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Abstract Background In the practice of postoperative pain management, pain is still poorly managed in low resource setting where the practice of epidural and opioid free analgesia is impractical. There has been a recent trend of combining different drugs and concept of preemptive analgesia but the therapeutic superiority remains understudied for postoperative pain management. The aim of this study is to assess postoperative analgesic effect of preemptive Paracetamol, Paracetamol-diclofenac and Paracetamol-tramadol combination in patients undergoing laparotomy surgery. Methods Three-arm, randomized control trial study conducted on 63 patients undergone laparotomy surgery; group-P (paracetamol 1 g), group-PD (1 g + diclofenac 75 mg) and group-PT (paracetamol 1 g + tramadol 100 mg). The Numerical Rating Scale (NRS) pain rating system was used for this study. The primary endpoint of the study was total amount of analgesia consumption. Post-operative analgesic therapy [intravenous tramadol, 50 mg] were provided when patients complain of pain (request medication) or a numeric rating scale ≥4 was recorded. Secondary endpoint of the study were the time of first analgesic request and the intensity of the pain during 24 h post-op follow up period. Parametric data were analyzed using (ANOVA) and nonparametric data analyzed by Kuruska-Wallis H rank test. Chi-square test used for categorical variable. Statistical significance were sated at p value

BackgroundLaryngoscopy and endotracheal intubation are essential components of general anesthesia. But it is always associated with side effects called reflex cardiovascular responses. Many methods have been identified to attenuate these responses like intravenous lidocaine, deep inhalational anesthesia, vasodilators, intravenous magnesium sulphate even though therapeutic superiority remains understudied.MethodsAn institutional-based cohort study on 112 adult patients aged between 18-60 years was applied. 37 patients in the non-exposed group (Group N), 37 in the lidocaine group (Group L), and 38 in magnesium sulphate (Group M) were included. The hemodynamic parameters like heart rate, systolic, diastolic and mean arterial blood pressure at various time points up to 7 minutes post-intubation were recorded and the effect of both drugs to reduce hemodynamic responses was compared. Parametric data were analyzed using ANOVA and nonparametric data using the Kuruska-Wallis H rank test. P-value < 0.05 considered statistically significant.ResultsIn all three groups, there was a statistically significant rise in heart rate and blood pressure from baseline. There was a statistically significant difference in mean heart rate throughout study minutes among the groups (pConclusionIn conclusion, prophylactic administration of magnesium sulphate and lidocaine was effective in attenuating hemodynamic responses to the stress effect of laryngoscopy and intubation. But based on our finding prophylaxis of magnesium sulphate is associated with a more favorable hemodynamic response.

Despite the dramatic decline in the incidence of common opportunistic infections (OIs) after antiretroviral therapy initiation, they remain a significant cause of morbidity and mortality among children with HIV. For better interventions, information regarding the incidence and predictors of common OIs is essential for Children living with HIV. Still, there is a lack of studies in low and middle-income countries, including Ethiopia. Therefore, this study aims to assess the incidence and predictors of common OIs among Children living with HIV on anti-retroviral therapy (ART) at public health institutions in Bahir Dar City, Northwest Ethiopia. The reasons for excluding children not on ART is we want to study the effectiveness of chronic HIV care service, ART drugs and OIs prophylaxis drugs for the prevention of common OIs because it is obvious that the occurrence of OIs in children not on ART and OIs prophylaxis drugs is high. A health institution-based retrospective cohort study was done among 403 Human Immunodeficiency Virus-infected children at public health institutions in Bahir Dar City from 2010 to 2020. Data was entered using Epi-data version 4.6 and analyzed using STATA 14.0. A bivariable Cox-proportional hazards regression model was employed to appreciate the relationship between each explanatory variable with the outcome variable. In the bivariable analysis, variables with a p-value of less than 0.25 were candidates for the multivariable proportional hazard model. The Cox proportional hazards model was used to determine predictors of common opportunistic infections at a 5% significance level. The overall incidence rate of common opportunistic infections was 7.06 with a 95% confidence interval ((CI) 5.78, 9.75) per 100 person-years of observation. Statically significant predictors were World Health Organization (WHO) clinical stage III and IV (adjusted hazard ratio (AHR) = 1.90; (95% CI 1.34, 2.75), having fair/poor adherence to anti-retroviral therapy (ART) (AHR) = 1.80; (95% CI 1.25, 2.94) and hemoglobin level < 10 g/dl (AHR) = 2.00; (95% CI 1.36, 2.89). The overall incidence rate of common OIs among children living with HIV on ART was high. Independent predictors of common OIs among children on ART were advanced-stage of HIV disease, poor ART adherence, and lower hemoglobin level. Therefore, we recommend strongly working on the prevention of advanced stages of HIV disease and improving poor ART adherence to prevent the incidence of OIs among children living with HIV on ART., (© 2024. The Author(s).)

