Cathepsin L and dynamin-biomarkers of proteinuric renal disease

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in partial fulfilment for the degree of Master of Medicine in Internal Medicine Johannesburg 2016Background Chronic kidney disease (CKD) is a major public health problem. It is important to be able to identify those individuals at high risk of CKD progression in order to implement strategies to delay progression to end stage renal disease. Hence, early more sensitive biomarkers are required. Recently, promising new biomarkers have been identified for monitoring CKD progression. Objectives To determine whether Dynamin and Cathepsin L can be used as biomarkers for proteinuric chronic kidney disease (CKD). To compare the levels of Dynamin and Cathepsin L in serum and urine of participants with proteinuric kidney disease to those of normal controls. To determine if the levels of Cathepsin L and Dynamin correlates with the degree of proteinuria. Methods A prospective study of 37 patients with proteinuric kidney disease versus a healthy control group of 40 individuals, where the serum and urine levels of Cathepsin L and Dynamin were determined using an Enzyme Linked immunosorbent assay and the levels compared between the two groups. Data Analysis v The sample size was determined from previous similar studies, with assistance of a statistician. Sample size was calculated by comparing the means of the groups where the average value for sample 1= 1.0 (standard deviation=0.5); average value sample 2= 1.5 (standard deviation=0.5; alpha= 5% and beta= 20%. A sample size of 20 was initially selected for the kidney disease group and 20 for the Control group (to give a 1:1 ratio). The numbers were there after doubled to increase sample size in order to improve the statistics. An independent sample t-test was used to assess whether the mean serum Dynamin, urine Dynamin, serum Cathepsin L and urine Cathepsin L differed for the control group compared with kidney disease group. Pearson’s correlation analysis was used to measure the strength of the relationship between variables. Statistical significance was p<0.05. Results There was a significant increase in the level of urine Cathepsin L in the renal disease group 10.44±11.47 pg/ml compared with the control group 2.91±2.88 pg/ml; p= 0.000. There was no difference in the levels of serum Cathepsin L between the renal disease and the control groups (p= 0.23). There were no significant differences in the levels of Dynamin in the serum and urine of patients with proteinuric renal disease and controls (p-values 0.11 and 0.13 respectively). Although serum Cathepsin L (r = -0.22, p-value = 0.19), urine Cathepsin (r = -0.07, p-value = 0.68), and urine Dynamin (r = -0.04, p-value = 0.83) are negatively related to the degree of proteinuria, the correlation is not significant; all the p-values were greater than 0.05. Serum Dynamin (r = 0.12, p-value = 0.49) had a positive correlation to the degree of proteinuria but vi the correlation was not significant at the 5% significance level. Thus, there is no correlation between Cathepsin L and Dynamin levels with the degree of proteinuria. Discussion Podocyte dysfunction is a key element in understanding the progression of CKD resulting in proteinuria. In this study, levels of Cathepsin L and Dynamin were determined in participants with proteinuric renal disease and compared with healthy controls. Cathepsin L levels were elevated in the urine of the renal disease group, in keeping with the notion that Cathepsin L proteolysis plays a critical role in the various forms of proteinuria. There was negative correlation between the levels of proteinuria and Dynamin in the serum; however the correlation was not significant statistically. Conclusion Cathepsin L could potentially serve as a biomarker of proteinuric kidney disease.MT201

School Choice And Policy Response: A Comparative Context Between Private And Public Schools In Urban Ethiopia

Given today’s appetite and search for better quality education in Ethiopia, coupled with meager educational budget available for the sector, little attention has been given to see the comparative advantage of demand side financing in education. In the 1960s, 1970s and 1980s, the state-run education system was criticized for being elitist, rigid and irresponsive. Today, more than ever, there is a constant public out cry for access to quality educational services both in urban and rural settings. The starting point for school choice is the availability of private schooling. School choice is believed to increase the efficiency of educational services by encouraging competition and sharpening innovations in the sector. On top of that, it will help to strengthen publicprivate partnership to supplement the limited government capacity to expand educational opportunities and better target public subsidies to the poor. Many economists also think that school choice will bring about consumer satisfaction and could be regarded as the best measure of a product’s quality. The 1994 Education and Training Policy of Ethiopia also claim to establish conditions to encourage and support private investment in education. However, there is a view that its implementation has problems and little has been achieved in this direction

Assessment of Major Honey Bee Forage Resources and Floral Calendar Establishment in Selected Districts of Arsi Zone, Oromia Region State, Ethiopia

