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Home > Quality of Life and its Determinants in Subfertile Patients Seeking Fertility Care at Two Urban Fertility Centres in Nairobi

Quality of Life and its Determinants in Subfertile Patients Seeking Fertility Care at Two Urban Fertility Centres in Nairobi

Thesis Info

Author

Sikuku, Lawrence Makoha

Department

Obstetrics and Gynaecology (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

1676728065058

Similar


Introduction: Subfertility affects one in six couples worldwide with devastating psychosocial consequences impacting on quality of life (QoL). Assessment of QoL and institution of appropriate interventions in subfertility patients complements clinical management by reducing the psycho-social effects of subfertility and its treatment. No local or regional data exist on impact of subfertility on QoL using a fertility-specific QoL assessment tool. Objective: The study sought to determine the QoL of subfertile patients seeking fertility care at two urban fertility centres in Nairobi using the Fertility Quality of Life (FertiQoL) tool. Methods: This was a cross sectional study. Subfertile women of reproductive age (18-49 years) and their partners attending fertility clinics were recruited. Study participants completed the self-administered FertiQoL questionnaire, an internationally validated subfertility-specific tool consisting of 36 questions each on a five-point Likert scale. It assessed QoL in four core subscales (emotional, relational, social and mind/body) and two treatment subscales (tolerability and environment) with higher scores denoting better QoL. Mean FertiQoL scores and standard deviation (SD) were calculated for the total FertiQoL and subscales. Univariate analysis was used to examine association between age, sex, education status, comorbid conditions, duration of subfertility and cause of subfertility with QoL. Results: A total of 104 participants were recruited. The mean total FertiQoL score was 65.7 (SD=14.5). The mean Core FertiQoL score was 63.9 (SD=16.7). The emotional domain had the lowest mean score (57.5) while the relational domain had the highest mean score (72.5). Age less than 35 years was associated with lower emotional (P<0.04) and mind/body (P<0.03) scores. Previous live birth was associated with higher mind/body score (P<0.01). University education and previous pregnancy were associated with higher treatment environment (P<0.01) and treatment tolerability (P<0.005) scores respectively. Sex, cause of subfertility and type of treatment had no impact on QoL domain scores. No factor showed significant association with the total FertiQoL score. Conclusion: Study provided baseline QoL for the study population which is similar to that seen in other regions. Age more than 35 years, university education, previous live birth and previous v pregnancy had positive impact on FertiQoL subscales. There is need to assess QoL in subfertility patients using a reliable disease-specific tool such as FertiQoL.
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’’نیل کے سنگ‘‘ایک اظہاریہ

نیل کے سنگ :ایک اظہاریہ

                                                                                                                ڈاکٹر نذر عابد

                                                                                (صدرِ شعبہ اردو، ہزارہ یونیورسٹی ،مانسہرہ)

’’نیل کے سنگ‘‘ ڈاکٹر الطاف یوسف زئی کی سفر نامہ نگاری کی مسافت کا دوسرا پڑائو ہے۔ اس سے قبل وہ ’’تھائی لینڈ کے رنگ‘‘ کے نام سے اپنا تھائی لینڈ کا سفر نامہ قارئین کی نظر کر چکے ہیں۔ ان کے اولین سفر نامے کو علمی و ادبی حلقوں میں خاصی پذیرائی حاصل ہوئی ۔مقامِ اطمینان ہے کہ سفر نامہ نگاری کی تخلیقی مسافرت کے اس دوسرے پڑائو پر بھی سفر نامہ نگار سفر کرنے اور سفر لکھنے ہر دو حوالوں سے کسی قسم کی جسمانی ،ذہنی اور روحانی تھکن کا شکار نہیں ہوا۔ ’’نیل کے سنگ‘‘ ان کے دیارِ مصر کے سفر کے احوال و تاثرات کی روداد ہے جس میں وہ ہر دم ایک تازہ دم مسافر کے روپ میں نت نئی منزلوں کی جستجو میں سرگرداں نظر آتے ہیں۔

مصر دنیا کی قدیم تہذیبوں میں سے ایک ہے جسے تاریخی اعتبار سے انسانیت کے لیے دریائے نیل کا تحفہ قرار دیا جاتا ہے۔ ڈاکٹر الطاف یوسف زئی کو دنیا کی قدیم تہذیبوں سے جانکاری کے حوالے سے ایک خاص شغف ہے۔ مصر میں گزارے گئے وقت کے دوران میں انھوں نے اپنی طبعی مناسبت سے خوب کام لیتے ہوئے مصری تہذیب کی جڑوں تک رسائی حاصل کرنے کی کامیاب کوشش کی ہے۔ اس کا واضح اظہار اس سفر نامے میں مصر کے مختلف تاریخی و تہذیبی مقامات کے احوال پڑھتے ہوئے ہوتا ہے۔ ڈاکٹر صاحب نے ایسے مقامات بیان کرتے ہوئے تاریخ سے بھرپور استفادے کے ساتھ ساتھ مقامی باشندوں میں گُھل مل کر وہاں کے ماضی و حال کے متعلق ایک تہذیبی و تمدنی منظر نامہ مرتب کیا ہے۔ تاہم...

