A Uterine Stone: A Case Report

No Abstract

Effect of processing method on the Proximate composition, mineral content and antinutritional factors of Taro (Colocasia esculenta, L.) growth in Ethiopia

Although taro is widely grown in Ethiopia, it is an underutilized crop and little is known about its proximate and micro-element composition and the antinutritional factors of the raw, boiled and fermented products. Boiling and fermentation processing techniques are widely used in the country, especially within the rural community of the Southern region where the crop grows widely. A cultivar of taro grown in the country was analyzed for proximate and mineral composition and antinutritional factors. An investigation was also made on the effects of boiling and fermentation on the nutritional contents. Protein, fat, fiber, total ash and utilizable carbohydrates, respectively were found to be 6.43, 0.47, 2.63, 4.82 and 85.65%, while the Gross Energy was 372.55 Kcal/100g. The contents of the micronutrients namely: Fe, Zn, Mg, Ca, Na, P and Mn were 5.86, 43.08, 7.24, 45.23, 13.81, 7.77 and 3.61 mg/100g, respectively. Phytate for the raw product was 115.43 while oxalate and tannin were 243.06 and 47.69 mg/100g, respectively. Cyanide was not detected in all the samples. There was a significant difference (p < 0.05) in the contents of the proximate and mineral composition and antinutritional factors during boiling and fermentation. The protein content was lower by 9.37% and 8.46%, respectively, in the boiled and fermented products, under the sampling and processing conditions used in the study. The crude fat content was significantly different (p < 0.05) from the crude fat content of the boiled product which was 0.87%. On the other hand, analysis of variance conducted showed that the fiber content of raw sample was significantly different from the fermented samples. Fermentation resulted in a lower level of fiber which was 6.44% and phytates of about 84.75%. Boiling of taro resulted in a higher value of oxalate (70.9%). The data presented in this paper provide an evidence of the potential of Boloso I (which is one variety of taro) to serve as a nutrient dense product for the Ethiopian population provided that the techniques of its processing are optimized.Keywords: Ethiopia, Taro, Oxalates, PhytatesAfrican Journal of Food, Agriculture, Nutrition and Development, Volume 13 No. 2 April 201

Utility in the obstetric high dependency unit and intensive care unit in tertiary medical center in Ethiopia: a comparative cross-sectional study

Background: Globally, an estimated 10.7 million women have died due to obstetric complications in the last two decades, and two-thirds of these deaths occurred in sub-Saharan Africa. This study aims to assess the utility of the obstetric high dependency unit and intensive care unit and maternal outcome in a tertiary medical center in Ethiopia. Methods: A comparative cross-sectional study was conducted on critically ill obstetric clients admitted to St. Paul's Hospital Millennium medical college obstetric HDU from October 2020 to September 2022 and before the establishment of the obstetric HDU (who were admitted to the medical ICU). Binary and multivariate logistic regression was conducted to identify factors associated with maternal mortality before the establishment of the maternal HDU. Results: The minimum duration in both units was one day. The maximum duration was 14 days for HDU and 26 days for ICU. Following the establishment of the maternity HDU, the ICU admission rate decreased to 1.2 per 1000 deliveries. Obstetric patients diagnosed with DIC and HELLP syndrome upon admission to the ICU had a 4.9 times higher risk of mortality compared to their counterparts. Obstetric women admitted to the ICU and treated with inotropic agents or vasopressors had a 33.8 times higher risk of mortality compared to their counterparts. Conclusions: Obstetric admissions to the ICU significantly decreased following the establishment of the maternity HDU. Obstetric patients diagnosed with DIC and HELLP syndrome are more likely to develop unfavorably outcome

Podoconiosis treatment in northern Ethiopia (GoLBet): study protocol for a randomised controlled trial

