THE ROLE OF ANGIOTENSIN II TYPE 2 RECEPTORS (AT2RS) IN THE REGULATION OF CARDIO-RENAL AND NEUROPROTECTIVE ACTIVITIES: POTENTIAL THERAPEUTIC IMPLICATIONS

Most of the physiological effects of the rennin-angiotensin system (RAS) are mediated by angiotensin II (AgII) type one receptors (AT1R), producing cellular dedifferentiation and proliferation; vasoconstriction; renal tubule sodium (Na+) reabsorption etc. However, the pathophysiologic role of AgII type two receptor (AT2R) has not been clearly defined yet. This review was, therefore, aimed at summarizing a plenty of primary literatures related to the role of AT2R. AT2R is a special G protein coupled receptor that is not coupled with the usual second messengers. The expression level of AT2R is greater in the neonates and fetal ages than in adults though its expression is up-regulated following tissue injury in adults implicating its role in regulating cell differentiation, growth and inflammations. Most of the cellular actions mediated by AT2R are counter regulatory to that of AT1R. AgII produces the cellular effects by acting on AT2R via different signal transduction pathways. The common cellular effects mediated by AT2R are antiproliferative, anti-inflammatory, vasodilation, natriuresis, etc which may be essential for modulating the cardiovascular, renal and brain injuries caused by different etiologies. The principal molecular signal transductions mediated by AT2R involve stimulation of the bradykinin and/or nitric oxide-cGMP pathwy, inactivation of mitogen activated protein kinase pathway by stimulating tyrosine and serine/threonien phosphatses, production of the neuroprotective factors, like BDNF, etc. These signaling pathways may exert cardio-renal and neuroprotective functions. Therefore, the development of drugs that stimulate the AT2R may the potential target to promote the treatment of different disorders related to the cardiovascular, renal and brain dysfunctions. Keywords: Angiotensin II, AT2R, cardiovascular system, Renal system, neuroprotection Â

Rate and predictors of neonatal jaundice in northwest Ethiopia : prospective cohort study

Background: Neonatal jaundice is one of the most common clinical disorders occurred worldwide. About 1.1 million neonates develop jaundice per year globally and the vast majority of them found in sub-Saharan Africa and South Asia. There is a paucity of evidence on the incidence rate and predictors of neonatal jaundice in Ethiopia. Therefore, this study was aimed at determining the rate and predictors of neonatal jaundice in the northwest, Ethiopia. Methods: A prospective cohort study design was conducted at Debre Markos comprehensive, specialized Hospitals using 334 neonates from October 1, 2019, to June 30, 2020. Using a systematic random sampling technique, the study subjects were drawn. Data were entered into the Epi-DataTM Version 4.2 and analyzed using STATATM Version 14.0. The Kaplan-Meier survival curve was used to estimate the survival time. A generalized Log rank test was used to compare the survival curves of different categorical variables. Finally, both bi-variable and multivariable Cox-proportional hazards regression models were used to identify the predictors of neonatal jaundice. The Results: The overall incidence rate of jaundice among neonates was 4.5 per 100 person-hours. Long duration of labor [ARR = 3.5; 95% confidence interval (CI), (2.8– 8.7)], being male neonates [ARR= 5.2; 95% CI (3.5–7.3)], “O” blood group mothers [ARR = 4.5; 95% CI (3.4–10.3)], and having neonatal sepsis 3.4 [ARR=3.4; 95% CI: (2.5–6.1)] were predictors. Conclusion: The incidence rate of jaundice was higher in this study than the finding of the previous one. Being male, prolonged duration of labor, “O” blood group mothers and sepsis were the significant predictors. Hence, an effort has to be made to decrease the incidence rate of neonatal jaundice through improving newborn care and timely intervention for neonates with sepsis and delivered at a long duration of time as well as the neonates born from “o” blood type mothers are our recommendation

Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016

BACKGROUND: Detailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify exemplars for best practice. To accomplish this, the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) estimated age-specific and sex-specific all-cause mortality between 1970 and 2016 for 195 countries and territories and at the subnational level for the five countries with a population greater than 200 million in 2016. METHODS: We have evaluated how well civil registration systems captured deaths using a set of demographic methods called death distribution methods for adults and from consideration of survey and census data for children younger than 5 years. We generated an overall assessment of completeness of registration of deaths by dividing registered deaths in each location-year by our estimate of all-age deaths generated from our overall estimation process. For 163 locations, including subnational units in countries with a population greater than 200 million with complete vital registration (VR) systems, our estimates were largely driven by the observed data, with corrections for small fluctuations in numbers and estimation for recent years where there were lags in data reporting (lags were variable by location, generally between 1 year and 6 years). For other locations, we took advantage of different data sources available to measure under-5 mortality rates (U5MR) using complete birth histories, summary birth histories, and incomplete VR with adjustments; we measured adult mortality rate (the probability of death in individuals aged 15-60 years) using adjusted incomplete VR, sibling histories, and household death recall. We used the U5MR and adult mortality rate, together with crude death rate due to HIV in the GBD model life table system, to estimate age-specific and sex-specific death rates for each location-year. Using various international databases, we identified fatal discontinuities, which we defined as increases in the death rate of more than one death per million, resulting from conflict and terrorism, natural disasters, major transport or technological accidents, and a subset of epidemic infectious diseases; these were added to estimates in the relevant years. In 47 countries with an identified peak adult prevalence for HIV/AIDS of more than 0·5% and where VR systems were less than 65% complete, we informed our estimates of age-sex-specific mortality using the Estimation and Projection Package (EPP)-Spectrum model fitted to national HIV/AIDS prevalence surveys and antenatal clinic serosurveillance systems. We estimated stillbirths, early neonatal, late neonatal, and childhood mortality using both survey and VR data in spatiotemporal Gaussian process regression models. We estimated abridged life tables for all location-years using age-specific death rates. We grouped locations into development quintiles based on the Socio-demographic Index (SDI) and analysed mortality trends by quintile. Using spline regression, we estimated the expected mortality rate for each age-sex group as a function of SDI. We identified countries with higher life expectancy than expected by comparing observed life expectancy to anticipated life expectancy on the basis of development status alone. FINDINGS: Completeness in the registration of deaths increased from 28% in 1970 to a peak of 45% in 2013; completeness was lower after 2013 because of lags in reporting. Total deaths in children younger than 5 years decreased from 1970 to 2016, and slower decreases occurred at ages 5-24 years. By contrast, numbers of adult deaths increased in each 5-year age bracket above the age of 25 years. The distribution of annualised rates of change in age-specific mortality rate differed over the period 2000 to 2016 compared with earlier decades: increasing annualised rates of change were less frequent, although rising annualised rates of change still occurred in some locations, particularly for adolescent and younger adult age groups. Rates of stillbirths and under-5 mortality both decreased globally from 1970. Evidence for global convergence of death rates was mixed; although the absolute difference between age-standardised death rates narrowed between countries at the lowest and highest levels of SDI, the ratio of these death rates-a measure of relative inequality-increased slightly. There was a strong shift between 1970 and 2016 toward higher life expectancy, most noticeably at higher levels of SDI. Among countries with populations greater than 1 million in 2016, life expectancy at birth was highest for women in Japan, at 86·9 years (95% UI 86·7-87·2), and for men in Singapore, at 81·3 years (78·8-83·7) in 2016. Male life expectancy was generally lower than female life expectancy between 1970 and 2016, an

The effects of land use types and soil depth on soil properties of Agedit watershed, Northwest Ethiopia

Assessing the impacts of different land uses on soil physicochemical properties is a fundamental step towards sustainable land management. This study was conducted in Agedit watershed, northwest Ethiopia with the objective of determining the effects of land use and soil depth on soil physicochemical properties. Three major land use types: natural forest, grazing and cultivated lands were selected while soil samples were collected in the 0-20 and 20-40cm depths. Standard soil analytical procedures were followed in carrying out soil analysis. Statistical analysis revealed notable variations due to differences in land use type and soil depth. Sand and clay particles, bulk density, total porosity, pH, organic matter, total nitrogen, available phosphorus, cation exchange capacity and exchangeable K and Na were significantly affected (p ≤ 0.05 and/or p ≤ 0.01) by land use. In contrast, silt, particle density, carbon to nitrogen ratios, exchangeable Ca, and Mg and PBS were not significantly (p > 0.05) affected. With soil depth, higher mean values of total nitrogen, organic matter, exchangeable K and pH were recorded in the 0-20 cm than in the 20-40 cm depth. A shift from forest to other land use types caused a significant decline on soil fertility parameters which contributed to low agricultural productivity. The study area, therefore, needs immediate intervention to protect the remnant forests and to replenish the degraded soil properties for sustainable agricultural productivity.Keywords: cultivation, deforestation, grazing, land management, soil fertilit

