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Background: Shivering is commonly observed as a complication after Regional Anesthesia. Pethidine has been thought as a standard for prevention and treatment of shivering but it is not without side effects. Studies showed that dexamethasone also has promising effect with fewer side effects even though there are controversies. Objective: To compare the effect of prophylactic dexamethasone and pethidine on prevention of post-spinal anesthesia shivering for patients who underwent transurethral resection of the prostate (TURP) at Dagmawi Minilik second hospital from October 26 to January 24/2020. Methods: An institutional-based prospective cohort study was conducted on 64 patients who fulfilled inclusion criteria and underwent TURP. A convenient sampling technique was used to recruit study participants. Independent sample t-test statistics and Mann-Whitney U test were used for quantitative data that was distributed normally and none normally respectively. A Chi-square test was used to compare differences in categorical data. P-value <0.05 was considered as statistically significant. Result: The incidence and severity of shivering was comparable between pethidine and dexamethasone group (p value > 0.05). There was no statistically significant difference in the meantime to the first onset of shivering between dexamethasone (65 min) and pethidine (81 min) group (p = 0.23).The median consumption of total antishivering medication was comparable between dexamethasone (54.2 mg of tramadol) and pethidine (68.8 mg of tramadol) group (p = 0.21). Conclusion: Dexamethasone (4 mg) is equally effective as pethidine (25 mg) that of standard antishivering drugs. The use of dexamethasone (4 mg) as an alternative of pethidine as a prophylaxis for the prevention of shivering for patients undergoing TURP procedures under spinal anesthesia. Highlights:

Background: Status epilepticus (SE) is a life-threatening condition associated with at least 5 min of continuous seizures or repeated seizures without regaining consciousness between episodes. It is a medical emergency with significant morbidity and mortality. The most common causes of SE are previous seizures, stroke, trauma, metabolic disorders, and central nervous system tumor. The aim of this review was to systematically review articles and ultimately develop evidence-based guidelines for the management of SE in resource-limited settings. Methods: This review was presented under the Protocol for Systematic Reviews and Meta-Analyses (PRISMA). A literature search was performed in PubMed, Google Scholar, Cochrane, and Medline databases from 2007 to 2021. The keywords for the literature search were (SE or controlled clinical trial) AND (SE or randomized controlled trial), (SE or multicenter trial) AND (SE or meta-analysis) AND (SE or crossover study). Conclusion: SE is an urgent medical emergency that requires early recognition and aggressive treatment. Medical treatment is initiated when seizures continue for more than 5 min after all stabilization measures have been taken. Based on the available evidence, diazepam can be used as a substitute for lorazepam in the treatment of SE. Ketamine is effective when given before other anesthetics as a third-line treatment in refractory and very refractory epilepsy. Propofol reduced the number of days of mechanical ventilation in the treatment of SE and has better seizure control than thiopental. Music has been recommended as an adjunctive therapy for epilepsy medication.

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