Hematological Abnormalities and Associated Factors Among Patients with Hypothyroidism at the University of Gondar Comprehensive Specialized Hospital.

Objective: Abnormalities in blood cells are frequently associated with thyroid hormone disorders as a result of their involvement in the proliferation and production of blood cells. This study aimed to determine the magnitude and associated factors of hematological abnormalities in patients with hypothyroidism. Methods: A cross-sectional study was conducted from January 1 to June 30, 2023, at the University of Gondar Comprehensive Specialized Hospital. The present study included a total of 300 patients with hypothyroidism prospectively using the systematic random sampling technique. The hematological parameter data were collected using data extraction sheets, whereas the associated factor data were collected using both structured questionnaires and data extraction sheets. For complete blood cell counts, 4 mL of anticoagulated venous blood was collected and analyzed. The data were entered into Epi-data version 3.1 and analyzed with Stata version 14. Both bivariate and multivariate logistic regressions were performed to identify factors associated with hematological abnormalities. A P value < 0.05 was considered to indicate statistical significance. Results: The median value of red blood cell, hemoglobin, mean cell volume, white blood cell, and platelet were 4.63 x1012/µL, 14 g/dL, 84.3fl, 5.3 x103/µL, and 228, respectively. The overall incidences of anemia, leucopoenia, and thrombocytopenia in patients with hypothyroidism were 26.3% (95% confidence interval (CI): 21-32), 15.7% (95% CI: 14.2-17.2), and 9% (95% CI: 7.5-10.5), respectively. Lymphopenia was detected in 9% (95% CI: 8.6-10.1) of the patients, and neutropenia was detected in 6% (95% CI: 4.4-7.6) of the patients. Only three factors, female sex (adjusted odds ratio (AOR) =2.1, 95% CI=1.3-3.1), alcohol consumption (AOR= 3.8, CI=1.7-8.9), and febrile illness (AOR=2.7, 95% CI=1.3-5.4), were found to be significantly associated factors for anemia. Conclusion: The present study revealed heterogeneous hematological abnormalities in patients with hypothyroidism. Thus, early diagnosis and monitoring strategies are required to minimize complications in patients.

Insulin Resistance-Induced Platelet Hyperactivity and a Potential Biomarker Role of Platelet Parameters: A Narrative Review.

Background: Insulin has an inhibitory effect on platelets; however, this is compromised in circumstances of Insulin Resistance (IR), leading to platelet hyperactivity. Platelet parameters such as mean platelet volume, platelet count, and platelet distribution width are simple and accessible potential biomarkers for the early diagnosis and prognosis of IR. Therefore, the aim of this review is to provide insight on the current status of knowledge regarding IR-induced platelet hyperactivation and the potential biomarker role of platelet parameters. Methods: This narrative review included articles published in the English language. Searches were carried out at the electronic databases PubMed and Google Scholar. The search strategy was done by combining key words and related database-specific subject terms (Mesh terms) with the appropriate Boolean operators. Conclusion: Increasing insulin sensitivity in insulin resistant patients would possibly cause substantial reduction in platelet activation, which in turn reduce complications related with platelet hyperactivation. The standard methods to measure IR are not frequently employed in clinical practice due to their expensiveness and complexity. Thus, early detection of IR using a simple and more widely available biomarkers such as mean platelet volume, platelet count and platelet distribution width would be beneficial. Particularly in developing countries where resource scarcity is a major constraint of the health sector, utilizing such easy and affordable biomarkers may have a crucial role.

Postpartum anemia and its determinant factors among postnatal women in two selected health institutes in Gondar, Northwest Ethiopia: A facility-based, cross-sectional study.

Background: Anemia is highly prevalent globally and disproportionately affects postnatal women. It is a significant cause of maternal mortality and morbidity globally. Objective: The main aim of this study was to determine the extent of postpartum anemia and associated factors among postnatal women in two selected health facilities in Gondar, Northwest Ethiopia. Methods: A facility-based, cross-sectional study was conducted among 282 postnatal women from March to May 2021. A systematic sampling technique was used to recruit study participants from each institute. Sociodemographic, obstetric, and clinical data were collected through a semi-structured questionnaire. A venous blood sample was collected to determine the red blood cell parameters. A thin blood smear preparation was performed to examine blood morphology. In addition, direct wet mount and formalin-ether sedimentation techniques were used for stool examination to identify intestinal parasites. Data were entered into EpiData and exported to Stata 14 for statistical analysis. Descriptive statistics were presented in text, tables, and figures. A binary logistic regression model was used to identify factors associated with postpartum anemia. A p-value <0.05 was considered statistically significant. Results: The proportion of postpartum anemia was 47.16%; 95% CI; 41.30-53.03 with moderate, mild, and severe anemia accounting for 45.11, 42.86, and 12.03%, respectively. The majority of the anemia (94%) was of the normocytic normochromic type. It was associated with postpartum hemorrhage (AOR = 2.23; 95% CI: 1.24-4.01), cesarean section (AOR = 4.10; 95% CI: 2.11-7.78), lack of iron and folate supplementation during pregnancy (AOR = 2.12; 95% CI: 1.17-4.02), and low diet diversity level (AOR = 1.83; 95% CI: 1.05-3.18). Conclusion: The prevalence of anemia was found to be a major public health concern. Iron and folate supplementation during pregnancy, improved management of PPH, an effective cesarean section with post-operative care, and taking a diversified diet will reduce the burden. Therefore, identified factors should be considered to prevent and control postpartum anemia.

