Practice towards perioperative care of cesarean delivery in Debre Tabor Comprehensive Specialized Hospital, North Central Ethiopia: Cross-sectional study.

Background: Perioperative obstetric care is vital in clinical practice to improve maternal and neonatal outcomes. The standardized practice of perioperative obstetrics care service has a great role in the reduction of both expected and unexpected adverse outcomes. So, the purpose of this study was to assess the implementation of perioperative obstetric care services based on standards of Enhanced Recovery after Cesarean Delivery and the Society of Anesthesiology and Perinatology. Method and materials: A cross-sectional study was conducted on 161 mothers with an elective cesarean delivery from August 10, 2021, to May 15, 2022. The standard of this study was taken from evidence-based practice guidelines of perioperative practice for an elective cesarean delivery. Informed consent was taken from all study participants. The data was collected through direct observation using a standard checklist changed to standardized question forms with two checking components ("Yes", and "No"), and data were entered into SPSS version 20 for analysis and interpretation. Descriptive analysis was done and the results were expressed in numbers and percentages using a table. Results: A total of 161 elective cesarean sections were involved to identify the level of perioperative care. Administration of first-generation antibiotics prophylaxis, aqueous povidone-iodine solution-based skin preparations, and preparation for immediate neonatal resuscitation were fully performed based on the standards. Conclusions: The majority of elective caesarian deliveries were carried out below the recommended level as per the checklists for perioperative practice. So, added interventions are needed to improve perioperative obstetrics care services on those standards which are not totally applied and partially performed.

Assessment of perioperative anesthesia record sheet completeness: A multi-center observational study.

Background: Anesthesia record is an essential part of perioperative patient management and, it is one of the global patient safety challenges. The aim of this study is to assess the completeness of perioperative anesthesia record sheets in Amhara regional state hospitals of Ethiopia. Methods: A retrospective review of anesthetic records was employed for patients who underwent surgery in Amhara Regional State Hospitals of Ethiopia from December 1, 2019, to February 29, 2020. All the intraoperative, preoperative, and postoperative data completeness of anesthesia record sheets was assessed using a structured checklist. Results: A total of 420 perioperative anesthetic records were included in this study. The basic preoperative history was documented in less than 80% of anesthesia record sheets. A physical examination was done and the results of the basic investigations were recorded in less than 75% of anesthesia record sheets. The name and dose of anesthetic medications were documented in 91% of the anesthesia records sheets. The completeness of parameters related to postoperative plans and orders was less than 70%. Conclusion: The completeness of perioperative anesthesia record was poor in Amhara regional state hospitals of Ethiopia. Anesthesia professionals should document all the necessary perioperative parameters in the anesthesia record sheet.

Levels of Adherence and Associated Factors Among Children on ART Over Time in Northwest, Ethiopia: Evidence from a Multicenter Follow-Up Study.

BACKGROUND: Despite the increased availability of antiretroviral therapy (ART), its success depends on a high level of adherence to a life-long antiretroviral therapy. However, the extent and factors associated with adherence to ART are not well known, especially in the current study setup. Therefore, this study aimed to assess the level of adherence and associated factors among children on ART in Northwest, Ethiopia. METHODS: A retrospective follow-up study was conducted on human immunodeficiency virus (HIV)-infected children receiving ART at South Gondar public hospitals. Children receiving ART from January 1, 2015, to November 30, 2020, were included in the study. A computer-generated simple random sampling technique was employed. The data were entered into the EpiData version 3.1 and analyzed by STATA 14 statistical software. Bivariable logistic regression was fitted for each predictor variable. Moreover, those variables having a p-value ≤0.25 in bivariate analysis were fitted into a multivariable logistic regression model. P-value <0.05 was used to declare significance. RESULTS: A total of 363 HIV-infected children were involved in the study. From 363 HIV-infected children, the level of adherence to ART was found to be 78.2%, 95% CI (73.6, 82.2). TB co-infection [adjusted odds ratio (AOR) = 3.8, 95% CI (1.41, 10.1)], short duration on ART (AOR = 3.4, 95% CI (1.60, 7.20)), treatment failure (AOR = 10.2, 95% CI (3.95, 26.2)), and Zidovudine containing ART regimen (AOR = 3.5, 95% CI (1.1, 10.9)) were significant predictors of poor adherence. CONCLUSION: The current study showed that the level of adherence to ART was found to be low TB co-infection, short duration of ART, Zidovudine-containing ART regimen, and treatment failure were found to be significantly associated with poor adherence. Further studies on adherence rate and its determinants with multiple adherence measurements using prospective and multicenter studies were recommended.

