Ethiopian Journal of Health Sciences <p><em>Ethiopian Journal of Health Sciences</em> is a general health science journal addressing clinical medicine, public health and biomedical sciences. In rare instances, it covers veterinary medicine.</p>Other websites related to this journal: <a title="" href="" rel="nofollow" target="_blank"></a> Jimma University en-US Ethiopian Journal of Health Sciences 1029-1857 Copyright belongs to the journal. Editorial: Minimizing Preventable Deaths: The Should Be Focus In Ethiopian Health System No Abstract A Haileamlak Copyright (c) 2014-04-14 2014-04-14 24 2 100 100 10.4314/ejhs.v24i2. Prevalence of Shigella, Salmonella and Cmpylobacter Species and Their Susceptibility Patters Among Under Five Children With Diarrhea in Hawassa Town, South Ethiopia <p><strong>Background</strong>: Diarrhea is the leading cause of morbidity and mortality in under-five children in developing countries including Ethiopia. Therefore, up-to-date data on etiologic agent and susceptibility pattern are important for the management of bacterial diarrhea in under-five children, which was the main objective of this study.<br /><strong>Method</strong>: A cross-sectional study was conducted at Hawassa Adare Hospital and Millennium Health Center from June 6 to October 28, 2011. A total of 158 under-five children with diarrhea were selected using convenient sampling technique. Demographic and clinical data were collected using questionnaire. Fecal samples were collected and processed for bacterial isolation, and antimicrobial susceptibility testing following standard bacteriological techniques.<br /><strong>Results</strong>: A total of 158 fecal samples were collected from 81(51.3%) males and 77(48.7%) females of underfive children with diarrhea. Of the 158 fecal samples, 35(22.2%) bacterial pathogens were isolated. The isolated bacteria were Campylobacter species, 20 (12.7%), Shigella species, 11 (7.0%), and Salmonella species, 4 (2.5%). The majority of the isolates were sensitive to Chloramphenicol, Ciprofloxacin, Nalidixic acid and Cotrimoxazol and high rate of drug resistance was observed against Erythromycin and Amoxicillin.<br /><strong>Conclusions</strong>: The finding of this study indicates that Campylobacter species were the predominant etiologies and the presence of bacterial isolates resistant to the commonly prescribed drugs for treating diarrhea in children. Therefore, periodic monitoring of etiologic agent with their drug resistant pattern is essential in the management of diarrhea in children.</p><p><strong>Keywords:</strong> Diarrhea, Bacterial pathogen, Antimicrobial drugs, Under-five children, Hawassa, Ethiopia</p> M Getamesay B Getenet Z Ahmed Copyright (c) 2014-04-14 2014-04-14 24 2 101 108 10.4314/ejhs.v24i2.1 The Status of Iodine Nutrition and Iodine Deficiency Disorders among School Children in Metekel Zone, Northwest Ethiopia <p><strong>Background</strong>: Iodine deficiency disorders are serious public health problems in Ethiopia. The aim of this study was to measure the prevalence and severity of iodine deficiency disorders among school children in Metekel Zone.<br /><strong>Methods</strong>: A cross-sectional school based descriptive study was conducted between February 2011 and July 2012. One school containing 750 children aged between 6 and 18 years was randomly selected. Two hundred students from this school were selected by systematic random sampling. Physical examination was made according to WHO goiter classification system; 50 salt samples from households to which the sampled children belonged were tested for iodine using rapid field test kits and titration; a casual urine sample (5 ml) was taken from 30 children to measure urinary iodine spectrophotometrically, and 5 ml venous blood sample were collected from 37 children to measure thyroid relevant blood constituents using ELISA.