Medical Biochemistry

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Hemoglobin Profile of Anemic Ethiopian Patients Attending Tikur Anbessa Specialized Hospital
(Addis Ababa University, 2006-09) Degef, Maria; Worku, Yesehek (PhD)
Hemoglobinopathies are inherited abnormalities of hemoglobin molecule that affect the production, structure and function of Hb. Hb is the protein of the red blood cells that binds oxygen reversibly and transport it from the lungs to the tissue and return carbon dioxide from the tissue back to the lungs. Hemoglobin genes are subject to mutations that alter the synthesis and structure of the protein. These diseases are common lethal genetic defects in some part of the world. This study was undertaken to find out the hemoglobin profile of anemic patients attending follow-up clinics at the TASH. The study subjects included both genders, between 3 months to 68 years of age. Information was collected from the patients by a questionnaire designed to find out the relationship of hemoglobin variants with gender, age, family relation ship, etc. Blood films were prepared to look for morphological appearances of red cells and also malaria parasites. Out of 113 patients studied, only one was found to have malaria parasite on blood film. 90 % of the morphologies revealed variable size and shape of the red blood cells. The CBC revealed that the Hb of the patients ranged from 3.0 to 12.0 gm/dl and the MCV and MCH were 56.1-122.0 fl and 14.1-50.5pg respectively. The hemolysate that was subjected to agarose and Native-PAGE revealed that all the patients had HbA, HbF and HbA2 and three patients (2.65 %) of the participants had sickle hemoglobin band. There were six patients (5.3 %) with thick HbA2 band. It is clear from this study that there is a need to conduct this type of research on larger sample using sensitive methods, including DNA analysis to investigate the prevalence and distribution of Hemoglobinopathies in Ethiopia
Reference value determination of CD4+ T-Lymphocyte in HIV Sero- Negative Ethiopian pregnant women
(Addis Abeba University, 2009-07) Zewdie, Taye; Worku, Yesehak (PhD, Biochemistry); Chawla, R (PhD, Biochemistry); Tsegaye, Aster(PhD, Immunology); Amogne, Wondwossen(MD, Internist); Desalegn, Dawit(MD, Gynecologist); Deressa, Wakgari(PhD, Public Health)
In Ethiopia, reference intervals in clinical laboratories are commonly based on results obtained for western populations or from test kit manufacturers. The present cross sectional study aimed to establish reference interval for CD4 + T lymphocyte counts, in HIV sero-negative pregnant women attending antenatal care clinic at Yekatit 12 hospital. Flow cytometric analysis was performed to determine CD4 + and total T lymphocyte counts. Accordingly gestational ages between 4 and 38weeks (n=120) were used. Reference values obtained were 310-1185 cells/µl for Absolute CD4 + T cells count, 17.9-54.0% for CD4 T cells percentage, 690-2540 cells/µl for absolute CD3 + T cells count, 55-84% for CD3 T cells percentage, 952-2985 cells/ µl for absolute CD45 + lymphocyte count. The data revealed that CD4 absolute CD4 + + T cell percentage was stable throughout the pregnancy period while T cell count varies between trimesters indicating that CD4 + T cell percentage could be more reliable in the management of HIV infected pregnant women than the absolute value. In conclusion, T lymphocyte populations in pregnant women were different from non pregnant women. The clinical implication of these differences is the initiation of antiretroviral therapy (ART) in HIV infected pregnant women.
Association of Coffee Consumption with Insulin Sensitivity and Plasma Lipid Profile among Non-Diabetic Individuals in Addis Ababa
(Addis Abeba University, 2010-07) Mamo, Gizaw; Chawla, Rajinder(PhD); Umeta, Melaku (PhD); Chawla, Neena(PhD)
Abstract Background: Coffee is the most consumed beverage in the world and research has attempted to make clear health benefits received from coffee drinking. Type 2 diabetes is one of the diseases that are largely determined by lifestyles factors. The role of coffee in relation to type 2 diabetes and other diseases such as cardiovascular disease, hypertension and neurological diseases in Ethiopia has not been well investigated thoroughly. Objective: The aim of the present study is to investigate the relationship between coffee consumption and insulin sensitivity status among non-diabetic individuals in Addis Ababa. Materials and Methods: A cross-sectional study was conducted in 70 non-diabetic and apparently health individuals in Addis Ababa. The participants were 35 coffee drinkers (16 males; 19 females) and 35 non-drinkers (15 males; 20 females). Data regarding coffee consumption was obtained by using questioners and laboratory analysis. Blood samples were collected for analysis of insulin sensitivity indicators, namely-; serum fasting and post loading glucose and insulin level and serum lipid profile (cholesterol, triglyceride, free fatty acid, high density and low densit y lipoproteins). Results were compared among coffee consumers and non consumers using appropriate statistical parameters Results: Median of serum level of fasting and post-load glucose was 101.2 and 118.8 for coffee drinkers and 101.9 and 120.9 for non-drinkers. These results didn't show statistically significant (P>0.05) difference between the two groups. There was also no significance difference in the fasting (14.8 and 12.7) and post-loading (31.0 and 26.7) of blood insulin level between coffee drinkers and non-coffee drinkers. Similarly, blood level of fasting and post-loading glucose and insulin of noncoffee drinkers were not significantly difference from blood level of fasting and post-load glucose and insulin of the coffee drinkers of men, women, young and not-so young groups. Compared to non-coffee drinkers, coffee drinkers of men (p<0.01, p<0.05), young groups (p<0.05, p<0.05) and not-so young groups (p<0.05, p<0.05) showed significantly increased and decreased in blood concentration of free fatty acid and triglyceride respectively. The ratio of TG to HDL-C was significantly lowered in coffee drinkers. Other parameters were not significantly difference between coffee drinkers and non-drinkers. Conclusion: Significantly higher of blood free fatty acid level in coffee drinkers may indicate that coffee reduces insulin sensitivity. However, non-significantly lower of blood level of triglyceride and LDL-C with higher HDL-C, significantly decrease of the ratio of TG to HDL-C and nonsignificantly lower HOMA analysis for fasting and post-loaded in coffee drinkers may indicate coffee improves insulin sensitivity and has antioxidant activities.
