Home > Effect of Video-Based Information on Pre-Operative State Trait Anxiety Inventory Scores in Adult Patients Presenting for Elective Caesarean Section
Effect of Video-Based Information on Pre-Operative State Trait Anxiety Inventory Scores in Adult Patients Presenting for Elective Caesarean Section
Background: Preoperative anxiety is a common occurrence in patients presenting for surgery with a reported incidence of up to 80%. Higher incidences have been reported in the female population and in the obstetric population compared to general surgical patients. Increased preoperative anxiety has been associated with increased anaesthetic requirements, a more turbulent immediate postoperative course, poor patient satisfaction, protracted hospital stays, and poorer surgical outcomes. Provision of information relating to surgery and anaesthesia to patients has been proven to have benefit in allaying anxiety. However, the best format of information dissemination remains unknown and especially so targeting a specific patient population. Objective: The primary objective was to determine the effect of video information in addition to the pre-anaesthetic review on the mean preoperative STAI-S score in adult patients presenting for elective caesarean section under spinal anaesthesia at AKUHN. Secondary objectives were to determine the prevalence of preoperative anxiety in the obstetric population presenting for elective caesarean section at AKUHN as well as to determine the effect of age, level of education, parity and exposure to previous anaesthetic on preoperative anxiety. Study design: A randomized control trial. Study setting: Aga Khan University Hospital- Nairobi, Anaesthesia clinic. Study population: Adult patients presenting for elective caesarean section. Sample size: A target sample size of 36 patients,18 patients per arm, calculated to detect an 8.85 points difference in mean STAI-S scores from baseline between the two arms. Randomization: Computer-generated random numbers in sealed envelopes. Inclusion criteria: Adult patients booked for elective caesarean section reviewed in the clinic who had consented for spinal anesthesia. Exclusion criteria: Previous spinal anaesthetic, unable to read or write, poor eyesight, non- English speaking, high risk pregnancies, use of psychotropics, history of psychiatric illness. Data collection: Demographic data were collected using a data collection tool, and cumulative STAI S and T scores were recorded from filled questionnaires as per the accompanying manual. Data analysis: Continuous data were described in terms of means with standard deviation, and percentages as appropriate. Comparison of means was done using Student’s t and paired sample t tests. Fisher’s exact test was used to investigate the association of the independent factors and the anxiety scores. Results: 37 patients were randomized in this study. The mean STAI-T score in the sampled population was 45.64 (SD 5.625). The mean baseline STAI-S score was 46.32 (SD 4.911). There was no statistically significant difference in change in STAI score between
آہ! مولانا عبدالمجید ندوی افسوس ہے کہ ۲۳ مئی کو مولانا عبدالمجید ندوی صدر مدرس مدرستہ الاصلاح سرائے میر ایک حادثہ میں جاں بحق ہوگئے، اناﷲ وانا الیہ راجعون۔ وہ ایک تقریب میں شرکت کے لیے جارہے تھے، رانی کی سرائے میں کوئی بچہ ان کی گاڑی کی زد میں آگیا، مگر ڈرائیور کی ہوشیاری سے وہ بالکل بچ گیا اور اسے کوئی چوٹ نہیں آئی، اس کے باوجود بعض شرپسند لوگوں نے پتھراؤ کیا۔ جس سے مولانا کے دماغ پر ضرب شدید آگئی اور اعظم گڑھ اسپتال میں انھوں نے دم توڑ دیا۔ مدرستہ الاصلاح میں متوسطات تک تعلیم حاصل کرنے کے بعد وہ ندوۃ العلما لکھنؤ میں داخل ہوئے، فراغت کے بعد لکھنؤ یونیورسٹی سے ایم۔ اے کیا، پھر بی۔ایڈ کے لیے شبلی کالج اعظم گڑھ میں داخلہ لیا۔ ندوہ کی آخری جماعت میں تفسیر کا درس مولانا عبدالباری ندوی فلسفی سے لیا۔ جن کی تعلیم و تربیت کا خاص اثر ان پر پڑا، وہ کئی برس تک ان کے ساتھ ہی ان کے مکان میں رہے، اس سے ان کو بڑا علمی و دینی فائدہ پہنچا مگر باقاعدہ بیعت مولانا سید ابوالحسن علی ندوی مدظلہ سے ہوئے۔ اعظم گڑھ میں وہ میرے ساتھ رہتے تھے، ان کے دینی ذوق و رجحان، مذہبی حمیت، شعائردین اور ارکان اسلام کے احترام خصوصاً نماز کی پابندی اور اہتمام کی بنا پر مولانا شاہ معین الدین احمد ندوی ان کی بڑی قدر کرتے تھے اور شاہ صاحب نے دارالمصنفین میں لائبریرین کی حیثیت سے ان کا تقرر بھی کیا مگر وہ اپنے بعض مشاغل کی وجہ سے یہاں زیادہ دنوں تک قیام نہیں کرسکے۔ اس کے بعد مختلف وقتوں میں مدرستہ الاصلاح، جامعتہ الرشاد اور شعبۂ دینیات مسلم یونیورسٹی سے وابستہ ہوئے، ادہر چند برس سے وہ مدرستہ الاصلاح کے مہتمم تھے۔ ان میں لکھنے پڑھنے کی اچھی...
