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Abdulkerim Badgeba,1 Mulugeta Shegaze Shimbre,2 Mathewos Alemu Gebremichael,3 Biruk Bogale,4 Menur Berhanu,5 Hanan Abdulkadir6 1Department of Public Health, College of Medicine and Health Sciences, Werabe University, Werabe, Ethiopia; 2School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China; 3Department of Public Health, College of Health Sciences, Bonga University, Bonga, Ethiopia; 4School of Public Health, College of Medicine and Health Sciences, Mizan Tepi University, Mizan Aman, Ethiopia; 5Ohio State University Global One-Health Initiatives, Arba Minch, Ethiopia; 6Department of Reproductive Health, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, EthiopiaCorrespondence: Mathewos Alemu Gebremichael; Biruk Bogale, Email alemumathewos2017@gmail.com; burabogale@gmail.comBackground: Multidrug-resistant tuberculosis (MDR-TB) continues to be a public health problem. Globally in 2019, a total of 465,000 people developed rifampicin-resistant TB (RR-TB), of which 78% had MDR-TB. There is a paucity of evidence on the determinants of MDR-TB in southern Ethiopia. Hence, this study aimed to assess the determinants of MDR-TB in southern Ethiopia.Methods: A hospital-based case–control study was conducted in southern Ethiopia. The cases were all MDR-TB patients attending TB clinics, and controls were all patients who were declared as cured or treatment completed. The cases were selected by consecutive sampling, and a simple random sampling technique was used for controls. Multivariable logistic regression analysis was done to identify determinants of MDR-TB. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were computed, and statistical significance was declared at a P-value less than 5%.Results: A total of 191 participants, 67 cases, and 124 controls were included. TB patients facing social stigma (AOR = 8.9, 95% CI: 2.3– 34.6), living in a household with one room (AOR = 12.3, 95% CI: 2.3– 63.5), and two rooms (AOR = 9.7, 95% CI: 1.7– 54.8), having the previous history of TB treatment (AOR = 11.8, 95% CI: 2.9– 47), having baseline body mass index (BMI) less than 18.5Kg/m2(AOR = 4.5, 95% CI: 1.2– 16.8), and having pulmonary TB (AOR = 5.1, 95% CI: 1.33– 19.8) were determinants of MDR-TB.Conclusion: In this study, TB patients facing social stigma, living in one- and two-roomed houses, having a previous history of TB treatment, having low baseline BMI and pulmonary type of TB had higher odds of MDR-TB. Therefore, health workers in TB control programs should include mental health services in the TB care protocol, and priority should be given to malnutrition screening as a first-line diagnosis, nutritional supplements, and health education about proper housing.Keywords: multidrug-resistant tuberculosis, determinants, case-control, southern Ethiopia

Hanan Abdulkadir,1 Meseret Girma,1 Zeleke Gebru,1 Negussie Boti Sidamo,1 Gebremaryam Temesgen2 1School of Public Health, Arba Minch University, Arba Minch Town, Ethiopia; 2Department of Midwifery, Arba Minch University, Arba Minch Town, EthiopiaCorrespondence: Hanan Abdulkadir, School of Public Health, Arba Minch University, Arba Minch Town, Ethiopia, Email hanuahi@gmail.comIntroduction: Globally, there is a rapid increase in the prison population, and one out of nine prisoners suffers from common mental disorders such as depression and anxiety. However, there is a limitation of study on the magnitude of depression and its associated factors among prisoners in low- and middle-income countries including Ethiopia.Purpose: To assess the magnitude of depression and its associated factors among prisoners in Arba Minch and Jinka Town, Southern Ethiopia, 2021.Patients and Methods: A cross-sectional study was conducted among 650 selected prisoners in Arba Minch and Jinka Town. A simple random sampling technique was used to select the study participants. Data was collected using an open data kit and then exported to SPSS version 25 for analysis. Binary logistic regression analysis with a p-value < 0.05 with a 95% confidence level was used to declare statistical significance.Results: The magnitude of depression among the prisoners was 445 (72.0%) (95% CI: 68– 76%). Age ≥ 48 years (AOR = 3.09 95% CI 1.16– 8.28), being an urban resident (AOR = 2.21 95% CI 1.39– 3.49), using smokeless tobacco (AOR = 2.80 95% CI 1.50– 5.22), not doing physical exercise (AOR = 2.42 95% CI 1.54– 3.81), and lack of income generating job in the prison (AOR = 1.89 95% CI 1.19– 3.04) were significantly associated with depression.Conclusion: The magnitude of depression among prisoners was high. Age ≥ 48, urban residence, using smokeless tobacco, not doing physical exercise, and lack of income-generating job in prison were significantly associated with depression. Giving special attention and being supportive to older age, prohibiting the use of smokeless tobacco; facilitating places and materials for physical exercise and creating income generating opportunities by using prisoner’s skills and available resources, giving training for the health professionals working in the prison about diagnosis and treatment of depression, additionally giving training for the prisoners how to cope up with prison life may decrease the magnitude of depression among prisoners.Keywords: depression, prisoners, Southern Ethiopia

