Health problems of children with disabilities with special reference to HIV/AIDS in Southern Ethiopia

Background: Disability is often addressed exclusively as a medical concern. The greatest problems facing persons with disabilities (PWDs) are social inequity, poverty, and lack of human rights protection. Among others, these are reflected in their health status.Objective: To determine health problems encountered and associated factors; problems of access to health care and health information among Children with Disabilities (CWDs).Method: The study used a cross-sectional survey design with both quantitative and qualitative methods. Data from CWDs was collected using a survey, focus group discussion (FGD) and observations; information about CWDs was also collected from key informants (KIs) using in-depth interviews. Survey data were analyzed using SPSS version 11.Result: Eighty-seven percent of study participants experienced one or more health problems. Malaria-like illness and diarrheal diseases were reported as the main health problems. About 19% of them reported to have engaged in sexual intercourse, but none of them used HIV/AIDS preventive methods. Government health care facilities were the primary choice of health service for CWDs although most complained that the government health care facilities were not easily accessible because of economic problems, bureaucracies of the health institutions, negative attitude of health professionals and misconceptions of the society towards CWDs. More than half (52.0%) of them reported to have no health related information.Conclusion: Majority of CWDs were not enjoying the health care provisions available in the study area because of the limited access to the government health care facilities. Their access to HIV/AIDS information is also limited. Sexually active CWDs practice unsafe sex, some are exposed to sexual and substance abuse; putting them at risk of HIV infection. The findings of this study calls for appropriate health promotion and disease prevention education for CWDs. The study also indicated that CWDs are a group that requires specific health attention within the context of people with disabilities

Food and Feeding Habits of the Common Carp (Cyprinus carpio L. 1758) (Pisces: Cyprinidae) in Lake Koka, Ethiopia

Feeding habits of Cyprinus carpio was studied in Lake Koka, Ethiopia, in April and May (dry months) and July and August (wet months), 2011. The objective of the study was to identify the diet composition, seasonal variation in diet and ontogenetic dietary shift. Gut contents of435 fish were analyzed using frequency of occurrence and volumetric analysis. In frequency of occurrence method the number of gut samples was expressed as a percentage of all non-empty stomachs examined while in volumetric method the volume of each food category was expressed as a percentage of the total volume of the gut contents. Detritus, insects and macrophytes were the dominant food categories occurring in 97.0%, 85.2% and 53.3% of the guts and comprising 39.8%, 36.4% and 12.4% of the total volume of food items, respectively. The remaining food categories were of low importance in the diet. The frequency of occurrence and volumetric contributions of the different food categories of C. carpio significantly varied (U-test, p<0.05) during the dry and wet seasons. During the dry season, insects and detritus were important food categories, occurring in 94.4% and 98.6 of the guts and comprising 42.3% and 36.1% of the total volume of food, respectively. During the wet season, detritus was the most important food category. It occurred in 93.9% of the guts and accounted for 48.8% of the total volume of food. Insects and macrophytes were also important during the wet season, occurring in 68.2% and 74.3% of the guts and comprising 23.6% and 22.6% of the total volume of food, respectively. The contributions of animal origin food categories were important in the diet of juveniles whereas food of plant origin were more important in the diet of adults. However, there were no significant variations in the diet of individuals in the different size classes. Based on the results, it was concluded that C. carpio was omnivorous in its feeding habits in Lake Koka with considerable seasonal variation but insignificant onto genetic change in its diet.Keywords: Cyprinuscarpio, Lake Koka, Seasonal and Ontogenetic Variation in Diet, Ethiopia

Heavy Metals in Fish Muscle from an Ethiopian Rift-Valley Lake (Hawassa) and a Neighboring Stream (Boicha): Assessment of Human Health Risks

