Background: Post-traumatic stress disorder (PTSD) is prevalent among road traffic accident survivors (RTA), yet the psychological welfare of the persons has largely been ignored as health care professionals focus more on managing physical injuries. Many literatures from other parts of the world have addressed the issue of posttraumatic stress disorder among road traffic accident survivors, but such studies are mostly unavailable in sub-Saharan Africa, especially in Ethiopia. Therefore, this study examined the prevalence and determinants of PTSD among RTA survivors attending selected hospitals in southern Ethiopia. Methods: Institution based cross-sectional study design was employed from April 1/2018-Sep 30/2019. Data were collected from a sample of consecutively selected 423 RTA survivors through an interviewer-administered technique. A pre-tested post-traumatic stress disorder Checklist-Specific version (PCL-S) tool was used to screen PTSD. Data were entered and analysed using SPSS 22 software. A logistic regression model was fitted to identify determinants of PTSD. An adjusted odds ratio (AOR) with a 95% confidence interval was computed to determine the level of significance with a p-value of less than 0.05. Result: A total of 416 participants were included in the study and the response rate was 98.6%. The prevalence of probable PTSD among RTA survivors was 15.4% (64). After adjusting for the effects of potential confounding variables; time since accident (30-90 days) (AOR = 0.33; 95%CI (0.15, 0.73), history of previous road traffic accident (AOR = 2.67; 95%CI (1.23, 5.77), depressive symptoms (AOR = 2.5, 95% CI (1.10, 6.10)) and common mental disorder (AOR = 12.78, 95% CI (5.56, 29.36)) were significant determinants of PTSD. Conclusion: The prevalence of probable PTSD in the current study was high (15.4%). Time since accident, history of a previous road traffic accident, having depressive symptoms and common mental disorder were significant determinants of PTSD. RTA survivors attending adult Emergency and orthopedic clinics need to be screened for PTSD and get appropriate management.

Background Apgar score is used to evaluate the neonates’ overall status and response to resuscitation, as well as its prognosis beyond the neonatal period. Low fifth minute Apgar scores is more frequent and is associated with markedly increased risks of neonatal mortality and morbidity. In Ethiopia, the prevalence of birth asphyxia is high (22.52%). Birth asphyxia contributes to significant neonatal morbidities and mortalities due to severe hypoxic-ischemic multi-organ damage, mainly brain damage. Therefore, this study was aimed to identify determinants of low fifth minute Apgar score among newborns delivered by cesarean section. Methods An unmatched case control study design was conducted. The Apgar score is based on measures of heart rate, respiratory effort, skin color, muscle tone, and reflex irritability. The data collection tool or checklist was adapted from previous study done at Addis Ababa, Ethiopia. In this study, cases were all newborns with Apgar score < 7 whereas controls were all newborns with Apgar score >  = 7. The study participants were selected by simple random sampling technique. Data was into Epidata version 4.6 and exported to SPSS software version 24. Multivariable logistic regression was used to identify the independent effect of different factors at P < 0.05. Result Factors associated with low Apgar score were fetal birth weight < 2.5 kg [adjusted odds ratio (AOR) = 8.17, 95% confidence interval (CI): 1.03 ‒ 64.59] P = 0.046, skin incision to delivery time (AOR = 5.27; 95% CI: 2.20 ‒ 12.60) P = 0.001, pregnancy induced hypertension (AOR = 4.58, 95% CI: 1.75 ‒ 11.92) P = 0.002, antepartum hemorrhage (AOR = 3.96; 95% CI: 1.75 ‒ 8.94) 0.001, general anesthesia (AOR = 3.37, 95% CI: 1.72 ‒ 6.62) P = 0.001, meconium stained amniotic fluid (AOR = 3.07, 95% CI: 1.32 ‒ 7.12) P = 0.009 and emergency cesarean section (AOR = 2.17, 95% CI: 1.13 ‒ 4.15) P = 0.019. Conclusions Fetal birth weight < 2.5 kg, skin incision to delivery time, pregnancy induced hypertension, antepartum hemorrhage, type of anesthesia, meconium stained amniotic fluid and type of cesarean section were factors independently associated with Apgar score. Therefore, it is important to work on identified risk factors to reduce the impacts low fifth minute Apgar score in the in early adulthood..

Background: Caudal epidural analgesia is one of the most popular reliable, safe and commonly performed regional blocks in pediatric patients undergoing lower abdominal and lower limb surgery. Various adjuvants such as opioids or α2 agonists are being used to improve the quality and duration of caudal analgesia. Addition of Tramadol to local anesthetics has been noted to prolong the duration of analgesia after surgery. Objective: To assess the efficacy of adding caudal tramadol to bupivacine for post operative analgesia in pediatric infraumblical surgery. Method: Hospital based prospective cohort study design was employed. Comparison of two mean with equal sample size formula for two independent cohort was used to get sample size of 56 children's whose age is 1–14 years' old that undergone elective Infraumbilical surgery received caudal block with bupivacaine alone or with tramadol added. A systemic random sampling technique was used to select study participants. Postoperatively severity of pain either by FLACC/NRS, time to analgesic request and analgesic consumption were evaluated at 1st, 2nd,4th,8th,12th and 24th hrs. Pain severity, first analgesia request time and analgesic consumption were assessed using Mann–Whitney U test for 24 h. Chi-square test was used to assess homogenous categorical independent variables between the two groups and a p-value less than 0.05 was considered to be statically significant. Result: Tramadol with bupivacaine has prolonged postoperative analgesia with a median duration of 14 h compared to 5 h in bupivacaine alone. Moreover, total Paracetamol analgesic consumption was lower in tramadol group with a median total dose of 250 mg compared with 437.5 mg in bupivacaine group with statistically significant difference within 24 h (p < 0.018). Also, reduced the pain score in tramadol group, being statically significant at 4th, 8th and12th hours. Conclusion: Caudal tramadol with bupivacaine decrease postoperative pain severity, total analgesic consumption and prolong the duration of analgesia. Based on our finding we recommend the use of caudal tramadol with bupivacaine is effective for postoperative analgesia. Highlights:

