Background Patient satisfaction in relation to perioperative anesthesia care represents an essential aspect of quality health care management. The assessment of patient satisfaction is a reality of practice today for good patient satisfaction with health care provider interaction and health influencing factors. Objectives To assess the magnitude and associated factor of patient satisfaction towards anesthesia care at Hawassa University comprehensive specialized Hospital April 5, – May 5, 2019Gc. Method: A prospective cross-sectional study design was employed in an adult surgical patient scheduled for surgery under general anesthesia and the regional anesthesia level of satisfaction and factor associated with satisfaction was analyzed. Data was entered info version 7 and transfer to SPSS version 25 .0 for analysis. Normality test checked by using Shapiro-Wilk and Kolmogorov-Smirnov the data was normally distributed. Then the frequency, percentage, and cross-tabulation with different variables were determined, lastly, the magnitude and associated factor analyzed by binary logistic regression a multivariate logistic regression. Variables P-value < 0.2 binary logistic regression included in a multivariate logistic regression and p_value less than 0.05 was Taken as statistically significant. Result A Total of 200patient included in this study with a response rate of 100%. The main finding of this study was predictors of perioperative patient dissatisfaction were general anesthesia, duration of surgery, nausea, and vomiting, and pain after surgery. The magnitude of patient satisfaction is 60%. Odds of the patient who took general anesthesia were 2.31(1.096, 4.142) p = 0.026 more dissatisfied than regional anesthesia. Odds of the patient duration of surgery 2-3hr 0.313(0.124, 0.792) less likely dissatisfied than the duration of surgery 1hr.The odds of patient nausea and vomiting AOR = 2.575(1.163, 5.698) P = 002 more likely dissatisfied than didn’t have nausea and vomiting. The odds of patient pain after surgery AOR = 2.28(1.084, 4.76) more likely dissatisfied than the patient didn’t have pain after surgery. Conclusion patient satisfaction with perioperative anesthesia care Compared to another study magnitude of satisfaction very low, regular study and intervention should do every time /year in order to increase patient satisfaction.

Purpose: Emergency drugs and essential equipment are important to successfully manage patients in the intensive care unit (ICUs). The absence of these emergency drugs and essential equipment might result in mortality and morbidity which is more compounded in resource-limited settings. This study aims to assess the availability of emergency drugs and essential equipment in ICUs in hospitals in Ethiopia. Materials and Methods: A cross-sectional descriptive study design was employed in the intensive care unit of nine Amhara regional state hospitals in Ethiopia. This study was done from August 01, 2020, to September 01, 2020. The data were collected using a structured questionnaire, which were adopted from the Emergency Medicine Society of South Africa (EMSSA) guidelines. Tables and narration were used to describe results. Results: There were deficiencies of essential emergency items particularly in the pediatrics domain, devices to confirm tracheal intubation and equipment for managing difficult intubation. Emergency drugs like adrenaline, salbutamol puff, atropine, aspirin, furosemide, hydrocortisone, insulin, lidocaine, and medical oxygen were available in all ICUs, whereas amiodarone, sodium bicarbonate, glucagon, ipratropium nebulization, thiamine were not available in all ICUs. Conclusions and Recommendations: There were considerable deficiencies in emergency drugs and essential equipment. Based on our findings, we recommend to develop standardized checklists, regular audits, and healthcare personnel awareness program to improve checking, maintaining, restocking, and repairing the equipment in the emergency trolley.

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Background: Caudal block is the most preferred technique of postoperative analgesia in pediatrics, despite its limited duration of action. Many additives are used to improve the efficacy of caudal blocks, such as opioids or α2 agonists. Recently, there has been increased use of caudal dexamethasone as postoperative analgesia. Objective: To assess the efficacy of adding caudal dexamethasone on bupivacaine for postoperative analgesia in pediatric infra-umbilical surgery. Method: A prospective cohort study design was employed for two equal groups of 30 children aged 1–14 years scheduled for infra-umbilical surgery under caudal bupivacaine; those exposed to dexamethasone (BD) were considered to be the exposed group and those exposed to bupivacaine alone (B) were the non-exposed group. Pain severity, first analgesia request time as well as analgesic consumption were assessed using Mann-Whitney U test for 24 h. Chi-square test was used to analyze the homogenous categorical independent variables between these two groups and a p-value less than 0.05 was considered to be statistically significant. Result: The dexamethasone with bupivacaine group had significant prolonged postoperative analgesia with a median of 915 (650–1,440) minutes compared with 433 (328–555) minutes in the bupivacaine-alone group (p < 0.001). Moreover, the total analgesic consumption was significantly lower in the dexamethasone group with a median total dose of 55 (0–250) mg compared with 402 (95–812) mg in the bupivacaine group with (p < 0.001). Pain score in the dexamethasone group was reduced, being statically significant at 4th, 8th and 12th hrs. Conclusion: Dexamethasone with bupivacaine decreases postoperative pain severity and total analgesic consumption and prolongs the duration of analgesia. Therefore, we recommend the use of caudal dexamethasone with bupivacaine as an effective option for postoperative analgesia. Highlights:

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: Cesarean delivery is the most common major operation carried out in obstetrics worldwide, and is the single most important risk factor for postpartum maternal infection. Women undergoing cesarean delivery have a 5 to 20-fold greater chance of getting an infection compared with women who give birth vaginally. Currently, variable rates of surgical site infection, and women stayed longer after the procedure due to this infection. This study aims to know the real magnitude and associated factors. Method: Retrospective study design was used. A total of 431 cases were included by systematic random sampling from the cases that had undergone cesarean section during the study period. Data was collected using a pretested structured questionnaire. Data were entered into SPSS for analysis. Descriptive analysis was made also Bivariate and multivariate logistics have been made to see the relationship between the dependent and independent variables. The strength of associations was presented by odds ratio and a 95% confidence interval P-value<0.05 was considered statistically significant. Results: The magnitude of surgical site infection was 11.8% and about 98% were developed within two weeks. In this study, multiple vaginal examination rupture of membrane, prolonged labor, and estimated blood loss >500 ml were associated factors. Conclusion: the magnitude of SSI was high; and multiple vaginal examinations, rupture of membranes, prolonged labor, and estimated blood loss> 500 ml were significant factors for the occurrence. High light

Abstract:A bi-objective programming has been proposed for dealing with decision process involving two decision makers.In this paper, a bi-objective programming problem in which both objective functions are definite quadratic is considered. The feasible region is assumed to be a convex polyhedron. Solution methods namely; using KKT Conditions is developed. Illustrative examples for the method are presented and theorems and facts to support the method are also discussed. The solution of the examples are obtained using a LINGO (15.0) mathematical software.

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