Background: COVID-19 first broke out in china, Hubei province on December 29, 2019. Since then it took more than hundred thousand lives worldwide. Although all countries are taking varying degree of measures to curb the dissemination, the virus is still spreading rapidly in all part of the world. Adherence of peoples for COVID-19 precautions measures is one of the most important factors which determine the effectiveness of curbing the spread. However without having good attitude adherence of people toward precaution measures could be challenging. Therefore the aim of this study is to assess the attitude, practice and associated factors of southern Ethiopian residents toward COVID-19 and its prevention. Methods: A community based cross sectional study was conducted among 585 Southern Ethiopian residents. Bivariate and multivariate binary logistic regression was used to determine association between dependent and independent variables. Adjusted odds ratio with their 95% CI was used show the strength of association. P-value < 0.05 was used to decide statistically significant association.Result: Most of the study participants (90.3%) have good attitude toward COVID-19 and its prevention. Being younger age group, having chronic medical illness, using television as a source of information and having good knowledge were significantly associated with good attitude toward COVID-19.On other hand; only 20% of the study participants have good practice toward COVID-19 prevention. Educational status, occupation and having chronic medical illness, uses of religious teaching as information sources are associated factors for good practice against COVID-19 infection. Conclusion: We conclude that despite the presence good attitude in majority of respondents much work needed to improve rare practice of COVID-19 preventive measures.

Background: COVID-19 first broke out in China, Hubei province on December 29, 2019, since then it took hundreds of thousand lives worldwide. Although all countries are taking varying degrees of measures to curb the dissemination, the virus is still spreading rapidly in all parts of the world. Adherence of people for COVID-19 precaution measures is one of the most important factors which determine the effectiveness of curbing the spread. However, without having a good attitude, the adherence of people toward precaution measures could be challenging. Therefore, this study aims to assess the attitude, practice, and associated factors of Gedeo zone of Southern Ethiopia region residents toward COVID-19 and its prevention. Methods: A community-based cross-sectional study was conducted among 600 Gedeo zone residents of Southern Ethiopia. Bivariate and multivariate binary logistic regression were used to determine the association between dependent and independent variables. An adjusted odds ratio with 95% CI was used to show the strength of association. P-value<0.05 was used to decide a statistically significant association. Results: Most of the study participants (90.3%) have a good attitude toward COVID-19 and its prevention. Being a younger age group (AOR=3.82, 95% CI=1.76-19.07), having a diploma and above (AOR=2.53, 95% CI=1.15-7.50), having a chronic medical illness (AOR=2.73, 95% CI=1.01-7.44), and using television/radio as a source of information (AOR=2.65, 95% CI=1.27-5.54) were significantly associated with a good attitude toward COVID-19. On the other hand, only 20% of the study participants had good practice toward COVID-19 prevention. Educational status (P-value=0.00), occupation (P-value=0.01), and having a chronic medical illness (P-value=0.03), and use of religious teaching as information sources (P-value=0.02) were among the factors associated with good practice toward COVID-19 infection. Conclusion: We conclude that, despite the presence of a good attitude in the majority of respondents, much work is needed to improve the poor practice of COVID-19 preventive measures.

Background Femoral fracture is the most painful bone injury and performing spinal anesthesia is extremely challenging due to very poor positioning unless we have a very good mode of analgesia. Intravenous strong opioids are commonly used but to date nerve blocks are also being utilized. The reliability and effectiveness of the aforementioned methods are not conclusive to practice worldwide. The objective of the study was to compare the analgesic effect of intravenous fentanyl, femoral nerve block (FNB) and fascia iliaca block (FICB) during positioning patients with femoral fracture for spinal anesthesia. Methods A randomized controlled trial study was conducted on 72 elective adult patients with femoral fracture aged 18–65 years and ASA I and II those were allocated randomly into three groups. The intravenous fentanyl (IVFE) group received 1µg/kg IV fentanyl, FNB group received nerve stimulator guided FNB with 30 mL of 1% lidocaine with adrenaline and FICB group received FICB with 30 mL of 1% lidocaine with adrenaline. Pain intensity in numeric rating score (NRS), time to perform spinal anesthesia, quality of positioning and patient acceptance were assessed. SPSS version 26 and Kruskal–Wallis test were used to analyze data and p value <0.05 was considered significant. Results NRS Pain score during positioning was significantly lower in FNB and FICB groups than IVFE group [median (IQR)]; 2 (1–2.5), 2 (2–3)) vs. 3 (3–4) respectively; P<0.001 and P=0.001. However, FNB and FICB groups were not significantly different with (P=1.000). Time to perform spinal anesthesia was significantly longer in IVFE group 9.5 (9–10) minutes than both FNB and FICB groups 7 (6–8), 8 (6–8) respectively, P<0.001. The quality of positioning was significantly lower in the IVFE group than both FNB and FICB groups (P<0.001). Conclusion Preoperative FNB and FICB reduce pain score during positioning, shorten time to perform spinal anesthesia, better patient positioning and higher patient acceptance in a patient undergoing elective femoral bone fracture surgery. Trial Registration Pan African Clinical Trial Registry, PACTR202006669166858, registered on June 19, 2020. https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=12127 .

Background Postoperative delirium is the highest prevalence and life-threatening complication following geriatric surgery. The overall incidence rate varies from 5% to 52% of hospitalized surgical patients based on the type of surgery that often began in the postanesthesia care unit and continues up to 5 days post-surgery. Postoperative delirium manifests as a hypoactive, hyperactive and mixed subtype. The mechanism of delirium development is not clear, but it is accepted that delirium is a result of the patient’s underlying vulnerabilities or risk factors combined with an outside stressor such as infection or surgery. Objective To develop evidence-based recommendations for the prevention, diagnosis, and treatment of postoperative delirium. Methods Literature was searched from PubMed, CINAH, Google Scholar, and Cochrane databases that are published from 2010 to 2021 by formulating inclusion and exclusion criteria. Filtering was made depending on methodological quality, outcome, and data on population. Finally, 11 meta-analysis, 11 systematic reviews, 7 interventional studies, 11 observational studies, and recommendations of the previous clinical practice guideline developed by the American and European are included in this review. Results A total of 43 studies were considered in this evaluation. The development of this guideline was based on nine studies on risk stratification for postoperative delirium, eighteen studies on risk minimization and prevention for postoperative delirium, five studies on diagnosis for postoperative delirium, and eleven studies on treatments for postoperative delirium. Conclusion Postoperative delirium management can be categorized into risk assessment, risk minimization, early diagnosis, and treatment. Early diagnosis is critical to trigger focused and effective treatment. Non-pharmacological interventions are the first-line management for both hypoactive and hyperactive postoperative with considering contributory factors and underlying causes. Antipsychotics should only be used for hyperactive delirium individuals who try to harm themselves. Current evidence suggested that dexmedetomidine can be used as a treatment option for postoperative delirium.

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