The study was conducted from 2015 to 2017 G.C. with the objective of identifying and documenting honey bee forage plant resource, establishing flowering calendar and recommending the necessary seasonal colony management practices in selected districts of Arsi zone. Semi-structured questionnaire tool was used to collect data. Ninety beekeepers were selected and involved in data collection. Traditional, transitional and modern bee hives were used for honey production. The overall mean of colony owned per household in the current study areas was found to be 5.2+5.2. Honey production was conducted during two seasons namely: major and minor seasons. The mean of honey yield per traditional, transitional and modern hive was 10.8+5.9kg, 19.8+17.3kg and 33.2+48.9kg, respectively. 61.1% of the respondents harvest honey two times a year, whereas 34.5% of them harvest honey once a year and 4.4% of respondents three times a year. Honeybee was found to be in critical shortage of forage during months ranging from December to August. A total of 98 plant floras including trees, shrubs, herbs, cultivated crops and animal feeds and grasses were identified in the current study areas. Guizotia scabra, equiliptus globules and vernonia species were the most frequently identified plant species. The knowledge in the identification of honey bee flora and their flowering time has therefore paramount importance in assisting beekeepers to establish appropriate colony management calendar and honey flow season. Further detail studies focusing on bee flora should be conducted and awareness creation of experts and farmers on seasonal management of beehives through training is required. Keywords: honey bee, bee flora, flowering time, Arsi, Ethiopia DOI: 10.7176/JRDM/83-02 Publication date:March 31st 202

Climate Variability and Drought in the Past 30 Years in Central Rift Valley of Ethiopia

The study carried out in order to analyze climate variability and drought in Rift Valley of Ethiopia. Hence, a number of analyses, such as: the Precipitation Concentration Index (PCI) and Coefficient of Variation (CV) methods are used for rainfall variability, Markov chain second order method were used in order to analysis dry spell length, while standardized rainfall anomaly were used for drought severity class. From the analysis the annual rainfall was less variable for all stations; while the seasonal variability was higher as computed using both PCI and CV methods. When the main rainy season variability was compared with the second rainy season “Belg”, the second rainy season was more variable for all stations. As a result, PCI value showed that Belg rainfall varied from moderate concentration to high concentration. By using INSTAT software, the historical onset and cessation date and characteristics of dry spells were investigated. It is understood that the main rainy season starts on the 174th day of the year and stops on the early second decade of September. But the variability of onset rainfall is high it may lag up to 1 month while cession data is not exceed 15 days for all stations. The 5 day probability of dry spell in the area is more than 75% even during rainy season, while 30 day dry spell is not exceed 50% even during dry season. Most of the drought years were associated for each station; even if for some station the occurrence of drought year varies by one year. But 1965, 1972-73, 1978, 1980, 1984, 1994, 1995, 2001-02, 2009 and 2014/15 show that almost all station indict there was drought index in the study area even though the drought severity degree was different. The drought frequency and intensity in central rift valley of Ethiopia is increasing trend, among 31 severe droughts 21 of them happened before 1980. Keywords: Rainfall variability, Drought, SPI, PCI, Dry spell

Assessment of risky sexual practices with respect to HIV among South African young adults.

South Africa is one of the countries hardest hit by the HIV/AIDS pandemic in the world. With ever increasing prevalence rates of HIV infection, those who fall within the 14 - 29 years age group remain the population most at risk for HIV/AIDS. In spite of educational and awareness campaigns, the rates of new infections continues to rise among this age group, suggesting that these campaigns alone may not be as effective as was initially envisioned. Research exploring factors that may mediate or moderate the relation between HIV awareness and knowledge and behaviour has proliferated in recent years. The present study investigates whether the Health Belief Model constructs predict and perhaps moderate the relation between HIV knowledge / awareness and Risky sexual practices. The study further explores the role of Sexual orientation and attempts to reflect on the question of whether education and awareness programmes should be tailored for specific sub-populations. The sample consisted of 200 second year university students from the Humanities Faculty at the University of the Witwatersrand. Participants completed a survey of questions that consisted of Demographic information, Sexual Practices Questionnaire, HIV Knowledge Questionnaire, an AIDS Health Belief scale and Generalized Self efficacy Scale. Results yielded a significant relation between Perceived benefit (Health Belief Model construct) and HIV knowledge. No other significant differences were identified between the other variables

CONSTRUCTION WORK AND THE HOUSEKEEPING CHALLENGE IN LESOTHO

Published Conference ProceedingA key element of advances in site management practice is the provision of an environment in which construction work is completed without exposing people to harm. Among other issues, the removal of physical hazards on construction sites is dependent on housekeeping, which is a source of genuine worry in the industry in Maseru, Lesotho. With improvement intentions, this paper reports the outcome of a research, which sought responses to "why is housekeeping a continuing challenge in Lesotho construction?" Using a multiple case study research design in which the field work involve direct site observations and focus group interviews of construction site management and workers, the study established the poor state of housekeeping in Lesotho. The use of the 5-Why root cause analysis shows that unsafe work practices go hand-in-hand with poor housekeeping on observed project sites. Inadequate method of keeping the construction site clean was worsened by poor storage and disposal of materials and wastes on the sites. The importance of housekeeping in a craft based industry, such as Lesotho, is hinged on the health, safety, and wellbeing of workers, apart from site productivity. The evidence from the research shows that it is time for multi-stakeholder interventions that would eliminate poor housekeeping in the industry. Such interventions should apply behaviour-based safety techniques to support the efforts of compliance-based safety

