Brain functional connectivity in hyperthyroid patients: systematic review.

Introduction: Functional connectivity (FC) is the correlation between brain regions' activities, studied through neuroimaging techniques like fMRI. It helps researchers understand brain function, organization, and dysfunction. Hyperthyroidism, characterized by high serum levels of free thyroxin and suppressed thyroid stimulating hormone, can lead to mood disturbance, cognitive impairment, and psychiatric symptoms. Excessive thyroid hormone exposure can enhance neuronal death and decrease brain volume, affecting memory, attention, emotion, vision, and motor planning. Methods: We conducted thorough searches across Google Scholar, PubMed, Hinari, and Science Direct to locate pertinent articles containing original data investigating FC measures in individuals diagnosed with hyperthyroidism. Results: The systematic review identified 762 articles, excluding duplicates and non-matching titles and abstracts. Four full-text articles were included in this review. In conclusion, a strong bilateral hippocampal connection in hyperthyroid individuals suggests a possible neurobiological influence on brain networks that may affect cognitive and emotional processing. Systematic Review Registration: PROSPERO, CRD42024516216.

Multilevel analysis of anemia and associated factors among women of reproductive age (15-49 years) in Liberia: Evidence from the 2019/20 Liberia demographic and health survey data.

BACKGROUND: Anemia is a global public health problem, principally affecting young children and reproductive-age mothers. Although anemia is a main public health concern in low-income countries, there is no evidence about its prevalence and associated factors among women of reproductive age in Liberia. Thus, the purpose of this study was to identify the prevalence and associated factors of anemia among women of reproductive age in Liberia. METHODS: We used the data extracted from the fifth Liberia Demographic and Health Survey (LDHS-V) that were carried out between October 2019 and February 2020. The sample was chosen using a stratified two-stage cluster sampling procedure. Overall weighted samples of 4027 women of reproductive age were used in the analysis. Data weighting was carried out to obtain reliable estimates and standard errors as well as to restore the representativeness of the data. Stata version 14 software was used for data extraction, coding, and analysis. We used multilevel analysis to identify the significant factors associated with anemia among women of reproductive age. RESULTS: The prevalence of anemia among women of reproductive age in Liberia was 44.51 (95% CI: 42.97-46.04). From these, about 23.10% of women of reproductive age were mildly anemic, 20.63% were moderately anemic and 0.78% was severely anemic. In multivariable analysis; women with the groups of 20-24 years (adjusted odds ratio (AOR) = 0.72, 95% CI: 0.56, 0.92), 25-29 years (AOR = 0.57, 95% CI: 0.43, 0.77), 30-34 years (AOR = 0.59, 95% CI: 0.43, 0.83), 35-39 years (AOR = 0.56, 95% CI: 0.41, 0.79), 40-44 years (AOR = 0.61, 95% CI: 0.43,0.87), 45-49 years (AOR = 0.57, 95% CI: 0.39,0.82), overweight (AOR = 0.83; 95% CI: 0.70, 0.98), obese (AOR = 0.72; 95% CI: 0.58, 0.88), using modern contraceptive methods (AOR = 0.61; 95% CI: 0.52, 0.72), and being from the Northcentral region (AOR = 0.55; 95% CI: 0.43, 0.72) were significantly associated with lower odds of anemia. However, being pregnant (AOR = 1.34; 95% CI: 1.04, 1.73) and having higher parity (3 children or more) (AOR = 1.40; 95% CI: 1.03, 1.93) were significantly associated with higher odds of anemia. CONCLUSION: In the present study, the prevalence of anemia in women of reproductive age was relatively high. Therefore, it is better to provide special emphasis on high-risk groups such as pregnant and multiparous women.

Diagnostic performance of plasma D-dimer, fibrinogen, and D-dimer to fibrinogen ratio as potential biomarkers to predict hypertension-associated acute ischemic stroke.

Background: Ischemic stroke is a common type of stroke that leads to death and functional disability in hypertensive patients. However, there are no well-studied non-invasive and less expensive fluid biomarkers routinely used to detect ischemic stroke in hypertensive patients. Hence, this study aimed to tease out the performance of D-dimer, fibrinogen, and the D-dimer to fibrinogen ratio (DDFR) in predicting hypertension-associated acute ischemic stroke. Methods: A hospital-based cross-sectional study was done from October 2022 to January 2022 at Yikatit 12 Hospital Medical College, Ethiopia. We recruited 55 hypertensive patients who had an ischemic stroke and 110 who did not. A ROC curve was used to calculate the areas under the curves (AUCs) and determine the diagnostic power of the D-dimer, fibrinogen, and DDFR. The Youden index was used to find the best cut-off points for biomarkers in detecting acute ischemic stroke. A De Long test was employed to show whether there was a significant difference between the AUCs of biomarkers in diagnosing ischemic stroke. Results: D-dimer yielded the highest diagnostic power (AUC = 0.776) in detecting acute ischemic stroke, followed by DDFR (AUC = 0.763) and fibrinogen (AUC = 0.694), but there was no significant difference between them. At 0.52 µg/ml cut-off point, D-dimer had 82.9% sensitivity, 66.7% specificity, 62.5% PPV, and 85.3% NPV to diagnose acute ischemic stroke. Fibrinogen could detect acute ischemic stroke at 405.85 mg/dl level, with 70.0% sensitivity, 57.1% specificity, 41.2% PPV and 81.6% NPV. At a 1.83 ratio, DDFR might also identify ischemic stroke with 80.0% sensitivity, 67.1% specificity, 51.1% PPV, and 88.7% NPV. Conclusion: We showed D-dimer, fibrinogen, and DDFR as promising, affordable, and non-invasive biomarkers for the detection of ischemic stroke among subjects with hypertension. This will help clinicians make an early diagnosis and better guide patient therapy.