Background: Despite remarkable improvements in child health services utilization, childhood immunization has been poorly implemented in Ethiopia. However, evidence on the coverage of immunization among children from mothers/caregivers with no education (non-educated mothers were the most identified risk for underutilization of services) are scarce. Therefore, this study aimed to assess the determinants of full immunization coverage among children 12-23 months of age from deviant mothers/caregivers in Ethiopia., Methods: We analyzed data from the 2016 Ethiopia Demographic and Health Survey (EDHS) on a sample of 1,170 children 12-23 months of age identified from deviant mothers/caregivers (mothers/caregivers with no education) through a two-stage stratified sampling. A multilevel mixed-effect binary logistic regression analysis was used to identify the individual and community level determinants of full immunization coverage among children 12-23 months of age with their deviant mothers/caregivers. In the final model, a p -value of < 0.05 and adjusted odds ratio (AOR) with 95% confidence interval (CI) were used to select statistically significant determinants of full immunization coverage., Results: The overall full immunization coverage among children 12-23 months of age identified from deviant mothers/caregivers was 27.4% (95%CI: 25.0, 31.0) in Ethiopia. Deviant mothers/caregivers who are employed (AOR = 1.69, 95%CI: 1.68, 2.45), being in the rich household wealth status (AOR = 2.54, 95%CI: 1.53, 4.22), residing in city (AOR = 5.69, 95%CI: 2.39, 13.61), having one to three (AOR: 3.28, 95% CI: 2.12-5.07) and four and more ANC follow-up during the recent pregnancy (AOR: 3.91, 95% CI: 2.45, 6.24) were the determinants that increased full immunization coverage among children 12-23 months of age., Conclusions: Full immunization coverage among children 12-23 months of age from non-educated mothers/caregivers was low and far behind the national target of coverage. Therefore, a system-wide intervention should be used to enhance employability, wealth status, and key maternal health services like ANC follow-up among non-educated mothers/caregivers to increase their children's full immunization coverage., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Mihret Fetene, Debebe Negash, Shewarega, Asmamaw, Belay, Teklu, Aragaw, Alemu, Eshetu and Fentie.)

Introduction: Although the efforts at global and national levels have attempted to decrease the COVID-19 pandemic, the low level of preparedness among healthcare providers is a challenge mainly in developing countries. Hence, this study is aimed at assessing the level of preparedness for COVID-19 and its associated factors among frontline healthcare providers in South Gondar public hospitals, northwest Ethiopia., Methods and Materials: A hospital-based cross-sectional study was conducted among 207 selected healthcare providers who were working in South Gondar public hospital from July 08 to August 29, 2020. A pretested structured questionnaire was used to collect data. The healthcare providers were selected through simple random sampling techniques. Both bivariable and multivariable logistic regressions with a 95% confidence interval were fitted with 95% CI to establish the associated factors with a low level of preparedness. A p value < 0.05 was considered statistically significant., Results: The overall level of preparedness among healthcare providers for COVID-19 was found to be 41.3% (95% CI: 37.4, 44.7). Only 81 (40.1%) healthcare providers had prepared for telling their family and friends if they are infected with COVID-19. Besides, only 23.8% of healthcare providers obtained alcohol-based hand sanitizer in every patient room. Factors associated with a low level of preparedness include being male (AOR = 2.5, 95% CI: 1.22-4.94), unmarried (AOR = 3.4, 95% CI: 1.44-8.00), and working experience less than five years (AOR = 3.4, 95% CI: 1.29-9.09)., Conclusion: The level of preparedness among frontline healthcare providers towards COVID-19 was found to be very low. In the future, more emphasis should be placed on healthcare providers who are male, unmarried, and had working experience of lower than five years to decrease the burden of the COVID-19 pandemic., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2021 Ermias Sisay Chanie et al.)