Numerical methods for solving second-order initial value problems of ordinary differential equations with Euler and Runge-Kutta fourth-order methods

This paper presents two standard numerical methods for solving second order initial value problems for ordinary differential equations (ODEs). The Euler and the Runge-Kutta fourth-order methods are applied without any discretization or restrictive assumptions for solving ODEs. The numerical solutions obtained by the two methods are in good agreement with the exact solutions. The convergence and error analysis which are discussed demonstrate the effectiveness of the methods. The results obtained from the two numerical methods show that the RK4 method is appropriate, consistent, convergent, quite stable, and more accurate than the Euler's method

Assessment of the extent and monetary loss in the selected public hospitals in Jimma Zone, Ethiopia: expired medicine perspectives

IntroductionMedicine plays a crucial role in the field of healthcare as a therapeutically significant pharmaceutical product. By effectively preventing diseases, medicine has the power to save countless lives and improve the quality of life for people worldwide. However, despite hospitals' efforts to provide medical care to patients, a significant issue arises from the substantial amount of drugs that go unused due to expiration dates. This problem is particularly prevalent in resource-limited countries like Ethiopia, where the pharmaceutical supply system fails to adequately address the issue of expired drugs in public hospitals, leading to an unsatisfactory situation. Hence, the objective of this study was to assess the economic impact and volume of expired medicines in the selected public hospitals in Jimma Zone, Southwestern Ethiopia.MethodsA hospital-based cross-sectional study design was conducted to assess the economic impact and volume of expired medicines available in the public hospitals in Jimma Zone. All available hospitals that fulfilled the EFDA guidelines were included. The medication expiration rate was calculated by dividing the total monetary value of expired medicines in a year by the total value of medicines received in the same year multiplied by 100. Then, the collected data was cleared, filtered, coded, and quantitatively analyzed using the Microsoft Excel 2010 version.ResultsThe average medicine waste rate was 4.87% in the fiscal year of 2019/2020 and 2020/2021 in Jimma Zone public hospitals worth 32,453.3 US$. Additionally, the facility wasted an estimated of 2711.44 US$ on the disposal of expired medicines. The expiration of medicines has been linked to several issues, including near-expiry, irrational prescribing practices, and weak participation of clinicians in medicine selection and quantification of the facility. Additionally, only two hospitals had relatively good storage and handling practices.ConclusionOverall, the expiration rate of medicines in the public hospitals in Jimma Zone was greater than the allowed level of 2%. In order to optimize the allocation of healthcare funds and ensure the appropriate use of pharmacologically significant medications it is vital to conduct a comprehensive examination at the national level within a regional hospitals

The effects of improved sanitation on diarrheal prevalence, incidence, and duration in children under five in the SNNPR State, Ethiopia: study protocol for a randomized controlled trial.

BACKGROUND: Diarrhea is one of the leading causes of death, killing 1.3 million in 2013 across the globe, of whom, 0.59 million were children under 5 years of age. Globally, about 1 billion people practice open defecation, and an estimated 2.4 billion people were living without improved sanitation facilities in 2015. Much of the previous research investigating the effect of improved sanitation has been based on observational studies. Recent studies have executed a cluster-randomized controlled trial to investigate the effect of improved sanitation. However, none of these recent studies achieved a sufficient level of latrine coverage. Without universal or at least a sufficient level of latrine coverage, a determination of the effect of improved latrines on the prevention of diarrheal disease is difficult. This cluster-randomized trial aims to explore the net effect of improved latrines on diarrheal prevalence and incidence in children under five and to investigate the effect on the diarrheal duration. METHOD/DESIGN: A phase-in and factorial design will be used for the study. The intervention for improving latrines will be implemented in an intervention arm during the first phase, and the comparable intervention will be performed in the control arm during the second phase. During the second phase, a water pipe will be connected to the gotts (villages) in the intervention arm. After the second phase is completed, the control group will undergo the intervention of receiving a water pipe connection. For diarrheal prevalence, five rounds of surveying will be conducted at the household level. The first four rounds will be carried out in the first phase to explore the effect of improved latrines, and the last one, in the second phase to examine the combined effects of improved water and sanitation. For documentation of diarrheal incidence and duration, the mother or caregiver will record the diarrheal episodes of her youngest child on the "Sanitation Calendar" every day. Of 212 gotts in the project area, 48 gotts were selected for the trial, and 1200 households with a child under 5 will be registered for the intervention or control arm. Informed consent from 1200 households will be obtained from the mother or caregiver in written form. DISCUSSION: To our knowledge, this is the second study to assess the effects of improved latrines on child diarrheal reduction through the application of Community-Led Total Sanitation. TRIAL REGISTRATION: Current Controlled Trials, ISRCTN82492848

Phenotypic Bacterial Isolates, Antimicrobial Susceptibility pattern and Associated factors among Septicemia Suspected Patients at a hospital, in Northwest Ethiopia: Prospective cross-sectional study

