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Prevalence of Vitamin D Deficiency in an Ethnic African Urban Obstetric Population in an Equatorial City Hospital

Thesis Info

Author

Dodia, Raj Hasmukh

Department

Obstetrics and Gynaecology (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2013

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728063455

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Introduction: Low Vitamin D levels in pregnancy have been associated with an increased risk of gestational diabetes, pre-eclampsia, bacterial vaginosis, preterm birth, disordered fetal skeletal homeostasis, and impaired offspring lung health. As a result, current public health advice in several countries is to universally supplement Vitamin D during pregnancy. Data regarding the Vitamin D levels of the ethnic obstetric population in Kenya are not available; hence recommendations for Vitamin D supplementation have no scientific basis. Objectives of study: This research was carried out to determine the prevalence of deficiency of Vitamin D in ethnic African obstetric patients who had delivered at the Aga Khan University Hospital, Nairobi, Kenya, by measuring levels of twenty-five hydroxyVitamin D (25OHD - the status marker of Vitamin D), noting that levels in pregnancy worldwide vary from 18 - 84%, and local levels are unknown. Methods: This was a cross-sectional prevalence study carried out at the Aga Khan University Hospital in Nairobi, Kenya, with the study population being ethnic African females who had delivered at the facility. This site was chosen as it is an urban hospital found within the equatorial belt, where majority of the population is dark-skinned (higher melanin levels hamper Vitamin D production via skin, the primary method through which Vitamin D is produced in the body). Blood samples were collected from 97 sequentially sampled newly delivered women after informed consent, and the levels of 25OHD were measured. The prevalence of deficiency was thereafter calculated. The Vitamin D levels were also related to the patient’s Body Mass Index, and their categorical amount of sun exposure. Results: The prevalence of Vitamin D deficiency in the stated population was calculated to be 79.4% (95% CI 70.5 - 86.6%). No association was noted between the Vitamin D levels, and the Body Mass Indices of the participants, and neither was an associated relationship inferred between Vitamin D levels and the sun exposure times. Conclusion: It is concluded that the prevalence of Vitamin D deficiency is present in a significant proportion of the ethnic African urban mothers that choose to deliver at the Aga Khan University Hospital in Nairobi, Kenya. This figure is noted to be amongst the upper part of the range signifying Vitamin D deficiency in pregnancy the world over (18-84%). Recommendations: Further to this finding, the study provides evidence for routine Vitamin D supplementation during pregnancy in ethnic African females living in equatorial cities. Larger
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اے ربِ رحیم و کریم۔۔۔!
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تو رحیم۔۔۔خوشبو کی طرح روح میں اُتر کر!
میرے تڑپتے سسکتے دل کو۔۔۔!
اپنی آغوش میں لے کر۔۔۔اپنے ہاتھوں سے سہلاتا ہے
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تو ہی خالق۔۔۔ تو ہی مالک۔۔۔!
تیری کائنات میں اسرار جبرائیل ؑ کے ثبوت موجود ہیں
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تو مجھے بزم رقص سے۔۔۔!
کوہ قبیس کی طرف لسان شعور کے لہجے میں بلاتا ہے
مسافتوں کے مارے دل کو!
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تیری وجہ سے
لوح و قلم کو بھی ۔۔۔اپنے ہونے کا یقین ہے
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اپنی آغوش میں لے کر ۔۔۔اپنے ہاتھوں سے سہلاتا ہے

Factors Related to the Implementation of Evidenced-based Practice (EBP) of Nursing Staffing Levels in Hospitals: A Literature Review

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Relationship of Customer Relationship Management with Product and Organizational Performance in Manufacturing Industries

Relationship of Customer Relationship Management with Product and Organizational Performance in Manufacturing Industries There are several influencing factors concerned with the company and new product performance. Customer Relationship Management is one of them, which ultimately becomes backbone of an organization. The complete thesis designates the factors affecting Customer Relationship Management process, CRM technology and CRM reward system on New Product Performance and eventually on Company Performance. Many Studies on CRM and New Product Performance are continue from several years and deliberated its organization-wide importance. The CRM processes in the context of New Product Development described hypotheses for the additional research in relation with Company Performance. Data was collected from 233 respondents from seventeen randomly selected manufacturing organizations in Pakistan. The Pearson's correlation coefficient for company performance described a strong and positive relationship of all variables. The consistency of the construct was measured by evaluating the reliability by cronbach's alpha of individual items. For the testing of external validity, the procedure of confirmatory factor analysis was used which suggests the validity including reflective indicators of key construct by calculating regression weights through AMOS and SPSS. The SEM was used to calculate the path coefficients that evaluate strength of relationships. Separate models for the direct and indirect effects of company performance were examined for similarities and differences in perceptions. The outcomes described when a firm implements more its CRM processes in an NPD context, the higher the firm's new product performance. On the other hand, CRM technology did not positively influence the new product performance. In addition to this the application of CRM reward systems also did not facilitate new product performance. While introducing successful new products ever has a strong influence on improving company performance. In addition to this new product performance was an important mediator of the CRM processes and company performance link.