Medical Biochemistry

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Analysis of selected circulatory microRNAs in breast cancer before and after chemotherapy
(Addis Ababa Universty, 2018-09) Mulugeta, Yonas (Dr.); Seifu, Daniel(Associate Professor of Biochemistry Department of Biochemistry, AAU)
reast cancer is the second most common cause of death from cancer in women. There is now increased prevalence of breast cancer among African women. In Ethiopia it is the leading cancer type constituting 33% of all cancer cases in women. It is a heterogeneous type of disease which comprises of many biologically different and pathologically distinct features that lead to different treatment responses. Tests and procedures for diagnosis and prognosis of breast cancer are still limited to invasive procedures and imaging techniques. Based on their differential expression in disease and with their exceptional stability in biological fluids, microRNAs are noticeable candidates to be used as non-invasive diagnostic and prognostic biomarker. The association of change in expression level of microRNAs with clinicopathological parameters may demonstrate their potential in sorting the heterogeneous disease to specific subgroups for effective treatment options. The purpose of this study was to investigate the differential expression of specific circulatory microRNAs in breast cancer patients and study their association with clinicopathological parameters with samples from healthy volunteers serving as control. Changes in the level of microRNA after completing chemotherapy was also assessed and checked for association with serum CA 15-3 values to see the prognostic potential of specific microRNAs. XIV The levels of specific circulatory microRNAs in patient and control samples were analyzed using qRT-PCR. Serum CA 15-3 values from patient samples collected after completion of chemotherapy were measured using solid phase enzyme linked immunosorbent assay. In this study miRNA 21-5p was significantly over expressed in the serum of breast cancer patients when compared with controls (P<0.05). Receiver operating characteristic curve analysis shows its potential in differentiating breast cancer patients from controls with AUC value of 0.6 (P<0.05). A significant decrease in serum miR-326 was observed after chemotherapy (P<0.05) as compared to serum samples collected before chemotherapy. No correlations was found between serum CA 15-3 values and levels of circulatory microRNAs. Mean serum CA 15-3 value of patients with stage IV breast cancer was found to be high when compared with patients with other stages (P<0.001). Well-designed studies are required to elucidate the clinical validity of deregulated microRNAs in breast cancer to be used as diagnostic and prognostic biomarkers. Since deregulated miRNAs in the circulation are shared by several cancer types and subtypes, further studies are necessary to identify a well characterized cluster of miRNAs with discriminative ability.
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
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.
Antihyperglycemic and antihyperlipidemic effect of Persea americana mill fruit juice in high fat diet and low dose streptozotocin (STZ) induced type 2 diabetic male albino Wistar rats
(Addis Abeba University, 2020-06) Girma, Ture; Genet, Solomon (PhD); Tufa, Abdisa (PhD fellow)
Introduction:Type II diabetes is an alarming rate problem globally and in Ethiopia due to change in diatery habits and sedentary life style. Serious complications are associated with diabetes, particularly macrovascular and microvascular complications. Early controlling blood glucose significantly reduces the risk of complications of diabetes, but yet no effective cure for it, even though available drugs currently used in managing the disease are associated with several undesirable side effects. Traditional treatment with low cost and minimum side effect is used to treat diabetes across the world due to the different types of ingredients present in medicinal plants that act on a variety of targets by various modes and mechanisms. Ethiopia is rich in traditional medicinal plants and Persea americana mill is also part of this which people comsume as food. Objectives: In this study the effect of Persea americana mill fruit juice on FBG, weight, LDL-c, TG, TC, HDL-c and total protein in HFD/ low dose STZ indued type II diabetes mellitus has been evaluated in male albino wistar rats. Materials and Methods: Thirty six male albino wistar rats of 150-200 g weight were divided in to six different groups. Except six rats, the rest thirty fed on HFD for one month to induce prediabetes and insulin resistance, next followed by 35mg/Kg of STZ injection. Group I served as normal control; Group II served as diabetic control; Group III recieved 7mg/Kg of metformin; Group IV, V and VI were given 856 mg/kg, 1712 mg/kg and 2568 mg/kg of Persea americana mill fruit pulp juice for six weeks respectivily. The effect of fruit pulp juice on food intake and weight was measured by triple beam balance. After forty-five days treatment, the rats were fasted overnight (12 to 14 hours), anaesthetized and blood sample was collected by cardiac puncture for biochemical tests. Results were analyzed using one way ANOVA at a 5% level of significance. Results: In higher dose (2568 mg/Kg) of Persea americana mill fruit pulp treated group food consumption,weight, FBG, LDL-c were signifacantly reduced and HDL-c increased (P<0.005) compared to diabetic control. Middle dose (1712mg/Kg) treated group showed a decrease in FBG on 6 th week and improve HDL-c. Treatement of rats with Persea americana fruit juice change TG ,total protien and creatinine but not significant. Oral antidiabetes drug metformin showed significant reduction on pellet consumption, weight, FBG and lipid profile. Conclusion:These results indicated that Persea americana mill fruit juice has antihyperglycemic and antilipidemic effect possibly through reduction of fasting blood glucose, LDL-C and increasing HDL-C, in T2D induced rats. .