Effectiveness of Adaptation Measures Taken by Farmers in the Field of Effects of Climate Change in the Coastal Department in Benin

It is evident that climate change affects the well being of farmers and increases their vulnerability in the future if no action is taken into account by them. In fact, Various adaptation measures, such as crop diversification, changes in the dates of semi and crops, use of seed and fertilizer varieties, irrigation, use of tractors etc. are carried out by Farmers. However, these different measures have not yet had the same effect in reducing the negative effects of climate change on agriculture. Thus, this paper aims at evaluating empirically assess the effectiveness of these measures or strategies of adaptations on the performance of farms in Benin. Using the estimation technique of MCO, estimating the technical efficiency of farmers\u27 production reveals that the use of improved seeds and fertilizers also reduces the negative impact of climate change In addition, land irrigation and the number of weeding remain influential factors for which we do not have the necessary statistics to assess their efficiencie

The dynamics of on-farm management of sorghum in Ethiopia: Implication for the conservation and improvement of plant genetic resources

On-farm conservation of plant genetic resources for food and agriculture has received strong support worldwide in recent years. It has been justified on appealing assumptions: it complements ex situ conservation, allows co-evolutionary interaction of host-pathogens and crop-weed complexes, and involves local knowledge systems. This article illustrates how on-farm conservation being set for its sake is extremely difficult under farmers' dynamic management of plant genetic resources based on sorghum. The dynamics of their management could be explained by continued introduction, displacement, loss and maintenance of aboriginal landraces that have distinct functional attributes, patch-occupancy and relative abundance profiles. Such management and hence the dynamic landrace demography has largely been triggered by co-evolving biophysical stresses, spatial and seasonal variations. The best viable alternative to support farmers' management of genetic resources is to link conservation to crop improvement both to enhance on-farm genetic diversity and make the biophysical environment a comfortable home for the plant genotype

Pattern of Admission and Outcome of Neonate Admitted to Adama Hospital Medical College Neonatal Intensive Care Unit, Adama, Ethiopia

Background: Neonatal morbidity and mortality remains a major health problem, and contributes largely to under-five mortality, especially in developing countries. Hence, identifying the reasons for neonatal admission and outcomes in a hospital setting is important to improve the quality of existing practices in the hospital.Objective: The aim of this study was to assess the pattern of admission and outcomes of neonates admitted to Adama Hospital Medical College, Neonatal Intensive Care Unit (NICU).            Method: Institution based cross sectional study design was conducted. A total of 384 selected neonates who were admitted to Adama Hospital Medical College, Neonatal Intensive Care Unit (NICU) from 11/09/2015 to 10/09/2016 were included in this study. The data was collected using data collection check list. By using SPSS version 20, simple frequency and bivariate logistic regression used to summarize socio-demographic and other variables.  95% CI and P value less than 0.05 were considered statistically significant. Results: A total of 1550 neonates were admitted to NICU from 11/09/2015 to 10/09/2016, of those 384 were selected.The most common cause of admission diagnosis at NICU was sepsis 78.4% (301), followed by prematurity 14.1% (54) and respiratory distress 8.3% (32).Out of 384 selected neonates, 91.9% (353) improved and discharged, 4.9% (19) died, 1.8% (7) referred and 1.3% (5) left against medical advice. Among selected neonates deaths were high with the diagnosis of sepsis 52.6% (10) and respiratory distress 26.3% (5).Conclusion: This study shows that sepsis, prematurity and respiratory distress were the most common cause of neonatal admission; and also neonatal jaundice, perinatal asphyxia and meconium aspiration syndrome contribute less. From admitted neonates 91.9% were improved and discharged and 4.9% were died, among this fatality was highest for sepsis

Perspective Chapter: Evidence-Based Medicine - A New Approach for Medical Education and Practice

The new concept is gaining worldwide recognition and acceptance in medical education and practice. Evidence-based medicine (EBM) is the term used to describe this novel approach to the teaching and practice of medicine. The purpose of this chapter is to give you a brief overview of the components of EBM, EBM principles, the steps of EBM practice, and the skills required for EBM that can shape your approach toward EBM. A review of the English-language literature was conducted in PubMed, Google Scholar, and Google to obtain EBM definitions, the components of EBM, EBM principles, the steps of EBM practice, and the skills required for EBM. EBM is the integration of the best available research evidence with clinical expertise and patient values. It consists of three basic components: the best available evidence, clinical expertise, and patient values. The integration of these three components can be effectively achieved by completing the five steps of the EBM practice. The five-step process of EBM is asking, acquiring, appraising, applying the evidence in clinical decisions, and assessing the outcome