Hepatotoxicity among HIV-Infected Patients Receiving the Highly active Anti-retroviral Therapy: Impact of the Duration of the Therapy and Comorbid Diseases.
(Addis Abeba University, 2010-08) Tekola, Hiwot; Umeta, Melaku (PhD); Enkuselase, Fikre(PhD)
The rapid death and morbidity due to opportunistic infections in Human immunodeficiency virus (HIV) patients has been reduced by the introduction of Highly Active Retroviral therapy (HAART). However, hepatotoxicity is now evident as a limiting factor of the benefit of the treatment. The over all incidence is estimated to be 3- 18% and it is up to 30% in patients on HAART. The objective of the study was to assess the liver function of HIV-infected patients receiving HAART so that clinicians will be more careful in prescribing the medications for their patients. In this retrospective cross-sectional study, 750 HIV infected patients who have already started HAART participated. 521 and 229 patients were taking NVP and EFV based regimen, respectively. Chi square and Mann-Whitney test were used to compare base line characteristics between the two groups, which showed no significant difference. Assessment of hepatotoxicity of the different HAART regimens, after initiation of therapy showed no hepatotoxicity with time, as can be seen from median values of the four LFTs (ALT, AST, ALP and TB). The proportion of patients in different hepatototoxcity grades were also analyzed for both NVP and EFV groups. The results showed that severe hepatotoxicity was more common in NVP users groups than EFV groups. While with time, both groups showed high proportion of hepatotoxicity grades before treatment which generally decreases after the initiation of therapy. With in three months of initiation therapy, more severe cases of hepatotoxicity were found when compared with other durations of therapy. Risk factor determination by multivariant logistic regression revealed that sex and age were not factors for hepatotoxicty while corrilation results by spearman rank correlation coefficient of LFTs with each other showed only correlation of TB with the other LFTs was not significant. The suggestion made from these findings is that, hepatotoxicity is more common in NVP users than EFV users and both the drugs are associated with elevation of LFTs just after the start of HAART thus frequent monitoring of liver enzymes after initiation antiretroviral therapy is recommended. However, because of NVP and EFV-associated severe hepatotoxicity cases were observed after the first 12 weeks of therapy, these data indicate that such assessments should continue throughout the treatment period.
Protein and Albumin to Creatinine Ratio and their Loss in Urine Associated with Kidney Diseases.
(Addis Abeba University, 2011) Michael, Alemayehu; Prof. Nagpaul, Ravi
Abstract Background: Proteinuria is recognized as an independent risk factor for cardiovascular and renal disease and as a predictor of end organ damage. Appearance of albumin in the urine is one of the first sign of deteriorated kidney function. As the kidney functions decreases, the amount of albumin in the urine increases. So, Albumin: Creatinine ratio and/or Protein: Creatinine ratio on random urine sample provides significant results for quantitating proteinuria against conventional 24-hours sample collection. Objective: - To review and recommend the method(s) for quantitating proteinuria using urinary Albumin: Creatinine ratio and/or Protein: Creatinine ratio on random urine samples vis-a-vis conventional 24-hours urine collection for diagnostic evaluation of Kidney function. Methods: I performed a systematic review of literatures on measurement of Albumin: Creatinine ratio and/or Protein: Creatinine ratio on a random urine compared with the conventional 24hours urine collection method. Results: Data were extracted from 8 studies which investigating proteinuria in several settings. Patient groups in the studied were primarily those with hypertension, diabetic, preeclampsia or renal disease. Urine Microalbumin: Creatinine ratio, Albumin: Creatinine ratio and Protein: Creatinine ratio vs. 24-hours urine specimen has correlation coefficients (r>0.84, p<0.001) except urinary Microalbumin: Creatinine ratio (r ≈ 0.743) and Sensitivities, specificities for the tests were 83% (ranged 66% to 100%) and 76.5% (ranged 53% to 100%), respectively, whereas positive and negative predictive values were 80.5% (ranged 61% to 100%) and 87.5% (ranged 75% to 100%), respectively. Conclusion: The use of Albumin: Creatinine ratio and/or Protein: Creatinine on a random urine specimen provides significant correlation with conventional method of a 24-hours urine specimen collection. The analysis of the report reviewed has also revealed that, total Protein: Creatinine ratio has better sensitivity as compared to Albumin: Creatinine ratio in quantitating proteinuria.
