Anesthesia

Magnitude, clinical presentations, outcomes and Associated factors of guillain-barre syndrome among Pediatrics admited jumc southwest, Ethiopia

Sat, 01 Mar 2025 00:00:00 GMT

Magnitude, clinical presentations, outcomes and Associated factors of guillain-barre syndrome among Pediatrics admited jumc southwest, Ethiopia Dereje Abunu; Gashaw Tadesse Background: Guillain-Barre Syndrome (GBS) is a rare but serious neurological disorder in children, often requiring intensive care. This study aimed to evaluate the prevalence, clinical characteristics, management, outcome and its predictor of pediatric GBS cases admitted to JUMC (a tertiary care center) over a five-year period. Methods: An institution based cross-sectional study was conducted on 72 pediatric patients (<15years) admitted to JUMC for the diagnosis of GBS fulfilling the Brighton Criteria for GBS. Clinical features, diagnostic procedures, treatments, outcomes and its predictors were reviewed. Statistical associations between key clinical variables and outcomes were analyzed using logistic regression. Results: The prevalence of GBS was 0.9 per 100,000 children in the general pediatric population and 0.5 per 100 pediatric hospital admissions, it’s found to be a peaked in children aged 1–5 years. Males constituted 62.5% of the study, with a median age of 8.3 years. The majority (84.5%) presented with ascending symmetrical weakness, with 85% reaching peak weakness within two weeks. Quadriplegia was noted in 48.5% of patients, and neuropathic pain was reported in 37%. Antecedent infections, particularly upper respiratory tract infections, were identified in 80.6% of cases, with most cases occurring between September and December. Cranial nerve involvement was observed in 38.9.3%, and autonomic dysfunction in 27.8%. Intensive care was required for 58.9% of patients, with 37.3% needing mechanical ventilation. Respiratory failure and requirement for mechanical ventilation significantly increased the odds of mortality (AOR = 7.6, p = 0.007; AOR = 9.2, p = 0.027). Complications included ventilator associated pneumonia (42%), aspiration pneumonia (27%), urinary tract infections (17%), and bed sore (3%) Lumbar punctures revealed albumin cytological dissociation in 66.7% of cases. Despite this, only 9.6% of patients received intravenous immunoglobulin (IVIG), and 15% of these experienced treatment-related worsening. At discharge, 45% of patients showed partial recovery, 40.2% had no motor improvement without progression, and 5.6% died. The primary causes of death were respiratory failure and autonomic dysfunction. ii Conclusion: Pediatric GBS presents significant morbidity and mortality, with respiratory failure and requirement for mechanical ventilation being critical determinants of outcomes. Early recognition of respiratory complications and timely intensive care interventions are essential to improve outcomes and survival rate. Future studies should explore the role of electrophysiological testing, long term outcome and optimal therapeutic strategies, including broader use of IVIG.

Assessment of knowledge, Attitude and Practice of Enhanced Recovery after Surgery among Health care professionals at Jimma Medical Center, 2024

Sat, 01 Feb 2025 00:00:00 GMT

Assessment of knowledge, Attitude and Practice of Enhanced Recovery after Surgery among Health care professionals at Jimma Medical Center, 2024 Yonas Yacob; Edosa Kejela Background: ERAS is a multidisciplinary approach designed to optimize surgical recovery through evidence-based practices. Despite its proven benefits in reducing postoperative complications and hospital stays, there is limited understanding of ERAS among healthcare professionals in low- and middle-income countries (LMICs), particularly in Ethiopia. This study seeks to identify gaps in KAP that may hinder the effective implementation of ERAS. Objectives: To evaluate the KAP of Enhanced Recovery after Surgery among Health Care Professionals at Jimma Medical Center concerning ERAS protocols. Methods: A cross-sectional study design was employed from November to December 2024. The study population was including all anesthetists, senior surgeons, surgery residents, and nurses working in surgical wards at Jimma Medical Center. A structured questionnaire was developed to collect data on demographics, knowledge, attitudes, and practices related to ERAS. Data analysis was conducted using SPSS version 26, employing descriptive statistics. Bivariate and multivariate logistic regression analyses was performed to identify factors associated with dependent variable. Result: A total of 137 health care providers were included as study participants with a response rate of 94.4%. 63.5% (n=87) demonstrated good knowledge, 56.9% (n=78) held a positive attitude, and 52.6% (72) reported good practice toward enhanced recovery after surgery. Work experience, profession and training were significantly associated with knowledge toward enhanced recovery after surgery. Work experiences had positive attitude while being surgeons had negative attitude regarding enhanced recovery after surgery. Regarding practice of enhanced recovery after surgery, being surgeons and no training had poor practice. Conclusion and Recommendation: Overall knowledge, attitude and practice of health care providers toward enhanced recovery after surgery were good. Education, work experience, and on-the-job training play vital roles in determining health care providers' knowledge attitudes and practice towards enhanced recovery after surgery protocols. Health care providers should implement and adhere for enhanced recovery after surgery protocol.

