Herbal Spices as Food and Medicine: Microscopic Authentication of Commercial Herbal Spices.

Herbal spices are an agricultural commodity, economically very important and beneficial in primary healthcare in the food and medicine sectors. Herbal spices are used as food flavoring agents as well as in phytotherapies throughout the world and have nutritive benefits. The food and medicine industries widely employ artificial or natural adulteration to retard the deterioration and utilization of these adulterants in food and medicine products has given rise to significant apprehension among consumers, primarily stemming from the potential health risks that they pose. Thus, their characterization for the purpose of identification, origin, and quality assurance is mandatory for safe human consumption. Here, we studied 22 samples of commonly traded herbal spices that belong to 20 different genera and 21 species comprising 14 families, investigated macroscopically or organoleptically as well as histologically under microscopic examination. In this study, we provide details on organoleptic features including appearance, taste, odor, color, shape, size, fractures, types of trichomes, and the presence of lenticels among the examined herbal spices and these features have great significance in the detection of both natural as well as artificial deterioration. In terms of microscopic characterization, each examined plant part comprising different anatomical characteristics has taxonomic importance and also provides useful information for authentication from natural adulterants. Furthermore, the studied taxa were also described with nutritive and therapeutic properties. For condiments, herbal beverages and medicinal purposes, different herbal parts such as leaves, floral buds, seeds, fruit, and accessory parts like mericarp, rhizome, bulbs, and bark were used and commercially traded. Similarly, in this study, the leaves of Cinnamomum tamala and Mentha spicata, the floral buds of Syzygium aromaticum, the seeds of Amomum subulatum, Brassica nigra, Punica granatum, Myristica fragrans, Phyllanthus emblica, and Elettaria cardamomum, the mericarp of Coriandrum sativum, and Cuminum cyminum were observed. As a result, we show the potential of herbal spices as a source of many valuable phytochemicals and essential nutrients for food, nutraceutical, and homoeopathic medicine.

Epidemiology and Outcomes of Critical Illness and Novel Predictors of Mortality in an Ethiopian Medical Intensive Care Unit.

Low- and middle-income countries (LMICs) bear most of the global burden of critical illness. Managing this burden requires improved understanding of epidemiology and outcomes in LMIC intensive care units (ICUs), including LMIC-specific mortality prediction scores. This study was a retrospective observational study at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia, examining all consecutive medical ICU admissions from June 2014 to April 2015. The primary outcome was ICU mortality; secondary outcomes were prolonged ICU stay and prolonged mechanical ventilation. ICU mortality prediction models were created using multivariable logistic regression and compared with the Mortality Probability Model-II (MPM-II). Associations with secondary outcomes were examined with multivariable logistic regression. There were 198 admissions during the study period; mortality was 35%. Age, shock on admission, mechanical ventilation, human immunodeficiency virus, and Glasgow Coma Scale ≤8 were associated with ICU mortality. The receiver operating characteristic curve for this 5-factor model had an AUC of 0.8205 versus 0.7468 for MPM-II, favoring the simplified new model. Mechanical ventilation and lack of shock were associated with prolonged ICU stays. Mortality in an LMIC medical ICU was high. This study examines an LMIC medical ICU population, showing a simplified prediction model may predict mortality as well as complex models.

The caring competencies of nursing students: Comparing the four and two-year Bachelor of Nursing Programme.

The study was conducted to determine and compare the caring behaviours of nursing students in four-year BS Nursing (Bachelor of Science in nursing) and two-year Post- RN BSN (Registered nurse to Bachelor of Science in Nursing) programmes. A cross-sectional analytical study was conducted in the nursing institutes of KP from July to September 2022. The sample size was 383 calculated by using the Rao soft sample size calculator. through Caring Behaviour Inventory (CBI-24) having six point Likert scale. Descriptive and inferential statistics were calculated through SPSS 20.0. There were more males, i.e. 60.6%, as compared to female students (39.4%). The overall mean score of caring competencies of Post-RN BS Nursing (Registered nurse to Bachelor of Science in Nursing) was 27.17±2.17 which is higher than 23.19±4.1 for BSN students (Bachelor of Science in nursing). Caring behaviours of overall participants are correlated with gender (p=0.001), age (p=0.001), and semester (p=0.001). The caring competency of Post-RN BS nursing students' are higher than the BS Nursing programme students. That could be due to the clinical exposure of Post-Rn students after completing a three-year Diploma in General Nursing.

Perceptions Of Intermediate Students Towards Nursing As A Career Choice In Swat Khyber Pakhtunkhwa.