Therapeutic benefits of vitamin A for Type 1 Diabetics: A case of Gondar University Hospital Diabetic Center
(Addis Ababa University, 2011) Woretaw, Alemseged; Dr.Worku, Yesehak; Dr.Seifu, Daniel; Dr.Alemu, Shitaye
The incidence of diabetes mellitus has soared to epidemic proportions worldwide. The debilitating chronic hyperglycemia is caused by either lack of insulin as in diabetes type 1 or its ineffectiveness as in diabetes type 2. Frequent replacement of insulin with or without insulin analogs for optimum glycemic control is the conventional cumbersome therapy. The quest to find a cure for diabetes has led scientists to think new therapeutic strategies like re-educating the immune system, β-cell transplantation and rejuvenating β-cells of the pancreas in an attempt to restore β-cell function and resume physiologic glucose homeostasis. There are in vitro and animal studies suggesting that Retinoic acid (Vitamin A) induces differentiation of pancreatic ductal epithelial cells to insulin secreting cells and also plays an immunomodulatory role in the progression of the autoimmune process in Type 1 diabetes. Moreover, majority of diabetic patients have Vitamin A deficiency. However, there was inadequate information regarding in vivo effects of retinoic acid in diabetic patients and hence the need for this study. This study was an interventional study on 24 Type 1 Diabetic patients attending the chronic illness clinic at Gondar University Hospital. The patients were randomly divided in to two groups; treatment and control. The treatment group received vitamin A supplementation in addition to the conventional insulin therapy where as the control group continued with their conventional insulin therapy alone. Both groups were followed for 6 weeks and treatment effect compared across them in terms of glycemic control, C-peptide levels and lipid profile over the treatment period and both groups were comparable with regard to Age, sex, BMI, duration of disease, dosage of insulin therapy and other baseline biochemical parameters. Results showed a remarkable clinical benefit in the vitamin A treated group with HbA1c levels of 6.7% versus 8.44% for the control group though it was not statistically significant(P = 0.165). Furthermore, the mean C-peptide level among the treated group was raised to 1.06ng/ml from a baseline level of 0.48ng/ml (a 55% increase in endogenous insulin secretion) indicating the potential therapeutic benefits of vitamin A supplementation in Type 1 diabetics and obviating the need for further research preferably using a bigger sample size and a well-designed clinical trial. Besides, Vitamin A could protect or delay the onset of diabetes in high risk groups.
Investigation of Nutrient and Anti-nutrient Composition of Dioscorea cayenensis-D.rotundata complex
(Addis Abeba University, 2011-03) Kucha, Winner; Dr. Worku, Yesehak
Dioscorea species (Yams) rank as the world’s fourth most important tuber crop in economic terms and make a significant contribution to diets in some rural areas of Ethiopia where Ethiopia is one of the major producers in East Africa. However, there is insufficient study on their nutritional value and anti-nutritional composition. This study was designed to evaluate the proximate, mineral and anti nutritional composition of yam tubers (Dioscorea cayenensis- rotundata complex) collected from Sheko wereda, Bench Maji zone, South Nations, Nationalities and people’s Regional state. Effect of household processing methods namely boiling and frying on composition of Dioscorea was also investigated. To determine the proximate, mineral and anti nutritional composition chemical analysis were conducted using standard procedures. Data were analyzed using SPSS (SPSS Software for windows release 16.0; SPSS Inc., Chicago, IL, USA). In raw yam tubers, moisture was high 69.56 ± 0.2% for the yellow and 73.44±0.5% for the white tubers. Crude protein content was 1.85±0.04% for the yellow and 2.03±0.03% for the white tuber while ash was highest (4.10±0.01%) in the yellow 4.62±0.01% in the white tuber. Crude fat was low in both tubers 0.35±0.01% for the yellow and 0.18±0.01% for the white tuber while total carbohydrate was high in both tubers 20.95±0.1% and 19±0.06% for the yellow and white tubers respectively. The fiber contents were 3.19+ 0.05% for the yellow and 2.68+0.03% for the white tubers. Calcium and potassium were the major minerals found in both tubers. calcium contents of 52.55+ 0.01 and 60.52 +0.01 and potassium contents of 53.33+0.33 and 45.73+0.01 were found for the yellow and white tubers respectively. Phytate, tannin and oxalate contents were 38.2+0.002, 22.2+ 0.001 and 0.006+0.001 for the yellow tuber and 34.8+0.002, 28.8+0.001 and 0.006+ 0.001 for the yellow tuber. There were no significant difference (p>0.05) in the proximate, mimeral, phytate, tannin and oxalate contents of the raw tubers of the yellow and white varities. Boiling and frying significantly reduced (P<0.05) the level of phytate, tannins and oxalate in both tubers. Both tubers are found to be a good source of crude fiber, carbohydrate and minerals. The anti nutritional factors (phytate and oxalate) found in both the investigated tubers were lower than previous reports. Both boiling and frying seem to be best for the removal / inactivation of anti- nutritional factors. In terms of energy, if consumed at 350g per day, none would meet the FAO recommended values. The investigated samples can not be consumed as the sole source of energy to humans. In order to derive full nutritional potential from the yellow and white yam, they should be consumed together with protein-and fat-giving foods.
