Hemostatic Abnormality and Associated Factors in Diabetic Patients at Jimma University Specialized Hospital, Jimma, Southwest Ethiopia: A Comparative Cross-sectional Study

BACKGROUND: Diabetes mellitus is a group of heterogeneous disorders of multiple etiologies characterized by chronic hyperglycemia resulting from defects in insulin secretion and/or insulin action. Diabetes mellitus has been reported to disturb normal hemostasis by various mechanisms. However, data on hemostasis of diabetic patients in the study area are lacking. This study was aimed at determining hemostatic profile and associated factors of hemostatic abnormality in diabetic patients.METHODS: A comparative cross-sectional study was conducted involving a total of 238 (119 diabetic and 119 apparently healthy) individuals who came to the chronic care clinic, Jimma University Specialized Hospital. Socio-demographic and clinical data were collected through a structured questionnaire. A blood sample of 10ml was collected in EDTA (4ml), citrate (3ml) and chemistry (3ml) tubes to do platelet count, coagulation tests, and glucose and lipid profile analysis, respectively. Descriptive statistics as well as the median (25th,75th) percentile and Mann Whitney U test were used during data analysis.RESULTS: The overall hemostatic abnormality in diabetes individuals was 58.8%. The median (25th, 75th percentile) prothrombin time for diabetic and non-diabetic subjects was (12.8, 15.6) vs. (12.8, 14.2), respectively, and the difference was not statistically significant (p>0.05). The median (25th, 75th percentile) activated partial thromboplastin time was significantly different between the two groups (p<0.0001); (24, 36.8) vs. (36, 39.6). The median (25th, 75th percentile) fibrinogen level was significantly different between the two groups (p<0.0001); (277, 462) vs. (243, 328). The median (25th, 75th percentile) platelet count was also significantly different between the two groups (p<0.0001); (146,248) vs. (190,319). All variables were not significantly associated with hemostatic abnormality in multivariate regression analysis.CONCLUSION: An overall hemostatic abnormality in diabetic patients was found to be high. The APTT and platelet count were lower in diabetic patients whilst the fibrinogen level was higher. Routine coagulation tests should be part of tests among diabetic patients. Advanced coagulation tests should also be considered to identify specific markers so as to pinpoint the particular problem

The Impact of Internet Addiction on Mental Health: Exploring the Mediating Effects of Positive Psychological Capital in University Students

Introduction: The widespread use of the internet has brought numerous benefits, but it has also raised concerns about its potential negative impact on mental health, particularly among university students. This study aims to investigate the relationship between internet addiction (IA) and mental health (MH) in university students, as well as explore the mediating effects of positive psychological capital (PsyCap) in this relationship. Objective: The main goal of this study was to examine the psychometric properties of the measures and to determine whether internet addiction could negatively predict university students’ mental health, mediated through PsyCap. Method: A cross-sectional design with an inferential approach was employed to address this objective. The data were collected using the Psychological Capital Questionnaire (PCQ-24), Internet Addiction Scale (IAS), and Keyes’ Mental Health Continuum-Short Form (MHC-SF). The total sample of this study comprised 850 students from two large public higher education institutions in Ethiopia, of whom 334 (39.3%) were female and 516 (60.7%) were male, with a mean age of 22.32 (SD = 4.04). Several analyses were performed to achieve the stated objectives, such as Cronbach’s alpha and composite reliabilities, bivariate correlation, discriminant validity, common method biases, and structural equation modeling (confirmatory factor analysis, path analysis, and mediation analysis). Confirmatory factor analysis was conducted to test the construct validity of IAS, PCQ-24, and MHC-SF. Additionally, the mediating model was examined using structural equation modeling with the corrected biased bootstrap method. Results: The preliminary study results found that the construct validity of IAS, PCQ-24, and MHC-SF was excellent and appropriate. Furthermore, the findings demonstrate that internet addiction had a negative and direct effect on PsyCap and MH. Moreover, PsyCap fully mediated the relationship between IA and MH. Additionally, this study confirmed that all the scales exhibited strong internal consistency and good psychometric properties. Conclusion: This study contributes to a better understanding of the complex interplay between IA, PsyCap, and MH among university students, confirming previous findings. Recommendation: The findings, discussed in relation to the recent and relevant literature, will be valuable for practitioners and researchers aiming to improve mental health and reduce internet addiction by utilizing positive psychological resources as protective factors for university students

Organoleptic and palatability properties of drinking water sources and its health implications in Ethiopia: a retrospective study during 2010-2016

