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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

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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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بھلانے میں جن کو زمانے لگے ہیں

بھلانے میں جن کو زمانے لگے ہیں
وہی لوگ پھر یاد آنے لگے ہیں

سنبھلتا ہوا دیکھ کر پھر سے مجھ کو
حوادث کھڑے مسکرانے لگے ہیں

لگا بزم میں رہ گئے ہم اکیلے
کہا جب انھوں نے کہ جانے لگے ہیں

لگا ہاتھ سے ہے جو آنچل تمھارا
لگا ہاتھ جیسے خزانے لگے ہیں

خدایا! تو سن لے، اٹھے گی نہ ورنہ
جو ماتم کی صف ہم بچھانے لگے ہیں

ہمیں تو چلن، بد چلن زندگی کے
یہ سب سانپ سیڑھی کے دانے لگے ہیں

خدا دیکھ لے اب جو تو نے ہے کرنا
دعا سے بھی ہاتھ اب اٹھانے لگے ہیں

Illness Perception, Perceived Social Support and Quality of Life in Pulmonary Tuberculosis Patients

The objective of the current study is to determine the relationship between illness perception, perceived social support and quality of life in pulmonary tuberculosis patients. To this end, the World Health Organization Quality of life scale, the Brief Illness Perception Questionnaire, and the Multidimensional Scale of Perceived Social Support were used to measure the relationship between variables. The quantitative approach was used, with purposive sampling. A total of 150 patients with pulmonary tuberculosis were part of the final sample. Hierarchical multiple regression results indicate that social support of family, friends, and significant others, are significant positive predictors of quality of life in pulmonary TB patients. This study has implications for designing better health and social policy for pulmonary tuberculosis patients with respect to (i) advancing support from significant others, (ii) strengthening quality of life through daily activities and work opportunities, and (iii) provision of medical and treatment information consistently.

Catalytic Oxidation and Degradation of Organic Compounds Using Supported Transition Metals/Metal Oxides.

0.1 wt % Palladium/ZrO 2, Manganese oxide and cobalt oxide were synthesized in our laboratory. Zirconia was prepared in the laboratory by precipitation of zirconyl chloride with ammonium hydroxide. Pd/ZrO 2 was prepared by incipient wetness impregnation technique. Cobalt oxide was prepared by solid state mixing of cobalt nitrate and ammonium bicarbonate in an agate mortar at room temperature. Manganese oxide was also prepared by mechanochemical addition of potassium permanganate and Ammonium bicarbonate in a molar ratio of 2:3 respectively. The prepared catalysts were characterized by several physical/analytical methods that include nitrogen adsorption studies (Surface area and Pore Size Analysis), X-Ray Diffractometery, Fourier Transform Infra Red spectroscopy, particle size and Scanning Electron Microscope analysis. Pd/ZrO 2 was tested for the solvent free oxidation of benzyl alcohol and Toluene respectively. The reactions were carried out in liquid phase under mild conditions of temperature and pressure. Molecular oxygen was used as oxidant. The oxidation of BzOH was > 70 % selective towards benzaldehyde formation with a TOF>6000 per hour. Kinetic study showed that Langmuir Hinshelwood (L-H) mechanism was found to be followed when the experimental data was applied to the L-H equation. The oxidation of toluene was more selective towards benzyl alcohol formation in lower reaction temperature regime; however as the reaction temperature was increased the reaction became more selective towards benzoic acid. The main oxidation products were benzyl alcohol, benzaldehyde and benzoic acid however the main product was benzoic acid. Manganese oxide was prepared by solid state mechanochemical addition of potassium permanganate and Ammonium bicarbonate. The synthesized manganese oxide powder was employed for the oxidation of benzyl alcohol in liquid phase using n-heptane as a solvent. The reaction was found to very fast and 100% selective towards the formation of benzaldehyde atxv 363K and atmospheric pressure of oxygen. The reactions were performed at very low reaction temperatures i.e. 323-363K. Cobalt oxide was prepared by was prepared by solid state mechanochemical mixing of cobalt nitrate and ammonium bicarbonate. The synthesized catalyst was employed for the catalytic degradation of two different dyes i.e. Methylene Blue and Congo red. The catalyst was found to be extremely efficient towards the degradation of both these dyes. Both the organic dyes were successfully destructed in a very quick reaction time i.e. 10 minutes. Reactions were carried out in atmospheric conditions and room temperature. Various parameters affecting the degradation performance of the dye were examined such as time, catalyst loading, temperature, initial dye concentrations, speed of agitation and effect of partial pressure of oxygen. The removal percentage of dyes increased with increasing mass of Cobalt oxide up to an optimum mass but decreased with increasing initial concentrations. All the catalysts were heterogeneous in nature, which could be separated easily by simple filtration.