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Home > One Year Symptom Severity and Health-Related Quality of Life Changes Among Patients Undergoing Uterine Fibroid Embolisation

One Year Symptom Severity and Health-Related Quality of Life Changes Among Patients Undergoing Uterine Fibroid Embolisation

Thesis Info

Author

Mariara, Charles Muriuki

Department

Obstetrics and Gynaecology (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2014

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728055804

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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.
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کمپیوٹر عصرِ حاضر کی اہم ضرورت

کمپیوٹر عصر حاضر کی اہم ضرورت
نحمدہ ونصلی علی رسولہ الکریم امّا بعد فاعوذ بااللہ من الشیطن الرجیم
بسم اللہ الرحمن الرحیم
معزز اسا تذہ کرام اور میرے ہم مکتب ساتھیو!
آج مجھے جس موضوع پر اظہار خیال کرنا ہے وہ ہے:’’ کمپیوٹر عصر حاضر کی اہم ضرورت‘‘
کمپیوٹر عقلِ انسانی کا اک انعام ہے
زندگی کا سہل اس کے دم سے ہر اک کام ہے
صدرِذی وقار!
قوموں کی زندگی میں کچھ لمحات ایسے آتے ہیں جو ان کی زندگی میں امر ہو جاتے ہیں۔ قرآنِ پاک میں ہے کہ انسان کے لیے کائنات کی ہر چیز مسخر کر دی گئی ہے۔ ہر چیز انسان کے تابع ہے، انسان جب چاہے، جہاں چاہے اور جیسے چاہے کائنات کے ذرے ذرے پرحکومت کر سکتا ہے، قرآن پاک کی اس آیت نے اہل لب کی زندگی میں انقلاب برپا کر دیا، اور کمپیوٹر کو دیکھ کر قرآن پاک کی یہ حقیقت تو اور بھی الم نشرح ہو جاتی ہے کہ کائنات کی ہر چیز مسخر کر دی گئی ہے۔
جنابِ صدر!
کمپیوٹر عصر حاضر کی اہم ضرورت ہے ، یہ ہمارے لاکھوں مسائل حل کر دیتی ہے۔ کمپیوٹر کی ایجاد ایک ایسی ایجاد ہے کہ ہماری بے شمار مشکلات آناًفا ناًدرست انداز میں حل کر دیتی ہے، یہ اعدادوشمار کو جمع کرنے اور ان کا تقابلی جائزہ لینے کے کام بھی آتا ہے، دوسرے الفاظ میں اس کی اپروچ اور ڈاٹا کاعمل انسانی دماغ سے کئی گنا بہتر اور جلدحل ہوجاتا ہے یہ معلومات کو print کرنے کی صلاحیت بھی رکھتا ہے۔
صدرِ ذی وقار!
کمپیوٹر عصر حاضر میں اللہ تعالیٰ کا انعام ہے، ایک عظیم نعمت ہے، ایک نفع بخش ایجاد ہے، جس طرح اللہ تعالیٰ نے دنیا کے لیے اپنی نعمتوں کی فراوانی فرمائی ہے، اپنے انعاماتِ رفیعہ سے عوام النّاس کو نوازا...

DEVELOPMENT THROUGH INFRASTRUCTURAL CONNECTIVITY: CHINA’S BELT AND ROAD INITIATIVE AND POLICY OPTIONS FOR THE STATES INVOLVED

Belt and Road initiative (BRI) is the revival of the ancient Silk Road. From the historical analysis of the ancient Silk Road, it could be easily understood that nations around the Silk Road have cultural assimilation fostering mutual cohesion. In this context, BRI was proposed by the Xi Jinping administration, which provides a ground for a very old idea of bringing Eurasians under the development phenomenon for achieving common economic growth goals. Indeed, BRI is not only initiated to promote trade, but it will also increase multidimensional cooperation among nations, such as a cultural and educational exchange. It will bring closer not only the regional countries but even the continents to each other. Moreover, BRI will bring new enthusiasm to the old idea, and provides grounds for development and achieving common goals between the states. BRI is deemed to be a game changer for the states involved and China itself.

Catalytic Conversion of Syngas into Ethylene and Higher Hydrocarbons

A rapid growth in population and industrialization has resulted in a shortage of natural resources with increasing human demands. With the rapidly depleting petroleum resources, other venues such as the utilization of coal and biomass for energy production are under intense investigation. Fischer Tropsch (FT) technology is extensively used for the conversion of coal, natural gas and biomass derived syngas (CO+H2) to fuel by utilizing transition metals as catalysts. One of the main challenges in FT synthesis is the production of higher molecular weight waxes which blocks the active sites of the catalysts, resulting in decreased catalytic activity. The catalyst supports in FT synthesis is also very important as it not only enhances the dispersion of active metal catalyst but also provide active sites for hydrogenation and cracking of higher hydrocarbons. The present study was intended to explore Montmorillonite (MMT) as a novel support material for Co-based FT synthesis to increases the surface acidity, hydrogenation and cracking of higher molecular weight hydrocarbons. The lower thermal stability and lack of porosity in MMT was overcome by replacing the sodium ion present in the interlayer of MMT clay with different metal oxides (MOs) (M=Al and Zr) to achieve high surface area and pore volume. Along with the modification of catalyst support, the effect of Mn and Ce promoters have also been investigated in this study. A series of Al and Zr-pillared montmorillonite (Al-PILC and Zr-PILC) supported Co catalysts were fabricated by impregnation and hydrothermal methods. FT reaction was carried out in fixed bed micro reactor at temperature 225 oC, 260 oC Page ix and 275 oC and pressure of 1, 5, and 10 bar. It was found that Co supported Na montmorillonite (NaMMT) had lower CO-conversion and higher CH4-selectivity while the Al-PILC and Zr-PILC supported Co catalysts gives higher CO-conversion and lower CH4-selectivity. Moreover, increase in reaction temperature from 225 oC to 275 oC resulted in higher CH4-selectivity, higher CO-conversion and decreased in selectivity towards C5+ hydrocarbons. Increase in pressure from 5 to 10 bar resulted in decreased CH4-selectivity of the catalyst but increase in C5+ hydrocarbons and CO-conversion efficiency. The Addition of Mn as promoter to the Al-PILC and Zr-PILC supported Co nanoparticles significantly increased the selectivity of catalyst toward C2-C12 hydrocarbons as a result of the cracking of long chain C21+ hydrocarbons. The addition of Mn also resulted in a decreased selectivity toward CH4. On the other hand when Ce is used as a promoter, the selectivity toward C5-C12 hydrocarbons and CH4- increased and that of C21+ selectivity decreased. Significant enhancement in CO-conversion and CH4-selectivity was observed at higher reaction temperatures (>220 oC). The increase in pressure from 1 to 10 bars eventually resulted in enhancement in C5+ hydrocarbons and decrease in CH4 and C2-C5 hydrocarbons selectivity. All of these could be attributed to the synergistic effect of electronically and geometrically modified sites on the catalyst surface, their orientations and resultant intermediates concentration.