International Journal of Chronic Diseases
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The Burden of Noncommunicable Diseases in Ethiopia, 2000–2016: Analysis of Evidence from Global Burden of Disease Study 2016 and Global Health Estimates 2016

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International Journal of Chronic Diseases publishes original research articles, review articles, and clinical studies in all areas of chronic diseases.

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International Journal of Chronic Diseases maintains an Editorial Board of practicing researchers from around the world, to ensure manuscripts are handled by editors who are experts in the field of study.

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Review Article

Conceptualization of Heterogeneity of Chronic Diseases and Atherosclerosis as a Pathway to Precision Medicine: Endophenotype, Endotype, and Residual Cardiovascular Risk

The article discusses modern approaches to the conceptualization of pathogenetic heterogeneity in various branches of medical science. The concepts of endophenotype, endotype, and residual cardiovascular risk and the scope of their application in internal medicine and cardiology are considered. Based on the latest results of studies of the genetic architecture of atherosclerosis, five endotypes of atherosclerosis have been proposed. Each of the presented endotypes represents one or another pathophysiological mechanism of atherogenesis, having an established genetic substrate, a characteristic panel of biomarkers, and a number of clinical features. Clinical implications and perspectives for the study of endotypes of atherosclerosis are briefly reviewed.

Research Article

Acetic Acid-Induced Ulcerative Colitis in Sprague Dawley Rats Is Suppressed by Hydroethanolic Extract of Cordia vignei Leaves through Reduced Serum Levels of TNF-α and IL-6

Background. Ulcerative colitis (UC) is a recurrent inflammatory bowel disease (IBD) that causes long-lasting inflammation on the innermost lining of the colon and rectum. Leaf decoctions of Cordia vignei have been used in traditional medicine either alone or in combination with other plant preparations to treat the disease. Aim. In this study, we investigated the effect of hydroethanolic extract of Cordia vignei leaves (CVE) on acetic acid-induced UC in rats. Method. Male Sprague Dawley rats received oral treatment of either saline (10 ml/kg), sulfasalazine (500 mg/kg), or CVE (30-300 mg/kg) daily for 7 days. On day 4, colitis was induced by a single intrarectal administration of 500 μl of acetic acid (4% ). Rats were sacrificed on day 8 and colons were collected for histopathological examination. Blood was also collected for haematological assessment. Results. CVE significantly (P < 0.05) prevented colonic ulceration and reduced the inflammatory score. Serum levels of TNF-α and IL-6 were significantly reduced. Depletion of superoxide dismutase (SOD) and catalase (CAT) activities by acetic acid was significantly inhibited while lipid peroxidation indexed as malondialdehyde (MDA) level in the colon was reduced. However, loss of body weight was not significantly affected by treatment with CVE. Conclusion. This data suggest that CVE has a potential antiulcerative effect.

Research Article

The Influence of Family History of Type 2 Diabetes Mellitus on Positive Health Behavior Changes among African Americans

Type 2 diabetes mellitus (T2DM) is a disease that affects the body’s ability to metabolize glucose effectively. The disease is predicted to be prevalent in over 300 million people by the year 2030. African Americans (AA) have the highest prevalence rates of type 2 diabetes mellitus (T2DM) in the United States. Lifestyle modification and awareness of risk factors, including family history, are important aspects for prevention of developing T2DM. The purpose of this study was to understand if a family history of T2DM played an influential role in individuals making positive health behavior changes for T2DM prevention. The phenomenological study was grounded in the health belief model and also identified barriers associated with inactivity towards positive health behavior changes. Participants selected for this study were at least 18 years of age, self-identified as AA, self-reported a family history of T2DM, and were not diagnosed with the disease themselves. Transcriptions of twenty face-to-face interviews were analyzed via qualitative research software NVivo Version 12 for Mac. Participants demonstrated a strong awareness of T2DM with an accurate definition of T2DM and explanation of signs, symptoms, and prevention. Participants recognized family history as a risk factor in only 55% of the responses. However, family history played a major role in prevention in the lives of the participants. The participants reflected on personal barriers to health behavior changes and were encouraged to incorporate better life choices in their own lives. This research offers communities, healthcare providers, and stakeholders a better understanding of the importance of family history as a risk factor to T2DM as programs are developed to mitigate health disparities in the AA community.

