Browsing by Author "Samuel, Hirbo (B.Sc. M.Sc.)"

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    Assessment of the magnitude and associated factors of unplanned extubation in intensive care unit at Addis Ababa governmental hospitals. Addis Ababa, Ethiopia 2021
    (Addis Ababa University, 2021-08) Minda, Zewdu; Samuel, Hirbo (B.Sc. M.Sc.); Aweke, Senayit(MSC)
    Background: Unplanned extubation is the premature removal of an endotracheal tube accidentally during procedural activities or by the action of the patient. It is one of the commonly reported complications among mechanically ventilated patients in the intensive care unit. Objectives: Assess the magnitude and associated factors of unplanned extubation in intensive care unit at Addis Ababa governmental hospitals, Addis Ababa Ethiopia January8, 2021-May9, 2021 Methods: Hospital based cross-sectional study conducted on 317intubated patients in the intensive care unit which fulfilled the inclusion criteria at the selected Addis Ababa governmental hospitals, Addis Ababa Ethiopia from January8, 2021-May9, 2021.Data collection method was includes patients chart review, direct observation and by asking the physician. Collected data was entered to Epi-data version 4.6.0.2 and was analyzed by SPSS version 26 statistical software .All independent variables with the dependent variable was analyzed using binary logistic regression to determine the variables independently predictive of unplanned extubation. Odd ratio .P-value and 95% confidence interval was calculated to differentiate risk factors and to assess association strength. Variables with P-value<0.25 on bivariate analysis were going to multivariable analysis and P-value less than 0.05 was cut point to test the statistical significance. Result: The prevalence of unplanned extubation in this study was 19.74 %.Being male (AOR=3.132, 95%CI: 1.276-7.69), duration of intubation <5days (AOR=2.475, 95% CI: 1.0395.894), managed by junior resident (AOR=5.25, 95% CI: 2.125-12.969), being physically restrained (AOR=4.356, 95%CI: 1.786-10.624), night shift (AOR=3.282, 95%CI:1.4517.424)and agitation (AOR=4.934,95%CI:1.934-12.586) were significantly contribute to the occurrence of unplanned extubation. Conclusion and recommendation: This study showed that the prevalence of unplanned extubation was high in ICU at Addis Ababa governmental hospitals. We suggest to ICU staffs in Addis Ababa governmental hospitals to give special attention to early intubated patients especially for male individuals and the stakeholders of hospitals should rearrange the time of shift and physician schedule in ICU.
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    Effect of Low-Dose Intravenous Ketamine on Postoperative Pain after Cesarean Section following under Spinal Anesthesia in Zewditu Memorial Hospitals, Addis Ababa, Ethiopia, 2021, a prospective observational cohort study
    (Addis Abeba University, 2021-06) Tuni, Jemal; Samuel, Hirbo (B.Sc. M.Sc.); Aweke, Senait (B.Sc. M.Sc.)
    Background: Cesarean section is common obstetric procedures worldwide. Following cesarean delivery, mothers experience moderate to severe pain since postoperative analgesia of spinal anesthesia is limited by duration of local anesthesia drug used. Analgesic effect of local anesthesia agents could be extended by adding adjuvants like neostigmine, opioid and low dose of intravenous ketamine. Objective: This study was assess effect of low-dose intravenous ketamine on postoperative pain following cesarean section with spinal anesthesia in Zewditu Memorial Hospital, Ethiopia, 2021 Method: Sixty pregnant mothers planned for elective cesarean delivery under spinal anesthesia were involved in this prospective cohort study at zewditu memorial hospital. Participants were selected by systematic random sampling technique. Numerical rating scale pain score, time to request first analgesia and total analgesia consumptions were recorded in first 24 hours. Independent sample t- test, Mann–Whitney U-test and a chi-square was used for analysis based on distribution of data. Result- Numerical rating scale pain score at 1 st and 2 nd hour after surgery was significantly different between the groups with p≤ 0.05. But pain score at 6 th , 12 th , 18 th and 24 insignificant. Time to request first analgesia was significantly longer in exposed than Non-exposed group with p< .0001.The median(range) of tramadol consumption in 24 hour was 100(100_100) for exposed and 150(100_150) for non-exposed which was significant difference between both groups with (p- value ˂ .0001). But, diclofenac consumption was not significantly different (p =.576). Conclusion and Recommendation: Low dose intravenous ketamine (0.25mg/kg) before skin incision was extended postoperative first analgesia request by average of 45.5minutes and decrease total analgesia consumption in 24 hours. Based on this we recommend use of low dose ketamine as a part of postoperative pain treatment.