A Systemic Review on Effects of Phytoestrogen on Breast Cancer
(Addis Ababa University, 2011-06) Ayane, Tilahun; Seifu, Daniel (PhD)
Background: Interest in the physiological role of bioactive compounds present in plants has increased dramatically over the last decade. Of particular interest in relation to human health are the classes of compounds known as the phytoestrogens, which include several groups of non- steroidal estrogens including isoflavones, lignans and coumestans that are widely distributed within the plant kingdom. Epidemiological studies suggest that diets rich in phytoestrogens, particularly soy and unrefined grain products, may be associated with low risk of breast cancer. Objective: - This review presents the studies published so far by exploring a link between dietary phytoestrogens and breast cancer. Methods: A Medline, PubMed and Google internet search was conducted using the keywords breast cancer, phytoestrogens, soybeans, isoflavones, estrogen, estrogen receptor, coumestrole and lignans. Further articles were obtained by cross-matching references of relevant articles. Results: From the published data we may conclude that overall information about phytoestrogen consumption and breast cancer risk is still scarce: From all prospective studies and the case control studies in Asian populations we get the impression that consumption at young ages (adolescence or earlier) and consumption of high amounts may protect both against pre- and postmenopausal breast cancer. Conclusion: There is no clear evidence that phytoestrogens intake influences the risk of developing breast cancer. Keywords: -Breast cancer, phytoestrogens, soybeans, isoflavones, and lignan
A Systematic Review antioxidant and hepatoprotective effect of psidium guajava leaf and fruit extract
(Addis Ababa University, 2011-06) Molla, Tesfahun; Seifu, Daniel(PhD); Belayneh, Yididiya (PhD)
Background: Plant derived natural products such as flavonoids, terpenoids, carbohydrates, tannins, saponins, steroids, proteins, amino acids and Vitamin C have received considerable attention in recent years due to their diverse pharmacological properties including antioxidant and hepatoprotective activity. Psidium guajava (Myrtaceae) is one of such plants in folk medicine that has been used for the management of various disease conditions. Various parts of the plant has been used in traditional medicine .Antioxidants from medicinal plants play an important role in inhibiting and scavenging radicals, thus providing protection to human against infection and degeneration diseases. Objective: To review the antioxidant and hepatoprotective activity of psidium guajava. Methods: Computerised literature search was conducted using PubMed, Medline and Google search engine using different key words for studies investigating the antioxidant and hepatoprotective activities of Psidium guajava using the following as heading terms, psidium guajava, antioxidant, hepatoprotectie, Liver injury, oxidative stress. In addition, the reference lists of the retrieved articles helped me to find further articles, relevant to the present review that was not revealed through the searching procedure. Result: Out of a total of 152 articles on guava resulted 19 studies which were related to antioxidant and hepatoprotective activity of leaf and fruit extract were included in this review. These were then categorized into six groups; 1) Six studies on in vitro antioxidant studies with leaf extracts, 2) four studies on in vitro antioxidant studies with fruit extract, 3) one in vivo study on antioxidant with leaf extract in rat, 4) one in vivo study on antioxidant with fruit extract in rat, 5) one study antioxidant fruit extract in human and 6) six in vivo studies on hepatoprotective with leaf extract in rat. Conclusion: The antioxidant activity of Psidium guajava may be due to inhibition of the formation of radicals, scavenging of the formed free radicals, reducing of oxidized intermediates and the presence of the phenolic compounds. It also acts as promising hepato protective which is correlated directly with its ability to reduce activity of serum enzymes and enhance antioxidant defense status. The phenolic content in Psidium guajava extract played a significant role on the antioxidant and hepatoprotective activity.
