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Aberham Abere,1 Yibeltal Aschale,2 Banchamlak Tegegne,3 Tegegne Eshetu,1 Adane Derso1 1Department of Medical Parasitology, School of Biomedical and Laboratory Science, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia; 2Department of Medical Laboratory Sciences, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 3Amhara Public Health Institute (APHI), Bahir Dar, EthiopiaCorrespondence: Yibeltal Aschale, Tel +251922444340, Email yibeltal.aschale@yahoo.comBackground: Intestinal parasitic infections (IPI) are one of the most significant health issues around the world. Their burden is significant in Ethiopia with an estimated five million cases reported annually. This study aimed to evaluate the 10-year trend of IPIs at the Grarigy Health Center in northwest Ethiopia.Methods: A retrospective analysis was done at Grarigy Health Center to determine the 10-year (2011– 2020) trend of IPIs by reviewing stool examination reports from a laboratory logbook. The data was collected by laboratory personnel using data extraction sheets. Then, entered into EpiData, cleaned and analyzed using SPSS-20 software. The chi-square test was used to test for significant differences between variables.Results: A total of 9541 stool samples were examined over a 10-year period, of which, 5599 (58.7%) were from male participants and 3942 (41.3%) were from female participants. Participants in the study had an average age of 26.11 years. Infection with intestinal parasites was seen in 58.8% of people (n = 5612) (CI: 57.8– 59.8). A significant fluctuating pattern of IPIs was observed from 2011 to 2020 (P < 0.05). The highest peak of IPIs was recorded in 2020 (61.9%; 767 cases) and the lowest peak was observed in 2011 (49%; 99 cases). A total of 10 different genera of intestinal parasites were reported, of which, A. lumbricoides was the predominant (23.5%) followed by E. histolytica/dispar (16.6%). The highest cases of all intestinal parasites were reported between the ages of 5 and 14 years except H. nana (highest case reported in < 5 years).Conclusion: Prevalence of IPIs is substantial at the Grarigy Health Centre. A fluctuating trend was noticed in the past 10 years. A surveillance system should be in place to bring the burden of IPI down to a level where it has no public health effect.Keywords: intestinal parasite infection, trend analysis, Grarigy Health Center, Ethiopia, IPI

Solomon Rega,1 Yimer Melese,2 Alene Geteneh,3 Desie Kasew,4 Tegegne Eshetu,5 Sirak Biset4 1Department of Medical Laboratory Science, Woldia Comprehensive Specialized Hospital, Woldia, Ethiopia; 2Department of Medical Laboratory Science, Dessie Health Science College, Dessie, Ethiopia; 3Department of Medical Laboratory Science, College of Health Sciences, Woldia University, Woldia, Ethiopia; 4Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 5Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Sirak Biset, Tel +251 911-598-568, Email serbis33@gmail.comBackground: Despite ongoing intensive public health intervention efforts, intestinal parasitic infections (IPIs) remain a major public health problem in developing countries, including Ethiopia. Having updated epidemiological data focusing on the top common IPIs that cause emergency visits is crucial for implementing area-specific and evidence-based intervention strategies. Hence, this study aimed to determine the prevalence of IPIs in Woldia Comprehensive Specialized Hospital’s (WCSH) emergency laboratory over a six-year period.Methods: An institutional-based retrospective study was conducted to assess the prevalence of IPIs over a six-year period (2014– 2019) using a recorded saline wet-mount stool sample examination result in the laboratory logbook at WCSH’s emergency department.Results: In this study, of the total of 11,281 clinically suspected individuals who were requested for stool sample examination, 3908 (34.6%) individuals were diagnosed with IPs. The majority of confirmed cases were caused by protozoan parasites (32.9%), followed by helminth infections (1.7%). A slight fluctuating trend in the prevalence of IPs was observed in the six-year study period, with the highest prevalence documented in the year of 2014 (41.3%) and the lowest in 2017 (28.0%). Entamoeba histolytica/dispar and Giardia lamblia accounts for 95% of the IPs. The prevalence of protozoan infection was significantly higher in females (p-value = 0.0101), while H. nana (p-value =0.0138) and E. vermicularis (p-value = 0.0201) infections were higher in males. The highest and the lowest IP prevalence were reported in the age groups of 45– 54 years (40%) and under five years (25.6%), respectively.Conclusion and Recommendations: In the study area, nearly one-third of patients with emergency visits due to gastrointestinal symptoms were infected with IPs. This underlines the severity of the problem in the study area, which requires a collaborative effort of concerned bodies to minimize the burden of IP to the level where it is no longer a public health threat.Keywords: intestinal parasite infection, protozoa, helminth, emergency, Ethiopia

Fentahun Megabiaw,1 Tegegne Eshetu,1 Zeleke Kassahun,2 Mulugeta Aemero1 1Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2College of Medicine and Health Sciences Comprehensive & Specialized Hospital, University of Gondar, Gondar, EthiopiaCorrespondence: Mulugeta Aemero, Email bmeskel@gmail.com; mulugeta.aemero@uog.edu.etBackground: Infection with malaria in humans involves liver cell destruction, which alters the levels of liver enzymes and lipid profiles. A number of studies have been conducted to address the impact of malaria on liver enzymes and lipid profiles but no studies were addressed after antimalarial treatment in Ethiopia. This study is intended to fill this gap.Methods: An observational cohort study was conducted at Dembia Primary Hospital and Teda Health Center, from June to August 2020. Eighty eight malaria infected study participants were recruited using random sampling techniques. Socio-demographic data, capillary and venous blood samples were collected. Assessment of liver enzymes and lipid profiles was done using Beckman Coulter DC-700 clinical chemistry analyzer. Data were entered using Epi-data and exported to SPSS version 20 for analysis. One way ANOVA, independent t-test, and paired t-test were used to compare the mean liver enzymes and lipid profile. p-value< 0.05 was considered statistically significant.Results: Before anti-malaria treatment, among 88 study participants, elevated AST (87.5%), ALT (12.5%), ALP (43.2%), and TG (17.2%) and lower HDL (87.5%) and normal LDL and TC were observed. After treatment, 100% AST, ALT, HDL, and LDL and 92% ALP, 94.3% TC, and 86.4% TG levels were in the normal range. The mean level of AST and ALT increased while HDL decreased from low to higher density parasitaemia. Mean level of AST was significantly lower while ALT did not alter. HDL, LDL, and TC level were increased but statistically were insignificant (P> 0.05).Conclusion: Malaria could be responsible for increased liver enzymes and certain lipids while decreasing some lipid profiles. After anti-malaria treatment, these parameters were reversed to normal from 86.4% to 100%. Hence, prompt treatment is important to improve liver enzymes and lipid profile impairment during malaria infection.Keywords: malaria, anti-malaria drug, liver enzymes, lipid profiles, Ethiopia

