Medical Science and Health officer

Depth of Anesthesia and Their Associated Factors; Prospective Cross sectional Study at Jimma University Medical Center Jimma, Ethiopia.

2021-09-05T00:00:00Z

Depth of Anesthesia and Their Associated Factors; Prospective Cross sectional Study at Jimma University Medical Center Jimma, Ethiopia. Diriba Fayisa; Kifle Woldemichael; Edosa Kejela Background: Nowadays assessing of depth of anesthesia is an important issue across the world, because if it is not assessed or monitored correctly, the consequence can affect both physical and psychosocial health, prolong the recovery time, increase morbidity, and impairs quality of life and increase medical costs. Adequate depth of anesthesia helps to avoid overdose of anesthesia drugs, prevent awareness under general anesthesia, decrease post-operative pain intensity and decrease the analgesic requirements, and also improves patient outcome. The mortality associated with depth of anesthesia monitored with BIS is lower compared to those not monitored. So to overcome such problem it’s recommended to use Bispectral index (BIS) monitor during general anesthesia to assess depth of anesthesia which is not available in low income countries including Ethiopia. Objective: The present study aimed to assess depth of anesthesia, and their associated factors among patients underwent surgery with general anesthesia at JMC. Methods: Prospective cross sectional study design was applied for four months (September 2021 to December 2021) among patients who underwent surgery with general anesthesia. All patients available during data collection who met inclusion criteria were enrolled in the study as they randomly scheduled for surgery. Data were collected by structured questionnaire. Depth of anesthesia was assessed by BIS intraoperatively. Accidental intraoperative awareness was assessed by Brice questionnaire by hiring the trained data collectors. Data were cleaned, entered in to epidata (version 4.6.1) and finally exported to SPSS (version 26) for analysis. The factors associated with the outcome variables were determined by cross tabulation and logistic regression analysis. The correlation of the variables was analyzed by Pearson correlation. P-value of <0.05 was considered as statistically significant. The finding of the study was expressed by applying statistical analysis (mean, standard deviation, percentage) and presented using tables, graphs, figures and narration. Results: A total of 100 patients who underwent elective major surgery were enrolled in the study with the mean age of 43+14.9 years that ranged from 18-80 years. Less than half of the patients (43%) had adequate anesthesia depth while the remaining 57% (CI 47.13-66.87%) of surgeries were performed with either light or deep anesthesia. Inadequate depth of anesthesia was affected by mean MAC of isoflurane (<1.117), sex (female), number of premedication (<2), type of current surgery (cholecystectomy) and IV induction agents (thiopentone) having AOR, CI and p-value of 8.1(1.8-36.2), p=0.006; 4.1(1.1-14.6), p=0.032; 3.4(1.110.9),p=0.04; 0.1(0.02-0.6), p=0.016;0.03(0.002-0.5),p=0.014 respectively. Conclusion and recommendation: The prevalence of inadequate depth of anesthesia was high (57%).

Learning style preferences and its association with academic achievement of medical students enrolled with new initiative medical education curriculum at Ambo University

2022-04-29T00:00:00Z

Learning style preferences and its association with academic achievement of medical students enrolled with new initiative medical education curriculum at Ambo University Zekariyas, Sahile; Dr Solomon, Belay; Shewatatek, Gedamu Background: How well a learner understands and retains information largely depends on whether the information was received in the learners’ preferred learning modality. Even though learning styles expected to influence the way students engage in the learning process and academic achievement, there is limited evidence available in Ethiopia, particularly in medical education. Objective: To assess whether learning style preferences affect the academic achievement of medical students enrolled with new initiative medical education (NIME) curriculum at Ambo University. Methods: A cross-sectional study design was employed among 92 medical students. A standard structured questionnaire of VARK (Visual, Aural, Read-Write, Kinesthetic) version 8.1 used to assess the learning style preferences of medical students. The academic achievement obtained from secondary source with grade record review. Descriptive and analytical statistics were used. Kruskal–Wallis one way ANOVA and student t-test were employed to compare the academic achievement with learning style preferences. Chi-square test was used to measure the association between learning style and academic achievement. Pearson correlation was also computed to compare the academic achievement with VARK score. P-value <0.05 was used as the cut of point to determine the statistically significant difference or association. Result: Medical students more preferred a unimodal learning style (58.7%), with kinesthetic being the most preferred (61.11%). Of the 38 multimodal learning style preferences, 94.74% had preferred a quad-modal (VARK). The VARK score had no statistically significant difference by gender, age, or year of study (P value>0.05). The cumulative grade in both first- and second-year results had no statistically significant difference by learning styles of medical students. But kinesthetic learners had statistically nonsignificant higher median cumulative grade in both first year (CGPA=3.21) and second year (CGPA=3.24) results. The kinesthetic score was also positively correlated with the second-year cumulative grade, statistically significant (r=0.22, P value=0.03). Conclusions: The most common learning style among medical students was unimodal, kinesthetic was the most preferred. There was no statistically significant cumulative grade achievement difference by learning style preferences, but the kinesthetic score had statistically significant positive correlation with second-year cumulative grade. Understanding learning styles is critical for medical students and teachers when planning a learning and teaching strategy, respectively.