The study aimed to explore the views of intermediate students toward nursing as a career of choice. A cross sectional design was used for the study conducted between June and July 2022, in two public colleges in district Swat Khyber Pakhtunkhwa. The sample size of the study was 146, obtained through random sampling using a self-administrated questionnaire on a 3-point Likert scale. Previous studies show that (61%) agreed, (19%) were neutral, and (20%) disagreed for selecting nursing as a career. Eighty-two (56%) students in the current study agreed, 47 (32%) disagreed, and 17 (12%) were neutral when asked if they planned to enrol in nursing school. The study noted that intermediate students in district Swat have a positive attitude towards nursing as a result of the establishment of multiple nursing colleges and the opportunity to work as a nurse in government hospitals or as a nurse educator.

Epidemiology and genetics of early onset colorectal cancer-African overview with a focus on Ethiopia.

Colorectal cancer (CRC) is a common cause of cancer-related death worldwide, with high rates of late diagnosis and increased mortality in sub-Saharan Africa. Furthermore, there is an alarming uptrend in the incidence of early onset colorectal cancer (EOCRC) across the globe, thus necessitating the need for early screening in general and special populations. There is, however, limited data available on the incidence and genetic characteristics of EOCRC from resource-poor countries, particularly Africa. Moreover, there is lack of clarity if recommendations and mechanisms proposed based on data from resource-rich countries applies to other regions of the world. In this review, we appraise the literature on EOCRC, its overall incidence, and genetic components as it pertains to sub-Saharan Africa. In addition, we highlight epidemiologic and epigenetic findings of our EOCRC cohort in Ethiopia.

Solving the housing crisis in Nunavut, Canada.

In Canada, there are vast differences between the state of accommodation/housing, health, social inequalities, education and economic conditions for people in the northern and southern regions of the country. Overcrowding in Inuit Nunangat is a direct result of the promises made by past government policy that led to Inuit people settling in sedentary communities in the North on the understanding that they would be provided with social welfare. However, these welfare programmes proved to be either insufficient or non-existent for Inuit people. Therefore, Inuit are living in overcrowded homes in Canada, resulting in a severe housing shortage, poor-quality housing and homelessness. This has led to the spread of contagious diseases, mould, mental-health issues, gaps in education for children, sexual and physical violence, food insecurity and adverse challenges for the youth of Inuit Nunangat. This paper proposes several actions to ease the crisis. First, funding should be stable and predictable. Next, there should be ample construction of transitional homes which could be used to accommodate people before moving them into proper public housing. Policies regarding staff housing should be amended, and if possible, these vacant staff houses could provide shelter to eligible Inuit people, which could help lessen the housing crisis. The advent of COVID-19 has made the issue of affordable and safe housing more serious because without safe housing, the health, education and well-being of the Inuit people in Inuit Nunangat are in peril. This study focuses on how the governments of Canada and Nunavut are dealing with this issue.

Occult hepatitis B virus infection among patients with chronic liver disease of unidentified cause, Addis Ababa Ethiopia.

Occult hepatitis B virus infection (OBI) characterized by the absence of detectable HBsAg in the presence of HBV DNA in the serum and/or liver tissue remains a potential risk of transmission and diseases progression among different population groups. It could be associated with asymptomatic case up to chronic liver disease (CLD) and hepatocellular carcinoma (HCC). The objective of this study was to assess the magnitude and characteristics of OBI among patients with CLD of unidentified cause in Addis Ababa, Ethiopia. The study was conducted at the gastroenterology & hepatology referral clinic of three government and two private hospitals in Addis Ababa. Known CLD patients as evidenced by clinical and imaging criteria and/or with HBV surface antigen (HBsAg) negative results using rapid test kit were included. ELISA serological test to anti-HBc Ab, anti HBsAg Ab, and HBsAg were determined using BIORAD kits [ https://www.bio-rad.com ]. HBV-DNA was amplified, and viral loads were determined by quantitative real-time PCR using Abbott m2000rt platform following the manufacturer's instructions. Data analysis was done using SPSS version 20.A total of 48 CLD patients with no identified cause for their liver disease were identified during the study period. All the patients had evidence of CLD by clinical and imaging criteria and nine were excluded. Three (7.69%) of the 39 patients tested positive for HBsAg test done by ELISA making the negative predictive value of the rapid test kits 92.3% compared to ELISA. The remaining 36 patients had serology test for HBV and 16 (44.4%) had positive anti-HBV core antibody. Two (5.56%) of the 36 patients with HBV viral load determination had detectable HBV DNA suggesting presence of an occult hepatitis B infection. Occult hepatitis B infection is found to be an aetiology among CLD patients labelled as having no identified cause by the current standard of care using rapid HBsAg kits in a subset of patients in Ethiopia. This study signifies the high rate of OBI and past evidence of HBV infection among CLD patients and thus nucleic acid testing and/or anti-HBc shall be integrated to the routine health care system to minimize HBV infection risk of transmission and to enhance patient care.

