scholarly journals Magnitude And Associated Factors of Intraoperative Nausea And Vomiting Among parturients who gave birth with Cesarean Section under Spinal Anesthesia At Hospitals in South Gondar Zone, Ethiopia

Author(s):  
Basazinew Chekol Demilew ◽  
Fentaye Zewudu ◽  
Dinberu Dinberu Eshetie ◽  
Netsanet Temesgen Ayenew ◽  
Eshetie Molla

Abstract Background Intraoperative nausea and vomiting is common intraoperative conditions by which parturient feel discomfort and disturbed after spinal anesthesia. Methods Hospital based cross-sectional study was conducted on mothers underwent cesarean section with spinal anesthesia. Descriptive analysis and chi square test were employed. Bivariable and multivariable logistic regression were used to measure the association of factors with the outcome variable intraoperative nausea and vomiting. A p-value of ≤ 0.05 was used to decide statistical significance for multivariable logistic regression. Result A total of 246 parturients were participated in this study. The incidence of intraoperative nausea and vomiting was 40.2%. According to multivariable logistic regression, age greater than 30 years (AOR, 6.26; 95%CI, 2.2-17.78; p-value 0.001), primiparous ( AOR, 3.72; 95%CI, 1.35–10.24; p-value, 0.011), having motion sickness (AOR, 7.1; 95%CI, 2.75–18.33; p-value 0.001), emergency cesarean sectin (AOR, 9.85; 95%CI, 3.19–30.38; p-value 0.001), oxygen suplimentation (AOR, 0.021; 95%CI, 0.005–0.08; p-value 0.0001) and uterotonic agent (AOR, 2.99; 95%CI 1.24–7.22; p-value 0.015) had statistically significant association with intraoperative nausea and vomiting. Conclusion In our study, the overall incidence of intraoperative nausea and vomiting after spinal anesthesia was 40.2%. Parturients with age greater than 30 years, having motion sickness, didn’t got intraoperative supplemental oxygen, oxytocin used for uterotonic purpose, emergency surgery and primiparous were at increased risk intraoperative nausea and vomiting.

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261951
Author(s):  
Hulubante Bizuayew ◽  
Haimanot Abebe ◽  
Getachew Mullu ◽  
Likinaw Bewuket ◽  
Daniel Tsega ◽  
...  

Purpose Maternal surgical site infection after cesarean delivery is a clinical problem which contributes to significant morbidity and mortality. In Ethiopia admissions following cesarean section due to surgical site infection have been routine activities of health care institutions but there is limited scientific evidence on both the magnitude of the problem and factors associated with it making prevention mechanisms less effective. Therefore, this study aimed to assess magnitude and risk factors of post-cesarean section surgical site infection at primary hospitals of East Gojjam Zone, Northwest Ethiopia. Methods Institution-based cross sectional study with retrospective chart review was conducted from September 10–30 /2020 at 3 randomly selected primary hospitals of east Gojjam zone. The data were entered in Epi data version 3.1 and exported to Statistical Package for Social Science Software version 26. Post-cesarean section surgical site infection was measured based on disease classification and definition of the term by Center for Disease Control and Prevention. After checking for presence of multicollinarity, presence and degree of association of factors with outcome variable were computed through logistic regression analysis. Factors with P value ≤ 0.2 in bi-variable logistic regression analysis were included in the multivariable logistic regression analysis and those variables with P-value of <0.05 in multivariable analysis were considered statistically significant. Result From 622 medical records of women who underwent cesarean section, 77 (12.4%) of them developed surgical site infection. Rural residence [(AOR = 2.30, 95%CI: (1.29, 4.09)], duration of labor greater than 24hrs [(AOR = 3.48, 95%CI: (1.49, 8.09)], rupture of membrane>12hrs[(AOR = 4.61,95%CI:(2.34,9.09)], hypertension[(AOR = 3.14,95%CI:(1.29,7.59)] and preoperative Hematocrit ≤30%[(AOR = 3.22,95%CI:(1.25,8.31)] were factors significantly associated with post-cesarean section surgical site infections. Conclusion Magnitude of post-cesarean section surgical site infection was a significant problem in primary hospitals. Minimizing prolonged labor; minimize early rupture of membrane, properly managing patients with comorbidities like hypertension, strengthen prophylaxis and treatment for anemia during antenatal care and raising awareness for rural residents can reduce the problem. Zonal police makers should give emphasis to reduce its burden.