Antilipidemic Properties of Calpurnia Aurea Leaf Extract on High Fat Diet Induced Hyperlipidemia Male Albino wistar Rats
(Addis Ababa University, 2017-01) Welde, Mengistu; Natesan, Gnanasekaran (PhD)
Introduction: Hyperlipidemia is an elevation of the plasma lipids such as triglycerides, cholesterols, cholesterol esters, phospholipids and/or plasma lipoproteins including very low density lipoprotein and low density lipoprotein, and reduced in the circulating high-density lipoprotein levels. It is associated with an increased risk of coronary heart disease such as atherosclerosis and myocardial infarction. Objective: To investigate the antilipidemic properties of hydromethanolic extract of Calpurnia aurea leafs against high fat diet induced hyperlipidemic male albino wistar rats. Methods: Thirty albino Wistar rats’ 60-75days old and weight of 150- 200 grams were divided randomly in to six groups of five each. Group I served as normal control, group II received high fat diet (48.8% fat w/w) containing lard made from beef fat and mixed with hydrogenated vegetable oil, group III received high fat diet supplement with 3.5 mg/kg/day atorvastatin as standard control and the remaining three groups IV, V and VI received high fat diet along with hydromethanolc extract of Calpurnia aurea at (200,300 and 400) mg/kg/day respectively for 60 days. Food intake, Body weight, body mass index, serum lipid profiles and liver histopathology were assessed. Results: The result of this study revealed hydromethanolic extract of Calpurnia aurea /HMECA have dose dependent antilipidemic activities. Calpurnia aurea treatment of 400mg/kg caused a significant lowering of (p < 0.05) of serum LDL from 28.53±12.2 mg/dl to 9.70 ± 5.77 mg/dL; the serum Cholesterol level from 92.00± 13.0 mg/dl to 60.33± 8.60 mg/dl; and the serum triglyceride leve1from 71.83 ± 13.0 mg/dl to 84.73±19.4 mg/dl and on the other hand for the same dose it had significant elevated serum HDL levels from 11.66 ±1.23 mg/dl to 29.66± 1.52 mg/dl. At the medium dose of 300mg /kg it was not effective as 400mg /kg and at the minimal dose of 200mg/kg brought numerical difference not statisticaly significant among the serum lipid profile. Conclusion: These observations suggest that HMECA has a dose dependent antihyperlipidemic effect against high fat diet induced hyperlipidemia. The molecular mechanism of antilipidemic activities of this drug need to be studied. KEY WORDS: Calpurnia aurea, High fat diet, Hyperlipidemia, Lipid profile, Atorovastatin.
Assessment and Evaluation of Fatty acid Content and type in various types of imported oils in Ethiopia, using Gas Chromatography
(Addis Abeba University, 2019-02) Gedefaw, Zewdu; Dr. Genet, Solomon(Associate professor of Medical Biochemistry ); Dr.Menon, Menakath; Dr.Ele, Estifanos
Edible oil is a vital component of our diet. It is composed of different types of fatty acids. The type and proportion of fatty acid in oil determines the nutritional value, physical and chemical properties of edible oil and is also implicated in its quality and applicability for consumption. The main objective of this study was to assess and evaluate the fatty acid content and their type in imported edible oils widely consumed in Ethiopia. Five edible oils were analyzed for their fatty acid composition by Gas chromatography coupled with mass spectrometric detector (GCMS). Fatty acid profile was determined after fatty acids were transformed to their corresponding fatty acid methyl esters (FAMEs). The result of this study showed that Chief palm oil, Hayat palm oil and Mona palm oil contain the highest percentage of total saturated fatty acids, 69.97%, 53.53%, and 50.11% respectively. Palmitic acid and stearic acid were the predominant saturated fatty acids in these oils. Among the evaluated oils, the highest content of unsaturated fatty acids were determined in sunflower oil (84.41%), and soyabean oil (79.55%) with the predominant presence of linoleic acid and oleic acid, compared to total unsaturated fatty acid in Mona palm oil (48.89%), Hayat palm oil (46.29%) and Chief palm oil (28.53%). The fatty acid composition of soyabean oil contains a healthy mixture or proportion of all the types of saturated and unsaturated fatty acids. In addition, it contains balanced proportion of omega-6 to omega-3 fatty acid and P/S index value greater than one. Therefore, soyabean oil presented the healthiest fatty acid profile followed by sunflower oil and Mona palm oil, while Chief palm oil presented the least healthy fatty acid profile.