Abiy Ayele,1 Yalewayker Tegegne,2 Adane Derso,2 Tegegne Eshetu,2 Ayalew Jejaw Zeleke2 1Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Adane DersoCollege of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaTel +251930716000Email adanedm77@gmail.comBackground: Intestinal parasitic infections (IPIs) are small organisms that infect the gastro-intestinal tract of human beings. Causes malnutrition, iron deficiency anemia, impairment of physical and mental development in children. The aim of this study was to determine the prevalence of intestinal helminthiasis and associated factors among Kindergarten (KG) children in Gondar Town, northwest Ethiopia.Methods: Institution-based cross-sectional study was conducted on 390 Kindergarten children in Gondar town, Northwest, Ethiopia from March to May 2019. Study subjects were selected using systematic random sampling method. Data were gathered through direct interview by using a pretested questionnaire. Stool specimens were collected and examined using Kato Katz technique. Chi square was used to assess the association between variables and p-value less than 0.05 was taken as a statistical significance.Results: The overall prevalence of intestinal helminthiasis was 16.7%, while those of participants infected by soil-transmitted helminths (STHs) and intestinal Schistosomiasis were 13.8% and 5.9%, respectively. Ascaris lumbricoides was the predominant STHs (9%) followed by Trichuris trichiura (2.3%) and hookworm (1.5%). Light infection was observed in almost all of the infected study participants. Intestinal helminthiasis was found to be significantly associated with age, KG level of children, maternal occupation, and educational status of parents.Conclusion: A significant number of children were infected by intestinal parasites in the study area. A. lumbricoides and intestinal Schistosomiasis were the most predominant of the isolated parasites.Keywords: soil-transmitted helminths, intestinal schistosomiasis, preschool children

Ayalew Jejaw Zeleke,1 Adane Derso,1 Abebe Genetu Bayih,1,2 John S Gilleard,3 Tegegne Eshetu1 1Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Armauer Hansen Research Institute, Addis Ababa, Ethiopia; 3Host-Parasite Interactions Program, Department of Comparative Biology and Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, Calgary, CanadaCorrespondence: Tegegne Eshetu Tel +251921738483Email tegegneeshetu5@gmail.comBackground: Globally, soil-transmitted helminths affect beyond a billion people and cause 1.9 million disability-adjusted life years worldwide. It affects children disproportionately due to their unaware activities like walking barefoot, playing with dirty objects that might be contaminated with feces. The control of soil-transmitted helminths principally relies on periodic deworming using either a single dose of albendazole/mebendazole. To assure the effectiveness of this measure, performing continuous parasitological survey is necessary. Herein, the prevalence, intensity and associated factors of soil-transmitted helminth infections were assessed among school-aged children in northwest Ethiopia.Methods: A cross-sectional study design was conducted among school-aged children (6– 14 years old) from January 21st to February 21st/2019. Multistage sampling technique was employed. A Kato-Katz concentration technique was utilized to detect STHs in stool samples. Moreover, risk factors for STH infections were assessed using well-structured questionnaire. Bivariate and multivariate analyses were used to assess the association between explanatory and the outcome variables. The magnitude of the association was measured using the adjusted odds ratio (AOR) and 95% confidence interval (CI). A P-value < 0.05 was considered statistically significant.Results: The overall STHs prevalence in this study was 32.3% (95% CI: 29– 35.6%) with Ascaris lumbricoides being the predominant species (24.3%) followed by hookworm (8.9%) and Trichuris trichiura (1%). Most (80.3%) of the infected school-aged children had light-intensity infections. Age of 11 years and above (AOR, 12.9, 95% CI, 1.6– 103.6, P=0.004), being residing in Chuahit district (AOR, 3.9, 95% CI, 2.3– 6.5, P< 0.001), and untreated water supply (AOR, 1.7, 95% CI, 1.1– 2.7, P=0.018) were identified as predictors for the overall STH prevalence.Conclusion: Our findings revealed STH infections are considerable health problems in the study areas. Thus, public health interventions such as provision of safe water supply, health education, and de-worming programs should be regularly implemented in the study areas.Keywords: STH, helminths, prevalence, northwest Ethiopia

