Postoperative hyperglycemia among adult non-diabetic surgical patients at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.

BACKGROUND: Postoperative hyperglycemia is associated with morbidity and mortality in non-diabetic surgical patients. However, there is limited information on the extent and factors associated with postoperative hyperglycemia. This study assessed the magnitude and associated factors of postoperative hyperglycemia among non-diabetic adult patients who underwent elective surgery at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. METHODS: A facility-based cross-sectional study was conducted among 412 adult patients who underwent elective surgery at University of Gondar Comprehensive Specialized Hospital from April 14 to June 30, 2022 All consecutive postoperative non-diabetic elective surgical patients who were admitted to PACU during the data collection period and who fulfilled inclusion criteria were included in the study until the intended minimum sample size was achieved. And data were collected through interviews using a pretested semi-structured questionnaire. Postoperative hyperglycemia was defined as a blood glucose level of ≥ 140 mg/dl. Multivariable logistic regression was performed to identify the association between postoperative hyperglycemia and independent variables. Variables with a p-value less than 0.05 and a 95% confidence interval (CI) were considered statistically significant. RESULTS: A total of 405 patients' data were evaluated with a response rate of 98.3%. The median (IQR) age was 40 (28-52) years. The prevalence of postoperative hyperglycemia was 34.1% (95% CI: 29.4-39.0). Factors significantly associated with postoperative hyperglycemia included being overweight (AOR = 5.45, 95% CI: 2.46-12.0), American Society of Anesthesiologists (ASA) classification II and III (AOR = 2.37, 95% CI: 1.17-4.79), postoperative low body temperature (AOR = 0.18, 95% CI: 0.069-0.48), blood loss ≥ 500 ml (AOR = 2.33, 95% CI: 1.27-4.27), long duration of surgery, mild pain (AOR = 5.17, 95% CI: 1.32-20.4), and moderate pain (AOR = 7.63, 95% CI: 1.811-32.20). CONCLUSION AND RECOMMENDATION: One-third of the study participants had postoperative hyperglycemia. Weight, ASA classification, postoperative body temperature, duration of surgery, intraoperative blood loss, and postoperative pain were identified as a modifiable risk factors. Maintaining normal body temperature throughout the procedure, treating postoperative pain, and monitoring and controlling blood glucose level in patients at risk of hyperglycemia is crucial.

Attitude toward perioperative safety among operation room clinicians at Ethiopian University Hospital.

Patient safety is a fundamental of good quality and also a high priority for the health-care system. Maintaining patient safety reduces errors and harm that patients can suffer during health care. The operating room clinicians have a vital role in ensuring patient safety. The general objective of this study was to assess attitudes towards perioperative safety and associated factors among the operation room clinicians at the University of Gondar Comprehensive Specialized Hospital (UoGCSH), Northwest Ethiopia, 2022. A cross-sectional study was conducted on operation room clinicians at UoGCSH. The data were collected by using a self-administered structured questionnaire that included the Safety Attitude Questionnaire (SAQ). Binary logistic regression analysis was employed, and the strength of association was described in adjusted odds ratios with a 95% confidence interval (CI). A total of 260 (76% response rate) operation room clinicians have participated in this study. The mean ± SD of attitude toward perioperative safety was 57.8 ± 0.9. Only 32 (12.3%) operation room clinicians have shown a favorable attitude toward perioperative safety. Most of the clinicians were found to have unfavorable attitudes toward all domains of SAQ except the stress recognition domain. Age >30 years [adjusted odds ratios (AOR): 3.1, CI: 1.1, 8.7, P = .035], working for ≥40 h/week (AOR: 3.9, CI: 1.4, 11.1, P = .01), working in ophthalmologic (AOR: 12.0, CI: 3.8, 38.8, P < .001) and gynecologic (AOR: 3.6, CI: 1.1, 12.7, P = .04) operation rooms, and having training on perioperative safety (AOR: 2.6, CI: 1.1, 6.5, P < .03) were found associated with having favorable attitude toward perioperative safety. Most operation room clinicians had an unfavorable attitude toward perioperative safety and all the domains of SAQ except the stress recognition domain. Older age ≥ 30 years, working for ≥40 h/week, having safety-related training, and working in ophthalmologic and gynecologic operation rooms were found associated with having a favorable attitude toward perioperative safety.