2021 ◽  
Author(s):  
Haimanot Geletie Abebe ◽  
Hulubante fetene bizuayew ◽  
Getachew Kassa Mullu ◽  
Likinaw Zeleke Bewuket ◽  
Daniel Tefera Tsega ◽  
...  

Abstract Background Women after cesarean section have a five to twenty-times greater chance of getting an infection compared with women who give birth vaginally. Even though many efforts tried by the government and non-government organization in Ethiopia, a non-significant decline achieved and post cesarean section surgical site infection is still a problem. Scientific evidence on this is a step ahead for preventing and reducing post cesarean section surgical site infection. Therefore this study aimed to assess magnitude and risk factors of post cesarean section surgical site infection at primary hospitals of East Gojjam Zone, Northwest Ethiopia. Methods Institution based cross sectional study with retrospective chart review was conducted from September 10–30 /2020 at primary hospitals of east Gojjam zone. The data was entered in Epi data version3.1 and exported to Statistical Package for Social Science Software version 26. Presence and degree of association of factors with outcome variable were computed through logistic regression analysis. Factors with P value ≤ 0.2 in bi variable logistic regression analysis were included in the multivariable logistic regression analysis and those variables with P-value of < 0.05 in multivariable analysis were considered statistically significant. Result From 622 medical records of women who underwent cesarean section, 77 (12.4%) of them were developed surgical site infection. Rural residence [(AOR = 2.30, 95%CI :( 1.295, 4.098)], duration of labor greater than 24hrs [(AOR = 3.48, 95%CI :( 1.495, 8.086)], rupture of


2021 ◽  
Author(s):  
Bayou Tilahun Assaye ◽  
Tewabe Manaye ◽  
Zegeye Regasa ◽  
Gizaw Hayiley ◽  
Kirubel Biruk ◽  
...  

Abstract Background: The novel coronavirus(COVID-19) pandemic has been dramatically affecting healthcare organizations across the world. Accessing modern health care is still limited in developing countries due to different factors. Within physical distancing, telemedicine has become the preferred communication channel between health professions and patients. Therefore, this study was aimed to assess Perception and Associated factors for the implementation of telemedicine during the COVID-19 Pandemic among Health Professionals Working at Governmental health facility in Addis Ababa, Ethiopia, 2021.Methods: -Institutional-based cross-sectional study design was conducted among 845 study participants. A structured interview administrative questionnaire using ODK(open data kit) was used. A pre-test was done on 5% of the total sample size. The quality of data was assured by checking its completeness and consistency. Descriptive statistics Bivariable and multivariable logistic regression were fitted. Variables having P-value less than 0.25 during bi-variable logistics regression were entered into multivariable logistic regression. Adjusted odds ratio (AOR) with 95% confidence level (CL) were used to declare association between dependent and the outcome variable. Model fitness and multicollinearity was checked using by using Hosmer-Lemeshow AND Variable inflation factors(VIF) respectively.Result:- Over all 60.9% (95% CI: [57.5, 64.4]) of health professionals had a good perception towards telemedicine with response rate of 737( 87.2%). Health professionals who had IT supporting staff (AOR:7.13, 95% CI: 4.264-13.201), health professionals ’ being certified concerning with ICT (AOR:4.42, 95%CI: 2.69-7.524), frequency of using social media platforms (AOR=3.263, 95% CI: 1.621-6.561) were variables significantly associated with the perception of telemedicine among health professionals for control and prevention of COVID-19.Conclusion:- More than half of respondents had a good perception of telemedicine. being trained with ICT, accessibility of computers,s and Having IT support staff in their health facility were significantly associated with the level of telemedicine perception in the era of the COVID-19 pandemic. Therefore, the Ministry of health recommended to encourage the health professions and the stakeholders to collaborate on promotion of safe and evidence-based use of telemedicine during the current COVID-19 pandemic and future outbreaks.


2021 ◽  
Vol 9 ◽  
pp. 205031212110519
Author(s):  
Basazinew Chekol Demilew ◽  
Aragaw Tesfaw ◽  
Alemitu Tefera ◽  
Bekalu Getnet ◽  
Keder Essa ◽  
...  

