Medical Students’ Attitudinal Changes towards Cadaver Dissection: A Longitudinal Study

Background: Recently, not only the medical school curriculum but also medical students’ attitude towards cadaver-based learning of anatomy has changed. This investigation is therefore designed to analyse students’ attitudes towards human cadaveric dissection before and after exposure to dissection.Methods: A longitudinal survey was conducted among second year medical students in 2010 at the college of Medicine and Health Sciences, University of Gondar. All second year medical students (n=147) were included in the study where their attitudes were surveyed at three time points (one week prior to dissection session, a week after the initiation of dissection and eight weeks after the second survey). Three standardized and pretested questionnaires prepared in English were used to collected relevant data from the subjects.Results: Out of the 147 students 85.7% were males. The subjects’ age ranged between 18 and 23 with a mean and standard deviation of 19.5±1 years. This study has revealed that among majority of the students fear and nausea have decreased while their interest and excitement has increased on subsequent exposure to dissection (P<0.05). About 75% of students considered the dissection room as slightly or highly stressful. Smell of the cadaver and eye irritation as a result of the chemicals in it were the major aspects identified as making the dissecting room stressful. The result also showed that almost all (99%) considered cadaver dissection had very important educational value for anatomy learning.Conclusion: In the majority of the students fear and nausea had decreased while interest and excitement had increased on subsequent exposure to dissection. It also showed that chemical odour and eye irritations were the leading factors which create discomfort in the dissection room even though anatomical dissection by itself was not considered as a stressor. Thus, instructors are recommended to adequately prepare students mentally and emotionally before the commencement of the dissection session for an exciting and stress free anatomy learning though dissection

Risk factors for multidrug resistant tuberculosis patients in Amhara National Regional State.

Background: Multidrug resistant tuberculosis(MDR-TB) is becoming a major threat to tuberculosis control programs in Ethiopia.Objectives: To determine risk factors of MDR-TB patients in Amhara National Regional State, Ethiopia.Methods: Case-control study was conducted from May 2013 to January 2014. Resistance to rifampicin and isoniazid were done molecularly using line probe assay. TB patients infected with MDR-M.tuberculosis and non MDR-M.tuberculosis strain were considered as cases and controls, respectively. Data was collected using structured questionnaire with face to face interview. Patients’ clinical record review was also done.Multivariate analysis was computed to determine the risk factors of MDR-TB.Results: A total of 153 MDR-TB and equal number of non MDR-TB patients’ participated in the study. Patients who had TB treatment failure (AOR=13.5,CI=2.69-70), cavitations on chest x-ray (AOR=1.9,CI=1.1-3.38) and contact with MDR-TB patients (AOR=1.4,CI=0.19-0.39) were more likely to be MDR-TB patients. Low monthly income (AOR=1.1,CI=0.34-0.47),alcohol consumption (AOR=1.5,CI=0.2-0.98) and young age (AOR=2.9,CI=1.07-7.68) were the other risk factors of MDR-TB.Conclusions: TB treatment failure, cavitation on chest X-ray, contact with MDR-TB patients and low socioeconomic status were important risk factors for development of MDR-TB. Therefore, strict adherence to directly observed therapy, appropriate management of TB patients and advice on the value of nutrients are helpful to control the spreading of MDR-TB.Key words: Risk factors, MDR-TB, Ethiopia

Hepatotoxicity and Associated Risk Factors in Hiv-Infected Patients Receiving Antiretroviral Therapy at Felege Hiwot Referral Hospital, Bahirdar, Ethiopia