Mesay Samuel,1 Hanan Abdulkadir,2 Meseret Girma,2 Mustefa Glagn2 1Wolayta Zone Health Department, Wolayta Sodo, Ethiopia; 2School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, EthiopiaCorrespondence: Hanan AbdulkadirSchool of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, EthiopiaTel +251923590013Email hanuahi@gmail.comBackground: Cataract is the major cause of reversible blindness and visual impairment in developing countries. It has been assumed that there is poor access to information related to the cause, prevention, and treatment of cataract in developing countries. There is also a paucity of data on knowledge and attitude towards cataract in Ethiopia.Purpose: This study aimed to assess the knowledge and attitude of cataract and their associated factors among adults in Arba Minch Zuria Woreda, Southern Ethiopia.Patients and Methods: A community-based cross-sectional study was conducted among 623 adults from February 6 to April 16, 2020. The study participants were selected by the multi-stage sampling technique. Data were collected with a pre-tested structured questionnaire by using face-to-face interviews. The data were entered into Epi info version 7.2 and exported to SPSS version 23 for analysis. The level of statistical significance was set at a p-value less than 0.05 in multivariable logistic regression.Results: Among 623 total participants, 54.9% of them had good knowledge about cataract, while 37.9% of them had favorable attitude about cataract. Inability to read and write (AOR=0.104, 95% CI: 0.042– 0.258), primary school educational level (AOR=0.208, 95% CI: 0.091– 0.478), secondary school educational level (AOR=0.199, 95% CI: 0.088– 0.451), earning average monthly income 350– 820 Ethiopian birr (AOR=2.364, 95% CI: 1.277– 4.373), not having previous eye examination (AOR=0.605, 95% CI: 0.425– 0.861) and unavailability of eye clinic (AOR=0.65, 95% CI: 0.446– 0.945) were significantly associated with knowledge of cataract. No history of cataract (AOR=0.257, 95% CI: 0.157– 0.418) was significantly associated with attitude towards cataract.Conclusion: Significant portion of participants had poor knowledge and an unfavorable attitude towards a cataract. So, it is recommended that stakeholders in different hierarchies need to exert efforts on creating awareness about cataract by considering the education level of the community. Moreover, attention should be given to the availability and accessibility of the primary eye care unit.Keywords: cataract, knowledge, attitude, associated factors, Arba Minch Zuria Woreda, Southern Ethiopia

Diabetes is defined as a chronic metabolic disorder characterized by increased blood glucose level (hyperglycemia) which is a result of defects in insulin secretion, insulin action or both. Metformin has been the preferred drug of choice in the first-line management of type 2 diabetes, particularly in overweight or obese patients with normal kidney function. Diabetic patients experiencing erectile dysfunction, tend to try out herbal medicines for a remedy. Some of these herbal medicines such as Syzygium aromaticum and Garcinia kola are ethno medicinally used as enhancement agents in treating erectile dysfunction. The study aimed to determine the effect of the methanol extract of Syzygium aromaticum (clove buds) on the dissolution profile of different brands of commercially available metformin tablets to determine whether or not there is a possible interaction. The dissolution study was carried out to simulate the gastrointestinal tract pH with and without the herbal drug. Ppotassium dihydrogen orthophosphate adjusted to pH 6.8 using 0.1M NaOH, served as dissolution medium. Five milliliters (5 mi) of samples were withdrawn at predetermined time intervals. The results obtained showed that the percentage of drug release was higher when metformin was introduced alone in the dissolution medium compared to when it was in combination with cloves. The study thus, showed that Syzygium aromaticum buds decreased the release of metformin tablets, hence, patients on metformin and clove buds should be advised to delay the administration of the herb to avoid possible interaction which may lead to a decrease in bioavailability of the drug resulting in therapeutic failure. [ABSTRACT FROM AUTHOR]