Serum Magnesium Level and Magnesium supplementation on Type 2 Diabetes Mellitus: systematic Review
(Addis Ababa University, 2011-06) Assefa, Sefealem; Nagpaul, Ravi (proffessor)
Objective: To assess the association between serum magnesium levels and risk of type 2 diabetes and to evaluate the effect of magnesium supplementation on diabetes status. Design: Systemic review Data Sources: By the electronic databases searches journals and retrieved studies published in English language by systematically searching Medline, JCEM, European journals of Clinical Nutrition and American Medical Association from 1992 to Feb 2011 and by manually examining the references of the original articles. Study Selection: includes prospective cohort studies and random case control trials reporting relative risks with 95% confidence intervals for the association between magnesium intake and incidence of type 2 diabetes. Results: Most of the studies included in this review comprising patients of type 2DM showed significantly lower serum magnesium levels compared to the controls. Magnesium supplementation studies also showed resulted in significant improvement in serum levels of Mg, FGL, HDL-C; serum TG levels were found to decrease significantly while plasma cholesterol levels were not affected. Conclusions: Serum magnesium levels were significantly low in type 2 DM compared to the controls group. A direct relationship between the status of Diabetes and Mg levels was also noted. A significant improvement in serum Mg levels, FGL and HDL-C concentration was observed after Mg supplementation. No significant difference in levels of serum cholesterol was noted. Over all the Magnesium supplementation appeared to have improved the insulin sensitivity and metabolic control in type 2 diabetes mellitus
The involvement of Adiponectinin Type 2 Diabetes:A Systematic review of Findings Onhuman
(Addis Ababa University, 2011-06) Abere, Yohannes; Seifu, Daniel (PhD)
Background: The association of obesity with development of type 2 diabetes may be partly mediated by altered secretion of adipokines by adipose tissue. Greater adiposity down regulates secretion of adiponectin, an adipokine with anti-inflammatory and insulin sensitizing properties. The strength and consistency of the relation between plasma adiponectin and risk of type 2 diabetes is unclear. Objective: To review prospective studies of the involvement of adiponectin in type 2diabetes. Methods: A review search of the pub med, hinari and Google scholar search engine using different name of adiponectin and type 2 diabetes mellitus. This systemic review included prospective studies with plasma adiponectin levels as the exposure and incidence of type 2 diabetes. Results: Ten prospective studies with a total of 7018 participants and 1343 incident cases of type2 diabetes were included in the review. Higher adiponectin levels were monotonically associated with a lower risk of type 2 diabetes. This inverse association was consistently observed in whites, Middle East Asians, East Asians, Asian Indians, African Americans, Japan Americans and Native Americans and the inverse relationships are not differ by adiponectin assay, method of diabetes ascertainment, duration of follow- up. Conclusion: Higher adiponectin levels are associated with a lower risk of type 2 diabetes across diverse populations. Key words: adiponectin, adipose tissue, type 2 diabetes
The Role of Incretin Hormone in Type 2 Diabetes
(Addis Ababa University, 2011-06) Getachew, Dereje; Dr.Seifu, Daniel
Background: Type 2 diabetes mellitus is a metabolic disease associated with low quality of life and early death. It is now well established that beta-cell dysfunction and insulin resistance are two central defects in the pathophysiology of T2DM. Recently, improved understanding of the incretin effect on the pathophysiology of type 2 diabetes has led to development of new hypoglycemic agents. The incretin effect refers to the amplification of insulin secretion that occurs when glucose is ingested orally as opposed to infused intravenously in amounts that result in identical glucose excursions. Objective: To review the role of incretin hormone in type 2 diabetes. Methode: The review was conducted as a systemic review. Articles were searched from MEDLINE, HINARI and PUBMED in English language with the key words incretin or gut hormone, type 2 diabetes, and the role of incretin in type 2 diabetes. Result: A total of 65 studies were retrieved. Of these, 12 were considered to be relevant up on initial screening. Abstract of these 12 articles were reviewed and while 5 studies excluded. 7 studies were agreed upon to meet the inclusion criteria. Conclusion: The incretin effect was significantly reduced in patients with type 2 diabetes.GLP-1 concentrations and response is also reduced. But the GIP concentration is increased, reduced or normal. Incretin secretion is increased after oral glucose compared with intravenous infusion.
Assessment of Thyroid Function Tests for the Diagnosis of Subclinical Hypothyroidism and Detection of Clinical Hypothyroidism in Tikur Anbessa Specialized Hospital.
(Addis Abeba University, 2011-07) Azene, Habtamu; Umeta, Melaku (PhD); Fayed, Hassen (PhD); damene, Solomon (PhD); Enquselassie, Fikre(PhD)
Changes in hematological parameters in HIV-1 infected patients before and after antiretroviral therapy in Tikur Anbessa Specialized Teaching Hospital ART clinic.
(Addis Ababa University, 2011-11) Abiyu, Chalachew; Dr.Seifu, Daniel
HIV/AIDS is characterized by progressive damage to the body’s immune system that results in a number of opportunistic infections, immunological and hematological complications. Hematological complications have been documented to be the second most common cause of morbidity and mortality and are estimated to affect from 11% to 75% of patients with HIV disease. They are generally marked with cytopenias such as anemia, neutropenia, lymphopenia and thrombocytopenia. These abnormalities may be of greater concern in populations in subSahara Africa, where comorbidities such as malnutrition, malaria, and parasitic infections are common, and capacity to monitor adverse events related to ART is often limited. Although treatment of HIV infected patients using ART is accepted as the gold standard, few studies tried to assess hematologic responses to ART. A comparative cross sectional study was conducted to determine changes in hematologic parameters in HIV infected patients before and after ART from July to August 2011 in TASTH ART clinic. Socio-demographic, baseline hematologic parameters and ART related information of study participants were collected using a structured questionnaire. CBC and CD4+ T cell count was done for 340 HIV infected patients by hematological analyzer and FACS count, respectively. The data was entered and analyzed in simple descriptive statistical methods using SPSS window version 16. From this study, WBC, neutrophils, lymphocyte, hemoglobin and platelet count showed increment from the baseline by mean 0.36 x 10 3 / μL, 0.12 x 10 3 / μL, 0.25 x 10 / μL, 0.98 g/dL and 20 x 10 3 / μL, respectively after ART. Proportion of leucopenia, neutropenia, lymphocytopenia, anemia and thrombocytopenia was dropped from baseline 25.9% to 11.5% (pvalue= 0.000), 23.2% to 17.4% (p-value= 0.057), 24.1% to 9.1% (p-value= 0.000) 45% to 20.88% (p-value= 0.000) and 28.5% to 11.2% (p-value= 0.000), respectively. Nevertheless, reduction in mean hemoglobin (p-value= 0.070) and high proportion of anemia (p-value= 0.000) was observed in AZT than non-AZT containing ART treatment. In conclusion, ART was effective in improving blood cell count and decreasing hematologic abnormalities in HIV infected patients.