Prevalence, out come and factors associated with Operative vaginal delivery among women who gave Birth in tercha general hospital, snnpr regional state, Dawro zone, ethiopia. A three year retrospective study

2017-10-01T00:00:00Z

Prevalence, out come and factors associated with Operative vaginal delivery among women who gave Birth in tercha general hospital, snnpr regional state, Dawro zone, ethiopia. A three year retrospective study Jalel hordofa; Demisew amenu; Demeke kifle Background: Assisted vaginal delivery, with the use of forceps and vacuum extraction, offers the option to accomplish safe delivery for the mother and the clinician. A successful assisted vaginal delivery avoids caesarean section, its attendant uterine scar and its implications for future pregnancy. The present study was designed to determine prevalence and feto maternal outcome by comparing vacuum with forceps. Objectives: To determine prevalence, outcome and factor associated among mothers who gave birth by operative vaginal delivery in Tercha General Hospital during the study period January 1, 2014 to December 31, 2016. Methods: Facility based cross-sectional retrospective study was conducted by reviewing available data or hospital records of mothers who gave birth from January1, 2014 to 31 December 2016. The data was checked for its completeness. Then it was coded, entered, cleaned and analyzed using SPSS version 22.0. Descriptive statistics was run to explore the data and multiple logistic regressions were used to see the association and strength between dependent & independent variables. A p-value of less than 0.05 was considered statistically significant in all tests of association. Results: During the 3 years’ study period, the prevalence of operative vaginal delivery was 6.2 % from the total of 2,647 deliveries, and proportion of vacuum and forceps delivery was 4.2%and 2% respectively. Operative vaginal deliveries were more commonly employed on primi gravida 67.1%compared to multiparas and the most common indication was delayed second stage of labor for vacuum, 70.5% and non-reassuring fetal heart rate in the forceps group 57. 7%. Forceps and vacuum-assisted deliveries were both associated with maternal and newborn complications. Vaginal laceration, 11.6% for mothers, and cephalhematoma, 10.9%for newborns were the commonest complication of operative vaginal delivery. Mothers were from rural are high risk to develop complication than those mothers came from urban with, (AOR,4.4;95%CI: 1.52,12.7 ). Newborn who had birth weight >4000gram 38.5 times more likely to have unfavorable outcome as compared to newborn who had birth weight 2500-3999gram with 95%CI of 4.1,362.3 . Conclusion: Operative vaginal delivery rates in this center are comparable to other centers as are the possible complications. Furthermore, in this study maternal complication has shown to be significantly higher in those who come from rural area and lack of antenatal care. Additionally, birth weight 4000gram and above were associated with unfavorable maternal and neonatal outcome. A trial of labor and careful use of forceps or vacuum extraction are acceptable for most fetuses suspected to be macrosomic because there is no precise method for determining which mothers have macrosomic infants prior to delivery

Comparision of the effect of two different doses of Propofol in atteaunation of hemodynamic and cough Response to tracheal extubation among adult elective Surgical patients at jimma medical center, ethiopia 2022

2022-12-01T00:00:00Z

Comparision of the effect of two different doses of Propofol in atteaunation of hemodynamic and cough Response to tracheal extubation among adult elective Surgical patients at jimma medical center, ethiopia 2022 Fikirte mamo; Bayisa Bereka; Abebe Dukessa; Melka Biratu Background: Tracheal extubation is the purposeful removal of the endotracheal tube from the trachea. The act of extubation itself is physiologically stressful and is often accompanied by significant hemodynamic changes and respiratory tract complications. Extubation induced hemodynamic and cough response gives less attention by anesthesia professionals and the practice of using appropriate dose of propofol for attenuation of hemodynamic response during extubation lucks uniformity among anesthesia professionals. Objective: The objective of the study was to compare the effect of two different doses of propofol on attenuation of hemodynamic and cough response during extubation among adult elective surgical patients from August 2022 to December 2022 at Jimma medical center. Methods : A comparative cross sectional study were conducted on 102 adult elective surgical patients ages between 18 and 65 who required orotracheal intubation and randomly allocated to control group (n=34), propofol 0.5mg/kg (n=34) and propofol 1mg/kg (n=34). Hemodynamic parameters like heart rate, systolic blood pressure and mean arterial blood pressure were recorded just before residual effects of muscle relaxants were reversed as a baseline value and 1 st , 3 rd , 5 th and 10 minute after extubation. Cough response following extubation was graded as (grade 0, 1, 2 and 3). The hemodynamic parameters were analyzed using one way ANOVA, Post hock –Tukey test, Student unpaired t-test and chi square test and p- value < 0.05 were considered statistically significant. Result: The socio-demographic and clinical characteristics of the respondents were not statistically significant. There were a significant difference between control and propofol groups but there were no statistical significant difference between the two doses; both are effective on attenuation of hemodynamic parameters (heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure) at 1 st , 3 rd , 5 th and 10 minutes and cough response after extubation. Conclusion: There were no significant difference between the two doses. Both intravenous propofol 0.5mg/kg and 1mg/kg when given prior to extubation were effective on attenuation of hemodynamic parameters and cough response following extubation. Anesthetists might consider low dose propofol 0.5mg/kg for attenuation of hemodynamic and cough response to endotracheal extubation