Increasing Burden of Acute Hepatitis A among Ethiopian Children, Adolescents, and Young adults: A Change in Epidemiological Pattern and Need for Hepatitis A Vaccine.

Background: Hepatitis A is a vaccine-preventable, feco-oral infection due to poor sanitary conditions. It is predominantly acquired during early childhood and results in lasting acquired protective immunity. However, it results in severe disease which can end up in acute fulminant hepatitis and hepatic failure when acquired during adolescence and adulthood. The prevalence of acute hepatitis A is increasing among children, adolescents, and young adults from higher-income households. They acquire this infection at a later age when they are exposed for the first time to contaminated food and drinks after being brought up in a relatively clean environment. This calls for the introduction of the Hepatitis A vaccine in Ethiopia; possibly as part of the Expanded Program on Immunization (EPI). Methods: Socio-demographic and clinical data were collected from patients who were diagnosed to have hepatitis A infection at Adera Medical Center in 2020. Results: This study showed that clinical acute hepatitis A is becoming common among children, adolescents, and young adults from relatively high-income families. Among patients with acute hepatitis, 89% were from middle and high-income families. Conclusions: There is a need for the incorporation of hepatitis A vaccine in the Ethiopian EPI program.

Wind-noise reduction for infrasonic measurements using adaptive line enhancement.

Measurement quality and analysis capability of infrasonic signals are both affected by background wind-noise. Physical filters, i.e., barriers and pipe arrays, are traditionally employed to reduce such noise. However, limited efficacy, site dependence, cost, requirement of space, non-portability, and frequent maintenance are some of their major drawbacks. This work proposes an adaptive filtering-based adaptive line enhancer (ALE) noise cancellation scheme as an alternative. Two infrasonic sensors (Chaparral Physics 50A), are adjacently deployed. One sensor is fitted with a conventional four-armed non-porous hose array (physical filter), while the ALE scheme is applied to the second sensor, sans physical filter. In high wind-noise conditions, the ALE scheme seems to behave as a lowpass filter (cutoff at 0.2 Hz), with a maximum attenuation of 26 dB at 8 Hz, while the physical filter provides significant attenuation only above 4 Hz with a maximum attenuation of 17 dB at 8 Hz. Generally, at other frequencies, the ALE scheme provides up to 20 dB superior noise attenuation as compared to the physical filter. The ALE also provides up to 6 dB gain in the signal-to-noise ratio as compared to the physical filter, due to non-attenuation of the infrasonic signal.

Qualitative healthcare worker survey: Retrospective cross-sectional case study on COVID-19 in the African context.

Background: Despite the presence of COVID-19 epidemiologic data in Africa, there are gaps in the understanding of healthcare workers' concerns and fears early in the pandemic. Methods: A retrospective cross-sectional multi-country pan-African qualitative survey case study on the perceived effects of the COVID-19 pandemic on healthcare workers in the continent focused specifically on personal safety and misinformation. The survey was distributed to 13 countries via snowball sampling of practitioners between April 22 and May 15, 2020. The survey solicited free-form answers, resulting in a large spectrum of responses. Qualitative analysis included open and axial coding methods for thematic emergence. Results: A total of 489 analyzable responses were recorded. The majority of respondents (n = 273, 57%) highlighted personal safety concerns including lack of resources and training to prevent infection (33%); fear of infection and transmission (24%); lack of public awareness and compliance with regulations (12%); governmental concerns (9%) and economic insecurity (11%) amongst others. 328 respondents (67%) reported having heard misinformation about COVID-19. Responses included misinformation regarding origin of the virus (11%), false modes of transmission (6%), differential effect for specific groups (30%), unproven cures (35%), and disbelief in existence (11%). Responses for misinformation and fears revealed categorical associations between certain countries. Conclusion: Addressing fears and concerns of frontline healthcare workers facilitates their essential role in combating community misinformation, and further understanding could provide essential insight to institutions and governments to direct resource allotment and community education.

Tannin phenotyping of the Vitaceae reveals a phylogenetic linkage of epigallocatechin in berries and leaves.

