Browsing by Author "Ayele Blen"

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    Adherence of Health Care Workers to Hand Hygiene at Intensive Care Unit Tikur Anbesa Specialized Hospital, Addis Ababa, 2024/25, Observational Study
    (Addis Ababa University, 2025-04-15) Mullu Adissu; Ayele Blen
    Hand hygiene (HH) is recognized as the single most effective strategy for preventing health care–associated infections. In developing countries, data on hand hygiene compliance is available only for few health-care facilities. This study aimed to assess hand hygiene adherence of health-care workers working at ICU of TASH, Addis Ababa, Ethiopia
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    Assessment of Patient Satisfaction with Preoperative Anesthetic Evaluation and Associated Factors at Tash, Addis Abeba, Ethiopia
    (Addis Ababa University, 2025-05) Regassa Samrawit; Ayele Blen
    Patient satisfaction with reoperative anesthesia care is a key indicator of healthcare quality, influencing both patient experience and outcomes. In Ethiopia, limited evidence exists on the level of patient satisfaction with preoperative anesthetic evaluation, especially at Tikur Anbessa Specialized Hospital (TASH).
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    Determinants of Postoperative Outcomes of Newborns with Tracheoesophageal Fistula at Tikur Anbessa Specialized Hospital, Addis Ababa University, Addis Ababa, Ethiopia
    (Addis Ababa University, 2024-05) Negash Amanuel Yishak; Ayele Blen
    Background: Esophageal Atresia with Tracheoesophageal Fistula (EA/TEF) is a potentially life-threatening condition that causes serious complications unless prompt surgical intervention is done to restore normal breathing and nutrition. Despite advances in surgical techniques and perioperative care, EA/TEF remains a challenging condition to manage as the postoperative results fluctuate significantly between various hospitals and geographical areas.In Ethiopia, large-scale studies are scarce on identifying determinants of postoperative outcomes in newborns with EA/TEF. Objectives: To identify the determinants of postoperative outcomes in EA/TEF newborns. It examined the interplay between patient-related factors, surgical factors, and anesthetic-related factors in determining postoperative outcomes, including mortality, length of hospital stay, and the incidence of complications. Methods: A single-center retrospective cross-sectional hospital-based study was conducted at the Tikur Anbessa Specialized Hospital (TASH). The pediatric HMIS database was used to manually abstract the data of operated newborns with the diagnosis of EA/TEF. The collected data was analyzed and presented as descriptive statistics and regression methods were run toassess statistically significant outcome-predicting factors. Results: Our retrospective cross-sectional study of 122 operated EA/TEF patients identified electrolyte abnormalities (AOR: 0.081, 95% CI: 0.007 – 0.887, p-value: 0.040) and postoperative complications (AOR: 0.126, 95% CI: 0.052 – 0.303, p-value: 0.000) have a significant association to determine the postoperative outcome of EA-TEF newborns. Conclusion and Recommendation:The study underscores standardized preoperative preparation and the implementation of protocols for thorough assessment and optimization. Vigilant postoperative monitoring, infection prevention, and comprehensive management strategies are imperative for enhancing patient survival rates.
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    Incidence and associated factors for failed spinal anesthesia undergoing elective surgery at Tikur Anbesa specialized hospital. Prospective observational study.
    (Addis Ababa University, 2023-05) Eshete Abraham; Tesfaye Birhane; Ayele Blen
    The objective of this study is to review the incidence and associated factors contributing to failed spinal anesthesia, a well-known complication associated with various factors that can lead to poor surgical outcomes. Several factors contribute to this complication, including obesity, difficult spinal needle insertion, spinal cord anomalies, improper medication administration, technical errors, and co-morbidity. In summary, failed spinal anesthesia is a critical concern that may lead to considerable morbidity and mortality. Therefore, appropriate measures should be taken to mitigate this complication by analyzing potential risks, adhering to proper techniques, and increasing awareness among anesthesia providers. Objectives-To study the incidence and associated factors of failed spinal anesthesia in adults who underwent elective surgery in Tikur Anbessa hospitals at Addis Ababa, Ethiopia. Methods-A prospective observational survey was conducted on 280 eligible adult elective surgical patients July 1st to November 30th, 2023 at TASH, Addis Ababa, Ethiopia. Simple random sampling method was employed for selecting samples. Data was entered and analyzed with SPSS version 27. Bi-variate and multivariate logistic regression analysis was done to access significance of factors associated with failed spinal anesthesia.At 95% confidence interval a p-value of less than 0.05 was considered as statistically significant. Outcomes -The incidence of failed SA among the adult who underwent elective surgery under SA was 18.5% (51/276)).Multivariate logistic regression analysis showed that anaesthesia providers who had < 2 year of work experience (AOR =8.195,95%CI = 3.324-20.205) , bloody CSF appearance during lumbar puncture (AOR = 21.268, 95% CI = 8.564-52.81) and count of spinal attempted is more than two times (AOR=3.262, 95%, CI=1.417-7.509) were found to be a significant factor for SA.
