Browsing by Author "Abiy Sileshi"

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    Attitude, knowledge, and Associated Factors on Anesthesia Informed Consent among Adult Elective Surgery at Selected Addis Ababa Public Hospitals.
    (Addis Abeba University, 2020-06) kelelegn Tamrat; Abiy Sileshi; Danieal Tinbit
    Background: Informed consent is the backbone for recent medical practice and it is grounded in ethical and legal concept-that patients have the right to understand what is being done to their bodies (personal autonomy) and agree to the potential consequences of the healthcare intervention. Informedconsent is considerably beyond putting a signature to the form; the anesthesia professional and the patient develop the anesthesia plan through discussion ofalternatives and risks and benefits of the plan. Objective; The objective of this study was to explore the patient's knowledge, attitude and associated factors on anesthesia informed consent among adult elective surgery at a selected public hospital in Addis Ababa. Methods; Institutional based Cross-sectional study designed was used with including all elective surgery scheduled patients from December 23/2019 to March 23/2020 with consecutive sampling technique and proportional allocation. A Structured questioner was used with trained data collectors. Data were coded, entered into EPI data v.7 and data was exported to SPSS version 21 statistical package for analysis. Binary logistic regression was used to deal with the response variable. The crude and adjusted odds ratios with their corresponding 95% confidence intervals were computed. Work plan and budget; The study was conducted from December 23/2019 to March 23/2020 with a total budget of 29, 240 ET Result; Patient knowledge about the anesthesia informed consent, 65.8% were knowledged and34.2% were not knowledgeable. Marital status, educational level, professionals who provide anesthesia informed consent and place were anesthesia informed consent taken were significantly associated with patient’s knowledge. Concerning the attitude of patients, about 44.3% (181) had a positive attitude, and 55.7% (228) had a negative attitude. Sex, marital status,educational level, and place were anesthesia informed consent provided had significantly affected with patient attitude. Conclusion; Patients who were under the study had limited knowledge and attitude and different factors were affected them.
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    The Effect of Anesthetic Technique on Fetal outcome among Mothers Undergoing Caesarean Section for Non-Reassuring Fetal Status At Addis Ababa Public Hospitals, Addis Ababa Ethiopia
    (Addis Abeba University, 2020-06) Tadesse Berihu; Abiy Sileshi
    Background: Emergency Cesarean Sections are performed for various reasons. One of the reasons to do Cesarean Section (CS) is non-reassuring fetal status. Cases with emergency caesarean sections like non-reassuring fetal status are challenging for the obstetric anesthetist and obstetrician because such cases are highly associated with life-threatening complications for the fetus and/or the mother. So, choosing appropriate anesthetic technique in such cases is essential in decreasing fetal and maternal morbidity and mortality. Objective: To assess the effects of anesthetic technique, General Anesthesia (GA) versus Spinal Anesthesia (SA), over neonatal outcome of newborns delivered by CS for the indication of nonreassuring fetal status in Addis Ababa government hospitals,in 2019/2020 Methods:A prospective cohort study was conducted on 200 pregnant mothers who came forces for the indication of non-reassuring fetal status and fulfill the inclusion criteria for the study.Patients in SA group (n = 100) received spinal anesthesia with 10 mg of bupivacaine while the GA group (n = 100) received general anesthesia. Study participants were selected by systematic random sampling technique after proportional allocation to the study hospitals. Data were collected using preoperative chart review, maternal interview and intraoperative observation. Comparisons of numerical variables between study groups were done using independent sample t-test and categorical variables were performed using chi-square test. Significance wasdetermined at p-value < 0.05. Results: There was a significant difference in the mean of 1 minute Apgar score between SA and GA groups among newborns delivered by caesarean section for the indication of non-reassuring fetal heart status (Mean = 7.28, SD = 1.16) and (M = 6.64, SD = 1.44; p = 0.001) for SA and GA respectively. But there was no significant difference in 5 minute Apgar score. There was no significant difference in neonatal intensive care unit admission between GA and SA groups, χ2(1) = 0.31, p =0.57. Conclusions: this study revealed that newborns delivered under SA had better 1 minute mean Apgar score when compared with GA. Based on this we recommend SA for mothers with the diagnosis of non-reassuring fetal status.