Timely initiation of breastfeeding and its factors among women delivered via cesarean section under spinal anesthesia at the University of Gondar Comprehensive Specialized Hospital, north-west Ethiopia, 2021: a hospital-based cross-sectional study.

The mode of delivery influences breastfeeding practice. Moreover, cesarean deliveries under anesthesia-related risk factors affect the timing of breastfeeding initiation compared to vaginal deliveries. In addition, high rates of cesarean section (CS) deliveries and low breastfeeding rates are important public health concerns for all developing countries. Objective: This study aimed to determine the timely initiation of breastfeeding and its factors among women delivered via CS under spinal anesthesia. Methods: Institutional-based cross-sectional study was employed among 422 systematically selected mothers from April to June 2021. Data were collected by a structured questionnaire. Data entry and analysis were done using Epi Data and Stata version 14.0. Binary logistic regressions were computed to identify factors. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to declare statistical significance. Results: Delayed initiation of breastfeeding (DIBF) was 41.8%. Mothers who had an emergency CS (AOR =2.13, 95% CI [1.21-3.75]), had less than four antenatal care (ANC) follow-ups (AOR=1.77, 95% CI [1.02-3.13]), had moderate to severe pain during the perioperative period (AOR=2.65, 95% CI [1.24-5.54]), primipara (AOR=1.89; 95% CI [1.20-3.25]), used intraoperative opioid medications (AOR=1.86; 95% CI [1.01-3.30]), and had no skin-to-skin contact (AOR=2.1, 95% CI [1.27-3.51]) were associated with DIBF. Conclusion and recommendation: DIBF after cesarean delivery was high. Emergency CS, less than four ANC visits, immediate postoperative pain, and lack of skin-to-skin contact were factors associated with delayed breastfeeding. Health care providers, especially anesthetists, in the operation theater, should implement multimodal analgesics and minimize opioid consumption. Moreover, they should keep the newborn in skin-to-skin contact to initiate breastfeeding in the operation theater soon after birth.

Translation, reliability, and validity of Amharic versions of the Pelvic Floor Distress Inventory (PFDI-20) and Pelvic Floor Impact Questionnaire (PFIQ-7).

PURPOSE: Pelvic Floor Disorders (PFDs) affects many women and have a significant impact on their quality of life. Pelvic Floor Impact Questionnaire (PFIQ-7) and Pelvic Floor Distress Inventory (PFDI-20) help to assess PFDs; however, both are not culturally translated into the Amharic-language. Hence, we aimed to translate the English versions of short forms of the PFDI-20 and PFIQ-7 into Amharic-language and evaluate their psychometric properties in Amharic-speaking Ethiopian women with symptomatic PFDs. METHODS: The PFDI-20 and PFIQ-7 were translated into Amharic language using standard procedures. The Amharic versions were completed by 197 patients (response rate 92%) with PFDs from University of Gondar specialized and comprehensive Hospital. Internal consistency and test-retest reliability were examined through Cronbach's alpha and Intraclass correlation coefficients (ICC). A relative criterion standard, POP-SS-7 score, was correlated with total PFDI-20 and subscale POPDI-6 scores using spearman's rank order correlation (SCC). Construct validity was evaluated by known group validity using the Mann-Whitney U test. RESULTS: Both instruments were successfully translated and adapted with an excellent content validity (> 0.90). The Amharic versions of the PFDI-20 and PFIQ-7 showed excellent internal consistency and test-retest reliability in both summary and subscales (Cronbach's alpha: 0.92 for PFDI-20 and 0.91 for PFIQ-7; and ICC: 0.97 for PFDI-20 and 0.86 for PFIQ-7). Criterion validity was good for POPDI-6 (SCC = 0.71; p < 0.001). Moreover, construct validity was acceptable, showing significant differences among groups of PFDs in the PFDI-20 and PFIQ-7 scores (Mann-Whitney U Test; p < 0.001). CONCLUSIONS: The Amharic versions of the PFDI-20 and PFIQ-7 are comprehensible, reliable, valid, and feasible in Ethiopian Amharic-speaking women with PFDs to evaluate symptoms and its impact during research and clinical practice. However, further studies are needed to evaluate the responsiveness.