Hematological abnormalities and associated factors among metabolic syndrome patients at the University of Gondar comprehensive specialized hospital, Northwest Ethiopia.

BACKGROUND: Metabolic Syndrome (MetS) is a cluster of interconnected metabolic diseases. Hematological abnormalities are common but neglected complications of MetS. Thus, this study aimed to determine the magnitude of hematological abnormalities and their associated factors among MetS patients at the University of Gondar comprehensive specialized hospital, Northwest Ethiopia. METHOD: A hospital-based cross-sectional study was conducted at the University of Gondar comprehensive specialized hospital from March to May 2022. A total of 384 MetS patients were selected using a systematic random sampling technique. Data were collected using pre-tested structured questionnaires and checklists. Anthropometric and blood pressure measurements were taken, and blood sample was collected for complete blood count determination. Stool and blood film examinations were performed to detect intestinal and malaria parasites, respectively. Data were entered into EpiData 3.1 and analyzed by Stata 14.0 software. Bivariate and multivariate logistic regression models were fitted to identify factors associated with hematological abnormalities. A p-value of < 0.05 was considered statistically significant. RESULTS: The magnitude of anemia, leukopenia, leukocytosis, thrombocytopenia, and thrombocytosis was found to be 13.3%, 0.5%, 2.9%, 1.6%, and 2.3%, respectively. Being male (AOR = 2.65, 95% CI: 1.14, 6.20), rural residency (AOR = 5.79, 95% CI: 1.72, 19.51), taking antihypertensive medications (AOR = 3.85, 95% CI: 1.16, 12.78), having elevated triglyceride level (AOR = 2.21, 95% CI: 1.03, 4.75), and being overweight or obese (AOR = 0.32, 95% CI: 0.16, 0.64) were significantly associated with anemia. CONCLUSIONS: Anemia was the most prevalent hematological abnormality identified in the present study, followed by leukocytosis and thrombocytosis. Anemia was a mild public health problem among MetS patients in the study area. Routine anemia screening for all MetS patients, especially for those with significant associated factors, may help in the early detection and effective management of anemia, which subsequently improves the patients' quality of life.

Hematological abnormalities before and after initiation of cancer treatment among breast cancer patients attending at the University of Gondar comprehensive specialized hospital cancer treatment center.

BACKGROUND: Breast cancer is the most frequent and fatal cancer type globally. The fatality rate of breast cancer is mostly due to disease complications like hematological alterations. Therefore, this study aimed to assess the hematological abnormalities before, during, and after the initiation of cancer treatment in breast cancer patients at the University of Gondar comprehensive specialized hospital. METHODOLOGY: Hematological profiles were collected from 267 breast cancer patients who attended the cancer treatment center from September 2017 to August 2021. A data extraction sheet was used to extract data from the patient's medical chart, including sociodemography, clinical, and hematological profiles. EPI info version 3.5.1 and SPSS Version 25 softwares were used for data entrance and analysis, respectively. Descriptive statistics were summarized using frequency and percentage. The Friedman test followed by a Wilcoxon signed rank test was used to compare the mean difference between the hematological profiles at zero and after the 4th and 8th cycles of treatment. RESULT: Of the total participants, 91% were females, and the median age of the study participants was 45 (IQR = 36, 55) years. Red blood cell, white blood cell, and lymphocyte counts, as well as hematocrit and hemoglobin values, were significantly reduced after the initiation of cancer treatment, while the platelet count and red cell distribution width were significantly increased. The prevalence of anemia was 21.7% (95% CI: 16.6, 26.8), 22.7% (95% CI: 17.6, 27.8), and 26.4% (95% CI: 21.3, 31.5) before, during, and after the initiation of cancer treatment, respectively. The prevalence of leukopenia before, during, and after treatment was 9.7%, 18.8%, and 15.1%, respectively. Finally the prevalence of thrombocytopenia was 6.3%, 3.4%, and 8% at before, during, and after treatment, respectively. CONCLUSION: This study concluded that many hematological parameters were significantly affected by the breast cancer treatment. Therefore, proper patient follow-up and provide appropriate interventions related to their hematological abnormalities is crucial. It is also important to conduct further prospective studies to confirm the findings of this study.

