Medical Biochemistry

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Comparison of Immunohistochemistry with PCR Based Technology for Molecular Subtyping of Breast Cancer in Addis Ababa, Ethiopia
(Addis Abeba univerisity, 2022-06) Oma, Dessiet; Degef, Maria Degef
Background: Breast cancer (BC) is a complex and heterogeneous diseases, characterized by several molecular subtypes with distinct morphologies and clinical implications that lead to differences in response to various treatment and clinical outcomes. Immunohistochemistry (IHC) is used for molecular subtyping of BC. However, IHC is subject to observer variability. Endpoint RT-PCR gene expression analysis may improve observer variability and diagnostic accuracy. Objective: This study aimed to compare IHC with PCR based technology for molecular subtyping of breast cancer. Method and Materials: In this comparative cross-sectional study a total of 54 BC tissue samples were collected from Tikur Anbessa Specialized Hospital (TASH), St. Paul's Hospital Millennium Medical College (SPHMMC), and Yekatit 12 Hospital Medical College. The sample was sent to a Clinic and Polyclinic for Gynecology, Martin-Luther University, Halle Saale, Germany for laboratory analysis. Out of 54 tissue samples, 41 were qualified for IHC analysis of ER, PR, HER2, and Ki-67 protein expression and endpoint RT-PCR analysis of ER, PR, and HER2 gene expression. Kappa statistics were used to assess the concordance between IHC and the endpoint RT-PCR. Furthermore, the socio-demographic and clinico-pathologic characteristics were evaluated. Results: The overall percent agreement (OPA) between endpoint RT-PCR and IHC was 68.3% for ER (PPA 71.1%; NPA 33.3%), 39.0% for PR (PPA 14.3%; NPA 92.3%), and 82.9% for HER2 (PPA 62.5%; NPA 87.9%). Cohn’s kappa values of 0.018 (<0.20), 0.045 (<0.200), and 0.481 (0.41-0.60) were generated for ER, PR, and HER2, respectively. Concordance for molecular subtypes was only 56.1% (23/41) and 0.20 kappa value. IHC and endpoint RT-PCR based molecular subtyping was shown to be discordant for 18Conclusion: Molecular subtyping using endpoint RT-PCR was fairly concordant with IHC. Our result is promising that endpoint RT-PCR may provide a cost-effective, applicable BC molecular subtyping methods that can be better applied in low settings.
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.
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.
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.
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.
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.
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 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.
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.
Genetic Predisposition for Preeclampsia in a Population of Pregnant Women in Adama and the Surrounding Areas, Ethiopia
(Addis Abeba University, 2020-12) Mihretie, Tsehayneh Kelemu(Phd); Melka, Daniel Seifu(PhD); Hansson, Stefan(MD, PhD); Abebe, Markos(PhD)
Introduction: Preeclampsia (PE) is a global health problem, which is the major cause of maternal and fetal deaths. The majority of PE related deaths occur in low- and middle-income countries with limited-resource. Currently there is no cure for the syndrome, delivery remains the only option. The etiology of PE is not elucidated yet. However, several studies suggest a hereditary predisposition for acquiring the disease. Accordingly, studies have showed the role of killer cell immunoglobulin-like receptor’s (KIRs) expressed by uterine natural killer (uNK) cells and human leukocyte antigen-C (HLA-C) in familial predisposition of PE. In addition, recent evidences indicated the probable role of the CD99 expression in the pathogenesis of PE in a fetal sex dependent fashion. Such evidences are lacking in the Ethiopian context. Therefore, the general aim of the study was to evaluate the genetic predisposition for PE in a cohort of Ethiopian pregnant women. Methods: A case-control study design was used. The study was conducted at Adama Regional Referral Hospital. We involved 288 (131 PE, 157 controls) study participants for the first part of the study and 241 (105 PE, 136 controls) study participants for the second part of the study. The demographic and clinical data was collected using questionnaire. The maternal venous and cord blood was collected, and DNA extracted using QIAGEN reagent. The DNA was amplified using traditional polymerase chain reaction (PCR) and real time quantitative PCR (RT qPCR) using TaqMan TM Genotyping master mix (Applied Biosystems by Thermo Fisher Scientific, Waltham, MA, USA) and published primers. The data analysis was done using SPSS version 26.0. The Chi-Square test was used to evaluate the association between variables. The p-value <0.05 was used as cut-off point for the association of variables. Results: the mean age, systolic and diastolic blood pressures were higher while gestation age was lower in PE group compared to controls. A statistically significant association was observed in frequency of KIRAA, KIR2DS1 and in a subset of non-self HLA-C between the PE and control groups. In addition, a statistically significant association was showed in maternal regulatory region low CD99 expression genotype (CC) between PE mothers of males compared to controls. Conclusion: The KIRAA plays role in predisposition of PE while KIR2DS1 may play role in protection of Ethiopian pregnant women from PE. In addition, maternal regulatory region CC genotype may predispose mothers for PE in fetal sex-dependent fashion.