Assessment of Acute Malnutrition Using Transthyretin Levels in Blood of Children Under Five Years of Age in Tikur Anbessa Specialized Hospital and Yekatit 12 Hospital, Addis Ababa
(Addis Ababa University, 2015-03) Tsegaye, Behailu; Genet, Solomon (PhD)
Background: - Malnutrition is one of the leading causes of morbidity and mortality in children under the age of five years in developing countries, including in Ethiopia. The most important forms of malnutrition in Ethiopia is protein energy malnutrition, but there is no reliable laboratory method present to assess acute malnutrition. Transthyretin level of immunochromatography method is one of the newly introduced method for the identification of children with acute malnutrition recently admitted to Hospital and used as valuable laboratory measurements in the identification of patients requiring malnutrition assessment and nutritional support. Objective: - To evaluate acute malnutrition status in children of age less than five years, who attend in Tikur Anbessa Specialized Hospital and Yekatit 12 hospital; by using anthropometric methods, and by measuring albumin and transthyretin level in blood serum samples. Methods: - Hospital based cross sectional study design was applied from August 2014 to December 2014. 51 malnourished and 51 non- malnourished children were recruited for this study. Anthropometric measurements (weight, height, length, MUAC) were performed and serum transthyretin and albumin levels were measured as biochemical parameters in these hospitalized patients. Results: - The mean age of the cases and controls were 1.14 year and 1.48 year, respectively. Comparison of mean between control and study group shows 14.32 cm and 10.45 cm for MUAC, 4.24 g/dl and 3.86 g/dl for albumin and 303.08mg/l and 132.89 mg/l for transthyretin for control group and study group respectively. All above mean values shows significant difference between controls and study groups with p value < 0.0005. Prevalence of malnutrition assessed by weight for height were categorized as 21.6% for moderate malnutrition and 78.4% for severe malnutrition. Using MUAC it could be predicted that 23.5% were moderately malnourished and 76.5% were severely malnourished. But using transthyretin tests, the prevalence of 82.4% for moderate malnutrition and 13.7% for severe malnutrition were obtained. Multivariate analysis revealed positive correlation between albumin and transthyretin level (r = 0.307, P=0 .03), but there was no significant correlation between anthropometrics measurement with biochemical measurements. The sensitivity and specificity of transthyretin using MUAC as reference standard were 91.60 %, and 15.38% (0.0318 Kappa agreement). The sensitivity of transthyretin using weight for height (wasting) as reference standard was 100 %, and specificity was 17.5 %. (0.16 Kappa agreement). Transthyretin validation by using MUAC as reference material was found to be a sensitivity of 81.82 % and specificity of 47.5 % with cut off of transthyretin 120 mg/l. Conclusions: - Transthyretin is a better acute malnutrition marker in the serial nutritional assessment and it is a cost effective, feasible, reliable tool for malnutrition screening, particularly for the purpose of settings where it is difficult to perform a more detailed and comprehensive nutritional assessment. Key words: - Transthyretin, Albumin, Anthropometric parameters, Acute Malnutrition
Assessment of Cardiometabolic Risks and Associated Factors among Ethiopian Public Health Institute Staff Members
(Addis Ababa Universty, 2018-10) Geto, Zeleke; Seifu, Daniel (PhD)
Background: - Non communicable diseases are increasingly becoming the global cause of premature death encompassing cardiovascular diseases, cancer, respiratory diseases and diabetes mellitus. Cardiovascular diseases are the major cause of death accounting about nearly half from all deaths by non-communicable diseases as a result of increasing cardiometabolic risks such as insulin resistance, impaired glucose intolerance, dyslipidemia, hypertension and central obesity. Objective: -Was to assess the magnitude and associated risk factors for cardiometabolic risks among Ethiopian Public Health Institute staffs. Methodology: - Cross section study design was conducted from January to October 2018 on Ethiopian Public Health Institute staff members using WHO Non-Communicable Diseases (NCD) step survey instrument version 3.1.2008. A total of 450 study participants were involved in this study. The data collection tools were questionnaires, physical measurement and biochemical analysis. The questionnaire was modified with expanded and optional questions like chat chewing to suit local needs. Biochemical analysis were done using COBAS 6000 analyzer. SPSS version 20 was used for statistical data analysis. Ethical clearance was obtained from EPHI Institutional review board (EPHI-IRB) and Addis Ababa University Biochemistry Department ethics and research committee (DRERC). Results: - The prevalence of metabolic syndrome was 124/450 (27.6%). Prevalence of central obesity, low HDL and hypertension were 80.2%, 41.3% and 23.6% respectively. Likewise, only 24% of the study participants were free from any components of metabolic syndrome and about 40% of the participants had at least two and above components used in metabolic syndrome. Conclusion: Prevalence of metabolic syndrome was significant in studied population which increases morbidity and premature mortality with CVD and Type 2 DM. Metabolic syndrome will lead to increased cardiometabolic risks causing death from CVD and Type 2 DM. Interventions focused on life style change, nutritional elements and physical activities and early screening are recommended to overcome the disease burden.
Assessment of hemodialysis-associated thrombocytopenia and other factors among patients on renal replacement therapy in Addis Ababa Ethiopia
(Addis Ababa University, 2019-12) Abeje, Seblework; Genet, Solomon(Associate Professor, PhD); Menon, Menakath(Associate Professor, PhD)
Background; Hemodialysis is one of the renal replacement therapies, in addition to peritoneal dialysis and renal transplantation. Hemodialysis can improve morbidity and mortality in renal patients; however it has different multifactorial idiosyncratic complications that occur during the dialysis and/or during long term use of hemodialysis. Dialysis as treatment modality is extremely scarce in Ethiopia and affordable to only the rich. Objectives: The objective of this study was to assess the prevalence of thrombocytopenia and associated factors among ESRD patient under hemodialysis in Addis Ababa Ethiopia from May 1st to June 1st, 2019: Method: Institution based cross sectional study was conducted in Addis Ababa Ethiopia from May 1st to June 1st, 2019. 100 patients who were on hemodialysis during the study period were involved in the study. Platelet number was determined by flow cytometry. The collected data was checked for completeness, entered to computer and statistically analyzed using SPSS version 25.0 Results: The total number of patients in the study was 100. The mean age of the subjects was 40.25± 12.84 years, with a range of 18-76 years and 70% (70) of the study subjects were male. 85% of the study subjects had hypertension, and 19% had diabetes mellitus. Only 5% had co- morbidities likely to contribute to CKD, such as chronic glomerulonephritis and renovascular disease. The mean duration of hemodialysis was 0.78 ±0.42 years, with a range of 2 months to 3.5 years. The mean pre dialysis and post dialysis platelet count was 233.5×103±72.13cells/μl and 178×103 ±71.8 cells/μl respectively and thought it is in the normal range PT and PTT showed slight increase post HD (16.66±3.19) seconds compared to pre HD (15.4±5.69) seconds and 34±6.76 seconds compared to pre HD 33.8±5.34 seconds respectively. Age of patients COR=0.4(0.12, 1.356) and duration of treatment COR=0.43(.118, 1.531) were statistically insignificantly associated with thrombocytopenia. Conclusion and recommendation: Over all prevalence of thrombocytopenia was higher in the study area and coagulation parameters; prothrombin time and partial thromboplastin time showed slight increase after hemodialysis among ESRD patient.
