Background Cirrhosis and other chronic liver diseases (collectively referred to as cirrhosis in this paper) are a major cause of morbidity and mortality globally, although the burden and underlying causes differ across locations and demographic groups. We report on results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 on the burden of cirrhosis and its trends since 1990, by cause, sex, and age, for 195 countries and territories. Methods We used data from vital registrations, vital registration samples, and verbal autopsies to estimate mortality. We modelled prevalence of total, compensated, and decompensated cirrhosis on the basis of hospital and claims data. Disability-adjusted life-years (DALYs) were calculated as the sum of years of life lost due to premature death and years lived with disability. Estimates are presented as numbers and age-standardised or age-specific rates per 100 000 population, with 95% uncertainty intervals (UIs). All estimates are presented for five causes of cirrhosis: hepatitis B, hepatitis C, alcohol-related liver disease, non-alcoholic steatohepatitis (NASH), and other causes. We compared mortality, prevalence, and DALY estimates with those expected according to the Socio-demographic Index (SDI) as a proxy for the development status of regions and countries. Findings In 2017, cirrhosis caused more than 1•32 million (95% UI 1•27-1•45) deaths (440 000 [416 000-518 000; 33•3%] in females and 883 000 [838 000-967 000; 66•7%] in males) globally, compared with less than 899 000 (829 000-948 000) deaths in 1990. Deaths due to cirrhosis constituted 2•4% (2•3-2•6) of total deaths globally in 2017 compared with 1•9% (1•8-2•0) in 1990. Despite an increase in the number of deaths, the age-standardised death rate decreased from 21•0 (19•2-22•3) per 100 000 population in 1990 to 16•5 (15•8-18•1) per 100 000 population in 2017. Sub-Saharan Africa had the highest age-standardised death rate among GBD super-regions for all years of the study period (32•2 [25•8-38•6] deaths per 100 000 population in 2017), and the high-income super-region had the lowest (10•1 [9•8-10•5] deaths per 100 000 population in 2017). The age-standardised death rate decreased or remained constant from 1990 to 2017 in all GBD regions except eastern Europe and central Asia, where the age-standardised death rate increased, primarily due to increases in alcohol-related liver disease prevalence. At the national level, the age-standardised death rate of cirrhosis was lowest in Singapore in 2017 (3•7 [3•3-4•0] per 100 000 in 2017) and highest in Egypt in all years since 1990 (103•3 [64•4-133•4] per 100 000 in 2017). There were 10•6 million (10•3-10•9) prevalent cases of decompensated cirrhosis and 112 million (107-119) prevalent cases of compensated cirrhosis globally in 2017. There was a significant increase in age-standardised prevalence rate of decompensated cirrhosis between 1990 and 2017. Cirrhosis caused by NASH had a steady age-standardised death rate throughout the study period, whereas the ot...

Background About 425 million adults had diabetes mellitus globally in 2017. Type 2 diabetes accounts for the enormous majority of diabetes cases and it is gradually growing which is predicted to increase by 48% in 2045. Imbalanced cellular carbohydrate and lipid metabolism cause an increase in postprandial blood glucose level which eventually leads to the onset and progression of type 2 diabetes mellitus. The lack of effective and safe carbohydrate hydrolyzing enzyme inhibitors contributes to the increasing prevalence. Thus, this study was targeted to assess the α-amylase inhibitory potential of isolates obtained from Aloe megalacantha Baker and Aloe monticola Reynolds, which are among the commonly used folkloric remedies for the management of diabetes mellitus. Method The α-amylase inhibitory effect of Aloe megalacantha Baker and Aloe monticola Reynolds were evaluated using the 3,5-dinitro salicylic acid method. 2, 2-Diphenyl-2-picrylhydrazyl free radical scavenging property was also used to test the antioxidant effect of both plants. Results were analysed using GraphPad Prism software version 8. Results The more polar isolates (AM 1 and AG 1 ) were possessed stronger α-amylase inhibition activity than the leaves latex and the other strains (AM 2 and AG 2 ). Leaf latex of A. megalacantha , AM 1 , AM 2 , leaf latex of A. monticola , AG 1 , and AG 2 were found to have an IC 50 value of 74.76 ± 1.98, 37.83 ± 3.31, 96.75 ± 1.98, 78.10 ± 1.88, 56.95 ± 1.88 and 64.03 ± 3.60 μg/mL, respectively ( P < 0.001 ). The leaf latexes of A. megalacantha and A. monticola showed a significant ( P < 0.001 ) free radical hunting property with an IC 50 value of 890.1 ± 1.73 and 597.5 ± 2.02 μg/mL, respectively. Conclusion Hence, the outcomes of the present investigation partly justify the acclaimed use of Aloe megalacantha and Aloe monticola for the treatment of diabetes.

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Introduction Medication non-adherence is a major public health problem among diabetes mellitus patients. However, there is a lack of data regarding its magnitude and the factors contributing to Ethiopia’s non-adherence, especially in the Tigrai region. This study was conducted to assess the magnitude of non-adherence and its contributing factors among diabetes mellitus patients in the Eastern Zone of Tigrai, Northern Ethiopia. Materials and Methods A hospital-based cross-sectional study was conducted at Adigrat and Wukro General Hospitals using a pre-tested, self-administered, semi-structured questionnaire developed from the relevant literature and a checklist developed to review patient medical cards for the period of the 15th of March to the 15th of July, 2019. Data were analyzed using Statistical Package for Social Sciences version 20. Association between the dependent and the independent variable was performed using logistic regression and a p-value of <0.05 was considered significant. Results From a total of 321 study participants, 63.9% of the patients were non-adherent to their medications. Two-month dose issued on each visit (AOR = 2.865, 95% CI 1.380–5.949), dose issued for more than three months (AOR = 4.314, 95% CI 1.526–12.195), monthly income below 500 birr (AOR = 5.048, 95% CI 2.094–12.168), monthly income between 500 and 2000 birr (AOR = 2.593, 95% CI 1.032–6.517), distance greater than 24 kilometers from hospital to home (AOR = 10.091, 95% CI 3.509–29.020), more than four prescribed medications per visit (AOR=7.192, 95% CI= 2.171–23.824), never receiving counseling (AOR=22.334, 95% CI= 9.270–53.810), and diabetes-related admission (AOR=0.248, 95% CI= 0.078–0.789) were significantly associated with patients’ non-adherence to diabetes mellitus medications. Conclusion The level of diabetic medication adherence was suboptimal, and our study highlights that better monthly earning, nearby health-care accessibility, fewer prescribed medication, and getting appropriate counseling about diabetes mellitus were predictive of adherence to medications. Hence, an urgent intervention targeting the development of guidelines that involve these determinates should be employed to improve health care.