Uptake of human papilloma virus vaccine and its determinants among females in East Africa: a systematic review and meta-analysis.

INTRODUCTION: Cervical cancer is the most common malignant tumor among women. It is the main cause of death among women in sub-Saharan African countries. Particularly, the incidence and mortality rates are highest in East Africa. Even though the burden of human papilloma virus-related cervical cancer is high in East Africa, there is no conclusive evidence about the prevalence of human papilloma virus vaccine uptake and its predictors. OBJECTIVE: To assess the pooled prevalence of human papilloma virus vaccine uptake and its determinants in East Africa. METHOD: Eligible articles were searched on PubMed, Embase, Scopus, Cochrane Library, Google Scholar, and Google. Those articles incorporating the outcome of interest, both analytical and descriptive study designs, and published or unpublished articles at any time were included. Keywords and Medical Subjects Heading terms or synonyms of human papilloma virus vaccine and Boolean operators were used to retrieve the articles. To assure the quality of articles, Joana Brigg's Institute critical appraisal checklist for cross-sectional studies was used. Sensitivity analysis was conducted to assess the heterogeneity among the studies, and a random effect model was used to analyze the pooled effect size. RESULT: A total of 29 articles were included, and the pooled prevalence of HPV vaccine uptake in East Africa was 35% (95% CI: 26-45%). Good knowledge (OR = 1.6, 95%CI; 1.43-1.8), positive attitude (OR = 2.54, 95% CI; 2.13-3.03), ever heard about HPV vaccine (OR = 1.41, 95% CI; 1.03-1.94), mother educational status above college (OR = 1.84, 95%CI; 1.03-3.31), middle wealth index (OR = 1.33, 95%CI; 1.04-1.7), ≥ 9 family size (OR = 0.76, 95%CI; 0.68-0.98), availability of promotion (OR = 2.53, 95%CI: 1.51-4.26), availability of adequate vaccine (OR = 4.84, 95%CI; 2.9-8.08), outreach vaccination practice (OR = 1.47, 95%CI; 1.02-2.12) and family support (OR = 4.3, 95% CI; 2.98-6.21) were the significant factors for the uptake of human papilloma virus vaccine. CONCLUSION: As compared to the global strategic plan, the pooled prevalence of HPV vaccine uptake in east Africa was low. The uptake of the HPV vaccine was higher among adolescents than youths. Knowledge about the HPV vaccine, attitude towards the HPV vaccine, ever hearing about the HPV vaccine, residence, mother's educational status, mother's occupational status, wealth index, and family size were the significant determinants of HPV vaccine uptake. Therefore, we recommend focusing on awareness creation and behavioral change to expand the uptake of vaccines in East Africa.

Recent Advancements in Reducing the Off-Target Effect of CRISPR-Cas9 Genome Editing.

The CRISPR-Cas (Clustered Regularly Interspaced Short Palindromic Repeat (CRISPR)) and the associated protein (Cas9) system, a young but well-studied genome-editing tool, holds plausible solutions to a wide range of genetic disorders. The single-guide RNA (sgRNA) with a 20-base user-defined spacer sequence and the Cas9 endonuclease form the core of the CRISPR-Cas9 system. This sgRNA can direct the Cas9 nuclease to any genomic region that includes a protospacer adjacent motif (PAM) just downstream and matches the spacer sequence. The current challenge in the clinical applications of CRISPR-Cas9 genome-editing technology is the potential off-target effects that can cause DNA cleavage at the incorrect sites. Off-target genome editing confuses and diminishes the therapeutic potential of CRISPR-Cas9 in addition to potentially casting doubt on scientific findings regarding the activities of genes. In this review, we summarize the recent technological advancements in reducing the off-target effect of CRISPR-Cas9 genome editing.

High burden of diabetes and prediabetes among cancer patients at University of Gondar comprehensive specialized hospital, Northwest Ethiopia.