Assessment of Malnutrition and Inflammatory status in cervical cancer patients attending Tikur Anbessa specialized hospital.
(Addis Abeba University, 2021-06) Assefa, Etsegenet; Dr.Degef, Maria; Dr.Tigeneh, Wondemagegnhu; Dr. Gnanasekaran, Ñatesan
Background: Globally cervical Cancer is the fourth common cancer accounting for 6.6% of all female cancers. Oncogenic human papillomavirus (HPV) specifically types 16 and 18 is the most important risk factor associated with cervical cancer. Studies have indicated that approximately 88.33% of gynecological cancer patients experience malnutrition; and Inflammation that play a pivotal role in the progression of cervical cancer. Various nutritional and inflammatory parameters such as serum Total Protein, Albumin, Ferritin and Hematological parameters; Hemoglobin, LMR NLR, RDW and PLR used as Prognostic Biomarker of cancer associated with inflammation and malnutrition in cervical cancer patient. Objective: The aim of the present study was Assessment of Malnutrition and Inflammatory Status in Cervical Cancer Patients attending Tikur Anbessa Specialized Hospital. Methodology: Hospital based comparative cross-sectional study was conducted on 50 cervical cancer patients and 50 healthy individuals. Socio demographic data were collected by using standardized questionnaire. Anthropometric data and Blood collection was done through standardized techniques and Automated COBAS 6000 and Sysmex KX-21N hematology analyzers were used to analyze the samples. Statistical data analysis was held by SPSS version 25. Student’s t-test was used to compare the mean value of continuous variables of two groups, one way analysis of variance (ANOVA) was used to compare the relationship of categorical variables between deferent stages of the cancer. Other associations were performed with Pearson’s correlation coefficient. A P-value of <0.05 at 95% confidence level was considered to be statistically significant in all the analyses. Result: The mean age of cervical cancer patient and control group was 52.4 years. The cervical cancer Patients had significantly decreased Albumin and increased Total Protein and significantly increased Ferritin levels than controls group. Among hematological parameters there was a signiﬁcantly increases in Red blood distribution width (RDW), Neutrophiles to Lymphocytes ratio (NLR) and Platelet to Lymphocytes ratio (PLR). There was also decrease in Hemoglobin and Lymphocyte to Monocyte ratio (LMR) in the cervical cancer Patients and also those parameters expresses their effect in cervical cancer from stage II to stage IV. Albumin negatively correlated with serum ferritin (r=-0.120*, p=0.002) and RDW (r=-0.018*, p= 0.001) in cervical cancer patient and negatively correlated with serum total protein (r=0.943*, P<0.001) in control group. NLR positively correlated with PLR (r=0.764**, p=0.000) and LMR (R=1.000**, P=0.000) in cervical cancer patients. Conclusions: Malnutrition and inflammation are common experience in patients with cervical cancer. The result of this study showed low level of serum Albumin, Hemoglobin and LMR; and high level of serum Total Protein, Ferritin and other Hematological Parameters such as NLR, RDW and PLR. This may serve as markers for assessment of malnutrition and inflammation and may also use as a prognostic factor in cervical cancer patients. Therefore, further study is recommended on the assessment of malnutrition and inflammation in cervical cancer patients with a large group of participants.