Background: In Human Immunodeficiency Virus (HIV) infected patients on antiretroviral treatment (ART), hepatotoxicity is life threatening. Its outcome may lead to liver failure and death. This study was conducted to determine the rate and determinants of elevated alanine amino transferase (ALT) (referred as >40IU/L for both males and females).Methods: A cross sectional study was conducted on HIV infected individuals who are on ART and suspected of drug resistance at Felege Hiwot Referral Hospital, Bahir Dar from July to December 2012. Venous bloods were collected from each patient and processed parallely to determine ALT, number of HIV RNAs, CD4 and CD8 T cells count, anti hepatitis C virus (HCV) and hepatitis B surface antigen.Results: Out of 269 HIV infected patients receiving ART, 32% were confirmed of grades 1-4 levels of elevated ALT. The rate of severe hepatotoxicity (grade 3 and 4) was 1.84%. Patients with increased CD8 T cell counts (P=0.011; AOR=1.82; CI: 1.12 - 2.54), alcohol over use (P=0.014; AOR = 1.23; CI: 1.36- 3.29) and detectable HIV-1 RNA copies (P=0.015; AOR=2.07; CI: 1.15-3.74) independently predicts the elevation of ALT.Conclusions: In HIV infected patients on ART, extreme elevations of ALT were infrequent but minor elevations were common so that patient-linked variables such as use of alcohol intake must be taken in to account for better clinical management of ART patients. The role of active HCV co-infection on the treatment outcome of ART should be further studied.Key words: ALT, HIV, ART, Bahir Dar, Ethiopi

Brief Communication: Comparison of formol-acetone concentration method with that of the direct iodine preparation and formol-ether concentration methods for examination of stool parasites

Background: Formol-ether concentration technique is taken as a gold standard method to detect most intestinal parasites; however, because of its low safety and hazardous impact a need for better technique has a paramount importance.Objective: To evaluate a formol- acetone concentration method in comparison with the conventional direct iodine preparation and formol- ether concentration methods in detecting intestinal parasites.Methods: A total of 382 stool samples were collected from Tseda elementary school children, in 2006. Samples were processed and examined using formol-acetone concentration, the direct iodine stained smear, and formol-ether concentration methods.Results: Formol-ether detected 79.1% of parasites followed by formol-acetone (73.6%) and direct iodine preparation (50.3%). Statistical (P< 0.05) difference was observed for the detection of over all positivity of any parasites between the two concentration methods. However, the sensitivity, specificity, and positive predicative value of formol-acetone were 88.1%, 81.3%, and 94.7%, respectively respective to formol-ether method. Almost similar detection ability was also observed by the two concentration methods for A. lumbricoids, H. nana, T. trichuira, and S. stercoralis. However, there was difference in the detection rate of hookworm and S. mansoni.Conclusions: for safety and hazard free laboratory set up, this new method might be used as an alternative choice for formol-ether concentration method. [Ethiop. J. Health Dev. 2010;24(2):148-151

Tragic and heroic moments in the lives of forced migrants : memories of political asylum-seekers in post-apartheid South Africa

This article examines the memories of a group of Cameroonian asylum-seekers in South Africa, analyzing personal accounts of memories of fear, suffering, and pain as well as resilience and heroism during their forced migration. The article argues that the legitimacy of applications for asylum often depends on accurate and consistent memories of specific life-threatening episodes at home and during migration. Drawing on theoretical conceptions such as construction of memory, autobiographical memory, and politics of storytelling, this article teases out how personal memories of asylum-seekers provide a discursive space to access and understand the asymmetries of seeking political asylum in post-apartheid South Africa.Cet article étudie les souvenirs d’un groupe de chercheurs d’asile d’origine camerounaise en Afrique du Sud. Il analyse leurs témoignages personnels de souvenirs associés à la peur, la souffrance et la douleur, ainsi que ceux de la persévérance et de l’héroïsme lors de leur migration forcée. L’article maintient que la légitimité des demandes d’asile dépend souvent des souvenirs précis et cohérents de situations spécifiques impliquant un danger de mort qu’ils ont subies dans leurs pays ainsi que lors de la migration. En faisant appel à des conceptions théoriques telles que la construction de la mémoire, la mémoire autobiographique, et la politique des récits narratifs, l’article fait ressortir la façon dont les souvenirs personnels des chercheurs d’asile produisent un espace discursif pour accéder et comprendre la dimension asymétrique inhérente à la recherche d’un asile politique en Afrique du Sud post-apartheid.http://road.issn.org/issn/1920-7336-refuge-#.WTjvBWz_qM8am2017Unit for Academic Literac

