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Home > Chronic Post Mastectomy Pain in Adult Female Patients at Aga Khan University Hospital Nairobi

Chronic Post Mastectomy Pain in Adult Female Patients at Aga Khan University Hospital Nairobi

Thesis Info

Author

Mbete, Jared Owour

Department

Anaesthesiology (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2019

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728039186

Similar


Introduction: Breast cancer is a major cause of morbidity and mortality worldwide among women. The improvement in diagnostic and treatment strategies has led to a larger number of survivors who have breast cancer. However, there are complications attributed to breast cancer treatments, including chronic post mastectomy pain (CPMP). CPMP causes physical, social, emotional and functional disability. Once established, it is difficult to treat and negatively impact quality of life of the affected patients. Despite the big number of patients with breast cancer who undergo mastectomy at AKUHN, the burden of CPMP and factors associated with it remain unknown. Objectives: To determine the burden of CPMP and its associated risk factors in adult female patients at AKUHN. Study design: A descriptive cross-sectional study. Study setting: The AKUHN. Study population: Female breast cancer patients who underwent mastectomy at AKUHN between January 2008 and December 2017. Sampling process: Stratified sampling with subgroups based on year of surgery. Sample size: Assuming a CPMP prevalence of 10% and an attrition rate of 10% in the study population, a sample of 370 patients would be required to detect an odds ratio of developing CPMP of 2.5 with a p-value< 0.05. Statistical analysis: By the use of SPSS version20. The study outcome: A total of 480 patients’ contacts were successful, of which 49 declined the interview, 22 were deceased, while 409 patients were alive and responded to the study interview. The prevalence of PMCP was 14.4% with 9.3% who also had arm pain. The severity of pain was distributed as mild, moderate and severe at 55.9% (33), 40.7% (24) and 3.4% (2) respectively. The only predictor of CPMP which was statistically significant in this current study was age while the rest were not. Conclusion: The prevalence of CPMP in the current study in our institution is relatively low compared to other studies. In the study, the only associated factor with CPMP that is statistically significant is age; which corresponds with the studies reviewed. Recommendation: We recommend a closer follow up of patients under the age of fifty years as they are more prone to develop CPMP. We also recommend a multicenter study which will give a larger sample size with a population of diverse demographic profiles; subjected to different types and techniques of breast surgeries, different surgical set-ups; different post-operative care; and different post-operative pain management for a more conclusive outcome.
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پروفیسر علی محمد خسرو

پروفیسر علی محمد خسرو
سخت افسوس ہے کہ ۲۴؍ اگست کی شب میں ساڑھے گیارہ بجے مشہور مسلم دانشور، ملک کے ممتاز ماہر اقتصادیات اور علی گڑھ مسلم یونیورسٹی کے وائس چانسلر اور چانسلر پروفیسر سید علی محمد خسرو نے داعی اجل کو لبیک کہا، اناﷲ وانا الیہ راجعون۔
۷؍ اگست کو دل کا شدید دورہ پڑا تو اسپتال میں داخل کیے گئے لیکن مرض بڑھتا گیا اور آخر دنوں میں حالت اتنی خراب ہوگئی تھی کہ خود سے سانس نہیں لے سکتے تھے اور آلہ تنفس کا سہارا لینا پڑا بلڈپریشر بہت لو ہوگیا تھا بالآخر ۷۹ برس کی عمر میں وقت موعود آگیا، پس ماندگان میں ایک صاحبزادے اور ایک صاحبزادی ہیں۔
۲۵؍ اگست کو غالب اکیڈمی بستی حضرت نظام الدین کے قریب عرس محل میں عصر بعد نماز جنازہ ادا کی گئی اور درگاہ عمادالدین فردوسی کے پاس خسر و باغ میں تدفین ہوئی۔
موت تو ہر ایک کو آنی لابد ہے لیکن خسرو صاحب کی موت ایک بڑا قومی و ملی سانحہ ہے، وہ ملک کے مایہ ناز فرد، قومی اہمیت کے حامل اور زرعی و مالی اقتصادیات میں عالم گیر شہرت کے مالک تھے اور جس ملت سے ان کا تعلق تھا اس میں بڑا قحط الرجال ہے، اس کے یہاں جو جگہ خالی ہوتی ہے وہ پر نہیں ہوتی، خسرو صاحب جیسے بلند پایہ، عالی دماغ، کامل الفن اور یگانہ شخص کی خالی جگہ بھی پر ہوتی نظر نہیں آتی۔
سید علی محمد خسرو کا تعلق حیدر آباد کے ایک ممتاز خاندان سے تھا، وہ یہیں ۱۹۲۵؁ء میں پیدا ہوئے تھے، مدرسہ عالیہ اور نظام کالج سے فارغ التحصیل ہونے کے بعد لندن چلے گئے اور لیڈز یونیورسٹی سے معاشیات میں ایم۔اے اور پی۔ایچ۔ڈی کیا، وطن واپس آنے کے بعد عثمانیہ یونیورسٹی میں درس و تدریس کی خدمت انجام دی،...

