Determinants of prelabor rupture of membrane among pregnant women attending governmental hospitals in Jimma zone, Oromia region, Ethiopia: A multi-center case-control study.

BACKGROUND: Prelabor rupture of membrane defined as the rupture of fetal membranes before the beginning of uterine contractions, is a common complication of pregnancy and the leading cause of preterm birth. In Ethiopia, the prevalence of prelabor rupture of membrane varied significantly between settings due to variations in risk factors. Besides, there was no study conducted using primary data, particularly in the Jimma zone, Ethiopia. Therefore, this study aimed to identify determinants of prelabor rupture of membrane among pregnant women attending governmental hospitals in the Jimma zone, Oromia region, Ethiopia. METHODS: An institutional-based unmatched case-control study design was conducted from October 15 to December 15, 2021, at four governmental hospitals. A consecutive sampling technique was used to select 316 participants (79 cases and 237 controls). Women with prelabor rupture of the membrane were confirmed by history, sterile vaginal examination, and ultrasound as cases, and their counterparts as controls. An interviewer-administered questionnaire was used to collect data on maternal (obstetric, medical, behavioral) and fetal-related characteristics. The data were entered into Epi Data version 4.6 and analyzed using SPSS version 25. Descriptive statistics, bi-variable, and multivariable logistic regression were computed. The odds ratio with a 95% confidence level was used, and the significance level was declared at a p-value < 0.05. RESULTS: A total of 316 participants (79 cases and 237 controls) were included in this study. Pregnancy-induced hypertension (AOR = 3.06, 95% CI: 1.41-6.64), history of abortion (AOR = 3.67, 95% CI: 1.56-8.65), urinary tract infections (AOR = 2.61, 95% CI: 1.13-6.06), abnormal vaginal discharge (AOR = 2.65, 95% CI: 1.21-5.79), maternal khat chewing (AOR = 3.40, 95% CI: 1.70-6.80), mid-upper arm circumference less than 23 cm (AOR = 2.80, 95% CI: 1.51-5.19), and fetal presentation (breech) (AOR = 2.63, 95% CI: 1.10-6.28) were determinants of prelabor rupture of membrane among pregnant women. CONCLUSION: This study revealed that the aforementioned factors were found to be determinants of prelabor rupture of membrane among pregnant women. Therefore, hospitals should give focus to the early screening, diagnosis, and treatment of pregnancy-induced hypertension, urinary tract infection, and abnormal vaginal discharge to reduce the burden of prelabor rupture of membranes.

Squamous Cell Carcinoma of Skin Cancer Margin Classification From Digital Histopathology Images Using Deep Learning.

OBJECTIVES: Now a days, squamous cell carcinoma (SCC) margin assessment is done by examining histopathology images and inspection of whole slide images (WSI) using a conventional microscope. This is time-consuming, tedious, and depends on experts' experience which may lead to misdiagnosis and mistreatment plans. This study aims to develop a system for the automatic diagnosis of skin cancer margin for squamous cell carcinoma from histopathology microscopic images by applying deep learning techniques. METHODS: The system was trained, validated, and tested using histopathology images of SCC cancer locally acquired from Jimma Medical Center Pathology Department from seven different skin sites using an Olympus digital microscope. All images were preprocessed and trained with transfer learning pre-trained models by fine-tuning the hyper-parameter of the selected models. RESULTS: The overall best training accuracy of the models become 95.3%, 97.1%, 89.8%, and 89.9% on EffecientNetB0, MobileNetv2, ResNet50, VGG16 respectively. In addition to this, the best validation accuracy of the models was 94.7%, 91.8%, 87.8%, and 86.7% respectively. The best testing accuracy of the models at the same epoch was 95.2%, 91.5%, 87%, and 85.5% respectively. From these models, EfficientNetB0 showed the best average training and testing accuracy than the other models. CONCLUSIONS: The system assists the pathologist during the margin assessment of SCC by decreasing the diagnosis time from an average of 25 minutes to less than a minute.

Determining Anterior Fontanel Size and Associated Factors Among Term Neonates on the First Day of Life Born at Jimma University Medical Center (JUMC), Southwest Ethiopia: A Linear Regression Model.

BACKGROUND: Knowledge of the normal variation in AF size may be helpful to cue early diagnosis of congenital hypothyroidism, hyperthyroidism, cardiac disease, meningitis, degree of dehydration or provide a clue to disorders of neural and skeletal development. However, the data is scarce. Therefore, this study was aimed to determine AF size and associated factors among term neonates on the first day of life born in Jimma University Medical Center (JUMC), Southwest Ethiopia. METHODOLOGY: An institution-based cross-sectional study design was used to consecutively sample term and health newborns. Descriptive statistics, one-way ANOVA, independent samples t-test and correlation were implemented. Finally, multiple Linear regressions were used to see the association of the dependent and independent variables at 95% confidence interval. The significance level was declared at <0.05 p-value. RESULTS: The mean AF size of the study population was 3.018 cm with standard deviation (±SD) of 0.909 cm (range 0.4-5.50cm). A multiple linear regression analysis revealed that neonatal birth weight (B=0.001, 95% CI: 0.000-0.001, p=0.000), crown heel length (B=0.048, 95% CI, 0.018-0.078, p=0.002), labor duration (B= -0.028, p=0.001, 95% CI: -0.45; -0.012), and gender of the neonates (B=-0.275, 95% CI: -.441; -.109, p=0.001) were statistically significantly associated with AF size. In a multiple linear regression analysis AF size was explained by independent variables by 54.3%. CONCLUSIONS: AF size of the study population was 3.018 cm with a standard deviation (±SD) of 0.909 cm. Birth weight, crown heel length, duration of labor, and gender of the neonate were significantly associated with AF size.