Pathogenicity test of Fusarium oxysporum isolates in causing tomato wilt disease (TWD) was carried out on two tomato varieties (UC 82B and Rio-grande) in a screen house located at the Teaching and Research Farm of Federal University of Agriculture, Makurdi during 2015 cropping season. The experiment was a 2 x 11 factorial laid out in Completely Randomized Design (CRD) and replicated three times. F. oxysporum isolates tested were coded as: FoAs1, FoAs2, FoAg, FoNb, FoSb, FoAm, FoAk, FoOr, FoAd and FoUAM together with an uninoculated control. All the isolates of F. oxysporum tested were pathogenic, causing wilt on the plants from 3 weeks after inoculation (WAI), with severity of wilt been significantly higher (P=0.05) in FoUAM. Isolates of F. oxysporum showed significant difference (P=0.05) both in incidence and severity compared with the control. Effect of F. oxysporum isolates on some agronomic characteristics such as plant height, number of fruits, fruit weight and number of branches on the two varieties of tomato at 12 weeks after sowing (WAS) was significantly different (P=0.05) with the control experiment. Highest severity score of 5.00 was calculated in FoUAM while the least of 4.33 was in FoSb compare with uninoculated value of 2.50. It is therefore, concluded that the two tomato varieties are pathogenic to F. oxysporum isolates and illicit disease in tomato hence reduced the yield of the crop. [ABSTRACT FROM AUTHOR]

A palpable thyroid nodule is a common clinical problem; the ultrasonography (US) and fine needle aspiration biopsy (FNA) are its main diagnostic tools. This article aimed to study the reliability and advantages of ultrasound as a diagnostic aid in predicting malignancy in thyroid nodules and to reduce the number of unnecessary surgery. Two hundreds and thirty three patients were examined by ultrasound, and then fine needle aspiration cytology under ultrasound guidance (US-FNAC) was done for 210 of them. From those 210 patients we obtained the histopathological proof of 58 patients who underwent surgery. We calculated the sensitivity, specificity and accuracy of US-FNAC. There are certain sonographic criteria that suggest malignancy these include microcalcification, irregular margins, and hypoechogenicity of the nodule. The sensitivity, specificity, and accuracy of US-FNAC were 80%, 96%, and 94% respectively. Although ultrasound can not reliably distinguish benign from malignant nodules, but it can identify suspected nodules based on certain sono-graphic criteria.

Named Data Networking (NDN) performs its routing and forwarding decisions using name prefixes. This removes some of the issues affecting addresses in our traditional IP architecture such as limitation in address allocation and management, and even NAT translations etcetera. Another positivity of NDN is its ability to use the conventional routing like the link state and distance vector algorithm. In route announcement, NDN node broadcasts its name prefix which consists of the knowledge of the next communicating node. In this paper, we evaluate the performance of mobility management models used in forwarding NDN contents to a next hop. This makes it crucial to select an approach of mobility model that translates the nature of movement of the NDN mobile routers. A detailed analysis of the famous mobility model such as the Random Waypoint mobility and Constant Velocity were computed to determine the mobility rate of the NDN mobile router. Simulation analysis was carried out using ndnSIM 2.1 on Linux Version 16.1. we build and compile with modules and libraries in NS-3.29. The sample of movement of the mobile router is illustrated and our result present the viability of the Constant Velocity model as compared with the Random Way point. [ABSTRACT FROM AUTHOR]

In extension with the previous work, recycling of the waste polyolefins by dissolution/reprecipitation method, has been investigated. The goal of study was to explore the influence of organo-modified/unmodified sodium montmorillonite clays, on the behaviours of waste polyolefins inclusive low density polyethylene (LDPE) and high density polyethylene (HDPE). 1-5 wt % of unmodified (MMT) and Organo-modified clay (OMMT) were added to the polyolefins, to prepare polyolefin-clay nanocomposites by melt intercalation method. X-ray diffraction (XRD) and Field Emission Scanning Electron Microscope (FESEM) were used to estimate the dispersion of clay in the polymer matrices and the morphology of nanocomposites. Thermogravimetric analysis (TGA) and Differential Scanning Calorimetry (DSC) were used to analyse the change in the thermic properties of the waste polyolefins nanocomposites. The XRD and FESEM results showed an intercalated structure in the HDPE and LDPE with Organo-clay nanocomposites, whereas no exfoliation was observed with unmodified clay in both waste HDPE and LDPE, respectively. DSC and TGA, showed an improved thermal behaviours in the HDPE/Organo-clay nanocomposites (3 wt%) clay loading. Melting temperature and crystallization percentage were observed to increase in 1, 2, and 3 wt% loadings. In waste LDPE/clay nanocomposites, no improvement was established in the thermal stability. [ABSTRACT FROM AUTHOR]