Patients' knowledge and perception of anesthesia and the anesthetists: Cross-sectional study.

Background: Anesthesiology was misconceived as a behind the screen specialty. Despite significant advancements in its scope, anesthesia remains have a poor public image, clients are not even aware of an anesthetist as a medically qualified health professional, particularly in underdeveloped countries. There has been very little study done on the public's awareness of anesthesia in Ethiopia. This study was conducted to assess the level of patients' knowledge and perception of anesthesia and the anesthetists. Methods: Institution-based, cross-sectional study was conducted from January to May 2021, at the University of Gondar comprehensive specialized hospital, Ethiopia. Consenting participants were asked to answer a standard questionnaire in a personal interview to assess their knowledge about anesthesia and the anesthetist. Descriptive statistic was used to explain the study participants with study variables and to describe their perception about anesthesia and anesthetists. Binary logistic regression analysis was performed to identify the association between the level of knowledge and independent variables. The strength of the association between the independent variables and the level of knowledge was presented by an adjusted odds ratio and 95% Confidence Interval. Results: A total of 307 study participants were included in this study with a response rate of 100%. Of these 113 (36.8) were males and 194 (63.2) were females. Two hundred twenty (71.7%) study participants answered less than half of the questions correctly and had a poor level of knowledge the rest 87 (28.3%) had a good level of knowledge and the mean knowledge score was1.72 ± 0.45. Previous anesthesia exposure (p value = 0.001) and occupation (p value = 0.022) of participants had statistically significant association with the level of knowledge. Conclusion: and recommendation: We have found that patients had very limited (poor) knowledge and perception regarding anesthesia and the role of anesthetists. Anesthetists should do a complete pre-anesthetic assessment which helps them to achieve good patient recognition.

Risk factors for postoperative throat pain after general anaesthesia with endotracheal intubation at the University of Gondar Teaching Hospital, Northwest Ethiopia, 2014.

INTRODUCTION: Postoperative sore throat is listed from the top as patients' most undesirable outcome in the postoperative period. It is believed to originate from mucosal dehydration or edema, tracheal ischemia secondary to the pressure of endotracheal tube cuffs, aggressive oropharyngeal suctioning, and mucosal erosion from friction between delicate tissues and the endotracheal tube. Even if the problem was indicated in many literatures, it has never been studied in our country. The study aimed to assess prevalence and factors associated with postoperative sore throat among patients who were operated under general anesthesia with endotracheal intubation. METHODS: Hospital based cross sectional study was conducted from February 25 - April 10, 2014 in Gondar University hospital. Patient interview and chart review were employed for data collection. Bivariate and multivariate logistic regressions were used to determine the association. RESULTS: A total of 240 out of 299 patients were included in this study with a response rate of 80.3%. The prevalence of postoperative sore throat within 48 hours after operation was 59.6%. Factors which had association with postoperative sore throat from the multivariate logistic regression were female sex (AOR = 3.3, 95% CI: 1.07, 10.375), repeated number of attempts to intubate (AOR = 3.291, 95% CI: 1.658, 6.531), and the use of nasogastric tube (AOR = 0.41, 95% CI: 0.174, 0.965) respectively. CONCLUSION: The prevalence of postoperative sore throat was high in Gondar University Hospital. Awareness creation about the problem should be made for health professionals and postoperative sore throat management protocol need to be introduced.