Prevalence and factors associated with postoperative sore throat in Ethiopia: A systemic review and meta-analysis, 2023.

Background: Postoperative sore throat (POST) remains a stressful impact of postoperative airway management, and it contributes to mortality and morbidity after general anesthesia. Its pooled prevalence and determinants in Ethiopia have not been fully studied. This study intended to assess the pooled prevalence and risk variables for POST in Ethiopia. Methods: A systematic review and Meta-analysis were performed as per the recommendation of PRISMA. To evaluate the pooled prevalence and factors significantly associated with POST in Ethiopia, electronic databases were searched till November 30/2023 and publications were chosen based on inclusion criteria. To assess the quality of the included studies, the Joanna Briggs Institute criteria was used. STATAMP 17 software was used for all data analysis. Results: Databases were searched for possible research using Medical Subject headings or entries or key phrases. Only 12 articles were included in the final analysis after screening by titles, abstracts, and full text based on the qualifying criteria. The pooled prevalence of POST in Ethiopia is 47.3 %. The determinants of POST in Ethiopia were female sex, repeated attempts at intubation, blood visible on the tip of an endotracheal tube or laryngoscope, prolonged duration of intubation, and using endotracheal intubation over laryngeal mask airway. Conclusion: In Ethiopia, the overall prevalence of postoperative sore throat is substantial. Prolonged intubation for more than 2 h, using ETT over LMA, Sex being female multiple attempts at intubation, and blood seen on the tip of ETT or Laryngoscope were the determinant factors of POST in Ethiopia.

Prevalence and Factors Associated with Postoperative Nausea and Vomiting in an Ethiopian Comprehensive Specialized Hospital.

Background: Postoperative nausea and vomiting (PONV) is a common and uncomfortable anesthetic and surgical consequences. It may cause severe distress to the patient and may cause the recovery process to be delayed. Identifying the reasons may aid in reducing the magnitude and problems. The purpose of this study was to determine the prevalence and risk factors for PONV after general anesthesia in an Ethiopian hospital. Methods: From March 1 to May 30, 2019, a cross-sectional study was designed. A patient interview was used to obtain data on the occurrence of PONV, and a chart review was used to collect data on other demographic and clinical variables. To identify associated factors, variables with a P-value of 0.2 in binary logistic regression were transformed into a multivariable logistic regression. The strength of the association and level of significance waswere demonstrated using crude and adjusted odds ratios with 95% confidence intervals and P-values of 0.05. Results: The study included 162 participants, with a remarkable 100% response rate. Within 24 hr after surgery, 51.2% of patients had nausea and vomiting. When compared to their counterparts, female patients, patients who received perioperative opioid medication, patients with a history of PONV, and patients with a history of motion sickness reported a statistically significant difference (higher incidence) in PONV. Conclusion: This study only comprised ASA physical classes 1 and 2 patients who did not receive preventive antiemetics. In the research area, the total prevalence of vomiting and nausea was 51.2%. Female sex, perioperative opioid usage, a history of nausea and vomiting, and a history of motion sickness were discovered to be statistically significantly associated with a higher incidence of PONV.

Prevalence and associated factors of postoperative suxamethonium-induced myalgia in surgical patients at Debre Tabor Comprehensive Specialized Hospital Ethiopia: a cross-sectional study.