Abstract Background Septicemia is potentially fatal infection caused by pathogenic bacteria infiltrating the bloodstream, resulting in morbidity and mortality among Ethiopian hospital patients. Multidrug resistance is a therapeutic challenge in this patient population. There is an insufficiency data among hospitals in Ethiopia. Hence, this study aimed to assess the phenotypic bacterial isolates, antimicrobial susceptibility pattern, and associated factors among septicemia suspected patients. Methods Prospective cross-sectional study was conducted among 214 septicemia suspected patients from February to June 2021 at Debre Markos Comprehensive Specialized hospital in northwest, Ethiopia. Blood samples were collected aseptically and processed to identify bacterial isolates by using different standard microbiological procedures. Antimicrobial susceptibility pattern was performed using the modified Kirby Bauer disc diffusion on Mueller Hinton agar. Epi-data V4.2 was used to enter data and SPSS V25 for analysis. The variables were assessed using a bivariate logistic regression model with a 95% confidence interval, and declared statistically significant; P-value was < 0.05. Results The overall bacterial isolates was found 45/214 (21%) in this study. Gram-negative and positive bacteria were 25/45(55.6%), 20/45(44.4%) respectively. The most common bacterial isolates were Staphylococcus aureus12/45 (26.7%), Klebsiella pneumoniae 8/45(17.8%), Escherichia coli 6/45 (13.3%). Gram-negative bacteria showed susceptibility to amikacin (88%), meropenem, imipenem (76%) but, (92%) resistance to ampicillin, (85.7%) amoxicillin-clavulanic acid. S.aureus (91.7%) was resistance to Penicillin, (58.3%) cefoxitin and (75%) susceptible to ciprofloxacillin. S.pyogenes and S.agalactia were (100%) susceptible to Vancomacin. Multidrug resistance was found in 27/45(60%) of the bacterial isolates. The main predictors related to patients suspected of septicemia were prolonged hospitalization (AOR = 2.29, 95% CI: 1.18, 7.22), fever (AOR = 0.39, 95%CI: 0.18, 0.85) and length of hospital stay (AOR = 0.13, 95%CI: 0.02, 0.82). Conclusions Incidence of bacterial isolates among septicemia suspected patients were high. The majority of the bacterial isolates were multidrug-resistant. To prevent antimicrobial resistance, specific antibiotic utilization strategy should be applied

Land Use/Land Cover Change Modeling and the Prediction of Subsequent Changes in Ecosystem Service Values in a Coastal Area of China, the Su-Xi-Chang Region

Monitoring the impact of current Land Use/Land Cover (LULC) management practices on future Ecosystem Services (ESs) provisioning has been emphasized because of the effect of such practices on ecological sustainability. We sought to model and predict the impacts of future LULC changes on subsequent changes in Ecosystem Service Value (ESV) in fragile environments undergoing complex LULC changes, Su-Xi-Chang region. After mapping and classifying the LULC for the years 1990, 2000, and 2010 using GIS and remote sensing, a Cellular Automata (CA)–Markov model was employed to model future LULC changes for the year 2020. ESV was predicted using the projected LULC data and the modified ES coefficients adopted by Xie et al. (2003). The projected results of the changes in LULC reveal that construction land expanded extensively, mainly at the expense of farmland, wetland, and water bodies. The predicted results of the ESVs indicate that water bodies and farmland are the dominant LULC categories, accounting for 90% of the total ESV. Over the study period, ESVs were diminished by 7.3915 billion CNY, mostly because of the decrease in farmland, water bodies, and wetland. A reasonable land use plan should be developed with an emphasis on controlling construction land encroachment on farmland, wetlands, and water bodies. The rules of ecological protection should be followed in LULC management to preserve ecological resources

Prevalence and Predictors of Pulmonary Tuberculosis among Prison Inmates in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

Introduction. Prisoners in Sub-Saharan Africa (SSA) are at a high risk of tuberculosis (TB) infection due to overcrowding and poor ventilation. Consequently, TB is a leading cause of morbidity and mortality in prison, and many inmates face a number of barriers to TB control and had limited information in the region. Thus, the aim of this systematic review and meta-analysis was to estimate the overall pooled prevalence of pulmonary TB and predictors among prison inmates in SSA. Methods. From 2006 to 2019, a systematic review and meta-analysis was conducted using various databases, including PubMed, Embase, Web of Science, and Scopus. The data were extracted in Microsoft Excel using a standardized data extraction format, and the analysis was carried out with STATA version 14. To detect heterogeneity across studies, the I2 and the Cochrane Q test statistics were computed. To determine the overall prevalence of TB and predictors among prison populations, a random effect meta-analysis model was used. Results. Of the 3,479 retrieved articles, 37studies comprising 72,844 inmates met the inclusion criteria. The pooled prevalence of pulmonary TB among prison inmates in SSA was 7.74% (95% CI: 6.46-8.47). In the subgroup analysis, the highest prevalence was found in the Democratic Republic Congo (DRC) (19.72%) followed by Zambia (11.68%) and then Ethiopia (9.22%). TB/HIV coinfection (OR 4.99 (95% CI: 2.60-9.58)), Body mass index (BMI<18.5) (OR 3.62 (95% CI: 2.65-6.49)), incarceration (OR 4.52 (95% CI: 2.31-5.68)), and previous TB exposure (OR 2.43 (95% CI: 1.61-3.56)) had higher odds of pulmonary TB among inmates. Conclusion. The prevalence of pulmonary TB among SSA prison inmates was found to be high as compared to total population. TB/HIV coinfection, BMI, incarceration duration, and TB exposure were all predictors with pulmonary tuberculosis in prison inmates. As a result, emphasizing early screening for prisoners at risk of pulmonary TB is an important point to achieving global TB commitments in resource-limited settings