Concentrations of heavy metals (Cr, Co, Fe, Ni, Cu, Zn, As, Se, Pb and Hg) in muscle tissues of two fish species (Clarias gariepinus and Oreochromis niloticus) in an Ethiopian rift-valley lake (Hawassa) and a neighboring stream (Boicha) were determined. Target hazard quotients (THQ), hazard index (HI) and target cancer risk (TCR) were used as indices to evaluate potential human health risks from fish consumption. Average concentrations of metals decreased in the order Zn>Fe>Se>Cu>Hg>As>Ni>Cr>Co>Pb and Zn>Fe>Se>Cu>As>Hg>Cr>Ni>Pb>Co in muscle tissues of C. gariepinus and O. niloticus, respectively. Mean concentrations of Hg (0.34+0.04 mg kg-1) in muscle tissues of C. gariepinus from Lake Hawassa, and As (0.18+0.05 mg kg-1) as well as Hg (0.46+0.03 mg kg-1) in muscle tissues of C. gariepinus from Boicha stream were above the safety limits set by WHO/FAO. Likewise, mean concentrations of As (0.31+0.03 mg kg-1) and Hg (0.19+0.05 mg kg-1) in muscle tissues of O. niloticus from Lake Hawassa and Cr (0.19+0.03 mg kg-1), As (0.33 +0.04 mg kg-1), and Hg (0.34+0.09 mg kg-1) in O. niloticus from Boicha stream were also above safety limits. From the results of human health risk assessments it was concluded that Cr, Cu, Hg and As pose potential health risks due to consumption of the two fish species from both water bodies. Moreover, effects of all heavy metals put together may affect human health as indicated by the high HI. Effluents from industries are assumed to be the main sources of the heavy metals. Therefore, regular monitoring of the water bodies and policy interventions with respect to waste disposal are recommended to protect the health of the ecosystem and the public. Keywords: Fish consumption, health risk, heavy metals, Lake Hawass

Metformin and insulin treatment of gestational diabetes: effects on inflammatory markers and IGF-binding protein-1 – secondary analysis of a randomized controlled trial

Abstract Background Gestational diabetes mellitus (GDM) is characterized by disturbed glucose metabolism and activation of low-grade inflammation. We studied whether metformin treatment has favorable or unfavorable effects on inflammatory markers and insulin-like growth factor-binding protein 1 (IGFBP-1) in GDM patients compared with insulin, and whether these markers associate with major maternal or fetal clinical outcomes. Methods This is a secondary analysis of a previous randomized controlled trial comparing metformin (n = 110) and insulin (n = 107) treatment of GDM. Fasting serum samples were collected at the time of diagnosis (baseline, mean 30 gestational weeks [gw]) and at 36 gw. Inflammatory markers serum high-sensitivity CRP (hsCRP), interleukin-6 (IL-6), matrix metalloproteinase-8 (MMP-8) and glycoprotein acetylation (GlycA) as well as three IGFBP-1 phosphoisoform concentrations were determined. Results In the metformin and insulin groups combined, hsCRP decreased (p = 0.01), whereas IL-6 (p = 0.002), GlycA (p < 0.0001) and all IGFBP-1 phosphoisoforms (p < 0.0001) increased from baseline to 36 gw. GlycA (p = 0.02) and non-phosphorylated IGFBP-1 (p = 0.008) increased more in patients treated with metformin than those treated with insulin. Inflammatory markers did not clearly associate with pregnancy outcomes but non-phosphorylated IGFBP-1 was inversely associated with gestational weight gain. Conclusions Metformin had beneficial effects on maternal serum IGFBP-1 concentrations compared to insulin, as increased IGFBP-1 related to lower total and late pregnancy maternal weight gain. GlycA increased more during metformin treatment compared to insulin. The significance of this observation needs to be more profoundly examined in further studies. There were no evident clinically relevant relations between inflammatory markers and pregnancy outcome measures. Trial registration The trial comparing metformin and insulin treatment was registered in ClinicalTrials.gov ( NCT01240785 ) November 3, 2010. Retrospectively registered

Metformin and insulin treatment of gestational diabetes : effects on inflammatory markers and IGF-binding protein-1-secondary analysis of a randomized controlled trial

Background: Gestational diabetes mellitus (GDM) is characterized by disturbed glucose metabolism and activation of low-grade inflammation. We studied whether metformin treatment has favorable or unfavorable effects on inflammatory markers and insulin-like growth factor-binding protein 1 (IGFBP-1) in GDM patients compared with insulin, and whether these markers associate with major maternal or fetal clinical outcomes. Methods: This is a secondary analysis of a previous randomized controlled trial comparing metformin (n = 110) and insulin (n = 107) treatment of GDM. Fasting serum samples were collected at the time of diagnosis (baseline, mean 30 gestational weeks [gw]) and at 36 gw. Inflammatory markers serum high-sensitivity CRP (hsCRP), interleukin-6 (IL-6), matrix metalloproteinase-8 (MMP-8) and glycoprotein acetylation (GlycA) as well as three IGFBP-1 phosphoisoform concentrations were determined. Results: In the metformin and insulin groups combined, hsCRP decreased (p = 0.01), whereas IL-6 (p = 0.002), GlycA (p <0.0001) and all IGFBP-1 phosphoisoforms (p <0.0001) increased from baseline to 36 gw. GlycA (p = 0.02) and non-phosphorylated IGFBP-1 (p = 0.008) increased more in patients treated with metformin than those treated with insulin. Inflammatory markers did not clearly associate with pregnancy outcomes but non-phosphorylated IGFBP-1 was inversely associated with gestational weight gain. Conclusions: Metformin had beneficial effects on maternal serum IGFBP-1 concentrations compared to insulin, as increased IGFBP-1 related to lower total and late pregnancy maternal weight gain. GlycA increased more during metformin treatment compared to insulin. The significance of this observation needs to be more profoundly examined in further studies. There were no evident clinically relevant relations between inflammatory markers and pregnancy outcome measures.Peer reviewe