The Benazir Income Support Program (BISP), introduced in 2008-09, is a unique cash support scheme for economically stressed families. Its uniqueness arises from several facets. The cash transfers are provided only to women aged over 18 years and have been ever married. It is unconditional and aimed at supplementing income as opposed to alleviating poverty. It was politically neutral, given that the facility to identify potential beneficiaries was extended to all parliamentarians, irrespective of party affiliation. A set of filters, applied electronically, ensured objectivity in beneficiary selection. Disbursement mechanism was automated to ensure minimal leakage. This paper outlines the process of the preparatory work that went into designing BISP – the conceptual debates, the beneficiary identification and disbursement procedures, etc. – involving a combination of high quality research with political decision making. It also addresses the debates surrounding BISP, cites independent empirical studies that show that the parliamentarian-based beneficiary selection mechanism was efficient and equitable and did indeed cover the deserving, and also responds to the variety of criticisms. ______
Background: The main aim of treatment of symptomatic fibroids by various modalities including uterine fibroid embolisation is to alleviate symptoms and ultimately improve the quality of life. The efficacy of this modality of treatment in women with significant fibroid burden and large uterine volumes is not clear.
Objective: To determine the change in symptom severity and health-related quality of life among patients who have undergone uterine fibroid embolisation for treatment of symptomatic uterine fibroids.
Setting: Aga Khan University Hospital, Nairobi
Methods: A prospective before and after study (observational) of patients undergoing uterine fibroid embolisation. Prior to embolisation, study participants underwent a pelvic MRI and filled in the Uterine Fibroid Symptom and Quality of Life questionnaire (UFS-QoL), a disease-specific symptom and health-related quality of life questionnaire for fibroids. The same questionnaire was administered after one year.
Outcome measures: The main outcome was change in symptom severity score. Secondary outcome measures were change in health-related quality of life (HRQoL) score, the correlation between age, parity, uterine volume, fibroid number and change in the symptom severity and health-related quality of life scores and the incidence of an additional intervention.
Results: Data from 80 study participants were included in the analysis. The mean change (improvement) in the symptom severity score was -29.6(SD±27.1) [95% CI -35.6 to -23.6, P<0.001] with a mean change (improvement) in health-related quality of life score of 35.7(SD±32.7) [95% CI 28.4 to 42.9, P<0.001].There was a significant positive correlation between fibroid number and change in symptom severity score. There was no significant correlation between age, parity, uterine volume and change in symptom severity score. There was a significant positive correlation between parity and change in the health-related quality of life score. There was no significant correlation between age, uterine volume, fibroid number and change in the health-related quality of life score. The incidence of a major and minor surgical intervention during the one year follow-up period was 6.25% and 12.5% respectively.iv
Conclusions: UFE is associated with a statistically significant and clinically useful improvement in symptom severity and health-related quality of life in women with symptomatic fibroid disease and is an effective treatment option of symptomatic fibroids in patients with large myoma burden or large uterine volumes.