Assessment of Malnutrition Using Biochemical Markers among Female Breast Cancer Patients Attending Tikur Anbessa Specialized Hospital, Ethiopia
(Addis Ababa University, 2017-06) Gebremeskel, Kibrom; Genet, Solomon (PhD)
Introduction: Breast cancer is the most common cancer worldwide. Malnutrition occurs frequently in cancer patients. Malnourished cancer patient responds poorly to therapeutic interventions, such as chemotherapy, radiotherapy and surgery with increased morbidity and mortality. Objective: The aim of the present study was to evaluate malnutrition in breast cancer patients through biochemical markers at Tikur Anbessa Specialized Hospital, Ethiopia. Materials and methods: Hospital based cross-sectional study was conducted in 50 breast cancer patients and 50 healthy individuals from January to April 2017 at Tikur Anbessa Specialized Hospital, Ethiopia. The required amount of blood was withdrawn from both group by well trained nurses in the hospital and serum stored at -800c refrigerator until analysis. Data were collected on socio demographic factors, biochemical, anthropometric and hematological parameter. Result: The mean age of the study and control group was 43.06 year. Comparison of mean between study and control group shows 3.89 ± 0.04 g/dl and 4.34 ± 0.17g/dl for albumin, 3.92 ± 0.08 g/dl and 3.35 ± 0.04 g/dl for globulin, 1.73 x 103 ± 0.29 cells / mm3 and 2.35 x 103 ± 1.12 cells /mm 3 for total lymphocyte count, 0.72 ± 0.03 mg/l and 0.96 ± 0.03 mg/l for creatinine, 25.19 ± 1.22 mg/l and 21.62 ± 1.01 mg/l for urea for study and control group respectively. All the above mean values show statistically significant difference between study and control groups with p value < 0.05. There were no statistically significant difference mean value levels of total protein and body mass index in our study. Prevalence of malnutrition assessed through albumin was 32%, TLC 46% and BMI 36%. Pearson correlation analysis revealed positive correlation between globulin and total protein level (r = 0.84, P < 0 .0001) and negative correlation between albumin and globulin level (r = -0.48, p < 0.0001) in the breast cancer patients. Albumin positively correlated with TLC (r = 0.51, p= 0.03) in the breast cancer patients. Conclusion: The present study revealed serum albumin, globulin, creatinine, urea level were reliable biochemical markers combined with TLC for assessment of malnutrition in breast cancer patients. Key words: breast cancer, Malnutrition, Albumin, Globulin, creatinine and total lymphocyte Count
Assessment of Metabolic Syndrome Among Government Offices Workers of Some Randomly Selected Offices in Aksum Town, Central Zone, Tigray Region, Ethiopia
(Addis Abeba University, 2021-08) Mamo, Ephrem; Dr. Gizawe, Solomon Tebeje( Assistant Professor); Dr.Gebre, Solomon Genet( Assistant Professor); Abrar, Mohammed Mehdi(PhD Candidate )
Background: Metabolic syndrome is a serious public health concern that describes a cluster of disorders and is associated with several health problems. The global prevalence of metabolic syndrome has increased dramatically in the past decade, workplace which directly influence the physical, mental and social well-being of employees are considered important environmental and social determinants for risk of metabolic syndrome. Therefore, biochemical profiling of these population is required. Objectives: This study aimed to assess the association between working environment and metabolic syndrome among workers in Aksum town, central zone, Tigray Region, Ethiopia. Methods: A cross sectional study was conducted from September, 2020 to August, 2021 in Aksum town. A standard questionnaire was used to collect data on socio-demographic variables. Biochemical analysis was done using COBAS C 311 analyzer for the determination of lipid profile, fasting blood glucose and anthropometric measurements. The data were interred into SPSS version 25 and binary logistic regression and linear regression were analyzed to evaluate the association between variables. If P. value ≤ 0.05, it is considered as statistical significance. Result: The findings of this study showed that the magnitude of metabolic syndrome was 16.0% (13% government office workers & 3% Daily laborers). The most common metabolic syndrome components among government office workers reduced high-density lipoprotein-cholesterol were 19%, hypertriglyceridemia was 22% & hypertension was 24%, had significant positively associated with a higher risk of metabolic syndrome (P< 0.05). Hyperglycemia were 18% and abnormality of body mass index was 30% frequently found in government office workers (P >0.05). Government office workers 35% had less vigorous physical activity level, 38% had less type of olive oil used for cooking & 27% had less than 3 serving of fruits and vegetables per week as compared to daily laborers (P< 0.05). Conclusion: In this study, the prevalence of metabolic syndrome was (16%), 13% of government office workers had a higher comparable to 3% of daily laborers. Metabolic syndrome was more common in government office workers, urban population and with advancing age, by hypertension, dyslipidemia and central obesity were the most frequent components of metabolic syndrome.
Assessment of neutrophil-lymphocyte ratio as an inflammatory marker among type 2 diabetes mellitus patients with and without diabetic nephropathy
(Addis Abeba University, 2020-11) Zewude, Mesfin; Dr.Genet, Solomon (PhD, Assoc. Prof.); Dr.Gizaw, Solomon Tebeje(PhD); Dr. Gnanasekaran, Netsan (PhD. Asst. Prof.)
Background: Diabetic nephropathy (DN) is one of the microvascular complications of diabetes mellitus manifested as increased albumin in urine excretion. Total leucocyte count is a crude, but a sensitive indicator of inflammation and studied in many non-communicable diseases such as acute myocardial infarction, stroke, heart failure and cancer as index of inflammation. In this study, the neutrophil-lymphocyte ratio (NLR) was evaluated between T2DM patients with and without DN. Objective: To assess the neutrophil-lymphocyte ratio as an inflammatory marker among Type 2 diabetes mellitus (T2DM) patients with and without diabetic nephropathy. Methodology: A cross-sectional study was conducted to compare NLR between type 2 diabetic patients with and without DN at Bole 17 Health Center, Addis Ababa, Ethiopia from October 15, 2019 to April14, 2020. Convenient sampling technique was used to recruit the study participants. The data was entered in to Epi-data statistical software version 3.1 and then exported to SPSS software version 22.0 for analysis. Simple descriptive statistics such as mean, standard deviation, and percentages were used to present socio-demographic characteristics and magnitude of patients with DN, without DN and NLR ratio. Appropriate statistical tests, including student t-test, chi-square test, and Pearson correlation were done to analyze the statistical data. The p-values < 0.05 were considered statistically significant. Results: Out of the 199 DM patients, 22.6% and 77.4% were found with diabetic nephropathy (albumin positive) and without diabetic nephropathy (albumin negative), respectively. Interestingly, the mean NLR value (2.66±0.49) was found higher in diabetic patients with DN compared to the mean NLR (1.65±0.20) of diabetes patients without DN (p <0.0001). Conclusion: The NLR was significantly increased in T2DM patients with DN, suggesting that inflammation and endothelial dysfunction could be an integral part in the pathogenesis of DN, and NLR may be considered as a predictor and a prognostic biomarker of DN.