BACKGROUND Podoconiosis is one of the forgotten types of leg swelling (elephantiasis) in the tropics. Unlike the other, better-known types of leg swelling, podoconiosis is not caused by any parasite, virus or bacterium, but by an abnormal reaction to minerals found in the clay soils of some tropical highland areas. Non-governmental Organizations (NGOs) have been responsible for the development of simple treatment methods without systematic evaluation of its effectiveness. It is essential that a large scale, fully controlled, pragmatic trial of the intervention is conducted. We aim to test the hypothesis that community-based treatment of podoconiosis lymphoedema reduces the frequency of acute dermatolymphangioadenitis episodes ('acute attacks') and improves other clinical, social and economic outcomes. METHODS/DESIGN This is a pragmatic, individually randomised controlled trial. We plan to randomly allocate 680 podoconiosis patients from the East Gojjam Zone in northern Ethiopia to one of two groups: 'Standard Treatment' or 'Delayed Treatment'. Those randomised to standard treatment will receive the hygiene and foot-care intervention from May 2015 for one year, whereas those in the control arm will be followed through 2015 and be offered the intervention in 2016. The trial will be preceded by an economic context survey and a Rapid Ethical Assessment to identify optimal methods of conveying information about the trial and the approaches to obtaining informed consent preferred by the community. The primary outcome will be measured by recording patient recall and using a simple, patient-held diary that will be developed to record episodes of acute attacks. Adherence to treatment, clinical stage of disease, quality of life, disability and stigma will be considered secondary outcome measures. Other outcomes will include adverse events and economic productivity. Assessments will be made at baseline and at 3, 6, 9 and 12 months thereafter. DISCUSSION The evidence is highly likely to inform implementation of the new master plan for integrated control of Neglected Tropical Diseases (NTDs), in which podoconiosis is identified as one of eight NTDs prioritised for control. Potentially, an estimated 3 million patients in Ethiopia will therefore benefit from the results of this trial. TRIAL REGISTRATION International Standard Randomised Controlled Trial Number. REGISTRATION NUMBER ISRCTN67805210 . Date of registration: 24 January 2013

Rapid Ethical Appraisal: A tool to design a contextualized consent process for a genetic study of podoconiosis in Ethiopia

Background: Obtaining genuine informed consent from research participants in developing countries can be difficult, partly due to poor knowledge about research process and research ethics. The situation is complicated when conducting genomic research on a disease considered familial and a reason for stigmatisation. Methods: We used a Rapid Ethical Appraisal tool to assess local factors that were barriers to getting genuine informed consent prior to conducting a genetic study of podoconiosis (non-filarial elephantiasis) in two Zones of Ethiopia. The tool included in-depth interviews and focus group discussions with patients, healthy community members, field workers, researchers/Institutional Review Board (IRB) members, elders, religious leaders, and podoconiosis administrators who work closely with patients. Results: Most patients and healthy community members did not differentiate research from routine clinical diagnosis. Participants felt comfortable when approached in the presence of trusted community members. Field workers and podoconiosis administrators preferred verbal consent, whereas the majority of patients and healthy community members prefer both verbal and written consent. Participants better understood genetic susceptibility concepts when analogies drawn from their day-to-day experience were used. The type of biological sample sought and gender were the two most important factors affecting the recruitment process. Most researchers and IRB members indicated that reporting incidental findings to participants is not a priority in an Ethiopian context. Conclusions: Understanding the concerns of local people in areas where research is to be conducted facilitates the design of contextualized consent processes appropriate for all parties and will ultimately result in getting genuine consent

Animal board invited review: Genomic-based improvement of cattle in response to climate change

Climate change brings challenges to cattle production, such as the need to adapt to new climates and pressure to reduce greenhouse emissions (GHG). In general, the improvement of traits in current breeding goals is favourably correlated with the reduction of GHG. Current breeding goals and tools for increasing cattle production efficiency have reduced GHG. The same amount of production can be achieved by a much smaller number of animals. Genomic selection (GS) may offer a cost-effective way of using an efficient breeding approach, even in low- and middle-income countries. As climate change increases the intensity of heatwaves, adaptation to heat stress leads to lower efficiency of production and, thus, is unfavourable to the goal of reducing GHG. Furthermore, there is evidence that heat stress during cow pregnancy can have many generation-long lowering effects on milk production. Both adaptation and reduction of GHG are among the difficult-to-measure traits for which GS is more efficient and suitable than the traditional non-genomic breeding evaluation approach. Nevertheless, the commonly used within-breed selection may be insufficient to meet the new challenges; thus, cross-breeding based on selecting highly efficient and highly adaptive breeds may be needed. Genomic introgression offers an efficient approach for cross-breeding that is expected to provide high genetic progress with a low rate of inbreeding. However, well-adapted breeds may have a small number of animals, which is a source of concern from a genetic biodiversity point of view. Furthermore, low animal numbers also limit the efficiency of genomic introgression. Sustainable cattle production in countries that have already intensified production is likely to emphasise better health, reproduction, feed efficiency, heat stress and other adaptation traits instead of higher production. This may require the application of innovative technologies for phenotyping and further use of new big data techniques to extract information for breeding

Integrating indigenous and exogenous communication channels and capabilities through community-based armyworm forecasting

