BackgroundMetabolic syndrome is a cluster of the most dangerous heart attack risk factors such as diabetes and prediabetes, abdominal obesity, high cholesterol and high blood pressure. Hyperuricemia is a condition in which the serum uric acid concentration is greater than 5.5 mg per deciliter for child and greater than 7.2 and 6.0 mg per deciliters for male and female adults respectively.MethodsA cross-sectional study was conducted to determine the magnitude of hyperuricemia and associated factors among type 2 diabetes mellitus patients at Hawassa Comprehensive Specialized Hospital (HCSH) from February 28 to May 30 /2017. A random sampling technique was used to include 319 study subjects and a signed consent had been provided by each study subject before running any data collection. An interviewer administered structured questionnaire was used to collect socio-demographic and some clinically useful data. In addition to this, we reviewed the records of the study subjects to obtain other useful clinical data. Five milliliter blood specimen was collected from each study subjects after overnight fasting. A25TM Bio-System Random Access chemistry analyzer was used for blood sample analysis. All data were checked visually, coded and entered into epi-data version 3.4 and statistical analysis was performed using SPSS version 20.0 software. Bi-variate and multivariate logistic regressions were used to determine the association between explanatory and the outcome variables.ResultsThe prevalence of hyperuricemia and metabolic syndrome among type 2 diabetic patients in the study area were 33.8%(n = 106) and 70.1% (n = 220) respectively. Having age greater or equal to 45 years (AOR: 1.9, CI: 1.-3.2, P value =0.015) and having metabolic syndrome (AOR: 2.6, CI: 1.5–4.7, P value = 0.001) were the determinant variables for hyperuricemia among type 2 diabetic patients.ConclusionThere was high prevalence of hyperuricemia among type 2 diabetic patients with high prevalence of metabolic syndrome. Therefore, regular health information about life style modification, early diagnosis and treatment for hyperuricemia and metabolic syndrome are essential to reduce hyperuricemia and metabolic syndrome in type 2 diabetic patients.

Background Highly active anti-retroviral therapy (HAART) prolongs the life span of people living with HIV (PLWHIV) and intensely reduces HIV-related morbidity and mortality. Globally, HIV-associated non-communicable diseases are becoming major public concerns, and chronic comorbidities have appeared as a substantial reason for morbidity and mortality in HIV patients with prolonged use of HAART. Purpose A cross-sectional study design was used to assess the magnitude of diabetes mellitus and risk factors among adult HIV patients exposed to HAART at Jimma Zone Public Hospitals from May to July 30, 2018. Patients and Methods A convenient sampling technique was used to include a total of 271 adult HIV patients on HAART visiting the selected health facilities at the time of data collection. Socio-demographic and clinical data were collected by interviewer-administered questionnaire and by reviewing patients’ record data. Bivariate and multivariate logistic regressions were used to identify variables that are independent predictors for diabetes mellitus. Results The prevalence of diabetes and pre-diabetes among PLWHIV exposed to HAART was 11.4% and 16.6%, respectively. The prevalence of diabetic dyslipidemia in PLWHIV exposed on HAART was 8.9% (n=24). Government workers (AOR: 0.17, 95% C.I=0.03–0.85, P=0.031), long duration in HAART use (AOR: 11.06, 95% C.I:1.03–18.67, P=0.047), hyper-triglyceridemia (AOR: 2.62,95% C.I:0.82, 8.39, P=0.005), LDL-C <130 mg/dl (AOR: 4.04, 95% C.I=1.33–12.30, P=0.014), and obesity (AOR: 9.62, 95% C.I: 1.01–91.52, P=0.049) were independent risk factors for diabetes mellitus in PLWHIV exposed to HAART. Conclusion Exposure to HAART increased the prevalence of diabetes mellitus in PLWHIV although it enhances quality of life, improves immune functions and prevents the onset of opportunistic infections. Therefore, regular screening for blood glucose level for PLWHIV on HAART is advisable.