Cancer and diabetes mellitus (DM) are diagnosed within the same individual more frequently and share common risk factors. Although diabetes among cancer patients may result in more aggressive clinical courses of cancer, there is limited evidence about its burden and associated factors. Hence, this study aimed to assess the burden of diabetes and prediabetes among cancer patients and its associated factors. Institution-based cross-sectional study was conducted at the University of Gondar comprehensive specialized hospital from 10 January to 10 March 2021. A systematic random sampling technique was used to select 423 cancer patients. The data was collected using a structured interviewer-administered questionnaire. Prediabetes and diabetes diagnosis was made based on World Health Organization (WHO) criteria. Bi-variable and multivariable binary logistic regression models were fitted to identify factors associated with the outcome. Adjusted Odds Ratio (AOR) with a 95% confidence interval was estimated to show the direction and strength of associations. Variables with a p-value less than 0.05 in the multivariable model were considered significantly associated with the outcome. The final analysis was based on 384 patients with cancer. The proportion of prediabetes and diabetes was 56.8% (95% CI 51.7, 61.7) and 16.7% (95% CI 13.3, 20.8), respectively. Alcohol consumption was found to increase the odds of elevated blood sugar among cancer patients (AOR: 1.96; 95%CI: 1.11, 3.46). The burden of prediabetes and diabetes is alarmingly high among cancer patients. Besides, alcohol consumption was found to increase the odds of having elevated blood sugar among cancer patients. Hence, it is essential to recognize cancer patients are at high risk of having elevated blood sugar and design strategies to integrate diabetes and cancer care.

Prevalence of Diarrhea, Intestinal Parasites, and Associated Factors Among Under-Five Children in Dabat District, Northwest Ethiopia: Multicenter Cross-sectional Study.

Background: Despite global interventions to prevent and control diarrhea, it remains a public health problem leading to childhood morbidity and mortality majorly in developing countries. According to the World Health Organization, data from 2021 indicated that diarrheal disease is responsible for 8% of deaths in children under the age of 5. In the world, more than 1 billion under-five children live in poverty, social exclusion, and discrimination affected by intestinal parasitic infections and diarrhea disease. In sub-Saharan African countries like Ethiopia, diarrheal diseases and parasite infections continue to cause significant and persistent morbidity and mortality in under-five children. Therefore, the purpose of this study was to assess the prevalence and associated factors of intestinal parasites and diarrheal diseases in children under the age of 5 years in Dabat District, Northwest Ethiopia in 2022. Method: A community-based, cross-sectional study was carried out from September 16 to August 18th 2022. Four hundred households with at least one child under the age of 5 years were recruited by simple random sampling technique. Sociodemographic, clinical, and behavioral factors were also collected using pretested interviewer-administered questionnaires. Data was entered into Epi-data version 3.1 and exported to Statistical Package for Social Science (SPSS) version 25 for analysis. Binary logistic regression was performed to identify factors associated with diarrhea and intestinal parasitic infections. The level of significance was computed at a P-value ⩽ .05. Descriptive statistics such as frequency and other summary statistics were used for describing sociodemographic variables and determining the prevalence of diarrhea and intestinal parasites. Tables, figures, and texts were used to present the findings. The variables having a P-value of less than .2 in the bivariable analysis were entered into the multivariable analysis at a P-value of ⩽.5. Results: According to this study, the prevalence of diarrhea and intestinal parasites among under-five children was 20.8% (95% CI: [16.8-37.8] and 32.5% (95% CI: [28.6, 37.8], respectively. In multivariable logistic analysis at a P-value of ⩽.5, the educational level of mothers (Adjusted odds ratio [AOR]: 3.7, 95% CI: [1.52, 8.95], residence (AOR: 4.7, 95% CI: [1.52, 8.09]), undernutrition (AOR: 3.6, 95% CI: [1.09, 11.3]), latrine availability (AOR:3.9, 95% CI: [1.23, 9.56]), types of the latrine (AOR: 5.9, 95% CI: [3.42, 11.66]), water treatment (AOR = 7.6; 95% CI: [6.4, 12.7]), eating uncooked vegetable or fruits (AOR = 4.6; 95% CI: [1.025, 15.2]), and source of water (AOR = 4.5; 95% CI: [2.32,8.92]) were significantly associated with diarrheal disease. Intestinal parasitic infection was also significantly associated with undernutrition (AOR = 3.9; 95% CI: [1.09, 9.67]), latrine availability (AOR = 2.1; 95% CI:[1.32, 9.32]), types of the latrine (AOR = 2.8; 95% CI: [1.92, 8.12]) residence (AOR = 4.7; 95% CI: [1.52, 8.09]), water treatment, source of water for drinking (AOR = 4.5; 95% CI: [2.32, 8.92]), eating uncooked vegetables or fruits (AOR = 6.7:95% CI: [3.9, 9.8]), and deworming children with anti-parasitic medication (AOR = 2.4; 95% CI: [1.34, 5.62]), washing hands after latrine used (AOR = 2.2: 95% CI: [1.06, 3.86]). Conclusion: The prevalence of diarrhea and intestinal parasite among under-five children was 20.8% and 32.5%, respectively. Undernutrition, latrine availability, types of latrines, residence, eating uncooked vegetables or fruits, and source of water for drinking and water treatment were associated with intestinal parasitic infection and diarrheal disease. Deworming children with antiparasitic medications and washing hands after latrine use was also significantly associated with parasitic infection. Hence, awareness creation activities on latrine utilization and building, keeping personal hygiene, safe water supply, feeding cooked vegetables or fruits, taking anti-parasitic medications, practice hand washing habit after toilet use are strongly recommended.

