Search or add a thesis

Advanced Search (Beta)
Home > Accuracy of Interim Radiology Resident Ct Reports Given During on Call Hours in a Competency Based Radiology Training Program

Accuracy of Interim Radiology Resident Ct Reports Given During on Call Hours in a Competency Based Radiology Training Program

Thesis Info

Author

Ojwang, Stephen O.

Department

Imaging and Diagnostic Radiology (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2012

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728035865

Asian Research Index Whatsapp Chanel
Asian Research Index Whatsapp Chanel

Join our Whatsapp Channel to get regular updates.

Similar


Background: In many academic hospitals globally, radiology residents provide preliminary interpretations of CT studies performed outside of regular working hours. As part of a competence based education (CBE) system this is with a view to continue providing the necessary radiology consultation while at the same time exposing the radiology resident to much needed experience in making independent decisions and in developing professional skills.Realtime cases are the foundation of any competency based educational program. Discrepancies however do occur between the residents’ interim reports generated after normal working hours and the final reports released to the clinician. This may lead to adverse clinical outcomes including worsened morbidity, repeated imaging or delayed diagnosis. Objectives: The primary objective was to prospectively define the extent and factors contributing to discrepancy in out of hours CT reporting. Secondary objectives were to identify the most common discrepancies that occur during after-hours reporting, risk factors for such discrepancies and to establish ways of improving patient management in a competency based training institution. Design: Prospective cohort study of patients undergoing CT scans at Aga Khan University Hospital (AKUH)-Nairobi, carried out over a consecutive duration of six months from October 2011 to end of March 2012. Sampling method: Consecutive sampling of all interim CT scan reports by residents after normal working hours was done. Data analysis: The data collected were analyzed using Stats Program Software, SPSS version 16.The proportion of major and minor discrepancies were determined within a 95% confidence interval.Categorical variables of interest including type of radiological examination, confidence level of the resident at the time of reporting, level of residency and time of reporting were plotted and displayed in tables, pie charts and stacked columns against the major and minor discrepancy rates. Potential associations between major discrepancy rates and numerical variables including adequacy of clinical information and level of confidence of the resident during reporting were tested using Chi square. Results: The major discrepancy rates were 4.5% with an overall discrepancy rate (both major and minor discrepancies) of 11.7% i.e. 34 out of 291 reports. Majority of these of these were errors of observation (19 out of 34).There were five (5) false positives and one (1) error of interpretation or cognition. These errors led to change in management in fifteen cases, increased patient morbidity in ten cases, required additional imaging in three cases, necessitated or resulted in extended hospital stay in four patients and did not potentially alter
Loading...
Loading...

Similar Books

Loading...

Similar Chapters

Loading...

Similar News

Loading...

Similar Articles

Loading...

Similar Article Headings

Loading...

سرکار دی تاہنگ

سرکار دی تاہنگ

اکھاں تھکیاں تک تک راہ او خاناں
چھیتی آ ہن دیر نہ لا او خاناں
تسان ٹر گئے بہاراں رس گیاں
سسی ستی تے مہاراں کھس گیاں
تہاڈی یاد آئی اکھاں پس گیاں
بن ساون پیاس بجھا او خاناں
اکھاں تھکیاں تک تک راہ او خاناں
تہاڈے پیار سانوں مجبور ہے کیتا
توں ٹر گیا ساتھوں چپ چپیتا
کی دساں میرے نال جو بیتا
رہے اوکھا وقت نبھا او خاناں
اکھاں تھکیاں تک تک راہ او خاناں

تفسیر روح المعانی کی روشنی میں حضرت عیسی (علیہ السلام) کی رفع سماوی کا تحقیقی جائزہ

Jesus of Nazareth is the central figure of the Christian religion, a savior believed to be both God incarnate and a human being. He is also known as Jesus Christ, the term “Christ” meaning anointed or chosen once. Most of the details of his life are unclear, and much of what is known about his life comes from the four Gospels of the Bible. The Gospels tell the story of Jesus’s auspicious birth in a stable in Bethlehem, and then of his life as an adult, a teacher with miraculous powers who foretold his own death to his closest followers, called apostles. Jesus, betrayed by the apostle Judas, was crucified by the Romans, and his resurrection three days after his death was taken as proof of his divinity. The date of Jesus’s birth to Mary is celebrated each December 25th as Christmas Day. The occasion was used as the base year for the modern Christian calendar, though researchers now believe that earlier estimates were inexact and that Jesus was actually born between 4 B.C. And 7 B.C. The date of the crucifixion is now marked as Good Friday, and the resurrection celebrated as Easter.