Suxamethonium is considered by many to be the best drug for providing ideal intubating conditions, short surgical procedures, and rapid sequence induction. However, its usefulness is limited by the frequent occurrence of adverse effects like postoperative myalgia. Therefore this study aimed to assess the prevalence and associated factors of postoperative suxamethonium-induced myalgia. An institutional-based cross-sectional study was conducted on 210 patients who underwent surgery with general anesthesia. The data was collected by using structured and pretested questionnaires and analyzed using SPSS version 20.0. Logistic regression was conducted to identify significant predictors based on a P-value of less than 0.05 with a 95% confidence level. Among 210 patients the prevalence of suxamethonium-induced postoperative myalgia in the first 48 h was 88 (41.9%). Patients having previous anesthesia and surgical exposure (AOR 5.29, 95% CI 1.86-15.05), patients having a co-existing disease (AOR 2.69, 95% CI 1.08-6.67), patients that had not taken premedication (analgesia) (AOR 4.64, 95% CI 1.69-12.74), anesthesia maintenance using halothane (AOR 4.5 95% CI 1.7-11.4) and relaxation maintained with suxamethonium (AOR 3.1, 95% CI 1.2-8.1) were significantly associated with the prevalence of postoperative myalgia. The magnitude of suxamethonium-induced postoperative myalgia was high. So it is better to do with preventive techniques. As much as possible it is better to avoid using suxamethonium and necessary to use better to Premedicate with nonsteroidal anti-inflammatory drugs and non-depolarizing neuromuscular medications.

Patients' and Healthcare Professionals' Perspectives on Preoperative Informed Consent Procedure Obstacles and Potential Solutions, 2021: A Qualitative Study.

Background: Informed consent discussions are individualized not only with regard to the patients' surgical condition and goals but also with their varying information needs, health literacy, and anxiety. Information is lacking regarding the views of patients and concerned healthcare professionals on the informed consent process. Objective: This study is aimed to explore patients' and healthcare professionals' perceived barriers during informed consent process and identify suggested solutions for improvement. Methods: Patients who underwent elective surgery, anesthetists, and surgeons were the subjects of a qualitative study employing focused group discussions and in-depth interviews. The study participants were chosen through the use of purposeful sampling. Results: The main barriers identified by the patients include: inadequate explanation about the intended procedure, family's influence in the decision-making, fear of surgery, fear of light/power interruption, inadequate time for discussion, and not letting the family members attend the discussion. On the other hand, healthcare professionals also identified various barriers, which includes: inability of patients to understand the information, limited time to discuss with patients in detail, poorly designed informed consent form, poor awareness of patients, fear of patient refusal for surgery if the risks and associated health problems are explained, lack of adequate investigation to confidently explain about the disease condition, use of medical jargons, poor documentation habit of professionals and lack of legal system regarding ethical dilemmas. Conclusions and Recommendation: Patients and healthcare professionals have identified avoidable barriers that need the attention of concerned health professionals, educators, and the healthcare delivery system.

The analgesic efficacy of erector spinae plane block versus paravertebral block in thoracic surgeries: a meta-analysis.

Background: Acute postoperative pain after thoracic surgery might lead to chronic postsurgical pain (PSP), which lowers quality of life. The literature suggests thoracic paravertebral block (PVB) as a pain management approach. The ESPB (erector spinae plane block) is regarded to be an effective PVB alternative. The analgesic efficacy of the two analgesic therapies is controversial. The purpose of this study is to compare the analgesic efficacy of ESPB and PVB in preventing acute PSP. Methods: We searched relevant articles in PubMed, Cochrane Library, Embase, Web of Science, and Google Scholar databases. The primary outcome was postoperative pain score, with secondary outcomes including analgesic consumption, the frequency of rescue analgesia, and postoperative nausea and vomiting. Results: This meta-analysis included ten RCTs with a total of 670 patients. PVB significantly lowered the pain scores at movement at 12 h following surgery as compared to the ESPB. The PVB group used much less opioids within 24 h after surgery compared to the ESPB group. However, there were no significant differences between the groups in terms of postoperative rescue analgesia or in the incidence of postoperative nausea and vomiting (p > 0.05). Conclusion: PVB produced superior analgesia than ESPB in patients who underwent thoracic surgeries. In addition, PVB demonstrated greater opioid sparing effect by consuming much less opioids. Systematic review registration: This trial is registered on PROSPERO, number CRD42023412159.

Nurses' knowledge and attitude towards children pain management: a multi-site survey study.