<br /><strong>Results</strong>: The total goiter prevalence was 39.5%; 60% of the salt samples contained no iodine. The median urinary iodine concentration ranged from 20.54 – 62.2 (39.9 μg/L). School children who were assessed for thyroid hormones showed 18.92% elevated and 27.03% suppressed TSH levels.<br /><strong>Conclusion</strong>: The study demonstrated that iodine deficiency is still a severe public health problem in Metekel Zone. There is a need to further strengthen the existing controlling and monitoring system in order to achieve proper elimination of IDDs in the community.<br /><strong></strong></p><p><strong>Keywords</strong>: Iodine deficiency disorder, iodized salt, urinary iodine concentration, thyroid functions</p> G Kibatu E Nibret M Gedefaw Copyright (c) 2014-04-14 2014-04-14 24 2 109 116 10.4314/ejhs.v24i2.2 Use of Complementary and Alternative Medicine for Work Related Musculoskeletal Disorders Associated with Job Contentment in Dental Professionals: Indian Outlook <p><strong>Background:</strong> High prevalence rates of work-related musculoskeletal disorders (WRMSD) among dentists have been reported. Complementary and alternative medicine (CAM) therapies can be helpful in managing and preventing work-related musculoskeletal disorders. The purpose of this study was to determine if dental professionals are using CAM for work-related musculoskeletal disorders. Who have greater job satisfaction: dentist who uses Complementary and alternative medicine (CAM) or conventional therapy (CT) as a treatment modality for WRMSD<br /><strong>Method</strong>: Dentists who registered in Uttar Pradesh state, India under Indian Dental Council, Uttar Pradesh branch (n=1134) were surveyed. Data were analyzed using univariate and bivariate analyses and logistic regression.<br /><strong>Result</strong>: A response rate of 53% (n=601) was obtained, revealing that 82% (n=487) of the respondents suffered from work-related musculoskeletal disorders. The use of complementary and alternative medicine or conventional therapy was reported among 80% (n=390) of the dentists with work-related musculoskeletal disorders. Complementary and alternative medicine users reported greater overall health compared to conventional therapy users (P&lt;0.001). Of those with work-related musculoskeletal disorders, 35.5% (n=172) considered a career change for once, and 4.0% (n=19) reported having left dentistry.<br /><strong>Conclusion</strong>: Complementary and alternative medicine therapies may improve quality of life, reduce work disruptions and enhance job satisfaction for dentists who suffer from work-related musculoskeletal disorders. It is important that dentists incorporate complementary and alternative medicine strategies into practice to facilitate musculoskeletal health that will enable longer and healthier careers, increase productivity, provide safer workplace and prevent musculoskeletal disorders.</p><p><strong>Keywords</strong>: CAM, dentist, musculoskeletal disorders</p> G Devanand BD John GK Rajendra K Bushra K Alpana J Ankita Y Ankit S Priya A Satya S Neha Copyright (c) 2014-04-14 2014-04-14 24 2 117 124 10.4314/ejhs.v24i2.3 Analysis of Diagnostic Value of Cytological Smear Method Versus Cell Blocks Method in Body Fluid Cytology: Study of 150 Cases <p><strong>Background</strong>: Aspiration of serous cavities is a simple and relatively non-invasive technique to achieve diagnosis. Cytologic evaluation of body cavity fluid is diagnostically challenging.<br><strong>Methods</strong>: A total of 150 fluid specimens were examined for conventional cytological smear (CS) and cell block method (CB). Out of 150 fluids, 79 were pleural fluid, 69 were ascitic fluid and 2 pericardial fluid. Each fluid specimen was divided in two equal parts: one part was subjected to conventional smear technique, while the other part was subjected to 10% alcohol-acetic acid-formalin cell block technique. Overall morphological details, cellularity, architecture, nuclear and cytoplasmic details were studied in both CS and CB techniques.