Occupational exposure to blood and body fluids and associated factors among health care workers at the University of Gondar Hospital, Northwest Ethiopia.

BACKGROUND: Occupational exposure to blood and body fluids (BBFs) is a serious concern for health care workers (HCWs) and presents a major risk factor for transmission of infectious diseases such as hepatitis B virus (HBV), hepatitis C virus, and human immune deficiency virus. The main objective of this study was to assess the magnitudes of occupational exposure of blood and body fluids and associated factors among health workers at the University of Gondar Hospital. METHODS: An institution-based cross-sectional study was conducted from 1 February to 31 May 2017 at the University of Gondar Hospital. A total of 282 health care workers were selected by simple random sampling technique. Descriptive data was presented as absolute number with percentage, and multivariate analysis was used to assess the statistical association between associated factors and occupational exposure to BBFs. A P value of < 0.05 was considered as statistical significant. RESULT: A total of 282 HCWs participated with the mean (±SD) age of 30.51 ± 5.86 year. Of the total, 58.5% (165) and 42.2% (119) of the study participants had been exposed to BBFs splash and needlestick injury (NSI) in their lifetime, respectively. However, 39.0% (110) and 20.6% (58) of the HCWs were exposed to splash and NSI in the past 1 year, respectively. Not wearing eye goggle, lack of training on infection prevention, taking of HBV vaccination, and recapping of used needle were risk factors associated with BBFs splash exposure, whereas taking HBV vaccination and recapping of used needle were associated risk factors with NSI exposure. CONCLUSION: This study showed a high percentage of occupational exposure to blood and body fluids among health care workers. Not wearing eye goggle, HBV vaccine status, and recapping needles were found to be independent predictors of occupational exposure to BBFs among HCWs. Therefore, relevant stakeholders need to formulate strategies to create a favorable working environment and increase their adherence to universal precautions.

Hyperuricemia and its Association with Cardiovascular Disease Risk Factors in Type Two Diabetes Mellitus Patients at the University of Gondar Hospital, Northwest Ethiopia.

BACKGROUND: Hyperuricemia is associated with cardiovascular disease (CVD) that presents in diabetes mellitus patients. Therefore, the aim of this study was to appraise the serum uric acid and its association with CVD risk factors among diabetes mellitus patients. METHODS: A cross-sectional study was carried out at the University of Gondar hospital from February to March, 2018. A total of 384 study participants were selected by systematic random sampling technique. Five milliliter blood sample was collected and analyzed using Mindray BS-200E machine. The data was analysed into SPSS version 20. Logistic regression model was used to investigate associated factors. A p-value <0.05 was considered statistically significant. RESULTS: The prevalence of hyperuricemia among type 2 diabetic patients was 31.5%. The serum uric acid concentration was higher among male (33.1%) compared to female (28.9%). Elevated systolic blood pressure (AOR: 4.4, 95%CI: 2.1-9.3), family history of DM (AOR: 1.5, 95%CI: 1.2-2.5) and BMI ≥ 25 Kg/m2 (AOR: 1.4, 95%CI: 1.1-3.7) were significantly associated with hyperuricemia. Increased BMI (52.4%), high waist circumference (63.0%) and elevated systolic blood pressure (58.2%) were the major CVD risk factors. CONCLUSION: The prevalence of hyperuricemia was high in type 2 diabetes patients. The major predictors of CVD risk factors were elevated systolic blood pressure, family history of DM and BMI ≥ 25 Kg/m2 which lead to early diagnosis and treatment for hyperuricemia. Lastly, CVD risk factors are essential to reduce the disease among type 2 diabetic patients.

Role of Gut Microbiota in Type 2 Diabetes Mellitus and Its Complications: Novel Insights and Potential Intervention Strategies.

Type 2 diabetes mellitus has become one of the fastest growing public health problems worldwide. The disease is believed to involve a complex process involving genetic susceptibility and environmental factors. The human intestine harbors hundreds of trillions of bacteria, as well as bacteriophage particles, viruses, fungi, and archaea, which constitute a complex and dynamic ecosystem referred to as the gut microbiota. Increasing evidence has indicated changes in the gut microbiota composition or function in type 2 diabetic patients. An analysis of 'dysbiosis' enables the detection of alterations in the specific bacteria, clusters of bacteria, or bacterial functions associated with the occurrence of type 2 diabetes. These bacteria are involved predominantly in the control of inflammation and energy homeostasis. This review attempts to show that the gut microbiota are important factors for the occurrence of type 2 diabetes and are important for the treatment of gut microbiota dysbiosis through bariatric surgery, fecal microbiota transplantation, prebiotics, and probiotics.

Tumor Lysis Syndrome in Patients with Hematological Malignancies.

Tumor lysis syndrome is a metabolic complication that may follow the initiation of cancer therapy. It commonly occurs in hematological malignant patients particularly non-Hodgkin's lymphoma and acute leukemia due to chemotherapy or spontaneously. It is characterized by a biochemical abnormality such as hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia and its clinical outcome is directly related to these biochemical abnormalities. Prevention and treatment of tumor lysis syndrome depend on immediate recognition of patients at risk. Therefore, identifying patients at risk and prophylactic measures are important to minimize the clinical consequences of tumor lysis syndrome. Patients with low risk should receive hydration and allopurinol. On the other hand patients with high risk should receive hydration and rasburicase in an inpatient setting. It is important to start therapy immediately, to correct all parameters before cancer treatment, to assess risk level of patients for TLS, and to select treatment options based on the risk level. In this review a comprehensive search of literatures was performed using MEDLINE/PubMed, Hinari, the Cochrane library, and Google Scholar to summarize diagnostic criteria, incidence, predicting factors, prevention, and treatment options for tumor lysis syndrome in patients with hematological malignancies.