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Home > Eligibility and Patient Barriers to Peritoneal Dialysis in Patients With Advanced Chronic Kidney Disease

Eligibility and Patient Barriers to Peritoneal Dialysis in Patients With Advanced Chronic Kidney Disease

Thesis Info

Author

Saleem Mohamed Abdulkarim

Department

Internal Medicine (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

1676728049033

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Introduction: The burden of chronic kidney disease is on the rise in Kenya and is a significant cause of morbidity and mortality. While definitive treatment is renal transplantation, many patients require renal replacement therapy in the form of hemodialysis or peritoneal dialysis. The predominant modality utilized in Kenya is currently hemodialysis despite peritoneal dialysis having similar survival outcomes with the potential benefit of cost-effectiveness. There is need therefore to explore why peritoneal dialysis remains underutilized and whether patient factors may be contributory to barriers that limit the uptake of peritoneal dialysis. Purpose: The main objective of this study is to determine eligibility for peritoneal dialysis of patients considered potential candidates for the modality. In addition, barriers to the same will be determined. Further, the impact of support (family support or paid assistance) on PD eligibility will be determined. Methods: This was a descriptive cross-sectional study where patients who are potentially PD candidates were consecutively recruited. A multidisciplinary team assessed these patients for PD eligibility and this was done using a standardized tool. Contraindications and barriers to the modality were recorded as was the presence or absence of support for the provision of self-care PD. Other demographic and clinical data were also recorded using a standardized questionnaire. The impact of support on peritoneal dialysis eligibility was also determined. Results/Conclusion: In this study on eligibility of patients with advanced CKD for self-care PD we found 68.9% of the patients eligible. Surgery-related abdominal scarring was the most common contraindication. Barriers to self-care PD were identified in 45.9% and physical barriers were more common than cognitive barriers. Presence of support was associated with a significant increase in PD eligibility (P<0.001%).
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ان کو خبر نہیں کہ لہو بولتا بھی ہے

ان کو خبرنہیں کہ لہو بولتا بھی ہے
نحمدہ ونصلی علی رسولہ الکریم امّا بعد فاعوذ بااللہ من الشیطن الرجیم
بسم اللہ الرحمن الرحیم
معزز اسا تذہ کرام اور میرے ہم مکتب شاہینو!
آج مجھے جس موضوع پر گفتگو کرنی ہے وہ ہے:’’ان کو خبرنہیں کہ لہو بولتا بھی ہے ‘‘
جنابِ صدر!
ہر اک کا انداز گفتگو مختلف ہے، فلک کی فضاء میں طیور بولتے ہیں، جنگل و بیاباں میں درندے بولتے ہیں، گھر میں کو چہ گرد مرغ بولتے ہیں، رات کی تنہائیوں میں مختلف جانور آوازیں نکالتے ہیں، فصیح زبان میں حیوان ناطق بولتے ہیں، انسانوں کے گروہ کانمائندہ انسان زبان کھول کر بولتا ہے۔
معزز سامعین!
جو عظمت کی داستاں رقم کر جاتے ہیں، جو اپنی جان کا نذرانہ پیش کر کے تاریخ کے اوراق کی زینت بن جاتے ہیں، جو زندگی کی بازی ہار کر بھی دامنِ حیات سے وابستہ رہتے ہیں وہ لوگ زندگی میں نہیں بعد از وفات بھی فلک جرأت و شجاعت پر آفتاب بن کر چمکتے ہیں۔ ان کی رگوں میں دوڑنے والا خون بھی حرارت و تمازت لیے ہوتا ہے اور شہادت کی منزل پر فائز ہونے کے باوجود بھی ان کا لہو بولتا ہے۔ جیسے آج کل کشمیر کے مجاہدین دشمن کے خلاف صف آرا ہیں۔
جنابِ صدر!
زندگی کے پر لطف لمحات گزارنے کے بعد جب وہ شہادت کے مقام پر رفیعہ کے حصول میں کامیاب ہوتے ہیں تو ان کے جسم سے بہنے والا خون بھی پس ماندگان کے لیے مہمیز ثابت ہوتا ہے اور یہی اس کی آواز ہے کہ انسانیت کے دامن سے مر بوط لوگ ایک ایسے جذبے سے حصول منزل کے لیے مستعد ہو جاتے ہیں۔
جنابِ صدر!
قوموں کی زندگی میں کچھ ایسے لمحات بھی آتے ہیں۔ جب انہیں تاریخ کے نازک ترین...

