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A Meta-Analysis on Higher-Risk Sexual Behavior of Women in 28 Third World Countries  [PDF]
Asres Berhan, Yifru Berhan
World Journal of AIDS (WJA) , 2012, DOI: 10.4236/wja.2012.22011
Abstract: Background: Previous reports on sexual behaviours and risks of HIV infection in relation to socioeconomic status of women were contradictory. The purpose of this study was to determine the consistency of risky sexual behaviour among women with regard to their age, residence, educational level and wealth index. Methods: Subgroup and pooled meta-analysis was done on risky sexual behaviour and HIV prevalence of women aged 15 - 49 years using the recent Demographic and Health Surveys data (DHS 2003-2009) from 28 countries in and outside Africa. Pooled and individual countries odds ratios were calculated using Mantel-Haenszel (M-H) statistical method. Random effect analytic model was applied since there was significant heterogeneity among surveys (I2 > 50%). Sensitivity analysis was also done to examine the effect of outliers. Results: Out of 207,776 women reported to have sex within 12 months prior to the respective surveys, 36,530 (17.6%) were practicing higher-risk sex. Risky sexual behavior was found to have statistically significant association with women living in urban areas, attained secondary and above education and owned middle to highest wealth index. Sensitivity analysis demonstrated the stability of the pooled odds ratios for outliers. Better education attainment, high wealth index and being employed were also associated with high HIV prevalence. Conclusion: This analysis has shown the high prevalence of higher-risk sexual behaviour and high HIV infection among wealthier and better educated women regardless of geographic location of the selected low to middle income countries. Further study is required to establish how and why being good in socioeconomic status associated with risky sexual behaviour.
Predictors of Perinatal Mortality Associated with Placenta Previa and Placental Abruption: An Experience from a Low Income Country
Yifru Berhan
Journal of Pregnancy , 2014, DOI: 10.1155/2014/307043
Abstract: A retrospective cohort study design was used to assess predictors of perinatal mortality in women with placenta previa and abruption between January 2006 and December 2011. Four hundred thirty-two women (253 with placenta previa and 179 with placental abruption) were eligible for analysis. Binary logistic regression, Kaplan-Meier survival curve, and receiver operating characteristic (ROC) curve were used. On admission, 77% of the women were anaemic (<12?gm/dL) with mean haemoglobin level of 9.0?±?3.0?gm/dL. The proportion of overall severe anaemia increased from about 28% on admission to 41% at discharge. There were 50% perinatal deaths (neonatal deaths of less than seven days of age and fetal deaths after 28 weeks of gestation). In the adjusted odds ratios, lengthy delay in accessing hospital care, prematurity, anaemia in the mothers, and male foetuses were independent predictors of perinatal mortality. The haemoglobin level at admission was more sensitive and more specific than prematurity in the prediction of perinatal mortality. The proportion of severe anaemia and perinatal mortality was probably one of the highest in the world. 1. Introduction Placenta previa (placenta implanted over the internal cervical os) and placental abruption (premature separation of normally implanted placenta) are the major causes of antepartum haemorrhage in the third trimester of pregnancies and major contributors of obstetric haemorrhage in general [1]. Each of these conditions has a prevalence rate of 0.5% to 2% in most parts of the world [2–4]. Because of the changes in the lower uterine segment length and placental migration as the pregnancy advances, the prevalence of placenta previa has an inverse relation to the gestational age [5]. In other words, it is suggested that reporting of placenta previa in early gestation is likely to overestimate its actual prevalence at term. Placenta previa and placental abruption have long been recognized as major obstetric complications that result in maternal and fetal mortality as well as morbidity. The effect of these two bloody obstetric complications on perinatal health is multifactorial: blood loss, premature delivery, intrauterine growth restriction, the risk of perinatal asphyxia, the risk of sepsis, and hyperbilirubinemia [2, 6–8]. A Danish national cohort study was associated with an increased risk of neonatal mortality, prematurity, low Apgar scores, low birthweight, and transfer to a neonatal intensive care unit [9]. Several other studies from developing countries have also shown that pregnant women complicated by
