Belete Biadgo

Bacterial isolates and their antibiotic susceptibility patterns among patients with pus and/or wound discharge at Gondar university hospital

BackgroundIn spite of advances in control of infections, wound infections have not completely controlled due to many reasons. The widespread uses of antibiotics, together with the length of time over which they have been available have led to major problems of resistant organisms contributing to morbidity and mortality. This study was aimed to assess bacterial isolates and their drug susceptibility patterns from patients with pus and/or wound discharge.MethodsA retrospective study was conducted at Gondar University Hospital from all individuals who provide pus and/or wound discharge sample from September, 2009 to August, 2012. Socio-demographic and laboratory results were collected from the University Hospital Microbiology Laboratory unit registration books by using a standard data collection format. Data were analyzed using SPSS version 20 software. P-value ≤ 0.05 was considered statistically significant.ResultA total of 628 study subjects were included in the study with bacterial isolation rate of 441 (70.2%). Of all, 344 (54.8%) were males. Two hundred eighty two (63.9%) of the isolates were gram positive and 159 (36.1%) were gram negative. About 331/ 441 (75.0%) of the total isolates were Staphylococcus aureus (32.9%), Coagulase Negative staphylococci (14.7%), Streptococcus spp. (11.6%), Escherichia coli (9.5%), Klebsiella spp. (6.3%). The result showed that 66.2% of the isolates were resistant to tetracycline, followed 59.8% for ampicillin, 59.1% for cotrimoxazole, 51.7% for penicillin; least resistant being 6.3% for gentamycin.ConclusionHigh prevalence of bacterial isolates were found; S. aureus being the dominant. Most of the isolates were resistant to many of the antibiotics tested where all isolates of Pseudomonas spp. being resistant to two or more antibiotics. Antibiotic susceptibility test is necessary for effective control of wound infections.

Prevalence of tuberculous lymphadenitis in Gondar University Hospital, Northwest Ethiopia

BackgroundTuberculous is the leading cause of death worldwide with a large number ofdeaths occurring in developing countries. Tuberculous lymphadenitis is amongthe most common presentations of extra pulmonary tuberculous. This studyattempts to determine the magnitude of tuberculous lymphadenitis frompatients with lymph node aspirate in Gondar University Hospital, NorthwestEthiopia.MethodsRetrospective study was conducted. Data were collected from registration bookof Gondar university Hospital pathology laboratory after checking thecompleteness of patient’s necessary information like age, sex and fineneedle aspiration cytology results. Data were entered and analyzed usingSPSS version 16 statistical package. Chi-square test was done to determineassociations.ResultA total of 3,440 lymph node aspirates were examined using fine needleaspiration cytology. Of these, 2,392 (69.5%) cases were found to havetuberculous lymphadenitis. Male 1647(47.9%) to female 1793(52.1%) ratio ofall study subjects were 0.9:1. Females (54.1%) were more affected than males(45.9%). Age, sex and site of aspiration were found to be statisticallyassociated with tuberculous lymphadenitis (p-value < 0.001).The age group of 15–24 years had the highest prevalence of tuberculouslymphadenitis followed by those of 25–34 years old. The most affectedsites were cervical lymph nodes (47.5%) followed by auxiliary (19.4%) andsubmandibular (12.9%) lymph node regions. None of the records documented theHIV status of subjects.ConclusionThe prevalence of tuberculous from lymph node aspirate was found to be higherinvolving the frequently affected site of cervical lymph node. The HIVstatus of patients with all forms of tuberculous should have to be checkedand documented. Further prospective and advanced studies are recommended todetermine the specific etiologic agents and contributing factors.

Type 2 Diabetes Mellitus and Its Association with the Risk of Pancreatic Carcinogenesis: A Review.

The prevalence of diabetes mellitus (DM) and associated diseases such as cancers are substantially increasing worldwide. About 80% of the patients with pancreatic cancer have glucose metabolism alterations. This suggests an association between type 2 DM and pancreatic cancer risk and progression. There are hypotheses that show metabolic links between the diseases, due to insulin resistance, hyperglycemia, hyperinsulinemia, low grade chronic inflammation, and alteration in the insulin-insulin-like growth factor axis. The use of diabetes medications can influence the extent of carcinogenesis of the pancreas. This study briefly reviews recent literature on investigation of metabolic link of type 2 DM, risk of carcinogenesis of the pancreas and their association, as well as the current understanding of metabolic pathways implicated in metabolism and cellular growth. The main finding of this review, although there are discrepancies, is that according to most research long-term DM does not raise the risk of pancreatic cancer. The longest duration of DM may reflect hypoinsulinemia due to treatment for hyperglycemia, but recent onset diabetes was associated with increased risk for pancreatic cancer due to hyperinsulinemia and hyperglycemia. In conclusion, the review demonstrates that type 2 DM and the duration of diabetes pose a risk for pancreatic carcinogenesis, and that there is biological link between the diseases.

Hematological indices and their correlation with fasting blood glucose level and anthropometric measurements in type 2 diabetes mellitus patients in Gondar, Northwest Ethiopia

Background Diabetes mellitus is (DM) a global public health problem and a complex disease characterized by chronic hyperglycemia that leads to long-term macrovascular and microvascular complications. Recent studies have reported the role of hematological indices in contributing to the vascular injury in diabetic patients. Thus, the aim of this study was to determine hematological indices and their correlation with fasting blood glucose level and anthropometric measurement in type 2 DM patients in comparison with healthy controls. Methods A comparative cross-sectional study was conducted at the chronic illness clinic of Gondar University Hospital from February to April 2015. A total of 296 participants (148 cases and 148 healthy controls) were selected using systematic random sampling technique. Data were collected using a pretested structured questionnaire. Fasting blood glucose levels and hematological indices were determined by using Bio Systems A25 and Sysmex-KX 21N analyzers, respectively. Independent sample t-test, Mann–Whitney U-test, and correlation statistics were used. A P-value <0.05 was considered as statistically significant. Result There was significant difference in red blood cell distribution width (47.3±2.6 fL vs 45.2±3 fL) between diabetic patients and controls. Total white blood cells in 103/µL (6.59±1.42 vs 5.56±1.38), absolute lymphocyte count in 103/µL (2.60±0.70 vs 2.04±0.63), and absolute neutrophil count in 103/µL (3.57±1.46 vs 3.11±1.04) increased significantly in diabetic patients compared with controls, respectively. Among platelet indices, mean platelet volume (10.4±1.1 fL vs 9.9±1.1 fL) and platelet distribution width (14.5±2.1 fL vs 13.4 ±2.1 fL) were found to be significantly increased in the diabetic patients (P<0.05). Anthropometric measurements significantly correlated with white blood cell and platelet indices. Conclusion The study showed statistically significant difference in some hematological parameters of diabetic patients compared to controls. Thus, hematological indices could be useful indicators of vascular complication and glycemic control in type 2 DM patients.

Seroprevalence of hepatitis B and C virus infection among patients attending serology laboratory of Gondar University Hospital

BackgroundHepatitis B virus (HBV) and hepatitis C virus (HBV) infections accounts for substantial proportions of the world wide liver disease. The two hepatotropic virus share common modes of transmission and their co-infection are common. Patients with dual HBV and HCV infection have more severe liver disease and are at increased risk of progression to hepatic cell carcinoma. This study was aimed to assess the prevalence of HBV and HCV among patients attending serology laboratory of Gondar University Teaching Hospital.MethodsA retrospective study was conducted from January 2007 to December 2011 at serology laboratory of Gondar University Teaching Hospital. Data were cross checked for completeness, entered and analyzed using SPSS version 16 statistical package.ResultsFrom the total of 2,684 clinicaly suspected hepatitis patients, 563 (20.98%) were positive for HBsAg and anti-HCV test. Of all, 14.4% were seropositive for HBV (male= 7.89% female=6.27%) (p-value=0.011) while 12.4% were seropositive for HCV (male =7.6% and female=4.13%) (p-value<0.001). The co-incidence of HBV and HCV were found to be 36 (6.39%) (male=3.9% and female=2.4%) (p-value <0.001). Majority of HBV (30.2%) and HCV (30.7%) infections were detected among age group of 25–34 years old (p-value=0.36) and 15–24 years old (p-value<0.001) respectively.ConclusionThe overall prevalence of HBV and HCV is high. Males and younger age groups were more affected. Community awareness about the transmission and prevention of viral hepatitis infection should be strengthened by giving health education and herd immunization.

High Prevalence of Undernutrition among Children in Gondar Town, Northwest Ethiopia: A Community-Based Cross-Sectional Study

Objective To assess undernutrition and associated factors among children aged 6–59 months in Gondar Town, northwest Ethiopia. Methods A community-based cross-sectional study was conducted in 2014. Multistage sampling method was used to select study participants. Structured interviewer administered questionnaire and anthropometric measurements were used. Binary logistic regression was fitted to identify associated factors. Results The prevalences of wasting and stunting were 6.8% and 45.7%, respectively. Higher odds of wasting were observed among children whose fathers were daily laborers (AOR = 2.63), children who had eating problem (AOR = 2.96), and those who were not exclusively breast-fed for the first six months (AOR = 5.63). Similarly, higher odds of stunting were found among female children (AOR = 1.65), children who lived in households having four to six families (AOR = 2.14), and children who did not start breast-feeding within one hour of birth (AOR = 0.67). Conclusion Childhood undernutrition was a significant problem. Child eating problem, paternal occupation, and exclusive breast-feeding were associated with wasting, whereas family size, child sex, and breast-feeding initiation time were associated with stunting. Therefore, strengthening of early initiation and exclusive breast-feeding, promoting healthcare seeking behavior, and designing social support programme for poor family are recommended to reduce undernutrition.

Transfusion-transmissible viral infections among blood donors at the North Gondar district blood bank, northwest Ethiopia: A three year retrospective study

Background Transfusion-transmissible viral infections, such as hepatitis C virus (HCV), hepatitis B virus (HBV), and human immunodeficiency virus (HIV), remain a major public health problem in developing countries. The prevalence of these viral infections among blood donors may reflect the burden of these diseases among populations. Therefore, the aim of this study was to assess the sero-prevalence of transfusion-transmissible viral infections among blood donors. Methods A retrospective study was conducted using data obtained from registration books of blood donors from the Ethiopian North Gondar District Blood Bank from 2010 to 2012. Descriptive statistics, such as percentages, medians and interquartile ranges were computed. A binary logistic regression model was fitted to identify factors associated with each viral infection. The odds ratio with a 99% confidence interval was calculated. A p-value < 0.01 was considered statistically significant. Result A total of 6,471 blood donors were included in the study. Of these, 5,311 (82.1%) were male, and 382 (5.9%) were voluntary blood donors. Overall, 424 (6.55%) of the blood donors were sero-reactive for at least one transfusion-transmissible viral infection. Of all study participants, 233 (3.6%) were sero-reactive for HBV, 145 (2.24%) were sero-reactive for HIV, and 51 (0.8%) were sero-reactive for HCV. Four (0.062%) of the study’s participants were co-infected: 3 (75%) with HBV-HCV and 1 (25%) with HIV-HBV-HCV. Being a farmer, unemployed or employed donor was significantly associated with transfusion-transmissible viral infections compared to being a student donor. Conclusion The prevalence of transfusion-transmissible viral infections is substantial and has increased overtime. Hence, it demands more vigilance in routine screening of donated blood prior to transfusion. Further community-based studies to identify societal risk factors are necessary.

Hepcidin in Iron Homeostasis: Diagnostic and Therapeutic Implications in Type 2 Diabetes Mellitus Patients

The prevalence of type 2 diabetes is increasing in epidemic proportions worldwide. Evidence suggests body iron overload is frequently linked and observed in patients with type 2 diabetes. Body iron metabolism is based on iron conservation and recycling by which only a part of the daily need is replaced by duodenal absorption. The principal liver-produced peptide called hepcidin plays a fundamental role in iron metabolism. It directly binds to ferroportin, the sole iron exporter, resulting in the internalization and degradation of ferroportin. However, inappropriate production of hepcidin has been shown to play a role in the pathogenesis of type 2 diabetes mellitus and its complications, based on the regulation and expression in iron-abundant cells. Underexpression of hepcidin results in body iron overload, which triggers the production of reactive oxygen species simultaneously thought to play a major role in diabetes pathogenesis mediated both by β-cell failure and insulin resistance. Increased hepcidin expression results in increased intracellular sequestration of iron, and is associated with the complications of type 2 diabetes. Besides, hepcidin concentrations have been linked to inflammatory cytokines, matriptase 2, and chronic hepatitis C infection, which have in turn been reported to be associated with diabetes by several approaches. Either hepcidin-targeted therapy alone or as adjunctive therapy with phlebotomy, iron chelators, or dietary iron restriction may be able to alter iron parameters in diabetic patients. Therefore, measuring hepcidin may improve differential diagnosis and the monitoring of disorders of iron metabolism.