Awoke Minwuyelet,1 Tegegne Eshetu,1 Dagnaneh Milikit,1 Yibeltal Aschale2 1Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Department of Medical Laboratory Sciences, College of Health Sciences, Debre Markos University, Debre Markos, EthiopiaCorrespondence: Yibeltal AschaleCollege of Health Sciences, Debre Markos University, P.O. Box 269, Debre Markos, EthiopiaTel +251922444340Email yibeltal.aschale@yahoo.comBackground: Malaria is one of the major public health problems worldwide. In Ethiopia, an increase in malaria incidence may be attributed to the presence of community-wide asymptomatic Plasmodium infection. This study aims to assess asymptomatic Plasmodium infection and associated factors in Gondar Zuria district, Northwest Ethiopia.Methods: A community-based cross-sectional study was conducted in Gondar Zuria district from May to June 2019. Angacha and Hamsafeg villages were randomly selected from Tachtseda and Hamsafeg kebeles, respectively. Fifty-three (53) households were selected using systematic random sampling to recruit a total of 251 study participants. Sociodemographic data were collected using structured questionnaires. Thin and thick blood films were prepared and examined for evidence of parasites. Data were entered and analyzed using SPSS version 23. The association between dependent (asymptomatic Plasmodium infection) and independent (sex, age group, family size and previous history of malaria) variables was explored using bivariate and multivariate logistic regression. Statistically significant association was declared at a P-value of < 0.05.Results: A total of 251 individuals were tested, of whom 53.4% were females and 33.5% were above the age of 30 years. The prevalence of asymptomatic Plasmodium infection was 12%. The highest prevalence of malaria was observed in females (6.4%) and among the age group 15– 29 years (4.4%). The majority (70%) of study participants had < 500 parasites/μL of blood. A high parasitemia level (ie ≥ 1000 parasites/μL of blood) was observed in the age group 15– 29 years. Age group, bed net usage and previous history of malaria were significantly associated with asymptomatic Plasmodium infection (P< 0.05).Conclusion: Asymptomatic Plasmodium infection remains an important public health problem in the study area. Further studies using more sensitive diagnostic methods are required to scale up the eradication and control program of malaria.Keywords: asymptomatic malaria, Plasmodium infection, Gondar Zuria, Ethiopia

Under the influence of transforming growth factor-beta (TGFβ), glioma-associated microglia produce molecules that promote glioma growth and invasion. Olfactomedin-like 3 (Olfml3), a novel, secreted glycoprotein, is known to promote several non-CNS cancers. While it is a direct TGFβ1 target gene in microglia, the role of microglia-derived OLFML3 in glioma progression is unknown. Here, we tested the hypotheses that microglial Olfml3 is integral to the pro-tumorigenic glioma-associated microglia phenotype and promotes glioma cell malignancy. Using an Olfml3 knockout microglial cell line (N9), we demonstrated that Olfml3 is a direct target gene of all TGFβ isoforms in murine microglia. Moreover, loss of Olfml3 attenuated TGFβ-induced restraint on microglial immune function and production of cytokines that are critical in promoting glioma cell malignancy. Importantly, microglia-derived OLFML3 directly contributes to glioma cell malignancy through increased migration and invasion. While exposure to conditioned medium (CM) from isogenic control microglia pre-treated with TGFβ increased mouse glioma cell (GL261) migration and invasion, this effect was abolished with exposure to CM from TGFβ-treated Olfml3-/- microglia. Taken together, our data suggest that Olfml3 may serve as a gatekeeper for TGFβ-induced microglial gene expression, thereby promoting the pro-tumorigenic microglia phenotype and glioma cell malignancy.

Under the influence of transforming growth factor-beta (TGFβ), glioma-associated microglia produce molecules that promote glioma growth and invasion. Olfactomedin-like 3 (Olfml3), a novel, secreted glycoprotein, is known to promote several non-CNS cancers. While it is a direct TGFβ1 target gene in microglia, the role of microglia-derived OLFML3 in glioma progression is unknown. Here, we tested the hypotheses that microglial Olfml3 is integral to the pro-tumorigenic glioma-associated microglia phenotype and promotes glioma cell malignancy. Using an Olfml3 knockout microglial cell line (N9), we demonstrated that Olfml3 is a direct target gene of all TGFβ isoforms in murine microglia. Moreover, loss of Olfml3 attenuated TGFβ-induced restraint on microglial immune function and production of cytokines that are critical in promoting glioma cell malignancy. Importantly, microglia-derived OLFML3 directly contributes to glioma cell malignancy through increased migration and invasion. While exposure to conditioned medium (CM) from isogenic control microglia pre-treated with TGFβ increased mouse glioma cell (GL261) migration and invasion, this effect was abolished with exposure to CM from TGFβ-treated Olfml3-/- microglia. Taken together, our data suggest that Olfml3 may serve as a gatekeeper for TGFβ-induced microglial gene expression, thereby promoting the pro-tumorigenic microglia phenotype and glioma cell malignancy.

Abstract Background Postoperative hyperglycemia is associated with morbidity and mortality in non-diabetic surgical patients. However, there is limited information on the extent and factors associated with postoperative hyperglycemia. This study assessed the magnitude and associated factors of postoperative hyperglycemia among non-diabetic adult patients who underwent elective surgery at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. Methods A facility-based cross-sectional study was conducted among 412 adult patients who underwent elective surgery at University of Gondar Comprehensive Specialized Hospital from April 14 to June 30, 2022 All consecutive postoperative non-diabetic elective surgical patients who were admitted to PACU during the data collection period and who fulfilled inclusion criteria were included in the study until the intended minimum sample size was achieved. And data were collected through interviews using a pretested semi-structured questionnaire. Postoperative hyperglycemia was defined as a blood glucose level of ≥ 140 mg/dl. Multivariable logistic regression was performed to identify the association between postoperative hyperglycemia and independent variables. Variables with a p-value less than 0.05 and a 95% confidence interval (CI) were considered statistically significant. Results A total of 405 patients’ data were evaluated with a response rate of 98.3%. The median (IQR) age was 40 (28-52) years. The prevalence of postoperative hyperglycemia was 34.1% (95% CI: 29.4–39.0). Factors significantly associated with postoperative hyperglycemia included being overweight (AOR = 5.45, 95% CI: 2.46-12.0), American Society of Anesthesiologists (ASA) classification II and III (AOR = 2.37, 95% CI: 1.17–4.79), postoperative low body temperature (AOR = 0.18, 95% CI: 0.069–0.48), blood loss ≥ 500 ml (AOR = 2.33, 95% CI: 1.27–4.27), long duration of surgery, mild pain (AOR = 5.17, 95% CI: 1.32–20.4), and moderate pain (AOR = 7.63, 95% CI: 1.811–32.20). Conclusion and recommendation One-third of the study participants had postoperative hyperglycemia. Weight, ASA classification, postoperative body temperature, duration of surgery, intraoperative blood loss, and postoperative pain were identified as a modifiable risk factors. Maintaining normal body temperature throughout the procedure, treating postoperative pain, and monitoring and controlling blood glucose level in patients at risk of hyperglycemia is crucial.

Objective This study aimed to assess 7-day perioperative maternal mortality and risk factors at Tibebe Ghion Specialized Hospital.Design A single-centre prospective cohort study.Setting A tertiary hospital in North-West Ethiopia, 01 June 2019 to 30 June 2021.Participants A total of 979 pregnant mothers who underwent caesarean section were enrolled in this study. Mothers who did not have cellphones and who had incorrect information for follow-up were excluded from the study.Outcome measure Perioperative death measured from intraoperative time to the seventh day following caesarean section.Results The most frequent indication for caesarean section was failure to progress, followed by fetal distress and elective caesarean delivery, accounting for 40.04%, 24.72% and 20.43% of all cases, respectively. The 7-day perioperative maternal mortality rate was 1.83%. Maternal bleeding (adjusted relative risk (ARR) = 11.80; 95% CI 1.12, 124.08) and not using the WHO surgical safety checklist (ARR = 6.88; 95% CI 3.14, 15.07) were independently associated with increased risk of 7-day perioperative mortality.Conclusion In this study, mortality after caesarean section was higher than in high-income countries. Implementation of targeted interventions focusing on the prevention and management of maternal bleeding, along with the consistent use of the WHO surgical safety checklist, could potentially contribute to improving the overall safety and outcomes of caesarean sections.

This study examines the optimal parameters for augmenting a DAHAWT through a CFD analysis. Previous literature has looked into using diffusers to increase wind turbine energy generation, although the impacts of the surface of the diffuser, flange angles, and the interactive effects of all related angles were not fully taken into account. The current research primarily focuses on examining the impacts of the diffuser with circumferential holes and flat surfaces of diffusers, flange angles (0[Formula: see text] ,10[Formula: see text] 15[Formula: see text] and 20[Formula: see text]), flange surfaces of the diffuser, the interactive effects of the opening angles, and all related angles for a wind speed of 4.5 m/s. For the inlet shroud-flanged hole diffuser surfaces, the optimum velocity of 9.35 m/s for the inlet shroud angle of 24[Formula: see text], 8[Formula: see text] opening angles and 0.3 flanges height-to-throat ratio were obtained. For the current study, an optimum increase in velocity of 107.77% compared with the intake velocity to the chamber. About an 8.97% increment in power was attained for the optimum power output. The optimal speed was recorded 0.175 meters away from the diffuser’s inlet section, suggesting that this is where the turbine should be placed. The present research’s numerical fluid dynamics findings were verified with results from the experimental literature, and the outcomes showed an acceptable standard of consensus among both of them. As a next step, the integration of the circumferential hole diffuser with wind turbine system simulation, economic analysis, and hands-on work with field testing are suggested.

Abstract Trauma is the leading cause of mortality in persons under 45 and a significant public health issue. Trauma is the most frequent cause of perioperative mortality among all surgical patients. Little is known about perioperative outcomes among trauma patients in low-income countries. This study aimed to assess the incidence and identify predictors of perioperative mortality among adult trauma victims at Tibebe Ghion Specialised Hospital. From June 1, 2019, to June 30, 2021, a prospective cohort study was conducted at Tibebe Ghion Specialized Hospital. Demographic, pre-hospital and perioperative clinical data were collected using an electronic data collection tool, Research Electronic Data Capture (REDCap). Cox proportional hazard model regression was used to assess the association between predictors and perioperative mortality among trauma victims. Crude and adjusted hazard ratio (HR) with a 95% confidence interval (CI) was computed; a p-value

A bathtub shaped failure rate can be obtained from a mixture of two increasing failure rate (IFR) models. The failure rate of the mixture of an exponential distribution, and a Weibull distribution with strictly increasing failure rate is studied.

This research examines the optimal 3D geometric parameters and shape of empty diffusers to enhance the mass flow rate of the HAWT rotor plane using a detailed parametric study. Previous works have investigated the use of diffusers to augment turbine power output; however, different curvature surfaces and the effects of all associated angles have not been considered for a thorough evaluation. This work mainly focuses on analyzing the effect of opening angles (2° to 22°), inlet shroud angles (8° to 24°), flange height ratios, flange angles (0° and 15°), and shape of the diffuser as well as flanges on velocity, pressure at the diffuser entry, and through the diffuser section at a wind speed of 4.5 m/s. At an inlet-shroud angle of 24° and an opening angle of 8°, with a diffuser flange height-throat diameter ratio of 0.3, the system achieved an 82.9% increase in flowrate. The diffuser with an inlet shroud-side lower stepped flange showed an optimum velocity of 9.12 m/s (maximum) and 8.2 m/s (average), resulting in a 102.66% and 82.2% increase in velocity, respectively. The percentage increase in velocity of the present study is 92.61%, compared with the previous maximum increase in rate of 53.8%, and then an increase in velocity of 38.81% was obtained. The optimum speed occurred at 0.175 m from the inlet section of the diffuser, indicating where the turbine should best be located. The CFD results from this work were validated with experimental data from the literature, showing a good agreement between the two. Integrated diffuser-turbine system simulation and experimental work with field tests are recommended as a way forward.

