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Home > Surgical Site Infection Rates in Breast Cancer Surgery at a University Hospital in Nairobi, Kenya

Surgical Site Infection Rates in Breast Cancer Surgery at a University Hospital in Nairobi, Kenya

Thesis Info

Author

Nyaoncha, Andrew Nyangau

Department

General Surgery (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

1676728068184

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Back ground: Surgical site infections (SSI)following breast cancer surgery remain a significant cause of morbidity with the use of single dose pre-operative antibiotic prophylaxis. As a result the use of peri-operative antibiotics is common and unregulated, with no knowledge of the infection outcomes with their use. Objectives: To establish the SSI outcomes with the use of peri-operative antibiotic prophylaxis, evaluate the common risk factors for SSI development and assess for other important outcomes following breast cancer surgery. Methods: A prospective surveillance study for patients undergoing breast cancer surgery using the National Nosocomial Infections Surveillance (NNIS) system. Analysis: Analysis for the rates of surgical site infections and the prevalence of common risk factors for SSI development and their importance Outcomes: An SSI rate of 6% was observed using peri-antibiotic prophylaxis and a strict surveillance protocol. This was significantly reduced rate compared with other studies of antibiotic prophylaxis. The most significant risk factors for SSI in the study population were age >65 years, obesity and diabetes. Seroma formation, shoulder dysfunction and medial upper arm numbness were the other surgical complications noted.
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خاتمة الكتاب

القرآن الكريم هو الكتاب الرئيسي في الإسلام، الذي يُقدِّسه ويؤمن به المسلمون أنّه كلام الله المنزّل على نبيه محمد صلي الله عليه وسلم -للبيان والإعجاز،المنقول عنه بالتواتر حيث يؤمن المسلمون أنه محفوظ في الصدور والسطور من كل مس أو تحريف، وهو المتعبد بتلاوته، وهو آخر الكتب السماوية بعد صحف إبراهيم والزبور والتوراة والإنجيل.كما يعدّ القرآن أرقى الكتب العربية قيمة لغوية ودينية، لما يجمعه بين البلاغة والبيان والفصاحة.وللقرآن أثر فصل في توحيد وتطوير اللغة العربیة وآدابها وعلومها الصرفية والنحوية، ووضع وتوحيد وتثبيت اللّبنات الأساس لقواعد اللغة العربية۔

قال الله تعالی:" إِنَّ عَلَيْنَا جَمْعَهُ وَقُرْآنَهُ  فَإِذَا قَرَأْنَاهُ فَاتَّبِعْ قُرْآنَه (سورة القیامة : ۱۸)

كان الإعجاز القرآني خليقا أن يثير في الحياة الإسلامية مباحث على جانب عظيم من الأهمية يتصدى بها العلماء للكشف على وجوه البلاغة القرآنية.

 وبذل العلماء جهودا مشكورة، وقاموا بمحاولات مضنية، لإبراز البلاغة القرآنية في صورة موحية ذات ظلال، ولكنهم وقفوا غالبا عند النص الواحد، فاقتطعوه اقتطاعا من الوحدة القرآنية الكبرى ، ودرسوه دراسة تحليلية جزئية ذهب بمعالم جمالها الذي لا يتناهى حول مشكلة اللفظ والمعنى، فكانت النزعة الكلامية تفسد عليهم تذوقهم للنصوص، وإدراكهم مواطن البلاغة والإعجاز.

قال الجاحظ في كتابه الحيوان: "ولي كتاب جمعت فيه آيات من القرآن الكريم لتعرف بها ما بين الإيجاز والحذف، وبين الزوائد والفضول والاستعارات، فإذا قرأتها رأيت فضلها في الإيجاز، والجمع للمعاني الكثيرة بالألفاظ القليلة.