Assessment of the effect of antiretroviral therapy on renal and liver functions among HIV-infected patients: a retrospective study

Background The emergence of highly active antiretroviral therapy (HAART) has dramatically improved quality of life in prolonging survival of human immunodeficiency virus (HIV)-infected patients on treatment in developed as well as developing countries. However, the main shortcoming of HAART in long-term use is its potential to cause liver and kidney derangements that may be life threatening. The drugs are actively accumulated in the proximal renal tubule resulting in functional disturbance with mitochondrial injury being one of the most important targets recognized. Therefore, the aim of this study was to assess the adverse effects of HAART on kidney and liver functions among HIV-infected patients presenting to the University of Gondar Hospital, Ethiopia. Materials and methods An institution-based retrospective study was conducted from 2010 to 2015 on a subset of HIV-infected patients. Data were collected from the registration book of the University of Gondar Hospital antiretroviral clinic laboratory after checking the completeness of age, gender, creatinine, blood urea nitrogen, and alanine aminotransferase level. Data were entered and analyzed using SPSS version 20. Descriptive statistics, chi-square test, one-way analysis of variance, and logistic regression were done to determine associations. A P-value <0.05 was considered statistically significant. Results A total of 275 study subjects were included in the study. Of these, 62.2% were females, and the overall prevalence of chronic kidney disease (CKD) before and after treatment was 3.6% and 11.7%, respectively. A majority of the CKD patients were in stage 3 for patients after treatment. The overall prevalence of hepatotoxicity was 6.5% and 16.7% before and after treatment, respectively. A majority of the patients developed Grade 2 hepatotoxicity 66.7% and 65.2% before and after treatment, respectively. Binary and multiple logistic regression analysis indicated that the female gender was a risk factor for CKD. Conclusion The prevalence of nephrotoxicity and hepatotoxicity were high among patients who took HAART. Stage 3 nephrotoxicity and Grade 2 hepatotoxicity had the highest incidences of the total toxicities, and the female gender was a risk factor for nephrotoxicity. Further prospective studies are recommended to determine the effect of HAART and contributing factors.

Biochemical Profiles of Pregnant and Non-pregnant Women Attending at the University of Gondar Hospital, Northwest Ethiopia: A Comparative Cross-sectional Study

Background Pregnancy is a natural physiological statement with hormonal and metabolic changes that helps the growth and survival of the fetus. However, biochemical profiles derangement may lead to pregnancy complications. Therefore, there is a need for determining biochemical profiles among pregnant women. Methods A comparative cross-sectional study was conducted among pregnant and non-pregnant women at the University of Gondar Hospital, from February to April, 2015. Fasting blood sample was collected from 139 pregnant and 139 age matched non-pregnant women using systematic random sampling technique. Interviewer-administered questionnaire was used to collect socio-demographic and clinical data. Fasting blood glucose and lipid profile were measured by A25 Biosytemchemistry analyzer using enzymatic calorimetric methods. Data analysis was done using SPSS version 20. Level of significance between groups was analyzed using independent student t-test and Mann-Whitney U test. A p-value of <0.05 was considered as statistically significant. Result Pregnant women as compared to non-pregnant had significantly increased glucose (96.35±14.45 and 81.12±9.86 mg/dl), total cholesterol (211.9±40.88 and 172.40±29.64 mg/dl) [p<0.05], respectively. It had also significantly high triglycerides (190.81±81.04 and 107.43±45.80 mg/dl) and low-density lipoprotein cholesterol (116.03±37.26 and 86.12±27.29mg/dl) [p<05] in pregnant as compared to non-pregnant women. The level of high-density lipoprotein cholesterol was significantly lower in pregnant women (59.58±14.26) than control (63.63±11.4, P <0.05). Conclusion There were statistically significant increment in glucose, total cholesterol, triglycerides, low-density lipoprotein cholesterol and decrement in high-density lipoprote in cholesterol levels among pregnant women compared with non-pregnant women. Therefore, pregnant women have to be monitored closely for their biochemical profiles to avoid adverse pregnancy outcomes.