A mean platelet volume in inflammatory bowel disease: A systematic review and meta-analysis.

BACKGROUND: Inflammatory bowel disease (IBD) is a chronic gastrointestinal tract inflammatory state, which is affecting millions of individuals in the world. It can affect alimentary canals such as colon, rectum, ileum and other parts. In IBD, platelet parameters underwent several changes. Therefore, the aim of this review was determining the estimated pooled mean platelet volume and mean difference in inflammatory bowel disease to elucidate its potential diagnostic value. METHODS: Articles were extensively searched in bibliographic databases using Medical Subject Heading and entry phrases or terms. In addition, articles were directly searched in Google Scholar to account for the studies omission in searching bibliographic databases. Observational (cohort, cross-sectional and case-control) studies, published in English language and conducted on IBD were included. For studies meeting the eligibility criteria, the first author's name, publication year, population, study design, study area, sample size, mean platelet volume and standard deviation were extracted and entered in to Microsoft-excel. The analysis was done by Stata version 11. In order to estimate the pooled mean platelet volume and mean difference, random effect model was done. The heterogeneity was quantified using Higgin's I2 statistics. Publication bias was determined using Egger's test statistics and funnel plot. Sub-group analysis based on population carried to reduce heterogeneity. RESULTS: A total of 17 relevant articles with 2957 participants (1823 IBD cases and 1134 healthy controls) were included to this study. The pooled estimated MPV was 9.29fl; 95% CI: 9.01-9.57 and 9.50fl; 95% CI: 8.81-10.20 in IBD and control groups, respectively. The standardized pooled estimate of mean difference in mean platelet volume was -0.83fl; 95% CI: -1.15, -0.51; I2: 93.1%; P-value < 0.001. In subgroup analysis based on population, the highest estimated mean difference in MPV was observed among patients of CD; -2.30; 95% CI: -3.46, -1.14; I2: 97.8%; P-value < 0.001. CONCLUSION: According to the current systematic review and meta-analysis, mean platelet volume was lower in IBD compared to control. The decreased mean platelet volume could be attributed to platelet consumption or sequestration associated with the progression of IBD. As a result, in IBD, mean platelet volume can provide diagnostic and prognostic information.

Anemia in African malnourished pre-school children: A systematic review and meta-analysis.

Generating accurate epidemiological data on the magnitude of anemia in malnourished children is a vital step for health policymakers. Therefore, this study is aimed to synthesize the overall magnitude of anemia in African malnourished pre-school children. We have searched the databases PubMed/MEDLINE, Embase, Scopus, Web of Science, Google Scholar, and Google to identify relevant articles. Joana Brigg's Institute critical appraisal tool was used to assess the quality of articles. A random-effects model was applied to estimate the pooled prevalence of anemia in malnourished children. The I2 statistics were used to examine heterogeneity among the included studies. In the presence of heterogeneity, a subgroup analysis has been used. The funnel plot analysis and Egger's tests were used to investigate the presence of publication bias. A total of 15 articles with 12,211 study participants were included in this study. Anemia was observed in 57.53% (95% CI: 47.05, 68.01) of African malnourished pre-school children. Moreover, the prevalence of anemia was 58.52% (95% CI: 43.04, 73.81) and 56.18% (95% CI: 40.24, 72.13) in HemoCue and auto-machine diagnosis method of anemia, respectively. This review showed that the magnitude of anemia was high among African malnourished pre-school children. Therefore, planning preventive measures to decrease anemia and its complications in malnourished children in Africa is an important step.

Phenotype, Allele and Genotype Frequency of ABO and Rhesus D Blood Groups of Blood Donors at the North Gondar District Blood Bank, Northwest Ethiopia.