Background: Adequate children's pain management is universally considered an ethical obligation. In evaluating and treating children's pain, nurses invest more time and take a leading role. This study aims to evaluate the knowledge and attitudes of nurses towards the treatment of pediatric pain. Materials and Methods: A total of 292 nurses working at four South Gondar Zone hospitals of Ethiopia was surveyed. To gather information from study participants, the Pediatric Nurses' -Knowledge and Attitudes- Survey Regarding Pain (PNKAS) was employed. Frequency, percentage, mean, and standard deviation of the data were used for descriptive analysis, while Pearson correlation, one-way between-groups analysis of variance, and independent-samples t-test were used for inferential analysis. Results: A large percentage of nurses (74.7%) lacked adequate knowledge and attitudes (PNKAS score <50%) for pediatric pain treatment. The mean ± SD accurate response score of 43.1% ± 8.6% was achieved by nurses. An increase in pediatrics nursing experience was significantly correlated with nurses' PNKAS score (p < 0.001). The mean PNKAS scores of nurses who had official pain management training differed in a statistically significant way as compared to its counterpart (p < 0.001). Conclusion: Nurses who are working South Gondar Zone of Ethiopia have insufficient knowledge and attitudes towards treatment of pediatric pain. Therefore, pediatric pain treatment in-service training is urgently needed.

The effects of intravenous tramadol vs. intravenous ketamine in the prevention of shivering during spinal anesthesia: A meta-analysis of randomized controlled trials.

Background: Shivering is a common complication after subarachnoid administration of local anesthetics. Intravenous ketamine and tramadol are widely available anti-shivering drugs, especially in developing settings. This meta-analysis aimed to compare the effects of intravenous ketamine vs. tramadol for post-spinal anesthesia shivering. Materials and methods: PubMed/MEDLINE, Web of Science, Cochrane Library, Embase, and Google Scholar databases were used to search for relevant articles for this study. Mean difference (MD) with 95% confidence interval (CI) was used to analyze continuous outcomes, and risk ratio (RR) with 95% CI to analyze categorical results. The heterogeneity of the included studies was assessed using the I2 test. We utilized Review Manager 5.4.1 to perform statistical analysis. Results: Thirteen studies involving 1,532 patients were included in this meta-analysis. Ketamine had comparable effects in preventing post-spinal anesthetics shivering [RR = 1.06; 95% CI (0.94, 1.20), P = 0.33, I 2 = 77], and onset of shivering [MD = -0.10; 95%CI (- 2.68, 2.48), P = 0.94, I 2 = 0%], lower incidences of nausea and vomiting [RR = 0.51; 95%CI (0.26, 0.99), P = 0.05, I 2 = 67%], and lower incidences of bradycardia [RR = 0.16; 95%CI (0.05, 0.47), P = 0.001, I 2 = 33%], higher incidence of hallucinations [RR = 12; 95%CI (1.58, 91.40), P = 0.02, I 2 = 0%], and comparable effects regarding the incidences of hypotension [RR = 0.60; 95%CI (0.30, 1.21), P = 0.15, I 2 = 54%] as compared to tramadol. Conclusions: Intravenous ketamine and tramadol are comparable in the prevention of post-spinal anesthetic shivering. Ketamine had a better outcome with less occurrences of nausea, vomiting, and bradycardia. However, ketamine was associated with higher incidences of hallucinations than tramadol.

Patients' satisfaction and associated factors towards preoperative informed consent process: A cross-sectional study.

