Browsing by Author "Seifu Ashenafi"

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    Admission Pattern and Treatment Outcomes among Patients Admitted to Pediatric Intensive Care unit in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia ,2020/21:A Cross-sectional Study
    (Addis Ababa University, 2021-06) Eshetu Oliyad; Tafessa Dawit ; Seifu Ashenafi
    ABSTRACT BACKGROUND: The knowledge of the pattern of admission and treatment outcome of critically diseased pediatric patients admitted to pediatric intensive care units in developing countries where the resource is scarce may help for the identification of priorities and resources to make the facility better. The prevalence of pediatric intensive care unit mortality often varies globally, depending on the facilities of the intensive care unit, the availability of workers, and admission patterns. OBJECTIVE: The objective of this study was to assess admission pattern and treatment outcome of children admitted to a pediatric intensive care unit (PICU), at Tikur Anbessa specialized hospital, Addis Ababa Ethiopia, from October 2018 to October 2020 METHODS: The study was a cross-sectional study design among 361 pediatrics patients admitted to the pediatric intensive care unit of Tikur Anbessa Specialized Hospital Addis Ababa Ethiopia from October 2018-October 2020 by using a systematic random sampling technique. Descriptive statistics were summarized with data, tables, and figures for display results. The distribution of the data was checked with a normality curve. Bivariate and multivariate analyses were used to see the association of an independent variable on the outcome variable. Factors with a p-value of less than 0.2 in bivariate analysis were exported to multivariate analysis to see if they are independent factors for the outcome variable. The adjusted odds ratio was used to show the strength of association with a 95% confidence interval and the p-value of less than 0.05 was taken as statistical significance in multivariate analysis. RESULTS: A total of 361(100%) charts were sampled for data collection; 197 (54.6%) were male and 164(45.4) were female. The most common cause of admission was, septic shock (27.14%), whereas the least cause of admission was Asthma 9(2.50%). The mean age at admission was 39.44±44.87 months. The overall mortality rate of our pediatric intensive care unit was 43.8%. From multivariate regression analysis need for mechanical ventilation (AOR= 11.08, 4.25-28.87, 95%CI, P=0.001), need for inotropic (AOR = 10.67, 4.09-27.81, 95%CI P<0.001), comorbidity (AOR=8.38, 3.5-20.5 , 95%CI P<0.001), length of PICU stay from 2-7 days (AOR =7.27, 1.7330.55, 95%CI P=0.007) and severe GCS (<8) with (AOR =10.51, 3.81-29.05, 95%CI P<0.001) were independent determinant of mortality. CONCLUSION: The mortality rate at our PICU was 43.8%. Septic shock and meningitis were the common cause of death and the largest death has happened in less than 7 days of admission
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    Assessment of Dissatisfaction, Refusal and Associated Factors after Spinal Anaesthesia for Elective Surgical Procedures in Public Hospitals in Addis Ababa, Ethiopia, 2020/2021, A Cross Sectional Study
    (Addis Abeba University, 2021-06) Yimam Ali; Seifu Ashenafi
    Background: Spinal anaesthesia is the most common type of regional anaesthesia technique which helped for a wide range of surgical procedures. Patient satisfaction with anaesthesia care is important to monitor the quality of anaesthesia delivery system. It is important to identify the reasons and the risk factors for patients’ dissatisfaction and refusal after spinal anaesthesia for continuous improvement of quality of anaesthesia services. Objectives: The aim of this study was to assess the dissatisfaction, refusal and associated factors after spinal anaesthesia for elective surgical procedures in public hospitals in Addis Ababa, Ethiopia,2020/2021. Methods: A multicentre cross-sectional study was conducted from December 30 to April 14,2020/2021, in selected public hospitals in Addis Ababa, Ethiopia. A total of 227 patients older than 18 years old scheduled for elective surgery under spinal anaesthesia were incorporated in the study.A five point likert scale was used to assess patients preoperative, intraoperative, and postoperative satisfaction level of anaesthesia service. Both bivariate and multivariate logistic regressions were used to measure association of predictor and outcome variable at 95% CI using adjusted odds ratio.P value <0.05 was used to declare statistical significance. Results: A total of 227 patients included in this study and overall proportion of patients who were satisfied with spinal anaesthesia was 150 (66.1%). Risk factors of dissatisfaction were backache (AOR=4.73, 95%CI=1.97, 11.36), headache (AOR=3.68, 95%CI=1.54, 8.80), and intraoperative nausea &vomiting (AOR=3.33(1.43, 7.73). 188(83%) of patients would choose spinal anaesthesia again whereas 39(17%) would refuse to undergo spinal anaesthesia in the future and its risk factors were intraoperative pain, fear of awareness and backache. Conclusion and recommendation: Patients satisfaction towards spinal anaesthesia was very low in our setup compared to many other previous studies. Backache, headache and intraoperative nausea and vomiting were risk factors which results patients dissatisfaction.Explaining the benefits and risks of anaesthesia, and understanding the patient’s opinion is essential to increase satisfaction with anaesthesia service.
