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Home > Cumulative Incidence of Post Dural Puncture Headache Following Caesarean Section under Spinal Anaesthesia at the Aga Khan University Hospital Nairobi

Cumulative Incidence of Post Dural Puncture Headache Following Caesarean Section under Spinal Anaesthesia at the Aga Khan University Hospital Nairobi

Thesis Info

Author

Gisore, Ednah K.

Department

Anaesthesia (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2009

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728043317

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Introduction: Post dural puncture headache can be a debilitating complication of subarachnoid anaesthesia for a new mother. Successful management of post dural puncture headache requires adherence to clear policies and protocols with close follow up of patients by an experienced obstetric anaesthetist. Objective: This study examined the cumulative incidence and severity of post dural puncture headache in obstetric patients who consented for spinal anaesthesia for caesarean section at the Aga Khan University Hospital, Nairobi. Study site:The Aga Khan University Hospital, Nairobi. Study Design:Prospective Cohort study. Study Population:All women who underwent caesarean sections under spinal anaesthesia and fulfilled the inclusion criteria. Sample size:One hundred and thirteen (113) women. Method:Spinal anaesthesia was performed in a hundred and thirteen women undergoing caesarean sections. They were followed up to determine the occurrence of Post Dural Puncture Headache, its severity, onset and duration. Duration of study:This study that was conducted between January 2009 and April 2009 both months inclusive. Results:The overall cumulative incidence of post dural puncture headache was found to be 20.35%.In this study, it was shown that the PDPHA was significantly higher in patients in whom the cutting type (Quincke) of needle was used than in those whose spinal anaesthetics were administered using the pencil point needle (80.5% and 19.5% respectively: p = 0.042).None of the other variables assessed had statistically significant correlation with PDPHA. Conclusion: The incidence of PDPHA at AKUH, Nairobi in women undergoing spinal anaesthesia for caesarean section is higher than the incidences reported in the current literature and significantly related to the needle type used. Recommendations:The incidence of post dural puncture headache can be significantly reduced in the obstetric population if the pencil point spinal needle was to be routinely used. We also recommend that the use of the Quincke needles should be discouraged due to their statistically significant association with PDPHA.
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تقریظ دوم

تقریظ ِ دوئم
زیرِ نظر کتاب’’نسیم سخن‘‘ نظروں سے گزری ۔یہ ایک مجموعہ تقریر ہے اور خدمتِ خلق کے جذبہ کے تحت اس کو مدون کیا گیا ہے۔ اس میں طلبا و طالبات کی ضروریات کو خصوصی طور پر پیشِ نظر رکھا گیا ہے۔ طلبا کے لیے ترغیبی انداز اختیار کیا گیا ہے۔ تقاریر میں اختصار اور جامعیت کو ملحوظِ خاطر رکھا گیا ہے۔ گزشتہ ادوار میں مقابلہ جات میں متعدد مرتبہ پوزیشنیں حاصل کرنے والا حافظ محمد اکرم راشدؔ کا یہ مجموعہ تقاریر ’’نسیم سخن‘‘ آئندہ بھی ضرور کفایت کرے گا۔ اس میں موجود مواد تشنگانِ علم کی پیاس بجھانے میں ممد و معاون ثابت ہو گا۔ ایک جگہ پر اتنی تقاریر کا مل جانا ناممکن نہیں تو محال ضرور ہے۔
حافظ محمد اکرم راشدؔ سے میرا دیرینہ تعلق ہے۔ یہ ایک علم دوست انسان ہیں۔ خاندانی شرافت اور علم کی بہاریں انھیں ورثے میں ملی ہیں۔ان کی طبع میں حلم و بردباری ہے۔ اپنی تمام تر خصوصیات کو عوام الناس میں بالعموم اور طلبا میں بالخصوص منتقل کرنے کا جذبہ رکھتے ہیں۔ یہ دینی علوم کا حظِ وافر رکھنے کے ساتھ ساتھ ایم۔اے، ایم۔ایڈ بھی ہیں اور ایم۔اے عربی میں گولڈ میڈلسٹ بھی ہیں۔آپ ایک گورنمنٹ ہائی سکول سے بطور رئیس مدرسہ ریٹائر ہوئے ہیں۔ فی الوقت جامع مسجد این۔ بلاک عارف والا میں بطور خطیب فرائض سر انجام دے رہے ہیں۔ عارف والا اوراس کے مضافات میں بطور خوش نویس بھی ان کی شناخت ہے۔قبل از ایں ’’نگارشاتِ راشد‘‘ کے نام سے مختلف مضامین و مقالات پر مشتمل ان کی کتاب زیورِ طباعت سے آراستہ ہو کر منظرِ عام پر آچکی ہے۔اللہ تعالیٰ ان کی اس کد وکاوش کو قبول فرمائے۔
رانا کوثر خاں
چیف ایکزیکٹو آفیسر(ایجوکیشن)
ڈسٹرکٹ ایجوکیشن اتھارٹی ، پاک پتن