Is the Sexual Behaviour of HIV Patients on Antiretroviral therapy safe or risky in Sub-Saharan Africa? Meta-Analysis and Meta-Regression
Asres Berhan, Yifru Berhan
AIDS Research and Therapy , 2012, DOI: 10.1186/1742-6405-9-14
Abstract: We included both cross-sectional studies that compared different ART-na?ve and ART-experienced participants and longitudinal studies examining the behavior of the same individuals pre- and post-ART start. Meta-analyses were performed both stratified by type of study and combined. Outcome variables assessed for association with ART experience were any sexual activity, unprotected sex and having multiple sexual partners. Random-effect models were applied to determine the overall odds ratios. Sub-group analyses and meta-regression analyses were performed to examine sources of heterogeneity among the studies. Sensitivity analysis was also conducted to evaluate the stability of the overall odds ratio in the presence of outliers.The meta-analysis failed to show a statistically significant association of any sexual activity with ART experience. It did, however, show an overall statistically significant reduction of any unprotected sex, having multiple sexual partners and unprotected sex with HIV negative or unknown HIV status with ART experience. Meta-regression showed no interaction between duration of ART use or recall period of sexual behavior with the sexual activity variables. However, there was an association between the percentage of married or cohabiting participants included in a study and reductions in the practice of unprotected sex with ART.In general, this meta-analysis demonstrated a significant reduction in risky sexual behavior among people on ART in sub-Saharan Africa. Future studies should investigate the reproducibility and continuity of the observed positive behavioural changes as the duration of ART lasts a decade or more.
Virologic Response to Tipranavir-Ritonavir or Darunavir-Ritonavir Based Regimens in Antiretroviral Therapy Experienced HIV-1 Patients: A Meta-Analysis and Meta-Regression of Randomized Controlled Clinical Trials
Asres Berhan, Yifru Berhan
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0060814
Abstract: Background The development of tipranavir and darunavir, second generation non-peptidic HIV protease inhibitors, with marked improved resistance profiles, has opened a new perspective on the treatment of antiretroviral therapy (ART) experienced HIV patients with poor viral load control. The aim of this study was to determine the virologic response in ART experienced patients to tipranavir-ritonavir and darunavir-ritonavir based regimens. Methods and Findings A computer based literature search was conducted in the databases of HINARI (Health InterNetwork Access to Research Initiative), Medline and Cochrane library. Meta-analysis was performed by including randomized controlled studies that were conducted in ART experienced patients with plasma viral load above 1,000 copies HIV RNA/ml. The odds ratios and 95% confidence intervals (CI) for viral loads of <50 copies and <400 copies HIV RNA/ml at the end of the intervention were determined by the random effects model. Meta-regression, sensitivity analysis and funnel plots were done. The number of HIV-1 patients who were on either a tipranavir-ritonavir or darunavir-ritonavir based regimen and achieved viral load less than 50 copies HIV RNA/ml was significantly higher (overall OR = 3.4; 95% CI, 2.61– 4.52) than the number of HIV-1 patients who were on investigator selected boosted comparator HIV-1 protease inhibitors (CPIs-ritonavir). Similarly, the number of patients with viral load less than 400 copies HIV RNA/ml was significantly higher in either the tipranavir-ritonavir or darunavir-ritonavir based regimen treated group (overall OR = 3.0; 95% CI, 2.15 – 4.11). Meta-regression showed that the viral load reduction was independent of baseline viral load, baseline CD4 count and duration of tipranavir-ritonavir or darunavir-ritonavir based regimen. Conclusions Tipranavir and darunavir based regimens were more effective in patients who were ART experienced and had poor viral load control. Further studies are required to determine their consistent viral load suppression effect as the duration of treatment is more prolonged.
