Enhanced ultrasonic degradation of methylene blue using a catalyst-free dual-frequency treatment.

Methylene blue is one of the most common pollutants found in wastewater, primarily due to its widespread use in the dye industry. Consequently, it is imperative to explore environmentally friendly and efficient methods for degrading this pollutant into non-toxic byproducts. While ultrasonic degradation methods in combination with additives or catalysts have proven effective, such additives or catalysts may inadvertently contribute to secondary pollution. Moreover, the preparation of these catalysts imposes an additional burden in terms of effort and cost. To address these issues, this paper introduces a catalyst-free dual-frequency ultrasound degradation approach for methylene blue. The sonochemical quality of the cavitation bubbles is improved using this technique because the bulk solution is populated with two types of bubbles, whose mean sizes are determined by the dual ultrasound frequencies. The findings demonstrate that, under identical acoustic power density conditions, dual-frequency ultrasound consistently outperforms single-frequency modes across all investigated parameters. Furthermore, the larger the difference between the dual frequencies used, the more effective the degradation of methylene blue. Finally, after just 20 min of sonication, a degradation efficiency of 91% was achieved with dual frequencies of 20 and 80 kHz at an acoustic power density of 209.63 ± 6.94 W/L. Consequently, this technique offers an environmentally friendly, catalyst-free, and highly effective method for degrading methylene blue.

Rapid, Cheap, and Effective COVID-19 Diagnostics for Africa.

BACKGROUND: Although comprehensive public health measures such as mass quarantine have been taken internationally, this has generally been ineffective, leading to a high infection and mortality rate. Despite the fact that the COVID-19 pandemic has been downgraded to epidemic status in many countries, the real number of infections is unknown, particularly in low-income countries. However, precision shielding is used in COVID-19 management, and requires estimates of mass infection in key groups. As a result, rapid tests for the virus could be a useful screening tool for asymptomatic virus shedders who are about to come into contact with sensitive groups. In Africa and other low- and middle-income countries there is high rate of COVID-19 under-diagnosis, due to the high cost of molecular assays. Exploring alternate assays to the reverse transcriptase polymerase chain reaction (RT-PCR) for COVID-19 diagnosis is highly warranted. AIM: This review explored the feasibility of using alternate molecular, rapid antigen, and serological diagnostic assays to accurately and precisely diagnose COVID-19 in African populations, and to mitigate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RT-PCR diagnostic challenges in Africa. METHOD: We reviewed publications from internet sources and searched for appropriate documents available in English. This included Medline, Google Scholar, and Ajol. We included primary literature and some review articles that presented knowledge on the current trends on SARS-CoV-2 diagnostics in Africa and globally. RESULTS: Based on our analysis, we highlight the utility of four different alternatives to RT-PCR. These include two isothermal nucleic acid amplification assays (loop-mediated isothermal amplification (LAMP) and recombinase polymerase amplification (RPA)), rapid antigen testing, and antibody testing for tackling difficulties posed by SARS-CoV-2 RT-PCR testing in Africa. CONCLUSION: The economic burden associated COVID-19 mass testing by RT-PCR will be difficult for low-income nations to meet. We provide evidence for the utility and deployment of these alternate testing methods in Africa and other LMICs.

In-situ observations and acoustic measurements upon fragmentation of free-floating intermetallics under ultrasonic cavitation in water.

Grain refinement in alloys is a well-known effect of ultrasonic melt processing. Fragmentation of primary crystals by cavitation-induced action in liquid metals is considered as one of the main driving mechanisms for producing finer and equiaxed grain structures. However, in-situ observations of the fragmentation process are generally complex and difficult to follow in opaque liquid metals, especially for the free-floating crystals. In the present study, we develop a transparent test rig to observe in real time the fragmentation potential of free-floating primary Al3Zr particles under ultrasonic excitation in water (an established analogue medium to liquid aluminium for cavitation studies). An effective treatment domain was identified and fragmentation time determined using acoustic pressure field mapping. For the first time, real-time high-speed imaging captured the dynamic interaction of shock waves from the collapsing bubbles with floating intermetallic particles that led to their fragmentation. The breakage sequence as well as the cavitation erosion pattern were studied by means of post-treatment microscopic characterisation of the fragments. Fragment size distribution and crack patterns on the fractured surface were then analysed and quantified. Application of ultrasound is shown to rapidly (<10 s) reduce intermetallic size (from 5 mm down to 10 µm), thereby increasing the number of potential nucleation sites for the grain refinement of aluminium alloys during melt treatment.

