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Background: Post-Dural puncture headache is a major complication of neuraxial anesthesia that can occur following spinal and epidural anesthesia. It is, postural, and frontal and relieved when the patient is supine position and aggravated during standing, sitting, coughing. Therefore, we aimed to determine the incidence and factors associated with post dural puncture headache following cesarean section under spinal anesthesia. Methods: An institution based cross sectional study was conducted from March 01 to May 29, 2019. A total of 384 willing patients were included in the study after obtaining ethical consent. Data was entered and analyzed using Statistical Package for Social Sciences (SPSS) window version 20. Descriptive statistics, cross-tabs and binary logistic regression analysis were performed to identify the association between post dural puncture headache and independent variables. The strength of the association was presented using adjusted odds ratio with 95% confidence interval and p-value<0.05 was considered as statistically significant. Results: The incidence of post dural puncture headache was 31.3% (95% CI: 26.8, 35.9) with response rate of 92.5%. Majority of the patients who developed it were on the 2nd day with majority of the pain being moderate. In this study body mass index, Size of spinal needle, number of attempt and educational status of anesthetists were significantly associated with it. Conclusion: In this study non-obese patients, big spinal needles, repeated number of attempts and educational status of anesthetists were the independent associated risk factors for post dural puncture headache. Highlights

Background: Traumatic chest injury is responsible for 10%–15% of all trauma-related hospital admissions across the world. It is also responsible for approximately 25% of trauma related death. Several predictors have been described for mortality following chest trauma however, limited published studies were available in Ethiopia. Objective: To assess mortality rate and factors associated with death in traumatic chest injury patients over five year's period from June 2016 to June 30, 2020 G.C. Method: A retrospective cross-sectional study was done from June 2016 to June 30, 2020. Data was collected from patients’ chart. The collected data was entered into Epi-info version 7 and transferred to SPSS version 20.0 for processing and analysis. Bivariable and multivariable logistic regression was used to show factors associated with mortality. P- Value < 0.05 was considered statistically significant. Result: A total of 419 patient charts were eligible for this study. The majority of patients (55.8%) sustained blunt chest injuries and violence (52.5%) was the leading cause of injuries. Hemopneumothorax (27.7.0%), hemothorax (22.9%) and rib fracture (17.2%% were the most common type of injuries. Associated extra-thoracic injuries were noted in 70.4% of patients, from those, extremity injury (22.2%), head/neck injuries (21.7%) and abdominal injuries (18.1%) were the commonest. Most patients (64.7%) were treated successfully with chest tube. Nearly, one third (35.3%) had complications including pneumonia (13.8%) and Atelectasis (12.6%). The mean length of hospital stay was 9.40 days. The overall traumatic chest injury mortality rate was 26%. Mortality was significantly associated with age >50 year [AOR 9.32, 95% CI, 2.72–31.86], late presentation beyond 6hr (AOR 7.17, 95% CI 1.76–29.21), bilateral chest injury (AOR 3.58 95% CI 1.53–8.38), penetrating chest injury (AOR 3.63 95% CI 1.65–7.98), presence of extra-thoracic injury (AOR 4.80, 95% CI, 1.47–15.72) and need for mechanical ventilation (AOR 11.18, 95% CI 2.11–59.23). Conclusion: The mortality rate in traumatic chest injury was high. Late presentation beyond 6hr, age >50-year, penetrating injury, bilateral chest injury, associated extra thoracic injury, and need for mechanical ventilation were identified as possible risk factors for mortality in traumatic chest injury patients. Highlights

Introduction: Emergency orthopedic surgeries are performed on a daily and night basis across the world and, different levels of postoperative pain is commonly reported early and late in the postoperative period. Despite the availability of evidence-based international reports, still it is not clearly stated in Ethiopia. Objective: To determine the incidence and associated factors of post operative pain after Emergency Orthopedics Surgery. Methods: A multi-centered prospective observational cohort study was conducted to determine the incidence and associated factors of postoperative pain after emergency orthopedic surgeries from March 1 to May 30, in 2020. Data was analyzed using Statistical Package for Social Sciences, version 20. To identify the association between outcome variable and independent variables, descriptive statistics, cross tabulation and binary logistic regression were used. Categorical data were analyzed using chi-square test. Adjusted odd ratios were computed with 95% confidence interval and p-value < 0.05 was used to determine the significance of the study. Result: The overall incidence of moderate to severe postoperative pain within the first 24 h after emergency orthopedics surgery was 70.5% (95% CI: 64, 77). On multivariable logistic regression analysis; history of having preoperative pain (AOR: 7.92, 95% CI: 3.04, 20.63), history of preoperative anxiety (AOR: 6.42, 95% CI: 2.59, 15.90), preoperative patient expectation about postoperative pain (AOR: 6.89, 95% CI: 2.66, 17.78) and being general anesthesia (AOR: 4.08, 95% CI: 1.30, 12.77) were significantly associated with moderate to severe postoperative pain after emergency orthopedics surgery. Conclusion: Postoperative pain management should be given a high priority in emergency orthopedics surgery. Appropriate pain management strategy should be implemented to decrease postoperative pain suffering. Factors associated with postoperative pain were; preoperative history of pain and anxiety, patient expectation about postoperative pain and being general anesthesia. Highlights:

Background: spinal anesthesia is easy to access, cheap safe for surgery done below umbilicus but it has a lot of complications like total spinal, high spinal, hypotension and sever neurological abnormality due to in adequate preparation and poor practice while administration spinal anesthesia in the operation theatres. This audit was aimed to improve practice of spinal anesthesia in our theatre meet the audit standards or not. Methods: This audit was conducted from January 01/2019 to February 01/2019. Anesthetists who administers spinal anesthesia in surgical and obstetric operation rooms were included. Data were collected by direct observation using standardized checklist prepared from recommendations of Ney work Society of Regional Anesthesia (NYSORA). Data were collected prospectively before, during and after administer spinal anesthesia. Results: Total of 50 anesthetists were observed before, during and after they deliver spinal anesthesia. From those audit standards only communication with patients during spinal injection to end of surgery was fully practiced. However, anesthetist should wash their hands, wear sterile gown and the area should be draped with fenestrated drapes in a sterile fashion were not practice. Conclusions: Practice of spinal anesthesia in our operation theatre was satisfactory. But still it needs some improvement that scored below the average and those audit standards that were not practiced at all. Highlights: