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Background: Anemia is the most common hematologic abnormalities in AIDS patients usually associated with disease progression and poor clinical outcomes. Zidovudine (AZT), which is one of the nucleoside reverse transcriptase inhibitor drug families of the first line antiretroviral therapy regimen for HIV/AIDS patients, causes anemia due to early long-term of higher-dose therapy. This study was aimed to assess the magnitude and associated factors of anemia among AZT containing HAART experienced adult HIV/ADIS patients at University of Gondar Comprehensive Specialized Referral Hospital, northwest, Ethiopia, 2019., Methods: A retrospective cohort study was conducted among a total of 320 adult AZT based HAART experienced HIV/AIDS patients from January 2016 to December 2018. Systematic random sampling technique was used to select the patients' charts. All required data for this study were extracted from patients' medical charts. Data were coded, cleared and entered into Epi Info version 3.5.3, and transformed to SPSS version 20 for analysis. Descriptive statistics, bivariable and multivariable logistic regression models were fitted to identify associated factors of anemia and P-value < 0.05 was considered as statistically significance., Results: A total of 320 adult AZT based HAART experienced HIV/AIDS patients' charts were assessed. Of the total patients, 198 (61.9%) were females and 133 (41.6%) were within the age range of 35-45 years. More than half, 237(76.9%) of the patients were from the urban area and 186 (58.1%) were on WHO clinical stage III at the baseline. The prevalence of anemia was 50% (95% CI 44.7-55.0%), 44.1% (95% CI 38.4-50.0%), 35.6% (95% CI 30.3-40.6%), 40% (95% CI 34.4-45.6%), 40.6% (95% CI 35.0-46.3) and 39.1% (95% CI 33.4-44.1%) at baseline, 6 months, 12 months, 18 months, 24 months and 30 months of follow-up period, respectively. The overall prevalence of anemia was 41.6%. Anemia had significant association with WHO clinical stage and base line Hgb values., Conclusions: A significant number of participants were anemic in this study. WHO clinical stage and baseline Hgb value were the contributing factors for anemia among these patients. Therefore, anemia needs an immediate intervention on associated factor to improve the anemic status and living condition of HIV patient., (© 2021. The Author(s).)

Improving our understanding of how different land uses and management practices affect soil nutrient outflows in sub-Saharan Africa could aid in developing sustainable practices. The objective of this study was to analyse the variation in outflows of soil total nitrogen (TN) and available phosphorus (P av ) as influenced by land use types (cropland, grazing land, and bushland) and land management practices (soil bunds for cropland and exclosures for non-croplands) in the three contrasting agro-ecological zones of the Upper Blue Nile basin, Ethiopia. Field data were collected for TN and P av outflows by water erosion (Eo), leaching (Lo), product harvest (Ho), and gaseous emissions (Go) from 18 runoff plots (30 m × 6 m) for two years (2018-2019). TN and P av losses significantly varied (p < 0.05, p < 0.01) among agro-ecological zones, land use types, and management practices. Losses of TN ranged from 39.6 to 55.5 kg ha -1 yr -1 and those of P av from 4.1 to 5.9 kg ha -1 yr -1 , with a total replacement cost of US$26-38 ha -1 yr -1 . Nutrient losses and cost generally increased from lowland (Dibatie) to midland (Aba Gerima) to highland (Guder), although the highland and midland sites did not differ significantly (p > 0.05) in nutrient losses. Cropland showed significantly higher TN and P av losses than other land use types, but TN loss did not differ significantly between grazing and bushland. In all land use types at all sites, the magnitude of nutrient losses was Ho >Eo >Lo >Go. In plots with land management practices, TN and P av losses associated with Eo, Lo, and Go were reduced on average by 44-76%, 9-47%, and 1%-36%, respectively. These practices were most effective to reduce Eo nutrient losses. Further study is required to analyzing the soil nutrient balance and identify priority areas for implementing mitigation measures., Competing Interests: Declaration of competing interest The author(s) declare that have no any conflict of interest., (Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.)

The nutritionally imbalanced poor-quality diet feeding is the major constraint of dairy production in tropical regions. Hence, alternative high-quality roughage-based diets are required to improve milk yield and reduce methane emission (CH4). Thus, we tested the effects of feeding natural pasture hay, improved forage grass hays (Napier and Brachiaria Hybrid), and treated crop residues ( Eragrostis tef straw) on nutrient digestibility, milk yield, nitrogen balance, and methane emission. The eight lactating Fogera cows selected for the experiment were assigned randomly to a 4 × 4 Latin square design. Cows were housed in well-ventilated individual pens and fed a total mixed ration (TMR) comprising 70% roughage and 30% concentrate. The four roughage-based basal dietary treatments supplemented with formulated concentrate were: Control (natural pasture hay (NPH)); treated teff straw silage (TTS); Napier grass hay (NGH); and Brachiaria hybrid grass hay (BhH). Compared with the control diet, the daily milk yield increased ( p < 0.01 ) by 31.9%, 52.9%, and 71.6% with TTS, NGH, and BhH diets, respectively. Cows fed BhH had the highest dry matter intake (8.84 kg/d), followed by NGH (8.10 kg/d) and TTS (7.71 kg/d); all of these intakes were greater ( p = 0.01 ) than that of NPH (6.21 kg/d). Nitrogen digestibility increased ( p < 0.01 ) from the NPH diet to TTS (by 27.7%), NGH (21.7%), and BhH (39.5%). The concentration of ruminal ammonia nitrogen was higher for cows fed NGH than other diets ( p = 0.01 ) and positively correlated with plasma urea nitrogen concentration (R² = 0.45). Feeding TTS, NGH, and BhH hay as a basal diet changed the nitrogen excretion pathway from urine to feces, which can help protect against environmental pollution. Estimated methane yields per dry matter intake and milk yield were decreased in dairy cows fed BhH, NGH, and TTS diets when compared to cows fed an NPH diet ( p < 0.05). In conclusion, feeding of TTS, NGH, and BhH roughages as a basal diet to lactating dairy cows in tropical regions improved nutrient intake and digestibility, milk yield, nitrogen utilization efficiency, and reduced enteric methane emission., Competing Interests: The authors declare no conflict of interest.

Browse species are important sources of forage for livestock in Ethiopia, especially during the dry season, when the quality and quantity of green herbage is limited. However, browse species have anti-nutritional factors, such as polyphenols. This study evaluated the extent to which polyethylene glycol (PEG) can reduce the anti-nutritional effects of polyphenols whose extent is expected to vary depending on the species type and season on the in vitro fermentation of these plant samples. We selected ten browse species commonly used as livestock feed based on their tannin content, and sixty samples of the leaf and twig of these species were collected during the wet and dry seasons. The study was designed as 10 × 2 × 2 factorial arrangement with 10 browse species (Acacia nilotica, Crateva adonsonia, Dombeya torrida, Ekebergia capensis, Ensete ventricosum, Erythrina brucei, Maesa lanceolate, Sesbania sesban, Stereospermum kunthianum, and Terminalia laxiflora), 2 seasons (wet and dry) and 2 states of PEG (with and without PEG). The effects of tannin on the nutritive characteristics were also evaluated by adding PEG as a tannin-binding agent. The chemical composition and in vitro fermentation products of these samples differed significantly (p < 0.001) among browse species. Specifically, total extractable phenol (TEP) ranged from 26.3 to 250.3 g/kg, total extractable tannin (TET) from 22.8 to 210.9 g/kg, and condensed tannin (CT) from 11.1 to 141.3 g/kg, respectively. Season, species, and their interaction have a significant (p < 0.05) effect on the chemical composition and fermentation characteristics of most browse species. The addition of PEG increased gas production (GP), in vitro organic matter digestibility (IVOMD), metabolizable energy (ME) concentration, dry matter degradability (DMD), and volatile fatty acids (VFA), on average, by 76.8%, 47.9%, 42.2%, 21.2%, and 20.2%, respectively. Secondary polyphenols (TEP, TET, CT, and SCT) were significantly (p < 0.001) and negatively correlated with GP, IVOMD, ME, and VFA. Preferable species namely E. ventricosum, S. sesban, M. lanceolata, E. capensis, and A. nilotica were selected for supplementation in terms of their chemical composition, IVOMD, and mitigating effects of PEG on anti-nutritional functions of their secondary compounds. In conclusion, PEG markedly reduced the anti-nutritional effects of polyphenols and improved the in vitro fermentation of browse species harvested in contrasting seasons.

