Cogan’s anterior internuclear ophthalmoplegia in young Ethiopian: A case report and review of literature

Introduction: Lesions in medial longitudinal fasciculus (MLF) produce internuclear ophthalmoplegia (INO) with characteristic horizontal gaze abnormality. Here, the author reports a rare clinical spectrum of internuclear ophthalmoplegia called Cogan’s anterior internuclear ophthalmoplegia in young Ethiopian suspected to have multiple sclerosis. To the best of the author’s knowledge, this is the first report in non-white population near the equator.Case presentation: A 19-year-old female Ethiopian patient presented with bilateral internuclear ophthalmoplegia. Attempted convergence was abnormal. The patient regained normal ocular mobility after six months of follow-up.Conclusion: Isolated reversible internuclear ophthalmoplegia in a previously healthy young patient could be an initial manifestation of a serious illness like multiple sclerosis. Though the incidence of multiple sclerosis in non-white population near the equator is low, high index of suspicion and close follow up are warranted.KEYWORDS Medial longitudinal fasciculus lesion; Internuclear ophthalmoplegia; Horizontal gaze abnormality; Multiple sclerosi

The impact of central corneal thickness on intraocular pressure among Ethiopian glaucoma patients: a cross-sectional study

BACKGROUND: Raised intraocular pressure (IOP) is the only causal risk factor for glaucoma that can be therapeutically manipulated to change the course of the disease process. Though Goldman applanation tonometry (GAT) is the “gold standard” for IOP measurement, readings of IOP with GAT are affected by central corneal thickness (CCT). The aim of this study is to determine the impact of CCT on IOP among Ethiopian glaucoma patients. METHODS: It was a multicenter cross-sectional study and all glaucoma patients visiting their respective eye clinic during the study period were included. A total of 199 randomly selected glaucomatous eyes from 199 patients aged 18 years and above were employed. The CCT was measured by OcuScan™ RxP Ophthalmic Ultrasound and IOP was measured with Goldmann applanation tonometer. Linear regression and bivariate correlation analysis were carried out and level of significance was taken at 5%. RESULTS: The mean IOP was 19.46(±7.05) mmHg and mean CCT was 508.07(±33.26) μm. The mean IOP for primary open angle glaucoma (POAG), ocular hypertension (OHT), normal tension glaucoma (NTG), pseudoexfoliative glaucoma (PXG) and primary chronic angle closure glaucoma (PCAG) patients was 19.22 mmHg, 21.39 mmHg, 14.33 mmHg, 33.25 mmHg and 14.75 mmHg respectively. The mean CCT values were 502.24 μm (POAG), 524.32 μm (OHT), 500.75 μm (NTG), 579.00 μm (PXG) and 530.25 μm (PCAG). Age of the patient and glaucoma surgery had an influence on corneal thickness. A positive relationship was found between CCT and IOP (p < 0.001). CONCLUSIONS: The mean CCT of Ethiopian glaucoma patients is thin in comparison to other ethnic groups and patients with OHT have thicker corneas than POAG patients. Hence determination of CCT for each patient is necessary in the up-to-date glaucoma management

Adoption of soil organic carbon-enhancing practices: A case of two watershed sites in Ethiopia.

This study aimed at identifying the factors that determine the decision to adopt and the intensity of adoption of soil organic carbon (SOC)-enhancing practices using two watershed sites in Ethiopia: Yiser (Amhara region) and Azugashube (Southern region). The study used survey data collected from 379 sample households drawn from four Kebele/village administrations at each watershed site. Multivariate and ordinary least squares regressions were used to identify the factors that determine the decision to adopt the SOC-enhancing practices and the factors that determine the extent of adoption of these practices, respectively. The study classified these various practices into three classes: soil and water conservation, agronomic, and agroforestry SOC-enhancing practices. We find that the decision to adopt soil and water conservation practices is negatively related to both the decision to adopt agronomic and to adopt agroforestry SOC-enhancing practices. On the contrary, we find that the decision to adopt agronomic and agroforestry practices is complementary. The study also identified diverse agroecological, farming system, institutional, and household characteristics that determine the decision to adopt and the intensity of adoption of the three SOCenhancing practices. Among the different variables, the study found location as a strong determinant of the type and intensity of adoption of the SOC practices

Exercise and Diabetes Mellitus

In the past 20 years, the magnitude of diabetes has increased dramatically in many parts of the world and the disease is now a worldwide community health problem. Diabetes mellitus is associated with numerous systemic complications that affect the retina, heart, brain, kidneys and nerves. Abnormal/reduced sensation, diminished reflexes, decreased proprioception and reduced muscle strength in lower limbs leads to balance and functional problems in patients with diabetic peripheral neuropathy. Evidences strongly support that physiotherapists play a significant role in the prevention, treatment and management of diabetes mellitus and its associated complications. Physiotherapy management techniques and rehabilitation interventions, including exercise prescription and education will help to facilitate patient participation in programs that improve and maintain physical well-being which has a significant impact on their activities of daily living and health-related quality of life (HRQOL)

Prescription Pattern of Injection at Out Patient Pharmacy Department of Adama Hospital Medical College, Adama,