Cross sectional comparative study of hematological parameters in people withatherosclerotic cardiovascular disease and those with cardivascular risk alone.
(Addis Abeba University, 2021-06) Abate, Ebsitu; Degef, Maria(PhD, Assistant Professor); Dr.Melkie, Addisu(Associate professor); Dr.Gnanasekeran, Natesan(PhD, Assistant professor)
Background Cardiovascular disease (CVD) is the foremost killing disease worldwide and ASCVD is one of the prominent types of CVD which is mainly associated with a condition called atherosclerosis. Various risk factors are associated with its incidence. These are hypertension, diabetes, dyslipidaemia, smoking, genetic factors etc. Presence of ASCVD as well as its risk factors results in disturbance of various physiological and biological function of the body. Haematological parameters for instance tend to be disturbed in the presence of abnormal physiological and biological function. Aim: Therefore, in this prospective cross sectional comparative study we have assessed and compared the pattern of haematological parameters in peoples having established atherosclerotic cardiovascular disease (ASVD) vs. peoples having ASCVD risks alone who attended TASH Addis Ababa, Ethiopia and also correlated haematological parameters with the novel inflammatory marker hsCRP. Method: -Blood samples were collected from study participants and serum was extracted for the lipid and hsCRP analysis and the remaining whole blood is used for haematological parameters determination using SYSMEX machine while Roche/Hitachi Cobas 6000 analyser that uses immunoturbidimetric assay was used to determine hsCRP whereas lipid profile was first determined by spectrophotometric analysis and then repeated by using Roche/Hitachi Cobas 6000 analyser. The total number of participant was100 (50 in each group). Result: -White blood cells (WBC), mean cell volume (MCV), red cell distribution width (RDW) and monocyte (MONO) are significantly higher in pre-existing ASCVD and also have significant association with the presence of ASCVD. Mean platelet volume (MPV) significantly higher in ASCVD risked group and associated with the presence of the risk. Additionally, in correlation analysis of highly sensitive C-reactive protein (hsCRP) with hematological parameter hsCRPs show significant correlation with MPV. It is higher and significantly associated with the presence of risk factors as well. Conclusion: -Using this affordable, routinely tested and easily available tests may help to infer future ASCVD risk as well as the presence of ASCVD morbidity while hsCRP level in comparison group vs. cases require further study.
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.