Exploitation of Energy Potential Through Utilization of Municipal Solid Waste

The epic challenge of the present era is filling the gap between energy demand and supply with clean, reliable, and affordable energy. Energy from fossil fuels has remained the choice of Pakistan like other countries. The huge quantity of municipal solid waste (MSW) generation and over consumption of fossil fuels because of growing population have created many environmental as well as socio-economic problems in Pakistan. Converting waste to renewable energy source has two-fold benefits. One, it reduces environmental degradation and two, fulfills the energy needs necessary for economic growth. The present study was formulated in order to overcome dual problems of the country that are open dumping and/or burning of solid waste and energy shortage. Core objective of present study is to develop an integrated MSW management model that would focus on the use of waste to energy (WtE) as the key component of sustainable MSW management. Hyderabad city of Sindh, Pakistan was selected as a case study for quantification, composition, characterization and energy potential of MSW. In the first phase of the study, samples of MSW were collected and characterized according to the sampling methodology. About eight scenarios were developed according to the nature of components of MSW and were compared. From comparison it has been found that scenario three and five are the best options for energy potential of biological treatment (1.13MW/100tons/day) and thermal treatment (11.86-22.40MW/100tons/day) respectively. The contribution of energy from solid waste has been estimated that is 0.07% through bio-chemical and 0.34% through thermo-chemical in the total primary energy supply of the country. Moreover, results of study revealed that about 70% of imported energy can be reduced by bio-chemical and completely can be replaced by thermochemical process of solid waste. Not only this but also burden on energy from other primary sources of the country would be reduced up to 1.86% cumulatively by adopting thermo-chemical process of waste. In the second phase of the study, fresh samples of food waste (FW) and yard waste (YW) were collected and characterized for biochemical methane potential (BMP) of substrates.Three inoculums namely buffalo dung (BD), sewage sludge (SS) and effluent from continuous stirrer tank reactor (CSTRE) at three inoculum to substrate ratios (ISRs) were optimized by BMP test system. The highest methane yield of FW and YW was achieved as 428 Nml g-1 VS added and 304 Nml g-1 VS added respectively by using BD as inoculum at ISR-5. Also, the first order decay model was used, which gave best fit for methane potential of substrates with BD inoculum at ISR-5. In the third phase of the study, further optimized inoculum and ISR were used to optimize methane potential of fruit, vegetable and yard waste (FrVYW) of summer and winter seasons by mixing at different ratios. From overall results, maximum methane was obtained from tri-substrates at mixing ratio of (1:1:1) that is in the range of 530-621Nml/gmVS, maximum stands for winter season wastes whereas minimum is from summer season wastes. The anaerobic digestion (AD) of optimized mixing ratio of FrVYW was carried out for optimization of hydraulic retention time (HRT) and organic loading rate (OLR) by continues stirrer tank reactor (CSTR). The maximum methane production, VSR and methane content of selected substrates were obtained at HRT of 20days with OLR of 5%TS (2.5kgVS/m3/d) that are 0.530 L/gVS, 86% and 76% respectively. Therefore, 20days and 5%TS (2.5kgVS/m3/d) are optimum HRT and OLR respectively for biomethane yield of FrVYW at mixing ratio of (1:1:1). In the fourth and last stage of the study, on the basis of above results and findings, four scenario options were developed by mixing eight scenarios and tested by different treatment options. The 3E (energy, economical and environmental) assessment of WtE technologies including composting, AD, LFGR, Incineration, Gasification, MRF of each scenario performed to develop integrated MSW model. Study concluded that AD for S-2 (putrescible components of MSW), Gasification for S-3 (non-putrescible components of MSW) and MRF for S-6a (recyclable components of MSW) are best options as a premise an integrated MSW management model for Hyderabad city, Pakistan. The findings of present study would be useful for decision makers to decide that which treatment option would be best for exploitation of energy through utilization of MSW in Pakistan.