Assessment of Plasma D-Dimer level and its Correlation with Disease Severity among Hypertensive Patients
(Addis Abeba University, 2019-09) Chekol, Endeshaw; Dr. Genet, Solomon(PhD); Dr.Menon, Menakath(PhD )
Introduction: Hypertension is a single most important risk factor for cardiovascular disease, and the growing public health issue in developing countries. It has been reported that inappropriate acute thrombus formation (hypercoagulability) is the pathophysiological substrate underlying increased risk and severity of target organ damage of hypertension, such as acute coronary syndrome and stroke that can cause significant morbidity and mortality. Plasma D-dimer level has been reported to be a good biochemical marker of thrombosis. Objectives: The objective of this study was to assess plasma D-dimer level and its correlation with disease severity among hypertensive patients at Yikatit 12 Hospital Medical College. Methods: A hospital based comparative cross-sectional study was conducted at Y12HMC. Hundred participants (60 hypertensives and 40 controls) were recruited in the study. Data were collected using structured questionnaire through face to face interview, reviewing medical records and direct measurement of variables. The data was analyzed using SPSS version 25.0 and categorical variables were described by frequency and percentage while continuous variables by mean and standard deviation. The association and correlation between variables were determined using correlation coefficients, regression analysis, and also using different parametric and non-parametric tests accordingly. Results: Among study participants, female to male ratio was 1.4 and the mean age was 52 year with a range of 20 to 80 years. Among hypertensives,30(50.0%) were in stage 1 while 14(23.3%) and 16(26.7%) were in stage 2 and severe hypertension respectively. We observed higher D-dimer levels among hypertensives when compared with the healthy controls (p<0.001). The plasma D-dimer levels were found to be increased significantly with the severity of hypertension (p<0.001). D-dimer found to have a diagnostic power of 86.9% in differentiating complicated from uncomplicated hypertension at 0.83mg FEU/l cut-off value. Conclusion and recommendations: This study suggests that D-dimer level was higher in hypertensives than control groups and it was also increasing significantly with the severity of hypertension suggesting hypercoagulability plays a role in the pathogenesis of cardiovascular disorders and thromboembolic complications of hypertension. But further studies need be done on larger scale and using more robust study designs such as case control and cohort to establish the causality of the association between severity of hypertension and D-dimer level.
Assessment of RBC-folate level and other determinant factors of neural tube defect among first trimester pregnant women who attends ante natal care in Lideta and T/haimanot health centers, Addis Ababa, Ethiopia.
(Addis Ababa Universty, 2018-08) Adela, Alemu; Seifu, Daniel (PHD, Department of medical biochemistry)
Background: Folate is an essential vitamin for de novo DNA synthesis and cell proliferation. Deficiency of this vitamin during first trimester pregnancy is associated with unintended pregnancy and birth outcomes, particularly neural tube defects. Objective: The aim of this study was to assess folate status, and other determinant factors of neural tube defect among first trimester pregnant women who were attending antenatal care in Lideta and T/haimanot health centers, Addis Ababa, Ethiopia. Materials and methods: Institutional based cross-sectional study was conducted from August 8, 2017 to January 3, 2018 at Lideta and T/haimanote health centers. For this study, 160 participants were enrolled via convenience sampling method. Red blood cell folate was measured by electrochemiluminescence binding assay method and MCV was measured by Beckman coulter method. Data were entered in to Epi-Data version 3.1 and analyzed by SPSS version 22.0. Descriptive statistics was used to describe demographic characteristics and to determine magnitude of folate deficiency. Logistic regression was used to identify risk factors of folate deficiency. P-value of < 0.05 was considered as statistically significant. Results: In the present study, 44/160 (27%) participants had RBC folate level < 400ng/mL, insufficient to prevent neural tube defect. The magnitude of macrocytosis was 2.4% among 82 participants. Besides, only 13/160 (8.1%) participants found to have information about folate and five of them correctly know the timing of folic acid supplementation. The prevalence of folate supplementation during the first trimester was also only two/one hundred sixty (1.3%). Bivariate regression shows income as a determinant factor for folate deficiency (p value = 0.01). Regular consumption of fruit (OR: 0.44, CI: 0.21-0.89), vegetable (OR: 0.38, CI: 0.71-2.29) and milk (OR: 0.47, CI: 0.23-.96) were found to lower the possibility of getting folate deficiency by the bivariate regression. But, regular vegetable intake was the only continued determinant factor by the multivariate regression (adjusted OR: 0.41, CI: 0.18-0.93). Conclusion: This study established that 27.5% of the first trimester pregnant women had a folate status insufficient to prevent neural tube defect. Furthermore, folic acid usage among the first trimester pregnant women was very low. This study also identified that regular consumption of leafy green vegetable as an independent factor to overcome folate deficiency.
Assessment of renal function among HIV positive patients taking tenofovir and non-tenofovir containing highly active anti retroviral therapy (HAART) at Ayder comprehensive specialized hospital, Mekelle, Ethiopia.
