Unprecedented land use and land cover (LULC) changes in the Gilgel Tekeze catchment of the upper Nile River basin in Ethiopia may have far-reaching consequences for the long-term sustainability of the natural resources base. This study analyzed the dynamics and hydrologic effects of LULC changes between 1976 and 2003 as shown in satellite imagery. The effects of these LULC changes on the hydrologic response were investigated using the WetSpa model to estimate spatially distributed average annual evapotranspiration, surface runoff, and groundwater recharge. Digital image analysis revealed major increments of cultivated land and settlements of 15.4 and 9.9%, respectively, at the expense of shrubland and grazing lands. Population growth and the associated demand for land were found to be the major driving forces. The WetSpa simulation showed an increase in annual surface runoff of 101 mm and a decrease in groundwater recharge of 39 mm over the period 1976-2003. These results signify an increasing threat of moisture unavailability in the study area and suggest that appropriate land management measures under the framework of the integrated catchment management (ICM) approach are urgently needed.
Background
Adverse drug reactions (ADRs) have continued to be a public health challenge with significant clinical and healthcare costs. However, little is known regarding the incidence of ADR in Ethiopia, particularly in the study setting. Thus, this study aimed to assess the incidence and patterns of ADRs in patients admitted to the University of Gondar comprehensive specialized hospital (UoGCSH).
Methods
A prospective observational follow-up study was conducted on admitted patients at the medical ward in the UoGCSH from May to August 2022. A multifaceted approach involving daily chart review and patient interviews was employed to collect the data. A standard Naranjo ADR Probability Scale measuring tool was used to characterize the probability of existing ADR. The data was analyzed using the Statistical Package for Social Sciences (SPSS) version 25. Logistic regression analysis was employed to determine the association between the occurrence of ADRs and other variables. A p-value at the 95% confidence interval was considered statistically significant.
Results
This study included 237 participants in total. The average length of follow-up was 16.4 (±5.2) days. Overall, 65 ADRs were identified, resulting an incidence rate of 27.4 (95% CI: 19.8–30.4) per 100 admissions. The most common ADRs were hypokalemia (10.7%), followed by constipation, diarrhea, hypotension, and rash (9.2% each). The majority of these ADRs (73.8%) were classified as "definite" by the Naranjo ADR probability scale. Gastrointestinal tract (GIT) (41.5%) and metabolic (18.6%) were the most frequently exposed systems for ADR. Antibiotics (26.2%) and cardiovascular medications (24.7%) were the most frequently implicated medications in existing ADRs. ADRs were significantly associated with age (p = 0.035), the presence of comorbidities (p = 0.021) and complications (p = 0.008), and receiving a higher number of medications (p = 0.04).
Conclusion
In this study, ADR was identified in about one-fourth of the participants. Older patients, patients with comorbidities and complications, and patients who received a higher number of medications were more likely exposed for ADRs. Healthcare providers should strictly follow the admitted patients to minimize ADRs.
The resistance to surface and subsurface damage during lubricated rolling-sliding wear of a carburised low-alloy sintered steel and the effect of shot peening were investigated. The formation of both contact fatigue cracks and of brittle tensile cracks may be predicted by a theoretical model that was experimentally validated. Carburising is effective in increasing the resistance to contact fatigue, but pores in a hard and brittle matrix may act as pre-existing cracks. Shot peening increases the contact fatigue resistance since compressive residual stresses oppose the nucleation of surface cracks.
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