Analysis of diabetic patients admitted to Tikur Anbessa Hospital over eight years period

Abstract: A retrospective analysis of all diabetic admissions to the adult medical wards of Tikur Anbessa Hospital (TAH) over a period of eight years from 1987 to 1994 was done. There were a total of 7739 medical admissions. Out of these, there were 736(9.5%) diabetic admissions. The records of 553 (75.1%) diabetic admissions were retrieved and analyzed. There were 453 patients with 553 episodes of admissions. Of these, 381 patients were admitted once, 55 patients twice, and 17 patients three or more times. The mean age was 42.3±17.7 years and there were 323 males (58.4%) and 230 females (41.6%). Two hundred eighty three (51.2%) were Insulin Dependent Diabetes Mellitus (IDDM) and 270 (48.8%) were Non-Insulin Dependent Diabetes Mellitus (NIDDM) patients. The median duration of hospital stay was 18 days. There was no difference in hospital stay between IDDM and NIDDM patients (p>0.05). The overall mean duration of diabetes mellitus was 7.9±7.1 years. The mean duration of diabetes mellitus was significantly lower in IDDM as compared to NIDDM patients (5.7±5.2 years versus 10.2±7.2 years;X2=54.7;p<0.001). The causes of admissions were infection (26.9%), poor metabolic control (19.3%), acute complications of diabetes (19.3%), and chronic complications of diabetes and its sequelae (17.5%). The overall mortality rate was 15.9%. The causes of death were infection in 30.7%, diabetic ketoacidosis in 18.2%, renal failure in 15.9%, stroke in 12.5%, liver disease in 10.2%, and myocardial infraction in 3.4%. It is noted that significant percentages of admissions and deaths were preventable. We recommend the implementation of the national diabetes program, intensification of diabetes education, tight metabolic control, and adequate provision and procurement of drug supply in order to prevent and reduce the mortality and morbidity of diabetic patients. [Ethiop. J. Health Dev. 1999;13(1):9-13

Hematological parameters in apparently Healthy Eritrean blood donors at the National Blood Transfusion Center, Asmara, Eritrea.

Introduction: This study was done to measure the Hemoglobin levels, Red Blood Cells count, and Red Blood cell parameters: MCV, MCH, MCHC, RDW, and Hematocrit of the apparently healthy blood donors attending the National Blood Bank of Eritrea. Methods: Blood samples were collected from the peripheral veins into the (EDTA)-tube and examined for Red Blood Cell count (RBC), hemoglobin (Hb), Hematocrit (%), mean cell volume (MCV), mean cell hemoglobin (MCH), mean cell hemoglobin concentration (MCHC), and red cell distribution width (RDW), analyzed and measured by automated blood analyzer. Results: The mean Hemoglobin level was 14.428±1.485 g/dl, RBCs count was 4.744±0.482×1012/L, HCT was 41.929 ±3.75%, Red cell distribution width (RDW) mean was 13.571±0.744%, MCV was 88.582± 4.0558 Fimtoliter, MCH was 30.470±2.188 picogram, and MCHC was a mean of 34.393±1.347g/dl. The difference between males and females in MCV and MCHC was significant in favor of female donors. And a weak positive correlation had been found between the weight and age of donors and the Hemoglobin level. All the measured values were found to be within the global referenced ranges. Conclusion: Hemoglobin, RBCs count and RBCs indices of apparently healthy Eritrean blood donors were measured for reference, and all values were found within normal reference ranges

Quality Matters and Not Quantity: Evidence on Productivity Impacts of Extension Service Provision in Ethiopia

This paper contributes new empirical evidence and nuanced analysis on the gender difference in access to extension services and how this translates to observed differences in technology adoption and agricultural productivity. We employ a cross-sectional instrumental-variable regression method using a regionally-representative dataset of more than 7,500 households and 32,000 plots in four major regions in Ethiopia that was collected during the 2010 main season. Results suggest that female heads of households and plot managers are less likely to get extension services and less likely to access quality services than their male counterparts after controlling for plot, household, and village level characteristics. Receiving advice from development agents (DAs) is strongly and positively related to adoption of improved seed and fertilizer for both females and males, as hypothesized. However, beyond their influence through fertilizer and improved seed use, visits by or advice from DAs are not significant in all productivity models estimated for females and males, which is in contrast to past studies. In some crop-specific productivity models estimated, it is the perceived quality of DA visits and access to radio that appear to be strongly and positively significant in explaining productivity levels for both female and male farmers. Our results highlight the need for productivity models that are stratified by gender and crop