BACKGROUND: Knowledge of the ABO and RhD group distribution is essential for blood banks inventory and assuring quality blood transfusion services. The objective of this study was to determine the frequency of ABO and RhD phenotype, allele, and genotype among blood donors at North Gondar District Blood Bank from 2010 to 2012, Northwest Ethiopia. METHODS: The data of the current study were obtained from registration logbooks of blood donors registered. The ABO and RhD grouping was done by using commercially available monoclonal antibodies (anti-A, anti-B and anti-D) by slide methods. Results with no agglutination by anti-D antibody were confirmed using anti-human globulin test. Descriptive statistics were analyzed using SPSS version 20. The allele and genotype frequency of the donors was determined by Hardy-Weinberg equilibrium assumption. The difference between the observed and expected frequency was tested by online Chi-square calculator. P-value of <0.05 was considered statistically significant. RESULTS: Among 6471 blood donors, 82.1%, 94.1% and 55.4% were males, replacement donors and in the age group of 21-30 years, respectively. Blood group O (47.04%) and blood group AB (4.81%) were the dominant and least common, respectively. The distribution of the RhD negative blood group was 5.76%. The distribution of A, B and O alleles was 0.1714, 0.1433 and 0.6859, respectively. Moreover, the genotype frequency of AA, AO, BB, BO, AB and OO was 0.0294, 0.2350, 0.0205, 0.1966, 0.0491 and 0.4704, respectively. The genotype frequency of DD, Dd and dd was 0.5774, 0.3649 and 0.0576, respectively. The result showed that there was no statistically significant difference between observed and expected allele and genotype frequency (P-value >0.05). CONCLUSION: Blood group O and AB were the most and least prevalent, respectively. The allele and genotype frequency of the population was fulfilled the Hardy-Weinberg equilibrium assumption. This finding might be useful for blood transfusion services.

Hematological malignancies in the Northwest Ethiopia.

BACKGROUND: The effect of malignant diseases is increasing globally, particularly in developing countries as shown by recent cancer statistics from the world health organization reports. It is anticipated that with an increase in life expectancy consequent upon the improved standard of living and increasing urbanization, the burden of hematological malignancies in sub-Saharan Africa particularly in Ethiopia is likely to increase recently. Therefore, this study was aimed to determine the incidence and trend of hematological malignancy in Northwest Ethiopia. METHODS: A facility-based retrospective study was conducted from 2015 to 2019 at the University of Gondar and Bahir-Dar Felegehiwot comprehensive specialized hospitals. Hematological malignancy data were collected by using a data collection sheet that was consisted of patients' socio-demography, clinical, and laboratory data. Then, data were entered into Epi-info 3.5.1 and exported to SPSS version 20 for analysis. Skewness and kurtosis were used to check data distribution. Descriptive statistics were summarized as percentages, means, and standard deviations of background variables, and the trend were analyzed. RESULTS: In this study, a total of 1,342 study participants were included. The mean age of study participants was 41.49 ± 16.3 years with a range of 1 to 92 years. About 58.3%, 52.2%, and 80% of the cases were observed among males, 18-45 age group, and urban residences, respectively. Of the total cases, 92.9% and 7.1% were lymphoma and leukemia, respectively. On the other hand, from lymphoma cases, 72.3% and 27.7% were HL and NHL, respectively while from leukemic cases, 61.1%, 23.2, 6.3%, 4.2%, and 5.3% were CLL, ALL, CML, AML, and other HM types, respectively. In this study, there was no trend. CONCLUSION: We concluded that lymphoma was the dominant type of hematological malignancy observed in northwest Ethiopia. The study indicated that the majority of cases were observed among male, urban residents, and adult populations aged 18-45 years. Therefore, special focus should be given to the highly affected population. Further, a prospective cohort study should be conducted for a better understanding of the prevalence and associated factors to it.

Hematological profiles of visceral leishmaniasis patients before and after treatment of anti-leishmanial drugs at University of Gondar Hospital; Leishmania Research and Treatment Center Northwest, Ethiopia.

BACKGROUND: Visceral leshimaniasis is a parasitic disease characterized by systemic infection of phagocytic cells and an intense inflammatory response. The progression of the disease or treatment may have an effect on hematological parameters of these patients'. Thus, the current study sought to compare the hematological profiles of visceral leishmaniasis patients before and after treatment with anti-leishmaniasis drugs. METHOD: An institutional-based retrospective cohort study was conducted among visceral leishmaniasis patients admitted to the University of Gondar comprehensive specialized referral hospital leishmaniasis research and treatment centre between September 2013 and August 2018. Hematological profiles were extracted from the laboratory registration book before and after treatment. Data were entered to Epi-info and exported to SPSS for analysis. Descriptive statistics were summarized using frequency and percentage to present with the table. The mean, standard deviation, median, and interquartile range were used to present the data. Furthermore, using the paired t-test and the Wilcoxon Signed rank test, the mean difference for normally and non-normally distributed data was compared. Spearman and Pearson correlation analysis were used to describe the relationship between hematological parameters and various variables. A P value of 0.05 was considered statistically significant. RESULT: With the exception of the absolute neutrophil count, all post-treatment hematological parameters show a significant increase when compared to pre-treatment levels. Prior to treatment, the prevalence of anemia, leukopenia, and thrombocytopenia was 85.5, 83.4, and 75.8%, respectively, whereas it was 58.3, 38.2, and 19.2% following treatment. Furthermore, parasite load was found to have a statistically significant negative correlation with hematological profiles, specifically with white blood cell and red blood cell parameters. CONCLUSION: According to our findings, patients with visceral leishmaniasis had improved hematological profiles after treatment. The effect of treatment on parasite proliferation and concentration within visceral organs, in which the parasite load could directly affect the patient's hematological profiles, may be associated with the change in hematological profiles.

