Determinants of long acting and permanent contraceptive methods utilization among married women of reproductive age groups in western Ethiopia: a cross-sectional study

Introduction: In Ethiopia information on the level of utilization of the long term and permanent contraceptive methods and associated factorsis lacking. The aim of this study was to understand the determinant factors of long acting and permanent contraceptive methods use among married women of reproductive age in Western Ethiopia. Methods: A community based cross- sectional study design was employed. Multi stage sampling was used to select 1003 study participants. Data was collected from April 10 to April 25,2014 using a pre- tested structured questionnaire. The data were entered using Epi-info version 3.5.1 and exported to SPSS version 20 for analysis. Multivariate logistic regression analysis was done to identify predictors of long acting and permanent contraceptive methods at 95% CL. Results: Use of long acting and permanent contraceptive methods in this study was found to be 20%. Survey results showed a significant positive association between utilization of long acting and permanent contraceptive methods and women's education (AOR=1.72, 95%CI = 1.02 - 3.05), women's occupation (AOR = 2.01, 95% CI = 1.11 - 3.58), number of live children (AOR = 2.42, 95% CI: 1.46- 4.02), joint fertility related decision (AOR = 6.11, 95% CI: 2.29- 16.30), having radio/TV (AOR = 2.31, 95% CI: 1.40 - 3.80), and discussion with health care provider about long acting and permanent contraceptive methods (AOR = 13.72, 95% CI: 8.37 - 22.47). Conclusion: Efforts need to be aimed at women empowerment, health education, and encouraging open discussion of family planning by couple

Pengaruh Promosi Terhadap Loyalitas Nasabah Di PT. Bank Mandiri Kantor Cabang Dotulolong Lasut Manado.

PT. Bank Mandiri Branch Office Dotulolong lasut Manado realized that to stimulate customer loyalty, then the sale becomes important in influencing the loyalty of its customers. The purpose of this study was to determine whether there is a relationship between customer loyalty promotion with the PT. Bank Mandiri Branch Office Dotulolong Lasut Manado. The method used in this research is quantitative method associative approach and datasource are customers of PT. Bank Mandiri Branch Office Dotulolong Lasut Manado. The result showed that, there is a significant relationship between promotion with customer loyalty in the PT. Bank Mandiri Branch Office Dotulolong Lasut Manado, where the relationship is detected at r = 0.73 .Perhitungan KP detected that the factors determining the sale of 52.8% Changes in customer loyalty factor while 42.8% Changes in customer loyalty determined other factors. It is recommended that PT Bank Mandiri Branch Office Manado keep doing promotion to continue to stimulate the customer so that it can improve their Clients Loyalty. This also will affect postitif not only short term but also for the long term. Keywords: Promotion, Customer Loyalty

Dexketoprofen/tramadol 25 mg/75 mg: randomised double-blind trial in moderate-to-severe acute pain after abdominal hysterectomy

Statistical Analysis of TOTPAR over 2, 4, 6 and 8 h (ANCOVA) (ITT Population) (single-dose phase). (DOCX 16 kb

Towards sustainable processing of columbite group minerals: elucidating the relation between dielectric properties and physico-chemical transformations in the mineral phase

Current methodologies for the extraction of tantalum and niobium pose a serious threat to human beings and the environment due to the use of hydrofluoric acid (HF). Niobium and tantalum metal powders and pentoxides are widely used for energy efficient devices and components. However, the current processing methods for niobium and tantalum metals and oxides are energy inefficient. This dichotomy between materials use for energy applications and their inefficient processing is the main motivation for exploring a new methodology for the extraction of these two oxides, investigating the microwave absorption properties of the reaction products formed during the alkali roasting of niobium-tantalum bearing minerals with sodium bicarbonate. The experimental findings from dielectric measurement at elevated temperatures demonstrate an exponential increase in the values of the dielectric properties as a result of the formation of NaNbO3-NaTaO3solid solutions at temperatures above 700 °C. The investigation of the evolution of the dielectric properties during the roasting reaction is a key feature in underpinning the mechanism for designing a new microwave assisted high-temperature process for the selective separation of niobium and tantalum oxides from the remainder mineral crystalline lattice

Electroencephalographic Findings, Antiepileptic Drugs and Risk Factors of 433 Individuals Referred to a Tertiary Care Hospital in Ethiopia

Background: Little is known about the characteristics of electroencephalogram (EEG) findings in epileptic patients in Ethiopia. The objective of this  study was to characterize the EEG patterns, indications, antiepileptic drugs (AEDs), and epilepsy risk factors.Methods: A retrospective observational review of EEG test records of 433 patients referred to our electrophysiology unit between July 01, 2020 and  December 31, 2021.Results: The age distribution in the study participants was right skewed unipolar age distribution for both sexes and the mean age of 33.8 (SD=15.7) years. Male accounted for 51.7%. Generalized tonic clonic seizure was the most common seizure type. The commonest indication for EEG was  abnormal body movement with loss of consciousness (35.2%). Abnormal EEG findings were observed in 55.2%; more than half of them were Interictal epileptiform discharges, followed by focal/or generalized slowing. Phenobarbitone was the commonest AEDs. A quarter (20.1%) of the  patients were getting a combination of two AEDs and 5.2% were on 3 different AEDs. Individuals taking the older AEDs and those on 2 or more AEDs  tended to have abnormal EEG findings. A cerebrovascular disorder (27.4%) is the prevalent risk factor identified followed by brain tumor, HIV  infection, and traumatic head injury respectively.Conclusion: High burden of abnormal EEG findings among epileptic patients referred to our unit. The proportion of abnormal EEG patterns was  higher in patients taking older generation AEDs and in those on 2 or more AEDs. Stroke, brain tumor, HIV infection and traumatic head injury were  the commonest identified epilepsy risk factors