Insulin Resistance, Dyslipidemia and Cardiovascular Disease Risk in HIV-1 Infected Adults Receiving Protease Inhibitor based Combined Antiretroviral Therapy in the Art Clinic of Tikur Anbessa Referral Hospital.
(Addis Abeba University, 2011-12) Amare, Hagos; seifu, Daniel(PhD); Tsegaye, Aster (PhD); Amogne, Wondwossen(MD, Internist)
Treatment with highly active antiretroviral therapy (HAART) has improved the prognosis of patients with AIDS. However, it has also increased the incidence of various metabolic disorders, in particular insulin resistance accompanied by dyslipidaemia, hyperglycaemia and lipodystrophy. This is often predispose to type 2 diabetes and increased mortality from cardiovascular disease which is more common in protease inhibitor based regimen. This cross sectional study was designed to assess the occurrence of insulin resistance, dyslipidemia and cardiovascular disease risk in HIV-1 infected adults taking protease inhibitor based combined antiretroviral therapy and to compare with those taking NNRTI-based regimen in a total of 134 subjects that contain equal number of cases and controls. Accordingly, variables like age, sex, type of regimen, duration of ART were collected and anthropometric variables and blood pressure was measured. Moreover, biochemical variables like glucose, insulin and lipid profile were determined using standard and calibrated clinical chemistry analyzers along with a parallel control run in a fasting serum sample collected from the patients. HOMA and total cholesterol to HDL ratio as well as triglyceride to HDL ratio were also calculated using a standard formula. The results revealed an elevated serum triglyceride concentration and a trend toward increase in insulin resistance on patients treated with PI-based regimen (cases), compared to NNRI-based regimen (controls). Insulin resistance was observed in 34.3% of the cases as compared to 28.4% in the controls as assessed by HOMA-IR. HOMA-IR mean values were similar and did not differ significantly between the two groups. Dyslipidemia was also more prevalent among the cases as compared to the controls. Accordingly, 58.2% patients on PI based regimen and 47.8% on NNRTI-based regimen had high cholesterol levels (> 5.1 mmol/L). However, the difference was not statistically significant (p = 0.226) and the same is true for their means (210 ± 41versus 200 ± 35, P = 0.137). Equally higher percentage of patients had high LDL level (>2.6 mmol/L) on both groups and there was no statistically significant difference in the proportions as well as mean values between the two groups (65.7% versus 64.2%, p = 0.856; 109 ± 32 versus 112 ± 31, p = 0.584). In this study, it appeared that hypertriglyceridemia (>1.7 mmol/L) affected almost three fourth (74.6%) of the patients on PI-based regimen and 34.3% on NNRTI-based regimen (p<0.001). Statistically significant difference was also observed between the mean values of triglyceride (210 ± 41versus 169 ± 124, p = 0.003). Similar trends were apparent when comparing the TG/HDL ratio in both groups, with 74.6% of patients on PI-based regimen and 38.8% on NNRTI-based regimen presenting with high TG/HDL ratio (> 3.8) (p <0.001). Further aggravating the cardiovascular risk, a significantly higher proportion of patients on PI-based regimen had higher total cholesterol /HDL ratio (61.2%) as compared with those on NNRTI-based regimen, 40.3% (p=0.016). Likewise, the mean differences between the two groups were also statistically significant for both TG/HDL and TC/HDL (6.96 ± 4.6 versus 3.98 ± 2.69 and 5.7±1.7 versus 5.0 ± 1.4) with p values 0.026 and <0.001 respectively. Moreover a significantly higher proportion of patients on PI-based regimen were found to have metabolic syndrome as compared to the controls (32.8% versus 17.9%, P = 0.047), with 10.4% of patients on PI-based regimen estimated to have an intermediate (10-20%) risk of developing cardiovascular disease in the coming ten years as compared to only 1.5% on NNRTI-based regimen(P = 0.029) Taken together, this study concluded that patients on PI- based cART have higher risk of developing insulin resistance and cardiovascular problems.