Characterising the cavitation activity generated by an ultrasonic horn at varying tip-vibration amplitudes.

Dual-perspective high-speed imaging and acoustic detection is used to characterise cavitation activity at the tip of a commercial 20 kHz (f0) ultrasonic horn, over 2 s sonications across the range of input powers available (20 - 100%). Imaging at 1 × 105 frames per second (fps) captures cavitation-bubble cluster oscillation at the horn-tip for the duration of the sonication. Shadowgraphic imaging at 2 Mfps, from an orthogonal perspective, probes cluster collapse and shock wave generation at higher temporal resolution, facilitating direct correlation of features within the acoustic emission data generated by the bubble activity. f0/m subharmonic collapses of the primary cavitation cluster directly beneath the tip, with m increasing through integer values at increasing input powers, are studied. Shock waves generated by periodic primary cluster collapses dominate the non-linear emissions of the cavitation noise spectra. Transitional input powers for which the value of m is indistinct, are identified. Overall shock wave content within the emission signals collected during sonications at transitional input powers are reduced, relative to input powers with distinct m. The findings are relevant for the optimisation of applications such as sonochemistry, known to be mediated by bubble collapse phenomena.

Health related quality of life of gynaecologic cancer patients attending at Tikur Anbesa Specialized Hospital (TASH), Addis Ababa, Ethiopia.

BACKGROUND: Being diagnosed with gynaecologic malignancy certainly will have different sequelae which can hamper quality of life (QOL).This study aimed to assess health related quality of life (HRQOL) among gynaecologic cancer patients attending at Tikur Anbesa Specialized Hospital (TASH), Addis Ababa, Ethiopia. METHODS: This study employed facility-based cross-sectional study design on 153 gynaecological cancer patients attending TASH using the Amharic version of the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30). We used descriptive statistics, independent t test and one way analysis of variance (ANOVA) in statistical analysis. RESULTS: The mean Global Health Status (GHS) was 40.95(SD ± 24.35) and of the functional scores, social function was most affected (42.26, SD ± 32.08), whereas cognitive function is the least affected domain (mean = 88.21, SD ± 18.49). The highest score on the symptom scores was found to be financial difficulties (mean = 64.76, SD ± 32.43) followed by pain (mean = 55.12, SD ± 29.64) and fatigue (mean = 53.97, SD ± 28.54); the lowest score on the contrary was scored for diarrhea (mean = 1.19, SD ± 7.38). As stage increases there was a statistically significant reduction in GHS (p = 0.005) and in all functional score domains except the physical and emotional function. Advancement in stage of the disease has also affected significantly the symptom score domains except financial difficulties, nausea /vomiting and diarrhea. Patients who never went to school have scored a statistically significant lower score in GHS, physical function, role function and social function (p < 0.05). CONCLUSION: GHS, social function, financial difficulties, pain and fatigue were the most affected domains; however, cognitive function and diarrhea were less affected components of HRQOL of gynaecologic cancer patients. Place of residence, educational status, marital status, payment type, cancer type and stage of the disease were associated with different quality of life scores.

Reliability and Validity of Amharic Version of EORTC QLQ-C 30 Questionnaire among Gynecological Cancer Patients in Ethiopia.

BACKGROUND: Cancer is a growing public health problem worldwide. The focus of cancer treatment, in addition to curation, is improving the quality of life (QOL). This study aimed to assess the reliability and validity of Amharic version of European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30) among gynecological cancer patients in Ethiopia. METHODS: A facility-based cross-sectional study was conducted using the Amharic version of EORTC QLQ-C30 on 153 gynecological cancer patients in Tikur Anbassa Specialized Hospital (TASH), Addis Ababa, Ethiopia. Descriptive statistics, correlation analysis and multivariable linear regression were employed in statistical analysis. RESULTS: The Amharic version of EORTC QLQ-C30 had a Cronbach's α value of 0.81. The internal consistency for each domain of EORTC QLQ-C30 was also acceptable (Cronbach's α >0.7) except for cognitive function domain (Cronbach's α = 0.29). Stepwise multivariable linear regression analysis showed that emotional functioning (p<0.001), fatigue (p<0.001) and social functioning (p = 0.004) were the determinative scales of EORTC QLQ-C30 on global health status (GHS). The clinical validity test (Known group validity) showed that there were significant differences in score for twelve out of 15 domains, between surgery and radiation scheduled patients. All items of emotional function, role function, fatigue, and GHS meet the discriminate validity criterion. CONCLUSION: The Amharic version of EORTC QLQ-C30 found to be reliable and had an acceptable validity to assess the QOL for gynecological cancer patients. We recommend further work on the validity and responsiveness of the EORTC QLQ-C30 with stronger design.