Background: Professional belonging is an individual's engagement in their profession and where they see themselves in that profession. Midwives who have strong sense of belonging can provide compassionate care to pregnant women, newborns and families throughout their lives. The generation of evidence on sense of midwives professional belongingness is a critical step for maternal and neonatal mortality reduction. However, there is a lack of evidence about professional belongingness and influencing factures among midwives in Ethiopia particularly the study area. Objective: To determine factors influencing midwives’ professional belongingness in public hospitals in Amhara regional state, northwest Ethiopia, 2022. Methods: Institution-based cross-sectional study was conducted from February 21 to April 1, 2022. A cluster sampling technique was used to select 636 midwives. Data were collected using a self-administered and structured questionnaire, entered into Epi-Data version 4.6.software and exported to SPSS version 23 for analysis. A binary logistic regression analysis was fitted to identify factors associated with professional belongingness and p-value

In multicell massive MIMO system, the maximum limit on area throughput can be achieved by improving spectral efficiency and cell density, as well as bandwidth. In order to evaluate the area throughput for such scenarios, the spectral efficiency (SE) that utilizes the linear zero forcing uplink combining scheme, can be modeled under the Rician fading channel and the BS in case of up-links, is responsible to estimate the channel. Different from existing work, the proposed model incorporates various estimators such as minimum mean square error (MMSE), element-wise minimum mean square error estimators under Rician fading. The multicell scenarios with uplink (UL) massive MIMO has been analyzed using the proposed model under different cases such as pilot reuse factor, coherence block length, different number of antennas, and different estimators. The simulation results and analysis are presented based on these parameters. It is found that the average summation of SE per cell can be improved by optimizing MMSE channel estimation using ZF UL combiner, installing multiple BS antennas, serving multiple number of UEs per cell, and using efficient pilot reuse factor. The MMSE and ZF uplink combining are found to be more suitable in improving SE as compared to MMSE-MR. For example, the uplink SE of MMSE channel estimator for pilot reuse factors, 1, 3, and 4, is calculated as 22.5 bit/s/Hz/cell, 22.3 bit/s/Hz/cell, and 21 bit/s/Hz/cell, respectively. The uplink SE for EW-MMSE channel estimator with pilot reuse factors, 1, 3, and 4, is calculated as 22.5 bit/s/Hz/cell, 22 bit/s/Hz/cell, and 22 bit/s/Hz/cell, respectively. For the uplink SE of LS channel estimators, it can be 17.9 bit/s/Hz/cell, 20.2 bit/s/Hz/cell, and 20 bit/s/Hz/cell with pilot reuse factors as f = 1, 3, and 4, respectively. So, for f = 3, the maximum calculated uplink SE for MMSE, EW-MMSE, and LS is 17.6 bit/s/Hz/cell, 17.8 bit/s/Hz/cell, and 13 bit/s/Hz/cell, respectively. It can be concluded that the improved performance is obtained by reducing the pilot contamination at a pilot reuse factor f = 3 with different values of SNR, coherence block length, number of UEs, and number of BS antennas. There is also trade-off between the pilot contamination mitigation and the larger SE. However, there is not much effect on coherence block as when it increases, then the SE increases as well.

Abstract Background Tuberculosis (TB) is an airborne chronic infectious disease mainly caused by Mycobacterium tuberculosis complex bacteria. Currently, about 1.7 billion (26%) of the world’s population are considered to be infected with M. tuberculosis. The risk of acquiring tuberculosis is higher on some segments of societies including people with severe mental illness. As a result, World health organization (WHO) strongly recommends screening for tuberculosis in such risk groups and setting. Methods A cross-sectional study was conducted to assess the prevalence of active tuberculosis and associated factors among patients with chronic psychotic disorders admitted at St. Amanuel Mental Specialized Hospital and Gergesenon Mental rehabilitation center from February to June, 2020. All admitted patients were screened for any sign of TB as recommended by WHO. Presumptive TB cases were identified. Sputum samples were collected and tested by Xpert MTB/RIF assay. Data analysis was performed using SPSS version 25.0 statistical software and Chi square analysis was used to test the statistical association. Results From a total 3600 pschotic patients screened for TB, 250 (6.94%) presumptive tuberculosis cases were detected. From these, 27 (10.8%) were positive by Xpert MTB/RIF assay. Most of the patients were males (68.4%). The mean ± SD age of the participant was 36.5 ± 9.7 years. The overall prevalence of tuberculosis was found to be 750 per 100,000 population. The number of patients per room (p = 0.039) was associated with Xpert MTB/RIF positive active tuberculosis. Conclusion The prevalence of active tuberculosis among chronic psychotic patients was high. Number of admitted patients per room was identified as risk factors for Xpert MTB/RIF positive active tuberculosis. Therefore, to control TB transmission in chronic mental health treatment facilities, efforts should be directed to periodic screening for early case detection and improving the number of patients per room.

Abstract Background Anxiety is a common phenomenon in some professions including medical emergency settings. Nurses deal with grief and other psychological disturbances when they lost clients due to death at clinical settings. Thus, the level of anxiety among nurses working at emergency and intensive care unit is expected to higher as a result of life threatening cases and frequent loss of clients at emergency settings. However, the burden of anxiety and its associated factors among nurses working in emergency clinical settings are not well addressed in Ethiopia. Methods An institutional based cross-sectional study design was conducted among 415 randomly selected nurses working at emergency and Intensive Care Unit at public hospitals in Addis Ababa. Data were collected using interviewer administered questioner. The Hamilton Anxiety Rating Scale was used to measure level of anxiety symptoms. The collected data were entered to a computer using Epi-Data Version 3.1 and exported to SPSS Version 20.0 for analysis. Binary logistic regression was used to identify factors associated with anxiety. Variables with P- Values of