Sero-epidemiology and associated factors of HIV, HBV, HCV and syphilis among blood donors in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Transfusion transmissible infections (TTIs) remain a major public health problem in developing countries including Ethiopia. In Ethiopia, comprehensive information about sero-epidemiology of major TTIs is lacking at the national level. Therefore, this systematic review and meta-analysis was aimed at providing the pooled estimate of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis among blood donors in Ethiopia. METHODS: Relevant studies published until May 31, 2019 were searched through PubMed/Medline, EMBASE, SCOPUS, HINARI, Cochrane database library, Web of Science, Google Scholar and Google. The methodological quality of articles was assessed using Joanna Brigg's Institute critical appraisal checklist for prevalence and analytical studies. The pooled sero-epidemiology of HIV, HBV, HCV and syphilis were determined using the random-effects model. Heterogeneity between the studies was assessed using the I2 statistics. Publication bias was assessed by visual inspection of the funnel plot and Egger's statistics. RESULTS: A total of 7921 articles were retrieved, and 7798 were screened for eligibility after duplicates removed. Forty-nine full-text articles were assessed for eligibility; of which 45 were eligible for qualitative and quantitative synthesis: categorized as 36, 34, 31 and 23 studies for estimations of HBV, HIV, HCV and syphilis, respectively. In the random-effects model, the pooled sero-epidemiology of HBV, HIV, HCV and syphilis was 5.20, 2.83, 0.93 and 1.50%, respectively. Moreover, being a male blood donor was significantly associated with HBV and syphilis infection, whereas being a replacement blood donor was significantly associated with a high burden of HIV, HBV and HCV infections. CONCLUSION: The pooled sero-epidemiology of major TTIs among blood donors was high. Therefore, there is a need to design prevention and control strategies in a comprehensive approach to reduce the burden.

Coagulopathy and its associated factors among patients with a bleeding diathesis at the University of Gondar Specialized Referral Hospital, Northwest Ethiopia.

BACKGROUND: Coagulopathy is the major cause of mortality and morbidity throughout the world. Globally, about 26-45% of healthy people have a history of bleeding symptoms, which may be a result of thrombocytopenia, factor deficiency, or pathological inhibitory. OBJECTIVE: To assess coagulopathy and its associated factors among patients with bleeding diathesis at the University of Gondar Specialized Referral Hospital from January to May 2020. METHOD: A cross-sectional study was conducted on 384 study participants with bleeding diathesis recruited by using a convenient sampling technique. Socio-demographic and clinical characteristics were collected by using questioners. Then 6 ml venous blood was collected with a needle and syringe method. About 3 ml blood was transferred to EDTA test tube for platelet count and 2.7 ml blood was transferred to a test tube containing 0.3 ml of 3.2% sodium citrated anticoagulant for coagulation test. For those study participants with prolonged coagulation tests, a mixing test was done. Blood film and stool examination were also done for malaria and intestinal parasite identification, respectively. The data were entered into EPI-Info version 3.5.3 and then transferred to SPSS version-20 for analysis. Descriptive statistics were summarized as percentages, means, and standard deviations. Bivariate and multivariate logistic regression was used to identify the associated factors, and a P-value less than 0.05 was considered statistically significant. RESULTS: In this study, the prevalence of coagulopathy was 253/384 (65.9%; 95% CI: 61.16, 70.64). From them, 21.3% (54/253), 51.4% (130/253), and 27.3% (69/253) had only thrombocytopenia, only prolonged coagulation test, and mixed abnormality, respectively. Among participants with prolonged coagulation time, the prevalence of factor deficiency was 21.1% (42/199). Cardiac disease (AOR = 4.80; 95% CI: 2.65, 23.1), and other chronic diseases (AOR = 8.1; 95% CI: 1.84, 35.58) were significantly associated with coagulopathy. CONCLUSION: In this study, coagulopathy due to inhibitory was a public health problem. The participants with cardiac and other chronic diseases were at high risk for coagulopathy. Therefore, mixing tests could be done for all prolonged coagulation tests and it could be considered as a routine laboratory test.

