Introduction. World health organization estimates that more than half a million women lose their lives in the process of reproduction worldwide every year and most of these mortalities are avoidable if mothers have access to maternal health care services. Objectives. This study was conducted with objectives of determining the prevalence of utilization of maternal health care services and identifying factors affecting it. Methodology. A community based cross-sectional survey was conducted in six kebeles of Kombolcha district. A total of 495 women of reproductive age participated in the study and their selection was made using simple random sampling technique and data was collected using an interviewer-administered structured questionnaire. The data was analyzed using SPSS version 16. Results. A total of 495 women were included in this study and from these women about 86.1% had at least one ANC visit during their last pregnancy. About 61.7% of mothers had less than four visits which is less than the recommended and 46.2% started it in the second trimester. Only 25.3% of respondents gave birth in health institutions and rural women were less likely to use institutional delivery 20.9% compared to urban women 35.9%. Recommendations. More efforts should be given to educate society in general and mothers in particular, to strengthen community participation and to increase the accessibility of maternal health care services. Moreover, providing accurate information about the services provided in the health institutions is required from the concerned governmental and nongovernmental organizations.

BackgroundA significant barrier to organ transplantation is the cellular rejection that occurs and mediated by antibodies, T cells, and innate immune cells. This study was aimed to determine the number of CD4+CD25+Foxp3+ Treg, CD4+IFN-γ−IL-17+ Th17, CD4+IFN-γ+IL-17− Th1 and CD4+IFN-γ+IL-17+ Th1/17 cells in renal transplant recipients (RTR).MethodsRenal transplantation was performed for a total of 35 patients with end-stage renal failure. The number of CD4+CD25+Foxp3+ Treg, CD4+IFN-γ−IL-17+ Th17, CD4+IFN-γ+IL-17− Th1 and CD4+IFN-γ+IL-17+ Th1/17 cells, and the serum level of IFN-γ, TNF-α, IL-2, IL-4, IL-6, IL-10, and IL-17 were measured in pre- and post-transplant patients and 10 healthy controls (HC) using flow cytometry and Cytometric Bead Array (CBA). The association between the number of different subsets of CD4+ T-cells and clinical parameters were analyzed among the pre- and post-transplant patients, and the healthy controls.ResultsThe number of CD4+IFN-γ−IL-17+ Th17, CD4+IFN-γ+IL-17− Th1 and CD4+IFN-γ+IL-17+ Th1/17 cells were significantly increased in patients with End-Stage Renal Failure (ESRF) compared to the HC. Stratification analysis indicated that AMR (Acute antibody mediated acute rejection), AR (acute rejection) and CR (chronic rejection) groups displayed greater number of CD4+IFN-γ−IL-17+ Th17, CD4+IFN-γ+IL-17− Th1 and CD4+IFN-γ+IL-17+ Th1/17 cells as well as high level of serum IL-2, IFN-γ, TNF-α and IL-17. But, the AMR, AR and CR groups have shown lower level of CD4+CD25+Foxp3+ T cells and serum IL-10 compared to transplant stable (TS) patients. Moreover, the number of Tregs were negatively correlated with the number of Th17 cells in RTR patients. The number of Tregs and Th17 cells were positively correlated with the eGFR and serum creatinine values, respectively.ConclusionThe imbalance between different types of CD4+ T cells and dysregulated inflammatory cytokines may contribute towards renal transplantation rejection.

This aim of this study was to assess the potential role of IL-33 in the pathogenic process of chronic hepatitis B (CHB). The levels of serum IL-33 and soluble ST2 (sST2) in CHB patients and healthy controls (HC) were determined using enzyme-linked-immunosorbent serologic assay, and the Th1 (IFN-γ, TNF-α, IL-2) and Th2 (IL-4, IL-6, IL-10) cytokines by cytometric bead array. It was found that the levels of serum IL-33 in CHB patients were significantly higher than that of HC at the base line, but decreased after treatment with adefovir dipivoxil for 12 weeks. The levels of serum sST2, as a decoy receptor of IL-33, were significantly higher in CHB patients than the HC. There was no correlation between the levels of serum sST2 and IL-33. The concentrations of serum Th1 (IFN-γ, IL-2) and Th2 (IL-6, IL-10) cytokines in CHB patients significantly increased after treatment compared to the baseline. These results suggest that IL-33 is involved in the pathogenesis of CHB and that adefovir dipivoxil therapy can attenuate the production of IL-33 in patients with CHB.