Anemia and other hematological profiles of pregnant women attending antenatal care in Debre Berhan Referral Hospital, North Shoa, Ethiopia

Abstract Objective The aim of the study was to determine level of anemia and other hematological profiles in pregnant women attending antenatal care clinic in Debre Berhan Referral Hospital, Ethiopia. Results Prevalence of anemia was 2.8% and that of thrombocytopenia was 10.2%. Out of the anemic pregnant mothers, 5 (62.5%) were mildly anemic and 2 (25%) were severely anemic. The factor age  0.05)

Mediating effects of women’s empowerment on dietary diversity during pregnancy in Central West Ethiopia: A structural equation modelling

Background Considerable proportions of pregnant women consume inadequately diversified diets in Ethiopia. On the other hand, women’s empowerment is identified as a means of achieving maternal nutrition improvement. However, evidence on the relationship between multiple dimensions of women’s empowerment and dietary diversity during pregnancy is limited in Ethiopia. Objective This study aimed to assess the mediating effects of women’s empowerment in the pathway between women’s education and dietary diversity during pregnancy in West Shewa zone, Ethiopia. Methods A health facility-based cross-sectional study was conducted among 1,383 pregnant women in 2021. Dietary diversity was measured using the minimum dietary diversity for women (MDD-W) tool. Exploratory and confirmatory factor analyses were employed to identify and validate women’s empowerment dimensions. Structural equation modelling (SEM) was used to examine the pathways linking pregnant women’s education and empowerment to dietary diversity during pregnancy. Results From the latent dimensions of women’s empowerment produced by factor analyses, pregnant women’s education was directly associated with household decision-making power, psychological and time dimensions. In turn, household decision-making power, psychological and time dimensions were associated with dietary diversity during pregnancy. The direct relationship between pregnant women’s education and dietary diversity was insignificant, but the total indirect effect and total effect were significant. Household decision-making power, psychological and time dimensions were significant mediators in the relationship between pregnant women’s education and dietary diversity. However, economic dimension was related to neither pregnant women’s education nor dietary diversity. Conclusion This study highlights pregnant women with better education are more likely to be empowered in household decision-making, psychological and time dimensions; and those empowered pregnant women are more likely to consume more diverse diets, suggesting women’s access to higher education could have a positive indirect effect on consumption of more diverse diets during pregnancy by empowering women in the study area

Prevalence and risk factors of hypertension among adults: A community based study in Addis Ababa, Ethiopia.

BackgroundIn all areas of the World Health Organization, the prevalence of hypertension was highest in Africa. High blood pressure is a significant risk factor for coronary and ischemic diseases, as well as hemorrhagic stroke. However, there were scarce data concerning the magnitude and risk factors of hypertension. Thus, this study aimed to identify the prevalence and associated factors of hypertension among adults in Addis Ababa city.MethodA community-based cross-sectional study was conducted from June to October 2018 in Addis Ababa city. Participants aged 18 years and older recruited using a multi-stage random sampling technique. Data were collected by face-to-face interview technique. All three WHO STEPS instruments were applied. Additionally, participants' weight, height, waist, hip, and blood pressure (BP) were measured according to standard procedures. Multiple logistic regressions were used and Odds ratios with 95% confidence intervals were also calculated to identify associated factors.ResultsIn this study, a total of 3560 participants were included.The median age was 32 years (IQR 25, 45). More than half (57.3%) of the respondents were females. Almost all (96.2%) of participants consumed vegetables and or fruits less than five times per day. Eight hundred and sixty-five (24.3%) of respondents were overweight, while 287 (8.1%) were obese. One thousand forty-one 29.24% (95% CI: 27.75-30.74) were hypertensive, of whom two-thirds (61.95%) did not know that they had hypertension. Factors significantly associated with hypertension were age 30-49 and ≥50 years (AOR = 2.79, 95% CI: 1.39-5.56) and (AOR = 8.23, 95% CI: 4.09-16.55) respectively, being male (AOR = 1.88, 95% CI: 1.18-2.99), consumed vegetables less than or equal to 3 days per week (AOR = 2.44, 95% CI: 1.21-4.93), obesity (AOR = 2.05, 95%CI: 1.13-3.71), abdominal obesity (AOR = 1.70, 95% CI: 1.10-2.64) and high triglyceride level (AOR = 2.06, 95% CI: 1.38-3.07).ConclusionIn Addis Ababa, around one in three adults are hypertensive. With a large proportion, unaware of their condition. We recommend integrating regular community-based screening programs as integral parts of the health promotion and disease prevention strategies. Lifestyle interventions shall target the modifiable risk factors associated with hypertension, such as weight loss and increased vegetable consumption

Time to initiation of antenatal care and its predictors among pregnant women in Ethiopia: Cox-gamma shared frailty model.