Diagnosing the time-dependence of active region core heating from the emission measure: I. Low-frequency nanoflares

Observational measurements of active region emission measures contain clues to the time-dependence of the underlying heating mechanism. A strongly non-linear scaling of the emission measure with temperature indicates a large amount of hot plasma relative to warm plasma. A weakly non-linear (or linear) scaling of the emission measure indicates a relatively large amount of warm plasma, suggesting that the hot active region plasma is allowed to cool and so the heating is impulsive with a long repeat time. This case is called {\it low-frequency} nanoflare heating and we investigate its feasibility as an active region heating scenario here. We explore a parameter space of heating and coronal loop properties with a hydrodynamic model. For each model run, we calculate the slope $\alpha$ of the emission measure distribution $EM(T) \propto T^\alpha$. Our conclusions are: (1) low-frequency nanoflare heating is consistent with about 36% of observed active region cores when uncertainties in the atomic data are not accounted for; (2) proper consideration of uncertainties yields a range in which as many as 77% of observed active regions are consistent with low-frequency nanoflare heating and as few as zero; (3) low-frequency nanoflare heating cannot explain observed slopes greater than 3; (4) the upper limit to the volumetric energy release is in the region of 50 erg cm$^{-3}$ to avoid unphysical magnetic field strengths; (5) the heating timescale may be short for loops of total length less than 40 Mm to be consistent with the observed range of slopes; (6) predicted slopes are consistently steeper for longer loops

Evaluation of the diagnostic performance of PanbioTM Abbott SARS-CoV-2 rapid antigen test for the detection of COVID-19 from suspects attending ALERT center

BACKGROUND: The emergence and rapid spread of coronavirus disease 2019 (COVID-19), a potentially lethal disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is causing public health issues around the world. In resource-constrained nations, rapid Abbott SARS-CoV-2 antigen test kits are critical for addressing diagnostic gaps in health institutions and community screening. However, there is no evidence or proof of diagnostic performance in Ethiopia. The aim of this study was to compare the performance of PanbioTM Abbott SARS-CoV-2antigen rapid test kit to the gold standard, RT-PCR, in COVID-19 patients with clinical symptoms suggestive of COVID-19. METHOD: A prospective, cross-sectional study was conducted between November 2021 and April 2022, on 120 suspected patients recruited from outpatient, emergency, and intensive care units in one of the tertiary hospitals in Ethiopia. Nasopharyngeal swabs were collected from suspected cases and were tested using the Abbott SARS-CoV-2 kit, a rapid diagnostic test (RDT) and compared to the reference standard RT-PCR. RESULT: The sensitivity and specificity of the RDT were 74.2% and 100%, respectively. A total of 62 samples (51.6%) were RT-PCR positive. Of these, 46 were Ag-RDT positive. Sensitivity among symptomatic patients was 79.4% (95% CI 68.3-90). The Abbot RDT and RT-PCR had a Kappa value of agreement of 0.735 (p < 0.001). These values were acceptable when compared to the WHO's suggested thresholds. CONCLUSION: The finding from this study support the use of the Abbot RDT as a diagnostic tool in COVID-19 suspects, mainly in those with higher viral loads

Characterizing the unmet HIV prevention needs and HIV risk vulnerabilities of adolescent girls and young women in Ethiopia

Although the disparity in HIV prevalence among young women and their male counterparts is not new, there is increasing recognition that addressing the unmet HIV prevention needs among AGYW is necessary to achieve epidemic control. In Ethiopia, data characterizing unmet HIV prevention needs and HIV risk vulnerabilities among AGYW, particularly out of school AGYW, have been limited. Armauer Hansen Research Institute and Johns Hopkins Bloomberg School of Public Health through Project SOAR conducted an integrated HIV biobehavioral survey (IBBS) focused on out-of-school adolescent girls and young women (AGYW) aged 15–24 years to assess AGYW HIV risk vulnerability. The purpose of the IBBS was to estimate HIV and STI prevalence among AGYW and to assess HIV risk vulnerability. Prior to conducting the IBBS, formative work mapped potential recruitment locations to reach out-of-school AGYW. Stakeholder engagement was also conducted, including engagement with the Federal HIV/AIDS Prevention and Control Office (FHAPCO), to ensure that the IBBS filled identified data gaps