A comparative study on first stage versus second stage caesarean section on maternal and perinatal outcome.

BACKGROUND: Caesarean delivery (C/D) can be done in the first or second stage of labor. One fourth of the primary C/D are reported to be performed in the second stage of the labor but are more complicated compared to the ones performed in the first stage. OBJECTIVE: To compare maternal and perinatal outcomes of caesarean delivery (C/D) performed in the second stage of labor compared with the first stage in the Ethiopian setting. METHODS: An institution based comparative cross-sectional study was conducted in three teaching hospitals in Addis Ababa, Ethiopia. A sample size calculation for double proportion was used, and, for every second stage C/D, the next three consecutive first stage C/D cases were taken as controls till the desired sample size was achieved. mean and standard deviation for continuous and proportion for categorical variables were used for descriptive statistics. T-test for difference in independent mean and chi square test to compare proportions was utilized. Odds ratio with 95% CI was used to measure the strength of association of selected variables. RESULT: A total of 3238 deliveries were attended in the three teaching hospitals during the study period making the (C/D rate of 30.1%. Three hundred eighty-eight emergency caesarean delivery cases were enrolled using the aforementioned technique with the proportion of 97 (10.9%) second stage and 291 (89.1%) first stage C/D. The most common indications in the first stage were non-reassuring fetal heart rate pattern (NRFHRP) accounting for 110 (37.8%) followed by arrest or protraction disorder of 68 (23.4%), whereas the commonest indication for the second stage C/D was cephalopelvic disproportion 46 (48.5%). Significant difference observed in the mean blood loss between the second stage and first stage C/D, 552 ml vs. 410 ml, (OR 30.13, 95% CI 16.25-55.85). Similarly, the women in the second stage C/D had longer mean hospital stay and mean longer operation time than first stage C/D, 5.34 vs. 6.96 days, (OR 1.72, 95% CI 1.05-2.85), and 31.12 min vs. 37.5, (OR 2.33, 95% CI 1.33-4.07), respectively. Five caesarean hysterectomies were done for postpartum haemorrhage and four cases of extension of incision site were encountered following second stage C/D compared to none in the first stage C/D. CONCLUSION: Though no maternal death or significant perinatal complications were encountered, women with second stage C/D had significant maternal morbidities than first stage cesarean delivery. Therefore, utmost effort should be made to avoid the procrastination of the decision for C/D to the second stage, but if such compelling situations are encountered, precautions, like involvement of the most senior person and vigilance to minimize the expected complications is warranted.

A pilot study on detection and genotyping of humanpapilloma virus isolated from clinically diagnosed Ethiopian women having cervical intraepithelial neoplasia.

BACKGROUND: Human Papilloma virus associated cervical cancers are more prevalent in developing countries compared to developed countries. Cervical cancer is reported as the most frequent malignancy among women visiting hospitals in Ethiopia. This study is a pilot study designed to examine the prevalence and genotypes of HPV in twenty Ethiopian women, clinically diagnosed to have cervical neoplasia, while visiting gynecology unit of a tertiary level referral hospital in Addis Ababa. The objective of this study was to detect the presence of HPV L1 gene and respective genotypes among women clinically diagnosed with different grades of cervical neoplasia. METHODOLOGY: A total of 20 fresh biopsy samples were collected from clinically diagnosed cases, DNA extracted and further amplified using PCR for HPV L1 and beta globin genes. The PCR amplicons were denatured and allowed for hybridization onto a nitrocellulose strip containing the type-specific probes for 27 HPV genotypes representing both high and low risk groups as well as beta globin genes. Socio-demographic characteristics and clinical findings of the participants were recorded on structured questionnaires. RESULTS: Amplification of HPV L1 gene by PCR detected 17 cases out of 20. Based on reverse line blot hybridization assay, the most frequent genotype identified was HPV16 (13/20). Mixed infection of HPV 16 with HPV 33, HPV 35, HPV 45 and HPV 58 was detected from other four study participants. CONCLUSION: Human papilloma virus type 16 was the most prevalent genotype identified from the subjects screened. Further investigation with statistically sound sample size would help to clearly visualize the existing trend in Ethiopia regarding factors for high risk HPV positivity and multiple gravidity, young age at first coitus and cervical neoplasia.

