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Perceived Barriers Among Pregnant Women Towards Cervical Cancer Screening

Thesis Info

Author

Lamuka, Visavilwa Vincent

Department

Family Medicine (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

1676728057617

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Background: Cervical cancer remains the most common cancer in women in Eastern Africa in general and Tanzania in particular. However, to a large extent cervical cancer is preventable by effective screening programmes as has been demonstrated in many developed countries. Developing countries lack formal national screening programmes. Screening is usually mainly done opportunistically. Objective: To assess the perceived barriers to uptake of cervical cancer screening among pregnant women attending antenatal clinics in two hospitals in Dar es Salaam. Methodology: This was a qualitative study, conducted at two hospitals in Dar es salaam, a government facility (Amana District Hospital) and a private facility (Aga Khan Hospital Dar-es-Salaam).14 Face-to-face in-depth interviews were conducted among 12 pregnant women aged 21 years and above attending antenatal clinics (ANC) at the two hospitals. Participants were selected through a combination of purposeful and convenient sampling. A brief screening questionnaire to identify participants with some knowledge of cervical cancer was used to select subjects for the in-depth interviews. The theoretical frame of reference was the Health Belief Model (HBM). The questionnaires were formed on the basis of the HBM. This provided a frame for the questions and will to some extent have guided the analysis and interpretation of the responses to the questionnaires and the interview data. The interview data were however categorised as described in the phenomenological method of analysis, giving themes that were not directed by the HBM. The analysis was therefore mainly data driven. The study examined the various community, institutional, and individual factors that are perceived to impede cervical cancer screening among an at-risk population in Dar-Es-salaam. Results: The thematic analysis of the interviews gave insight into the women's understanding of cervix cancer and screening for this cancer in relation to their health, their private lives and in the encounters with the health care system. This was described in five themes that emerged: Women’s poor knowledge about cervical cancer and its screening, Difficulty discusing matters of reproductive health, Perception of low personal Risk, Negative Perception Around The disease -death Sentence, Deficiencies of the Healthcare Providers/System. Conclusion: Low level of awareness and misconceptions about cervical cancer and its screening are important perceived barriers coupled with structural barriers like crowding and unreliable services in the hospitals. These could be addressed by increasing awareness and improving knowledge by incorprating this education in ANC classes. Increasing number of healthcare workers, improving patient flow systems in the hospitals
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جوشؔ ملیح آ بادی

جوشؔ ملیح آبادی
پاکستان ہی میں اردو کے مشہور شاعر جوش ملیح آبادی کی وفات ہوئی، انھوں نے اردو شاعری کی صنف نظم گوئی کو بڑی ترقی دی، غزل کے بجائے نظم گو کی حیثیت سے زیادہ مقبول ہوئے، ان کے مداح ان کے فن اور شاعرانہ مہارت کے بڑے قدردان رہے، مگر ان کے کچھ ناقد ایسے بھی ہیں، جو ان کی شاعری ہی میں خیالات کی بلندی اور پاکیزگی کے بجائے صرف گھن گرج اور چیخ و پکار زیادہ پاتے ہیں، دینی حلقوں میں تو اپنے ملحدانہ اور رندانہ طرز فکر کی وجہ سے اچھی نظر سے نہیں دیکھے جاتے، مگر جب کبھی اردو شاعری کی تاریخ لکھی جائے گی تو اس میں ان کے شاعرانہ فن کی وجہ سے ان کو نمایاں جگہ دی جائے گی۔ (صباح الدین عبدالرحمن، اپریل ۱۹۸۲ء)

سوشل میڈیا اور اسلامی جمہوریہ پاکستان : ثقافتی مبارزہ،چیلنجزاور ممکنہ حل Social Media and the Islamic Republic of Pakistan: Clash of Civilizations, Challenges and Possible Solutions

This research explores the dynamic interaction between social media and the Islamic Republic of Pakistan, revealing a complex culture war unfolding in the digital landscape. The study examines how social media platforms have become arenas of competition, where traditional Islamic values collide with the global influence of digital communication. By examining the ways in which social media have shaped and reflected Pakistani cultural identity, the research examines the tension between modernity and conservatism, as well as challenges to established social norms. Additionally, it analyzes the role of social media in promoting communication, political discourse, and diverse voices in the context of Pakistan's cultural landscape. By shedding light on this culture war, this research contributes to understanding the complex relationship between social media and the Islamic Republic of Pakistan. Keywords: Social media, Islamic Republic of Pakistan, Clash of Civilizations, digital communication, Islamic Culture.

Synthesis, Characterization and Biological Screening of Metal Complexes With Some Heterocyclic Ligands

Present thesis describes the synthesis, characterization and biological screening of sulfonamide ligands; their complexes and five membered heterocyclic ligands (Thiohydantoin ligands); their complexes aiming in search of new candidates to fight with microorganisms. Thanks to metals for being the charm of medicinal and pharmaceutical chemistry since many decades. To extend this search, 20 ligands were synthesized. Ligands containing sulfonamide moieties are prepared by the reaction of ten different amino acids with p-toluene sulfonyl chloride. The compounds are isolated in pure form and checked by TLC. The single crystal structure of the compounds is also reported and dicussed.These compounds were then reacted with transition metals e.g, Zn (II), Sb (III) chloride and Sb (III) bromide and thirty new metal complexes have been synthesized. Further, these sulfonamide derivatives were cyclized in the presence of NH 4 SCN, acetic anhydride and base to form 5-membered heterocyclic ring containing thio group. Forty, new complexes of these thiohydantoins with transition metals e.g. Zn (II), Sb (III) chloride and Sb (III) bromide have been synthesized. All of the synthesized complexes were heat, air and moisture stable after formation, but during the complex formation, moisture and air was avoided to prevent the oxidation of the compounds using standard schlenk line and glove box techniques. The stability profile enhances the link between organometallics and drug design and discovery. Purity of all of the synthesized compounds was conventionally monitored with the help of TLC in different solvent systems. All of the synthesized compounds and their complexes with transition metals were characterized by elemental analysis, FTIR, GC- MS and 1 H NMR , 13 C NMR spectroscopy, the structure was finally confirmed with the help of single crystal structure. All the characterization data is reported in this work and discussed. All the synthesized compounds and their metal complexes were evaluated for their carbonic anhydrase, intestinal alkaline phosphate inhibition, antileshminial, anti oxidant, anticancer and antibacterial activities. The results of these bioassays are also reported and discussed in detail, e.g., the sulfonamide ligands showed excellent carbonic anhydrase activities, while the activity was enhanced 40-60% in case of zinc complexes but the antimony (III) complexes have showed slightly less CA activities. Similarly, the complexes of antimony with sulfonamide ligands have showed excellent antileshminial activities, while the zinc (II) complexes have showed comparatively less activities. Moreover, the results of intestinal alkaline phosphatase activities iiihave proved that the metal complexes of sulfonamide and thiohydantoin ligands have showed increased activities as compared to parent sulfonamide ligands. Additionally, the said complexes also showed enhanced cytotoxic activities against BHK-21 and H-157 cell lines. The antibacterial activity against Gram –ve and Gram +ve bacteria were outstanding in case of metal complexes of the sulfonamides. Results of antibacterial evaluation of all the compounds as percent inhibition against these bacteria are reported and discussed. The activity of different synthesized compounds as percentage inhibition against concentration and time are included and discussed in detail. We can summarize by saying that the newly synthesized ligands and their metal complexes have provided important candidates for drug discovery which can be further improved to be used as drugs with enhanced pharmacological action and lesser side effects.