BACKGROUND AND AIMS: Condensed tannins, responsible for berry and wine astringency, may have been selected during grapevine domestication. This work examines the phylogenetic distribution of condensed tannins throughout the Vitaceae phylogenetic tree. METHODS: Green berries and mature leaves of representative true-to-type members of the Vitaceae were collected before 'véraison', freeze-dried and pulverized, and condensed tannins were measured following depolymerization by nucleophilic addition of 2-mercaptoethanol to the C4 of the flavan-3-ol units in an organic acidic medium. Reaction products were separated and quantified by ultrahigh pressure liquid chromatography/diode array detection/mass spectrometry. KEY RESULTS AND CONCLUSIONS: The original ability to incorporate epigallocatechin (EGC) into grapevine condensed tannins was lost independently in both the American and Eurasian/Asian branches of the Vitaceae, with exceptional cases of reversion to the ancestral EGC phenotype. This is particularly true in the genus Vitis, where we now find two radically distinct groups differing with respect to EGC content. While Vitis species from Asia are void of EGC, 50 % of the New World Vitis harbour EGC. Interestingly, the presence of EGC is tightly coupled with the degree of leaf margin serration. Noticeably, the rare Asian EGC-forming species are phylogenetically close to Vitis vinifera, the only remnant representative of Vitis in Eurasia. Both the wild ancestral V. vinifera subsp. sylvestris as well as the domesticated V. vinifera subsp. sativa can accumulate EGC and activate galloylation biosynthesis that compete for photoassimilates and reductive power.

Allium sulaimanicum: A new Allium species and section from Pakistan.

A new species, Allium sulaimanicum, is described from northern Balochistan and southern Khyber Pakhtunkhwa in Pakistan based on morphological, molecular, and cytological studies. The new species is characterised by long runner-like cylindrical rhizomes of adult plants, cylindrical bulbs, linear leaves with minute soft hairs along veins, campanulate perigonium, and white to creamy white, ovate to elliptical, 4.5-5-mm-long acute tepals, with brownish to purplish nerves, stamens as long as to slightly longer than tepals, yellow to brick red anthers, hexagonal ovary, and white and papillate/warty along angles. The presence of long herbaceous rhizomes indicated serious isolation of the new species; hence, a new section Sulaimanicum is proposed to accommodate the new species. The new species is diploid with a chromosome number of 2n = 16. Detailed morphological description, illustrations, phylogenetic analyses based on sequences of plastid spacers (rpl32-trnL (UAG) and trnQ-rps16) and nuclear ITS, karyotype features, and a distribution map of the new species are provided.

Non-Motor Symptoms and Associated Factors in Parkinson's Disease Patients in Addis Ababa, Ethiopia: A Multicenter Cross-Sectional Study.

BACKGROUND: Non-motor symptoms (NMSs) of Parkinson's disease (PD) were often overlooked and less studied. Little is known about NMSs in Ethiopia. The aim of the study was to determine the prevalence of NMSs and associated factors. METHODS: A multi-center cross-sectional observational study was conducted. NMS questionnaire was used to screen for the NMSs. Both descriptive and analytical statistics were used to analyze the data. RESULTS: Total of 123 PD patients with median of 4 years were investigated. The mean age of PD patients was 62.9 years. The mean age of PD onset was 58.3 years. In 23.6% the age of onset was below age 50. Males accounted 72.4%. Majority of the patients were on Levodopa alone and 31.7% were on levodopa plus trihexyphenidyl. Longer duration of illness was associated with frequent occurrence of NMSs. Constipation was the commonest NMS (78%), followed by urinary urgency (67.5%) and nocturia (63.4%). An unexplained pain was reported by 45.5 %, cognitive impairment (45.5%), and sleep disturbance was reported by 45.5% of the study participants. Neurophysciatric symptoms were reported by small proportion of the patients. Lower monthly earning was associated with swallowing problem, unexplained weight change, and lighheadness. CONCLUSION: The prevalence of NMS was high among PD patients in Ethiopia. Constipation was the commonest NMS. Longer duration of illness was associated with frequent occurrence of NMSs. Lower monthly earning was associated with swallowing problem, unexplained weight change, and lighheadness.

Taxonomy of Vincetoxicum s.str. (Asclepiadoideae, Apocynaceae) from southern Asia including three new species and resurrected names.