Vertical transmission of group B Streptococcus and associated factors among pregnant women: a cross-sectional study, Eastern Ethiopia

Tesfaye Assebe Yadeta,1 Alemayehu Worku,2 Gudina Egata,3 Berhanu Seyoum,4 Dadi Marami,4 Yemane Berhane5 1School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 2Department of Epidemiology and Biostatistics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia; 3School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 4Department of Medical Laboratory Science, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 5Department of Epidemiology, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia Background: Vertically transmitted group B Streptococcus (GBS) causes fetal and neonatal infections. However, there is limited information on the vertical transmission of GBS in low-income countries. This study, therefore, aimed to determine the rate of vertical transmission of GBS and associated factors among pregnant women in Eastern Ethiopia.Subjects and methods: A cross-sectional, facility-based study was conducted among pregnant women in Harar town, Eastern Ethiopia, from June to October, 2016. GBS positivity of pregnant women was confirmed by culture of rectovaginal swab. Vertical transmission at birth was confirmed by culture on swabs taken from the ear canal, umbilicus, axilla, groin, and nose within 6 hours after birth. Prevalence ratio (PR) along with 95% CI was estimated to examine factors associated with vertical transmission using log binomial regression analysis.Results: Out of 231 GBS-colonized pregnant women at delivery, 104 births were identified as GBS colonized with a vertical transmission rate of 45.02% and 95% CI: 38.49, 51.68. Of 104 vertical transmission cases, 65 (62.50%) received no intrapartum antibiotic prophylaxis (IAP), 28 (26.92%) received it <4 hours before delivery, and 11 (10.58%) received it ≥4 hours before delivery. Pre-labor rupture of membranes at term (PR: 1.93; 95% CI: 1.04, 3.57), prolonged rupture of the membrane ≥18 hours (PR: 1.76; 95% CI: 1.13, 2.74), intrapartum maternal fever (PR: 1.40; 95% CI: 1.13, 1.75), and IAP received ≥4 hours (PR: 0.17; 95% CI: 0.09, 0.30) were significantly associated with vertical transmission of GBS.Conclusion: The magnitude of vertical transmission of GBS was very high. However, the rate of adequate IAP received by mothers was very low. Efforts need to be strengthened to screen pregnant women during antenatal care and IAP should be used as necessary. Furthermore, maternal vaccination may provide a feasible strategy to reduce the vertical transmission. Keywords: GBS, vertical transmission, newborn, log binomial, Harar, at birth, IA

Peripheral Blood Mitochondrial DNA Damage as a Potential Noninvasive Biomarker of Diabetic Retinopathy

Citation: Mishra M, Lillvis J, Seyoum B, Kowluru RA. Peripheral blood mitochondrial DNA damage as a potential noninvasive biomarker of diabetic retinopathy. Invest Ophthalmol Vis Sci. 2016;57:4035-4044. DOI:10.1167/iovs.16-19073 PURPOSE. In the development of diabetic retinopathy, retinal mitochondria become dysfunctional, and mitochondrial DNA (mtDNA) is damaged. Because retinopathy is a progressive disease, and circulating glucose levels are high in diabetes, our aim was to investigate if peripheral blood mtDNA damage can serve as a potential biomarker of diabetic retinopathy. METHODS. Peripheral blood mtDNA damage was investigated by extended-length PCR in rats and mice, diabetic for 10 to 12 months (streptozotocin-induced, type 1 model), and in 12-and 40-week-old Zucker diabetic fatty rats (ZDF, type 2). Mitochondrial copy number (in gDNA) and transcription (in cDNA) were quantified by qPCR. Similar parameters were measured in blood from diabetic patients with/without retinopathy. RESULTS. Peripheral blood from diabetic rodents had significantly increased mtDNA damage and decreased copy numbers and transcription. Lipoic acid administration in diabetic rats, or Sod2 overexpression or MMP-9 knockdown in mice, the therapies that prevent diabetic retinopathy, also ameliorated blood mtDNA damage and restored copy numbers and transcription. Although blood from 40-week-old ZDF rats had significant mtDNA damage, 12-week-old rats had normal mtDNA. Diabetic patients with retinopathy had increased blood mtDNA damage, and decreased transcription and copy numbers compared with diabetic patients without retinopathy and nondiabetic individuals. CONCLUSIONS. Type 1 diabetic rodents with oxidative stress modulated by pharmacologic/ genetic means, and type 2 animal model and patients with/without diabetic retinopathy, demonstrate a strong relation between peripheral blood mtDNA damage and diabetic retinopathy, and suggest the possibility of use of peripheral blood mtDNA as a noninvasive biomarker of diabetic retinopathy

