CASE REPORT- Vaginal Leech Infestation: A Rare Cause of Hypovolumic Shock In Postmenopausal Woman

BACKGROUND: Human leech infestation is a disease of the poor who live in rural areas and use water contaminated with leeches. Like any other body orifices, vagina can also be infested by leech when  females use contaminated water for bathing and/or douching. Although this condition is very rare in  postmenopausal women, it causes morbidities and mortalities.CASE DETAILS: A 70 year old Para X (all alive) abortion I mother, postmenopausal for the last 20 years, presented with vaginal bleeding of 3 weeks duration to Gimbie Adventist Hospital, Western Ethiopia. On  examination, she had deranged vital signs and there was a dark moving worm attached to the cervical os. She was admitted with the diagnosis of hypovolumic shock and severe anemia secondary to  postmenopausal vaginal bleeding. After the patient was stabilized with intravenous crystalloids, the leech was removed from the vagina. She was then transfused with two units of whole blood and discharged with good condition on the 3rd post procedure day with ferrous sulphate.CONCLUSION: Vaginal leech infestation in postmenopausal woman can cause hypovolumic shock and severe anemia. Therefore, in order to decrease morbidities from failure or delay in making the diagnosis, health care providers should consider the possibility of vaginal leech infestation in postmenopausal  woman from rural areas and those who use river water for drinking, bathing and/or douching and  presented with vaginal bleeding. In addition, the importance of using clean water and improving access to safe water should be emphasized.KEYWORDS: vaginal leech infestation, postmenopausal vaginal bleeding, Ethiopi

Numeracy Skills, Decision Errors, and Risk Preference Estimation

Basic numeracy skills are obviously important for rational decisionmaking when agents are facing choices between risky prospects. Poor and vulnerable people with limited education and numeracy skills live in risky environments and have to make rational decisions in order to survive. How capable are they to understand and respond rationally to economists’ tools for the elicitation of risk preferences? Can we make designs that are simple enough for them to give rational responses that reveal their true preferences? And how much does variation in their limited numeracy skills contribute to decision errors and the estimated sizes of their risk preference parameters? Finally, we ask whether Expected Utility (EU) theory is sufficient or whether Rank Dependent Utility (RDU) does better in the analysis of decision errors and risk preferences in our context. We try to answer these research questions based on a large sample of rural youth business group members from Ethiopia based on two variants of a Certainty Equivalent - Multiple Choice List (CE-MCL) approach with 12 and 10 Choice Lists (CLs) per subject. Numeracy skill scores are constructed based on a math test with 15 contextualized questions. The experiment facilitates the estimation of structural models while separating the effects of numeracy skills on decision errors in a Fechner error specification that is a function of numeracy skills and experimental design characteristics. The structural models estimate alternatively Expected Utility (EU) and Rank Dependent Utility (RDU) models, the latter with two-parameter Prelec probability weighting functions.It allows us to assess whether limited numeracy skills are correlated with EU-type risk tolerance (utility curvature) and RDU-type of probabilistic risk tolerance in the form of probabilistic insensitivity and optimism/pessimism bias. We find that weak numeracy skills are associated with slightly less risk tolerance in EU models, with stronger probabilistic insensitivity in RDU models, and with more random noise (Fechner error) in both types of models. However, even the subjects with the weakest numeracy skills performed quite well in the simple CE-MCL experiments with the binary choice elicitation approach, indicating that it was capable of revealing the risk preferences of such subjects with very low numeracy skills as they produced only marginally more decision errors than subjects with better numeracy skills

Can the risky investment game predict real world investments?

