Comparison between intravenous lidocaine and dexamethasone in reducing postoperative sore throat after endotracheal extubation at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia; a prospective cohort study.

BACKGROUND: Post-operative sore throat is the common complaint and uncomfortable side effect in patients receiving general anesthesia with endotracheal intubation. Drugs with analgesic and anti-inflammatory properties, like steroids and local anesthetics, are the best options for postoperative sore throat prophylaxis. Therefore, this study aimed to compare the effects of intravenous lidocaine and dexamethasone in reducing postoperative sore throat following endotracheal extubation at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, from January 1 to March 30, 2023 G.C. METHODS: A prospective cohort study was carried out at Tikur Anbessa Specialized Hospital. Data from 50 patients in the lidocaine (1.5 mg/kg), 50 in the dexamethasone (8 mg), and 49 in the control groups were analyzed. The data were collected using observation based on structured questionnaires. A systematic random sampling technique was applied to select respondents. The data were entered into EpiData version 4.6.0.6 and transferred to STATA version 17 statistical software for analysis. A comparison of continuous data among the groups were performed using a one-way ANOVA test for parametric data. The Kruskal-Wallis rank test was used for non-parametric data. Associations between variables were tested using chi-squared test, Fisher's exact test, and binary logistic regression. Bivariable and multivariable logistic regression was used to determine degree of association. RESULTS: The incidence of POST was 40%, 32%, and 57.1% in the lidocaine, dexamethasone, and control groups, respectively (P = .0356). Dexamethasone reduced the incidence of POST during the first 24 h (AOR: 0.374, 95% CI: 0.149-0.939). However, no difference was observed in the severity of POST at 3 h (p = 0.130), 6 h (p = 0.096), 12 h (p = 0.313), and 24 h (p = 0.525) of the post-extubation period among the three groups. IV lidocaine did not effectively reduce the incidence and severity of postoperative sore throat at different time intervals. CONCLUSION AND RECOMMENDATION: Intravenous dexamethasone is more effective than intravenous lidocaine in reducing the incidence of postoperative sore throat among the groups. Based on these findings, intravenous dexamethasone is recommended to decrease the incidence of postoperative sore throat.

Perioperative mortality of caesarean section in North-West Ethiopia: a prospective cohort study.

OBJECTIVE: This study aimed to assess 7-day perioperative maternal mortality and risk factors at Tibebe Ghion Specialized Hospital. DESIGN: A single-centre prospective cohort study. SETTING: A tertiary hospital in North-West Ethiopia, 01 June 2019 to 30 June 2021. PARTICIPANTS: A total of 979 pregnant mothers who underwent caesarean section were enrolled in this study. Mothers who did not have cellphones and who had incorrect information for follow-up were excluded from the study. OUTCOME MEASURE: Perioperative death measured from intraoperative time to the seventh day following caesarean section. RESULTS: The most frequent indication for caesarean section was failure to progress, followed by fetal distress and elective caesarean delivery, accounting for 40.04%, 24.72% and 20.43% of all cases, respectively. The 7-day perioperative maternal mortality rate was 1.83%. Maternal bleeding (adjusted relative risk (ARR) = 11.80; 95% CI 1.12, 124.08) and not using the WHO surgical safety checklist (ARR = 6.88; 95% CI 3.14, 15.07) were independently associated with increased risk of 7-day perioperative mortality. CONCLUSION: In this study, mortality after caesarean section was higher than in high-income countries. Implementation of targeted interventions focusing on the prevention and management of maternal bleeding, along with the consistent use of the WHO surgical safety checklist, could potentially contribute to improving the overall safety and outcomes of caesarean sections.

The magnitude of mortality and its determinants in Ethiopian adult intensive care units: A systematic review and meta-analysis.

Introduction: Despite mortality in intensive care units being a global burden, it is higher in low-resource countries, including Ethiopia. A sufficient number of evidence is not yet established regarding mortality in the intensive care unit and its determinants. This study intended to determine the prevalence of ICU mortality and its determinants in Ethiopia. Methods: PubMed, Google Scholar, The Cochrane Library, HINARI, and African Journals Online (AJOL) databases were systematically explored for potentially eligible studies on mortality prevalence and determinants reported by studies done in Ethiopia. Using a Microsoft Excel spreadsheet, two reviewers independently screen, select, review, and extract data for further analysis using STATA/MP version 17. A meta-analysis using a random-effects model was performed to calculate the pooled prevalence and odds ratio with a 95% confidence interval. In addition, using study region and sample size, subgroup analysis was also performed. Results: 9799 potential articles were found after removing duplicates and screening for eligibility, 14 were reviewed. Ethiopia's pooled national prevalence of adult intensive care unit mortality was 39.70% (95% CI: 33.66, 45.74). Mechanical ventilation, length of staying more than two weeks, GCS below 9, and acute respiratory distress syndrome were major predictors of mortality in intensive care units of Ethiopia. Conclusion: Mortality in adult ICU is high in Ethiopia. We strongly recommend that all health care professionals and other stakeholders should act to decrease the high mortality among critically ill patients in Ethiopia.