BackgroundTimely initiating antenatal care (ANC) is crucial in the countries that have high maternal morbidity and mortality. However, in developing countries including Ethiopia, pregnant mother's time to initiate antenatal care was not well-studied. Therefore, this study aimed to assess time to first ANC and its predictors among pregnant women in Ethiopia.MethodsA community-based cross-sectional study was conducted among 7,543 pregnant women in Ethiopia using the Ethiopian Demographic Health Survey (EDHS), 2016 data. A two-stage stratified cluster sampling was employed. The Kaplan-Meier (KM) method was used to estimate time to first antenatal care visit. Cox-gamma shared frailty model was applied to determine predictors. Adjusted Hazard Ratio (AHR) with 95% confidence interval was reported as the effect size. Model adequacy was assessed by using the Cox-Snell residual plot. Statistical significance was considered at p value ResultsThe median time to first ANC was 5 months with IQR (3,-). The independent predictors of time to first ANC visit were primary education [AHR: 1.24 (95%CI, 1.13-1.35)], secondary education [AHR: 1.28(95% CI, 1.11-1.47)], higher education [AHR: 1.43 (1.19-1.72)] as compared to women with no formal education. Having media exposure [AHR: 1.13 (95% CI, 1.03-1.24)], early initiation of ANC increases by 25% [AHR: 1.25 (95% CI, 1.12-1.40)] in poorer, 32% [AHR: 1.32 (95% CI, 1.17-1.49)] in middle, 37% [AHR: 1.37 (95% CI, 1.20-1.56)] in richer and 41% [AHR: 1.41 (95%CI, 1.1.19-1.67)] in richest households as compared to poorest household wealth index. Living in city administration, media exposure and community women literacy were also enabler factors, while, long distance from health facility and nomadic region residency were hindering factors of early ANC visit.ConclusionsThe current study revealed that women's time to first antenatal care visit was by far late in Ethiopia as compared to the world health organization recommendation (WHO). The predictors of time to first ANC visit were education status of women, having media exposure, level of household wealth index, community women literacy ad distance to health facility. It is vital that maternal and child health policies and strategies better to be directed at women development and also designing and applying interventions that intended to increase timely initiation ANC among pregnant-women. Researchers also recommended conducting studies using a stronger design like a cohort to establish temporality and reduce biases

Prevalence of goiter and associated factors among adolescent girls in the highland area of Northwest Ethiopia

Background: Goiter is a common public health issue in Ethiopia; however, there is not much evidence of it among adolescent girls, especially in Northwest Ethiopia. Objective: This study aimed to determine the prevalence and associated factors of goiter in adolescent girls living in the highlands of Northwest Ethiopia. Methods: From 5 January to 15 February 2022, 560 adolescent girls participated in this study. A multistage sampling method was used. Participants were checked for goiter using World Health Organization guidelines. Using a quick test kit, the amount of iodine in samples of table salt was determined. After being entered into Epi Info version 7, the data were exported to the SPSS version 22 for statistical analysis. Binary logistic regression was applied. It was decided to set the statistically significant level at p  < 0.05. Results: In this study, the total prevalence of goiter among adolescent girls was 33.4% (95% CI: 26.3%–39.4%). The odds of goiter were 5.3 times higher among adolescents whose families had a history of goiter (AOR = 5.34, 95% CI: 3.65–9.74). The likelihood of developing goiter was 3.7 times greater among adolescent girls who consumed cabbage at least once per week (AOR = 3.74, 95% CI: 2.46–8.31). In addition, adolescent girls who did not consume meat at all were 3.3 times more likely to develop goiter (AOR = 3.32, 95% CI: 1.95–6.78). Similarly, the odds of getting goiter among adolescent girls from families who use salt with inadequate levels of iodine (0–14) were 9.84 times greater compared to their counterparts (AOR = 9.84, 95% CI: 5.61–26.24). Conclusion: In the study area, goiter was very common. Therefore, the district’s health sector should make an effort to raise community knowledge by spreading important messages regarding the proper use of iodized salt and food sources