Practice of non-pharmacological post-operative pain management and associated factors among nurses working in public referral hospitals of Amhara regional state, Ethiopia, 2019

Background: Postoperative pain is a combined effect of several unpleasant sensory, emotional and mental experiences. Patient’s previous experiences, nature and duration of surgery, site and size of the incision and the extent of surgical trauma are some of the factors affecting the degree of post-operative pain. Objectives: To assess practice of non-pharmacological post-operative pain management and associated factors among nurses working in public referral hospitals of Amhara regional state, Ethiopia. Method: Institutional based cross-sectional study was conducted among nurses working in public referral hospitals of Amhara regional state, Ethiopia from March to April 2019. Census method was employed to select study participants. Data were entered into Epi info version 7.2.0.1 and exported to SPSS window version 20 for analysis. Binary and multivariable logistic regression was used to see the association between dependent and independent variables. The odds ratio with a 95 % confidence interval was computed. P-value < 0.05 was used to declare association. Results: Three hundred nurses working in post-operative units of selected referral hospitals of Amhara regional state were involved in the study. The respondents’ ages (Mean ± SD.) were (29.8 ± 7.3) years and their experience (Mean ± SD) post-operative unit was (3.8 ± 3.3) years. Majority (59.7 %) of the respondents were females. This study revealed that about 50.2 % of nurses were not applied non-pharmacological post-operative pain management techniques for their patients. Nurse’s educational status, attendance of training, attitude of nurses, willingness of patients, experience in nursing, marital status and working unit were associated with practice of non-pharmacological post-operative pain management with p-value of < 0.05. Conclusion: In this study, nearly half of nurses didn’t apply non-pharmacologic pain management techniques for patients when they had pain. In-service training and educational development are recommended for nurses about non-pharmacologic pain management

Incidence and predictors of tuberculosis among children on antiretroviral therapy at northeast Ethiopia comprehensive specialized hospitals, 2022; A multicenter retrospective follow-up study

Introduction: Around the world, tuberculosis (TB) is the most common cause of mortality and morbidity in both adults and children. The incidence of tuberculosis (TB) is increased worldwide by co-infection with the human immunodeficiency virus (HIV), particularly in Sub-Saharan Africa. As a result, the study aimed to determine the incidence and predictors of tuberculosis among children on antiretroviral therapy at northeast Ethiopia Comprehensive Specialized Hospitals. Methods: An institution-based retrospective follow-up study was carried out in northeast Ethiopia’s Comprehensive Specialized Hospitals, among 362 children on antiretroviral therapy from January 1, 2007, to September 30, 2021. The data were entered into Epi Data version 4.6.1 and then exported to STATA version 16 for analysis. Bivariate and multivariable Cox proportional hazards model was used to discover tuberculosis predictors. Variables with a p-value of <0.05 at 95% confidence intervals in the multivariable Cox proportional hazard model were considered statistically significant. Results: Among the 358 Human Immunodeficiency Virus-infected children, two-thirds (69.3%) were over ten years old. The overall tuberculosis incidence rate was 2.0 (95%CI: 1.5–2.6) per 100 person-years with a total of 2452 years of observations. WHO clinical stages III and IV [AHR: 3.2 (95% CI 1.8–5.5)], being severely stunted [AHR = 2.1 (95% CI, 1.5–358)], and “Fair” and “poor” adherence levels to antiretroviral therapy [AHR = 4.0 (95% CI 1.5–10.8)] were independent predictors of tuberculosis. Conclusion: The incidence of tuberculosis in children infected with HIV/AIDS was high in this study. The risk of tuberculosis (TB) in HIV/AIDS-infected children has been linked to WHO stages III and IV, severe stunting, and ''Fair'' and ''Poor'' ART adherence. As a result, children with HIV/ADIS should be evaluated on a regular basis in order to improve the quality of ART services and reduce the incidence rate of tuberculosis among children

Cognitive adverse effects of epilepsy and its predictors attending outpatient department of South Gondar zone hospitals, Amhara Region, Ethiopia 2020 /2021.

