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Home > Prevalence of Positive Depression Screen Among Post Miscarriage Women at the Aga Khan University Hospital

Prevalence of Positive Depression Screen Among Post Miscarriage Women at the Aga Khan University Hospital

Thesis Info

Author

Mutiso, Steve Kyende

Department

Obstetrics and Gynaecology (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2017

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728062366

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Introduction: Miscarriages are a common pregnancy complication affecting about 10-15% of pregnancies. Miscarriages may be associated with a myriad psychiatric morbidity at various timelines after the event. Depression has been shown to affect about 10-20% of all women following a miscarriage. However, no data exists in the local setting informing on the prevalence of post-miscarriage depression. Objective: To determine the prevalence of positive depression screen among post-miscarriage women at the Aga Khan University hospital, Nairobi. Methods: The study was cross-sectional in design. Patients who had a miscarriage were recruited at the post-miscarriage clinic review at the gynecology clinics at Aga Khan University Hospital, Nairobi. The Edinburgh postnatal depression scale was used to screen for depression in the patients. Prevalence was calculated from the percentage of patients achieving the cut –off score of 13 over the total number of patients. Secondary analysis was done using Univariate and multivariate analysis to compare clinical variables between the screen - positive and screen - negative women in order to delineate the potential pattern of association between the two among the study subjects. Results: A total of 182 patients were recruited for the study. The prevalence of positive depression screen was 34.1% since 62 of the 182 patients had a positive depression screen. Univariate analysis revealed that education level (p=0.039) and mode of conception (p=0.005) impacted on the outcome of the depression screen. In multivariate analysis, multiple factors impacted on the depression screen and these included: age (p=0.009), education level (p=0.001), gestation at miscarriage (p=0.04), marital status (p=0.043), prior miscarriage (p=0.011) and mode of conception (p=0.03). Moreover, of the patients who had a positive depression screen, 21(33.1%) had thoughts of self-harm. Conclusion: A positive depression screen is present in 34.1% of women in our population 2 weeks after a miscarriage. More so, factors that seem to impact on the positive depression screen include a younger age, a lower education level, an older gestational age at miscarriage, being single, an assisted mode of conception and a prior miscarriage. Thoughts of self-harm are present in about a third of these women (33.1%) hence pointing out the importance of screening these women using the EPDS after a miscarriage.
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ساری راتیں کراں وچار

ساری راتیں کراں وچار
دکھاں درداں نال وہار
دکھاں دی پنڈ چائی پھردا
بھارا ہویا سرے تے بھار
کدی خزاں اُداسی ناہیں
حسن ترے دی عجب بہار
ہونٹ تیرے نیں لال گلابی
اکھاں تیریاں مست خمار
دکھاں درداں ہجراں کُٹھا
برہوں تیرے نیں سٹیا مار
کدی حنیف توں پچھیں جا کے
کہیڑی کیتی درداں کار

امنا عائشة ملكة العفاف رضي االله عنها

This research aims to explore various features of Syyidah some highlights paper This. Personage noble s'(ر الله عا) ishah‘A’ distinguished aspects of her biographical account, her extraordinary intelligence, eminent rank amongst other wives of the Prophet Muḥammad (r), excellence over women of the world and being mentioned in the Qur’ān for her praiseworthy character. The scholarly areas, in which, she outshone others in Islamic intellectual heritage, include the Quranic exegesis, Ḥadīth narratives, jurisprudence, scholastic reasoning: analysis of jurisprudential methodology and principles of deduction of rulings and opinions. She adopted multifarious modes in this regards including explicit, direct, generalized, inductive and analogous approaches in the Islamic intellectual scholarship. By acknowledged was (ر الله عا) ishah‘A of grandeur The the companions of the Prophet, her scholarly point of view in conciliation of the problems of the Qur'ān and Ḥadīth made her stand out amongst all. She was a keen researcher, peaceful preacher and the greatest scholar of Islām of all times. Her knowledge and command over religious and social matters made her one of the most reliable experts of the Qur'ān, Ḥadīth and Fiqh. Such was her stature as the archangel Jibrā’īl presented his salutation to her.

Long-Term Outcomes and Factors Associated With Mortality Among Patients With Moderate to Severe Pulmonary Hypertension in Kenya

Background: Pulmonary hypertension (PH) is a condition that carries significant morbidity and mortality. Studies done in sub-Saharan Africa have reported poor short-term outcomes. However, data on long-term outcomes and prognostic factors are lacking. Objectives: This study sought to determine the one and two-year survival rates and prognostic factors associated with mortality in patients with moderate to severe PH. Methods: A retrospective review of moderate to severe PH patients [pulmonary artery systolic pressure (PASP), ≥45 mmHg] diagnosed at Aga Khan University Hospital, Nairobi from 2014 to 2017 was carried out. Demographic, clinical and in hospital outcome data were extracted from medical charts; and telephone interviews were conducted to determine out of hospital outcomes. Kaplan-Meier method was used for survival analysis and log rank tests were done to assess for differences between subgroups. Cox regression modelling with multivariable adjustment were used to identify factors associated with all-cause mortality. Results: A total of 659 patients were enrolled in this study, of which 50 (7.6 per cent) were lost to follow-up. The median PASP was 56 mmHg (interquartile range, 49–68 mmHg). After a median follow-up of 626 days, the one and two-year overall survival rates were 73.8 and 65.9 per cent, respectively. Using multivariate cox regression analyses, mortality was significantly associated with age, diabetes mellitus, atrial fibrillation, WHO functional class III and IV, severe pulmonary artery systolic pressures, right ventricular and left v ventricular systolic dysfunction. However, gender, systemic arterial hypertension, rheumatic heart disease and presence of significant valvular abnormalities had no significant association with mortality. Conclusion: Pulmonary hypertension is associated with poor long-term outcomes in African patients with overall survival rate of 65.9 per cent at two years. Identification of poor prognostic factors can assist in identifying high-risk patients.