Prevalence and determinants of anemia among children aged from 6 to 59 months in Liberia: a multilevel analysis of the 2019/20 Liberia demographic and health survey data.

Background: Anemia is a serious worldwide public health issue that happens at any stage of life but primarily affects young kids and pregnant mothers. Although anemia has a significant impact on child health, its magnitude and associated factors in children aged 6-59 months have not been yet studied in Liberia. Therefore, the aim of this study was to identify the prevalence and determinants of anemia in children aged 6-59 months in Liberia. Methods: The data was extracted from Liberia Demographic and Health Survey, conducted from October 2019 to February 2020. The sample was obtained using a stratified two-stage cluster sampling technique. An overall weighted sample of 2,524 kids aged 6-59 months was involved in the final analysis. We used Stata version 14 software for data extraction and analysis. A multilevel logistic regression model was employed to identify factors associated with anemia. Variables with a P-value of <0.2 in the bivariable logistic regression analysis were selected as candidates for multivariable analysis. In multivariable analysis, the adjusted odds ratios (AOR) with the 95% confidence interval (CI) were declared as the determinants of anemia. Results: The prevalence of anemia in children aged 6-59 months in Liberia was 70.8% [95% CI: 68.9%, 72.5%]. Of these, 3.4% were severe anemia, 38.3% were moderate anemia and 29.1% were mild anemia. Children aged 6-23 and 24-42 months, being stunted, children from households with unimproved toilet facilities, children from households with unimproved water sources, and lack of media (television) exposure were significantly associated with higher odds of anemia. However, using mosquito bed nets, living in the Northwestern and Northcentral region were significantly associated with lower odds of anemia among children 6-59 months. Conclusion: In this study, anemia in kids aged 6-59 months in Liberia was a main public health issue. Age of the child, stunting, toilet facility, water source, exposure to television, mosquito bed net use, and region were significant determinants of anemia. Therefore, it is better to provide intervention for the early detection and management of stunted children. Similarly, interventions should be strengthened to address unimproved water sources, unimproved toilet facilities, and lack of media exposure.

Evaluation of thromboembolic event, basic coagulation parameters, and associated factors in patients with colorectal cancer: a multicenter study.

Background: Patients with colorectal cancer are at an increased risk of hemostatic disturbances, and recent studies have shown that coagulation disorders could be the first sign of malignancy. Although coagulopathy is a significant cause of cancer-related death and disability, it is usually underestimated, and there has been no recent scientific evidence regarding the exact burden and its specific determinants. Moreover, the public health importance of the risk of coagulopathy among patients with colorectal polyps has not been addressed. Materials and methods: An institution-based comparative cross-sectional study was conducted on a total of 500 study participants (250 colorectal cancer patients, 150 colorectal polyp patients, and 100 controls) from January to December 2022. Venous blood was collected for basic coagulation and platelet analysis. Descriptive statistics and non-parametric tests (Kruskal-Wallis and Dunn-Bonferroni pairwise comparisons) were used to compare study parameters among the groups. The test results were expressed as medians and interquartile ranges. Binary logistic regressions were fitted, and statistical significance was declared at a p-value of less than 0.05, with 95% CI. Results: The prevalence of coagulopathy among colorectal cancer patients was 198 (79.2%; 95% CI: 73.86, 83.64), while the prevalence was 76 (50.7%; 95% CI: 45.66, 54.34) among colorectal polyp patients. From the final model, age between 61 and 70 (AOR = 3.13: 95% CI: 1.03, 6.94), age > 70 years (AOR = 2.73: 95% CI: 1.08, 4.71), hypertension (AOR = 6.8: 95% CI: 1.07, 14.1), larger tumor size (AOR = 3.31: 95% CI: 1.11, 6.74), metastatic cancer (AOR = 5.8: 95% CI: 1.1, 14.7), and BMI ≥30 kg/m2 (AOR = 3.8: 95% CI: 2.3, 4.8) were positively associated with coagulopathy. Conclusion: This study showed that coagulopathy is a major public health concern among patients with colorectal cancer. Therefore, existing oncology care efforts should be strengthened to prevent coagulopathy among patients with colorectal cancer. Moreover, patients with colorectal polyps should receive more attention.

Dyslipidemia and serum cystatin C levels as biomarker of diabetic nephropathy in patients with type 2 diabetes mellitus.