ADNEXAL TORSION A FIVE-YEARS RETROSPECTIVE REVIEW IN TWO HOSPITALS.

BACKGROUND: Adnexal torsion remains a challenging diagnosis, often leading to delayed operative intervention and resultant ovarian loss. Objective: To describe the clinical profile and therapeutic approaches of adnexal torsion in the Ethiopian setting. METHODS: A retrospective cross sectional descriptive chart review ofwomen with surgically proven adnexal torsion was conducted in two teaching hospitals from Jan 1 2007 - Dec 31, 2011. RESULTS: A total of 53 women with AT were analyzed. About 33(62%) of torsion occurred in the age group of 20 - 29 years. The most common symptoms were lower abdominal pain 52 (98.1 %) followed by nausea and vomiting 46 (86.8%), whereas, the common physical findings were lower abdominal tenderness 49(92.5%) and palpable pelvic mass 40 (76.9%). Adnexal torsion was considered in the diferential diagnosis upon initial evaluation only in 27 (51%) of the cases. Of the study subjects, only 7(13.2%) had surgery within 24 hours of arrival to the facility and the mean time from initial evaluation to surgery was 53.8±44.5 hours. Moderately positive correlation was observed between ultrasound and intra-operative adnexal size measurement (r = 0.716, p = 0.000). Using non-parametric independent sample test, none of the clinical profile categories studied show significant difference in mean time from initial evaluation to surgery. Despite the overwhelmingly benign pathology, most 46 (86.8%) ofpatients underwent adnexectomy_with only 3(5.7%) adnexal salvage rate. CONCLUSION: Delayed surgical intervention and low ovarian salvage rate inspite of predominantly benign pathology was observed. Therefore, high degree of suspicion, especially in patients with high risk factors, and timely intervention must be exercised in an effort to salvage the adnexae.

Fertility desires predictors among people living with HIV/AIDS at art care centers of two teaching hospitals in Addis Ababa.

BACKGROUND: Studies from different contexts worldwide in both developed and developing countries in the era of wide access to antiretroviral drugs indicate that many HIV positive individuals continue to exhibit high risk sexual behaviors, fertility intentions being one of the many characteristics. OBJECTIVE: Identify the level and determinants of fertility desire among people living with HIV/AIDS (PLWHAs) at antiretroviral treatment (ART) centers. METHODS: A cross-sectional study was conducted on randomly sampled, 396 PLWHAs. Odds ratio along with 95% confidence intervals were used to measure the association of the study variables with the outcome variable. RESULTS: The majority of respondents were females, 330 (83.3%), and 224 (56.6%) were in the age category of 25-35 years with the mean age of 33.5 +/- 6.61 years. From a total of 396 study subjects interviewed, 172 (43.3%) desired to have children in the future, out of which 123 (71.5%) stated positively that they intended to give birth in the near future, and of these 33 (26.8%) had taken action and are currently pregnant. CD4 count above 350/mm3, partner's desire to have a child, life time history of not having live births and number of alive children are the most important predictors of fertility desire reported in this survey. CONCLUSION: Fertility desire remains to be high. This will pose serious challenges in areas of high HIV prevalence, like Ethiopia, on the implementation of the PMTCT programs. The strong predictors of fertility desire found in our study on the other hand can be used by policy makers, planners, and health service providers in the planning and implementation of the PMTCT programs. We suggest a large scale studies to be undertaken in the future.

Foreign body in the vagina (FBV) in women of two different age groups.

We are presenting two case series of vaginal foreign body (VFB) in patients belonging to two different age groups. The literature review, summary of the two cases, and, the corresponding discussions will be presented.

Bilateral loss of inferior pubic rami: a case report.

We are reporting a rare case on a fourteen years old girl who presented with a vague abdominopelvic pain and frequent complaints of urinary symptom of hesitancy since her early childhood. The bilateral loss of the inferior pubic rami is a very rare clinical and congenital abnormality as evidenced by the world literature. This is the first ever reported case in an Ethiopian subject.

Vaginal calculus following severe form of female genital mutilation: a case report.

