Robust reference intervals for Liver function test (LFT) analytes in newborns and infants

BACKGROUND: Reference intervals (RIs) are ranges of upper and lower limits of a given analyte which are used for a laboratory test to determine whether a disease is present or absent or to know if the patient is at risk for future disease states. In Ethiopia, a country with highly diversified population groups and geographical sites, there are no established RIs to metabolic analytes including the liver function test (LFT) analytes for the pediatric population though it has been known that liver function assessment in this population is vital as a result of varied vulnerability to both endogenous and xenobiotic substances. METHODS: A cross sectional study was conducted in Tikur Anbessa Specialized Hospital (TASH) and Teklehaymanot Health Center (THC) from November 2010 to April 2011. 117 cord blood (from newborns) and venous blood samples (from infants) were collected and analyzed using HumaStar 300. All pre-analytical, analytical and post-analytical aspects were thoroughly controlled. A robust, CLSI/ IFCC recommended, method was used for the determination of upper and lower end points covering 95% of the reference values of each analyte with respective 90% CIs using MedCalc® software. RESULTS: Combined RIs for newborns and infants were established for albumin, AST, ALP, direct bilirubin and total bilirubin to be 3.88-5.82 g/dl, 16.1-55.4U/l, 130-831U/l, <0.41 mg/dl and <1.37 mg/dl respectively. But, separated RIs were indicated for ALT and GGT as 1.2-23.1U/l and 6.94-24.8U/l ALT; and 30.6-160.7U/L and 10–28.2U/l GGT for newborns and infants respectively. Some maternal and infantile factors were identified to affect the values of analytes. CONCLUSION: Almost all analytes were different from previously reported values for other target population of similar age group, kit insert values and adult values. So, interpretation of values of these analytes in newborns and infants of Ethiopian population sounds better to be performed by using such RIs taking the effect of some maternal and infantile factors in to account

The antiviral properties of edible medicinal plants: potential remedies against coronaviruses

SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is an unparalleled challenge for the international community. Subsequently, an extraordinary effort has been made to contain SARS-CoV-2. However, this has been largely limited to behavioral changes and vaccination. To make the containment strategies effective, behavioral changes and vaccination need to be complemented with alternative prevention methods and curative treatments. This work reports the antiviral properties of some of the commonly known edible medicinal plants that can be used as potential remedies to suppress coronaviruses. A growing body of evidence substantiates that edible medicinal plants with antiviral properties that have been proven effective against sibling coronaviruses likely contain the spread of SARS-CoV-2, and they may also suppress the fatality of COVID-19 (coronavirus disease 2019). The secondary metabolites found in herbal medicines do not cause pathogens to develop drug resistance, which is a common problem in conventional medicines. The use of edible medicinal plants is much safer and causes less panic, thereby avoiding the fear associated with the use of herbal medicines. Right dosages and mixtures of edible medicinal plants need to be rigorously investigated to circumvent unanticipated side effects and chronic health risks

Evidence for a role of Anopheles stephensi in the spread of drug- and diagnosis-resistant malaria in Africa

Anopheles stephensi, an Asian malaria vector, continues to expand across Africa. The vector is now firmly established in urban settings in the Horn of Africa. Its presence in areas where malaria resurged suggested a possible role in causing malaria outbreaks. Here, using a prospective case-control design, we investigated the role of An. stephensi in transmission following a malaria outbreak in Dire Dawa, Ethiopia in April-July 2022. Screening contacts of patients with malaria and febrile controls revealed spatial clustering of Plasmodium falciparum infections around patients with malaria in strong association with the presence of An. stephensi in the household vicinity. Plasmodium sporozoites were detected in these mosquitoes. This outbreak involved clonal propagation of parasites with molecular signatures of artemisinin and diagnostic resistance. To our knowledge, this study provides the strongest evidence so far for a role of An. stephensi in driving an urban malaria outbreak in Africa, highlighting the major public health threat posed by this fast-spreading mosquito

Reduced Mitochondrial Membrane Potential is a Late Adaptation of Trypanosoma brucei brucei to Isometamidium Preceded by Mutations in the γ Subunit of the F1Fo- ATPase