BackgroundEpilepsy is the most common neurologic disorder which is further complicated by neurobehavioral co-morbidities, cognitive impairment, psychiatric disorders, and social problems. However, assessments of cognitive status of epileptic patients are far too low during clinical visits. This calls for early neuropsychological assessment soon after the diagnosis of epilepsy for a better treatment plan and outcome for epileptic patients.ObjectiveThis study aimed to assess the cognitive adverse effects of epilepsy and its predictors attending outpatient departments of South Gondar Zone hospitals Amhara region Ethiopia 2020/2021.MethodsA multi-center institutional-based cross-sectional study was conducted. A total of 509 respondents were included with a response rate of 93.9%. Previously adapted pretested structured questionnaire was used containing, socio-demographic, clinical, and seizure related factors. Mini-Mental State Examination (MMSE) was used to measure cognitive impairment. A systematic random sampling technique was applied. Data were entered into Epi data version 4.4.2 then exported to SPSS version 24 for analysis. Descriptive statistics, bivariable and multivariable binary logistic regressions with odds ratios and 95% confidence interval were employed. The level of significance of association was determined at a p-value ResultsPrevalence of cognitive impairment in this study was 69.2% (95%CI; 65.4, 73.1). Rural residents (AOR = 4.16,95%CI, 1.99,8.67), respondents who couldn't read and write (AOR = 2.62, 95%CI; 1.24, 5.5,) longer duration of seizure disorder (AOR = 4.59,95%CI; 2.01,10.52), taking combined Phenobarbital and Phenytoin (AOR = 4.69,95%CI; 1.88,11.69), having history of head injury (AOR = 3.29,95%CI;1.30,8.32), having depression (AOR = 4.76,95%CI;2.83,7.98), and anxiety (AOR = 3.11,95%CI; 1.58,6.12) were significantly associated with cognitive impairment.ConclusionsPrevalence of cognitive impairment in this study was high. Regular neuropsychiatric assessment of patients with epilepsy should be encouraged especially for those participants with longer durations of illness, who are rural residents, who take combined Phenobarbital and Phenytoin, participants who had a history of head injury, depression, and anxiety

Socio-demographic characteristics of patents with epilepsy attending outpatient department of South Gondar zone hospitals Amhara, Ethiopia, 2021(n = 509).

Socio-demographic characteristics of patents with epilepsy attending outpatient department of South Gondar zone hospitals Amhara, Ethiopia, 2021(n = 509).</p

Substance-related factors of cognitive impairment in patients with epilepsy attending outpatient department of south Gondar zone hospitals Amhara Ethiopia 2020 /2021(n = 509).

Substance-related factors of cognitive impairment in patients with epilepsy attending outpatient department of south Gondar zone hospitals Amhara Ethiopia 2020 /2021(n = 509).</p

Factors associated with cognitive impairment among patients with epilepsy attending outpatient department of South Gondar hospitals 2020(n = 509).

Factors associated with cognitive impairment among patients with epilepsy attending outpatient department of South Gondar hospitals 2020(n = 509).</p

Seizure and medication-related factors of cognitive impairment in patients with epilepsy attending outpatient department of south Gondar zone hospitals Amhara Ethiopia 2021(n = 509).

Seizure and medication-related factors of cognitive impairment in patients with epilepsy attending outpatient department of south Gondar zone hospitals Amhara Ethiopia 2021(n = 509).</p

Comparison of circulating lipid profiles, D-dimer and fibrinogen levels between hypertensive patients with and without stroke

Background: Stroke is one of the leading causes of global mortality and disability, particularly in hypertensive patients. This study aimed to compare lipid profile, fibrinogen, and D-dimer levels between hypertensive patient with and without stroke. Methods: This was a facility-based cross-sectional study conducted from November 2022 to January 2023 among 115 hypertensive patients (70 patients without stroke and 45 with stroke) who had follow-up at Yikatit 12 Hospital Medical College, Ethiopia. All data analyses were done using SPSS version 25.0 and comparisons of variables between groups were made using the Chi-square test, independent sample t-test, and Mann-Whitney U test. Multiple logistic regression analysis was done to identify predictors of stroke among hypertensive patients. A p-value <0.05 was assumed to be statistically significant for all statistical tests. Results: Significantly elevated levels of TC, LDL-C, D-DI, and fibrinogen were observed in the stroke group than in the non-stroke group (p-value<0.05). The mean values of TC, D-DI, and fibrinogen were significantly higher in patients with ischemic stroke compared to those with hemorrhagic stroke. Duration of hypertension (AOR: 1.21; CI: 1.10, 2.09), TC (AOR:1.07; CI: 1.01, 1.22), D-DI (AOR: 1.15; CI: 1.05, 1.69) and fibrinogen (AOR:1.19; CI: 1.10, 2.89) were identified to be independent predictors of stroke in hypertensive patients. Conclusion: The circulating levels of TC, LDL-C, D-DI and fibrinogen in hypertensive patients with stroke were significantly higher than in those without stroke. But only TC, D-DI, and fibrinogen were found to be predictors of stroke in hypertensives. Considerably higher TC, D-DI, and fibrinogen levels were also seen in patients with ischemic stroke than in those with hemorrhagic stroke. This confirms the key roles of dyslipidemia (hypercholesterolemia) and aberrant hemostatic activation to stroke development, notably ischemic stroke