Introduction and Objective: Postdural puncture headache is one of the most frequent late complications of spinal anesthesia. There are different factors that might predispose for postdural puncture headache. Therefore, the main aim of this study was to assess the incidence of postdural puncture headache and its associated factors for parturients who gave birth by cesarean section under spinal anesthesia. Methods: Hospital-based longitudinal study was conducted on mothers who underwent cesarean section with spinal anesthesia. Descriptive analysis and chi-square test were employed. Bivariable and multivariable logistic regression were used to measure the association of factors with the presence of postdural puncture headache. A p-value of ⩽0.05 was used to decide statistical significance for multivariable logistic regression. Result: A total of 119 parturients were participated in this study. The incidence of postdural puncture headache was 20.2%. According to multivariable logistic regression, having previous spinal anesthesia (adjusted odds ratio = 7.028; 95% confidence interval = 2.377–20.781; p = 0.0001), using 20- and 22-gauge needle (adjusted odds ratio = 4.206; 95% confidence interval = 1.247–14.187; p = 0.021), and repeated attempt (adjusted odds ratio = 4.699; 95% confidence interval = 1.594–13.872; p = 0.05) had statistically significant association with postdural puncture headache. Conclusion: Larger gauge needle size, repeated attempt, and previous spinal anesthesia might increase the incidence of postdural puncture headache.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S51-S51
Author(s):  
Anna E Moscowitz ◽  
Esther Y Bae ◽  
Ricardo M La Hoz ◽  
James B Cutrell ◽  
Marguerite Monogue

Abstract Background Given the increased mortality associated with delayed recognition of sepsis, emergency departments (ED) often use protocols to rapidly identify and treat suspected sepsis. However, screening criteria such as systemic inflammatory response syndrome (SIRS) lack specificity and may over-diagnose sepsis in patients otherwise stable for discharge. Our study describes outcomes and identifies factors associated with ED readmission in those initially discharged directly from the ED who met sepsis criteria. Methods This retrospective cohort study evaluated adult patients (≥ 18 years) seen in the ED at UTSW Medical Center from January to June 2018 who met all the following: ≥ 2 SIRS criteria; received ≥ 1 dose of intravenous (IV) broad-spectrum antibiotic(s) in the ED; were discharged home. A multivariable logistic regression model identified factors associated with 30-day re-admission to our ED, using clinically significant variables parsimoniously. A two-sided P value &lt; 0.05 was considered significant. Results A total of 179 patients were included. Forty-four patients (25%) returned to the ED within 30 days of their initial visit; of those 44, 63.6% (28) returned for issues related to their prior visit, and 50% (22) were admitted to the hospital. Table 1 compares baseline demographics of patients with suspected sepsis readmitted to the ED with those not readmitted within 30 days after initial ED discharge. In univariable analysis, quick Sequential Organ Failure Assessment (qSOFA), and length of antibiotic therapy (ED plus discharge antibiotics) were associated with ED re-admission (table 1). Receipt of antibiotics on discharge was not significant. In the final multivariable analysis (table 2), initial qSOFA ≥ 2 alone was associated with increased risk of ED re-admission (OR 7.5, p=0.01). Table 1. Baseline demographics of patients readmitted and not readmitted to the ED within 30 days after ED discharge with suspected sepsis Table 2. Multivariable logistic regression of risk factors for patients readmitted and not readmitted to the ED within 30 days after ED discharge with suspected sepsis Conclusion In this cohort, 25% of patients with suspected sepsis initially discharged from the ED were readmitted to our ED within 30 days. A qSOFA ≥ 2 at the initial ED visit was associated with increased risk of readmission, suggesting a potential use of qSOFA to triage those warranting admission or closer follow-up. Larger prospective studies are warranted in this understudied population of patients who meet screening sepsis criteria but are discharged from the ED. Disclosures All Authors: No reported disclosures


2020 ◽  
Vol 15 ◽  
Author(s):  
Arash karimi ◽  
Jahanbakhsh Nejadi ◽  
Mahnaz Shamseh ◽  
Nooshin Ronasi ◽  
Mehdi Birjandi