The Antidiabetic Effects and Antioxidant Activities of Taverneira Abbysinicas’ Root Crude Methanol Extracts in STZ Induced Type 2 Diabetic Rats
(Addis Ababa University, 2012-06) Araro, Abbate; Dr.Seifu, Daniel
Diabetes mellitus (DM) is a heterogeneous complex metabolic disorder resulting from defective insulin secretion, resistance to insulin action or both. Broadly it is classified into two categories type-1, and type-2. It is a chronic disease characterized largely by disordered metabolism, glucose urea, negative nitrogen balance, and hyperglycemia. In the long term hyperglycemia has pathologic effects such as atherosclerosis, neuropathy, nephropathy, and others which largely are due to oxidative stress. Since the currently available oral hypoglycemic drugs and insulin have limitations the search for better treatments is going on. Despite the developments of modern treatments the interests in the plant remedies have been renewed. In similar fashion to other countries, in the indigenous system of Ethiopian traditional medicine different plants are used to treat various diseases, such as diabetes mellitus, hypertension, malaria and gastrointestinal disorders of various origins of which Moringa stenopetala, Melia azedarach and Taverniera abyssinica are the most common. The present study was carried out to investigate the hypoglycemic and antidiabetic effects and antioxidant activities of the methanolic crude root extracts of Taverniera abyssinica in STZ induced diabetic rats. The effects of the plants’ crude root extracts on blood sugar, the level of plasma MDA, plasma total peroxides, plasma total antioxidant capacity was measured and the level of oxidative stress index was determined. Results of intraperitoneal glucose tolerance test showed that crude root extracts of Tavererneira abbysinica have hypoglycemic effect but not immediate. In the long term treatment the plants’ crude root extract exhibited anti-diabetic effects on day 10 (p<0.001), day 15 (p<0.001), and day 20 (p<0.001) at doses of 100mg/Kg and 200 mg/Kg per BW following intraperitoneal administration and was dose dependent with maximum effect observed at a dose of 200mg/Kg. The level of MDA was decreased by 74.07% in Taverniera abyssinica treated groups compared to diabetic control receiving 1.0mL of distilled water. . The present study also showed that the level TPP was decreased by 55.12% in Taverniera abyssinica treated group compared to diabetic control. But the level of TAC was higher by 5.43% in Taverniera abyssinica treated group compared to diabetic control. However, the level of TAC was increased the study showed the level of oxidative stress is decreased by half (50%) in Taverniera abyssinica treated groups compared to diabetic control. Generally, this study demeonstrated that the crude root extracts of Taverniera abyssinica has hypoglycemic, and antidibetic effects and antioxidant activities.
The Role of Crude Ethanol Extract of Ginger Rhizome (Zingiber Officinale) on the Liver Biomarkers of CCl4 –Induced Hepatotoxicity in Male Wistar Albino Rats.
(Addis Ababa University, 2012-06) Weldegeorgs, Mulu; Dr.Seifu, Daniel
Introduction: Liver, an imperative organ has a crucial role in the metabolism of xenobiotics that causes it to succumb to numerous hepatic diseases. Synthetic drugs exploited in the treatment of liver diseases are incompetent and may sometimes lead to serious side-effects. In this context, herbal therapy has emerged as a proficient approach with good values in treating hepatic diseases. Ginger have been proven to be effectual as hepatoprotective agent and it may serve as a vital source of potentially useful new compounds for the development of effective therapy to combat a variety of liver problems caused by many toxins including carbon tetrachloride. Objectives: The present study was designed to explore the role of crude ethanol extract of ginger rhizome on the biomarkers of CCl induced hepatotoxicity in male Wistar albino rats. Methods: Twenty eight rats were used throughout the study. Rats were divided into four groups with seven in each. Group 1 (normal control) received 1mL/kg of corn oil, group 2 (standards) received 350mg/kg vitamin E, group 3 (treated) received 200mg/kg crud ginger extract, group 4 (negative control) received 0.5mL/kg CCl 4 4 . Liver toxicity was induced by intraperitoneal administration of CCl dissolved in 1mL corn oil at a dose of 0.5mL /Kg body weight. Administration of crude ethanol ginger extract at a dose of 200 mg/kg body weight was started a week after CCl treatment and was performed for five weeks (totally six weeks). Results: The results revealed that hepatotoxic rats supplemented with 200mg/kg showed a significant decrease in MDA, ALT and TP with the same p-value (p<0.01) and AST (p<0.001) as compared to negative control. ALP (p<0.01), DB (p<0.05) and TB (p<0.001) in treated groups compared to the negative control, but no significant difference was observed in treated, normal and the standards. Serum TC, LDL-c, and TG were increased significantly (P<0.05) in CCl 4 treated group, while HDL-c level was decreased significantly compared to the rest of the groups. In ginger treated group, the serum levels of TC, LDL-c, and TG were significantly (p<0.001) decreased, but HDL-c was significantly (p<0.05) higher than negative control. Serum levels of TC, LDL-c, and TG in standards were decreased significantly (P<0.001), but HDL-c increased none significantly compared to negative control. The levels of TC, LDLc, HDL-c, and TG in treated group were non-significantly different compared to the normal control and the standards. Conclusion: The study revealed that ginger rhizome showed a promising hepatoprotective effect, because it contains antioxidants and potent lipid lowering phytoconstituents. Despite the above, further study is recommended to investigate the active ingredients of the extract and their exact mechanism of action.