Background: Informed consent is a process that needs time and effort to satisfy patients' desires. Patient dissatisfaction on preoperative informed consent process may be caused by multiple factors of clinical practice. This study aimed to assess patients' satisfaction and associated factors of informed consent process among elective surgical patients. Methods: A cross-sectional study was conducted on 404 postoperative patients who signed the informed consent for elective surgery. A systematic sampling technique was applied to select the study participants. Modified Leiden perioperative patient satisfaction tool was adapted to assess patients' satisfaction with preoperative informed consent process. Data were entered in to Epi-data version 4.20 and exported to SPSS version 20 for analysis. Bivariate and multivariable logistic regression was computed to identify independent variables associated with patient satisfaction towards preoperative informed consent process. A p-value of less than 0.05 was used to declare the statistical significance. Results: The overall satisfaction of patients with preoperative informed consent process was 70.3%. Multivariable logistic regression analysis revealed that, being male (AOR: 4.75, 95% CI: 2.47-9.16), primary school (AOR: 8.42, 95% CI: 4.74-7.55), secondary school (AOR: 2.17, 95% CI: 5.74-8.62), rural residence (AOR: 1.8, 95% CI: 2.1-3.9) and received general anesthesia (AOR: 2.92, 95% CI: 1.62-5.26) were significantly associated with patients' satisfaction with the informed consent process. Conclusion: The overall patients' satisfaction on preoperative informed consent process was relatively low. Being male, low level of education, living in rural area, and receiving general anesthesia were significantly associated with patients' satisfaction on informed consent process. Surgeons and anesthesia professionals need to work more to improving the satisfaction of patients with preoperative informed consent process. Researchers are expected to do periodic assessment of patients' level of satisfaction and factors affecting satisfaction.

Patient satisfaction and its associated factors towards perioperative anesthesia service among surgical patients: A cross-sectional study.

Background: Patient satisfaction with perioperative anesthesia services is not well established in developing countries like Ethiopia. This study aimed to assess surgical patients' satisfaction with perioperative anesthesia service and its associated factors. Method: A cross-sectional study design was conducted in patients who underwent surgeries at Debre Tabor Comprehensive Specialized Hospital, in North Central Ethiopia. Data were collected by Leiden perioperative care patient satisfaction questionnaire (LPPSq) within 24 h postoperatively, after translating to the local language (Amharic). Bivariable and multivariable logistic analyses were done to identify factors associated with satisfaction with perioperative anesthesia service care. Statistical significance level was set at P < 0.05 with 95% CI. Results: Analysis was done on 387 patients with a response rate of 94.8%. The overall mean satisfaction of patients with perioperative anesthesia care was 62.62% and about 53.7% [95% CI= (48.6-58.4)] of patients were satisfied with perioperative anesthesia service. The mean satisfaction of perioperative anesthesia service in the patient-staff relationship domain was 61.44%; in the information provision domain was 60.32%, and in the fear and concern domain was 72.06%. Conclusion: There was a moderate level of satisfaction in patients with perioperative anesthesia service. Among the subscales of LPPSq, the lowest satisfaction score was in the information provision and the highest satisfaction score was in the fear and concern domain.

The practice of foreign body removal from the ear, nose, and upper esophageal in children in Ethiopia: A retrospective descriptive study.

BACKGROUND: Ear, nose, and upper esophageal foreign body (FB) impaction in children is a common emergency in-hospital service. There are no clear guidelines regarding the management of ingested FBs. This study aimed to determine the FB in terms of type, anatomic site, management outcome, and associated complications. METHODS: Retrospective study of children with ear, nose, and upper esophageal FB managed under general anesthesia (GA) at operating room of Wolkite Hospital in the southern part of Ethiopia between January 2019 and February 2021. Data were collected from the medical chart of the patients using a prepared checklist. The parameters included were age, sex, FB anatomic site, type, management outcome, and associated complications related to FB or procedure modalities. RESULTS: A total of 169 (31.4%) study subjects were required GA for the removal of FBs. The mean age was 4.45 ± 3.20 years. Under 5 years old children comprises 61.5% of total cases. The most common anatomic site of FB impaction was in the ear 97 (57.4%). The most commonly found type of FB was cereals or seeds, which constituted 102 (60.35%). The complication rate was 18.35%. Epistaxis was the commonest complication (6.51%) from the nose while canal abrasion (5.92%) was common from the ear. CONCLUSION: Ear, nose, and upper esophageal FBs were found more frequently in younger children. The ear was the most common anatomic site of FB impaction followed by the nose and upper esophageal. The most common type of FB was cereals or seeds. LEVEL OF EVIDENCE: 4.