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    Hydropower Retrofitting Feasibility study for a comparative Engineering and Economic Analysis: A case Study of Tendaho Dam
    (Addis Ababa University, 2026-05) Abiy Sileshi; Tilahun Nigussie
    This study assesses the technical and economic feasibility of retrofitting the Tendaho Dam in Ethiopia for hydropower generation while preserving its primary irrigation function. Three retrofit strategies are evaluated: the Dedicated Waterway Strategy (Option I), the Bifurcation Strategy (Option II), and the Channel Utilization Strategy (Option III). A sequential, quantitative, engineering-based methodology is applied, integrating hydrological analysis, engineering assessment, hydraulic modelling, and economic evaluation. Long-term hydrological data, including river discharge, reservoir levels, and irrigation releases, are analysed to determine dependable flows and available head. Structural and operational characteristics of the dam are assessed using original design documents and verified through field observations to identify physical constraints and ensure irrigation compliance. Technically feasible retrofit options are modelled using established hydropower equations to estimate installed capacity, power output, and annual energy generation. Economic and financial performance is evaluated using the RETScreen platform, employing indicators such as Net Present Value (NPV), Levelized Cost of Energy (LCOE), and payback period. The results demonstrate that retrofitting the Tendaho Dam is both technically and economically feasible. Options I and II achieve installed capacities exceeding 16 MW and annual energy generation greater than 111,000 MWh, confirming that the existing structural and hydraulic systems can support large-scale hydropower development without compromising irrigation requirements. Option III, although smaller in scale, remains technically viable and highlights the potential for incremental hydropower retrofitting. Financial analysis indicates that engineering design choices strongly influence economic outcomes. Option II yields the highest NPV, followed by Option I, while Option III generates only marginal returns. Cost-effectiveness analysis shows that Options I and II achieve LCOE values between 0.013 and 0.017 USD/kWh, well below the IRENA benchmark of 0.05 USD/kWh, whereas Option III, although feasible, is less competitive. The study concludes that optimized hydropower retrofitting of the Tendaho Dam offers a cost-effective and low-impact pathway for expanding renewable energy generation
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    Incidence and Associated Factors of Postoperative Delirium among Elderly Elective Orthopedic Surgical Patients in Selected Addis Ababa Public Hospitals, Ethiopia, 2024, A Multi Center Longitudinal Study.
    (Addis Ababa University, 2024-05) Asrat Yegle; Abiy Sileshi; Seifu Ashenafi
    Background: Delirium is a neurocognitive disorder characterized by an acute and relatively rapid decline in cognition, disturbance of consciousness, reduced ability to focus and shift of attention. Additionally, it is well recognized that it mostly affects elderly patients, and its incidence is increased during the postoperative period. Occurring in 8% to 20% of older patients after an operation, and frequently it occurs between 24 hours and 5 days after surgery. And it can result in serious medical management problem; therefore, identification of the possible contributing factors and magnitude of the burden will help in the management of delirium in elderly patients. Objective: To assess the incidence and associated factors of postoperative delirium among elderly elective orthopedic surgical patients in selected Addis Ababa public hospitals, Ethiopia,from February 2024 to May 2024. Method and tools: A multi-center longitudinal study was conducted on elderly patients in four selected Addis Ababa public hospitals from February 2024 to May 2024, and a systematic sampling technique was used to select the study participants. Patients aged ≥65 years old who underwent elective orthopedic surgery were included in this study. Data was collected through chart review and interview of patients, and postoperative delirium was assessed by using confusion assessment method (CAM). Both bivariable and multivariable logistic regression model were used for statistical analysis. Results: 220 patients who underwent elective orthopedic surgery at four selected Addis Ababa public hospitals were included; most of the patients were male, 68.1% of the patients underwent lower extremity surgery, and 62.3% of the patients received spinal anesthesia. The incidence ofpostoperative delirium among elderly elective orthopedic surgical patients was 33.7%, and age65-75(AOR =0.468, 95%CI (0.226-0.97),perioperative opioid usage (AOR=2.200, 95%CI(1.073-4.5313), intraoperative anticholinergic usage(AOR=2.238,95%CI(1.831-4.235),history of hospitalization(AOR=2.24,95%CI(1.202-4.206),and blood transfusion (AOR=2.83,95%CI(1.295-6.193) were significantly associated with postoperative delirium. Conclusion: The incidence of postoperative delirium among elderly elective orthopedic surgical patients was high in the study area (33.7%); advanced age, blood transfusion, intraoperative anticholinergic usage, pervious history of hospitalization and perioperative opioid usage were the associated factors for postoperative delirium. Recommendation: We recommend that special attention should be paid for elderly patients with history of hospitalization, blood transfusion, who use opioid and anticholinergic medications. in addition to this, reducing opioid-based pain treatment is important. We also recommend that feature researchers to do ongoing research on long-term impact of postoperative delirium on elderly patients.