مسئلہ ختم نبوت پر دلائل کا منہج و اسلوب : تجزیاتی مطالعہ

The belief of the finality of Prophet Hood (Khatm e Nabuwwat) is the basic belief of the Muslim Ummah, and this belief has been adopted since the first day. From the time of the Prophet ﷺ until now, the belief in the end of Prophet Hood has been protected on practical grounds and intellectually. Muslim scholars and philosophers, while strengthening it on the basis of rational and simulated arguments, did not leave a single aspect from which it could be undermined. They presented simulated arguments for the misguided sects in Muslim Ummah and for the non-Muslims, presented rational arguments in such a way that there was no reason left to disbelieve this belief. In this research article, there is a description of the simulated and rational arguments that are usually presented, such as the Quranic verses and their interpretation, the Hadiths, and the sayings of the scholars. And it has also been narrated what their style of reasoning is, in the same way, the legislation that has been passed in this regard in Pakistan has been presented in detail. Hopefully, this will make it clear what are the services of scholars and thinkers on this issue and what is their style.

Characterisation of Local Topaz to Develop a Radiation Dosimeter

Thermoluminescent dosimeter (TLD) is a device used to evaluate integrated dose of ionizing radiation. Natural mineral topaz as a thermoluminescent (TL) material has been studied for radiation dosimetry. The northern area of Pakistan along with Himalayas, due to its geological settings, is rich in topaz which is found in pegmatite rocks. Four mines namely: Kharguluk, Nyit, Sabser, and Yono in district Skardu were selected for sampling of topaz. Relatively big pieces of topaz were converted into chips and powder of micron size. Pellets of topaz composite with glass 1:2 wt.% and teflon 2:1 wt.% were prepared by compressing and sintering. The mineral was recognized as topaz through phase identification by XRD (X-ray diffraction). The mineral collected from Kharguluk mine was not topaz rather mixed with quartz. The elemental analysis by the XRF (X-ray fluorescence) of topaz of understudy mines resulted about 56.554, 22.030, 11.293, 9.560 and 0.453 at.% of the elements O, Si, Al, F and H. These results confirmed the mineral as topaz. The irradiation of topaz pieces with fast neutrons and thermal treatment produced deep and London blue colours in topaz. The TL response of virgin topaz of understudy mines generated a single huge peak in glow curve at temperature around 250 oC, which is the gesticulation of topaz. The INAA (Instrumental Neutron Activation Analysis) of topaz from the three mines detected the elements Na, Ga and Cs in three mines, while As and Sb were detected in Yono and Nyit mines respectively. The photoinduced emission spectra of topaz powder from three mines at the excitation wavelength 230 nm produced two bands. One band is at 430 nm and other at 470 nm which are the characteristics of topaz. The pellets of the composites were sintered at 400 to1200 oC. The TL response of the composites and [OH]/[F] ratio decreased with increasing sintering temperature. The optimum temperature selected for preparation of topaz composites was 900 oC. The effect of ultraviolet (UV) and visible light on topaz revealed that UV and visible light contribute to phototransference of charge. The TL glow curves of topaz chips, topaz-glass and topaz-teflon composites showed stable peaks (dosimetric peaks) at about 250-260, 250-260 and 257-265 oC respectively. Initially, the fading was maximum (27-30 %) and became 6-9% after few days. Chips and pellets showed the linearity with dose, good reproducibility, independent dose rate, linear dose response and strong energy dependence below 600 keV. The chips and pellets were found suitable for dosimetry for dose greater than 0.01 Gy at high energy beams. Saturation in the TL response was observed above 2000 Gy. The pellets of topaz-glass showed better mechanical stability than topaz chips and topaz-teflon pellets. The cutting of topaz chips was found difficult and time consuming, while the preparation of pellets of topaz-glass and topaz-teflon was relatively easy. Topaz-glass showed better TL dosimetric features as compared to topaz chips and topaz-teflon composites. These are recommended to be used at the facilities where high radiation doses are involved. The TL analysis of the glow curves using IRM (Initial Rise Method), Tm-Tstop, PSM (Peak Shape Method) and VHR (Variable Heating Rate) method showed that topaz and its composites with glass and teflon follow second order kinetics. The thermal activation energies 0.976- 1.576 eV for natural topaz were found to be greater than 0.488-0.627 eV for topaz- glass and 0.447-0.616 eV for topaz-teflon. The thermal activation energy found by VHR was 1.35 times higher than determined by PSM and IRM. The OSL (optical stimulated luminescence) dosimetric characteristics of the pellets of topaz-glass and topaz-teflon composites were studied for various energy beams of photons and particles using CW (continuous wave)-OSL mode. Blue light as a stimulation source for OSL generated a rapid decaying response within 10 s and then a long non-zero tail was observed. The integrated OSL (IOSL) response met the dosimetric requirements for topaz-glass and topaz-teflon at dose greater than 0.01 Gy and 1.0 mGy respectively. The TL response of topaz before and after OSL measurement showed two peaks in the glow curve at the same position. After OSL measurement, decline of about 1.35 times less in intensity of peak 2 was observed. Radiation dose was measured at IPEN, Brazil with the TLDs: LiF, topaz- chips and the composites of topaz-glass and topaz-teflon. Using the respective calibrations curves and applying the fading corrections, the measured dose proved that topaz and its composites are suitable for radiation dosimetry at high radiation areas. The price of topaz based TLDs is less than commercial dosimeters. Topaz-glass and topaz-teflon pellets can be recommended for the measurement of dose greater than 0.01 Gy by the TL method, while topaz-teflon are suitable for dose greater than 1.0 mGy using OSL read out. Further exploration of topaz from other mines of Pakistan, their TL/OSL analysis and applicability at sterilization, irradiation and medical centres is strongly recommended.