Research Article

Hippocampal Growth Factor and Myokine Cathepsin B Expression following Aerobic and Resistance Training in 3xTg-AD Mice

Aerobic training (AT) can support brain health in Alzheimer’s disease (AD); however, the role of resistance training (RT) in AD is not well established. Aside from direct effects on the brain, exercise may also regulate brain function through secretion of muscle-derived myokines. Aims. This study examined the effects of AT and RT on hippocampal BDNF and IGF-1 signaling, β-amyloid expression, and myokine cathepsin B in the triple transgenic (3xTg-AD) model of AD. 3xTg-AD mice were assigned to one of the following groups: sedentary (Tg), aerobic trained (Tg+AT, 9 wks treadmill running), or resistance trained (Tg+RT, 9 wks weighted ladder climbing) (/group). Rotarod latency and strength were assessed pre- and posttraining. Hippocampus and skeletal muscle were collected after training and analyzed by high-resolution respirometry, ELISA, and immunoblotting. Tg+RT showed greater grip strength than Tg and Tg+AT at posttraining (). Only Tg+AT improved rotarod peak latency (). Hippocampal IGF-1 concentration was ~15% greater in Tg+AT and Tg+RT compared to Tg (); however, downstream signals of p-IGF-1R, p-Akt, p-MAPK, and p-GSK3β were not altered. Cathepsin B, hippocampal p-CREB and BDNF, and hippocampal mitochondrial respiration were not affected by AT or RT. β-Amyloid was ~30% lower in Tg+RT compared to Tg (). This data suggests that regular resistance training reduces β-amyloid in the hippocampus concurrent with increased concentrations of IGF-1. Both types of training offered distinct benefits, either by improving physical function or by modifying signals in the hippocampus. Therefore, inclusion of both training modalities may address central defects, as well as peripheral comorbidities in AD.

Research Article

Chronic Diseases Multimorbidity among Adult People Living with HIV at Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia

Background. Due to the wide implementation of antiretroviral therapy (ART), people living with HIV (PLWHIV) are now living longer. This increased the risk of developing noncommunicable chronic diseases (NCCDs) among them. Objective. We aimed to describe prevalence of NCCDs multimorbidity among PLWHIV at Hawassa University Comprehensive Specialized Hospital (HUCSH). Method. In April 2016, institution-based cross-sectional study was conducted among PLWHIV, years at the ART unit of HUCSH. A nurse working in the ART unit interviewed patients and reviewed medical records. Data on the NCCDs and its risk factors were obtained. List of diseases considered in this study were arthritis, diabetes mellitus, hypertension, congestive heart failure (CHF), rheumatic heart diseases (RHD), chronic bronchitis, asthma, and cancer. Results. More than half of the respondents (196) had at least one of the NCCDs and 34 (8.9%) had multimorbidity. The main system of the body affected were the musculoskeletal system, 146 (38.2%) and respiratory system, 46 (12.0%). There was no significant difference in the prevalence of individual NCCDs by gender. Patients aged above 44 years, patients with ART duration of at least 6 years, and patients with higher CD4 counts had increased odds of having any one of the NCCDs. Multimorbidity patients with a longer ART duration had an increased risk. Conclusion. The prevalence of NCCD multimorbidity among PLWHIV was high. Monitoring the occurrence of NCCDs among PLWHIV and noncommunicable disease care is recommended.

Research Article

Assessment of Quality of Life of Epileptic Patients in Ethiopia

Background. Patients with epilepsy are at an increased risk of poor quality of life. Purpose. We aimed at assessing the quality of life and its determinants among epileptic patients at University of Gondar Referral Hospital (UoGRH), Ethiopia. Methods. Institution based cross-sectional study was conducted on epileptic patients on follow up at UoGRH from January 15 to April 15, 2017. Information including socio-demographic profile and diagnosis was extracted from medical records and patients. Quality Of Life In Epilepsy-10 (QOLIE-10) tool was used to measure the quality of life. Independent t-test and one-way analysis of variance were used to look for factors associated with quality of life. The level of statistical significance was declared at -value ≤ 0.05. Results. A total of 354 patients were included in the study and mean age was 29.1 ± 11.7 years. The mean QOLIE-10 score was 19.85. One hundred ninety-four (54.8%) of participants had a good quality of life. Being illiterate, unemployment, and presence of co-morbid medical condition were associated with poorer quality of life. Conclusion. Nearly half of the participants had a poor quality of life. Patients with co-morbidity, illiteracy, and unemployment should be given special emphasis in order to improve their quality of life.

International Journal of Chronic Diseases
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