This paper presents a taxonomic study of genus Vincetoxicum s.str. from southern Asia. Eleven regional endemic species are recognized on the basis of herbarium studies and fieldwork. Three new species are described: V. lenifolium sp. nov. (endemic to Pakistan), V. stewartianum sp. nov. (endemic to India), and V. subcanescens sp. nov. (endemic to Pakistan, Kashmir and Tibet). Three species names, V. cabulicum, V. glaucum and V. kenouriense, previously treated as synonyms of V. glaucum, V. canescens and V. hirundinaria, respectively, are resurrected. A neotype is designated for the Afghani endemic V. cabulicum. A lectotype is chosen from the syntypes of V. glaucum. We resolve the long-standing taxonomic problems in three species complexes: V. arnottianum, V. luridum, V. sakesarense, and V. stocksii; V. glaucum, V. canescens and V. cabulicum; and V. hirundinaria and V. kenouriense. Geo-taxonomic distinctions of southern Asian taxa are highlighted by excluding from henceforth the long misrecognized western Eurasian taxa V. canescens and V. hirundinaria. Furthermore, a detailed account of the genus including illustrations of whole plants, leaves and corona, distribution maps, a taxonomic key, morphological descriptions, synonymy, notes, and information on phenology, distribution and habitats is provided. Finally, provisional conservation assessments are provided, which indicate that V. cardiostephanum and V. sakesarense are critically endangered.

Gilbert Syndrome in a Young Ethiopian Man: First Case Report.

BACKGROUND: Gilbert syndrome is a well-recognized condition causing unconjugated hyperbilirubinemia with otherwise normal transaminases and liver function tests. CASE: A 21 year old male patient presented with recurrent episodes of jaundice over four years. The episodes were preceded by stressful conditions and intercurrent illnesses. All laboratory prameters were normal except an unconjugated hyperbilirubinemia. A diagnosis of Gilbert syndrome was made after careful clinical evaluation. CONCLUSION: Recognizing Gilbert syndrome has important clinical implicaitions by avoiding uncessary and expensive workup of patients with jaundice. Mangement entails avoiding stressful conditions and prolonged fasting.

Hepatitis B-related hepatocellular carcinoma: surveillance strategy directed by immune-epidemiology.

Hepatitis B infection (HBV) is one of the most common causes of hepatocellular carcinoma (HCC) worldwide. The age of occurrence, prognosis and incidence vary dramatically depending on the region of the world. This geographic variation is largely dependent on the contrasting incidence of HBV, age of transmission of the virus, the timing of integration into the human genome, and different HBV genotypes, as well as environmental factors. It results in a wide difference in viral interaction with the immune system, genomic modulation and the consequent development of HCC in an individual. In this review, we describe many factors implicated in HCC development, provide insight regarding at-risk populations and explain societal recommendations for HCC surveillance in persons living with HBV in different continents of the world.

COVID-19 in Africa: Survey Analysis of Impact on Health-Care Workers.

As coronavirus disease 2019 (COVID-19) spreads across Africa, little is known about the impact of the pandemic on health-care workers (HCWs) in the region. We designed an anonymous survey distributed via e-mail and phone messaging to 13 countries through the African Hepatitis B Network. We obtained 489 analyzable responses. We used risk ratio analysis to quantify the relationship between binary variables and χ2 testing to quantify the statistical significance of these relationships. Median age of respondents was 30 years (interquartile range, 26-36 years) and 63% were physicians. The top three sources of information used by HCWs for COVID-19 management included the Ministry of Health of each country, the WHO, and social media. Forty-nine percent reported a decrease in income since the start of the pandemic, with the majority experiencing between a 1% and a 25% salary reduction. Sixty-six percent reported some access to personal protective equipment; only 14% reported appropriate access. Moreover, one third of respondents reported no availability of ventilators at their facility. Strikingly, the percentage of HCWs reporting never feeling depressed changed from 61% before the pandemic to 31% during the pandemic, with a corresponding increase in daily depressive symptoms from 2% to 20%. Most respondents (> 97%) correctly answered survey questions about COVID-19 symptoms, virus transmission, and prevention. Our survey revealed African HCWs face a variety of personal and professional context-dependent challenges. Ongoing support of HCWs through and after the COVID-19 pandemic is essential.

Risk of Healthcare Worker Burnout in Africa during the COVID-19 Pandemic.

COVID-19 is now impacting every country in Africa and healthcare workers (HCWs) across the continent remain susceptible to professional burnout. We designed a 43-question survey addressing multiple aspects of the COVID-19 pandemic. The survey was anonymous, distributed via email and phone messaging to 13 countries in Africa. We obtained 489 analyzable responses. 49% off HCWs reported a decrease in income, with the majority experiencing between 1-25% salary reduction. Sixty-six percent reported some access to personal protective equipment (PPE), 20% had no access to PPE and only 14% reported proper access. Strikingly, the percentage reporting never feeling depressed changed from 61% before the pandemic to 31% during the pandemic, with an increase in daily depression from 2% to 20%. We found no association between depression and change in income, household size, availability of PPE or lockdown. Safety concerns related to stigma from being HCWs affected 56% of respondents.