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    Efficacy of Meperidine Versus Tramadol as a Treatment Agent on Post Spinal Anaesthesia Shivering, Hemodynamic Stability and Therapeutic Side Effects in Parturients at Mateme Gandhi Memorial Hospital, Addis Ababa, Ethiopia, from 1- Dec-2016 to 28-Feb-2017: A Prospective Cohort Study
    (Addis Abeba University, 2017-06) Seifu Ashenafi; Aregawi Adugna
    Background: Spinal anesthesia is most commonly preferred anesthesia types in the clinical practice. Post Spinal Anesthesia Shivering (PSAS) is one of the frequent side effects of spinal anesthesia and results in ill patient outcome. It occurs during both general and spinal anesthesia,but it is more cumbersome during spinal anesthesia. From many approaches tried to overcome this problem; non-pharmacological one is supper effective in prevention of PSAS. But it is very costly and not applicable in all settings. The pharmacological approach is more commonly used and is accessible in almost all settings. Objective: The objective of the study was to compare the therapeutic effect of meperidine and Tramadol in control of PSAS during elective cescerean section in parturient who gave birth under spinal anesthesia, in the quest for a drug with more efficacy and less side effects. Methods and Materials: In this prospective cohort study 74 parturients of ASA I and II who underwent elective cescerean delivery under spinal anesthesia and developed PSAS at Gandhi Memorial Hospital from Dec 1, 2016-Feb 28, 2017 were included. Parturients were treated with either Meperidine 0.5 mg/kg (n=37) Tramadol 0.5mg/kg (n=37) depending on inclusion criteria.Time from treatment to cessation of PSAS in minutes, Hemodynamic variables before spinal anesthesia (baseline), after spinal anaesthesia, at 5,10 and 30 minutes after PSAS was treated were taken. Reoccurrence of PSAS and therapeutic side effects were recorded.Data were entered into Epi info version 7 and exported to SPSS version 20 for analysis.Differences of Categorical data were analyzed with the Chi-Square test. Numerical data between groups were evaluated using independent samples t-test or Mann-Whitney U test. A p value of<0.05 was considered to be statistically significant. Results: The hemodynamic changes like mean arterial pressure (MAP), Heart rate (HR), arterial saturation (Spo2) and body temperature changes were all comparable between the groups i.e. there was no statistically significant difference between the groups. Disappearance of shivering after treatment was significantly earlier in Tramadol group (3.08±1.3 minutes) than Meperidine group (4.45±3.18 minutes) (P<0.021). Recurrence of shivering after treatment was less in Tramadol group 6(16.2%) than Meperidine group 9(24.3%). Sedation as a side effect was higher in Meperidine group 9(24.3%) than Tramadol group 3(8.1%). Nausea and vomiting was, however, found to be higher in Tramadol group 9(24.3%) than Meperidine group 3(8.1%). These side effects, however, were not statistically significant. Dizziness and pruritus were not observed in clients of both groups. Conclusion: Both tramadol and pethidine effectively controlled shivering in clients during cesarean section under spinal anaesthesia. But tramadol offered rapid onset, less recurrence and less sedation as a side effect when compared to meperidine. Recommendation: we recommend responsible health professionals and authorities of health organizations to implement tramadol for the treatment of PSAS during cescerean section.