Comparative assessment of serum lipid profile, complete blood count and viral load levels between HIV positive patients taking dolutegravir and efavirenz based antiretroviral therapy at wolkite health center, southern Ethiopia
(Addis Abeba University, 2021-08) Sahilu, Bedilu; Dr. Addisu, Sisay (PhD, Assistant Professor of Biochemistry); Dr. Gnanasekaran, N (PhD, Assistant Professor of Biochemistry)
Background: Highly active antiretroviral therapy can achieve rapid HIV suppression and allows restoration of the immune system. However, their long-term use has been associated with various immunological, biochemical and haematological abnormalities such as dyslipidemia, insulin resistance, lactic acidosis, anemia, leukocytopenia, neutropenia and thrombocytopenia Objective: The main aim of this study was to compare lipid profile, complete blood count, and viral load levels between HIV positive patients taking dolutegravir and efavirenz based ART at Wolkite Health Center, Southern Ethiopia. Methods: Institution based comparative cross-sectional study was employed to include 75 efavirenz and 75 dolutegravir based ART treated patients, during their routine appointment using consecutive probabilistic sampling technique from May 2020 to July 2021 at Wolkite Health Center, Southern Ethiopia. Results: This study revealed patients on efavirenz based showed statistically significant (p = 0.030) decrease in HDL-C concentration as compared to dolutegravir based antiretroviral therapy users. The mean values of neutrophil was statistically significantly lower (p= 0.009) among dolutegravir based ART users. Moreover, the mean values of platelet count was statistically significantly higher (p = 0.033) in the efavirenz than the dolutegravir based antiretroviral groups. Viral load suppression rate among dolutegravir and efavirenz based antiretroviral therapy users were 94.6% and 86.7% respectively. Conclusion: Compared with efavirenz, dolutegravir based ART showed a better lipid profile and significant improvements in erythroid and lymphoid cell lines with lower prevalence of anaemia. Whereas, efavirenz significantly improved ameliorated platelet indices compared with dolutegravir based ART. Both of treatment regimens showed comparable efficacy in viral load suppression.
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.
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.
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.
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.
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.
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.
Serum Analysis of Major Biochemical Changes among Patients with Multi-drug Resistant Tuberculosis (MDR-TB) in Mekelle Hospital, Tigray, Ethiopia
(Addis Abeba University, 2014-07) Berhe, Desalegn Teklu; Dr.Seifu, Daniel; Dr.Desalegn, Fikreselam
Introduction: Adverse drug reaction (ADRs) defined as: any unintended adverse response to a drug occurring at a therapeutic dose and resulting in either death, drug withdrawal, change in the administration of the frequency or dose of the drug, is one of the major concerns about SLDs to treat MDR-TB. Hypothyroidism, liver toxicity, renal dysfunction and electrolyte disturbances have been reported among the prevalent ADRs during MDR-TB treatment. However, these ADRs had not investigated in Ethiopia. Objectives: The aim of this study was to investigate the sero- prevalence of adverse drug reactions (ADRs) and associated risk factors among MDR-TB patients with second line drugs. Methods: this prospective, observational cohort study was carried out from August 2013 to April 2014 in Mekellle Hospital. 68 confirmed pulmonary MDR-TB patients by Tigray Regional Laboratory were followed and evaluated for ADRs development during the study period. Routine laboratory test according to ADRs monitoring schedule was done in Ayder Referral Hospital in collaboration with Mekelle Hospital. Demographic and clinical information were extracted from standardized clinical files. Results: There were 67.6% male and 32.4% female patients. The mean patient age was 32.62 ± (11.173) years. Among the 68 patients screened for adverse drug reactions, electrolyte related abnormality (hypokalemia 47/68(69.11%), hypomagnesaemia18/68(26.47%) and hypocalcaemia 8/68(11.76 %) was 83.80%, nephrotoxicity 22/68(32.35%), hypothyroidism16/68(23.53%) and hepatotoxicity 10/68(14.71%) were recorded. Conclusions: High rate of hypokalemia, nephrotoxicity, hypothyroidism and hepatotoxicity was observed in this cohort. This is a treatable and reversible; however, it may go undiagnosed in the absence of regular monitoring. Care providers should not wait for clinical symptoms, as this risks compromising treatment adherence. Electrolyte related abnormalities and renal toxicity was the most prevalent among others. Higher magnitude of ADRs was observed among older, females and HIV co-infected patients on ART/anti-TB.

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