KONSEP SETTING DAN STRATEGI PENGELOLAAN RUANG BERMAIN DALAM PENGEMBANGAN KREATIVITAS ANAK USIA DINI

Penelitian ini untuk mengetahui: 1) konsep setting ruang bermain yang dapat menunjang kreativitas anak; 2) penataan ruang bermain yang dapat menunjang kreativitas anak yang sesuai dengan perkembangannya; 3) pengelolaan elemen fsik ruang bermain dalam mengembangkan kreativitas anak; 4) pola seting ruang bermain (indoor) yang dilakukan di dua tempat penitipan anak (TPA) besar di Yogyakarta. Jenis penelitian ini adalah penelitian lapangan (field research) bersifat deskriptif kualitatif non statistik dengan menggunakan studi kasus (case study). Data diperoleh melalui observasi, dokumentasi, dan wawancara kemudian dianalisis dengan analisis tringulasi Moleong, yakni tringulasi sumber, tringulasi dengan metode, dan tringulasi dengan teori. Penelitian ini dilakukan di dua tempat peneitipan anak (TPA) besar yang ada di Yogyakarta yaitu Taman Pengasuhan Anak (TPA) Beringharjo dan Lembaga Pendidikan Islam Terpadu Untuk Anak Usia Dini Tiara Candra. Hasil penelitian ini menemukan bahwa: 1) konsep setting ruang bermain yang pada setiap lembaga yaitu menggunakan konsep home schooling dengan beyound centre and circle times (BCCT). 2) penataan ruang bermain dengan menggunakan sistem pembelajaran berdasarkan BCCT dan sudut ruang bermain yang disesuaikan dengan peralatan  dan sesuai dengan masa perkembangannya. 3) pengelolaan elemen fisik ruang bermain seperti pemilihan warna dan furniture disesuaikan dengan kebutuhan anak serta tidak mengandung bahan yang berbahaya. 4) pola setting ruang bermain ditata sesuai dengan konsep ruang bermain seperti yang telah diprogramkan. Kata kunci: Ruang Bermain, Anak Usia Dini, Kreativitas

Proximate Composition of Edible Portion of Labeo Calbasu During Winter Season from Indus River, Ghazi Ghat, Dera Ghazi Khan, Southern Punjab, Pakistan

Body composition of Labeo calbasu is categorized as water, protein, lipids, ash as main components of body. And carbohydrates are present in edible portion of fish as negligible amount. Total sample that were collected are fifty. All these samples collection is done from Indus River, Ghazi Ghat, Dera Ghazi Khan, Southern Punjab, Pakistan. Labeo calbasu proximate composition of edible portion is of great interest. All samples have average wet total weight of edible portion is 156.44 g that ranges from 112.17-205.45 g and dry weight average of edible portion 27.26 g. Total length average 23.35 cm that ranges from 22.2-32 cm size. By applying statistical formulas with the help of computer relationship value of different parameters were calculated. The values of correlation coefficient (r), standard error of mean, intercept (a) , regression coefficient (b) and value of ?t? also be evaluated. When %Water (x) taken as constant, value of r for different parameters is calculated as % Ash wet weight (y) 0.781, % Ash dry weight (y) 0.240, % Fat wet weight (y) 0.328, % Fat dry weight (y) 0.407, % Protein wet weight (y) 0.974, % Protein dry weight(y) 0.418. Condition factor taken as (x) value of (r) for different calculations is calculated as % Water (y) 0.259, % Ash wet wt., g (y) 0.330.% Fat wet wt., g (y) 0.204. % Protein wet wt., g (y) 0. 211. Body dry weight, g (x) relationship with different intercepts gives the r value as % Water (y) 0.728, % Ash wet wt. (y) 0.557, % Ash dry wt. (y) 0.201, % Fat wet wt. (y) 0.204, % Fat dry wt. (y) 0.338, % Protein dry wt. (y) 0.349. Total length cm (x) give r value for % Water (y) 0.009, % Ash wet wt. (y) 0.127, % Ash dry wt. (y) 0.146, % Fat wet wt. (y) 0.088, % Fat dry wt. (y) 0.041, % Protein wet wt. (y) 0.045 and % Protein dry wt. (y) 0.091.Log body dry weight, g (x) relationship with different logs quantities r is calculated as Log watercontent, % g (y) 0.721, Log total ash content, g (y) 0.797, Log total fat content,0.209, Log protein total content, g (y) 0.974. At Log total length, cm and different intercepts log relationships r value is Log water content %, g 0.0167, Log ash total content, g (y) 0.416, Log fat total content, g (y) 0.226, Log fat total content g 0.226, Log protein total content g 0.310. It is concluded in Labeo calbasu that average of water content in fish edible tissues are 82.38 %. Total ash average weights are 3.30 g while % ash wet weighs 2.13 g and % ash dry weighs 12.22 g in edible portion of fish. Total fat contents are 3.46 g while wet fat weighs 2.23 % g and fat dry weighs 13.02 %. Total protein average 20.49 g proteins in wet fish edible flesh weight 13.25 % and protein dry weighs 74.76 %.