Background: There is uncertainty as to the optimal approach for screening and diagnosis of gestational diabetes mellitus (GDM). Based on systematic reviews published in 2003 and 2008, the U.S. Preventive Services Task Force concluded that there was insufficient evidence upon which to make a recommendation regarding routine screening of all pregnant women., Objectives: (1) Identify properties of screening tests for GDM, (2) evaluate benefits and harms of screening for GDM, (3) assess the effects of different screening and diagnostic thresholds on outcomes for mothers and their offspring, and (4) determine the benefits and harms of treatment for a diagnosis of GDM., Data Sources: We searched 15 electronic databases from 1995 to May 2012, including MEDLINE and Cochrane Central Register of Controlled Trials (which contains the Cochrane Pregnancy and Childbirth Group registry); gray literature; Web sites of relevant organizations; trial registries; and reference lists., Methods: Two reviewers independently conducted study selection and quality assessment. One reviewer extracted data, and a second reviewer verified the data. We included published randomized and nonrandomized controlled trials and prospective and retrospective cohort studies that compared any screening or diagnostic test with any other screening or diagnostic test; any screening with no screening; women who met various thresholds for GDM with those who did not meet various criteria, where women in both groups did not receive treatment; any treatment for GDM with no treatment. We conducted a descriptive analysis for all studies and meta-analyses when appropriate. Key outcomes included preeclampsia, maternal weight gain, birth injury, shoulder dystocia, neonatal hypoglycemia, macrosomia, and long-term metabolic outcomes for the child and mother., Results: The search identified 14,398 citations and included 97 studies (6 randomized controlled trials, 63 prospective cohort studies, and 28 retrospective cohort studies). Prevalence of GDM varied across studies and diagnostic criteria: American Diabetes Association (75 g) 2 to 19 percent; Carpenter and Coustan 3.6 to 38 percent; National Diabetes Data Group 1.4 to 50 percent; and World Health Organization 2 to 24.5 percent. Lack of a gold standard for the diagnosis of GDM and little evidence about the accuracy of screening strategies for GDM remain problematic. The 50 g oral glucose challenge test with a glucose threshold of 130 mg/dL versus 140 mg/dL improves sensitivity and reduces specificity. Both thresholds have high negative predictive values (NPV) but variable positive predictive values (PPVs) across a range of prevalence. There was limited evidence for the screening of GDM diagnosed less than 24 weeks' gestation (three studies). One study compared the International Association of Diabetes in Pregnancy Study Groups' (IADPSG) diagnostic criteria with a two-step strategy. Sensitivity was 82 percent, specificity was 94 percent. Only two studies examined the effects on health outcomes from screening for GDM. One retrospective cohort study (n=1,000) showed more cesarean deliveries in the screened group. A survey within a prospective cohort study (n=93) found the same incidence of macrosomia (≥4.3 kg) in screened and unscreened groups (7 percent each group). Thirty-eight studies examined health outcomes for women who met different criteria for GDM and did not undergo treatment. Methodologically strong studies showed a continuous positive relationship between increasing glucose levels and the incidence of primary cesarean section and macrosomia. One of these studies also found significantly fewer cases of preeclampsia, cesarean section, shoulder dystocia and/or birth injury, clinical neonatal hypoglycemia, and hyperbilirubinemia for women without GDM compared with those meeting IADPSG criteria. Among the other studies, fewer cases of preeclampsia were observed for women with no GDM and women who were false positive versus those meeting Carpenter and Coustan criteria. For maternal weight gain, few comparisons showed differences. For fetal birth trauma, single studies showed no differences for women with Carpenter and Coustan GDM and World Health Organization impaired glucose tolerance versus women without GDM. Women diagnosed based on National Diabetes Data Group GDM had more fetal birth trauma compared with women without GDM. Fewer cases of macrosomia were seen in the group without GDM compared with Carpenter and Coustan GDM, Carpenter and Coustan 1 abnormal oral glucose tolerance test, National Diabetes Data Group GDM, National Diabetes Data Group false positives, and World Health Organization impaired glucose tolerance. Fewer cases of neonatal hypoglycemia were found among patient groups without GDM compared with those meeting Carpenter and Coustan criteria. There was more childhood obesity for Carpenter and Coustan GDM versus patient groups with no GDM. Eleven studies compared diet modification, glucose monitoring, and insulin as needed with no treatment. Moderate evidence showed fewer cases of preeclampsia in the treated group. The evidence was insufficient for maternal weight gain and birth injury. Moderate evidence found less shoulder dystocia with treatment for GDM. Low evidence showed no difference for neonatal hypoglycemia between treated and untreated GDM. Moderate evidence showed benefits of treatment for reduction of macrosomia (>4,000 g). There was insufficient evidence for long-term metabolic outcomes among offspring. Five studies provided data on harms of treating GDM. No difference was found for cesarean delivery, induction of labor, small for gestational age, or admission to a neonatal intensive care unit. There were significantly more prenatal visits among those treated., Conclusions: While evidence supports a positive association with increasing plasma glucose on a 75 g or 100 g oral glucose tolerance test and macrosomia and primary cesarean section, clear thresholds for increased risk were not found. The 50 g oral glucose challenge test has high NPV but variable PPV. Treatment of GDM results in less preeclampsia and macrosomia. Current evidence does not show that treatment of GDM has an effect on neonatal hypoglycemia or future poor metabolic outcomes. There is little evidence of short-term harm from treating GDM other than an increased demand for services. Research is needed on the long-term metabolic outcome for offspring as a result of GDM and its treatment, and the "real world" effects of GDM treatment on use of care.