Background: Postoperative nausea and vomiting (PONV) is a common complication associated with the use of anesthesia. Several antiemetics are used to reduce the incidence and severity of PONV. The aim of this study is to investigate the role of dexamethasone and ondansetron to treat PONV in patients undergoing cesarean section (c-section) under spinal anesthesia. Methods: This double-blind clinical trial study was performed on patients who were referred to the operating room of Haji Karim Asali Hospital of Khorramabad for elective cesarean section in 2016-17. Upon meeting the inclusion criteria, patients were allotted into two groups (n=60). Group A received 8mg of dexamethasone and group B received 4mg of ondansetron after spinal anesthesia. The Visual Analog Scale (VAS) questionnaire and Depression-Anxiety-Stress Scale (DASS) questionnaire was used for the analysis. Patients with mild to moderate stress, anxiety, and depression were included in the study. Data were analyzed using SPSS 16 software. Results: There was no difference in the demographic data of the two groups. The mean severity of nausea in group A was significantly higher than in group B. The frequency of vomiting in group A was 20 times higher than group B, which was found to be statistically significant, p = 0.018. Concerning the type of delivery with the frequency of nausea, the results showed that the frequency of nausea in group A was 3.24 times higher than group B, however, this difference was not statistically significant, p = 0.106. Conclusion: Based on the results of this study, ondansetron had a significant effect on the alleviation of postoperative nausea and vomiting, as compared to dexamethasone in c-section surgical candidates.


2021 ◽  
Vol 11 (2) ◽  
pp. 20 ◽  
Author(s):  
Bright Opoku Ahinkorah ◽  
Richard Gyan Aboagye ◽  
Francis Arthur-Holmes ◽  
Abdul-Aziz Seidu ◽  
James Boadu Frimpong ◽  
...  

(1) Background: Psychological problems of adolescents have become a global health and safety concern. Empirical evidence has shown that adolescents experience diverse mental health conditions (e.g., anxiety, depression, and emotional disorders). However, research on anxiety-induced sleep disturbance among in-school adolescents has received less attention, particularly in low- and middle-income countries. This study’s central focus was to examine factors associated with t anxiety-induced sleep disturbance among in-school adolescents in Ghana. (2) Methods: Analysis was performed using the 2012 Global School-based Health Survey (GSHS). A sample of 1342 in-school adolescents was included in the analysis. The outcome variable was anxiety-induced sleep disturbance reported during the past 12 months. Frequencies, percentages, chi-square, and multivariable logistic regression analyses were conducted. Results from the multivariable logistic regression analysis were presented as crude and adjusted odds ratios at 95% confidence intervals (CIs) and with a statistical significance declared at p < 0.05. (3) Results: Adolescents who went hungry were more likely to report anxiety-induced sleep disturbance compared to their counterparts who did not report hunger (aOR = 1.68, CI = 1.10, 2.57). The odds of anxiety-induced sleep disturbance were higher among adolescents who felt lonely compared to those that never felt lonely (aOR = 2.82, CI = 1.98, 4.01). Adolescents who had sustained injury were more likely to have anxiety-induced sleep disturbance (aOR = 1.49, CI = 1.03, 2.14) compared to those who had no injury. Compared to adolescents who never had suicidal ideations, those who reported experiencing suicidal ideations had higher odds of anxiety-induced sleep disturbance (aOR = 1.68, CI = 1.05, 2.71). (4) Conclusions: Anxiety-induced sleep disturbance among in-school adolescents were significantly influenced by the psychosocial determinants such as hunger, loneliness, injury, and suicidal ideation in this study. The findings can help design appropriate interventions through effective strategies (e.g., early school-based screening, cognitive-behavioral therapy, face-face counseling services) to reduce psychosocial problems among in-school adolescents in Ghana.


BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Senri Yamamoto ◽  
Hirotoshi Iihara ◽  
Ryuji Uozumi ◽  
Hitoshi Kawazoe ◽  
Kazuki Tanaka ◽  
...  