First Evolution of Radon Concentrations Spatial Distribution based on the geological parameters and multiple linear regression method in schools of Sjenica community, Western Serbia (Balkan area)

Purpose: The paper deals with the analysis of radon survey in 34 schools over Sjenica community, in West Serbia, aiming at systematically continuation of previously performed surveys (2008-2010) in the 340 schools in South Serbia, as the project activities (Serbian Ministry of Education Since and Technical Development) considering optimization of the design of a national survey and improving the knowledge of radon distribution in Serbia. In addition , the results of this survey triggered, based on Sjenica (Pestar) region complex geology and measured annual Rn concentrations, an attempt of the explanation of radon spatial variation in Sjenica community by multivariable linear regression (MLR) method in total of 36 public buildings investigated (beside schools, the kindergarten and meterological station). Argumatation: Schools are workplaces which are subject to Rn regulations (EC 2014,BSS).Among other, the BSS require establishing reference levels for long-term indoor Rn concentration, not exceeding 300 Bq/m3 for both dwellings and workplaces. The 36 public buildings were surveyed the whole year in the Sjenica community in West Serbia by long term measurements with CR-39 detectors (commercially named Gamma 1, Landaurer, Sweden). Sjenica community is the largest community of 1059 km2 surface in Serbia and it was found that indoor radon (Rn) lower than 100 Bq/m3 are most probable and although with lower probability,that Rn higher than action level of 300 Bq/m3could occur in 14% of the buildings , indicating potential of the investigated area as high natural background area. The highest measured indoor Rn concentration was 1130 Bq/m3. Conclusion: The predictive model was developed, in order to determine how geological parameters best merge to explain the indoor radon concentrations. The results of this investigation highlight that it is possible to predict indoor radon concentrations using the geological data to an acceptable level of accuracy with a limited number of measurements. There is potential of the investigated area as high natural background area

TNFa and IL-2 armed adenoviruses enable complete responses by anti-PD-1 checkpoint blockade

Releasing the patient's immune system against their own malignancy by the use of checkpoint inhibitors is delivering promising results. However, only a subset of patients currently benefit from them. One major limitation of these therapies relates to the inability of T cells to detect or penetrate into the tumor resulting in unresponsiveness to checkpoint inhibition. Virotherapy is an attractive tool for enabling checkpoint inhibitors as viruses are naturally recognized by innate defense elements which draws the attention of the immune system. Besides their intrinsic immune stimulating properties, the adenoviruses used here are armed to express tumor necrosis factor alpha (TNFa) and interleukin-2 (IL-2). These cytokines result in immunological danger signaling and multiple appealing T-cell effects, including trafficking, activation and propagation. When these viruses were injected into B16.OVA melanoma tumors in animals concomitantly receiving programmed cell-death protein 1 (PD-1) blocking antibodies both tumor growth control (p <0.0001) and overall survival (p <0.01) were improved. In this set-up, the addition of adoptive cell therapy with OT-I lymphocytes did not increase efficacy further. When virus injections were initiated before antibody treatment in a prime-boost approach, 100% of tumors regressed completely and all mice survived. Viral expression of IL2 and TNFa altered the cytokine balance in the tumor microenvironment towards Th1 and increased the intratumoral proportion of CD8+ and conventional CD4+ T cells. These preclinical studies provide the rationale and schedule for a clinical trial where oncolytic adenovirus coding for TNFa and IL-2 (TILT-123) is used in melanoma patients receiving an anti-PD-1 antibody.Peer reviewe