Perinatal mortality and associated risk factors: a case control study
Getachew Bayou, Yifru Berhan
Ethiopian Journal of Health Sciences , 2012,
Abstract: BACKGROUND: Perinatal mortality is reported to be five times higher in developing than in developed nations. Little is known about the commonly associated risk factors for perinatal mortality in Southern Nations National Regional State of Ethiopia. METHODS: A case control study for perinatal mortality was conducted in University hospital between 2008 and 2010. Cases were stillbirths and early neonatal deaths. Controls were those live newborns till discharged from the hospital. Subgroup binary logistic regression analyses were done to identify associated risk factors for perinatal mortality, stillbirths and early neonatal deaths. RESULTS: A total of 1356 newborns (452 cases and 904 controls) were included in this analysis. The adjusted perinatal mortality rate was 85/1000 total delivery. Stillbirths accounted for 87% of total perinatal mortality. The proportion of hospital perinatal deaths was 26%. Obstructed labor was responsible for more than one third of perinatal deaths. Adjusted odds ratios revealed that obstructed labor, malpresentation, preterm birth, antepartum hemmorrhage and hypertensive disorders of pregnancy were independent predictors for high perinatal mortality. In the subgroup analysis, among others, obstructed labor and antepartum hemorrhage found to have independent association with both stillbirths and early neonatal deaths. CONCLUSION: The perinatal mortality rate was more than two fold higher than the estimated national perinatal mortality;and obstructed labor, malpresentation, preterm birth, antepartum hemmorrhage and hypertensive disorders of pregnancy were independent predictors. The reason for the poor progress of labor and developing obstructed labor is an area of further investigation.
Extracranial hemorrhage in babies admitted to neonatal units over a 10-year period
Yifru Berhan, Assaye Kassie
Ethiopian Journal of Health Development , 2004,
Prediction of Groundwater Level Fluctuation towards Rainfall Induced Landslide: Case of Blue Nile Gorge, Central Ethiopia  [PDF]
Bisrat Ayalew Yifru, Fasika Mekonnen Ayehu
Open Journal of Modern Hydrology (OJMH) , 2017, DOI: 10.4236/ojmh.2017.74016
Abstract: The groundwater level fluctuation was studied in a complex geological setting region where a frequent landslide is observed in a rainy season. Steady and transient states of flow are modeled with different hydrogeological parameters. The models are calibrated to satisfy the observed field conditions and expected results from the scientific point of view. The results reveal that the groundwater level fluctuation and flow direction in the region are complex. In limited areas, the fluctuation of groundwater is significant from season to season while in others the level remains stable in all seasons of the year. Following that, the result of groundwater flow model was exported to GeoStudio to simulate the slope stability of selected slope. The factor of safety was calculated using Slope/W. The effect of pore-water on the factor of safety was cross-checked by remodeling the slope without water. The results and sensitivity analysis of slope stability confirm that the rise of groundwater level decreases the factor of safety significantly only on critical slope section.