The incentivized risky investment game has become a popular tool in lab-in-the-field experiments for its simplicity and ease of comprehension compared to some of the more complex Multiple Choice List approaches that have been more commonly used in laboratory experiments. We use a field experiment to test whether the game can predict real-world investments by the same subjects based on the assumption that the game can provide a reliable measure of risk tolerance and that risk tolerance is an important predictor of investment behavior. The results show that the game cannot predict investment behavior in our sample. There are two reasons for this. First, we find substantial measurement error and low correlation when the game is repeated one year later for the same subjects. Measurement error is so large in our sample that the “obviously related instrumental variable” (ORIV) approach of Gillen, Snowberg and Yariv (2019) could not remedy the problem. Second, the game appears to suffer from low asset integration due to narrow bracketing, explaining its limited predictive power and the failure to detect attenuation bias due to measurement error. Subjects’ cognitive memory of the game played one year earlier is strongly positively related to investment intensity in the game and this result is much enhanced when correcting for the endogeneity of cognitive memory

Gender differences in investments and risk preferences

We analyze individual investment behavior among 822 young men and women that are members of 111 formal business groups in northern Ethiopia.We collected baseline data and investment data one year later combined with incentivized field experiments to obtain dis-aggregated risk preference data. We find that business women on average invest significantly less at individual level than business men but Cohen’s d values for the gender difference are moderate in size. Women are found to have higher Constant Relative Risk Aversion coefficients, to be more loss averse, but also to be more optimistic in their expectations than men. Women were also poorer in non-land assets, came from more land-poor parents and had lower incomes. The gender differences in risk attitudes and baseline endowments could explain some of but not all of the gender differences in investments

Dispersive estimates for linearized water wave type equations in Rd\mathbb R^d

We derive a $L^1_x (\mathbb R^d)-L^{\infty}_x ( \mathbb R^d)$ decay estimate of order $\mathcal O \left( t^{-d/2}\right)$ for the linear propagators $$\exp \left( {\pm it \sqrt{ |D|\left(1+ \beta |D|^2\right) \tanh |D | } }\right), \qquad \beta \in \{0, 1\}. \quad D = -i\nabla,$$ with a loss of $3d/4$ or $d/4$-derivatives in the case $\beta=0$ or $\beta=1$, respectively. These linear propagators are known to be associated with the linearized water wave equations, where the parameter $\beta$ measures surface tension effects. As an application we prove low regularity well-posedness for a Whitham-Boussinesq type system in $\mathbb R^d$, $d\ge 2$. This generalizes a recent result by Dinvay, Selberg and the third author where they proved low regularity well-posedness in $\mathbb R$ and $\mathbb R^2$.Comment: 18 page

Study on the acaricidal effects of Azadirachta indica and Phytolacca dodecandra on Amblyomma ticks in Ethiopia

A study was carried out to investigate the acaricidal effect of extracts of Azadirachta indica (neem) and Phytolacca dodecandra (locally known endod in Ethiopia) on Amblyomma cohaerens and Amblyomma variegatum. An adult stage of A. cohaerens was collected from east Wollega zone of the Oromia region of Ethiopia and the larval stage of A. variegatum was obtained from tick rearing unit of the National Animal Health Diagnostic and Investigation Centre (NAHDIC), Sebeta, Ethiopia. Neem seed was  collected from Awash town of the Afar region. Berries of endod from Aklilu Lemma Institute of  Pathobiology and commercial neem oil were obtained from India. The water extract of the two plants at doses of 18,750 ppm, 37,500ppm, 75,000 ppm, 150,000 ppm and 300,000 ppm were tested on Petri dish and using the immersion method. The result showed that, neem seed water extract produced mortality rate of 16.6% on adult stage of A. cohaerens at a dose of 300,000 ppm. The LD50 indicated a dose of 370,854.7 ppm and no statistically significant (p>0.05) difference was observed among the two methods of applications. The same extract in both methods of application produced a mortality rates of 8.3%, 16.6% and 41.6 % at doses of 75,000ppm, 150,000ppm and 300,000ppm  respectively on A.variegatum and the probit analysis indicated LD50 of 366,64ppm. Endod extract did not produce any mortality at all doses tested on both species of ticks. Neem oil was also evaluatedat a concentration of 20%, 40%, 60%, 80% and 100%. At 100% concentration, the oil caused 50% mortality on adult of A. cohaerens whereas 20% concentration resulted  in 8.3% mortality rate. Likewise, 100%, 100% and 75% mortality rate on A. variegtum was observed at 100%, 80% and 20% concentrations of the oil respectively. Probit analysis indicated LD50 value of 11.7%  concentration. The water extracts of both plants did not  produce 100% efficacy while promising results were obtained by neem oil on larva of A. variegatum at high concentrations.Keywords: Acaricidal effect, Amblyomma variegatum, Amblyomma cohaerens, Azadirachta indica (neem), Phytolacca dodecandra (endod)