Smallholder farmers' adaptation to climate change and determinants of their adaptation decisions in the Central Rift Valley of Ethiopia

Background: The agricultural sector remains the main source of livelihoods for rural communities in Ethiopia, but faces the challenge of changing climate. This study investigated how smallholder farmers perceive climate change, what adaptation strategies they practice, and factors that influence their adaptation decisions. Both primary and secondary data were used for the study, and a multinomial logit model was employed to identify the factors that shape smallholder farmers’ adaptation strategies. Results: The results show that 90% of farmers have already perceived climate variability, and 85% made attempts to adapt using practices like crop diversification, planting date adjustment, soil and water conservation and management, increasing the intensity of input use, integrating crop with livestock, and tree planting. The econometric model indicated that education, family size, gender, age, livestock ownership, farming experience, frequency of contact with extension agents, farm size, access to market, access to climate information and income were the key factors determining farmers’ choice of adaptation practice. Conclusion: In the Central Rift Valley of Ethiopia, climate change is a pressing problem, which is beyond the capacity of smallholders to respond to autonomously. Farmers’ capacity to choose effective adaptation options is influenced by household demography, as well as positively by farm size, income, access to markets, access to climate information and extension, and livestock production. This implies the need to support the indigenous adaptation strategies of the smallholder farmers with a wide range of institutional, policy, and technology support; some of it targeted on smaller, poorer or female-headed households. Moreover, creating opportunities for non-farm income sources is important as this helps farmers to engage in those activities that are less sensitive to climate change. Furthermore, providing climate change information, extension services, and creating access to markets are crucial

Basic aspects of the pharmacodynamics of tolperisone, a widely applicable centrally acting muscle relaxant

Tolperisone (2-methyl-1-(4-methylphenyl)-3-piperidin-1-ylpropan-1-one hydro-chloride) was introduced in the clinical practice more than forty years ago and is still evaluated as a widely applicable compound in pathologically elevated skeletal muscle tone (spasticity) and related pains of different origin. In the present review, basic pharmacodynamic effects measured on whole animals, analyses of its actions on cell and tissue preparations and molecular mechanism of action on sodium and calcium channels are summarized as recently significantly new data were reported

Global, regional, and national prevalence and mortality burden of sickle cell disease, 2000–2021: a systematic analysis from the Global Burden of Disease Study 2021

Background Previous global analyses, with known underdiagnosis and single cause per death attribution systems, provide only a small insight into the suspected high population health effect of sickle cell disease. Completed as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, this study delivers a comprehensive global assessment of prevalence of sickle cell disease and mortality burden by age and sex for 204 countries and territories from 2000 to 2021. Methods We estimated cause-specific sickle cell disease mortality using standardised GBD approaches, in which each death is assigned to a single underlying cause, to estimate mortality rates from the International Classification of Diseases (ICD)-coded vital registration, surveillance, and verbal autopsy data. In parallel, our goal was to estimate a more accurate account of sickle cell disease health burden using four types of epidemiological data on sickle cell disease: birth incidence, age-specific prevalence, with-condition mortality (total deaths), and excess mortality (excess deaths). Systematic reviews, supplemented with ICD-coded hospital discharge and insurance claims data, informed this modelling approach. We employed DisMod-MR 2.1 to triangulate between these measures—borrowing strength from predictive covariates and across age, time, and geography—and generated internally consistent estimates of incidence, prevalence, and mortality for three distinct genotypes of sickle cell disease: homozygous sickle cell disease and severe sickle cell β-thalassaemia, sickle-haemoglobin C disease, and mild sickle cell β-thalassaemia. Summing the three models yielded final estimates of incidence at birth, prevalence by age and sex, and total sickle cell disease mortality, the latter of which was compared directly against cause-specific mortality estimates to evaluate differences in mortality burden assessment and implications for the Sustainable Development Goals (SDGs). Findings Between 2000 and 2021, national incidence rates of sickle cell disease were relatively stable, but total births of babies with sickle cell disease increased globally by 13·7% (95% uncertainty interval 11·1–16·5), to 515 000 (425 000–614 000), primarily due to population growth in the Caribbean and western and central sub-Saharan Africa. The number of people living with sickle cell disease globally increased by 41·4% (38·3–44·9), from 5·46 million (4·62–6·45) in 2000 to 7·74 million (6·51–9·2) in 2021. We estimated 34 400 (25 000–45 200) cause-specific all-age deaths globally in 2021, but total sickle cell disease mortality burden was nearly 11-times higher at 376 000 (303 000–467 000). In children younger than 5 years, there were 81 100 (58 800–108 000) deaths, ranking total sickle cell disease mortality as 12th (compared to 40th for cause-specific sickle cell disease mortality) across all causes estimated by the GBD in 2021. Interpretation Our findings show a strikingly high contribution of sickle cell disease to all-cause mortality that is not apparent when each death is assigned to only a single cause. Sickle cell disease mortality burden is highest in children, especially in countries with the greatest under-5 mortality rates. Without comprehensive strategies to address morbidity and mortality associated with sickle cell disease, attainment of SDG 3.1, 3.2, and 3.4 is uncertain. Widespread data gaps and correspondingly high uncertainty in the estimates highlight the urgent need for routine and sustained surveillance efforts, further research to assess the contribution of conditions associated with sickle cell disease, and widespread deployment of evidence-based prevention and treatment for those with sickle cell disease.publishedVersio