وسائل تشكيل الصورة للموت والحياة عند جبران خليل جبران

The concept of imagery plays an important role in literacy, critical and rhetorical studies. Different research studies describe the reality of imagery its role and methods of its formulation in literary work. Imageries are among those literary tools, through which writers share their experiences. The writer uses different literary tools to formulate imagery and to share their feelings with readers. These tools are simile, metaphor, sensuousness, personification and oxymoron etc. Khalil Jubran was among those writers who frequently used imagery in his work to reflect his inner feelings in a better way. This research study was focused only on the use of imagery tools in his work for the formulation of life and death.

Prevalence and Clinical Characteristics of Venous Thromboembolism at the Aga Khan University Hospital, Nairobi

Aim: To determine the prevalence of venous thromboembolism in patients presenting to the Aga Khan University Hospital, Radiology Department for lower limb compression ultrasonography with doppler and CT pulmonary angiography. In those found to have venous thromboembolism, the distribution of risk factors as described by Wells, the pattern of clinical presentation, the pattern of initial therapy, the length of hospital stay, major bleeding episodes and in hospital mortality were described. Design: Prospective survey Background: Venous Thromboembolism is a major cause of morbidity and mortality worldwide and its occurrence locally, as well as its clinical characteristics needs to be described in order to inform policy on prevention and treatment. Patients and Settings: Patients presenting to the Aga Khan University Hospital, Nairobi, Radiology Department for CT Pulmonary Angiography and Lower Limb compression ultrasonography with Doppler formed the study population. Methodology: All eligible patients undergoing CT pulmonary angiography and compression ultrasonography during the study period were entered into a database. In those found to have venous thromboembolism, a questionnaire was administered to assess risk factors, presentation, treatment and outcome of venous thromboembolism, with subsequent analysis. The prevalence of venous thromboembolism amongst those undergoing CT pulmonary angiography and compression ultrasonography was calculated as a proportion with 95% confidence interval. Results: Four hundred and ninety one patients had CT pulmonary angiography and lower limb compression ultrasonography with Doppler of which 55 were found to have venous thromboembolism. The prevalence of venous thromboembolism was 11.2% (95% C.I 8.41-13.99). Twenty eight patients (50.9%) had risk factors as described by Wells, with the most common being malignancy, the bedridden state and a previous history of venous thromboembolism, each occurring in 7 (12.7%) of the patients with risk factors. The most common clinical presentations were dyspnoea (73.3%), chest pain (40%) and tachycardia (53.3%) for pulmonary embolism, and lower limb swelling (88%) and lower limb pain (88%) for deep vein thrombosis .Eighteen (33%) of the 55 patients with venous thromboembolism were initiated on low molecular weight heparin which was the most common initial therapy used. In contrast the most common discharge anticoagulant was rivaroxaban used in 19 (44%) of hospitalized patients at discharge. Mean length of hospital stay was 4.2 days (SD±2.1 days, range 1-11 days). Admission to critical care units occurred in 22 (48.9%) of admitted patients. Two patients (4.4%) had major bleeding episodes while 2 patients (4.4%) died in the course of the admission. Conclusion: Based on these