Evaluation of Physicochemical Characteristics of Locally Produced and Commonly Imported Edible Oils in Addis Ababa, Ethiopia
(Addis Abeba University, 2012-06) Andargie, Abebaw; Dr. Seyifu, Daniel
Background: Fats and oils are a heterogeneous group of predominantly hydrophobic compounds. Although many plant parts may yield oil in commercial practice, oil is extracted primarily from seeds mainly using solvent extraction. Edible oils sold in Addis Ababa are mainly imported from Asian countries while others are locally produced. The quality of edible oil is a measure of identity and edibility and it is determined by analysis of physicochemical characteristics of edible oils following standard procedures. Aims of the study: The aim of this study is to assess the physicochemical characteristics of commonly imported and locally produced edible oils. Methods and materials: A total of 16 samples (12 locally produced and 4 commonly imported edible oil samples) were collected randomly in local markets. All samples were taken immediately to the laboratory and stored at room temperature until analyses were completed. The physicochemical properties, physical parameters like refractive index (RI), specific gravity (SG)and relative viscosity (RV)and chemical parameters like iodine value (IV), peroxide value (PV), saponification value (SV), acid value (AV), Free fatty acid contents (FFAs)and insoluble impurities (IIM)were assessed using standard procedures. Results: Most of the physical characteristics of imported edible oils are within the recommended values. Palm oils have significantly the lowest mean IV of all. Mean IV of Chief Brand palm oil is below the WHO recommended value while mean IV of Reinna Brand palm, rape seed and niger seed oils are higher than the recommended value. The mean SV of line seed, niger seed and cotton seed oils are higher than the recommended values. The mean PV of rape seed oil is higher than ESA (Ethiopian Standard Agency)recommended values. The mean AV of locally produced edible oils are higher than the ESA recommended values except cotton seed oil while mean AV of imported edible oils fall in the recommended value. The mean IIM values of locally produced oils exceed more than ten times than the Ethiopian standards recommended value while the imported oils of mean IIM values are very close to the maximum recommended value. Conclusion: Commonly imported edible oils have relatively better physicochemical characteristics than locally produced edible oils.
Blood Clotting Effect in Vitro and Wound Healing Activity in Vivo of Fresh Juice and Ethanolic Extracts of CROTON MACROSTACHYUS LEAVEA in Male Wistar Albino Rats.
(Addis Ababa University, 2012-07) Teshome, Teklu; Seifu, Daniel(PhD); Dr.Woldyes, Mihretu
Background: The plant remedies (both single plant and multi-herbal preparations) are used to promote wound healing since ancient times even if the mechanisms of action, toxicity and efficacy of very few of them have been evaluated scientifically. Preparations from plant sources have been traditionally considered effective to stop bleeding and promote wound healing. Juice extract from leaves of Croton macrostachyus has been traditionally used as a local haemostatic medicine to hasten clotting, however, this effect had not been tested in controlled experiments. Aim: There was no scientific evidence justifying the use of Croton macrostachyus, therefore the present study was aimed at evaluation of platelets aggregating and wound healing activity of the plant. Materials and methods: In the present study the Leaves of Croton macrostachyus were studied for procoagulant and wound healing activity by using ethanolic and fresh juice extract. The procoagulant activity was studied by using the effect of extracts on platelets aggregation. Wound healing activity was studied in excision model in rats, wound contraction, period of epithelization, hydroxyproline estimation and histopathological examinations were studied. Results: Ethanolic extract induced significant (P<0.05) platelets aggregation where as the fresh juice extract did not induce significant platelets aggregation. Platelets aggregation induced by ethanolic extract significantly increased as the time of contact increased (P<0.05). Treatment of wound with ointment containing 10% (w/w) of the ethanolic extract and 10% (w/v) of the fresh juice extract exhibited significant (P < 0.05) wound healing activity. Conclusion: The ethanolic extract of Croton macrostachyus leaves has procoagulant activity in that it promotes platelets aggregation in vitro that verifies its effect on haemostasis. Moreover, ethanolic extract of the plant leaves promoted wound healing in vivo that could be explained partly by its procoagulant activity and the aqueous juice extract had promoting effect on wound healing that could be explained by the multiple chemical constituents which are of water soluble.
Antidiabetic Activity of Ajuga Remota Benth (Harmegusa) Leaves in Streptozotocin Induced Diabetic Rats
(Addis Ababa University, 2013-08) Assefa, Freshet; Seifu, Daniel (PhD)
Ethnopharmacological relevance: The leaves of Ajuga remota (A. remota) have been utilized traditionally for the cure of diabetes mellitus and other ailments. Aim of the study: The present study was aimed to assess the antidiabetic activity of A. remota leaves extract in Streptozotocin (STZ) induced diabetic rats. Material and methods: Antidiabetic activity of the ethanol extracts of A. remota leaves (AREt) was studied in STZ induced diabetic rats. The effect of extract on fasting blood glucose, body weight, lipid profile, serum, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, urea, creatinine and total protein were analyzed. Glibenclamide was used as standard reference drug. Results: A. remota leaves ethanol extract (AREt) showed highly significant blood glucose lowering effect. After diabetic rats treated with AREt (200 and 400 mg/kg) for 28 days, there were a significant decrease in fasting blood glucose, total cholesterol, triacylglycerol, LDL- cholesterol, serum enzymes (alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase), and significant increase in body weight, serum total protein, HDL- cholesterol, levels as compared to untreated diabetic rats. Conclusion: The results of the experiments showed that A. remota leaves might be useful for management of diabetes mellitus and other abnormalities associated with this metabolic disorder. The present study might support the traditional use of A. remota for diabetes mellitus treatment. Key words: Ajuga remota, diabetes mellitus and streptozotocin

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