Introduction: Injection is an infusion method of putting drugs or fluids in to the body with a hollow needle and a syringe. The use of injection for treatment accompanied with variety of disadvantages including sepsis at administration, risk of tissue toxicity, costly difficulties in correcting the error.  Injections are very expensive compared to other dosage forms and require trained personnel for administration. Moreover, unhygienic use of injections can increase the risk of transmission of potentially serious pathogens, such as hepatitis, HIV/AIDS, and blood-borne diseases. It is estimated by the WHO that about 16 billion injections are undertaken in developing countries annually and are often irrationally used. Objective: The present study was aimed to assess the prescription pattern of injections in Adama Hospital Medical College. Method: Hospital based Prospective cross sectional study was done to assess prescription pattern of injections in outpatient pharmacy of AHMC. All Prescription cards from March 24, 2015 to May 24, 2015 were taken and reviewed using pre-tested data collection format. Finally data was edited, coded, tallied and cleaned. Descriptive statistics was computed. Result: On review of 500 prescription papers, 600 injections were prescribed. The percentage of prescriptions containing name of the patient, sex, age, address, date and card number were 490 (98%), 395 (79%), 405 (81%), 250 (50%), 300 (60%) and 480 (96%) respectively. The most commonly prescribed therapeutic class was inject able antibiotics 154 (25%), anti pains 120 (20%) and diuretics 66 (11%). Injections prescribed with over, under and optimum dose were 15 (2.5%), 9 (1.5%), 576(96%), respectively. About 18 (3%), 6 (1%) and 2 (0.3%) of antibiotics were prescribed by incorrect frequency, short and extended duration of administration, respectively. Only on 190 (38%), 65 (13%) and 480 (96%) of prescription papers were names, qualification and signature of the prescribers specified respectively. Conclusion: There was rational use of injections in the hospital though there are some problems that have to be considered. Key Terms: Injection medicine, prescribing pattern, prescribers, prescription, Adama

Novel uses of attenuated total reflectance infrared microspectroscopy combined with multivariate analysis in food processing

El objetivo general de esta tesis fue demostrar la aplicación de la microespectroscopía del infrarrojo cercano (ATR-IRMS) combinada con análisis multivariante (soft independent modeling of class analogy) como una técnica analítica rápida, simple y robusta para obtener información clave cuando diversas tecnologías emergentes fueron utilizadas para producir emulsiones alimentarias o inactivar microorganismos. En la primera parte de la tesis, ATR-IRMS se utilizó para detectar si la proteína de suero de leche utilizada como emulsificante, estuvo implicada en los fenómenos de ensuciamiento detectados en las superficies de las membranas utilizadas para producir emulsiones de aceite de girasol en agua. Esta técnica también se utilizó para detectar fácilmente qué protocolo de limpieza aplicado para reducir el proceso de ensuciamiento era el más eficaz. En la segunda parte de la tesis, ATR-IRMS combinada con el análisis multivariado fue la técnica clave para detectar que estructuras celulares del patógeno E. coli O157:H7 fueron principalmente afectadas cuando se utilizaron tratamientos térmicos y campos eléctricos pulsantes de alta intensidad aplicados a pH 4.0 y 7.0 para inactivar esta bacteria. Los modelos de calibración construidos con los datos espectrales y los valores de los ciclos de inactivación de E. coli O157:H7 obtenidos con medios nutritivos y selectivos, mostrando una buena correlación y el potencial de ser utilizados para predecir las bacterias lesionadas por estas dos tecnologías.The overall objective of this thesis was to demonstrate the application of attenuated total reflectance infrared microspectroscopy (ATR-IRMS) combined with multivariate analysis (soft independent modeling of class analogy) as a rapid, simple and robust analytical technique to obtain more insight when several emerging technologies are applied to produce food emulsions or inactivate microorganisms. In the first part of the thesis, ATR-IRMS was used to detect if whey protein was involved on the fouling phenomena detected to membrane surfaces used to produce sunflower oil and water emulsions. This technique was also evaluated to easily detect which cleaning protocol used to reduce the fouling was the most effective between those tasted. In the second part of the thesis, ATR-IRMS combined with multivariate analysis was the key technique to detect the E. coli O157:H7 cell structures mainly affected by heat and pulsed electric fields treatments applied at pH 4.0 and 7.0. Calibration models were built up with the IR data and E. coli O157:H7 log cycles of inactivation showing good correlation and potential to be used to predict injured bacteria

The effectiveness of neonatal health care services in the primary health care units in the north-west of Ethiopia

Improving the quality of newborn care services and accelerating the service utilization of sick young infants is required to contribute to the reduction of neonatal mortality and improve the wellbeing of the newborns. The purpose of this study was to explore the effectiveness of neonatal healthcare services in the primary healthcare units in the north-west of Ethiopia and develop guideline for effective neonatal care. A mixed method approach with a sequential explanatory design was employed to explore factors affecting the effectiveness of the neonatal healthcare services. Interviewer-administered questionnaires were administered to 221 health workers and health extension workers in 142 health facilities; and service statistics abstracted for 767 sick young infants’ from the sick young infant registers. Data was entered in the EpiData 3.1, exported to SPSS and STATA for analysis. In the qualitative study, twenty-six participants from the health centers and health posts were interviewed through focus group discussions. Thematic analysis was undertaken to explore factors affecting neonatal healthcare services. Results: The quality of newborn care with the domains of newborn resuscitation, follow-up care after resuscitation and thermal care; immediate care and breastfeeding advice for very low birthweight babies were found to be moderate at primary hospitals and urban health centres; low at rural health centres and health posts. The availability of essential equipment is significantly associated with the quality of neonatal care provision in the health facilities (p < 0.05). More than forty percent of health facilities were not meeting the quality of case management tasks for sick young infants, and the newborn care knowledge of health providers is significantly associated with the quality of sick young infants’ management (p < 0.05). The sick young infants’ service utilisation was only 6.3 percent from the expected sick young infants’ population. Overall, the effectiveness of the neonatal healthcare services has a significant association with the health facilitates readiness [95%CI: 0.134-0.768]. Conclusion: The quality of neonatal healthcare provision is low to moderate; and the service utilization of sick young infants is very low. Thus, the rural health centers and health posts should be prioritised for the effective neonatal care.Health StudiesD. Litt. et Phil. (Health Studies