A real‐time thermal imaging based, non‐contact respiration rate monitoring method was developed. It measured the respiration related skin surface temperature changes under the tip of the nose. Facial tracking was required as head movements caused the face to appear in different locations in the recorded images over time. The algorithm detected the tip of the nose and then, a region just under it was selected. The pixel values in this region in successive images were processed to determine respiration rate. The segmentation method, used as part of the facial tracking, was evaluated on 55,000 thermal images recorded from 14 subjects with different extent of head movements. It separated the face from image background in all images. However, in 11.7% of the images, a section of the neck was also included, but this did not cause an error in determining respiration rate. The method was further evaluated on 15 adults, against two contact respiration rate monitoring methods that tracked thoracic and abdominal movements. The three methods gave close respiration rates in 12 subjects but in 3 subjects, where there were very large head movements, the respiration rates did not match. [ABSTRACT FROM AUTHOR]

Background: Dropout from community-based health insurance (CBHI) membership is a common problem in low-income countries, even if its implementation leads to substantial improvement in the utilization of essential health services. Few studies have addressed the factors contributing to dropout rates in southern Ethiopia. Therefore, the purpose of this study was to determine the rate of CBHI dropout in southern Ethiopia as well as any contributing factors., Methods: This mixed-method cross-sectional study was conducted among 460 randomly selected CBHI-enrolled households at the Arba Minch Health and Demography Surveillance System site from November 1, 2021, to April 30, 2022. The quantitative data were collected by an open data kit (ODK). using an interviewer-based structured questionnaire and analyzed using Statistical Package for the Social Sciences (SPSS) version 25.0. Multivariable logistic regression was applied to identify significant variables. The qualitative data were used to support the quantitative findings and were gathered through in-depth interviews (by the CBHI coordinator and three purposively selected health extension workers) and focus group discussions (in two randomly selected villages). The qualitative data were analyzed using thematic analysis. Finally, triangulation was used to present both the quantitative and qualitative findings., Results: This study found that 92 (21.5%) people stopped their community-based health insurance membership. The presence of sick adults [AOR = 0.281, 95% CI (0.136-0.581)], trust of participants in the contracted health facilities [AOR = 0.227, 95% CI (0.121-0.436)], and poor knowledge of the participants [AOR = 5.518, 95% CI (1.526-19.950)] were significant predictors., Conclusion: The magnitude of the dropout rate was high in this study when compared with the national target. The absence of a sick adult, the absence of trust among participants, and the poor knowledge status of the participants were significant predictors. We suggest that the health facility managers, the CBHI coordinating office, and the district health office give priority to implementing a wide range of knowledge improvement activities and a transparent system in public health facilities. Studies with longitudinal research designs are called for at a wide range of national levels to address the limitations of this study., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Haile, Abdulkadir, Shewangizaw, Meskele, Temesgen, Haile, Niguse, Hailegebreal and Biratu.)