Many development interventions have failed to generate the desired impact among African resource-poor farmers for reasons including the centralised and top-down approach, lack of active community participation, and over-reliance on external information and technology delivery strategies and channels. The migrant African armyworm, Spodoptera exempta, is among the major challenges threatening livelihoods of millions of farmers in East and Southern Africa. Outbreaks occur suddenly and can devastate crops and pasture. National and regional forecasting services have been operational since the 1960s to provide warning of potential outbreaks. This system relies on information from armyworm moth traps usually operated at district level. These centralised services have a number of difficulties and limitations which include: delays in communicating trap catch data to the forecaster; forecasts are not village specific; forecasts do not reach many farmers; lack of responsibility and local ownership of traps. An innovative approach called community-based armyworm forecasting (CBAF) was developed as a response to these limitations. The new approach has been piloted and tested in several East African countries and found to be effective. CBAF establishes a system that allows each village to have its own traps and trained forecasters who collect and interpret data, and provide village specific forecasts. A recent project on CBAF piloted the approach in 10, 5 and 39 villages of Malawi, Zimbabwe and Tanzania, respectively, in the 1 st year, and in a further 25 and 38 villages of Malawi and Tanzania in the 2 nd year. Discussion with stakeholders, field observations and assessments conducted by the authors indicate that the initiative has generated a number of benefits. It built local capacity, and because of the location specific early warning it enabled farmers to combat the pest more effectively. It was noticed by the authors that local communication channels and folk media play an important role in CBAF, complementing and enhancing the effectiveness of exogenous channels. This paper discusses how CBAF makes effective use of different communication channels and capabilities, and highlights preliminary results.Tant d\u2019interventions de d\ue9veloppement n\u2019ont pas pu g\ue9n\ue9rer un impact satisfaisant parmi les fermiers africains sans resources pour de raisons multiples, dont l\u2019utilisation de l\u2019approche coercitive et centralis\ue9e, le manque d\u2019une participation active de la communaut\ue9 et le fait d\u2019avoir plus d\u2019attachement aux informations, aux strat\ue9gies et guides externes de vulgarization de technologies. Spodoptera exempta, une chenille aussi nomm\ue9e \u201cchenille africain migratrice\u201d est parmi les contraintes majeures aux moyens de subsistance de milliers de fermiers d\u2019Afrique orientale et australe. Son \ue9ruption est soudaine et peut d\ue9vaster des cultures ainsi que des pasturages. Les services nationaux et r\ue9gionaux de pr\ue9diction \ue9taient op\ue9rationnels depuis 1960 pour fournir des alertes sur des irruptions potentielles sur base d\u2019informations collect\ue9es sur des pi\ue8ges tendus aux chenilles au niveau du district. Ces services centralis\ue9s pr\ue9sentent un bon nombre de difficult\ue9s et limitations entre autre, le retard dans la communication des donn\ue9es de pi\ue8ges au pr\ue9visioniste, le manqu\ue9 de sp\ue9cificit\ue9 des pr\ue9visions, la lenteur dans la livraison des pr\ue9visions aux fermiers, le manque de responsabilit\ue9 et d\u2019appropriation locale de ces pi\ue8ges. En r\ue9ponse \ue0 ces limitations, une approche innovatrice appell\ue9e pr\ue9diction des chenilles au niveau communautaire (CBAF) \ue9tait initi\ue9e et test\ue9e dans plusieurs pays d\u2019Afrique de l\u2019Est. Cette approche s\u2019\ue9tait av\ue9r\ue9e efficace \ue0 point qu\u2019il avait permis \ue0 chaque village d\u2019avoir ses propres pi\ue8ges et des pr\ue9visionistes form\ue9s pour la collecte et l\u2019interpr\ue9tation des donn\ue9es ainsi que pour fournir des pr\ue9visions sp\ue9cifiques aux villages.Un projet recent sur CBAF avait ex\ue9cut\ue9 cette approche dans 10, 5 et 39 villages de Malawi, Zimbabwe et Tanzanie, respectivement, dans la premi\ue8re ann\ue9e, et dans plus de 25 et 38 villages de Malawi et Tanzanie au cours de la deuxi\ue8me ann\ue9e. Des r\ue9unions avec des partenaires ainsi que des observations et \ue9valuations sur terrain par des auteurs indiquent combien l\u2019initiative avait \ue9t\ue9 b\ue9n\ue9fique. Le renforcement de capacit\ue9 locale avait \ue9t\ue9 realis\ue9 et les alertes localement sp\ue9cifiques ont permis aux fermiers de combattre avec plus d\u2019efficacit\ue9 la peste. Il \ue9tait remarqu\ue9 que les cha\ueenes de communication locale ansi que les \u201cfolk media\u201d jouent un role important dans CBAF par leur compl\ue9mentarit\ue9 et la promotion de l\u2019efficacit\ue9 des cha\ueenes exog\ue8nes. Cet article discute comment CBAF fait bon usage de diff\ue9rentes cha\ueenes de communication et comp\ue9tences, et met en \ue9vidence les r\ue9sultats pr\ue9liminaires