<br><strong>Results</strong>: In this study, the utility of the CB method in the cytodiagnosis of malignant effusions was found to be highly significant as compared to the CS method. The additional yield of malignancy was 10% more as was obtained by the CB method.<br><strong>Conclusion</strong>: For the final cytodiagnosis of body fluid, there is statistically significant difference between the two techniques. In other words, CB is superior to CS method.</p> <p><strong>Keywords</strong>: Cell block, Cytodiagnosis, Effusion</p> Bhanvadia Viral M. Santwani P.M. Vachhani J.H. Copyright (c) 2014-04-14 2014-04-14 24 2 125 130 10.4314/ejhs.v24i2.4 Predictors of Treatment Seeking Intention among People with Cough in East Wollega, Ethiopia Based on the Theory of Planned Behavior: A Community Based Cross -Sectional Study <p><strong>Background</strong>: Early treatment seeking for cough is crucial in the prevention and control of Tuberculosis. This study was intended to assess treatment seeking intention of people with cough of more than two weeks, and to identify its predictors.<br /><strong>Methods</strong>: A community based cross-sectional study was conducted among 763 individuals with cough of more than two weeks in East Wollega Zone from March 10 to April 16, 2011. Study participants were selected from eighteen villages by cluster sampling method. Data collection instruments were developed according to the standard guideline of the theory of planned behavior. The data were analyzed with SPSS 16.0. Multiple linear regression was used to identify predictors.<br /><strong>Results</strong>: Mean score of intention was found to be 12.6 (SD=2.8) (range of possible score=3-15). Knowledge (β=0.14, 95%CI: 0.07-0.2), direct attitude (β=0.31, 95%CI: 0.25-0.35), belief-based attitude (β=0.03, 95%CI: 0.02-0.06) and perceived subjective norm (β=0.22, 95%CI: 0.13 -0.31) positively predicted treatment seeking intention. However, perceived behavioral control and control belief were not significantly associated with treatment seeking intention (p&gt;0.05). Being smoker (β=-0.97, 95%CI:-1.65- (-0.37)) and higher family income (β=-0.06, 95%CI:-0.07-(-0.01) were significantly associated with lower treatment seeking intention.<br /><strong>Conclusion</strong>: TPB significantly predicted treatment seeking intention among the study participants. Attitude and silent beliefs held by the respondents play an important role and should be given emphasize in prevention and control of Tuberculosis.</p><p><strong>Keywords</strong>: Tuberculosis, Cough, Intention, Treatment, Theory of Planned Behavior<br /><strong></strong></p> Y Addisu Z Birhanu D Tilahun T Assefa Copyright (c) 2014-04-14 2014-04-14 24 2 131 138 10.4314/ejhs.v24i2.5 Preliminary Antiplaque Efficacy of <i>Aloe Vera</i> Mouthwash on 4 Day Plaque Re -Growth Model: Randomized Control Trial <p><strong>Background</strong>: Due to increasing resistance to antibiotics and rising incidence of oral diseases, there is a need for alternative treatment modalities to combat oral diseases. The aim of the present study was to access the effect of<em> Aloe vera</em> mouthwash on the dental plaque in the experimental period of 4 days and to compare it with the bench mark control chlorhexidine and placebo (saline water).<br /><strong>Material and Methods</strong>: A total of 300 systemically healthy subjects were randomly allocated into 3 groups: <em>Aloe vera</em> mouthwash group (n=100), control group (=100)–chlorhexidene group and saline water-Placebo (n=100). To begin with, Gingival index (GI) and plaque index (PI) were recorded. Then, baseline plaque scores were brought to zero by professionally cleaning the teeth with scaling and polishing. After randomization of the participants into three groups they were refrained from regular mechanical oral hygiene measures. Subjects were asked to swish with respective mouthwash <em>(Aloe vera</em> mouthwash, 0.2% chlorhexidine gluconate mouthwash, or normal saline) as per therapeutic dose for 4 days.