Introduction: Curriculum-based sexual and reproductive health education (CBSRHE) is one of the preventive strategies targeting youth in higher institutions to protect them from sexual and reproductive health problems, despite never assessing the effect in Ethiopia. Therefore, this study aimed to assess the effect of CBSRHE on knowledge and attitude about SRH services to have safer sexual behaviors among first-year students of Arba Minch University., Method: We conducted a quasi-experimental study among purposively selected campuses. The campuses were allocated to (i) an intervention arm consisting of curriculum-based sexual and reproductive health, or (ii) a control arm for those who were free from intervention. Data was collected, at baseline and immediately after the intervention ended by using a structured self-administered questionnaire. To compare differences in the change from baseline to post-intervention between the two arms we use the chi-square test and independent-samples t-test. To see the effect of the CBSRHE by controlling the effect confounding inverse probability-weighted analysis was conducted., Result: A total of 832 and 820 students participated in a baseline and post-test respectively. The proportion of youth who practice receptive penetrative sex decreases from 40.9% to 28.3% in the intervention arm compared to 37.6% to 37.3% in the non-intervention arm between baseline and end line, with statistically significant differences between groups. However, there are statistically significant differences between the intervention and control groups in terms of changes in contraception utilization (X2 = 1.21; P>0.05). Furthermore, there were significant improvements in knowledge and attitude among the intervention arm a comprehensive knowledge of HIV/AIDS (ATE = 0.22,95% CI, 0.14 to 0.29; p < 0.01), an average change of attitude toward HIV/AIDS(ATE = 1.32, 95% CI, 1.18 to 1.47; p < 0.01), comprehensive condom knowledge score (ATE = 0.23, 95% CI, 0.13 to 0.33; p < 0.01) and the average change of attitude toward condom score (ATE = 1.83, 95% CI, 1.19 to 2.77; p < 0.01)., Conclusion and Recommendation: It was found that there was a significant difference in knowledge and attitude toward a disk sexual behaviors among r one student. This implies that the educational authority o the country can gain through the adoption of courses to all universities across the country, besides doing further comparative studies to determine the long-term effect of the course supported with models and/or theories like the theory of change., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Boti Sidamo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Childhood overweight and obesity are emerging public health challenges of the twety-first century. There was a 24% increase in the number of overweight children under the age of 5 years in low-income countries. Despite the significant risk of childhood overweight/obesity for non-communicable diseases, premature death, disability, and reproductive disorders in their adult life, little attention has been given. Therefore, we aimed to assess the prevalence of overweight/obesity and associated factors among under-five children., Methods: This study was conducted using data from a nationally representative sample of the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS). The Mini EDHS was a community-based cross-sectional study that covered all the administrative regions of Ethiopia. The data collection was conducted between March 21, 2019 and June 28, 2019. Both descriptive and analytic findings were produced. The overweight/obesity was measured by the weight-for-height (WFH) index, more than two standard deviations (+2 SD ) above the median of the reference population based on the BMI Z -score. To identify significantly asso., Results: A total of 5,164 under-five children were included in this study cited factors of overweight/obesity, a multilevel binary logistic regression model was fitted to account for the hierarchical nature of the data. Adjusted odds ratio (aOR) with a corresponding 95% confidence interval ( CI ) was reported to show the strength of association and statistical significance. The overall prevalence of overweight/obesity was 2.14% (95% CI : 1.74-2.53). The odds of overweight/obesity was higher among children aged <6 months ( aOR = 5.19; 95% CI : 2.98-9.04), 6-24 months ( aOR = 1.97; 95% CI : 1.18-3.29), delivered by cesarean section ( aOR = 1.75; 95% CI : 1.84-3.65), living in Addis Ababa city ( aOR = 2.16; 95% CI : 1.59-7.81), Oromia region ( aOR = 1.93; 95% CI : 1.71-5.24), having mothers with the age 40-49 years ( aOR = 3.91; 95% CI : 1.90-16.92), uses traditional contraceptive methods ( aOR = 2.63; 95% CI : 1.66-10.47) and households headed by male ( aOR = 1.71; 95% CI : 1.84-3.48)., Conclusion: This study showed that the prevalence of overweight/obesity among under-five was low in Ethiopia. There were several factors that affect childhood overweight/obesity including child age, maternal age, mode of delivery, sex of head of household, contraception use, and geography of residence. Therefore, strategies to reduce childhood overweight and obesity should consider an identified multitude of contributing factors., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Gebremichael, Mengesha, Hailegebreal, Abdulkadir, Arja and Wolde.)