Diversity, Structure and Regeneration Status of the Woodland and Riverine Vegetation of Sire Beggo in Gololcha District, Eastern Ethiopia

This study was conducted on the woodland and riverine vegetation of Sire Beggo in Gololcha District, eastern Ethiopia with the aim of documenting the floristic composition, population structure and identifying major plant community types. Preferential sampling method was employed to collect vegetation data by focusing on vegetation homogeneity. From the study sites, 70 quadrats (each measuring 20 x 20 m = 400 m2 ) were sampled. Regeneration status of woody plants was also assessed using the same quadrate size. The data on the herbaceous species were collected from five, 1 m x 1 m subplots laid at four corners each and one at the centre of the large plot. Vegetation classification was performed using TWINSPAN software package. A total of 185 plant species, representing 61 families were recorded. Fabaceae was the dominant family represented by 15 genera and 23 species, followed by Poaceae and Euphorbiaceae with 17 and 12 species each respectively. The output of TWINSPAN showed five plant community types. Structural analysis of the dominant species revealed different patterns of population structure. Some of the results of population structure and regeneration status indicated abnormal pattern which dictate the need for an urgent conservation of the study area.Keywords: Gololcha, Floristic composition, Structural analysis, Woodland, Ethiopia

Application of capital flow analysis to identify mechanisms for human capacity building in IS projects in a developing economy

Success in human capacity building in IS1 projects in developing economies is crucial in the face of myriads of challenges. Specifically lack of skills, failures of retaining, lack of producing quality and competent personnel, brain drain, low level of IT literacy, etc. remain significant obstacles. In this study, a model is proposed, as alternative tool, that draws on ecosystem theory, the application of capital flow analysis and critical realist data analysis framework, to identify mechanisms to develop an understanding of human capacity building in IS projects. Cases were taken from university-wide network and software development initiatives in Addis Ababa University, Ethiopia, and from continued efforts that realized the Ethiopian Educational and Research Network (EthERNet). Data collection was via interviews, observation and archival data. The analysis of the cases demonstrates the value of capital flow analysis to inform IS project managers for stimulating initial and continued human capacity building in a developing economy

Predictors of Treatment Seeking Intention among People with Cough in East Wollega, Ethiopia Based on the Theory of Planned Behavior: A Community Based Cross -Sectional Study

Background: Early treatment seeking for cough is crucial in the prevention and control of Tuberculosis. This study was intended to assess treatment seeking intention of people with cough of more than two weeks, and to identify its predictors.Methods: A community based cross-sectional study was conducted among 763 individuals with cough of more than two weeks in East Wollega Zone from March 10 to April 16, 2011. Study participants were selected from eighteen villages by cluster sampling method. Data collection instruments were developed according to the standard guideline of the theory of planned behavior. The data were analyzed with SPSS 16.0. Multiple linear regression was used to identify predictors.Results: Mean score of intention was found to be 12.6 (SD=2.8) (range of possible score=3-15). Knowledge (β=0.14, 95%CI: 0.07-0.2), direct attitude (β=0.31, 95%CI: 0.25-0.35), belief-based attitude (β=0.03, 95%CI: 0.02-0.06) and perceived subjective norm (β=0.22, 95%CI: 0.13 -0.31) positively predicted treatment seeking intention. However, perceived behavioral control and control belief were not significantly associated with treatment seeking intention (p>0.05). Being smoker (β=-0.97, 95%CI:-1.65- (-0.37)) and higher family income (β=-0.06, 95%CI:-0.07-(-0.01) were significantly associated with lower treatment seeking intention.Conclusion: TPB significantly predicted treatment seeking intention among the study participants. Attitude and silent beliefs held by the respondents play an important role and should be given emphasize in prevention and control of Tuberculosis.Keywords: Tuberculosis, Cough, Intention, Treatment, Theory of Planned Behavio