midwives under the supervision of senior obstetrics and gynecology and a neurosurgeon. Data were collected using a survey tool to collect maternal and newborn demographic data and a checklist developed to capture newborns with Neural Tube Defects. Data were analyzed using SPSS version 20. The prevalence of NTDs was calculated per 10,000 births. RESULT:Out of the 14,903 births during the study period, a total of 195 infants were born afflicted with Neural Tube Defects. The burden of infants with anencephaly and spina bifida was 66.4 and 64.4 per 10, 000 births, respectively. The overall incidence rate of NTDs in this study was 131 per 10, 000 births of which 23% were liveborn and 77% were stillborn. The highest burden of Neural Tube Defects was observed in Adigrat Hospital from Eastern Zone of Tigray (174 per 10,000 births) and Lemlem Karl Hospital from Southern Zone of Tigray (304 per 10,000 births) compared to Kahsay Abera Hospital from Western Zone (72.8 per 10,000 births) and Sihul Hospital from North Western Zone of Tigray (69.8 per 10,000 births). CONCLUSION AND RECOMMENDATION:Assuming that the non folic acid preventable rate should be 5 per 10,000 births, our prevalence rate is 131 per 10,000 births, and then we have a rate or an epidemic that is 26 times what it should be. This just emphasizes the urgency to implement effective programs to get all women of reproductive age to have adequate folic acid to prevent all of folic acid-preventable spina bifida and anencephaly, which would prevent 96% (125/130) of spina bifida and anencephaly in the Tigray Provence
Toxic effect of khat (Catha edulis) on memory: Systematic review and meta-analysis
Background: People use khat (Catha edulis) for its pleasant stimulant effect of physical activity, consciousness, motor, and mental functions. Although there are reports assessing the effect of khat on memory, there was no study based on formal systematic review and meta-analysis. Objective: We have therefore conducted this meta-analysis to determine the level of evidence for the effect of khat (C. edulis Forsk) on memory discrepancy. Methods: MEDLINE, Cochrane Library, PubMed, Academic Search Complete, SPORTDiscus, ScienceDirect, Scopus, Web of Science, and Google Scholar were searched to retrieve the papers for this review. Keywords utilized across database search were khat, cat, chat, long-term memory, short-term memory, memory deficit, randomized control trial, and cross-sectional survey. The search was limited to studies in humans and rodents; published in English language. Result: Finding of various studies included in our meta-analysis showed that the effect of acute, and subchronic exposure to khat showed that short-term memory appears to be affected depending on the duration of exposure. However, does not have any effect on long-term memory. Conclusion: Although a number of studies regarding the current topic are limited, the evidenced showed that khat (C. edulis) induced memory discrepancy