Maternal group B Streptococcus recto vaginal colonization increases the odds of stillbirth: evidence from Eastern Ethiopia

Abstract Background Group B Streptococcus (GBS) causes a significant number of stillbirths. Despite this, there is little documented information on the association between stillbirth and pregnant women’s GBS recto vaginal colonization in Sub Saharan Africa. As such, this study was aimed at identifying the association between stillbirth and pregnant women’s GBS recto vaginal colonization in Eastern Ethiopia. Methods A health facility-based cross-sectional study was conducted among 1688 pregnant women who came for delivery service in Harar town, Eastern Ethiopia between June to October in 2016. Data were collected using a pre-tested structured questionnaire and checklist (which utilize clinical record). Group B streptococcus positivity of the pregnant women was confirmed by culture of recto vaginal swab using selective media. The association between GBS colonization and stillbirth was examined using multivariable logistic regression analysis. A statistical significance was declared at p-value ≤0.05. Results Of the 1688 pregnant women who participated in the study, 144 had stillbirths, representing a prevalence of 8.53% [(95% CI: (7.19, 9.86)]. Group B Streptococcus colonization at birth was detected in 231 women (13.68%; 95% CI 12.04, 15.32). Of these 144 stillbirths 59 (40.97%) were from colonized mothers and 72(59.03%) were from non-colonized mothers. Of these 59 stillbirth from colonized mothers, 32(54.23%) were intrapartum stillbirth, 27(45.77%) were antepartum stillbirth occur before exposed to intrapartum antibiotic prophylaxis (IAP). After controlling for potential confounders, the odds of having a stillbirth were 8.93 times higher among recto vaginal GBS colonized pregnant women [AOR = 8.93; 95% CI; (5.47, 14.56)]. Conclusions This study demonstrated a significant association between maternal recto vaginal GBS colonization and stillbirth. Efforts to reduce stillbirth need to consider prevention of GBS colonization among pregnant women. Maternal vaccination may provide a feasible strategy to reduce stillbirth due to GBS

Atypical Antipsychotics and the Human Skeletal Muscle Lipidome

Atypical antipsychotics (AAPs) are a class of medications associated with significant metabolic side effects, including insulin resistance. The aim of this study was to analyze the skeletal muscle lipidome of patients on AAPs, compared to mood stabilizers, to further understand the molecular changes underlying AAP treatment and side effects. Bipolar patients on AAPs or mood stabilizers underwent a fasting muscle biopsy and assessment of insulin sensitivity. A lipidomic analysis of total fatty acids (TFAs), phosphatidylcholines (PCs) and ceramides (CERs) was performed on the muscle biopsies, then lipid species were compared between treatment groups, and correlation analyses were performed with insulin sensitivity. TFAs and PCs were decreased and CERs were increased in the AAP group relative to those in the mood stabilizer group (FDR q-value <0.05). A larger number of TFAs and PCs were positively correlated with insulin sensitivity in the AAP group compared to those in the mood stabilizer group. In contrast, a larger number of CERs were negatively correlated with insulin sensitivity in the AAP group compared to that in the mood stabilizer group. The findings here suggest that AAPs are associated with changes in the lipid profiles of human skeletal muscle when compared to mood stabilizers and that these changes correlate with insulin sensitivity

Plasma Lactate Levels Increase during Hyperinsulinemic Euglycemic Clamp and Oral Glucose Tolerance Test

Insulin resistance, which plays a central role in the pathogenesis of type 2 diabetes (T2D), is an early indicator that heralds the occurrence of T2D. It is imperative to understand the metabolic changes that occur at the cellular level in the early stages of insulin resistance. The objective of this study was to determine the pattern of circulating lactate levels during oral glucose tolerance test (OGTT) and hyperinsulinemic euglycemic clamp (HIEC) study in normal nondiabetic subjects. Lactate and glycerol were determined every 30 minutes during OGTT and HIEC on 22 participants. Lactate progressively increased throughout the HIEC study period (P<0.001). Participants with BMI < 30 had significantly higher mean M-values compared to those with BMI ≥ 30 at baseline (P<0.05). This trend also continued throughout the OGTT. In addition, those with impaired glucose tolerance test (IGT) had significantly higher mean lactate levels compared to those with normal glucose tolerance (P<0.001). In conclusion, we found that lactate increased during HIEC study, which is a state of hyperinsulinemia similar to the metabolic milieu seen during the early stages in the development of T2D