Background: Isometamidium is the main prophylactic drug used to prevent the infection of livestock with trypanosomes that cause Animal African Trypanosomiasis. As well as the animal infective trypanosome species, livestock can also harbor the closely related human infective subspecies T. b. gambiense and T. b. rhodesiense. Resistance to isometamidium is a growing concern, as is cross-resistance to the diamidine drugs diminazene and pentamidine. Methodology/Principal Findings: Two isometamidium resistant Trypanosoma brucei clones were generated (ISMR1 and ISMR15), being 7270- and 16,000-fold resistant to isometamidium, respectively, which retained their ability to grow in vitro and establish an infection in mice. Considerable cross-resistance was shown to ethidium bromide and diminazene, with minor cross-resistance to pentamidine. The mitochondrial membrane potentials of both resistant cell lines were significantly reduced compared to the wild type. The net uptake rate of isometamidium was reduced 2-3-fold but isometamidium efflux was similar in wild-type and resistant lines. Fluorescence microscopy and PCR analysis revealed that ISMR1 and ISMR15 had completely lost their kinetoplast DNA (kDNA) and both lines carried a mutation in the nuclearly encoded γ subunit gene of F1 ATPase, truncating the protein by 22 amino acids. The mutation compensated for the loss of the kinetoplast in bloodstream forms, allowing near-normal growth, and conferred considerable resistance to isometamidium and ethidium as well as significant resistance to diminazene and pentamidine, when expressed in wild type trypanosomes. Subsequent exposure to either isometamidium or ethidium led to rapid loss of kDNA and a further increase in isometamidium resistance. Conclusions/Significance: Sub-lethal exposure to isometamidium gives rise to viable but highly resistant trypanosomes that, depending on sub-species, are infective to humans and cross-resistant to at least some diamidine drugs. The crucial mutation is in the F1 ATPase γ subunit, which allows loss of kDNA and results in a reduction of the mitochondrial membrane potential

Investigating Effects of Integrated Reading and Writing Skills Instruction in Enhancing Students’ Critical Thinking Skills in EFL Classroom

The main concern of this study was to investigate the effects of integrated reading and writing skills instruction on EFL learners' critical thinking skills achievement at Bahir Dar University. At this point, a quasi-experimental research design was employed, and 96 English majoring students as experimental (n = 48) and control (n = 48) groups participated in the study with a random assignment. Herein, the experimental group was instructed through integrated reading and writing skills instruction and the control group with the conventional method for consecutive 12 weeks, and then, 25 (twenty-five) pre and post-tests of critical thinking questions were employed to assess students’ achievement. Data were collected through tests, and then the Kappa inter-rater reliability and split-half tests were employed to compute the reliability and internal consistency of both tests respectively. Finally, the data were analyzed using an independent t-test, and then the result of the pre-test revealed that both experimental and control groups were homogenous in critical thinking skills’ achievement. However, after the treatment, the post-test results depicted that the experimental group significantly outscored the control group. In a nutshell, the study showed the supremacy of integrated reading and writing skills instruction over the conventional approach in enhancing students’ critical thinking skills achievement

Effects of Using Corpus-Based Instructional Mediation on EFL Students’ Academic Writing Skills Improvement

This study aimed at examining the effects of corpus-based instructional mediation on EFL learners’ academic writing skills improvement. To conduct the research, a quasi-experimental research design was employed. A total of 72 EFL mechanical engineering students participated in the study, and they were selected through a simple random sampling technique.  Among them, 25 students were assigned to the experimental group and 47 students to the control group. The data were gathered by means of pre- and post-tests. Multivariate Analysis of Variance (MANOVA) was used to observe the statistical differences between the control and the experimental groups in their academic writing skills. The results showed that the students who were instructed through corpus-based instructional mediation outperformed than the students who were instructed in the conventional instructional approach. Particularly, the students who participated in the experimental group improved their content, communicative achievement, organization, grammar, and vocabulary usage than the students who participated in the control group. Therefore, this research calls for inclusion of corpus-based authentic linguistic elements in their teaching material when teaching academic writing courses in the EFL context

Repellent activity of essential oil of the stem of Kleinia squarrosa against mosquitoes

