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..

An intensive care unit is a special department of hospital or health care facility that provides intensive treatment medicine. Critically ill patients are admitted to the intensive care unit to reduce morbidity and mortality associated with acute illness, trauma or surgical procedures. This study aimed to assess clinical outcomes of patients admitted in intensive care units of Nigist Eleni Mohammed Memorial Hospital of Hosanna from January 2015 to January 2016. Institutional based cross sectional study design was conducted. All the study participants admitted to intensive care unit were included. Regular supervision and follow up was made. Data was entered into Epi info version 7 by investigators and was transported to SPSS version 20 for analysis. Bivariate and multivariate analysis was used to identify factors associated with patient's outcome. A total of 280 clients were enrolled into the study of which 46.42% died. About 26% of patients were found in the age group of 20 to 24 years and majority of them were male (58.2%). Patient with head injury is about six times more likely to die in the intensive care unit than patients with small bowel obstruction (AOR 6.620 (95% CI ((468-93.584). There were poor outcomes of patients admitted to intensive care unit so that it was strongly recommended to improve quality of care.Key word: Ethiopia, intensive care unit, cause of death, hospital discharge.

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

Background Apgar score is a practical method of systemically assessing newborn baby immediately after birth to identify those requiring resuscitation and to predict survival in neonatal period. This study was aimed to identify determinant of low fifth minute Apgar score among newborns delivered by Cesarean section. Methods An unmatched case control study design was conducted. Cases were newborns with Apgar score of < 7; controls were newborns with an Apgar score of > = 7. The study participants were selected by simple random sampling technique. Data was entered into Epi data version 4.6 and exported to SPSS software version 24. Multivariable logistic regression to identify the independent effect of different factors at P < 0.05. Result In this study, factors associated with low Apgar score (LAS) were fetal birth weight < 2.5kg [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 (PIH) (AOR = 4.58, 95% CI: 1.75 ‒ 11.92) p = 0.002, antepartum hemorrhage (APH) (AOR = 3.96; 95% CI: 1.75 ‒ 8.94) 0.001, type of anesthesia (AOR = 3.37, 95% CI: 1.72 ‒ 6.62) p = 0.001, meconium stained amniotic fluid (MSAF) (AOR = 3.07, 95% CI: 1.32 ‒ 7.12) p = 0.009 and type of cesarean section (CS) (AOR = 2.17, 95% CI: 1.13 ‒ 4.15) p = 0.019. Conclusions Fetal birth weight < 2.5kg, skin incision to delivery time, PIH, APH, type of anesthesia, MSAF and type of CS were independently associated with LAS. Therefore, it was strongly recommended that working on identified risk factors were paramount to improve then neonatal outcomes.