Diagnosis of clinical and subclinical varicocele: how has it evolved?

In this review, we examine the evolution and application of various diagnostic modalities for varicoceles starting with venography, scintigraphy, and thermography and their role in the evaluation of a varicocele patient. Some of these methods have been supplanted by less invasive and more easily performed diagnostic modalities, especially ultrasound and Doppler examination of the scrotum. Advances in ultrasound and magnetic resonance imaging hold the potential to expand the role of imaging beyond that of visual confirmation and characterization of varicoceles. The ability to identify the early indicators of testicular dysfunction based on imaging findings may have implications for the management of varicoceles in the future.     

The prevalence and associated factors of birth asphyxia among neonates delivered in Public Hospitals,Northern Ethiopia

IntroductionA body of evidences showed that birth asphyxia is a serious public health problem in low income countries including Ethiopia. There are sparse data on the prevalence of birth asphyxia and its associated factors among neonates in low income countries like Ethiopia, as well as the research area.ObjectiveTherefore, this study determined the prevalence and associated factors of birth asphyxia among newborns administered in public hospitals in Northern Ethiopia, 2019.Methods and materialsA cross-sectional study of health institution was carried out in December 2019. Systematic sampling technique was used. Data was collected through interviews and chart review. Multivariate logistical regression analysis was done to control confounders and identify significantly associated variable. AOR with 95% confidence intervals were computed to identify the factors independently assoiated with birth asphyxia.ResultsThe finding showed that the prevalence of birth asphyxia was 20.0%. Induction of labor (AOR=3.59, 95% CI: 1.36–9.46), Prolonged labor (AOR=3.59, 95% CI: 1.36–9.46), meconium-stained amniotic fluid (AOR=3.49), referred mothers (AOR=3.68, 95 % CI: 1.46–9.28), instrumental delivery (AOR=2.87, 95% CI: 1.09–7.55)and primiparous mothers (AOR=2.048 95% CI: 1.10–3.80). were significantly associated with birth asphyxia.ConclusionThe Prevalence of birth asphyxia notable high. Therefore; intra-partum care services should be strengthened to prevent birth asphyxia.     

Sergentomyia spp.: Breeding sites in vertisols and peri-domestic habitats in North West Ethiopia

Sand flies belonging to the genus Sergentomyia Franca & Parrot, 1920, are hematophagous insects feeding mostly on reptiles and birds, but some species feed also on mammals including humans. Sergentomyia spp. frequently comprise the vast majority of sand flies trapped along with Phlebotomus spp., the vectors of mammalian leishmaniasis. Within the framework of a project on the ecology and transmission of visceral leishmaniasis in Ethiopia, putative breeding sites of phlebotomine sand flies were studied. Large horizontal sticky traps (LHSTs) covered with sand fly-proof mesh were deployed over cracked vertisol and related habitats for up to 3 nights, and emerging sand flies were collected daily. Emergence traps (ETs) were also adapted to sample other putative breeding sites including tree trunks, termite mounds, rock piles and vertical river banks. Productive breeding sites were identified in the trunks and roots systems of trees, vertisol fields, cracks and burrows in vertisol dry river banks and termite mounds. Emerging flies were also collected form a stone wall and a rock pile situated inside a village. Significantly more Sergentomyia spp. were trapped in vertisols by ETs deployed over root system than in open fields. Similarly, more sand flies emerged from cracks in the vertisol in fallow Sorghum than in fallow sesame fields. Productive breeding sites were characterized by stable micro-climatic conditions. Species composition of emerging sand flies varied with habitat, season and geographical location.     

Beliefs about racism and health among African American women with diabetes: a qualitative study

Exposure to racism has been linked to poor health outcomes. Little is known about the impact of racism on diabetes outcomes. This study explored African American women's beliefs about how racism interacts with their diabetes self-management and control. Four focus groups were conducted with a convenience sample of 28 adult African American women with type 2 diabetes who were recruited from a larger quantitative study on racism and diabetes. The focus group discussions were transcribed verbatim and analyzed by the authors. Women reported that exposure to racism was a common phenomenon, and their beliefs did in fact link racism to poor health. Specifically, women reported that exposure to racism caused physiological arousal including cardiovascular and metabolic perturbations. There was consensus that physiological arousal was generally detrimental to health. Women also described limited, and in some cases maladaptive, strategies to cope with racist events, including eating unhealthy food choices and portions. There was consensus that the subjective nature of perceiving racism and accompanying social prohibitions often made it impossible to address racism directly. Many women described anger in such situations and the tendency to internalize anger and other negative emotions, only to find that the negative emotions would be reactivated repeatedly with exposure to novel racial stressors, even long after the original racist event remitted. African American women in this study believed that racism affects their diabetes self-management and control. Health beliefs can exert powerful effects on health behaviors and may provide an opportunity for health promotion interventions in diabetes.     