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    Survival Status and Predictors Of Postoperative Mortality in Patients Who Underwent Esophageal Surgeries for Esophageal Malignancies at Selected Governmental Hospitals Ethiopia, Addis Ababa: A Retrospective Cohort Study
    (Addis Ababa University, 2024-06) Birhanu Mintesinot; Abiy Sileshi ; Samuel Hirbo
    Introduction: Cancer is still the leading cause of death worldwide, and esophageal canceris the sixth leading cause of cancer-related deaths. For individuals with esophageal cancer,esophagectomy is the only treatment option available and it has a high risk of both death andmorbidity. Moreover, despite advances in preoperative optimization, surgery, and anesthesia techniques, as well as the introduction of neoadjuvant therapy, the mortality and morbidity associated with esophagectomy persist to be high. Objective: To assess the Survival status and predictors of postoperative mortality in patients who underwent esophageal surgeries for esophageal malignancies at selected governmental hospitals from 2018-2023 GC Ethiopia, Addis Ababa Methods: A Retrospective Cohort study was conducted. After the acquisition of data from the chart review, Data was analyzed using R version 4.3.3. Descriptive statistics for categorical variables were reported as frequency and percentages. Kaplan Meier curve and log-rank test were used to estimate the survival curve and the difference in survival among groups within each covariate respectively. After esophageal surgery, the impact of each covariate on the time to death was assessed using the Cox proportional hazard model. Results: 246 patients who underwent esophageal surgeries for esophageal malignancy at 4governmental hospitals in Addis Ababa were included over 5 years. The mean age of the patients was 52.1 years. 127(51.6%) had a T4 stage Cancer, 166(67.5%) had a tumor size <3.3cm, and Squamous cell carcinoma accounted for 207(84.1%) cases, Epidural Analgesia was the most commonly used analgesic technique 45(18.3%). 30-day mortality was 8.5%, The overall 1,2,3,4and 5-year survival rate were 49.8%, 30.2%, 15.4%, 15.4%, and 10.3% respectively. The median Survival time was 12 months. ASA score of > III. (AHR = 1.93, 95%CI 1.10-3.38), Hospital Acquired Pneumonia (AHR = 1.95, 95%CI: 1.06-3.59). Hypertension (AHR = 2.22, 95%CI: 1.04-4.73), Cervical anastomotic Leak (AHR = 2.17, 95%CI: 1.00-4.67), and sepsis (AHR = 3.69,95%CI: 1.49– 9.11). were identified as an independent predictor of postoperative mortality in the multivariate Cox regression model. Conclusion: In Ethiopia, patients who underwent esophageal surgeries for esophageal malignancy have a low 5-year survival rate. Patients who develop complications in the postoperative period are more likely to die compared to their counterparts Thus screening, prevention, and early management of postoperative complications is recommended to improve survival rate.