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    Incidence and Associated Factors of Emergence Delirium in Pediatric Patients Undergoing ENT Surgery at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia 2024 G.C
    (Addis Ababa University, 2024-05) Beshah Hanna; Ayele Blen; Indris Semira
    Background:Pediatric emergence delirium is a common phenomenon that occurs in children undergoing surgery under GA and is characterized by a brief period of disorientation, agitation and confusion upon waking up from anesthesia. Its duration is variable but is often self-limiting and typically resolves quickly but it can be distressing for both the child and their parents or caregivers as ED might be associated with severe adverse events, which might end up in the unintentional physical injury to the patient or personnel leading to prolongation of hospital stay and increased parental anxiety and dissatisfaction with perioperative care.This study aims to contribute to the current knowledge on ED in pediatrics undergoing ENT surgery, address knowledge gaps in its incidence and assess risk factors associated with it. Objective:To assess the incidence and associated factors of emergence delirium in pediatric patients undergoing ENT surgery under general anesthesia in TASH, Addis Abeba, Ethiopia. Method:An institutional-based prospective cross-sectional study was conducted from September 2023 to April 2024 G.C at TASH. During the study period 88 pediatric patients between the ages of 2 and 12 years, who have undergone elective ENT surgical procedures in the major OR were included in the study. Data was collected using a structured questionnaire by anesthetists and anesthesiology residents in the major OR and PACU. PAED scale was used to assess for ED and a PAED scale of 12 or more was taken as PED. Binary logistic regression analysis was performed to determine predictors of postoperative delirium in pediatric patients undergoing ENT surgery under general anesthesia. Results:The incidence of Pediatric emergence delirium in this study was 21.6%. Age (toddlers and preschoolers) (p-value 0.039, AOR=4.831; 95% CI:1.08,21.62), maladaptive behavior (p-value 0.003, AOR=12.16; 95% CI:2.278,64.91), premedication (p-value 0.043, AOR=0.11; 95% CI:0.013,0.928) and moderate to severe postoperative pain (p-value 0.005, AOR=11.05; 95% CI:2.058,59.34) were significantly associated with postoperative ED following ENT surgery. Conclusion:The incidence of ED in pediatric patients undergoing ENT surgery in TASH was found to be 21.6%. This study also highlights several factors emerging as significant predictors of ED with toddler and preschooler age group, preoperative maladaptive behaviors, lack of premedication and moderate to severe postoperative pain being highly associated with developing postoperative PED.
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    Incidence and Associated Risk Factors of Intraoperative Hypoxemia in Pediatric Patients Underwent Elective and Emergency Surgery Under General Anesthesia at Tikur Anbessa specialized Hospital,Addis Ababa,Ethiopia,2023/2024.
    (Addis Ababa University, 2024-05) Atale Surafiel; Ayele Blen; Endris Semira
    Background: Intraoperative hypoxemia is a very common respiratory adverse event in pediatric anesthesia. It causes hemodynamic instability like tachycardia, bradycardia, cardiac arrest, and hypoxic brain insults, and it is associated with increased morbidity and mortality.Even though it is common, there are a few studies’ that show the incidence of intraoperative hypoxemia increases with younger ages. Objective: The objective of this study is to determine the incidence of intraoperative hypoxemia and its associated patient, surgical, and anesthesia related risk factors in elective and emergency pediatric surgery at TASH. Method: The study design was a single-center analytic prospective observational study at Tikur Anbessa Specialized Hospital with a sample size of 208. Convenience consecutive sampling technique was used to select the patient. The data was collected from pediatric patients who have had non-cardiac surgery from induction to the emergence of general anesthesia by continuous monitoring and observation of the pulse oximetry record from the monitor. The observed data was documented in the prepared anonymous questionnaire. The data was entered, coded,cleaned, and analyzed by SPSS 29 software. Logistic regression was used to assess the association between the dependent and independent variable and p value< 0.05 at Confidenceinterval of 95% was used for assessing the statistical significance. Result: Among the 208 pediatric patients included in the study, 117 (56.2%) were experienced a drop insaturation at or below 90%. Forty four (37.6%) of this study participants (117) had only a one minuteduration of desaturation, and 49 (41.8%) of the participants had one episode. From 117, 91 (77.7%) were attributed to true hypoxemia, and the other 26 (22.2%) were artifacts. 34 (29%) occurred during induction, and the remaining occurred during maintenance and emergence. From all true hypoxemia,46(50.5%) were mild, and the remaining's were in the moderate to severe ranges. The study finding showed that the urgency of the surgery, neonatal age, higher ASA class and the presence of comorbidity were associated with hypoxemia by bivariate and multivariate logistic regression. Conclusion: Since intraoperative hypoxemia is prevalent in pediatric patients, understanding and addressing these risk factors may help to improve perioperative care and outcomes.