The objective of this study was to assess selected serum electrolytes imbalance and associated factors in diabetic patients attending their follow up appointments in Jimma University Medical Center (JUMC) from February 1 to April 1, 2019. Patients and methods: A cross sectional study design was used to assess the selected serum electrolytes in diabetic patients attending their follow up appointments at Jimma University Medical Center (JUMC) chronic illness clinic. A convenience sampling technique was used to include 279 diabetic patients in the study and an interviewer based questionnaire was used to include all necessary data from each diabetic patient. Five milliliters of blood were collected from each subject and processed and analyzed for blood glucose and serum electrolyte determination by ABX Pentra400 and Humalyte plus 5 ion-selective electrode (ISE) system clinical chemistry analyzers. Pearson's correlation coefficient model and multivariate logistic regression were used respectively to assess the correlation and significant association between abnormal serum electrolytes and independent variables. Results: A high prevalence of one or more serum electrolyte abnormalities was determined in diabetic patients. The overall prevalence was 42.0% (n=116/276) in which hyponatremia was the highest followed by hypochloremia and hypercalcemia, 40.6%, 14.9% and 10.9% respectively. Age, type of medication, and high body mass index (BMI) had strong positive correlations with abnormal serum concentration levels of sodium (r=0.611, P=0.731), potassium (r=0.752, P=0.812) and chloride (r=0.645, P=0.459). Being employed (AOR: 3.933, 95% C.I: 1.057-14.637, P value: 0.041), treated with mixed medications (AOR: 2.9, 95% C.I: 1.292-6.441, P value: 0.010) and being unable to control blood glucose level or being hyperglycemic (AOR: 3.2, 95% C.I: 2.179-5.721, P value: 0.000) were statistically identified as risk factors for serum electrolyte abnormalities in diabetic patients. Conclusion:The serum electrolyte concentration level was highly abnormal in diabetic patients. The prevalence of abnormal concentration was more common in diabetic patients with advanced age, and some variables had strong positive correlation with abnormal serum electrolyte level in diabetic patients.

Toxoplasma gondii is an extremely widespread intracellular obligate parasite that infects both animals and birds. This protozoan pathogen usually causes asymptomatic infection in humans but can cause significant disease in congenitally infected infants, immunodeficient patients and occasionally in immunocompetent individuals. In the complex life cycle of T. gondii, sexual development occurs uniquely in felines whereas asexual reproduction may take place in humans and other warm-blooded animals serving as intermediate hosts. The prevalence of infection varies considerably among different geographic areas and also among individuals, depending on a variety of factors, including culinary habits and cleanliness of surroundings. Studies to date show low genetic diversity of T. gondii, with three main lineages, designated types I, II and III, found at least within Europe and North America. T. gondii uses various mechanisms to invade host cells and to alter their signal pathways and gene expression. Kinases within the rhoptry, a unique apical organelle, and T. gondii granule proteins are key virulence factors that promote attachment to, and invasion of, host cells. Human Toxoplasma infection is acquired by ingestion of raw or undercooked meat that contains tissue cysts, or through the ingestion of water or food contaminated with oocysts. It is also transmitted congenitally from motherto-foetus and less commonly by transfusion of contaminated blood or transplantation of an infected organ. Life-threatening toxoplasmosis can develop in immunocompromised patients. Diagnostic tests are critical to surveillance, control and prevention of toxoplasmosis. However, different technologies presently utilized around the world to detect different parasite stages are not of a uniformly sufficient standard to indicate clearly the epidemiology and severity of infection at global, regional and national levels. While a prophylactic vaccine is licensed for veterinary administration, no similarly efficacious preparation is available to prevent human infections. Here, we review the epidemiology and genotypes of T. gondii, as well as current detection methods and the state of vaccine development. In addition, the mechanisms by which this parasitic pathogen invades and overcomes the human immune system are considered.

Background: Hepatitis C virus (HCV) infection is a major global public health problem that causes profound metabolic abnormalities, primarily in insulin-sensitive target tissues, notably the phenomenon of steatosis or fatty liver. The route of transmission and genetic mutation of HCV, together with the lack of reliable nation-specific epidemiological data on the distribution of genotypes and sub-genotypes of this RNA virus, provide significant challenges to correct diagnosis and effective treatment. Issue: HCV-induced insulin resistance in HCV-infected individuals is independent of the occurrence of metabolic syndrome and diabetes mellitus, primarily type 2 diabetes mellitus that causes insulin resistance. Some but not all HCV genotypes exert a steatotic effect. However, the molecular mechanism(s) by which HCV infection causes insulin resistance in insulin target tissues or hepatic steatosis is not elucidated clearly. Findings: Mechanisms proposed by experimental studies include interference with insulin signaling pathways, upregulation of genes controlling gluconeogenesis, phosphorylation of insulin receptor substrate proteins, and induction and overexpression of inflammatory cytokines that interact closely with host lipid metabolism. Conclusions: We review HCV genotypes and subtypes, the mechanisms by which HCV infection induces insulin resistance, the virus genotypes and subtypes that are implicated in this and those that are steatotic. We conclude by discussing the proposed mechanisms of steatosis and considering HCV laboratory investigation methods from traditional to current techniques.