<br /><strong>Results</strong>: The results showed that <em>Aloe vera</em> mouthrinse is equally effective in reducing plaque as Chlorhexidine compared to placebo over a period of 4 days. There was a significant reduction on plaque in<em> Aloe vera</em> and chlorhexidine groups and no statistically significant difference was observed among them (p&gt;0.05). <em>Aloe vera</em> mouthwash showed no side effects.<br /><strong>Conclusion</strong>: The results of the present study indicated that <em>Aloe vera</em> may prove an effective mouthwash due to its ability in reducing dental plaque.</p><p><strong>Keywords</strong>: Mouthwash, plaque, chlorhexidine</p> GR Kumar G Devanand BD John Y Ankit O Khursheed M Sumit Copyright (c) 2014-04-14 2014-04-14 24 2 139 144 10.4314/ejhs.v24i2.6 Occurrence of Urinary Tract Infection in Adolescent and Adult Women of Shanty Town in Dhaka City, Bangladesh <p><strong>Background</strong>: Urinary tract infection (UTI) is commonly experienced by women of various age groups especially elderly ones. We planned to find out the prevalent microbial strains causing UTI in slum inhabitant adolescent and adult women in Dhaka City, Bangladesh.<br /><strong>Methods amd Materials</strong>: Urine sample was collected from 462 UTI suspected female subjects. Pathogenic bacteria were identified using standard microbiological tests, and antimicrobial sensitivity profiles of the pathogens were determined.<br /><strong>Results</strong>: Bacteriuria was present in 9% of the subjects. A higher incidence (16.8%) of UTI was noted among adult women aged above 19 years. <em>Escherichia coli</em> (69%), <em>Streptococcus</em> spp. (15%) and <em>Pseudomonas aeruginosa</em> (7%) were more frequently isolated from the urine samples compared to <em>Enterococcus faecalis</em> (3%), <em>Staphylococcus aureus</em> (2%),<em> Klebsiella pneumoniae</em> (2%) and <em>Hafnia alvei</em> (2%). The<em> E. coli</em> isolates showed complete resistance to commonly used drugs, and 58% of these isolates were multidrug resistant (MDR). Minimum Inhibitory Concentration (MIC) values for ciprofloxacin ranged between 64μg/ml and 512μg/ml, and the Minimum Bactericidal Concentration (MBC) values against the isolates were 128μg/ml or above. Isolated strains of E. coli exhibited equal extent of ciprofloxacin resistance irrespective of the presence or absence of plasmid in them.<br /><strong>Conclusion</strong>: The extent of drug resistance among the uropathogens if ignored may render them uncontrollable. This study suggests regular monitoring of drug resistance phenotype of the UTI pathogens to reduce the morbidity of female UTI patients and offer better treatment strategy in the healthcare sectors of Bangladesh.</p><p><strong>Keywords</strong>: Urinary tract infection (UTI), Multidrug resistance (MDR), Adolescent women</p> SR Rahman MF Ahmed A Begum Copyright (c) 2014-04-14 2014-04-14 24 2 145 152 10.4314/ejhs.v24i2.7 Physical Activity and Pattern of Blood Pressure in Postmenopausal Women With Hypertension in Nigeria <p><strong>Background</strong>: Hormonal changes during menopause have been attributed to hypertension-a common public health concern. This study investigated physical activity (PA) and pattern of blood pressure (BP) in postmenopausal women newly diagnosed with hypertension and referred for treatment at the medicine outpatient clinic of a tertiary health facility in Ibadan, Oyo State, Nigeria. It compared BP pattern and adiposity variables [body mass index (BMI) and waist-hip ratio (WHR)] between two PA groups.<br /><strong>Methods</strong>: Purposive sampling technique was used to recruit 220 participants in this cross-sectional survey after obtaining their informed consent. International Physical Activity Questionnaire was used to assess PA level, while a 16-item questionnaire was used to assess socio-demographic and clinical profiles of the women. BP, BMI and WHR were assessed using standard measurement procedures. Descriptive statistics of mean ± standard deviation were used for data summarization and independent t-test was used to compare variables between low level and moderate to vigorous level PA groups.