In Vitro Screening of Cactus [Opuntia ficus-indicia (L.) Mill] Genotypes for Drought Tolerance  [PDF]
Berhan Mengesha, Firew Mekbib, Eyasu Abraha
American Journal of Plant Sciences (AJPS) , 2016, DOI: 10.4236/ajps.2016.713163
Abstract: Drought is one of the complex environmental factors affecting growth and yield of crops in arid and semi-arid areas of the world. In this context, this investigation was carried out to select drought tolerance cactus genotypes under in vitro condition. An experiment was carried out at Laboratory of Mekelle Agricultural Research Center, Northern Ethiopia. Six cactus pear genotypes namely, Gerao, Keyih Beles, Shenkor, Limo, Lemats Beles and Suluhna were used. Areoles were used as explants in tissue culture. The non-ionic water soluble polymer polyethylene glycol (PEG) of molecular weight 6000 was used as osmoticum to simulate water stress. In the first culture, the MS medium was supplemented with (2, 4-D (4 mg/l) and BA (0.5 mg/l) for callus induction. In all cultures MS medium was supplemented with 0, 10, 20 and 40 g/l polyethylene glycol (PEG) and was solidified with 0.8% agar and 30 g of sucrose. Significant differences were observed among the genotypes, PEG levels. In the first culture highest number of explants initiated callus on medium supplemented with no PEG but had not shown significant difference with 10 g/l PEG. At 10 g/l PEG, the callus induction frequency, callus fresh weight and plantlet regeneration were recorded highest for Suluhna (83.3%, 5.5 g and 63.3%), respectively. At 40 g/l PEG, callus induction frequency, callus fresh weight and plantlet regeneration were produced highest for Suluhna (41.7%, 2.75 g and 45%), respectively but no significant difference with Gerao, Limo and
Plant Genetic Resources: Selected Issues from Genetic Erosion to Genetic Engineering
Karl Hammer,Yifru Teklu
Journal of Agriculture and Rural Development in the Tropics and Subtropics , 2008,
Abstract: Plant Genetic Resources (PGR) continue to play an important role in the development of agriculture. The following aspects receive a special consideration:1. Definition. The term was coined in 1970. The genepool concept served as an important tool in the further development. Different approaches are discussed.2. Values of Genetic Resources. A short introduction is highlighting this problem and stressing the economic usfulness of PGR.3. Genetic Erosion. Already observed by E. Baur in 1914, this is now a key issue within PGR. The case studies cited include Ethiopia, Italy, China, S Korea, Greece and S. Africa. Modern approaches concentrate on allelic changes in varieties over time but neglect the landraces. The causes and consequences of genetic erosion are discussed.4. Genetic Resources Conservation. Because of genetic erosion there is a need for conservation. PGR should be consigned to the appropriate method of conservation (ex situ, in situ, on-farm) according to the scientific basis of biodiversity (genetic diversity, species diversity, ecosystem diversity) and the evolutionary status of plants (cultivated plants, weeds, related wild plants (crop wild relatives)).5. GMO. The impact of genetically engineered plants on genetic diversity is discussed.6. The Conclusions and Recommendations stress the importance of PGR. Their conservation and use are urgent necessities for the present development and future survival of mankind.
E. Berhan,D. Kitaw
South African Journal of Industrial Engineering , 2012,
Abstract: ENGLISH ABSTRACT: This paper deals with the role of marketing information systems for service quality in Ethiopian industries in terms of their IT infrastructure, data acquisition, information processing, business function, and service quality. A quantitative survey of 42 Ethiopian industries in 2009 indicated that most of these industries are dominated by noncomputerised information systems. The data acquisition and IT infrastructure strongly support the information process. Information processing significantly and positively predicts both service quality and business function. But the business function that uses processed data and information for its activities – such as planning, decision–making, and implementation – is not found to be a significant predictor of service quality. AFRIKAANSE OPSOMMING: In hierdie artikel word die rol van bemarkingsinligtingstelsels by diensgehalte in Etiopiese industrie bespreek in terme van hul IT-infrastruktuur, datavaslegging, inligtingsprosesseervermo , operasionele funksionering en diensgehalte. ’n Kwantitatiewe opname onder 42 Etiopiese industrie is in 2009 onderneem. Dit het getoon dat die meeste van hierdie industrie gedomineer word deur nie-rekenaargebaseerde inligtingstelsels. Die datavaslegging en IT-infrastruktuur ondersteun die inligtingsproses. Inligtingsprosesseervermo voorspel betekenisvol en positief wat die diensgehalte sal wees. Daarteenoor is gevind dat die operasionele funksionering wat verwerkte data en inligting aanwend vir aktiwiteite soos beplanning, besluitneming en implementering nie ’n indikator van diensgehalte is nie.
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