Matrix metalloproteinase-8 and tissue inhibitor of matrix metalloproteinase-1 predict incident cardiovascular disease events and all-cause mortality in a population-based cohort

Background Extracellular matrix degrading proteases and their regulators play an important role in atherogenesis and subsequent plaque rupture leading to acute cardiovascular manifestations. Design and methods In this prospective cohort study, we investigated the prognostic value of circulating matrix metalloproteinase-8, tissue inhibitor of matrix metalloproteinase-1 concentrations, the ratio of matrix metalloproteinase-8/ tissue inhibitor of matrix metalloproteinase-1 and, for comparison, myeloperoxidase and C-reactive protein concentrations for incident cardiovascular disease endpoints. The population-based FINRISK97 cohort comprised 7928 persons without cardiovascular disease at baseline. The baseline survey included a clinical examination and blood sampling. During a 13-year follow-up the endpoints were ascertained through national healthcare registers. The associations of measured biomarkers with the endpoints, including cardiovascular disease event, coronary artery disease, acute myocardial infarction, stroke and all-cause death, were analysed using Cox regression models. Discrimination and reclassification models were used to evaluate the clinical implications of the biomarkers. Results Serum tissue inhibitor of matrix metalloproteinase-1 and C-reactive protein concentrations were associated significantly with increased risk for all studied endpoints. Additionally, matrix metalloproteinase-8 concentration was associated with the risk for a coronary artery disease event, myocardial infarction and death, and myeloperoxidase concentration with the risk for cardiovascular disease events, stroke and death. The only significant association for the matrix metalloproteinase-8/ tissue inhibitor of matrix metalloproteinase-1 ratio was observed with the risk for myocardial infarction. Adding tissue inhibitor of matrix metalloproteinase-1 to the established risk profile improved risk discrimination of myocardial infarction (p=0.039) and death (0.001). Both matrix metalloproteinase-8 (5.2%, p <0.001) and tissue inhibitor of matrix metalloproteinase-1 (12.9%, p <0.001) provided significant clinical net reclassification improvement for death. Conclusions Serum matrix metalloproteinase-8 and tissue inhibitor of matrix metalloproteinase-1 can be considered as biomarkers of incident cardiovascular disease events and death.Peer reviewe

Heavy Metals in Fish Muscle from an Ethiopian Rift-Valley Lake (Hawassa) and a Neighboring Stream (Boicha): Assessment of Human Health Risks

Concentrations of heavy metals (Cr, Co, Fe, Ni, Cu, Zn, As, Se, Pb and Hg) in muscle tissues of two fish species ( Clarias gariepinus and Oreochromis niloticus ) in an Ethiopian rift-valley lake (Hawassa) and a neighboring stream (Boicha) were determined. Target hazard quotients (THQ), hazard index (HI) and target cancer risk (TCR) were used as indices to evaluate potential human health risks from fish consumption. Average concentrations of metals decreased in the order Zn&gt;Fe&gt;Se&gt;Cu&gt;Hg&gt;As&gt;Ni&gt;Cr&gt;Co&gt;Pb and Zn&gt;Fe&gt;Se&gt;Cu&gt;As&gt;Hg&gt;Cr&gt;Ni&gt;Pb&gt;Co in muscle tissues of C. gariepinus and O. niloticus, respectively. Mean concentrations of Hg (0.34\ub10.04 mg kg-1) in muscle tissues of C. gariepinus from Lake Hawassa, and As (0.18\ub10.05 mg kg-1) as well as Hg (0.46\ub10.03 mg kg-1) in muscle tissues of C. gariepinus from Boicha stream were above the safety limits set by WHO/FAO. Likewise, mean concentrations of As (0.31\ub10.03 mg kg-1) and Hg (0.19\ub10.05 mg kg-1) in muscle tissues of O. niloticus from Lake Hawassa and Cr (0.19\ub10.03 mg kg-1), As (0.33 \ub10.04 mg kg-1), and Hg (0.34\ub10.09 mg kg-1) in O. niloticus from Boicha stream were also above safety limits. From the results of human health risk assessments it was concluded that Cr, Cu, Hg and As pose potential health risks due to consumption of the two fish species from both water bodies. Moreover, effects of all heavy metals put together may affect human health as indicated by the high HI. Effluents from industries are assumed to be the main sources of the heavy metals. Therefore, regular monitoring of the water bodies and policy interventions with respect to waste disposal are recommended to protect the health of the ecosystem and the public