Background: In developing countries, open defecation is still a major health issue. While there has been a great deal of empirical research on latrine coverage. But little is known about household latrine utilization behavior. The objective of this study was to assess latrine utilization and associated factors among Community-Led Total Sanitation and Hygiene (CLTSH) implemented kebeles in Gurage Zone, Southern Ethiopia. Methods: A community-based cross-sectional study was conducted on 585 randomly selected households in Gurage Zone’s rural Community-Led Total Sanitation and Hygiene (CLTSH) implemented kebeles. The data were entered into Epi-data version 3.1 and analyzed in SPSS version 20. A binary logistic regression analysis was used to identify factors associated with latrine utilization, and a P -value

Mihretu Tagesse,1 Mulunesh Deti,1 Dessalegn Dadi,1 Berhanu Nigussie,2 Tizita Teshome Eshetu,1 Gudina Terefe Tucho1 1Department of Environmental Health Science and Technology, Institute of Health, Jimma University, Jimma, Ethiopia; 2Department of Behavioral Sciences, College of Education and Behavioural Science, Jimma University, Jimma, EthiopiaCorrespondence: Gudina Terefe TuchoDepartment of Environmental Health Sciences and Technology, Jimma University, Jimma, EthiopiaTel +251 911703978Email guditerefe@gmail.comBackground: Cosmetic products emits Total Volatile Organic Compound (TVOC) and Particulate Matter with an aerodynamic diameter of 10 micrometers (PM10) of different sizes and characteristics with adverse health effects. Despite the increasing need for cosmetic products, related pollutants level of concentration from beauty salon is not well understood in developing countries.Objective: This study aims to assess indoor air pollutant concentrations in the beauty salon and self-reported health problems among the salon workers in Jimma town.Methods: A cross-sectional study design was used on 87 beauty salons from May 13– 24, 2019. The concentrations of PM10, TVOCs, CO2, room temperature, and relative humidity were measured and triangulated with the survey data collected through measurements and questionnaires. A statistical software package, SPSS v.21, was used to analyze the data. A binary logistic regression was used to analyze categorical data and linear regressions to predict pollutants level and associated health outcomes.Results: The results show that 93.1% of the respondents are females, and 85% were below 30 years old. More than 60% of the respondents were married individuals. 56.3% and 44.8% of the workers work over 10 hours per day and work the whole week. 34.6% of the workers reported as worked during pregnancy. About 70% of the workers know the harmful effects of cosmetics, benefits of ventilation, and Personal Protective Equipment (PPE) use, but only 19.4% use face masks. The majority (88.5%) reported health problems after starting work in the beauty salon. The mean volume of the beauty salon was 36.3 m3, with a mean PM10 concentration of 0.465 mg/m3 and a mean TVOC concentration of 1034.2 μg/m3. These air pollutants have shown a statistically significant association with self-reported health problems. Hence, urgent intervention with subsequent continuous awareness creation is needed to reduce the health consequences of a beauty salon’s indoor air pollutants.Keywords: indoor air pollutants, cosmetic products, PM10, TVOCs, beauty salon, Jimma town, Ethiopia

Lidiya Gutema Lemu,1 Biruktawit Fekade Woldu,2 Natnael Eshetu Teke,3 Nardos Delelegn Bogale,1 Ermias Ayalew Wondimenew4 1Department of Midwifery, College of Health Science, Mizan Tepi University, Mizan-Aman, Ethiopia; 2Department of Midwifery, College of Medicine and Health Science, Wachemo University, Hossana, Ethiopia; 3Department of Midwifery, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia; 4Department of Nursing, College of Health Science, Mizan Tepi University, Mizan-Aman, EthiopiaCorrespondence: Lidiya Gutema LemuMizan Tepi University, Mizan-Aman, EthiopiaEmail lidyagutemal@gmail.comBackground: Despite being one of the few cancers that can be prevented with simple testing, cervical cancer is the fourth most common cancer in women. HIV-positive women showed a median three-fold higher incidence of cervical lesions.Aim: This study aims to assess the prevalence and factors associated with precancerous cervical lesions among HIV-infected women attending care and treatment clinic in selected hospitals of Southwestern Ethiopia.Methods: Institution-based cross-sectional study was conducted from February 1 to July 30, 2018. A systematic random sampling technique was employed to select 454 HIV-infected women. Pretested interviewer-administered questionnaire and medical record review were used for data collection. Visual inspection with Acetic acid was done for participants to detect precancerous cervical lesions. Data were analyzed by SPSS version 20. Binary and multiple logistic regression analyses were done. The presence and strength of association were determined using AOR with its 95% CI. Variables with a P value of less than 0.05 were considered as statistically significant.Results: The prevalence of precancerous cervical lesion was 18.7% [95% CI; (15.1– 22.4%)]. Currently, not being on highly active antiretroviral treatment [AOR= 2.31, 95% CI: 1.23– 4.39], age (20– 29 years) [AOR= 0.185, 95% CI: 0.036,0.939], has no history of sexually transmitted infection [AOR=0.026, 95% CI: 0.006– 0.116], has no history of genital wart [AOR= 0.261, 95% CI: 0.073– 0.934] and having one lifetime sexual partner [AOR=0.133, 95% CI: 0.024– 0.726] were found to be significantly associated with precancerous cervical lesion.Conclusion: The prevalence of Precancerous Cervical lesion was found to be high in this study. Expansion of screening services and undertaking preventive measures against sexually transmitted infection need to be emphasized.Keywords: precancerous cervical lesion, HIV positive, prevalence, factors, Ethiopia