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    Incidence of OF Laryngospasm and Associated Factors among Pediatric Patients who Undergo Surgery in Tikur Anbessa Specialized and Menelik Hospitals, Addis Ababa, Ethiopia,2023/2024: A Prospective Cross-Sectional Study.
    (Addis Ababa University, 2024-05) Mekonnen Hailemariam; Tesfay Birhane; Ayele Blen
    Background: Laryngospasm is a reflex closure of the upper airway caused by a spasm in the glottis muscle, which can lead to imminent respiration. Laryngospasm can happen at any stage of anesthesia. Laryngospasm causes increased morbidity and death as a result of hypoxia and hypercapnia. However, there has been little research into laryngospasm incidence and associated variables among children patients undergoing general anesthesia in Ethiopia. Objective: To assess the associated factors of laryngospasm and its incidence among pediatric patients who undergo surgery under general anesthesia in Tikur Anbessa specialized and Menelik referral hospitals from November 1, 2023 to May 1, 2024. Method: An institutional based cross-sectional study was conducted among pediatric patients who underwent surgery under general anesthesia in Tikur Anbessa specialized hospital and Menelik referral hospital, from November 1, 2023 to May 1, 2024. A consecutive sampling technique was utilized to recruit the study participants and data collected using a structured questionnaire. Data was entered in to SPSS software version 26 for analysis. A binary logistic regression model was fitted to assess the association between the outcome and predictor variables. A P-value less than 0.05 was used to declare statistical significance. Finaly, the results were reported in words, tables and graphs. Result: The laryngospasm incidence was 12.8% with 95% CI= (9-16). The majority of the incidents, 84.1% occurred during emergence phase of GA. The common triggering factors identified were multiple airway attempt (AOR: 13.71, [95% CI= 5.745-32.744]), inadequate depth of anesthesia (AOR: 7.814, 95% CI= 2.746-22.239]). The complications of laryngospasm identified were desaturation in 41(93.2%), bradycardia in 11(25%), inspiratory stridor in 24(54.5%), decreased air entry in 35(79.5%), increased inspiratory effort in 31(70.4%), paradoxical breathing in 25(56.8%), cyanosis in 1(2.3%), and pulmonaryaspiration in 1(2.3%) of the cases. Conclusion and recommendation: Laryngospasm is mainly associated with multiple airway attempt, inadequate depth of anesthesia, and upper respiratory tract infection. It is recommended to maintain adequate depth of anesthesia, decrease the number of airway attempts, optimize those with upper respiratory tract infections unless the surgery is urgent.
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    Translation and Validation of the Amsterdam Preoperative Anxiety and Information Score for Evaluation of Preoperative Anxiety in Adult Surgical Patients in Black Lion Hospital, Addis Ababa, Ethiopia.
    (Addis Abeba University, 2019-11) Ayele Blen; Tadesse Mahlet
    Background: Perioperative anxiety is described as a vague, uneasy feeling, the source of which is often nonspecific and unknown to the individual. It has the potential to affect all aspects of anesthesia such as preoperative visit, induction, perioperative and recovery periods. Although the magnitude and consequences of preoperative anxiety is well documented in developed world, there are limited studies conducted in Ethiopia. The use of anxiety screening instruments that take too much time to be filled will not be applicable clinically in our set up where enough time may not be given to conduct preoperative assessments. Objective: The primary aim of this study is to translate the APAIS into Ethiopian national language, Amharic and evaluate its validity in assessing the prevalence of preoperative anxiety in Black lion Hospital. Methods: A forward and backward translation of the items in APAIS was performed into Amharic by a legal bilingual expert. Three hundred sixty five sampled elective adult surgical patients scheduled for surgery at Black lion hospital were interviewed from July 01 to Aug 30,2019 using the Amharic version of the APAIS. Then, the validity of the translated version was checked by evaluating its psychometric properties of internal validity and acceptability. The results were also compared with findings of other similar studies. Results: The reliability of the Amharic version of the APAIS was high ( Cronbach's alpha of 0.87) and the data collected was a good fit ( RMSEA of 0.04) In addition, the questionnaire was well accepted 100% with no missing values for each dimension of the APAIS. The mean APAIS scores for total anxiety and desire for information were 11.6 and 6.0 respectively and 58.9% of the study participants had anxiety and those patients, who had some form of formal education, came from urban areas, had previous anesthesia experience and complications and who had average or high information requirement were more likely to be anxious. Conclusion: The Amharic version of the APAIS is a reliable and acceptable tool for measuring patients’ preoperative anxiety and their need of information. It can be used routinely as a screening instrument at pre anesthesia clinics to assess patients’ level of anxiety