Most commercially available repellents of mosquitoes and other biting arthropods are synthetic and  have a severe toxic effect to human. Moreover, these chemicals cause an irreversible damage to the ecosystem as some of them are non-degradable in nature. Therefore, there is a need to develop safe and effective alternatives to the currently available chemicals used to control vectors. In southern Ethiopia, the smoke obtained from burning the stem of Kleinia squarrosa Cufod. is used as a fumigant to ward off mosquitoes. In the present study hydrodistillation of the powdered stem of K. squarrosa gave a pale yellow oil (0.04%; w/w) with a characteristic pungent odor. A total of twenty-seven compounds have been identified by GC-MS analysis, accounting 48.71% of the total oil. The main constituents of the oil were (E)-iso-γ-bisabolene (9%), α-pinene (5.74%), caryophyllene (5.36%) and sabinene (5.55%). The powdered stem of K. squarrosa was also burned, and the smoke extracted to yield a trace amount brownish oil. Analysis of the oil by GC-MS afforded 36 compounds comprising 94.56% of the total peak area. Terpene-4-ol (18.09%), (E)-iso-γ-bisabolene (14.07%), 5-epi-7-epi-α-eudesmol (12.45%), and caryophyllene (8.35%) figured as major compounds. Mosquito repellent activity of the essential oil was tested on guinea pigs against Anopheles gambiae by a modified Kunming mice technique under laboratory testing conditions. The essential oil exhibited a dose-dependent repellent action in the dose range tested (0.03 - 5%; v/v) with ED50 and ED99.9 values of 1.49% and 4.74% (v/v), respectively. The study further revealed that that the essential oil possesses a 3 h complete protection time. The similarity in the chemical profiles of the essential oil and the oil extracted from the smoke obtained by burning K. squarrosa stem supports the traditional use of the plant as a fumigant to kill mosquitoes.Keywords: Kleinia squarrosa; fumigant; essential oil; mosquito repellent; Anopheles gambia

Is the difference in neonatal blood glucose concentration of caesarian and vaginally delivered term infants requiring separated reference intervals?

Abstract Background Mode of delivery has been reported to affect the cord blood glucose level of newborns. Vaginally delivered (VD) newborns were found to have relatively increased concentration of cord blood glucose than those delivered by cesarean section (CS). The aim of this study is thus to determine whether the difference in cord blood glucose concentration among VD and CS newborns is necessitating partitioned reference intervals (RIs) for the laboratory diagnosis of neonatal hypoglycemia. Methods A total of 60 newborns were included from Tikur Anbessa Specialized Hospital (TASH). Cord blood samples were collected and analyzed for glucose by Glucose-oxidase (GOD-PAP) method in TASH laboratory using HumaStar 300 from November 2010 to April 2011. All pre-analytical, analytical and post-analytical aspects were thoroughly controlled. A robust method was used for the determination of reference intervals using MedCalc® software Version 11.6.1. Results VD newborns accounted for 71.7% (n = 43) while the CS newborns accounted for 28.3% (n = 17). No statistically significant difference was noted in the studied demographic variables among VD and CS newborns except for blood glucose level. The RIs were then determined to be 2.46-6.85 mmol/l and 2.46-5.04 mmol/l for VD and CS newborns respectively. The combined RI was 2.24-6.48 mmol/l. Conclusion Combined RI better be used for the interpretation of cord blood glucose values in VD and CS newborns. Cord blood glucose concentrations of 2.24 mmol/l can be used as statistical estimates of cut off points for neonatal hypoglycemia in newborns irrespective of their mode of deliveries.</p

Resettlement and woodland management problems and options: A case study from north-western ethiopia

Deforestation in African dry forests is widespread and its drivers are complex and vary in space and time. In this paper, we assessed impacts of immigration on dry forests and options for improved management in a resettlement district in north-western Ethiopia. Key informants interviews, focus group discussions and household questionnaire survey were used to collect data. The results indicated that forests of the district are degrading in spatial coverage and quality. The most important drivers were land use change, excessive wood harvest, grazing pressure and forest fire following immigration. The continuous influx of people with different origins, cultures, religions and lengths of residence in the district underscores absence of social bonds for collective action to regulate access. This, coupled with weak formal regulatory system, market forces and policy incentives for farming, resulted in a near open access situation. Our findings confirm the negative relationships between migration and environment not necessarily because of the mere population number added through immigration but because of lack of regulatory frameworks (formal or informal) and poor social capital. Enforcing existing policy of farm size and putting institutional framework on the ground to regulate rate of immigration, extraction of forest products and to encourage tree planting to meet wood demand are suggested measures. We conclude that Government programmes that opt for resettlement as a measure for poverty alleviation must also have mitigating measures to reducing negative impacts on the natural resource base. Thus, the trade-off between environment and development must be carefully managed