Background Postoperative sore throat is a common, uncomfortable, stressful sequel of tracheal intubation that contributes to postoperative mortality and morbidity following general anesthesia. Therefore, reducing risks of post-operative sore throat is important to improve patient outcome. Objectives The objective of this systematic review and meta-analysis was to evaluate the incidence and risk factors of postoperative sore throat among patients who underwent surgery. Methods Studies were retrieved from PubMed, Cochrane Database, Cinahl, Scopus, Mednar, Hinari and Google Scholar by employing a combination of search terms with Boolean operators. Heterogeneity across studies was assessed using the Cochrane Q test. Funnel plot was used for visual assessment of publication bias. Subgroup analyses by country and meta-regression was performed to explore the possible causes of heterogeneity. Egger’s weighted regression test at a p-value < 0.05 was used to assess the presence of publication bias. Sensitivity analysis was performed to judge whether the pooled effect size was influenced by individual study. Stata v14.0 (Statacorp, College Station, Texas, USA) software was used for all statistical analyses. STATA software version 14 was used for all statistical analyses. Result A total of 11 studies with 5885 total sample size were included. The total number of patients who developed Post-operative sore throat was 2252. The pooled prevalence of Post-operative sore throat was 40.48% (95% CI: 35.16, 45.79). The visual inspection of the funnel plot showed the symmetrical distribution. Patients who had number of a single attempts were about 42.5% less likely to develop POST than patients who had multiple intubation attempts (OR: 0.58(0.38–0.88), P = 010, I2: 86.6%. Additionally, duration of tube in place less than 1 h was about 18.7% more likely to develop POST than who were not (OR: 1.19(0.29–4.79), P = 0.028, I2: 0.0%). The other independent predictors of POST were OR: 3.01(0.57–15.84), P = 0.19, I2: 92.3%) and OR: 1.56(0.97–2.58), P = 0.080, I2: 0.0%) respectively. Conclusions Patients’ age and sex, size of ETT and LMA, duration of ETT in trachea, experience of anesthetists’, number of attempts, induction agent, and smoking were revealed more common causes of sore throat. The number of attempts and the length of tube in place were both linked to the occurrence of postoperative sore throat. Research Registry Our unique identifying number is reviewregistry1416. Highlights

BackgroundEpilepsy remains one of the world's most common neurological diseases, but it appears to be widely misunderstood, particularly in under-resourced countries like Ethiopia. Improving individuals' knowledge and attitude toward epilepsy is critical for reducing the multifaceted impacts of epilepsy. Therefore, in this study, we sought to estimate the pooled levels of good knowledge and a favorable attitude toward epilepsy and also identify the associated factors using available data collected from different segments of the population.MethodsArticles were searched in international electronic databases. A standardized Microsoft Excel spreadsheet and STATA software version 16 were used for data extraction and analysis, respectively. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist was used to write this report. The random-effect meta-analysis model was used to estimate Der Simonian-Laird's pooled effect. Statistical heterogeneity of the meta-analysis was checked via Higgins and Thompson's I2 statistics (0–100%), and Cochran's Q test at P &lt; 0.10. Subgroups, based on the study regions, and sensitivity analyses were also performed. Publication bias was examined subjectively using funnel plots and objectively using the nonparametric rank correlation test of Begg and the regression-based test of Egger for small study effects with P &lt; 0.05 considered to indicate potential publication bias. Furthermore, the Trim-and-fill method of Duval and Tweedie was used to explore sources of publication bias for the favorable level of attitudes toward epilepsy.ResultA total of 12 studies with 6,373 study participants and 10 studies with 5,336 study participants were included to estimate the pooled level of good epilepsy knowledge and favorable attitudes respectively. The overall estimated levels of good epilepsy knowledge and favorable attitudes toward epilepsy among Ethiopians were 47.37% [(95% CI: 35.00, 59.74), I2 = 99.2, P &lt; 0.001] and 46.83%[(95% CI: 32.75, 60.90), I2 = 99.2, P &lt; 0.001] respectively. Subgroup analysis revealed that the pooled level of good epilepsy knowledge was 48.51% [(95% CI: 38.95, 58.06), I2 = 95.6%, P &lt; 0.001] in the Amhara region.ConclusionIn the current review, we found out that there is a huge knowledge gap and an unfavorable level of attitudes towardepilepsy, which demand immediate public health action as well as a targeted policy intervention.