Background:. Simultaneous ventral hernia repair with panniculectomy (VHR-PAN) is associated with a high rate of wound complications. Closed incision negative pressure wound therapy (ciNPWT) has been shown to lower complications in high-risk wounds. There is a debate in the literature as to whether ciNPWT is effective at preventing complications in VHR-PAN. The aim of our study was to evaluate if ciNPWT improves outcomes of VHR-PAN. Methods:. A retrospective review of patients who underwent VHR-PAN between 2009 and 2021 was conducted. Patients were divided into two groups: (1) those who received standard sterile dressings (SSD), or (2) ciNPWT. Primary outcomes were postoperative complications, including surgical site occurrences (SSO) and hernia recurrence. Results:. A total of 114 patients were identified: 57 patients each in the SSD group and ciNPWT group. The groups were similar in demographics and comorbidities. There were more smokers in the SSD group (22.8% versus 5.3%, P = 0.013). Hernia defect size was significantly larger in patients who received ciNPWT (202.0 versus 143.4 cm2, P = 0.010). Overall SSO was similar between the two groups (23.2% versus 26.3%, P = 0.663). At a mean follow-up of 6.6 months, hernia recurrence rate was significantly higher in the SSD group compared with that in the ciNPWT group. (10.5% versus 0%, P = 0.027). Smoking, diabetes, component separation, mesh type, and location were not significantly associated with hernia recurrence. Conclusions:. Application of incisional NPWT is beneficial in decreasing hernia recurrence in VHR-PAN, compared with standard dressings. Larger prospective studies are warranted to further elucidate the utility of ciNPWT in abdominal wall reconstruction.

Background The opioid epidemic across the U.S. poses an array of public health concerns, especially HCV transmission. HCV is now widely curable, yet incident rates are increasing due to the opioid epidemic. Despite the established trajectory from oral prescription opioids (OPOs) to opioid use disorder (OUD), OUD to injection drug use (IDU), and IDU to hepatitis C virus (HCV), OPOs are not a defined risk factor (RF) for HCV infection. The objective of this study was to observe rates of HCV testing and Ab reactivity (HCVAb+) in patients receiving OPOs to substantiate them as a RF, ultimately contributing to HCV elimination. Methods Data from MedStar Health patients receiving OPOs from 1/2017 to 12/2018 were collected and analyzed using chi-squared or student t -tests and logistic regression for uni- or multi-variable analyses, respectively. Statistical significance was defined as P

Abstract Background and aims Elemental mercury toxicity is a rare condition which can be difficult to diagnose due to its nonspecific signs and symptoms. The purpose of this investigation is to describe the presenting characteristics and treatment of adult and pediatric patients with elemental mercury poisoning. Methods A retrospective review was performed in six patients with elemental mercury exposure or intoxication who were treated in an outpatient medical toxicology clinic. Clinical signs and symptoms, laboratory assessments, and public health responses were reviewed. Results Headache, anorexia, rash, and personality changes were commonly reported symptoms in pediatric patients; the adult patients were asymptomatic or reported signs and symptoms included myalgias, tremors, and hypertension. Delays in diagnosis were common. Symptomatic patients had 24‐hour urine mercury concentrations greater than 20 mcg/L. Treatment, including removal from the exposure source as well as chelation with dimercaptosuccinic acid, resulted in resolution of signs and symptoms within 6 months of diagnosis. Conclusion The evaluation and treatment of patients with suspected elemental mercury poisoning frequently require a multidisciplinary approach including medical toxicologists and public health officials. A heightened awareness of the clinical presentations of this condition, as well as early identification and removal of patients from the source of exposure and consideration of chelation therapy, can result in accelerated patient recovery.

Obesity plays an essential role in the safety of pharmacologic drugs. There is paucity of data for direct oral anticoagulants (DOACs) in the obese, despite these agents becoming more widely used. The primary and secondary objectives of this study were to assess the safety and efficacy of DOACs in the overweight and obese populations when used for primary prophylaxis in the setting of non-valvular atrial fibrillation (NVAF) and for treatment of venous thromboembolisms (VTE). We conducted a retrospective cohort study in a large tertiary care center and obtained data through review of electronic health records. Among patients with NVAF and VTE on apixaban, there were no differences in rates of major bleeding (MB) and clinically relevant nonmajor bleeding (CRNMB) in the overweight and obese populations when compared to normal weight and underweight individuals. The multivariate adjusted analysis for rivaroxaban found that the odds of CRNMB for patients with BMI

AbstractObjective:The primary aim was to evaluate duration of action of a single 0.8 U/kg dose of insulin lispro protamine suspension (ILPS) in type 2 diabetes (T2DM) patients; secondarily to compare onset and duration of action of ILPS, glargine (G), and detemir (D) (0.8 U/kg) and evaluate pharmacokinetic (PK) and pharmacodynamic (PD) dose responses of ILPS.Research design and methods:In a single-center, double-blind, five-arm crossover study, 34 patients were randomized to a treatment sequence which included a single subcutaneous 0.8 U/kg dose of G and D and three doses of ILPS (0.4 U/kg, 0.8 U/kg, and 1.2 U/kg) and were studied using 24-hour euglycemic glucose clamps.Primary outcome measure:Duration of action was determined as the time to the last measurable glucose infusion rate (tRlast) during glucose clamps.Results:The duration of insulin action (tRlast) for ILPS at 0.8 U/kg was >23 hours and was similar to G (p  0.114) and D (p  0.570). Post-hoc analysis demonstrated the probability of achieving 24 hours of glucose-lowering activity after a 0.8 U/kg dose: 48 (ILPS), 43 (G), and 26 (D). Gtotand Rmaxwere significantly greater for ILPS versus G or D. The median ILPS time-dependent values demonstrated a significantly earlier maximum PD response (tRmaxand early 50 tRmax) versus either G or D. ILPS demonstrated dose-dependent increases in PK and PD measures across the dose range.Conclusions:Following a single 0.8 U/kg dose in T2DM patients, ILPS, G, and D demonstrated similar durations of glucose-lowering activity and ILPS demonstrated significantly greater glucose-lowering activity (Rmaxand Gtot) and earlier maximum PD response. These results potentially support once-daily dosing of ILPS in T2DM.Limitations:The observed number of 24-hour censored observations was higher than expected and the wash-out period for basal insulin treated patients may have been too short to definitively rule out a carry-over effect; however, such an effect, if present, would potentially only affect onset of action and not the primary outcome measure. [ABSTRACT FROM AUTHOR]