The use of perineural dexamethasone and transverse abdominal plane block for postoperative analgesia in cesarean section operations under spinal anesthesia: an observational study.

BACKGROUND: During transverses abdominal plane block (TAP) procedure to provide analgesia in cesarean section (CS) operation, the use of perineural dexamethasone as an additive agent may improve pain relief and may cause a prolonged block duration. This study aims to investigate whether perineural dexamethasone, when added to bupivacaine local anesthetic agent during a TAP block, may provide adequate pain relief without adverse events. METHODS: This is a prospective cohort study of fifty-eight patients undergoing elective CS with spinal anesthesia. We hypothesized to perform bilateral TAP block using perineural dexamethasone as an additive agent. The patients were randomly divided into two groups using a systematic random sampling method. While one group of patients received perineural dexamethasone of 8 mg additive agent together with bupivacaine 0.25% 40 ml (Group TAPD), the other group received only bupivacaine 0.25% 40 ml in TAP block (Group TAPA). The primary outcomes are the period for the first request of postoperative pain relief medication and the numerical rating scale (NRS) pain intensity scores at 2, 6, 12, and 24 h after surgery. The secondary outcomes are comparing the 24-h tramadol and diclofenac analgesic requirements and the incidences of side effects on postoperative day one. A p-value of < 0.05 is statistically significant. RESULTS: The time to first analgesic request was 8.5 h (8.39-9.79) in the TAPD group versus 5.3 h (5.23-5.59) in the TAPA group, respectively. (p < 0.001) The median NRS scores were significantly reduced in the TAPD group compared to the TAPA group at 6, 12, and 24 h after surgery (p-values < 0.001). The total analgesics consumption over 24 h postoperatively was lower in Group TAPD compared to Group TAPA (p < 0.05). CONCLUSION: An additive agent of perineural dexamethasone at a dose of 8 mg during bilateral TAP block for elective CS operation under spinal anesthesia provided better pain relief on postoperative day 1.

The current practice of aspiration prophylaxis in obstetric anesthesia: a survey among non-physician anesthetic providers working in hospitals in Ethiopia.

BACKGROUND: Pulmonary aspiration is one of the most important complications of obstetric anesthesia. Prevention of pulmonary aspiration is commonly performed by the application of different anesthetic maneuvers and administration of drugs. This study aimed to assess the non-physician anesthetic providers current practice of aspiration prophylaxis during anesthesia for cesarean section in Ethiopia. METHODS: This survey study was conducted from October 01 to November 05, 2020, on a total of 490 anesthetic providers working in hospitals in Ethiopia. A structured checklist was used to collect data from non-physician anesthetic providers. RESULTS: Four hundred and ninety (490) anesthetic providers participated in our study. The majority of the respondents (84%) were working in the public sector. Most of the cesarean delivery was done under regional anesthesia and more than half of anesthetic providers in Ethiopia administered aspiration prophylaxis routinely. Metoclopramide was the most frequently given as a prophylaxis for pulmonary aspiration. CONCLUSIONS: More than half of the anesthetic providers administered aspiration prophylaxis routinely. Metoclopramide was the commonest administered aspiration prophylaxis for parturients who underwent cesarean delivery to prevent aspiration.

Rectus sheath block and emergency midline laparotomy at a hospital in Ethiopia: A prospective observational study.