We present a case of vaginal calculus formation following an initial insult of female genital mutilation (FGM) and crocodile bite to the external genital. A literature review made with regards to acute and late complication of female genital mutilation. Female genital cutting existed as early as the 5th century B.C. This ritualistic practice has affected the physical, mental, and social well being of women and undermined the basic reproductive and sexual health rights of the female population. Worldwide, 85-114 million girls and young women are subjected to this dreadful practice. It is mostly practiced in Africa and Middle East. Various authors classify female genital cutting differently. The World Health Organization classifies FGM in to FOUR types. Female genital mutilation is associated with immediate, intermediate and long-term complications (1-4). The complications are strongly related to the variant of the mutilation, especially of the third and the fourth types where introcision or vaginal scraping is performed. Vaginal calculus formation is a rare phenomenon. Our patient had a total obliteration of the introitus, vaginal calculus formation and urethra-vaginal fistula, which were surgically managed and corrected

Viable pregnancies in women with different mullerian duct anomalies.

Some of the fascinating developmental anomalies encountered by Obstetricians and Gynecologists are mullerian duct disorder of various types. The diagnosis is usually made during workup for infertility, recurrent pregnancy loss or cyclic pelvic pain. Because of embryologic developmental structural share and proximity, it is not uncommon to find mullerian duct, urinary tract and skeletal anomalies concurrently. Three parous women with different mullerian duct malformations preoperatively diagnosed as ovarian tumor, ectopic pregnancy and footling breech are reported Intraoperatively, the first case was found to have uterine didelphys with blind hemivagina, lumbosacral bones defect and hypoplastic pelvic kidney. In the second case, bicornuate uterus with viable pregnancy and in the third case, fetus and placenta in separate cavity of partially septated uterus were identified Literature on the embryologic association of mesonephric and paramesonephric ducts anomaly, the reproductive outcome and place of metroplasic surgery are reviewed.

Assessment of quality of post abortion care in government hospitals in Addis Ababa, Ethiopia.

BACKGROUND: Unsafe abortion is the leading cause of maternal death in Ethiopia. It is also known to cause several acute and long-term complications leading to disabilities. In countries like Ethiopia where there is no access to safe abortion, improvement of the available postabortion care services is an important strategy. OBJECTIVES: The aim of the study is to assess the quality of health services with respect to postabortion care in hospitals in Addis Ababa, Ethiopia. METHODS: A cross sectional survey on quality of postabortion care was conducted among 422 postabortion patients attending four hospitals in Addis Ababa. Additionally, 42 service providers involved in providing postabortion care services were interviewed. Direct service delivery observation and inventory of equipment and supplies were also conducted. The data were analyzed using Statistical Package for Social Sciences. RESULTS: Interaction between service providers and patients was found to be satisfactory whereas information provision on important aspects of care such as danger signs and follow-up needs were very limited. Only about 20% and 3% received family planning counseling and contraceptive methods respectively. Other reproductive health related issues such as STIs and HIV/AIDS were rarely raised by the service providers during caring for the patients. Overall 92.3% of the patients responded that they were satisfied with the services they have received. CONCLUSION: The study has shown several missed opportunities and indicated important areas for future service delivery improvement.

Holoprosencephaly, cephalothorax' appearance with multiple cardiac anomalies: a diagnostic challenge.

Holoprosencephaly is one of the rare types of craniofacial congenital anomaly characterized by failure of differentiation of the procencephalon to diencephalon and telencephalon derivatives that accompanied by variable degree of orbitofacial dysmorphism. The case presented to our hospital in the third trimester of pregnancy with intrauterine fetal death was diagnosed prior to delivery as hydrocephalus to rule out hydrops fetalis. Autopsy examination showed distinctive features of holoprosencephaly of severe type in conjunction with a large head fused with the thorax to appear as a spherical ball ('cephalothorax' nature) and multiple cardiac malformations but with normally differentiated upper and lower limbs, intestines, female reproductive system and kidneys. We are reporting this unusual case to remind clinicians to be conscious on partly preventable teratogens specific to this anomaly, and if failed to do so, to diagnose as early as possible and terminate the pregnancy through vaginal route, within all the provision of the law.

An ovarian tumor larger than the patient's body weight.

Surface epithelial-stromal tumors constitute by far the most important group among all ovarian neoplasms. Sixty-four kilogram left ovarian serous cystadenoma was removed from a forty-nine kilogram weighing Ethiopian woman. She presented with twenty-five years history of abdominal swelling. She had extreme degree of difficulty in bearing her weight, which resulted in keeping her to the house. This unusually big tumor is discussed with clinicopathologic correlation and literature review.