<br /><strong>Results</strong>: Participants’ mean values include: age 61.6 ± 8.5 years, years since menopause 12.75± 8.15, BMI 28.63±4.99kg/m<sup>2</sup>, WHR 1.11±0.08, SBP and DBP 145.9±17.9; 93.7±11.4 mmHg respectively. Mean values of SBP, DBP, BMI and WHR were higher among participants with low PA compared to those with moderate to vigorous even though the difference was not statistically significant (P&gt;0.05).<br /><strong>Conclusion</strong>: Involvement in moderate to vigorous physical activities among menopausal women in Nigeria should be encouraged. This may reduce hypertension and adiposity with a possible control of cardiovascular disease risk.</p><p><strong>Keywords</strong>: Postmenopausal, Hypertension, Physical Activity, Blood Pressure, Adiposity</p> OO Ogwumike AF Adeniyi BT Dosa AO Sanya KO Awolola Copyright (c) 2014-04-14 2014-04-14 24 2 153 160 10.4314/ejhs.v24i2.8 Prevalence and Risk Factors of Depression in Ethiopia: A Review <p><strong>Background:</strong> Depression is the most common and disabling mental illness in the globe. It accounts for about 6.5% of the burden of diseases in Ethiopia. Regardless of its severity and relapse rate, there are no synthesized evidences about its prevalence and potential risk factors in Ethiopia. The aim of this review was thus to synthesize scientific information about the prevalence and potential risk factors of depression in Ethiopia.<br /><strong>Methods:</strong> Out of 37 papers, 31 were collected from PubMed, Medline and Google Scholar electronic databases, and the remaining six from Addis Ababa University, Department of Psychiatry. But, 13 articles were removed after reading the titles; five after reading the abstracts and two after reading the manuscripts and five of them were duplicates. Finally, 12 papers were reviewed and the pooled prevalence was also computed.<br /><strong>Results:</strong> The pooled prevalence of depression for the five studies, which had used Composite International Diagnostic Interview (CIDI), was 6.8% (95%, CI: 6.4-7.3); but, it increased to 11% (95% CI: 10.4-11.5) when three other studies that had used other screening tools were included. Demographic variables such as sex, age, marital status, violence, migration and substance use were associated with depression, but not with economic factors.<br /><strong>Conclusions:</strong> More attention should be given to socio-demographic risk factors and intimate partner violence, since they are potential risk factors of depression. The prevalence of depression in Ethiopia was also found comparable to that of some high-income countries.</p><p><strong>Keywords:</strong> Depression, risk factors of depression, impact of depression, prevalence, Ethiopia</p> T Bitew Copyright (c) 2014-04-14 2014-04-14 24 2 161 169 10.4314/ejhs.v24i2.9 The Ironies of Human Mind: A Case of Rett Syndrome <p><strong>Background:</strong> Rett Syndrome (RS) is a chromosome X-linked genetic neurological disorder characterized by developmental regression, particularly in relation to expressive language and use of the hands. It is also associated with profound mental retardation and almost exclusively affects females.<br /><strong>Case Details:</strong> A four and a half year old girl reported to our dental OPD for a dental checkup. On complete examination, she was diagnosed to be suffering from Rett Syndrome. Preventive therapies and proper oral hygiene instructions were explained to her mother.<br /><strong>Conclusion:</strong> Early diagnosis of such disorders is extremely important along with treatment of patients’ problems with love and care to prevent them from further pain and stress.</p><p><strong>Keyowrds</strong>: Rett Syndrome, stereotypic hand movements, behavior therapy.</p> S Chattopadhyay R Arora Copyright (c) 2014-04-14 2014-04-14 24 2 171 174 10.4314/ejhs.v24i2.10 Presence of Multiple Tendinous Insertions of Palmaris Longus: A Unique Variation of a Retrogressive Muscle <p><strong>Background:</strong> Palmaris longus, being the most variable muscle of the upper extremity is generally considered important morphologically rather than functionally. The palmar aponeurosis represents the distal part of the tendon of Palmaris longus.