BACKGROUND: Midline laparotomy is associated with severe postoperative pain. Literature showed controversial results regarding the efficacy of the rectus sheath block. METHODS: This is a prospective cohort study that recruits 30 patients in the rectus sheath block (RSB) group and 30 patients in the multimodal analgesia (MMA) group who underwent emergency midline laparotomy. The RSB was performed by an experienced anesthetist using a land-mark technique. Independent t-test and Mann-Whitney-U test were used for numeric data while Chi-Square or Fisher exact test was used for categorical variables. P-values < 0.05 were considered as statistically significant. RESULTS: The numeric rating scale score at the recovery was significantly reduced in an RSB group with a p-value of 0.039. Postoperative numeric rating scale scores at 3rd, 6th, 12th, and 24th hours were statistically significantly lower in the RSB group. Postoperative tramadol consumption in 24 h was significantly lower with a p-value of 0.0001 for the rectus sheath group. CONCLUSIONS: For midline laparotomy, adding a bilateral rectus sheath block at the end of the operation might be an effective postoperative analgesia option.

The efficacy of TAP block versus ilioinguinal block for post-cesarean section pain management: A systematic review and meta-analysis.

BACKGROUND: Controversy still exists regarding the analgesic efficacy of transverse abdominis plane (TAP) block versus ilioinguinal or iliohypogastric (IL/IH) nerve block for postoperative pain management following cesarean section. This meta-analysis aimed to perform relatively credible pooled results on the efficacy of the TAP versus IL/IH nerve block for postoperative pain management after cesarean section. METHODS: Databases such as: PubMed/MEDLINE, Google scholar, and google were systematically searched. studies compared the analgesic efficacy of TAP versus IL/IH nerve block for postoperative pain management following cesarean section were included. Data were extracted by three reviewers independently by using Microsoft Excel and then exported to STATA™ 16 version statistical software for analysis. We used a random-effects model meta-analysis and the mean difference of analgesic efficacy with a 95 â€‹% confidence interval was reported based on Preferred Reporting Items for systematic reviews and meta-analysis (PRISMA). RESULTS: Five studies with a total of 390 (196 in TAP and 194 in IL/IH) study participants were included in this meta-analysis. No statistically significant difference was observed between the TAP and IL/IH groups in time to first rescue analgesic request, total postoperative analgesic consumption in milligrams of intravenous tramadol equivalence, and post pain severity score at different points of time both rest and movement. CONCLUSION: This meta-analysis revealed that both approaches have similar postoperative analgesic efficacy following cesarean section. we recommend that the clinician may consider either approach for post-cesarean section pain management.

Knowledge, attitude, and practice of healthcare workers toward COVID-19 and its prevention in Ethiopia: A multicenter study.

BACKGROUND: An emerging respiratory disease abbreviated as coronavirus disease 2019 was first reported in December 2019 in Wuhan city of China. The virus is zoonotic and tends to be transmitted between animals to humans and humans to humans. The major route of transmission of coronavirus disease 2019 is droplet and close contact. The Ethiopian Ministry of Health has initiated training for health care workers at a different level. Thus, the main objective of this study is to assess the knowledge, attitudes, and practices of health workers in Ethiopia toward coronavirus disease 2019 and its prevention techniques. METHOD: An institution-based multicenter cross-sectional study was conducted in each of eight teaching and referral hospitals. A total of 422 Ethiopian healthcare workers were selected for the assessment of knowledge, attitude, and practice toward coronavirus disease 2019. Data were collected using a structured questionnaire. A logistic regression model was used to identify factors associated with the attitude and knowledge of healthcare workers toward coronavirus disease 2019 at a significance level of p < 0.05. RESULT: Three hundred ninety-seven healthcare workers participated in the study, with a response rate of 94%. Among these, 88.2% and 94.7% of respondents had good knowledge and positive attitudes, respectively. A respondent with a history of chronic medical illness (odds ratio: 0.193, 95% confidence interval: 0.063-0.593), social media, telecommunication, and television/radio as a source of information were significantly associated with knowledge (odds ratio: 3.4, 95% confidence interval: 1.5-7.4, OR: 4.3, 95% confidence interval: 1.3-14.3 and odds ratio: 3.2, 95% confidence interval: 1.4-7.2). In addition, respondents with a history of chronic medical illness were significantly associated with a negative attitude toward coronavirus disease 2019. CONCLUSION: The knowledge and attitude were good while; the practice was relatively low. Sources of information such as social media, telecommunication, and television/radio were positively associated with healthcare workers' knowledge about coronavirus disease 2019.