Abstract Background The efficacy of olanzapine as an antiemetic agent in cancer chemotherapy has been demonstrated. However, few high-quality reports are available on the evaluation of olanzapine’s efficacy and safety at a low dose of 5 mg among patients treated with carboplatin regimens. Therefore, in this study, we investigated the efficacy and safety of 5 mg olanzapine for managing nausea and vomiting in cancer patients receiving carboplatin regimens and identified patient-related risk factors for carboplatin regimen-induced nausea and vomiting treated with 5 mg olanzapine. Methods Data were pooled for 140 patients from three multicenter, prospective, single-arm, open-label phase II studies evaluating the efficacy and safety of olanzapine for managing nausea and vomiting induced by carboplatin-based chemotherapy. Multivariable logistic regression analyses were performed to determine the patient-related risk factors. Results Regarding the endpoints of carboplatin regimen-induced nausea and vomiting control, the complete response, complete control, and total control rates during the overall study period were 87.9, 86.4, and 72.9%, respectively. No treatment-related adverse events of grade 3 or higher were observed. The multivariable logistic regression models revealed that only younger age was significantly associated with an increased risk of non-total control. Surprisingly, there was no significant difference in CINV control between the patients treated with or without neurokinin-1 receptor antagonist. Conclusions The findings suggest that antiemetic regimens containing low-dose (5 mg) olanzapine could be effective and safe for patients receiving carboplatin-based chemotherapy.


2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Samuel Debas Bayable ◽  
Seid Adem Ahmed ◽  
Girmay Fitiwi Lema ◽  
Debas Yaregal Melesse

Background. Spinal anesthesia is the most common anesthetic technique for cesarean delivery. Patient satisfaction is a subjective and complicated concept, involving physical, emotional, psychological, social, and cultural factors. Regular evaluation of maternal satisfaction related to anesthesia service is an important parameter to the required changes and expansion of high-quality care services. We aimed to assess maternal satisfaction and associated factors among parturients who underwent cesarean delivery under spinal anesthesia. Methods. Institutional-based cross-sectional study was conducted from February to May 2019. A total of 383 parturients were enrolled to assess maternal satisfaction using a 5-point Likert scale. Both bivariable and multivariable logistic regression analyses were done. Variables of p value ≤0.2 in the bivariable analysis were a candidate for multivariable logistic regression. A p value <0.05 was considered as significantly associated with maternal satisfaction at 95% CI. Results. This study revealed that 315 (82.3%) of the parturients were satisfied. Single spinal prick attempts (AOR = 2.08, 95% CI = 1.05–4.11), successful spinal block (AOR = 7.17, 95% CI = 3.33–15.43), less incidence of postdural puncture headache (AOR = 2.36, 95% CI = 1.33–4.20), and prophylactic antiemetic use (AOR = 0.35, 95% CI = 0.19–0.66) were positively associated with maternal satisfaction. Conclusions. The overall maternal satisfaction receiving spinal anesthesia was considerably low. Single spinal prink attempts, successful spinal block, and less incidence of postural puncture headache can increase maternal satisfaction. Therefore, effective perioperative management, skillful techniques, and using the small-gauge Quincke spinal needle (25–27 gauge) may increase the maternal satisfaction and quality of spinal anesthesia management.


Author(s):  
Devi Meenakshi K. ◽  
Arasar Seeralar A. T. ◽  
Srinivasan Padmanaban

Background: Very low birth weight (VLBW) babies are at increased risk of a number of complications both immediate and late. Worldwide it has been observed that these babies contribute to a significant extent to neonatal mortality and morbidity. Aim of the study was to study the risk factors contributing to mortality in VLBW babies and to evaluate the morbidity pattern in these infants.Methods: A retrospective analysis of data retrieved from the case records of VLBW babies admitted in the NICU of Kilpauk Medical College between January 2015 to December 2015. Out of the 2360 intramural babies admitted during the study period, 99 babies were less than 1500 gms. The risk factors for these babies were analyzed for their association with the outcome. Data were statistically analyzed.Results: In present study, we found that sex of the baby, gestational age, obstetric score, birth asphyxia, pulmonary haemorrhage, ROP and presence of shock were found to be associated with increased mortality. By logistic regression analysis it was observed that birth weight of the baby (p value 0.002), duration of stay (p value 0.0006), presence of shock (p<0.0001), were the risk factors significantly associated with poor outcome.Conclusions: Among the maternal and neonatal factors analyzed in the study using logistic regression analysis, birth weight, duration of hospital stay and presence of shock were significantly related to poor outcome. Of these presence of shock was the single most important factor that predicted increased mortality.


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