Prevalence and Associated Factors of Anemia among Reproductive-Aged Women in Sayint Adjibar Town, Northeast Ethiopia: Community-Based Cross-Sectional Study.

BACKGROUND: Globally, anemia affects one-fourth of the world population including 30% of nonpregnant reproductive-aged women. It has a number of causes including micronutrient deficiencies and chronic infections, inherited or acquired disorders of hemoglobin synthesis and red blood cell production, or survival alterations. The aim of this study was to assess the prevalence and associated factors of anemia among reproductive-aged women in Sayint Adjibar town, South Wollo Zone, Northeast Ethiopia. METHODS: A community-based cross-sectional study was conducted from February to April among 359 reproductive-aged women (RAW). Systematic random sampling technique was implemented to select study participants. Sociodemographic, socioeconomic, and reproductive histories of study participants were collected using the structured and pretested questionnaire. Capillary blood and stool samples were collected from each study participant for hemoglobin and parasitological analysis, respectively. Data were entered into Epi Info version 7 and transferred to SPSS version 20 for analysis. Both bivariable and multivariable binary logistic regression models were fitted to identify associated factors of anemia. p value <0.05 was considered as statistically significant. RESULT: The median age of the study participants was 25 years. The overall prevalence of anemia was 24.2%. Among those anemic individuals, 49 (56.3%) were mildly anemic. Age category 36-49 years (AOR = 2.64; 95% CI: 1.05, 6.60), no formal educational status (AOR = 2.28; 95% CI: 1.06, 4.92), food insecurity (AOR = 1.92; 95% CI: 1.01-3.65), and body mass index of above 25 kg/m2 (AOR = 0.27; 95% CI: 0.08-0.87) were found to be statistically significant with anemia. CONCLUSION: The prevalence of anemia in this study was found as a moderate public health problem. The prevalence was significantly associated with women who had no formal education and were of older age group and those women living with household food insecurity and with higher body mass index. Therefore, it is better to design appropriate interventional strategies to reduce reproductive-aged women anemia. These include information, education, and communication activities focused on reproductive-aged women with no formal education and life-cycle-focused food security rather than targeted to only infants and young children or pregnant women.

Assessment of hematological parameters of petrol filling workers at petrol stations in Gondar town, Northwest Ethiopia: a comparative cross-sectional study.

BACKGROUND: Petrol is the non-specific term for petroleum which is used for inside combustion of engines. Petrol filling workers are highly vulnerable to occupational exposure to these harmful substances which lead to hemato-toxicity and blood disorders such as leukemia, aplastic anemia, and dysplastic bone marrow. Thus, this study was aimed to assess hematological parameters of petrol filling workers in Gondar town, Northwest Ethiopia. METHODS: A comparative cross-sectional study was conducted from January to March 2019 in Gondar town, Northwest Ethiopia. A total of 110 study participants comprising 55 study groups and 55 controls group were recruited by a convenient sampling technique. Socio-demographic data were collected using a structured questionnaire, and 3 ml of venous blood was collected for the determination of hematological parameters. The data were entered into Epi info 7.2.0.1 and analyzed by SPSS version of 20. Mean, standard deviation, median, and interquartile ranges were used to present the data. Independent t test and Mann-Whitney U test were used to compare the mean or median difference between parametric and non-parametric hematological parameters, respectively. Moreover, Pearson product-moment and Spearman's rank-order bivariable correlations analyses were used to describe the correlation between hematological parameters and duration of exposure to petrol. A P value of ≤ 0.05 was considered statistically significant. RESULTS: The study revealed that mean red blood cell count and hemoglobin level as well as the median hematocrit, mean cell hemoglobin concentration, platelet count, absolute lymphocytes count, and red cell distribution width values of petrol filling workers showed a significant increment compared with the control group. On the other hand, the mean cell hemoglobin value of petrol filling workers showed a significant decrement compared with healthy controls. Moreover, the duration of exposure to petrol showed a significant positive correlation with red blood cell count and mean cell hemoglobin concentration; however, a significant negative correlation was observed with mean cell volume. CONCLUSION: This study showed that the majority of hematological parameters of petrol filling workers showed an increment compared with healthy controls which might be associated with exposure to petrol chemicals. However, further longitudinal study with a larger sample size should be conducted to explore the impact of petrol exposure on hematopoiesis.

Genetic Pathway in the Pathogenesis of Therapy-Related Myeloid Neoplasms: A Literature Review.