روايات سيرت كى تحقيق كا حديثى معيار

Seerah is a separate Islamic science from Hadith as their primary sources are different. Although there are some extents where there is over laying between them, but traditionally Seerah has different principles as compared to Hadith. The Scholars of Hadith were very strict in applying their rules whereas the scholars of Seerah were more flexible. The reason is, when academics were dealing with Ahadiths and deducingdivine rulings, they wanted to make sure they were founding the rulings on Ahadiths that were authentic and sound. So that is why they applied very stringent rules to accept Ahadith. However, when it came to Seerah, they were more flexible in their rules, because they study this as history of The Prophet PBUH which does not touch the Sharia rulings. So, we find that writers of Seerah would accept narrations, they would not usually accept if they were dealing with Ahadith. This practice with Seerah narrations was followed by our early scholars. But recently, there is a new movement among some of our researchers that they wanted to apply the rules of Ahadith on Seerah. We do not agree this approach and in this article, we have had a humble effort to compile a set of rules for acceptance of Seerah narrations.

صوبہ سرحد میں مراکز افتاء کا قیام، معاشرتی خدمات، اثرات اور اصلاحی تجاویز

This thesis is mainly descriptive. It highlights the services and contributions rendered by the Muftis of NWFP (presently Khyber Pk) in the field of Islamic Jurisprudence. Their gigantic work which they have contributed in Jurisprudence striving for the excellent solution of the present day's problems, has been analyzed extensively and intensively. This work consists of five chapters, findings/suggestions and list of rich bibliography. Introductions, statement of problems, hypotheses, objectives of research, review of Literature and survey of the previous work have been added in the prefix. Chapter 01: It consists of profile of area, includes history of the area, its geography and political setup before and after the independence. History of establishment of Fatwa centers in NWFP etc have been discussed briefly but knowingly. In the third part the form and procedures of giving fatwa are mentioned as they use to do it at mosques and at their homes. Mahabat Khan and Qasim Ali Khan mosques were famous for this exercise which later on transformed into separate fatwa centers. Chapter 02: It deals with the exact definition of the word "Fatwa", its history, rulesprinciples and the significance of fatwa in the light of Holy Quran. Criteria, status of Muftis, and other related issues are also highlighted in this chapter. Chapter 03: Renowned Muftis of NWFP and their contributions are main theme of this Chapter. The pre and post independence period personalities for fatwas are discussed. In pre independence period Mufti Abdul Rahim Popalzai, Mufti Midrar Ullah, Mufti Abdul Karim Kolachi, Mulana Alauddin, Mulana Hammd Ullah Jan etc were well known for it. After independence Jamiah Haqqania emerged as the center for training and learning as well as center for issuing fatwa. All prominent muftis and centers of today have their roots in Jamiah Haqqania. This Chapter also deals with Muftis and fatwa centers and their sound political role .The most important of all was the fatwa endorsing Pakistan's independence. Another major fatwa of political significance was of getting or seeking independence from the British. The fatwa declaring war against USSR as jihad was given by Mufti Muhammad Farid of Jamiah Haqqania which had the most powerful political impact and resulted in disintegration of USSR. This was definitely the most important fatwa of the 20th century. Chapter three also highlights the contribution of three important Muftis and Fatwa contents which played a significant political role. Chapter 04: It deals with critical review of the work done in NWFP regarding Fatwas. In this chapter, a thorough and well documented evaluation of Fatwa is presented in detail. Chapter 05: This chapter overviews the impact of Fatwas on society. The Muftis and fatwa centers have contributed a lot in the society. They spread awareness among people, supported them to seek liberty and independence, but still some damages were also caused, as few so called muftis, for worldly advantages and privileges issued fatwas which caused material, physical and financial losses to the people. In this chapter the suggestions to prevent such events in future are also given. Each chapter contains references and descriptive notes of its own.