Prevalence of postoperative complications and associated Factors in adult patients admitted to the post anesthesia Care unit of jimma university medical centre, Ethiopia

Sat, 01 Feb 2025 00:00:00 GMT

Prevalence of postoperative complications and associated Factors in adult patients admitted to the post anesthesia Care unit of jimma university medical centre, Ethiopia Aemero Awoke; Edosa Kejela Background: Despite advancements in perioperative anesthesia, PACU complications remain common, especially in low-resource settings like Ethiopia, where limited resources and staffing shortages increase the risks. The post-anesthesia care unit (PACU) is a crucial component of the surgical process, providing patients with vital support and monitoring as they recover from anesthesia. Previous studies in neighboring African countries with comparable sociodemographic and economic profiles report varying incidences and prevalences of PACU complications and associated factors. Objective: To assess the prevalence of postoperative complications and associated factors in adult patients admitted to the post anesthesia care unit of Jimma university medical Centre, Ethiopia, 2024. Methods: An institutional based prospective cross-sectional study was conducted in the PACU of Jimma university medical Centre from October 1, 2024 to January 31, 2025. Two BSc-trained nurses collected data using a structured questionnaire under the supervision of the investigator. Data was analyzed using descriptive statistics, including frequencies, percentages. Inferential analyses (chi-square tests and logistic regression) have identified factors associated with complications. Results: A total of 421 patients admitted to the Post-Anesthesia Care Units (PACU) of JUMC were sampled. Out of this 44.4% had postoperative complications in the PACU and among those 15.9% patients had developed more than one complication. Pain, 17.4% of the complications is the most common complication followed by cardiovascular complications which is 15.2%, hypothermia 7.4%, respiratory complications 7.1% and GIT complications is 1.9%. Age (AOR = 1.97, 95% CI: 1.13–3.43), ASA classification (AOR = 3.54, 95% CI: 1.91–6.56), Duration of surgery (AOR = 1.74, 95% CI: 1.05–2.87) had significant association with the prevalence of postoperative complications in the PACU. Conclusions and Recommendations: Results from this study show that prevalence of postoperative complications in the PACU of JUMC is significantly high. Pain, cardiovascular complications and hypothermia are the most common complications which needs focus, early detection and addressed by the PACU and anesthesia team. Patients with advanced age, higher ASA class and who had prolonged duration of surgery requires close follow up in the PACU in order to reduce the prevalence of postoperative complications.

Assessment of adherence to pre-operative fasting guidelines and associated factors among elective pediatric surgical patients in Jimma University Comprehensive Specialized Hospital (JUCSH), Jimma, 2024G.C

Sat, 01 Mar 2025 00:00:00 GMT

Assessment of adherence to pre-operative fasting guidelines and associated factors among elective pediatric surgical patients in Jimma University Comprehensive Specialized Hospital (JUCSH), Jimma, 2024G.C Birhanu Gemechu; Garuma Babu Background; Anesthetic agents can impair protective airway reflexes, increasing the risk of aspiration and complications like pneumonia. Pre-procedural fasting is crucial, particularly in pediatric patients, to reduce aspiration risk, with specific fasting durations recommended by guidelines, although adherence varies. Objectives: To assess the adherence to pre-operative fasting guidelines and identify the associated factors among elective pediatric surgical patients at Jimma University Comprehensive Specialized Hospital. The study was conducted over a period of four months, from October, 2024 to January, 2025G.C Methods Study Design: A cross-sectional study was conducted on pediatric patients undergoing elective surgery at JUCSH between October 2024 and January 2025. Adherence Assessment: Adherence to preoperative fasting guidelines was evaluated by comparing actual fasting durations to recommended guidelines for clear fluids, solid foods, and breast milk. Population and Sample: The study included 113 pediatric patients scheduled for elective surgery and their primary caregivers, using a descriptive cross-sectional design. Data Collection and Analysis: Data were entered using EpiData version 4.6 and analyzed with SPSS version 27. Bivariate and multivariable logistic regression analyses were used to identify factors associated with adherence, with statistical significance set at p < 0.05 Results: Adherence to fasting guidelines was 25.7% (95% CI: 18.3%–33.1%). The mean age of participants was 3.47 years, with 75.2% male. The main reason for non-adherence was incorrect fasting instructions (64.3%). Factors associated with adherence included age (AOR = 0.690, 95% CI: 0.523–0.909, P = 0.008), prior complications due to non-fasting (AOR = 5.39, 95% CI: 1.07 7.10, P = 0.041), and patient scheduling (AOR = 0.178, 95% CI: 0.032–0.981, P = 0.047). Conclusion: Adherence to fasting guidelines was low. Factors such as age, previous complications, and patient scheduling influenced adherence. Improved education and communication are needed to enhance compliance. Recommendations; Improve surgical scheduling to minimize delays and maintain a structured sequence. Strengthen education programs for parents and guardians regarding fasting guidelines. Future research should explore the long-term impact of adherence on surgical outcomes.