Background: Diabetic nephropathy is a leading cause of end-stage renal disease. The diagnostic markers of nephropathy, including the presence of albuminuria and/or a reduced estimated glomerular filtration rate, are not clinically ideal, and most of them are raised after a significant reduction in renal function. Therefore, it is crucial to seek more sensitive and non-invasive biomarkers for the diagnosis of diabetic nephropathy. Objective of the study: This study aimed to investigate the serum cystatin C levels and dyslipidemia for the detection of diabetic nephropathy in patients with type 2 diabetes mellitus. Methodology: A hospital-based comparative cross-sectional study was conducted from December 2021 to August 2022 in Tikur, Anbessa specialized teaching hospital with a sample size of 140 patients with type2 diabetes mellitus. Socio-demographic data was collected using a structured questionnaire, and 5 mL of blood was collected from each participant following overnight fasting for biochemical analyses. Results: In type 2 diabetes patients with nephropathy, we found significant lipoprotein abnormalities and an increase in serum cystatin C (P < 0.001) compared to those without nephropathy. Serum cystatin C, systolic blood pressure, fasting blood glucose, total cholesterol, triglyceride, low density lipoprotein, very low-density lipoprotein, high density lipoprotein, and duration of diabetes were identified as being significantly associated with diabetic nephropathy (P < 0.05) in multivariable logistic regression analysis. The mean values of total cholesterol levels, triglyceride levels, and high-density lipoprotein cholesterol levels were also found to be significantly higher (P < 0.05) in females as compared to male type-2 diabetic patients. The fasting blood glucose levels and lipid profiles of the participants were found to be significantly associated with serum cystatin C levels. Conclusion: The present study found significant serum cystatin C and lipoprotein abnormalities in T2DM patients with diabetic nephropathy when compared with those without diabetic nephropathy, and these lipoprotein abnormalities were significantly associated with serum cystatin C levels.

HIV testing and associated factors among men (15-64 years) in Eastern Africa: a multilevel analysis using the recent demographic and health survey.

BACKGROUND: Despite significant efforts made to prevent human immunodeficiency virus (HIV) transmission, its testing coverage among men is still low and remains a major concern in low-income countries, particularly in East Africa. Therefore, this study aimed to determine the prevalence and associated factors of HIV testing among men in Eastern Africa. METHODS: We analyzed secondary data using Demographic and Health Surveys (DHS) drawn from Eastern African countries. Besides, we merged DHS data from eleven Eastern African countries. In this study, we included secondary data from 113, 270 men aged 15-64 years. The outcome variable of this study was "ever been tested for HIV". Bivariable and multivariable multi-level logistic regression analyses were employed. In the bivariable analysis, variables having a P-value of less than 0.2 were selected for multivariable analysis. Lastly, variables with a P-value of < 0.05 in the multivariable analysis were declared as a significant factor associated with HIV testing and the adjusted odds ratio (AOR) with the 95% confidence interval (CI) were computed to determine the strength and direction of the association. RESULTS: The overall prevalence of HIV testing among men in eastern Africa was 60.5% (95% CI: 60.2, 60.7%). In the multivariable multilevel analysis; participant's older age, being married, increased poverty, HIV knowledge, risky sexual behavior, and being covered by health insurance were positively associated with HIV testing coverage among men. However, men with higher community illiteracy levels, residing in rural settings, age at first sex ≥20 years, and higher stigmatized attitudes towards HIV/AIDS had lower odds of being tested for HIV. CONCLUSION: The overall prevalence of HIV testing among men in eastern Africa was relatively higher than the previous studies. The study revealed that age, marital status, residence, age at first sex, community poverty level, community illiteracy level, HIV knowledge, HIV stigma indicator, risky sexual behavior, and health insurance were significantly associated with HIV testing coverage among men. Therefore, all the concerned stakeholders need to develop an integrated strategic plan through providing special attention to the factors that affect the uptake of HIV testing to raise awareness about the importance of HIV testing and to prevent HIV/AIDS transmission.

Prevalence and associated risk factors of preterm birth among neonates in referral hospitals of Amhara Region, Ethiopia.

INTRODUCTION: Preterm birth (PTB) is the largest direct cause of neonatal mortality and the second leading cause of under-five mortality following pneumonia. Although there are studies conducted before, the magnitude of PTB remains a major issue in most developing countries including Ethiopia. Therefore, this study aims to assess the prevalence and associated factors of premature birth among newborns delivered in Amhara Region Referral Hospitals, Northern Ethiopia. METHODS: A hospital-based cross-sectional study was undertaken from February to April 2020. A systematic sampling technique was used to select 482 mother-newborn pairs. The data were collected by interviewing the mothers and reviewing their charts using a structured and pretested questionnaire. The outcome variable was preterm birth. Data were entered using Epi-data version 4.6 and then analyzed using STATA software (version 14). Bivariable and multivariable logistic regression analyses were done to determine the risk factors associated with premature birth. RESULTS: In this study, the prevalence of premature birth was 11.41% (95% CI: 8.9, 14.6%). In multivariable logistic regression model; maternal age < 20 years (Adjusted odds ratio (AOR) = 7.8: 95% CI 2.3-26), preeclampsia (AOR = 5: 95% CI 2.3-11), premature rupture of membrane (AOR = 3.9: 95%CI 1.6-9.0), chronic medical illness (AOR = 4.6:95% CI2.1-10), and history of stillbirth (AOR = 2.7: 95% CI 1.1-7.3) were significantly associated with preterm birth. CONCLUSION: The study indicates preterm birth is a major public health problem among newborns delivered in Amhara region referral hospitals. The risk factors associated with preterm birth are maternal age <20 years, preeclampsia, premature rupture of membranes, chronic medical illness, and history of stillbirth. Therefore, public health interventions have to be made to reduce the burden of prematurity through early detection and management of preeclampsia, premature rupture of membranes, and chronic medical illness. Obstetric care providers should give due attention to women with an age of <20 years and a history of stillbirth.