Identification and Characterization of AES-135, a Hydroxamic Acid-Based HDAC Inhibitor That Prolongs Survival in an Orthotopic Mouse Model of Pancreatic Cancer

Pancreatic ductal adenocarcinoma (PDAC) is an aggressive, incurable cancer with a 20% 1 year survival rate. While standard-of-care therapy can prolong life in a small fraction of cases, PDAC is inherently resistant to current treatments, and novel therapies are urgently required. Histone deacetylase (HDAC) inhibitors are effective in killing pancreatic cancer cells in in vitro PDAC studies, and although there are a few clinical studies investigating combination therapy including HDAC inhibitors, no HDAC drug or combination therapy with an HDAC drug has been approved for the treatment of PDAC. We developed an inhibitor of HDACs, AES-135, that exhibits nanomolar inhibitory activity against HDAC3, HDAC6, and HDAC11 in biochemical assays. In a three-dimensional coculture model, AES-135 kills low-passage patient-derived tumor spheroids selectively over surrounding cancer-associated fibroblasts and has excellent pharmacokinetic properties in vivo. In an orthotopic murine model of pancreatic cancer, AES-135 prolongs survival significantly, therefore representing a candidate for further preclinical testing

High seroprevalence of anti-SARS-CoV-2 antibodies among Ethiopian healthcare workers

BACKGROUND: COVID-19 pandemic has a devastating impact on the economies and health care system of sub-Saharan Africa. Healthcare workers (HWs), the main actors of the health system, are at higher risk because of their occupation. Serology-based estimates of SARS-CoV-2 infection among HWs represent a measure of HWs' exposure to the virus and could be used as a guide to the prevalence of SARS-CoV-2 in the community and valuable in combating COVID-19. This information is currently lacking in Ethiopia and other African countries. This study aimed to develop an in-house antibody testing assay, assess the prevalence of SARS-CoV-2 antibodies among Ethiopian high-risk frontline HWs. METHODS: We developed and validated an in-house Enzyme-Linked Immunosorbent Assay (ELISA) for specific detection of anti-SARS-CoV-2 receptor binding domain immunoglobin G (IgG) antibodies. We then used this assay to assess the seroprevalence among HWs in five public hospitals located in different geographic regions of Ethiopia. From consenting HWs, blood samples were collected between December 2020 and February 2021, the period between the two peaks of COVID-19 in Ethiopia. Socio-demographic and clinical data were collected using questionnaire-based interviews. Descriptive statistics and bivariate and multivariate logistic regression were used to determine the overall and post-stratified seroprevalence and the association between seropositivity and potential risk factors. RESULTS: Our successfully developed in-house assay sensitivity was 100% in serum samples collected 2- weeks after the first onset of symptoms whereas its specificity in pre-COVID-19 pandemic sera was 97.7%. Using this assay, we analyzed a total of 1997 sera collected from HWs. Of 1997 HWs who provided a blood sample, and demographic and clinical data, 51.7% were females, 74.0% had no symptoms compatible with COVID-19, and 29.0% had a history of contact with suspected or confirmed patients with SARS-CoV-2 infection. The overall seroprevalence was 39.6%. The lowest (24.5%) and the highest (48.0%) seroprevalence rates were found in Hiwot Fana Specialized Hospital in Harar and ALERT Hospital in Addis Ababa, respectively. Of the 821 seropositive HWs, 224(27.3%) of them had a history of symptoms consistent with COVID-19 while 436 (> 53%) of them had no contact with COVID-19 cases as well as no history of COVID-19 like symptoms. A history of close contact with suspected/confirmed COVID-19 cases is associated with seropositivity (Adjusted Odds Ratio (AOR) = 1.4, 95% CI 1.1-1.8; p = 0.015). CONCLUSION: High SARS-CoV-2 seroprevalence levels were observed in the five Ethiopian hospitals. These findings highlight the significant burden of asymptomatic infection in Ethiopia and may reflect the scale of transmission in the general population