Prevalence and Associated Factors of Burnout syndrome among Nurses in Public Hospitals,Southwest Ethiopia

BackgroundThe Burnout syndrome has been defined as a response to the chronic work-related stress typically found in professionals working in care service organizations. Therefore, this study aimed at assessing the prevalence of burnout syndrome and factors associated with burnout syndrome among nurses in public hospitals, Southwest Ethiopia, 2018.MethodAn institutional-based cross-sectional study was conducted from February 1^st, 2018 to April 1^st, 2018. Total number of nurses who fulfill the inclusion criterias were enrolled. Data was collected using the predesigned tool. Data were entered using EPI INFO version 7 and was exported to statistical packages for social science (SPSS) version 21.0 for analysis. Logistic regression was employed and odds ratio with a 95% confidence interval was used. Variables with a P value of less than 0.05 was considered statistically significant.ResultsA total of 282 eligible nurses were enrolled in the study with a mean age of 28.71 [SD ±7.047]. The prevalence of burnout syndrome among nurses was 96(34%). Predictor variables like; educational status, job title, work experience, fatigue, and social support were found to be strong predictor variables for burnout syndrome.ConclusionThis study revealed that a considerable proportion of nurses had burnout syndrome. Therefore, improved educational status and strong social support should be encouraged among nurses working in the health setting for the betterment of health care services, job satisfaction and quality of care in general.     

Making pregnancy safer initiative--program impact in selected pilot areas

OBJECTIVE: This paper highlights program evaluation carried out on Making Pregnancy Safer Program interventions implemented by FHD in partnership with WHO, UNICEF, UNFPA, SIDA Sweden, the World bank and European Commission to increase availability of Emergency Obstetric Care Services in four pilot regions. METHOD: A participatory evaluation design was employed that included FMoH, RHB and other key partners. The qualitative approach examined client and community perception, provider's perspectives and program manager's views at different levels with regard to service provision, quality of care, service utilization and the impact of the MPS strategy. The quantitative aspect assessed met and unmet needs, service utilization and quality of service. RESULTS: Evaluation shown positive trend in process indicators of maternal health service utilization. Staff who received training in Emergency Obstetric Care are better off in both skill and knowledge acquisition. Majority of facilities had basic resources and functions for Emergency Obstetrics care. However, infrastructure deficiencies such as absence of waiting area, lack of privacy for clients, lack of toilets and water, shortage of life saving drugs, lack of context specific IEC materials were observed. At the community level, the main reason for dissatisfaction with health facility services was poor service provider attitude. CONCLUSION: MPS established a strong foundation to build stronger, better quality of emergency obstetrics and neonatal care that are used by those who needed it. It is time to consolidate and sustain improvements and vigorously support Regional Health Bureaus to ensure quality emergency obstetrics and neonatal care can be made available for all pregnant women, and progress toward the Millennium Development Goals can be achieved.     

Determination of urinary iodine excretion to assess iodine deficiency level and iodine intake in primary school children, Bahir Dar, northwest Ethiopia

BACKGROUND: Iodine deficiency is a major public health problem all over the world, particularly among preschool children and pregnant women in low-income countries like Ethiopia and it is known to be the most common cause of preventable brain damage. OBJECTIVES: to determine urinary iodine concentration and to assess the level of iodine deficiency disorders. METHODS: A cross-sectional study was conducted in 386 randomly selected primary school children to determine urinary iodine concentrations as to assess level of iodine deficiency and iodine in take in Bahir Dar town. RESULTS: Median urinary iodine excretion was 58.8 mg/L (12.89 mg/L to 564.5 mg/L) which indicated the presence of mild iodine deficiency. Eighty seven percent of the children had urinary iodine excretion of below 100 mg/L and the intake of iodine was below 150 mg/day. CONCLUSIONS: Mild iodine deficiency disorder was found in Bahir Dar primary school children, Iodine intake was also found insufficient. Therefore, use of salt ionization should be advocated and strengthened.     

Lipoarabinomannan‐specific TNF‐α and IFN‐γ as markers of protective immunity against tuberculosis: a cohort study in an endemic setting

Lipoarabinomannan (LAM) is a virulent factor used for entry and survival of Mycobacterium tuberculosis (Mtb) in macrophages. Although the role of LAM for the diagnosis of tuberculosis (TB) has been extensively investigated, its cytokine response during natural Mtb infection in humans is largely unknown. In this study, LAM‐specific IFN‐γ, TNF‐α, and IL‐10 levels following whole blood assay were measured in untreated pulmonary TB patients, their contacts and community controls at baseline. In treated patients and contacts, cytokines were also measured at 6 and 12 months. At entry, 52.8% and 74.8% of controls and contacts were QFT‐GIT positive, respectively. At baseline, untreated TB patients and contacts had significantly lower IFN‐γ and TNF‐α response compared to community controls (p < 0.0001). Besides, untreated patients had significantly higher TNF‐α and IL‐10 response compared to their contacts (p < 0.0001). At 6 months, contacts and treated TB patients had significantly increased INF‐γ and TNF‐α response (p < 0.0001). In TB patients, IFN‐γ increased 10‐fold following chemotherapy suggesting its potential role for treatment monitoring. The data suggests that LAM might have an anti‐inflammatory effect during clinical TB and early Mtb infection. The data also suggests that LAM‐induced IFN‐γ and TNF‐α could be used as biomarkers of protective immunity.     

Nocardiosis in HIV seropositive clinically suspected pulmonary tuberculosis patients

To determine the frequency of nocardiosis in HIV-positive individuals clinically suspected of having tuberculosis (TB), 140 sputum samples were collected and processed by Gram stain, modified Ziehl-Neelsen staining and by culture on Lowenstein Jensen medium. Four (2.85%) patients were positive for nocardia by microscopy and five (3.6%) had positive culture for Nocardia asterioides. In areas where HIV-associated TB is common, some patients diagnosed as smear-negative pulmonary TB will actually have nocardiosis. Clinicians should be aware of this entity in HIV/immunocompromised patients with respiratory infections who fail to respond to antituberculous treatment.