Maternal and neonatal factors associated with low birth weight among neonates delivered at the University of Gondar comprehensive specialized hospital, Northwest Ethiopia.

Introduction: Low birth weight is a major contributory factor to infant mortality. Although low birth weight remains an important public health problem in Ethiopia, little emphasis is paid to its intervention as a means of reducing neonatal mortality. The aim of this study was to assess the magnitude of low birth weight and its associated maternal and neonatal factors in newborns delivered at the University of Gondar Comprehensive Specialized Hospital. Methods: Hospital-based cross-sectional study was conducted, and 481 study participants were selected using systematic random sampling methods. Pre-tested interviewer-administered questionnaires were used to collect the data. Bivariable and multivariable binary logistic regression was implemented. Finally, the odds ratio with a 95% CI and a p-value of <0.05 were used to identify factors associated with low birth weight. Result: The prevalence of low birth weight was 12.5% (95% CI; 9.8, 15.7%). Preterm birth (AOR = 38; 95% CI: 15.3, 93.0), pregnancy-induced hypertension (PIH) (AOR = 2.6; 95%CI: 1.1, 6.4), maternal body mass index (BMI) of < 18.5 kg/m2 (AOR = 6.8; 95% CI: 1.5, 31.1), and grand multiparity (AOR = 4.2; 95% CI: 1.2, 16) were factors positively associated with low birth weight. However, babies delivered from mothers with age > 35 years (AOR = 0.14:95% CI 0.03, 0.7) had lower odds of low birth weight. Conclusion: In this study, the prevalence of low birth weight was higher than in the previous studies. The study revealed preterm birth, PIH, BMI of < 18.5 kg/m2, and grand multiparity were independent factors that increase the low birth weight while maternal age > 35 years reduces the low birth weight. Therefore, healthcare professionals should emphasize the early identification and management of women with PIH, tackling prematurity, and preventing maternal malnutrition through nutritional counseling as much as possible.

Hearing loss and its associated factors among metal workshop workers at Gondar city, Northwest Ethiopia.

Introduction: Noise-induced hearing loss is a permanent sensorineural deficiency, which is caused by exposure to excessive noise sound. Although noise-induced hearing loss due to industrialization is a main public health problem in Ethiopia, studies on the prevalence and associated factors of hearing loss are scarce. Objectives: This study aimed to assess the prevalence and associated factors of hearing loss among workers at a metal workshop in Gondar city, Northwest Ethiopia. Methods: A cross-sectional study was employed among 300 participants using a stratified sampling technique. Data were collected using an interviewer-administered questionnaire. Bivariable and multivariable logistic regressions were conducted. In the multivariable logistic regression model, adjusted odds ratios (AOR) with a 95% confidence interval (CI) and a p < 0.05 were computed to determine the level of significance. Results: The prevalence of hearing loss among metal workshop workers was 30.7% [95% CI: (25.7, 35.7)]. Age between 30 and 44 years [AOR = 2.9; 95% CI: 1.2, 7.1], age between 45 and 65 years [AOR = 3.8; 95% CI (1.5, 9.5)], cigarette smoking [AOR = 2.3; 95% CI: 1.2, 4.5], working area noise level >85 dB [AOR = 2.2; 95% CI: 1.1, 6.5], working experience of 6-10 years [AOR = 1.8; 95% CI: 1.4, 6.0], working experience >10 years [AOR = 3.5; 95% CI: 1.3, 4.3], and using ear protection devices [AOR = 0.3; 95% CI: 0.1, 0.6] were significantly associated with hearing loss. Conclusion: The prevalence of hearing loss was considerably high. This study revealed that advanced age, cigarette smoking, increased working area noise level, and working experiences were found to increase the odds of having hearing loss. Therefore, it is important to emphasize metal workshop workers that are at high risk of hearing loss and develop preventive strategies to reduce the burden of this problem. Besides, minimizing working area noise levels, proper utilization of ear protection devices, and creating awareness about the impact of hearing loss are recommended.

Prevalence and associated factors of hypertension among adult patients attending the outpatient department at the primary hospitals of Wolkait tegedie zone, Northwest Ethiopia.