Background: The prison populations are more affected by mental illness than the general population but little attention is given to this population. And there is a limitation of study on the magnitude of anxiety and its associated factors. So this study aimed to assess the magnitude of anxiety and its associated factors among prisoners in Arba Minch and Jinka town, Ethiopia., Methods: An institution-based cross-sectional study was conducted among 650 randomly selected prisoners at Arba Minch and Jinka town. Data was collected by using open data kit then converted to excel and exported to SPSS version 25 for analysis. Descriptive statistics including frequency, means, and proportion were performed. Binary logistic regression was used to identify the associated variables. P < 0.05 was used to declare statistical significance., Results: The proportion of Anxiety among prisoners was 28% [N = 174, (95%CI, 25-32%)]. Age ≥ 48 (AOR = 4.21, 95%CI 1.99-8.93), age 38-47 (3.95, 1.94-8.07), being an urban resident (2.48, 1.56-3.95), not doing physical exercise (2.71, 1.53-4.79), having a chronic disease (1.63, 1.07-2.47), having 1-2 stressful life events (2.92, 1.59-5.35), duration of punishment > 5 years (2.92, 1.59-5.35) and lack of income-generating job in prison (2.54, 1.48-4.35) were significantly associated with anxiety., Conclusion: The magnitude of anxiety among prisoners was high. Age ≥ 48 and 38-47, urban residence, not doing physical exercise, having a chronic disease, having 1-2 stressful life events, duration of punishment > 5 years, and lack of income-generating job in prison were significantly associated with anxiety. Giving special attention and being supportive to older age and those who have a chronic disease, facilitating physical exercise, creating job opportunity in the prison, and giving training for prisoners on stress coping mechanism and anxiety is recommended., (© 2022. The Author(s).)

Background: Birth asphyxia is the inability of a newborn to start and conserve breathing immediately after birth. Globally, 2.5 million infants die within their first month of life every year, contributing nearly 47% of all deaths of children. It is the third cause of neonatal deaths next to infections and preterm birth. Ethiopia is one of the countries with the highest neonatal mortality and high burden of birth asphyxia in the world. The state of birth asphyxia is about 22.52% in Ethiopia, with incidence of 18.0% in East Africa Neonatal mortality incidence ratio was 9.6 deaths per 1000 live births among which 13.5% of neonatal mortality cases were due to birth asphyxia in southern Ethiopia. The effect of birth asphyxia is not only limited to common clinical problems and death; it also has a socio-economic impact on the families. Therefore, this study is aimed to identify determinants of birth asphyxia among newborn live births in public hospitals Southern Ethiopia., Methods: An Institution based unmatched case-control study was conducted among newborn live births in public hospitals of Gamo & Gofa zones, with a total sample size of 356 (89 cases and 267 controls, 1:3 case to control ratio) from March 18 to June 18, 2021, after obtaining ethical clearance from Arba Minch University. Cases were selected consecutively and controls were selected by systematic random sampling method. Data were collected using an adapted pretested semi-structured questionnaire through face-to-face interviews and record reviews using an extraction checklist for intrapartum & neonatal-related information. The collected data were entered into Epi data version 4.4 and exported to STATA version 14 for analysis. Finally, bi-variable and multivariable logistic regression analyses were performed to identify determinants of birth asphyxia. Statistical significance was declared at p-value ≤ 0.05 along with corresponding 95% CI of AOR used to declare statistical significance., Results: Anemia during pregnancy [AOR = 3.87, 95% CI (1.06- 14.09)], breech presentation [AOR = 3.56, 95% CI (1.19-10.65)], meconium stained amniotic fluid [AOR = 6.16, 95% CI (1.95-19.46)], cord prolapse [AOR = 4.69, 95%CI (1.04-21.05)], intrapartum fetal distress [AOR = 9.83, 95% CI (3.82-25.25)] and instrumental delivery [AOR = 5.91, 95% CI (1.51-23.07)] were significantly associated with birth asphyxia., Conclusion: The study revealed that anemia during pregnancy, breech presentation, meconium-stained amniotic fluid, cord prolapse, intrapartum fetal distress, and instrumental delivery were identified as determinants of birth asphyxia. Therefore, health professional and health institutions should give emphasis on care of mother and the newborn in actively detecting and managing asphyxia., (© 2022. The Author(s).)