Objective: Hypothyroid patients frequently request specific therapies from their physicians. Combination therapy is vigorously discussed at professional meetings. We wished to determine if physician prescribing patterns for hypothyroidism changed during 2017 after specific educational events.Methods: A survey addressing treatment of hypothyroidism was emailed to American Thyroid Association (ATA) members on three occasions in 2017. The Spring emails were sent prior to a satellite symposium addressing hypothyroidism, and prior to the annual Endocrine Society and ATA meetings; the December emails were sent after these events. Physicians were presented with thirteen theoretical patients and chose from 6 therapeutic options, including levothyroxine, synthetic combination therapy, thyroid extract, and liothyronine monotherapy. The patient scenarios successively incorporated factors potentially providing reasons for considering combination therapy. Multivariate repeated measures logistic regression analyses first examined effects of physician characteristics on prescribing the various therapies. Then, analyses also incorporated timing, by comparing prescribing patterns in February, March, and December.Results: In analyses of prescribing levothyroxine monotherapy vs. any T3 therapy, there was a trend of borderline significance (p = 0.053) for T3 therapy to be prescribed more in December compared with February-March combined. When multivariate analyses were performed controlling for time and physician characteristics, choice of therapy was only significantly affected by country of practice (OR 1.7, CI 1.3–2.2). Physician choice of therapies was also examined for the options of continuing (1) levothyroxine, vs. (2) increasing levothyroxine, (3) adding liothyronine either with or without levothyroxine reduction, or (4) replacing levothyroxine with desiccated thyroid extract or liothyronine. When multivariate analyses incorporating time and physician characteristics were performed, respondents in December (OR 1.5, CI 1.0–2.3) and those practicing in North America (OR 1.8, CI 1.2–2.6) were more likely to prescribe liothyronine.Conclusions: This survey shows that although current North American guidelines do not recommend combination therapy, such therapy is being prescribed more over time and is also more commonly prescribed in North America. It is possible our guidelines are failing to incorporate evidence that physicians are considering when prescribing combination therapy. Such evidence could include data about patient preferences, and this needs to be a focus of future studies.

Introduction: Emergency physicians frequently perform endotracheal intubation and mechanical ventilation. The impact of instituting early post-intubation interventions on patients boarding in the emergency department (ED) is not well studied. We sought to determine the impact of postintubation interventions (arterial blood gas sampling, obtaining a chest x-ray (CXR), gastric decompression, early sedation, appropriate initial tidal volume, and quantitative capnography) on outcomes of mortality, ventilator-associated pneumonia (VAP), ventilator days, and intensive care unit (ICU) length-of-stay (LOS). Methods: This was an observational, retrospective study of patients intubated in the ED at a large tertiary-care teaching hospital and included patients in the ED for greater than two hours postintubation. We excluded them if they had incomplete data, were designated “do not resuscitate,” were managed primarily by the trauma team, or had surgery within six hours after intubation. Results: Of 169 patients meeting criteria, 15 died and 10 developed VAP. The mortality odds ratio (OR) in patients receiving CXR was 0.10 (95% CI 0.01 to 0.98), and 0.11 (95% CI 0.03 to 0.46) in patients receiving early sedation. The mortality OR for patients with 3 or fewer interventions was 4.25 (95% CI 1.15 to 15.75) when compared to patients with 5 or more interventions. There was no significant relationship between VAP rate, ventilator days, or ICU LOS and any of the intervention groups. Conclusion: The performance of a CXR and early sedation as well as performing five or more vs. three or fewer post-intubation interventions in boarding adult ED patients was associated with decreased mortality. [West J Emerg Med. 2014;15(6):708-711]

Abstract Background In Jimma Zone, Ethiopia, the first-line treatment of uncomplicated falciparum malaria has been changed from sulphadoxine-pyrimethamine (SP) to artemether-lumefantrine (AL) in 2006. The objective of this study was to assess the effectiveness of AL in Jimma Zone two to three years after its broad introduction. Methods An open-label, single-arm, 42-day study of AL against falciparum malaria was conducted in four areas with moderate transmission in Jimma Zone between November 2008 and January 2009 and between August and December 2009. Patients (one-81 years) with uncomplicated Plasmodium falciparum mono-infection were consecutively enrolled. Follow-up visits were at day 2, 3, 7, 28 and 42 or any other day if symptoms reoccurred. Primary and secondary endpoints were PCR-corrected and uncorrected cure rates (molecular differentiation between recrudescence and re-infection) on days 28 and 42. Other secondary endpoints were gametocytaemia at day 7 and day 28, parasitaemia at day 2 and 3, and re-infection rates at day 28 and day 42. Results Of 348 enrolled patients, 313 and 301 completed follow-up at day 28 and at day 42, respectively. No early treatment failure occurred. For per protocol analysis, PCR-uncorrected cure rates at day 28 and 42 were 99.1% (95% CI 98.0-100.0) and 91.1% (95% CI 87.9-94.3), respectively. PCR-corrected cure rates at day 28 and 42 were 99.4% (95% CI 98.5-100.0) and 94.7% (95% CI 92.2-97.2), respectively. PCR-corrected cure rate at day 42 for children ≤5 years was 90.6% (95% CI 82.4-98.7) only. Adverse events were in general mild to moderate. Incidence of new infections was 3.4% during 42 days, no new infections with Plasmodium vivax were observed. Microscopically detected gametocytaemia was reduced by 80% between day 0 and day 7. Conclusion In general, AL was effective and well tolerated in Jimma Zone, Ethiopia. However, the PCR-corrected recrudescence rate per-protocol at day 42 for children ≤5 years was 9.4%. Therefore, further development should be monitored on a regular basis as recommended by WHO.