Joint Modeling of Blood Glucose Level, Systolic and Diastolic Blood Pressure with Time- To-Develop Microvascular Complications Among Co-Infected Patients of Diabetic Mellitus and Hypertension in Tepi General Hospital and MTUTH

Mon, 01 May 2023 00:00:00 GMT

Joint Modeling of Blood Glucose Level, Systolic and Diastolic Blood Pressure with Time- To-Develop Microvascular Complications Among Co-Infected Patients of Diabetic Mellitus and Hypertension in Tepi General Hospital and MTUTH Aragaw, Adem; Abate, Lemma; Bekele, Alemu Background:- Diabetes mellitus is currently a public health issue in both developed and developing nations and is linked to greater morbidity and mortality globally. We aim to model the progression of several biomarkers, including SBP, FBS, and DBP, as well as the correlation between various aspects of this progression and the time to develop microvascular complications in various association structures. Methods: A retrospective follow-up study was conducted on co-infected patients at Tepi General Hospital and MTUTH. Ethiopia with an enrollment time of September 2015 and followed for four years. We presented a joint model that consists of two related sub-models: a multivariate linear mixed model for FBS, SBP, and DBP level and a survival sub-model for the patient's developing retinopathy status. Three different forms of joint modeling in the Bayesian approach via R-statistical software were used. For the analysis, we used the JMBayes Markov Chain Monte Carlo (MCMC) algorithm to sample from the posterior conditional distributions. Results: Time had a significant effect on all repeated measurements (SBP, FBS, and DBP) (P<0.001) in the multivariate linear mixed model. The square root FBS, SBP, and DBP are statistically significant at a 5% level of significance in all forms of the joint models that we considered: This indicates that there is strong evidence of the association between the effect of the longitudinal square root FBS, SBP and DBP on the risk of developing retinopathy for Co infected patients. Time-updated FBS of Co Infected patients makes them develop complications earlier. Conclusion: At a 5% level of significance(p-value<0.05), the risk of patients' hazard become increases as the SBP, FBS, and DBP become increase. From a methodological perspective considering different association structures in joint modeling leads to appropriate decisions. The fixed effects of baseline age, residence, educational status, occupation, smoking, family history of DM, and weight significantly affect the developing retinopathy time(p-value<0.05).

Determinants of Marital Dissolution in Tepi city Administration and Mizan Aman city Administration

Sun, 01 Jan 2023 00:00:00 GMT

Determinants of Marital Dissolution in Tepi city Administration and Mizan Aman city Administration Abate, Lema; Bekele, Alemu; Aragaw, Adem; Korkoba, Dereje Background: Marital dissolution or divorce is one of the most dramatic events that can befall in a family. Compared to people in their first marriage, people who are currently married but have ever been divorced have a worse self-rated health, more chronic conditions, more mobility limitations, and more depressive symptoms. The objective of this study was to examine the determinants of marital dissolution in Tepi and Mizan-Aman city administration. Methods: A community based retrospective study design was conducted to assess factors associated with marital dissolution of ever-married individuals in study area using descriptive and inferential analysis. Multi–Stage sampling technique was used to select appropriate sample. From the survival analysis models; the Cox-proportional hazard model was selected to identify the factors associated with marital dissolution. Results: About 23.9% of participants were divorced or separated from their first partners and the mean survival time was 32 years and one month. Participants who were very unsatisfied and unsatisfied by encouraging support, sexual compatibility, and life before marriage and giving admiration from their partners were more exposed to divorce compared to very satisfied and satisfied. Cox proportional hazard regression model revealed that age, partner’s education levels, occupation, lie partner, consultancy and conflict resolution methods had significant effects on survival time of duration of marriage. The risk of marital dissolution was significantly lower for uneducated partners (HR=0.0.296; P=0.039), merchant (HR= 0.408; P= 0.007) and participants who never lie their partners (HR= 0.265; P = 0.000) compared to their counterpart. Conclusions: The findings of this study demonstrated that age group, partner’s education level, occupation type, lie partner, getting consultancy about marriage, and conflict resolution methods have significant effect on the survival time of marital dissolution. Participants whose age was less than or equal to 20 year during study time was more exposed to marital dissolution than whose age was greater than 40 years old. This implies that early marriage had significant effect on the duration of ever-married couples. Respondents who got consultancy about the marriage was less likely to divorce compared to participants who didn’t get consultancy

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Joint Modeling of Blood Glucose Level, Systolic and Diastolic Blood Pressure with Time- To-Develop Microvascular Complications Among Co-Infected Patients of Diabetic Mellitus and Hypertension in Tepi General Hospital and MTUTH

Determinants of Marital Dissolution in Tepi city Administration and Mizan Aman city Administration