Prevalence and factors associated with caesarean section in a comprehensive specialized hospital of Ethiopia: A cross-sectional study; 2020.

INTRODUCTION: Caesarean section is one of the lifesaving procedures of medical interventions attributed to the decrease of maternal and newborn mortality and morbidity rates. The World Health Organization (WHO) shows a cesarean rate between 5% and 15%. However, the prevalence of cesarean section is increasing globally as well as in Ethiopia. Different scholars argue that the prevalence and factors of the caesarian section vary in different countries and health institutions. The aim of this study was to assess the prevalence and factors associated with cesarean section in Debre Tabor Comprehensive Specialized Hospital. METHOD: An institutional-based cross-sectional study was conducted on a total of 320 mothers who gave birth at Debre Tabor Comprehensive Specialized Hospital from July 01, 2020, to October 30, 2020. The samples were selected using the convenience sampling technique. The Data were collected using a structured checklist. Bivariable and multivariable logistic regressions were used to check the association. P-values less than 0.05 were considered statistically significant. RESULTS: The overall prevalence of cesarean section was 39.1% in the current study. Mothers age 35-39 years, educational level college and above, employed, mothers with a monthly income of >6000, and mothers with a previous history of cesarean section were significantly associated with an increased risk of cesarean section. CONCLUSION: The prevalence of cesarean section was high in Debre Tabor Comprehensive Specialized Hospital. Age of the mothers, educational status, occupation, monthly income, and previous history of cesarean section were significantly associated with an increased occurrence of cesarean section.

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.

Assessment of satisfaction and associated factors of parturients underwent cesarean section with spinal anesthesia at the General Hospital, Ethiopia; 2019.

BACKGROUND AND AIM: Spinal anesthesia for cesarean section is now a day a popular plan of anesthesia because of its rapid onset and high frequency of successful blockade. It is a vital monitor to the quality of care in anesthesia. The main aim of this study was to assess the level of maternal satisfaction and associated factors after cesarean section under spinal. METHODS: Hospital-based cross-sectional study was conducted on mothers who underwent cesarean section with spinal anesthesia. Descriptive analysis and chi-square test were employed. Bivariable and multivariable logistic regression was used to measure the association of factors with the level of satisfaction. A p-value of ≤0.25 and ≤ 0.05 was used to decide statistical significance for bivariable and multivariable logistic regression respectively. FINDINGS: The overall satisfaction level of parturients after spinal anesthesia was 97(80.2%). The satisfaction level was 83.3% with PONV treatment, 98.3% with intraoperative analgesia, between 52.5% and 64.2% to preoperative activities, and 72.5% for postoperative patient care by the anesthetist. Having previous anesthesia was the independent factor that has a significant association with the level of satisfaction with AOR, 3.94; 95%CI, 1.24-12.45; P- 0.01. CONCLUSION: In general, the overall satisfaction of the mothers towards spinal anesthesia was fair with a satisfaction score of 80.2%. Parturients were highly dissatisfied with the preoperative visit and information subscale as compared to the other subscales.

Predictors of hypoxemia after general anesthesia in the early postoperative period in a hospital in Ethiopia: an observational study.

BACKGROUND: Early postoperative hypoxemia is a common problem after general anesthesia. The identification of factors associated with an increased occurrence of it might help healthcare professionals to hypoxemia risk patients, therefore this study aims to assess the incidence and factors associated with early postoperative hypoxemia among surgical procedures. METHODS: A prospective cohort study design was conducted from February 1, 2020 to June 30, 2020, on a total of 424 patients who underwent surgery under general anesthesia in Debre Tabor Comprehensive Specialized Hospital. The data was collected using a structured checklist. Bivariable and multivariable logistic regressions were used to check the association. RESULTS: The incidence of early postoperative hypoxemia was 45.8%. Patients having a BMI of 25-29.9 kg/m2 and BMI of 30-39.9 kg/m2, patients having a chronic disease, current smokers, SPO2 reading before induction of less than 95%, emergency surgery, and the absence of oxygen therapy during the period of transfer and/or in the post anesthesia care unit were significantly associated with an increased risk of hypoxemia in the early postoperative period. CONCLUSIONS: The incidence of early postoperative hypoxemia was high in Debre Tabor Comprehensive Specialized Hospital. Obese patients, patients having a chronic disease, current smokers, and lower oxygen saturations before induction, emergency surgery, and the absence of oxygen therapy were the main predictors of an increased occurrence of early postoperative hypoxemia.