Background: This retrospective study aimed to investigate the physicochemical properties of drinking water sources in Ethiopia and compare the water quality with the health-based target. For this purpose, the water quality database of Ethiopian Public Health Institute (EPHI) from 2010 to 2016 was used. Methods: The concentration and other properties of the water samples were analyzed according to the Standard Methods of Water and Wastewater analysis. Quality control and quality assurance were applied in all stages following our laboratory standard operation procedures (SOPs). Results: The concentration of the selected parameters varied based on the type of water sources. The mean concentration of turbidity was higher in spring water (21.3 NTU) compared to tap (12.6 NTU) and well (3.9 NTU) water sources. The mean concentration of total dissolved solids (TDS), electrical conductivity (EC), sodium (Na+), and sulfate (SO4 -2) was found to be higher in spring water sources than tap and well water sources. Comparably, the concentration of hardness, calcium, and magnesium was found to be higher in well water sources than spring and tap water sources. The bivariate analysis indicated that out of 845 analyzed water samples, more than 50% of the samples from Oromia region had turbidity, pH, TDS, hardness, Ca++, K+, and Na+ within an acceptable limit. In addition, the logistic regression analysis showed that water quality parameters were strongly associated with the type of water sources and regional administration at P < 0.05. Conclusion: More than 80% of the samples analyzed from drinking water sources were in agreement with WHO guidelines and national standards. However, the remaining 20% specifically, pH (25%), calcium (20%), hardness (18.1%), TDS (15.5%), and turbidity (13.3%) analyzed from improved water sources did not comply with these recommendations. Due to objectionable or unpleasant taste, people may force to look for alternative unprotected water sources that lead to health concerns. Keywords: Drinking water, Water quality, Water sources, Taste, Physicochemical properties, Retrospective study, Ethiopia, Logistic model

Sleep quality and associated factors among university students in Africa: a systematic review and meta-analysis study

BackgroundPoor sleep quality significantly impacts academic performance in university students. However, inconsistent and inconclusive results were found in a study on sleep among university students in several African nations. Therefore, this study aimed to estimate the pooled prevalence and associated factors of poor sleep quality among university students in Africa.MethodsThe databases PubMed, Scopus, Cochrane Library, Science Direct, African Journal Online, and Google Scholar were searched to identify articles. A total of 35 primary articles from 11 African countries were assessed and included in this systematic review and meta-analysis. Data were extracted by using a Microsoft Excel spreadsheet and exported to STATA version 14 for analysis. The I2 test was used to assess the statistical heterogeneity. A random effect meta-analysis model was employed with 95% confidence intervals. Funnel plots analysis and Egger regression tests were used to check the presence of publication bias. A subgroup analysis and a sensitivity analysis were done.ResultsA total of 16,275 study participants from 35 studies were included in this meta-analysis and systematic review. The overall pooled prevalence of poor sleep quality among university students in Africa was 63.31% (95% CI: 56.91-65.71) I2 = 97.2. The subgroup analysis shows that the combined prevalence of poor sleep quality in East, North, West, and South Africa were 61.31 (95% CI: 56.91-65.71), 62.23 (95% CI: 54.07-70.39), 54.43 (95% CI: 47.39-61.48), and 69.59 (95% CI: 50.39-88.80) respectively. Being stressed (AOR= 2.39; 95% CI: 1.63 to 3.51), second academic year (AOR= 3.10; 95% CI: 2.30 to 4.19), use of the electronic device at bedtime (AOR= 3.97 95% CI: 2.38 to 6.61)) and having a comorbid chronic illness (AOR = 2.71; 95% CI: 1.08, 6.82) were factors significantly associated with poor sleep quality.ConclusionThis study shows that there is a high prevalence of poor sleep quality among university students in Africa. Being stressed, in the second year, using electronic devices at bedtime, and having chronic illness were factors associated with poor sleep quality. Therefore, addressing contributing factors and implementing routine screenings are essential to reduce the burden of poor sleep quality.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42023493140

Post-traumatic stress disorder in the Ethiopian population dwelling in war-affected communities: a systematic review and meta-analysis

BackgroundPost-traumatic stress disorder (PTSD) is a significant mental health concern globally, particularly prevalent in populations exposed to war and conflict. This systematic review and meta-analysis aim to examine the prevalence and factors associated with PTSD among the Ethiopian population residing in war-affected communities.MethodsThe review was reported according to the PRISMA guidelines. Related eligible published articles were searched in electronic online databases such as PubMed, Scopus, Web of Science, MEDLINE/PubMed, Scopus, Embase, Science Direct, Web of Science, Google Scholar, and Google, which reported the prevalence and risk factors of PTSD among people dwelling in the war-affected area until January 2024. The relevant data was extracted using a Microsoft Excel spreadsheet. The meta-analysis was conducted using STATA version 11. The estimated pooled prevalence and risk factors were estimated using a random effect model. The potential risk of publication bias was checked using a funnel plot and Egger’s statistical test.ResultsA total of nine published studies with 6107 participants were analyzed in this meta-analysis. The estimated pooled prevalence of PTSD among people living in war-affected areas was 48.4%, with a 95% CI (37.1, 59.8). This study found a higher prevalence of PTSD among women than men. Being female (OR= 2.2, 95% CI: 1.2, 4.3), witnessing a murder of a loved one (OR= 3.0, 95% CI: 1.2, 7.5), depression symptoms (OR= 2.8, 95% CI: 1.4, 5.6), and anxiety symptoms (OR= 3.4, 95% CI: 1.4, 8.0), a close family member killed or seriously injured (OR= 3.1, 95% CI: 1.2, 7.7), a moderate and high perceived threat to life (OR= 3.4, 95% CI: 1.3, 9.1), and poor social support (OR= 4.4, 95% CI: 1.1, 18.7) were associated with post-traumatic stress disorder.ConclusionThe result of this study shows the high prevalence rate of PTSD in people living in war-affected areas. disparities in PTSD prevalence, with women being at higher risk, and identified risk factors were witnessing the murder of a loved one, experiencing depression and anxiety, and perceived threat to life. Addressing PTSD in war-affected communities requires comprehensive interventions that consider both individual and contextual factors.Systematic review registrationwww.crd.york.ac.uk/PROSPERO/, identifier CRD42024501384