(Addis Abeba University, 2020-06) Gebremedhin, Zemenfes; Dr.Genet, Solomon (PhD); Dr. Menon, Menakath(PhD)
Background: kidney disease is becoming a global burden on public health. The use of HAART worsens the progression of renal failure in HIV patients. Previous studies have incoherent TDF outcomes on renal wellbeing. General objective: To evaluate renal function among HIV positive adult patients taking tenofovir compared with non-tenofovir containing highly active antiretroviral therapy (HAART) Methods: Institutional based cross-sectional comparative study was conducted using a convenience sampling method from May 20/ 2019 to December /20/ 2019 at ACSH, Mekelle, Ethiopia. Socio-demographic and clinical characteristics of the study participants were assessed using medical records, structured questionnaire, anthropometric measuring tools (electronic weighing scale, adult height board), BDFACA Presto for CD4 determination, Pentra machine for analyzing renal function was used and the obtained data was analyzed using SPSS version 25.0. Result: During the enrolment to HAART, a total of( 9.1%,n=21) respondents had a lowered GFR level but after the intake of HAART for at least six months, the number of patients with lowered GFR level raised to 16.8%, n=39(9.5% for the TDF group and 7.3% for the non-TDF group). Among the total 39(16.8%) declined GFR cases, thirty (12.9%) of study participants had mild renal dysfunction, 18(81.1%) vs. 12 (70.6%) for TDF and non-TDF groups respectively. But there was no statistically significant correlation between the severity of renal dysfunction as described by GFR and the form of HAART regimen (P=0.31). After HAART initiation, there was no significant mean difference in almost all of the test parameters for renal function. In those who received TDF-group, renal dysfunction is significantly predicted by older age ≥50 years, being male, advanced immune-suppression (CD4<200cell/ml) and ≥ 10 years of HAART intake; whereas those on the non-TDF group, renal dysfunction was significantly predicted by older age ≥50 years and being male. Conclusion: We found no statistically significant differences in renal dysfunction of HIV positive patients on TDF and non-TDF containing HAART regimen, but the overall prevalence of renal dysfunction after six months of HAART follow-up was 16.8%. Therefore, to enhance the early detection of patients at high risk of kidney failure after initiation of HAART, renal function of all patients on HAART must be checked regularly by the health care providers.
Assessment of Renal function and Hematological Profile among Khat (Catha Edulis) Chewer and non Chewer Type 2 Diabetes Mellitus Patients Attending Harar Jugol Hospital, Eastern Ethiopia.
(Addis Abeba University, 2021-02) Reshid, Tewekel; Dr.Degef, Maria(PhD, Assistant Professor); Dr. Addisu, Sisay (PhD, Assistant professor)
Back ground: Diabetes mellitus (DM) is a common endocrine disorder characterized by the presence of chronic hyperglycemia and it’s the leading cause of end stage renal disease (ESRD). In addition to DM some factors suspected to be the cause of the renal problems are drug abuse. World Health Organization (WHO) classified khat (Catha edulis) as a substance of abuse. Khat interferes with normal body functions, which could lead to adverse health effects on organs and systems of the body. Objective: The aim of this study was to compare fasting blood sugar (FBS), renal function and hematological profile among khat chewer and non chewer type 2 DM (T2DM) patients attending at Harar Jugol Hospital, Eastern Ethiopia. Methodology: Comparative cross sectional study was conducted on a total of 100 T2DM patients that are divided into two groups (khat chewers and non chewers). Socio demographic data were collected by using standardized questionnaire. Blood sample collection was done through standardized techniques. Automated COBAS 6000 and Sysmex KX-21N hematology analyzers were used to analyze the samples. Statistical data analysis was held by SPSS version 25 model. Result: Serum FBS and creatinine concentration showed statistically non significant elevation among kaht chewers (p > 0.05). White blood cell (WBC), Platelet (PLT) and hematocrit (HCT) of the khat chewers were significantly higher than non chewers (p<0.05). On the other hand Mean Corpuscular Hemoglobin Concentration (MCHC) and Mean Platelet Volume (MPV) of the khat chewers were significantly lower than non chewers (p<0.05). Conclusion: Chewing khat among T2DM patients might have an effect on FBS, kidney function and hematological profile. Therefore further study is recommended on the effect of khat chewing among DM patients.
Assessment of serum electrolyte level and kidney function tests among Ethiopian public health institute staff members: a cross sectional study.
(Addis Ababa Universty, 2018-10) Derbew, Meseret; Seifu, Daniel (PhD)
Background: Chronic kidney disease (CKD) becomes one of the public health problems and major cause of mortality because of late diagnosis that makes it difficult to treat and prevent the adverse outcomes. CKD is asymptomatic until end stage. Early screening, detection, and identification of kidney disease or risk groups are based on laboratory findings. In developing country including Ethiopia screening is very rare and currently, hearing sudden death from kidney failure and its complication is increasingly becoming common. Objectives: The objective of this study was screening and early detection of chronic kidney disease (CKD) by assessing serum electrolytes and kidney function tests and to detect the associated risk factors for CKD among Ethiopian Public Health Institute (EPHI) Staff Members Methodology: Cross sectional based study was conducted using WHO stepwise survey among volunteers of EPHI staff members. Automated COBAS 6000 Analyzer was used to analyze the samples. Statistical data analysis was held by SPSS version 20 model and the association of risk factors with the prevalence of CKD was assessed using logistic regression. Data was collected by senior health professionals. Blood sample collection was done through standardized, calibrated, and sterile technique by laboratory technologist. Ethical clearance was obtained from Ethiopian Public Health Institute- Institutional Review Board (EPHI-IRB) and Addis Ababa University Biochemistry Department Ethics and Research Committee (DRERC). Results: Total of 412 study participants were screened in this study. About 51.2% were males and the majority of the study participants (41%) were between ages of 18-32 years. Most study participants (60%) were married. Alcohol drinking (66%) was the most common bad behavioral practice. None of these study participants showed chronic kidney disease. But about 3.6% by MDRD and 1.9% by CKD-EPI equations were in stage two kidney disease. Self-reported previous history of hypertension, diabetes, and CVD, obesity, and family history of kidney failure were common in the study participants which comprise 18%, 3.4%, 5.3%, 8.5%, and 6.1% respectively. Hyperkalemia (9.5%) and hypocalcemia (8.5%) were the most common electrolyte disorders. Hyponatremia and hypophosphatemia were not found. Conclusion: The prevalence of stage two kidney disease was relatively low and no one was under serious kidney disease (GFR <60mmoL/min/1.73m2). Older age, high BMI, and previous history of CVD were significantly associated factors for reduced glomerular filtration rate.
