Browsing by Author "Dedefo Gobena"

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    Assessment of Serum Amylase and Lipase Levels and Associated Factors among Type 2 Diabetes Mellitus follow up Patients at Hakim Gizaw Teaching Hospital Debre Berhan, Ethiopia
    (Addis Ababa University, 2025-07) Aseme Afewerk ; Kinde Samuel; Dedefo Gobena
    Background: Diabetes mellitus is the leading non communicable disease in most low and middle income countries. Due to lack of proper follow up tools in most peripheral areas, majority of patients attending follow-up appointment at diabetic clinics failed to maintain good glycemic control causing destruction of the exocrinal cells of pancreas resulting in impaired secretion of pancreatic amylase and lipase. Therefore, assessment of serum amylase and lipase in uncontrolled and controlled type 2 diabetes may possibly help to effectively manage diabetes mellitus. Objective: To assess the level of serum amylase and lipase and associated factors among type 2 diabetic follow-up patients, 2025. Methods: A hospital based comparative cross-sectional study design from February 05 to March 30, 2025 was conducted at Hakim Gizaw Teaching Hospital Debre Berhan, Ethiopia with a total of 112(56 controlled and 56 uncontrolled) type 2 diabetes mellitus (T2DM) patients recruited using convenient sampling technique. Sociodemographic data was collected by face to face interview using pre tested questionnaire. HbA1c, FBS, Serum amylase, and Serum lipase was measured using Siemens Dimension EXL 200 clinical chemistry analyzer. IBM SPSS Version 27 was utilized for data entry, clearing and analysis with a significance level of P <0.05. Result: The mean level of serum amylase and lipase were significantly decreased in uncontrolled T2DM than controlled T2DM (p<0.001). Serum amylase level showed statistically significant negative correlation with duration of DM (r = -0.599, p <0.001), Waist to Hip ratio (WHR) (r = 0.249, p = 0.008), SBP (r = -0.251, p = 0.008), DBP (r = -0.257, p = 0.006), FBS (r = -0.478, p = <0.001) and HbA1c (r = -0.575, p = <0.001). Serum lipase had a strong negative correlation with duration of DM (r = -0.484, p <0.001), FBS (r = -0.625, p = <0.001) and HbA1c (r = -0.679, p = <0.001). Increased HbA1c, taking OHA, abdominal discomfort were key associated factors for decreased serum amylase and lipase. The AUC from ROC curve for serum amylase and lipase was 0.849 and 0.955 respectively indicating the effectiveness of these enzymes to investigate glycemic status in T2DM. Conclusion: The study demonstrated that uncontrolled T2DM patients have significantly decreased serum amylase and lipase this might be due to destruction of exocrine compartment of pancreas. Therefore, these enzymes might be additional biomarkers to manage T2DM and further large scale studies are recommended to investigate their diagnostic role to predict glycemic control among T2DM.
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    Assessment of Urine Cotinine Levels in Active and Passive Smokers, and Studies of Cardiovascular Risk Factors in Ogolcho Town, Oromia, Ethiopia
    (Addis Ababa University, 2015-06) Dedefo Gobena; Ashall Frank
    Introduction: Tobacco use is a global escalating public health problem, especially in low-income countries, one-third of the adult males. Non-communicable diseases (NCDs) are a growing problem in Africa and it is partially caused by tobacco use. There are few studies of smoking practices and other cardiovascular risk factors in Ethiopia and it is unclear how prevalent many of these problems are, because their prevalence varies in different areas of the country. A more recently survey of smoking prevalence in 187 countries showed that global smoking prevalence fell from 41% in 1980 to 31% in 2012, and that Ethiopia ranks in the bottom five countries with the lowest smoking prevalence (below 10%), but there is evidence that smoking prevalence is increasing in Ethiopia. Objective: To assess active tobacco and passive smoking, for further screening of major cardiovascular risk factors (serum cholesterol levels, hypertension, fasting blood glucose, Body Mass Index and waist circumference) among residents of Ogolcho town, Oromia; and to examine carbon monoxide levels in homes in Ogolcho town. Methods:Across-sectional study was conducted on tobacco users, passive smokers and non-smokers in a rural population of Ethiopia in Ogolcho, from May 2014– May 2015.Subjects were interviewed, using a standardized WHO questionnaire, about their lifestyle habits and substance use. Blood specimens from individuals over 18 years old were taken for serum lipid profile and blood glucose levels. Urine was screened for cotinine (a nicotine metabolite) in active and passive smokers, using a One Step cotinine test that detects urine cotinine levels above 200 ng/mL.Anthropometric indices (BMI, waist circumference) and blood pressure were measured. Frequencies ofthe different variables were analyzed statistically. Results: Of 95 total participants, 33% (31) were active smokers, 56.3% (54) were passive smokers, 8.6% (8) were neither active nor passive smokers, and 2% (2) were purely shisha smokers. Over 80% of active and passive smokers chewed khat regularly, whereas about a half of smokers and non-smokers used alcohol. All active smokers smoked either in their house or in public places, where exposure of many nonsmokers, especially children and women, occurs. A high percentage of smokers smoked at home (41%), and passive smokers that were strongly positive for urine cotinine included two children aged 4 and 5. Of 85 passive and active smokers, 67 % (57) were positive for urine cotinine. Almost all (90%) active smokers, and 54% of passive smokers, were positive for urine cotinine. Cardiovascular risk factors other than smoking were common in the population studied. Active smokers had 25.8% prevalence of abdominal obesity, 48.4% were underweight, 3.2% overweight, 54.8% had elevated triglycerides, 42% were hypertensive, 48.4% had low HDL and 3.2% high fasting glucose. 10.3% of passive smokers had abdominal obesity, 17% were underweight, 24% overweight, 55% hypertensive, 38 % had elevated triglycerides and 24% had low HDL. Prevalence of CVD risk factors among non-smokers were: 12.5% elevated blood pressure, 50% abdominal obesity, 12.5% overweight and 37.5% overweigh. Non- smoker lipid profile prevalence was: elevated total cholesterol in 37.5% of subjects and decreased HDL level prevalence in 25% of non-smokers. Carbon monoxide levels were generally safe in homes, except within centimeter distances of charcoal stoves. Conclusion: This cross-sectional analysis indicates that khat and alcohol consumption, or both combined, are common among smokers and non-smokers in Ogolcho, and the prevalence of passive smoking is high. Urine cotinine testing was an effective way of studying passive and active exposure to cigarette smoke. The prevalence of CVD risk factors was high in the studied population, strongly supporting the importance of screening, prevention and treatment of smoking and other cardiovascular risk factors in Ethiopia.