اختلف العلماء -رحمهم الله تعالى- في لفظ القرآن لكنهم اتفقوا على أنه اسم فذهب جماعة من العلماء منهم الشافعي، الأشعري، ابن كثير ، الفراء، اللحياني ، الزجاج و ابن الأثير وغیر ذلک من العلماء اللغویین الذین ذهبوا إلى أنه اسم جامد غير مهموز كما ذكر الأشعري: إنه مشتق من قرنت الشيء بالشيء إذا ضممته إلیه ومنه قولهم: قرن بين البعيرين إذا جمع بينهما ومنه سمي الجمع بين الحج...

Al-Sukākī’s Classification of Metaphor and Qurānic Discourse

The present study is divided into two main sections; the first section will give a general overview about the figurative language and more focus on metaphor (istiᶜārah in Arabic) because the metaphor is considered as one of the most literary devices and the main category of the figurative language. So in this study has given various definitions of figurative language and metaphor according to Muslims and Non-Muslims linguists and along with this explained Al-sukākī’s classification of metaphor which is little close to Al-Jurjānī’s classification of metaphor and view respectably among Muslims and Non-Muslims linguists. The second section of this study deals with metaphors given in Holy Qur'ān, which are denoted according to Al-sukākī’s classification in this respect. In this reference the verses are presented with detailed tafsīrī literature so the reader could well comprehend the purposes and the classical aspect of metaphors in text and also could evaluate linguistic architecture of  Holy Qur'ān.

Yield Forecasting of Maize for Different Agronomic Practices under Climate Change and Variability Using Simulations and Remote Sensing

Yield forecasting is becoming increasingly important in the context of climate variability and change using approaches like remote sensing and crop modeling. Climate variability and change are affecting crops and efficiency of input resources. The situation is demanding efficient management of input resources. Changing climate is also affecting current production technology which needs modification using modern tools. Two field experiments were conducted at Water Management Research Center, University of Agriculture Faisalabad, Pakistan. Field experiments addressed above mentioned issues. The first experiment included full (100%) and three reduced levels (80%, 60% and 40%) of irrigation with four levels of nitrogen (160, 200, 240 and 280 kg ha-1) at different critical growth stages of maize. Second experiment involved four sowing dates (i.e.27 January, 16 February 8 March and 28 March) and three maize hybrids (i.e. P-1543, DK6103 and NK8711) during the years 2015 and 2016. Different system approaches were used to optimize the volume of irrigation, amount of nitrogen (N) and sowing date for maize hybrids. CERES-Maize model was calibrated and evaluated with second experiment. Calibrated model was used to explore the effects of climate variability and climate change (CC) at regional scale. Different adaption strategies were developed to mitigate the negative effects of climate change. Remote sensing framework was used for regional yield forecasting that can assess seasonal and interannual variability. In first experiment results from model and economic analysis showed that the N rates of 235, 229, 233, and 210 kg ha-1 were the most economical optimum N rates to achieve the economic yield of 9321, 8937, 5748 and 3493 kg ha-1 at 100%, 80%, 60% and 40% irrigation levels, respectively. The optimum level of irrigation was 250 mm. The results of second experiment revealed that grain yield was continuously decrease with delay in Planting date, among maize hybrids Poineer-1543 performed best in spring season. Model parametrization results showed a reasonably good result in prediction of biological and grain yield with RMSE values of 963 kg ha-1 and 451 kg ha-1. Different GCMs were used for understanding the CC impacts, which indicated that there would be increase of 3.4°C in maximum and 3.8°C in minimum temperature in hotdry GCM. The reduction in maize yield due to rise in temperature will be 27% under mid-century (2040-2069). Different adaptations options could be used with RAPs then maize yield would be increased by 15%.Landcover classification of maize were done by Machine Learning algorithms which estimate 14% less area reported by Reporting Service (CRS) of Punjab Pakistan for 2015 and 2016. For yield forecasting, seasonal multitemporal, a total of 8 LST and NDVI values for 64 farms were taken to develop model. Model was used to predict the yield of previous 10 year (2007-2016) which showed a high accuracy with mean % error of 1.25. Seasonal mean Tmax and Tmin of 10 years with predicted yield showed a negative relationship with Tmax. (R2= 0.76) and Tmin. (R2= 0.69). It can be concluded from the study that modern tools are very helpful to optimize input resources to ensure food security.