Lidocaine versus propofol administration on the attenuation of hemodynamic responses during extubation in the adult elective surgical patient: A prospective cohort.

BACKGROUND: Tracheal extubation is the process of removing a tube from the trachea. It is associated with an increase in heart rate, blood pressure, intracranial pressure, intraocular pressure, coughing, bronchospasm, laryngospasm, and bleeding. Many techniques, as well as drugs, have been attempted for attenuation of the airway and cardiovascular responses. Propofol and lidocaine are widely available drugs in resource-limited settings even though their relative effectiveness for smooth extubation is not well established. OBJECTIVES: To assess the effectiveness of intravenous lidocaine and propofol on the attenuation of extubation-induced hemodynamic responses in the adult elective surgical patient from November 01, 2019, to February 30, 2020, at Asella teaching and referral hospital, Ethiopia. METHODS: Institutional-based prospective observational cohort study design was conducted on 72 ASA I patients who underwent elective surgery. The study participants were allocated into three groups equally based on anesthetists' extubation plan; Group P, 0.5 mg/kg propofol, group L, 1.5 mg/kg lidocaine administered 2 min before extubation and group C was a control group. Data were analyzed by SPSS version 20 after the normality of the data was checked by the Shapiro Wilk test. One-way ANOVA followed by a Tukey posthoc test has been employed to find the pair-wise significance and a p-value of <0.05 was considered as statistically significant. RESULTS: A demographic status and clinical characteristics of the patient were comparable between groups with p-values of >0.05. After extubation; heart rate, systolic, diastolic, and mean arterial blood pressure were decreased significantly in groups of propofol and lidocaine within 10 min. Propofol shows better results in maintaining stable systolic blood pressure up to 3 min, while heart rate, diastolic, and mean arterial pressure were maintained stable up to 5 min after extubation (p = 0.001). CONCLUSIONS: 0.5 mg/kg propofol or 1.5 mg/kg lidocaine might help to attenuate extubation induced hemodynamic responses.

Medical and Health Science Students' Perception Towards a Problem-Based Learning Method: A Case of Debre Tabor University.

BACKGROUND: Problem-based learning is a student-centered innovative instructional approach in which students define their learning objectives by using triggers from the predefined problem case scenario. Problem-based learning is not about problem-solving; rather it uses appropriate problems to increase the problem-solving skills of students. This study aims to assess the medical and health science students' perception towards problem-based learning method. METHODS: An institution-based descriptive cross-sectional study was employed. All available graduating class Medical and Health Science students were included in this study. RESULTS: More than half of the students (59.4%) strongly agree that problem-based learning was helpful to understand basic sciences knowledge and 31.5% of the students disagree that tutors are prepared and qualified to run the session. Some of the students (27.3%) disagree that tutors evaluate students fairly. About fifty-two percent of the students have used both books and Internets for self-directed learning. CONCLUSION: More than half of students agree that problem-based learning helped them understand basic science knowledge. Some of the students disagree that tutors are prepared and qualified to run the session, and disagree that tutors evaluate students fairly.

Prevalence and associated factors of post dural puncture headache among parturients who underwent cesarean section with spinal anesthesia: A systemic review and meta-analysis, 2021.