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    Incidence and Associated Factors for Perioperative Respiratory Adverse Events in Elective Pediatric Surgical Patients with Recent Upper Respiratory Tract Infections in Selected Public Hospitals, Addis Ababa , 2025: A Prospective Cohort Study
    (Addis Ababa University, 2025-06-23) Tefera, Bekalu; Seifu Ashenafi
    Pediatric surgery patients frequently have perioperative respiratory adverse events (PRAEs), which are responsible for one-third of cardiac arrests and three-quarters of perioperative critical occurrences. Thus, upper respiratory tract infections (URIs) are the most frequent cause of PRAE and are the main reason for postponing surgical intervention in pediatric patient’s .Currently, there is no consensus on the best period to postpone surgery in children with recent upper respiratory tract infections.
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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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    Prophylactic Effect of Sub Hypnotic dose of Propofol in the Prevention of Intraoperative Post-Delivery N ausea and Vomiting in Mothers Undergoing Elective Caesarean Section Under Spinal Anaesthesia at ALERT Referral Hospital, Addis Ababa, Ethiopia, 2020,a Prospective Cohort Study.
    (Addis Abeba University, 2020-06) Bayisa Adane; Seifu Ashenafi ; Sitot Mulualem ; Tesfaye Siryet
    Background: Post-delivery Nausea and vomiting is one of the most common and unpleasant events affecting parturients undergoing caesarean delivery under spinal anaesthesia. It causes Parturient discomfort, it interferes with surgery, elevates the risk of bleeding as well asincreasing the risk of pulmonary aspiration. Objective: To assess the prophylactic effects of sub hypnotic dose of propofol in preventing the occurrence and severity of post-delivery nausea and vomiting in parturients who underwent elective Caesarean Section under Spinal Anaesthesia Methods: A prospective cohort study was done at Alert Referral hospital on 62 Parturients who came for elective caesarean section under spinal anaesthesia by using systematic random sampling method. Incidence of nausea and vomiting, severity of nausea and use ofrescue anti emetic were assessed. Distribution of numerical data analysed using Shapiro Wilk test. Independent t-test and Mann Whitney U test were used to compare symmetric and asymmetric data, respectively. Categorical variable between two groups were analysed using Chi Square or fisher exact test as appropriate. P value <0.05 was considered as statistically significant. Result: The incidence of PDNV was significantly lower in the propofol group when compared to non-propofol group the first 10 minutes post-delivery period (41.9% vs.74.2%) (P =0.01). The severity of nausea was statistically greater in the non propofol group compared to propofol group (32.3% in non propofol group experienced moderate nausea versus 3.2%) in the propofol group (p=0.006) and severe nausea was (0% Vs 22.7%, p=0.11)Less Intraoperative rescue antiemetic metoclopramide consumption was observed in sub hypnotic propofol group compared to non-propofol group. The median rescue ant emetic consumption was 10 mg in non-propofol group and 0 mg in propofol group (p<0.001). Conclusion and recommendations: Administration of prophylactic sub hypnotic dose of propofol (20 mg IV bolus) after delivery of the baby and clamping of the umbilical cord was effective in the prevention and immediate treatment of post-delivery nausea and vomiting and reduce need for Intraoperative rescue antiemetic for parturients undergoing elective caesarean section under spinal anaesthesia. The researcher recommend the use of prophylactic intravenous sub hypnotic dose of propofol(20 mg) for parturients undergoing elective caesarean section under spinal anaesthesia for the prevention of Intraoperative post-delivery nausea and vomiting.