Background:Outbreaks of healthcare-acquired infections have been linked to contaminated medical devices such as electronic thermometers, sphygmomanometers, stethoscopes, latex gloves, masks, neckties, white coats and other.Objective:The aim of this study was to assess non-critical healthcare tools as a potential source of healthcare-acquired bacterial infections and associated factors in public health hospitals of Harar, eastern Ethiopia from March 2016 to February 2017.Methods:A hospital-based cross-sectional study was conducted on 212 non-critical healthcare tools owned by different health professionals. The data were collected from each owner using self-administered questionnaire. Swab specimens were collected from 187 stethoscopes and 25 sphygmomanometers using sterile cotton tips. Bacterial investigation and antimicrobial susceptibility tests were performed using standard culture tests. The data were double entered into EPI-Data version 3.1 and exported into the Statistical Package for Social Sciences version 16 for analysis.Result:The overall prevalence of non-critical healthcare tool contamination was 53.8%. A total of 137 bacterial strains were isolated. Staphylococcus aureus was the most frequent isolate (35%). Resistance to two or more different classes of antimicrobial was found to be 19.3%. The proportion of stethoscopes or sphygmomanometers contamination owned by the health professionals who were not cleaned regularly before and after examining each patient was found to be high (77%). The majority of non-critical healthcare tools used by health professionals working in the intensive care unit were contaminated (75%) followed by medical wards (73.5%).Conclusion:This study confirmed that the majority of the stethoscopes and sphygmomanometers were contaminated with pathogenic bacteria known to be associated with healthcare-acquired infections. Most of the healthcare workers did not practice stethoscope and sphygmomanometers disinfection. Strict and careful decontamination of stethoscopes and sphygmomanometers need to be in place before use.

IL-37 is a new anti-inflammatory cytokine that plays an important role in protecting against tissue injury during infections via limiting immune and inflammatory reactions. This study aimed at determining serum IL-37 concentrations and HBeAg seroconversion in chronic hepatitis B virus (HBV) patients during Telbivudine (LDT) treatment. The serum levels of IL-37 were determined using enzyme-linked immunosorbent assay (ELISA) in 40 chronic hepatitis B virus infection (CHB) patients (HBeAg positive), 30 chronic hepatitis C virus infection (CHC) patients [25 with spontaneously resolved hepatitis C virus (SR-CHC)], and 30 healthy controls (HCs). Anti-inflammatory cytokines such as IL-2 and IL-10 were measured using cytometric bead array, and the concentrations of clinical parameters such as serum hepatitis B surface antigen (HBsAg), hepatitis B nucleocapsid antigen (HBeAg), alanine transaminase (ALT), aspartate transaminase (AST), HBV DNA, and hepatitis C virus (HCV) RNA loads were measured. It was found that the serum levels of IL-37 were higher in chronic HBV patients with high virus loads, but the association was not statistically significant. The serum levels of IL-37 were decreased in HBeAg seroconverted CHB patients after 48 weeks of LDT treatment. The serum levels of IL-37 had no significant difference in CHC patients compared with SR-HCV and HCs. The levels of anti-inflammatory cytokine, IL-2 and IL-10, were lower in CHB and CHC patients than the HC, but IL-2 levels increased after LDT treatment in CHB patients. The concentrations of serum IL-37 in CHB and CHC patients with abnormal levels of serum ALT ( > 50 U/L) or AST ( > 40 U/L) were significantly higher than CHB, CHC patients with normal levels of ALT ( < 50 U/L) or AST ( < 40 U/L). These results suggest that IL-37 may play a significant role in the immune response of CHB patients with HBeAg seroconversion. The serum levels of IL-37 are associated with liver damage in CHB patients.