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Comparison of three-fold converted hematocrit and micro-hematocrit in pregnant women.

BackgroundAnemia is one of the common complications of pregnancy. Hemoglobin concentration, Hematocrit, and Red cell count are laboratory tests used to diagnose anemia. In are source poor setting, there is a practice of using three-fold converted Hematocrit. This study is designed to assess the association and acceptability of three-fold converted Hematocrit as compared to the standard Micro-hematocrit method, in pregnant women.MethodThe cross-sectional study conducted from May 18 to June 12, 2018 involved 200 pregnant women who visited the Laboratory for a Hematocrit test. Three milliliter of venous blood was collected with EDTA tube to determine Hematocrit by the Micro-hematocrit method and Hemoglobin concentration measured by a HemoCue Hemoglobin B analyzer. A scatter plot, correlation coefficient, Bland and Altman plot, and Area under curve were employed to assess the agreement and acceptability of the calculated Hematocrit as compared to the standard Micro-hematocrit.ResultThe correlation coefficient, Intraclass correlation coefficient and concordance correlation coefficient were 0.91, 0.94, and 0.89, respectively. The Bland and Altman plot showed a mean difference of 0.94 with the limit of agreement ranges from 0.6 to 1.3. The area under the receiver operating characteristics with cut-off point of Hematocrit ConclusionGenerally there is excellent association between the two methods. The two methods were identical within inherent imprecision of both methods. Hence, the Hematocrit value, threefold calculated from the Hemoglobin was found to be acceptable to diagnose anemia in pregnant women

Organoleptic and palatability properties of drinking water sources and its health implications in Ethiopia: a retrospective study during 2010-2016

Background: This retrospective study aimed to investigate the physicochemical properties of drinking water sources in Ethiopia and compare the water quality with the health-based target. For this purpose, the water quality database of Ethiopian Public Health Institute (EPHI) from 2010 to 2016 was used. Methods: The concentration and other properties of the water samples were analyzed according to the Standard Methods of Water and Wastewater analysis. Quality control and quality assurance were applied in all stages following our laboratory standard operation procedures (SOPs). Results: The concentration of the selected parameters varied based on the type of water sources. The mean concentration of turbidity was higher in spring water (21.3 NTU) compared to tap (12.6 NTU) and well (3.9 NTU) water sources. The mean concentration of total dissolved solids (TDS), electrical conductivity (EC), sodium (Na+), and sulfate (SO4-2) was found to be higher in spring water sources than tap and well water sources. Comparably, the concentration of hardness, calcium, and magnesium was found to be higher in well water sources than spring and tap water sources. The bivariate analysis indicated that out of 845 analyzed water samples, more than 50% of the samples from Oromia region had turbidity, pH, TDS, hardness, Ca++, K+, and Na+ within an acceptable limit. In addition, the logistic regression analysis showed that water quality parameters were strongly associated with the type of water sources and regional administration at P < 0.05. Conclusion: More than 80% of the samples analyzed from drinking water sources were in agreement with WHO guidelines and national standards. However, the remaining 20% specifically, pH (25%), calcium (20%), hardness (18.1%), TDS (15.5%), and turbidity (13.3%) analyzed from improved water sources did not comply with these recommendations. Due to objectionable or unpleasant taste, people may force to look for alternative unprotected water sources that lead to health concerns

Numerical study on hybrid metallic sandwich structures subjected to air burst

Abstract This study presents a numerical investigation on the use of previously unexplored hybrid sandwich protective structural configurations with aim to resist airblast loading. A honeycomb, corrugated sheet, and woven interlaced core configurations are used to develop the hybrid system. An experimental result reported in the previous literature is used for validation of the finite element analysis models using Abaqus/Explicit finite element software with a conventional weapon blast related parametric codes. Then an extended numerical study is conducted further on various hybrid sandwich inner core topologies for maximizing protection against an air blast induced shock wave. The study demonstrated that a protective system, combining square honeycomb metallic cores with X-shaped corrugated sheets and fortified against in-plane compression and buckling, showed excellent shielding capabilities against airblast loading. This configuration also exhibited the highest energy dissipation, the least effective plastic strain, minimal back sheet displacement, and a favorable damage profile