<br /><strong>Case Details:</strong> We report here a unique case of palmaris longus presenting variation distally as its tendon divides to gain multiple attachments with the fascia covering the abductor pollicis brevis, flexor retinaculum and the tendon of flexor carpi ulnaris. In addition, it also continues as palmar aponeurosis as its normal course.<br /><strong>Conclusion:</strong> Presence of this kind of variation might result in compression of the median and ulnar nerves and may aggravate the complications in case of inflammation of palmar aponeurosis thus mimicking the manifestations of Dupuytren’s contracture.</p><p><strong>Keywords:</strong> Palmaris longus, palmar aponeurosis, Dupuytren’s contracture </p> K Naveen P Jyothsna RS Swamy SD Shetty P Abhinitha KB Rao Mohandas SB Nayak Copyright (c) 2014-04-14 2014-04-14 24 2 175 178 10.4314/ejhs.v24i2.11 HIV Patient with Mucous Membrane Pemphigoid: A Case Report <p><strong>Background:</strong> Mucous Membrane Pemphigoid, a new denomination of cicatricial pemphigoid, encompasses a group of chronic subepithelial autoimmune blistering diseases that predominantly affect the oral cavity and the eyes (conjunctivitis and symblepharon).<br /><strong>Case Details</strong>: A rare case of Mucous Membrane Pemphigoid (MMP) in a human immunodeficiency virus (HIV) positive patient is discussed with clinicohistopathological presentation.<br /><strong>Conclusion:</strong> Since our patient was HIV-positive and had lesions restricted to the oral mucosa with ocular involvement, only topical and intralesional steroids were preferred as the first line of treatment. Systemic corticosteroid therapy raises a concern regarding immunosuppression.</p><p><strong>Keyword</strong>s: HIV, MMP, Cicatricial pemphigoid.</p> AP Singh TR Chaitra TL Ravishankar SP Singh AK Mohapatra Copyright (c) 2014-04-14 2014-04-14 24 2 179 182 10.4314/ejhs.v24i2.12 Traumatic Bone Cyst of Idiopathic Origin? A Report of Two Cases <p><strong>Background</strong>: Traumatic bone cyst (TBC) is an uncommon non-epithelial lined cavity of the jaws. Traumatic bone cysts have been reported in the literature under a variety of names: solitary bone cyst, haemorrhagic bone cyst, extravasation cyst and simple bone cyst. The multitude of names applied to this lesion implies the lack of understanding of the true aetiology and pathogenesis. However, the term "traumatic bone cyst" is the most widely used name today (1).<br /><strong>Case Details:</strong> A 15 years old male patient presented with a complaint of swelling with mild, intermittent and non-radiating pain in the lower left back teeth region. There was expansion of the buccal cortical plate. Radiograph showed a multilocular lesion straddling between the roots of the teeth. In addition, 21 years old male patient came with a complaint of swelling with mild, continuous pain in the lower left jaw region. OPG showed well defined radiolucency with scalloped borders extending from the periapical region of the 1<sup>st</sup> premolar until the 2<sup>nd</sup> molar. The radiolucency was seen extending between the roots of the involved teeth.<br /><strong>Conclusion:</strong> The majority of TBCs are located in the mandibular body between the canine and the third molar. Clinically, the lesion is asymptomatic in the majority of cases and is often accidentally discovered on routine radiological examination, usually as a unilocular radiolucent area with a "scalloping effect”. Since material for histologic examination may be scanty or non-available it is very often difficult for a definite histologic diagnosis to be achieved (1).</p><p><strong>Keywords:</strong> Traumatic bone cyst, idiopathic origin</p> K Satish S Padmashree J Rema Copyright (c) 2014-04-14 2014-04-14 24 2 183 187 10.4314/ejhs.v24i2.13