Introduction: Hypertension, often known as increased blood pressure, is a worldwide public health concern. Globally, ~1 billion people have hypertension and 7.1 million die from this disease. It is disproportionately more prevalent in resource-poor nations, with inadequate health systems like Ethiopia. Moreover, information on the burden of disease from hypertension in the specific area, especially in the newly organized Wolkait Tegedie zone, is essential to develop effective prevention and control strategies. Therefore, this study aimed to assess the prevalence of hypertension and associated factors among adult patients evaluated at the outpatient department of the two district hospitals in the Wolkait Tegedie zone, Northwest Ethiopia. Methods: An institution-based cross-sectional study was conducted from September to October 2021. A systematic random sampling technique was used to select a total of 449 participants. The data were collected and then entered using EPI-INFO version 7 and exported to STATA 14 for analysis. Bivariable and multivariable binary logistic regression analyses were performed. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used as a measure of association. Variables having a p-value < 0.05 from the multivariable analysis were considered to have a significant association with the outcome. Results: The prevalence of hypertension among adult patients in this study was 44.91% [95% CI: 40.26%, 49.65%], of which 63.92% were new diagnoses. Being >60 years [AOR = 1.81; 95% CI: 1.11, 3.20], having poor physical exercise [AOR = 1.74; 95% CI: 1.01, 3.15], consuming cruddy oil [AOR = 15.22; 95% CI: 3.86, 60.12], having a family history of hypertension [AOR = 13.02; 95% CI: 3.75, 45.16], and having a history of diabetes mellitus (DM) [AOR = 8.05; 95% CI: 1.24, 51.49] had a statistically significant association with having hypertension. Conclusion: There is a relatively high prevalence of hypertension among adult patients in the outpatient department of the two primary hospitals, Northwest Ethiopia. Factors such as being of older age, having poor physical exercise behavior, cruddy oil consumption, and family history of DM and hypertension had a positive significant statistical association with being hypertensive. Community-based screening programs for hypertension should be designed and implemented to prevent this silent killer disease. Health education and promotion that focus on healthy nutrition and physical exercise should be delivered.

Therapeutic Application of Stem Cells in the Repair of Traumatic Brain Injury.

Traumatic brain injury is the main cause of injury-related deaths and disabilities throughout the world, which is characterized by a disruption of the normal physiology of the brain following trauma. It can potentially cause severe complications such as physical, cognitive, and emotional impairment. In addition to understanding traumatic brain injury pathophysiology, this review explains the therapeutic potential of stem cells following brain injury in two pathways: response of endogenous neurogenic cells and transplantation of exogenous stem cell therapy. After traumatic brain injuries, clinical evidence indicated that endogenous neural progenitor cells might play an important role in regenerative medicine to treat brain injury. This is due to an increased neurogenic regeneration ability of these cells following brain injury. Besides, exogenous stem cell transplantation has also accelerated immature neuronal development and increased endogenous cellular proliferation in the damaged brain region. Therefore, a better understanding of the endogenous neural stem cell's regenerative ability and the effect of exogenous stem cells on proliferation and differentiation ability may help researchers to understand how to increase functional recovery and tissue repair following injury.

Hypertension and Its Associated Factors Among Cancer Patients at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: Hospital-Based Cross-Sectional Study.

Introduction: Hypertension is the most common comorbidities in adult cancer patients. Although hypertension is a leading cause of cancer-related death and disability, there is no evidence about its prevalence and associated factors among cancer patients in Ethiopia. Therefore, this study aimed to assess the prevalence and associated factors of hypertension among cancer patients. Methods: Hospital-based cross-sectional study was conducted among cancer patients from January to March 2021. A systematic random sampling technique was performed to select 403 study participants. To collect the data, structured interviewer-administered questionnaires were used. Both bi-variable and multivariable binary logistic regression analyses were used to identify factors associated with hypertension. In the multivariable logistic regression analysis, adjusted odds ratios (AOR) with 95% confidence interval (CI) and P-value of less than 0.05 were used to determine significant factors. Results: The final result was based on 384 cancer patients. In this study, the prevalence of hypertension among adult cancer patients was 36.2% [95% CI: (31.5, 41.2)]. In the multivariable logistic regression analysis, age greater than 57 years [AOR = 5.0; 95% CI (1.7, 14.9)] and having a family history of hypertension [AOR 10.9; 95% CI (5.5, 21.6)] were found to be significantly associated with hypertension. Conclusion: The prevalence of hypertension among cancer patients was considerably high. Age >57 years and family history of hypertension were found to increase the odds of having hypertension among cancer patients. Therefore, it is important to emphasize cancer patients that are at high risk of hypertension and develop preventive strategies to decrease the burden of this disease. There is a need for routine screening for hypertension for those having a positive family history of hypertension and older age, as they have an increased likelihood of developing high blood pressure among cancer patients.

Prevalence and associated factors of cancer pain among adult cancer patients evaluated at an oncology unit in the University of Gondar Comprehensive Specialized Hospital, northwest Ethiopia.