Background: Pieces of evidence strongly indicate that providing high-quality family planning services is accompanied by an increase in contraceptive uptake and a decrease in contraception discontinuation. Contraceptive, especially Implanon discontinuation is a global issue that could be linked to a summary outcome indicator of poor family planning service quality. Although Implanon is becoming more popular among Ethiopian contraceptive users, little is known regarding the survival and predictors of discontinuation. The study aimed at exploring the survival and predictors of Implanon discontinuation among women enrolled in family planning units of Public hospitals in southern Ethiopia, 2021., Methods: A hospital-based retrospective cohort study was conducted among Implanon users who enrolled in family planning units of Public Hospitals. Five years of medical records, from January 1, 2016, to December 30, 2020, were reviewed. A total of 502 women were selected by using a random sampling technique. A standardized abstraction tool was used to collect data from medical records and registration books. The data were entered into Epidata Version 3.1 and then exported to STATA 14 for analysis. The median was calculated in the case of survival time. Across covariates, the Kaplan Meier survival curve was used to estimate time to Implanon discontinuation. To identify statistically significant predictors of Implanon discontinuation, a multivariable Cox proportional hazard model was fitted., Results: The incidence rate of Implanon discontinuation was 1.87(95% CI = 1.63, 2.15) per 100 person-months of observation. The overall estimated survival probability at the end of 24 and 36 months was 67.4% (95%CI, 62.5, 71.8) and 25.9% (95%CI, 18.4, 34.1) months respectively. Residence [AHR = 1.50; 95%CI: 1.09, 2.08], parity [AHR = 2.02; 95%CI: 1.65, 3.67], pre-insertion counselling [AHR = 2.41; 95%CI: 1.72, 3.70], experiencing heavy vaginal bleeding [AHR = 3.91; 95%CI: 2.67, 5.32], post-insertion follow up [AHR = 3.15; 95%CI:2.11, 4.75] were identified as a significant predictors of Implanon discontinuation., Conclusion: The risk Implanon of discontinuation was high, especially at 24 and 36 months. In family planning service delivery points, health care providers should pay special attention to clients who live in rural areas and do not have children. In addition, health care providers should provide pre-insertion counseling and post-insertion follow-up that focus on potential side effects. Finally, family planning units need to engage in early side effect management and reassurance to mitigate discontinuation., (© 2022. The Author(s).)

Azacitidine (Aza) is first-line treatment for patients with high-risk myelodysplastic syndromes (MDS), although its precise mechanism of action is unknown. We performed the first study to globally evaluate the epigenetic effects of Aza on MDS bone marrow progenitor cells assessing gene expression (RNA seq), DNA methylation (Illumina 450k) and the histone modifications H3K18ac and H3K9me3 (ChIP seq). Aza induced a general increase in gene expression with 924 significantly upregulated genes but this increase showed no correlation with changes in DNA methylation or H3K18ac, and only a weak association with changes in H3K9me3. Interestingly, we observed activation of transcripts containing 15 endogenous retroviruses (ERVs) confirming previous cell line studies. DNA methylation decreased moderately in 99% of all genes, with a median β-value reduction of 0.018; the most pronounced effects seen in heterochromatin. Aza-induced hypomethylation correlated significantly with change in H3K9me3. The pattern of H3K18ac and H3K9me3 displayed large differences between patients and healthy controls without any consistent pattern induced by Aza. We conclude that the marked induction of gene expression only partly could be explained by epigenetic changes, and propose that activation of ERVs may contribute to the clinical effects of Aza in MDS.

Early therapeutic decision-making is crucial in patients with higher-risk MDS. We evaluated the impact of clinical parameters and mutational profiles in 134 consecutive patients treated with azacitidine using a combined cohort from Karolinska University Hospital (n=89) and from King's College Hospital, London (n=45). While neither clinical parameters nor mutations had a significant impact on response rate, both karyotype and mutational profile were strongly associated with survival from the start of treatment. IPSS high-risk cytogenetics negatively impacted overall survival (median 20 vs 10 months; p<0.001), whereas mutations in histone modulators (ASXL1, EZH2) were associated with prolonged survival (22 vs 12 months, p=0.01). This positive association was present in both cohorts and remained highly significant in the multivariate cox model. Importantly, patients with mutations in histone modulators lacking high-risk cytogenetics showed a survival of 29 months compared to only 10 months in patients with the opposite pattern. While TP53 was negatively associated with survival, neither RUNX1-mutations nor the number of mutations appeared to influence survival in this cohort. We propose a model combining histone modulator mutational screening with cytogenetics in the clinical decision-making process for higher-risk MDS patients eligible for treatment with azacitidine., Competing Interests: CONFLICTS OF INTERESTGhulam Mufti: has received research funding from Celgene and been part of their advisory board.Eva Hellström-Lindberg: has received research grant from Celgene for the national MDS registry.Martin Jädersten: has recieved honoraria for lectures for Celgene.Austin Kulasekararaj: has recieved honoraria for advisory board and lectures for Celgene.