Factors to Consider in Midwifery Care during Climacteric and Monopause Period

This study discusses the management of climacteric obstetrics and menopause. Menopause is the final feminine cycle or when the final monthly cycle happens, one of the mental viewpoints of changing self-concept amid menopause is unquestionably menopausal ladies ended up on edge around their bodies and frame self-concept approximately how their bodies are. The side effects experienced by ladies some time recently menopause cause the mother to be ill-equipped approximately physical and mental changes. To decrease this, ladies must get ready themselves both physically and mentally for menopause. Ladies who are going through menopause go through the primary stages counting premenopause, perimenopause, menopause, and postmenopause, and menopause for the most part happens in ladies matured 45-50 a long time.

Temporal Human Action Detection in Long and Untrimmed Videos

With the advancement in information and communication technologies, sensing devices have now become pervasive. The pervasiveness of camera devices has enabled recording of video data at anytime and anywhere. It gives rise to a massive amount of untrimmed video data being produced, which consist of several human-related activities and actions including some background activities as well. It is important to detect the actions of interest in such long and untrimmed videos so that it can be further used in numerous applications i.e., video analysis, video summarization, surveillance, retrieval and captioning etc. This thesis targets temporal human action detection in long and untrimmed videos. Given a long and untrimmed video, the task of the temporal action detection is to detect starting and ending time of all occurrences of actions of interest and to predict action label of the detected intervals. Detecting human actions in long untrimmed videos is important but a challenging problem because of the unconstrained nature of long untrimmed videos in both space and time. In this work we solve the temporal action detection problem using two di erent paradigms: \proposal + classi cation" and \end-to-end temporal action detection". In proposal + classi cation approach, the regions which likely to contain human actions, known as proposals, arerst generated from untrimmed videos which are then classi ed into the targeted actions. To this end, we propose two di erent methods to generate action proposals: (1) un-supervised and (2) supervised temporal action proposal methods. In therst method, we propose unsupervised proposal generation method named as Proposals from Motion History Images (PMHI). PMHI discriminates actions from non-action regions by clustering the MHIs into actions and nonaction segments by detecting minima from the energy of MHIs. The strength of PMHI is that it is unsupervised, which alleviates the requirement for any training data. PMHI outperforms the existing proposal methods on the Multi-view Human Action video (MuHAVi)- uncut and Computer Vision and Pattern recognition (CVPR) 2012 Change Detection datasets.PMHI depends upon precise silhouettes extraction which is challenging for realistic videos and for moving cameras. To solve aforementioned problem, we propose a supervised temporal action proposal method named as Temporally Aggregated Bag-of-Discriminant-Words (TAB) which work directly on RGB videos. TAB is based on the observation that there are many overlapping frames in action and background temporal regions of untrimmed videos, which cause di culties in segmenting actions from non-action regions. TAB solve this issue by extracting class-speci c codewords from the action and background videos and extracting the discriminative weights of these codewords based on their ability to discriminate between these two classes. We integrate these discriminative weights with Bag of Word encoding, which we then call Bag-of-Discriminant-Words (BoDW). We sample the untrimmed videos into non-overlapping snippets and temporally aggregate the BoDW representation of multiple snippets into action proposals. We present the e ectiveness of TAB proposal method on two challenging temporal action detection datasets: MSR-II and Thumos14, where it improves upon state-ofthe- art methods. \Proposal + classi cation", requires multiple passes through testing data for these two stages, therefore, it is di cult to use these methods in an end-to-end manner. To solve this problem, we propose an end-to-end temporal action detection method known as Bag of Discriminant Snippets (BoDS). BoDS is based on the observation that multiple actions and the background classes have similar snippets, which cause incorrect classi cation of action regions and imprecise boundaries. We solve this issue bynding the key-snippets from the training data of each class and compute their discriminative power which is used in BoDS encoding. During testing of an untrimmed video, wend the BoDS representation for multiple candidate regions andnd their class label based on a majority voting scheme. We test BoDS on the Thumos14 and ActivityNet datasets and obtain state-of-the-art results.