Assessment of serum ferritin and hs CRP as diagnostic marker among breast, cervical and colorectal cancer patients attended Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
(Addis Ababa University, 2021-09) Wotera, Amanuel; Dr. Degef, Maria (PhD); Dr.Tebeje, Solomon
Background: Cancer is defined as group of diseases with uncontrolled cell growth. Inflammation is linked with cancer and stated as one of the hallmarks of cancer. hs-CRP, an acute-phase plasma protein that increases during systemic inflammation, is one of the most frequently used inflammatory biomarker. Similarly, serum ferritin, which is commonly used and convenient biomarker to assess iron level in the body is recently used as an important marker of inflammation. However, both hsCRP and serum ferritin level was not commonly used for early screening, prognosis or diagnosis of cancer. Objective: The aim of this study was to assess serum ferritin and hs-CRP level in breast, cervical and colorectal cancer before any treatment. Methods: Hospital based cross-sectional study was used as an appropriate study design. A total of 120 breast, cervical and colorectal cancer patients (40 in each cancer type), who did not take any type of treatment were included in this study. Biochemical tests of serum ferritin and hsCRP level were determined using COBAS c 501 and COBAS e 411 rack systems, respectively. Comparison of medians of serum ferritin and hsCRP among cancer types and among cancer stage was assessed using Kruskal- Wallis H tests. P-values less than 0.05 were considered to be statistically significant. Results: Increased level of hsCRP was observed on breast cancer (22.5 %), cervical cancer (50%), and CRC (37.3%) patients. Similarly, elevated serum ferritin level was observed on 12.5% breast, 30% cervical and 42.5% of colorectal cancer patients. Based on the stage of cancer, higher median (interquartile) value of hsCRP and serum ferritin was noticed on stage IV and II cancer patients respectively. Significantly higher median value of hsCRP was observed on cervical cancer patients (p< 0.005). But, insignificantly higher level of serum ferritin and higher level of serum hsCRP was seen on stage II (p=0.259) and stage IV (p=0.702) cancer patients, respectively. Conclusion: The current study proved that there was increment of serum ferritin and hsCRP in the three cancer cases. As a result, serum ferritin and hsCRP can be used as potential diagnostic biomarkers in breast, cervical and colorectal cancer.
Assessment of Serum lipid profiles and high sensititvity C-reactive protein among patients suffering from rheumatoid arthritis at Tikur Anbessa specialized Hospital, Addis Ababa, Ethiopia
(Addis Ababa Universty, 2018-12) Dessie, Gashaw; Getenet, Solomon (PhD)
Background: Rheumatoid arthritis is a chronic inflammatory disease characterized by severe pain of joints and swelling, joint damage and disability which leads to joint destruction and loss of function with unknown etiology. According to global burden of 2010 study, prevalence of 0.24%, rheumatoid arthritis is ranked among the top 15 of diseases causing disability worldwide. The complication of RA is related to cardiovascular diseases. The morbidity and mortality is related to systemic inflammation and dyslipidaemia. Objective: The general objective of this project is to assess serum lipid profiles and high sensitivity C-reactive proteins among patients suffering from rheumatoid arthritis and attending in Tikur Anbessa Specialized Hospital ( TASH ), Addis Ababa, Ethiopia. Material and Methods: Hospital based cross sectional comparative study was conducted to assess serum lipid profiles and high sensitivity C-reactive protein on rheumatoid arthritis patients in RA clinic at TASH. Patients who came to TASH during the study period were selected by convenience sampling method until the required sample size was achieved. Data was cleaned manually, coded, entered and analyzed by SPSS version 20. Written consent was obtained for willingness of patients to participate after getting official permission letter from Addis Ababa University and then from respective selected rheumatoid arthritis clinic. Result: The result of this study demonstrated that there was significant elevation of mean ± SD of TC, TC/HDL, LDL/HDL and lowered value of HDL-C was seen among RA patients than controls (P-value < 0.05). The mean ± SD of inflammatory marker, hsCRP was significantly higher among rheumatoid arthritis patients compared to controls (P value <0.05). HDL-C had significant negative correlation with high sensitive C-reactive protein where as TC/HDL-C and LDL/HDL-C had significant positive correlation with hsCRP (P < 0.05). Conclusion: In this study rheumatoid arthritis patients had lipid abnormalities and elevated systemic inflammation than controls. An increase in hsCRP and dyslipidaemia status among rheumatoid arthritis patients indicates the possible development of atherosclerotic event which is the underlying cause of cardiovascular risk. So, it is possible to conclude that RA patients are more likely to develop future cardiovascular coronary artery diseases compared to controls.

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