INTRODUCTION: PDPH is a headache that develops after dural puncture which worsens in an upright position, and improves with lying down. It could affect maternal satisfaction and health care quality. The prevalence and factors of PDPH vary based on different literature and there is no previous meta-analysis done. METHODS: This study was done by searching studies from databases PubMed/MEDLINE, Google scholar, and google. Data were extracted by three reviewers independently by using Microsoft Excel and then exported to STATA™ 16 version statistical software for analysis. Heterogeneity assessed using the I2 statistic. With a random model meta-analysis, the pooled prevalence of post-dural puncture headache and its associated factors (POR) with a 95% confidence interval was estimated. RESULT: Eight studies with a total of 175, 652 study participants were included to estimate the pooled prevalence of PDPH following cesarean section under spinal anesthesia. The pooled prevalence of PDPH in this meta-analysis was found to be 23.47% with 95% CI (10.53, 36.42). Having normal BMI, multiple attempts of spinal injection and spinal injection with a needle size of less than or equal to 22 gauge were positively associated with the PDPH with AOR and 95% CI of 1.22 (1.09, 1.35), 3.50 (1.55, 5.44) and 7.36 (4.93, 9.80) respectively. CONCLUSION: The pooled prevalence of PDPH among parturients who gave birth with the cesarean section under spinal anesthesia is estimated to be 23.47%. Having normal BMI, multiple attempts of spinal injection, and spinal injection with a needle size of less than or equal to 22 gauge were positively associated with the PDPH.

Effectiveness of wound site infiltration for parturients undergoing elective cesarean section in an Ethiopian hospital: A prospective cohort study.

BACKGROUND: Cesarean delivery (CD) is a commonly performed obstetric surgical procedure and causes moderate to severe postoperative pain. Wound site infiltration (WSI) is becoming a technique to provide postoperative analgesia in a limited-resource setting in regardless of controversy on its effectiveness. The current study is to assess its effectiveness as a part of postoperative analgesia for parturients undergoing elective Cesarean section. METHODS: A Hospital-based prospective cohort study was employed on 58 parturients that underwent elective Cesarean section. Study participants were allocated into the Wound site infiltration and Control group based on planned postoperative pain management. A student t-test was used for normally distributed data while non-normally distributed data were analyzed by Mann Whitney U test. Pearson Chi-squared or Fisher's exact test were used to analyzing categorical data as appropriate. A p-value < 0.05 considered as statistically significant. RESULTS: The median time to request the first analgesia was significantly prolonged within Wound site infiltration 314.31 ± 47.71 in minutes compared to control group 216.9 ± 43.18 with a P-value of <0.001. The postoperative verbal NRS score was significantly reduced in Wound site infiltration compared to the control group at 4th and 6th hours with p values of <0.001 and 0.04 respectively. CONCLUSION: Wound site infiltration performed following elective cesarean section under spinal anesthesia significantly prolonged time to request the first analgesia, decreases verbal NRS score, and total analgesic consumption within 24 h in postoperative period compared to control group.

The Current Practice of Spinal Anesthesia in Anesthetists at a Comprehensive Specialized Hospital: A Single Center Observational Study.

BACKGROUND: Spinal anesthesia block is the most widely practiced anesthesia technique due to its safety margin. It is an invasive procedure that could be associated with a variety of complications like total spinal, cardiovascular collapse, meningitis, paralysis, and even death. The aim of this study to assess the current practice of spinal anesthesia. METHODS: A Cross-sectional study design was conducted in Debre Tabor Comprehensive Specialized Hospital from November 01 to December 15, 2020. All anesthesia professionals who are working in the study Hospital were surveyed by the Purposive sampling technique. A standardized structured checklist prepared from recommendations of New York school of regional anesthesia guideline regarding the current Practice of spinal anesthesia was used to collect the data after taking written informed consent. Descriptive statistics were employed to summarize the results. RESULTS: A total of 24 anesthetists were observed of their practice before, during, and after administer of spinal anesthesia. All of the anesthetists were practicing the preparation and assembling of all necessary anesthesia equipments, resuscitation drugs, and basic monitors while all of the anesthetists did not wash their hands, wore a sterile gown, and draped the back of the patient with fenestrated drapes in a sterile fashion. CONCLUSION: Most of the anesthesiology professionals in our setting have a good preparation of all necessary anesthesia equipments, and resuscitation drugs, while the assessment of patient's emotional reaction and pain during injection, the skin preparation allowed to being dry and assessment of the degree of sensory and motor block of the patient were insufficient.