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    Comparison of Fasting Blood Glucose Level among Khat Chewers and Non-Khat Chewers in Diabetics and Healthy Individuals at Hiwot Fana Specialized University Harar Eastern Ethiopia.
    (Addis Abeba University, 2020-06) Mengistu Yordanos; Kinde Samuel ; Dedefo Gobena
    Background: -Khat chewing is a widely heled practice in our society. Moreover, studies aboutkhat chewing effect are contradictory. There is limited data about khat effect on blood glucosespecially in our setting. Therefore, this study aims to investigate this issue. Objective: In this study, we compared FBS among khat chewer and khat chewer diabetic andhealthy subjects. Method: A cross-sectional study include 200 confirmed diabetic and healthy subjects grouped into four groups (diabetic khat chewers n=50, diabetic non khat chewer n=50, healthy khat chewern=50 and healthy non-khat chewer n=50). FBS was determined by enzymatic method (GOD&GHK) using Biosystem A25 and COBAS 6000 chemistry analyzers at Hiwot Fana and St. Peterhospital clinical chemistry laboratory respectively. Non-parametric tests Mann-Whitney test (2independentsample test) and Kruskal-Wals test (K-independents sample test) were used tocompare fasting blood glucose among khat chewer and non-khat chewer with in the groups andbetween groups respectively. P<0.05 is taken to be statistically significant. Result: - Of the total respondents 83(41.5%) and 117(58.5%) were male and female respectively.Without age and gender adjustment the overall Median±IQR FBS difference among khat chewersand non-khat chewers were (159.5±83) mg/dl and (202±79) mg/dl respectively in diabetic patientsusing GOD. Similarly, when we compare between healthy non-khat chewers and khat chewers,khat chewers have lower (Median±IQR) fasting blood glucose level (82±18) mg/dl than that of thenon-khat chewers (94±13) mg/dl when tested by GOD. Generally, there was significantly lowerblood glucose level measured by both GOD and GHK methods in both diabetics and healthygroups of khat chewers. There was also percentage difference of median FBS with in the samegroup when measured by GOD and GHK methods. Conclusion and recommendation: -There was significant effect of khat on blood glucose levelamong khat chewer and non-khat chewer in diabetic and healthy individuals. Based on the presentstudy finding, further studies have to be conducted to identify khat constituent associated withhypoglycemic effect and further elucidate khat effect on systemic metabolism.
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    Glycemic Control and Associated Factors among Outpatients with Type 2 Diabetes at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
    (Addis Abeba University, 2021-10) Getachew Rodas; Kinde Samuel; Dedefo Gobena
    Background: The goals of glycemic management for patients with diabetes are to prevent or delaycomplications and optimize the quality of life. However, in clinical practice, the recommendedglycemic control target is very difficult to achieve. It is important, therefore, to identify factorsthat influence the outcomes of glycemia to improve the quality of diabetic management. Objectives: This study aimed to assess the level of glycemic control & identify the underlyingfactors associated with inadequate & poor glycemic control among type 2 diabetic outpatients atTikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods: Hospital-based prospective, cross-sectional study was conducted among systematicallselected 325 patients with type 2 diabetes who were attending diabetic clinics at Tikur AnbessaSpecialized Hospital. Pretested, structured, interviewer-administered questionnaires were used tocollect sociodemographic & diabetes-related information on participants between March and May2021. HbA1c was used to assess glycemic control according to the HbA1c target of <7% (‘good’control) as recommended by the American Diabetes Association for non-pregnant adults. TheHbA1c level in the range of 7-8% was defined as an ‘inadequate’ control & as ‘poor’ at levels >8%.Data entry and analysis were performed using SPSS v26. Multivariate logistic regression analysiswas used to identify determinants of glycemic control. Result: The median level of HbA1c of the participants was 8.4% (IQR 6.8-10.1) andapproximately three-quarters (73.8%) of the patients had inadequate & poor glycemic control(HbA1c ≥7%). Older age (AOR: 2.46, 95% CI: 1.28-6.01), DM duration of >10 years (AOR: 3.15,95% CI: 2.22-6.54), insulin therapy (AOR: 3.07, 95% CI: 2.10-6.12), poor diet compliance (AOR:1.97, 95% CI: 1.28-3.52) and failure to set targets for glycemic control (AOR: 3.42, 95% CI: 2.175.97)werefactors associated withinadequate&poorglycemic control. Conclusion: The study revealed that a considerable number of diabetic patients had inadequateand poor glycemic control levels. And this had been found to be associated with older age, longerduration of DM, insulin therapy, poor diet compliance, and failure to set control targets.