Introduction: Globally, cancer is the second leading cause of death and was responsible for 9.6 million deaths in 2018. Worldwide, 2 million people experience pain every day, and cancer pain is one of the major neglected public health problems, especially in Ethiopia. Despite reporting the burden and risk factors of cancer pain as a principal importance, there are limited studies. Therefore, this study aimed to assess the prevalence of cancer pain and its associated factors among adult patients evaluated at the oncology ward in the University of Gondar Comprehensive Specialized Hospital, northwest Ethiopia. Methods: An institution-based cross-sectional study was conducted from 1 January to 31 March 2021. A systematic random sampling technique was used to select the total sample size of 384 patients. Data were collected using pretested and structured interviewer-administered questionnaire. Bivariate and multivariate logistic regression models were fitted to identify the factors associated with cancer pain among patients with cancer. An adjusted odds ratio (AOR) with a 95% CI was computed to determine the level of significance. Results: A total of 384 study participants were involved, with a response rate of 97.5%. The proportion of cancer pain was found to be 59.9% (95% CI 54.8-64.8). The odds of cancer pain were escalated by anxiety (AOR = 2.52, 95% CI 1.02-6.19), patients with hematological cancer (AOR = 4.68, 95% CI 1.30-16.74), gastrointestinal cancer (AOR = 5.15, 95% CI 1.45-18.2), and stages III and IV (AOR = 14.3, 95% CI 3.20-63.7). Conclusion: The prevalence of cancer pain among adult patients with cancer in northwest Ethiopia is relatively high. Variables such as anxiety, types of cancer, and stage of cancer had a statistically significant association with cancer pain. Hence, to advance the management of pain, it is better to create more awareness regarding cancer-related pain and provide palliative care early on in the diagnosis of the disease.

Current Clinical Application of Mesenchymal Stem Cells in the Treatment of Severe COVID-19 Patients: Review.

Coronavirus-2019 disease is a newly diagnosed infectious disease, which is caused by the severe acute respiratory syndrome corona virus-2. It spreads quickly and has become a major public health problem throughout the world. When the viral structural spike protein binds to the angiotensin-converting enzyme-2 receptor of the host cell membrane, the virus enters into host cells. The virus primarily affects lung epithelial cells or other target cells that express angiotensin-converting enzyme-2 receptors in COVID-19 patients. Chemokines released by the host cells stimulate the recruitment of different immune cells. A cytokine storm occurs when a high amount of pro-inflammatory cytokines are produced as a result of the accumulation of immune cells. In COVID-19 patients, cytokine storms are the leading cause of severe acute respiratory distress syndrome. Mesenchymal stem cells are multipotent and self-renewing adult stem cells, which are obtained from a variety of tissues including bone marrow, adipose tissue, Warthon's jelly tissue, and amniotic fluid. Mesenchymal stem cells primarily exert their important therapeutic effects through 2 mechanisms: immunoregulatory effects and differentiation capacity. Mesenchymal stem cells can release several cytokines via paracrine mechanism or by direct interaction with white blood cells such as natural killer cells, T-lymphocytes, B-lymphocytes, natural killer cells, and macrophages, resulting in immune system regulation. Mesenchymal stem cells may help to restore the lung microenvironment, preserve alveolar epithelial cells, prevent lung fibrosis, and treat pulmonary dysfunction that is caused by COVID-19 associated pneumonia. Mesenchymal stem cells therapy may suppress aggressive inflammatory reactions and increase endogenous restoration by improving the pulmonary microenvironment. Furthermore, clinical evidence suggests that intravenous injection of mesenchymal stem cells may radically reduce lung tissue damage in COVID-19 patients. With the advancement of research involving mesenchymal stem cells for the treatment of COVID-19, mesenchymal stem cells therapy may be the main strategy for reducing the recent pandemic.

Prevalence and Associated Factors of Macrosomia Among Newborns Delivered in University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia: An Institution-Based Cross-Sectional Study.

BACKGROUND: Macrosomia is defined as a birth weight of newborns ≥4000 grams irrespective of gestational age. It is becoming a burning public health issue in most developing countries and contributes to maternal and newborn complications. Though macrosomia has been increasing in Ethiopia, evidence about its magnitude and associated factors is limited yet. Therefore, this study aimed to assess the prevalence and associated factors of macrosomia among newborns delivered at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. METHODS: An institution-based cross-sectional study was carried out from February 23rd to April 23rd, 2020. A total of 491 mothers and their newborns were included in the study. The data were collected by interviewing the mothers and reviewing their charts using a structured questionnaire. The outcome variable was newborn birth weight. Data were entered using Epi-data version 4.6 and analyzed using STATA version 14 software. Bivariable and multivariable binary logistic regression were used to identify the factors associated with macrosomia. RESULTS: The prevalence of macrosomia was 7.54%. Gestational age ≥40 weeks (adjusted odds ratio (AOR) = 4.1 (95% CI = 1.7-9.7)), diabetes mellitus (AOR=5.5 (95% CI = 1.2-25)), previous history of macrosomia (AOR = 3.7 (95% CI = 1.4-10)), and male sex (AOR = 3.4 (95% CI = 1.3-8.7)) were significantly associated with macrosomia. CONCLUSION: In the current study, the prevalence of macrosomia was relatively high. The study revealed that maternal diabetes mellitus, higher gestational age, history of macrosomia, and male newborns were the predictors of macrosomia. Thus, obstetric caregivers should give attention to early detection and management of mothers with diabetes mellitus, history of macrosomia, and gestational age of ≥40 weeks during pregnancy to prevent macrosomia and its complications.