Therapy-related myeloid neoplasms are a life-threatening and often fatal complication, associated with poor prognosis outcomes and with high-risk unfavorable cytogenetic abnormalities including complex karyotype. They occur after the treatment of primary malignancies using chemotherapy and/or radiation therapy. Such therapy is not specific to cancer cells, and also damages the deoxyribonucleic acid (DNA) of normal cells, resulting in unbalanced and balanced translocations. There are eight genetic pathways, whose details are summarized in this review, depending on the cytogenetic abnormalities induced. This abnormality is the major contributor to the development of therapy-related myeloid neoplasms. The etiology of these neoplasms depends on the complex interaction between the nature and dose of the cytotoxic agent, the environment, and the presence of subsequent inherited mutations. This review aims to elaborate upon recent knowledge regarding the etiology, pathogenesis, and genetic pathways of therapy-related myeloid neoplasms. A deeper understanding of their etiology would aid physicians in more careful monitoring of patients during or after cytotoxic therapy for hematological malignancy. Ultimately, this knowledge could influence initial treatment strategies, with the aim of reducing both the incidence and serious complications of neoplasms. Therefore, early detection of DNA lesions is vital. The authors recommend that primary malignancy be treated with targeted therapy.

Neonatal Iron: Factors Influencing its Level and Associated Complications - a Review Article.

BACKGROUND: Iron is an essential micronutrient which plays a significant role, particularly vital for early brain growth and function. Maternal iron condition influences the iron status of neonates since iron transferred from the mother is the only source for fetal iron. A depletion in iron as a result of rapid growth leads to iron deficiency which is common in neonates. Although there are inconsistencies with regard to the normal reference ranges for neonatal iron level, the current review summarized literature to provide compressive information about neonatal iron status and factors that influence its level. METHODS: This is a narrative review on the basis of relevant literatures mainly on neonatal iron from peer-reviewed journals. Electronic databases such as PubMed, PMC, Scopus, Science Direct, Google scholar, Google, and Yahoo were used to retrieve relevant literatures using key terms like "newborn iron, neonatal iron, iron overload, maternal factors, complication, iron level and neonates" separately and in combination. RESULTS: Several factors had been postulated as factors associated with neonatal iron status. The current review figured out that maternal obesity, gestational diabetes mellitus, preterm delivery, placental transferrin receptor, inappropriate iron supplementation, use of iron fortified formula, uses of recombinant erythropoietin therapy, smoking, maternal iron deficiency anemia, umbilical cord clamping, and transfusion are the major factors which can influence neonatal iron level. These factors may have either positive or negative effects on neonatal iron level. Both iron deficiency and iron overload at some stage in the fetal development or at early stage of neonatal development cause abnormal functions of multiple organ system of neonates and subsequently contributed to neonatal and childhood morbidity and mortality. CONCLUSIONS: By one and other means insufficient, late and extra maternal iron supplementation, early and delayed umbilical cord clamping have negative effects on the iron level of neonates. Therefore, careful prenatal and antenatal follow-up need to be strengthened with due emphasis for maternal iron assessment.

Prevalence and associated factors of anemia among full-term newborn babies at University of Gondar comprehensive specialized hospital, Northwest Ethiopia: a cross-sectional study.

BACKGROUND: Anemia in newborn babies causes asymptomatic to an acute life-threatening event. If untreated, it leads to a delay in brain maturation, tissue hypoxia, and stunted growth. In Sub-Saharan Africa, its burden ranges 23-66%. However, in Ethiopia, there is limited information regarding the prevalence and associated factors of newborn anemia. Thus, this study was aimed to assess the prevalence and associated factors of anemia among full-term newborn babies. METHOD: Cross-sectional study was conducted from February 1 to April 30, 2019, among 192 full-term newborn babies. A systematic random sampling technique was employed to select study participants. Socio-demographic characteristics were collected through interviews. Clinical data were collected by reviewing medical records. Cord blood was collected from the clumped cord. Complete blood count was analyzed by using the Sysmex KX-21 N hematology analyzer. SPSS 20 was used to analyze the data. Bivariable and multivariable binary logistic regression were used to identify associated factors. P-value < 0.05 was considered a statistically significant association. RESULT: The median (interquartile range) of cord hemoglobin was 15 g/dL (13.93-16.2 g/dL). From the total, 25% (95% CI: 18.9, 31.1%) of the newborns were anemic. From anemic 89.5, 6.3, and 4.2% were mild, moderate and severe anemia type, respectively. Maternal vegetable consumption habit (AOR = 0.34, 95%CI: 0.17, 0.69) were significant associated with anemia. CONCLUSION: Anemia among newborn babies found to be a moderate public health problem. Based on the finding early screening of newborn anemia may reduce further complications.