Non-Alcoholic Fatty Liver Disease and Associated Factors among Type 2 Diabetic Patients in Southwest Ethiopia.

BACKGROUND: Non-alcoholic Fatty Liver Disease (NAFLD) among type 2 diabetic patients is completely ignored in developing regions like Africa paving the way for public health and economic burden in the region. Therefore, the main objective of this research was to evaluate non-alcoholic fatty liver disease and associated factors among type 2 diabetic patients in Southwestern Ethiopia attending Diabetic Clinic of Jimma University Specialized Hospital (JUSH). METHODS: Facility based cross-sectional study design was used. Anthropometry, fatty liver (using utrasonography), liver enzymes, and lipid profiles were measured among type 2 diabetic patients who fulfilled the inclusion criteria. Socio-demographic and clinical characteristics were assessed using standard questionnaires. RESULTS: Ninety-six (96) type 2 diabetic patients were enrolled and non-alcoholic fatty liver disease prevalence was 73%. Of non-alcoholic fatty Liver disease documented patients, 35.4%, 31.3% and 6.3% exhibited mild, moderate and severe fatty liver diseases, respectively. Alanine aminotransferase (p ≤0.001), Triacyglycerol (p ≤0.001), total bilirubin (p ≤0.05), direct bilirubin (p ≤0.05) and diabetic duration (p ≤0.01) were significantly associated with non-alcoholic fatty liver disease among type 2 diabetic patients. The Aspartate aminotransferase/Alanine aminotransferase ratio among non alcoholic fatty liver disease patients was greater than one. CONCLUSIONS: The magnitude of non-alcoholic fatty liver disease is high among study groups and it needs urgent action by healthcare systems. Therefore, targeted treatment approach inclusive of non-alcoholic fatty liver disease should be designed.

Toxicological investigation of acute and chronic treatment with Gnidia stenophylla Gilg root extract on some blood parameters and histopathology of spleen, liver and kidney in mice.

BACKGROUND: In southeast Ethiopia, people locally use the roots of Gnidia stenophylla Gilg (Thymelaeaceae) to cure malaria and other diseases with no literature evidence substantiating its safety. The aim of this study was, therefore, to investigate the safety of the aqueous root extract of G. stenophylla after acute (single dose) and repeated sub chronic oral administration in mice. RESULTS: A single oral administration of the extract at 500, 1000, 2000 and 4000 mg/kg body weight did not induce any behavioral change and mortality in both sexes. The oral LD50 of the extract was found to be above 6000 mg/kg body weight in mice. Chronic treatment with the extract for 13 weeks did not induce any sign of illness and/or death and had no adverse effect on the body weight. Dose-related elevations of erythrocytes, hematocrit, hemoglobin, platelets and neutrophils differential and significant decrease in the number of lymphocyte were observed. Liver sections of mice treated with 800 mg/kg body weight, revealed mild inflammations around the portal triads and central veins; whereas the spleen and kidneys appeared normal with no detectable gross morphological and histopathological alteration at both doses. CONCLUSIONS: The results of this study revealed that aqueous root extract of G. stenophylla Gilg at antimalarial dose is safe even when taken for a longer period. At a higher dose, the extract may have a potential to increase some hematological indices but may induce mild hepatotoxicity as a side effect.

Effect of Oral Administration of Gnidia Stenophylla Gilg Aqueous Root Extract on Food Intake and Histology of Gastrointestinal Tract in Mice.

BACKGROUND: Aqueous preparations of a medicinal plant, Gnidia stenophylla Gilg (Thymelaeaceae) are commonly used to cure malaria and other ailments in Ethiopia. This study evaluated the safety of the plant extract by determining its effects on food intake and histology of gastrointestinal tract (GIT) after oral administration for 13 weeks in albino mice. METHODS: Thirty mice were equally assigned to three groups. Group I served as control and received a vehicle while groups II and III were given 400 and 800 mg/kg body weight/day plant extract respectively, orally, for 13 weeks. At the end of the study, the mice were scarified and postmortem gross and histopathological evaluations were performed on their stomachs and intestines. RESULTS: Chronic oral treatment with the extract for 13 weeks did not induce any sign of illness and death and had no effect on food intake of the mice. Furthermore, extract treatment at both doses did not produce any detectable gross morphological change in GIT. Microscopic evaluation of sections of the stomach, duodenum and jejunum of the mice treated with 400 mg/kg body weight did not show any histopathological change. In the mice treated with 800 mg/kg body weight, however, the GIT sections revealed cytoplasmic vacuolation, hydropic degeneration and excessive erosion of the surface mucosal cells. CONCLUSION: The results of this study revealed that aqueous root extract of G. stenophylla at effective antimalarial dose is safe even when taken for a longer period in mice. At a higher dose, however, the extract may induce gastrointestinal irritation. Further studies on other vital organs and non-rodent species including humans are recommended.