Blood donors' knowledge and attitude towards blood donation at North Gondar district blood bank, Northwest Ethiopia: a cross-sectional study.

OBJECTIVE: Blood transfusion saves millions of lives. But, the need and the actual number of donations are not balanced in Ethiopia. The actual reason is not clearly assessed; however, level of knowledge and attitude may be the main contributing factors. Thus, the current study aimed to assess blood donors' knowledge and attitude towards blood donation at North Gondar district blood bank. RESULTS: Of 401 blood donors, 142 (35.4%) and 379 (94.5%) were had adequate knowledge and positive attitude towards blood donation, respectively. About 343 (85.5%) of study participants had no previous experience of blood donation. Perceptions of fear of pain, medically unfitness to donate and lack of information on when, where and how to donate blood were mentioned as a reason for not donating blood. Educational status and residence were significantly associated with knowledge of blood donors. On the other hand, participants with secondary and higher education were more likely to have good attitude towards blood donation. Thus, blood banks should design strategies for health education about blood donation and transfusion.

Sero-prevalence and trends of transfusion-transmissible infections among blood donors at Bahir Dar district blood bank, northwest Ethiopia: A four year retrospective study.

BACKGROUND: Blood transfusion is an effective treatment for saving millions of lives even though transfusion- transmissible infections are the major problem. Therefore, the aim of this study was to assess the sero-prevalence and trend of transfusion-transmissible infections among blood donors. METHODS: A retrospective study was conducted form July 2014 to June 2018 at Bahir Dar district blood bank. Descriptive statistics was presented using percentages, medians and interquartile ranges. Logistic regression was used to explore risk factors associated with each transfusion transmissible infections. RESULT: From a total of 35,435 blood donors 2130 (6.0%) of them had serological evidence for at least one infection and 50 (0.14%) of them were confirmed as having multiple infections. The overall sero-prevalence of HBV, HCV, HIV and syphilis was 230 (6.0%) with 3.9%, 0.6%, 0.5% and 1.2% respectively. From those who had co-infection majority of them 22 (44.0%) were attributed to HBV-Syphilis co-infection and 1 (2.0%) study participant was co-infected with HBV-HIV- Syphilis infection. There was an increment in the overall prevalence of transfusion-transmissible infection;183 in 2014/2015 to 624 in 2017/2018. The sero-prevalence of HBV show a significant increment tend with respect to year of donation. On the other hand HCV and HIV sero-prevalence show an increasing trend from 2014 and decrease in 2018. The sero-prevalence of syphilis was 67 (1.3%) in 2015 and duplicate in 2016, 138 (1.5) but subsequently decrease to 110 (1.1%) in 2017 and in 2018 it was 114 (1.0%). CONCLUSION AND RECOMMENDATIONS: His finding showed growing evidence in the burden of transfusion-transmissible infection in blood donors despite which requires advanced and vigilance screening of donated blood prior to transfusion. More over there should be strategies for monitoring the implementation of post donation counseling for recruitment and retention of safe regular donors.

Knowledge, Attitude and Practice Regarding Blood Donation among Graduating Undergraduate Health Science Students at the University of Gondar, Northwest Ethiopia.

BACKGROUND: Blood transfusion is one of the most essential needs to manage patients suffering from various medical conditions. Nowadays, voluntary blood donors are the only source of blood in the blood banks. There is a great need to create awareness among the population at large and students about blood donation to maintain a regular blood supply. Health Science students can be used as best model to lead this initiative. Hence, the aim of this study was to assess the knowledge, attitude and practice regarding blood donation among graduating undergraduate Health Science students. METHODS: A descriptive cross-sectional study was conducted among graduating undergraduate Health Science students at University of Gondar using structured pre-tested self-administered questionnaire. Stratified sampling technique was employed to select study participants. A total of 225 students participated in the study. Data was entered into and analyzed using SPSS software version 20. Mean score was used to categorize the knowledge and attitude. Binary logistic regression model was fitted to identify factors associated with knowledge, attitude and practice regarding blood donation. RESULT: Among 255 undergraduate Health Science graduate students, 123(48.2%) and 202(79.2%) had adequate knowledge about and positive attitude regarding blood donation, respectively. About 12.5% of them had ever donated blood before. Age ≥25 years was significantly associated with practice of blood donation (AOR=4.33; 95%CI: 1.60, 11.76). CONCLUSION: Although the majority of the students had positive attitude regarding blood donation, blood donation practice was low. Age was found to be significantly associated with blood donation practice. Targeted strategies should be designed to increase awareness of health science students about blood donation. Strategies which encourage the students to donate blood voluntarily should also be designed.