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Home > The Effect of a Preanaesthesia Clinic Consultation on Adult Patient Anxiety in Aga Khan University Hospital; a Cohort Study

The Effect of a Preanaesthesia Clinic Consultation on Adult Patient Anxiety in Aga Khan University Hospital; a Cohort Study

Thesis Info

Author

Kamau, Anthony

Department

Anaesthesiology (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

1676728069070

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Background: Preoperative anxiety is a common perioperative complication, according to studies done it is seen in approximately 11-80% of adults undergoing surgery. Various pharmacological and non pharmacological techniques have been used to reduce preop anxiety. One of the goals of the preanaesthesia clinic is to allay anxiety. Literature shows that a preanaesthesia clinic evaluation reduces anxiety however b current studies done on anxiety and the preanaesthesia clinic have not quantified this reduction. Objective: To determine the reduction in anxiety in patients evaluated in the clinic versus those evaluated in the ward. Study Design: A cohort and before – after study Setting: The surgical outpatient clinics, the gynaecological outpatient clinic, the antenatal clinic, the wards and operating theatres at the Aga Khan University Hospital, Nairobi. Population: All the adult patients scheduled for non-cardiac elective surgical procedures during the study period. Sample size: 44 adult patients with 22 patients in each of the 2 groups i.e. anaesthesia clinic (AC) group and the ward group (W). Methods: 51 adult patients with 28 patients in anaesthesia clinic group and another 23 in the ward were sequentially recruited from both the surgical outpatient clinic, gynaecology outpatient clinic and antenatal clinic. The patient’s State Trait Anxiety Index (STAI) was taken once the patient was booked for theatre. The patient then had a preanaesthesia evaluation either in the preanaesthesia outpatient clinic (PAC) or in the wards. Another STAI score was taken in the preoperative area in theatre on the day of surgery. The patients were then traced back as to whether they had their intervention in the ward or the clinic and hence divided into two groups. The difference in the change of STAI scores in both groups was then analysed. Results: 51 adult patients were recruited i.e. 28 in the clinic group and 23 in the ward group. The majority of the recruited patients were female (n=38). Statistically significant difference was seen in the reduction of the anxiety scores between the clinic group 2.143(C.I=1.384-2.902) and ward group 0.739(C.I=0.168-1.311) with a p value=0.0051.There was also significant difference in reduction in anxiety scores within ward group in the patients with no prior anaesthetic experience having a greater reduction than those a prior anaesthetic experience. There were no other significant differences between the 2 groups. Conclusion: Patients evaluated in the anaesthesia clinic had a greater reduction in their anxiety but it was not as much as hypothesised which may
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62. Al-Jumu'ah/The Congregation

 

62. Al-Jumu'ah/The Congregation

I/We begin by the Blessed Name of Allah

The Immensely Merciful to all, The Infinitely Compassionate to everyone.

62:01
a. Whatever is within the celestial realm and the terrestrial world is Glorifying Allah – The One and Only God -
b. The Sovereign, The Holy, The Almighty, The All-Wise.

62:02
a. It is HE WHO assigned among the people who had no Scripture a Messenger – Muhammad ibn Abdallah - from among themselves
- to recite HIS Messages from The Qur’an to them, and
- to purify them spiritually from dogma, myth, and polytheism, and
- to teach them of the Law, and
- the wisdom - morality and beliefs, etc.
b. Though before this, they were clearly astray from the Divine Guidance.

62:03
a. And also HE assigned Muhammad to others from them who have not joined them as yet.
b. And HE is The Almighty, The All-Wise.

62:04
a. Such is the Grace of Allah, which HE confers upon whoever HE Wants.
b. And, HIS Grace, HE has now conferred upon The Last of the Prophets, Muhammad,
c. for Allah is the Possessor of Infinite Grace.

62:05
a. The likeness of those who had been charged with enacting and complying with laws of The Torah, then did not uphold it, is as the likeliness of a donkey carrying a load of books oblivious of benefiting from them.
b. How evil is the likeness of the people who deny and belie Allah’s Messages in The Torah and now in The Qur’an!
c. And Allah does not guide the people who have chosen to be misguided and are wrongdoers.

...

Blashphemy Law and its Interpretation a Pakistans Perspective

Blasphemy law is considered as very basic law in the Muslim societies. This study aims to examine the blasphemy law of Pakistan in historical perspective. Qualitative research designs and discourse analysis techniques have been used to analyse the existing data. In Indian Subcontinent, during the Muslim rules, blasphemy law was being followed and practiced in accordance with principles of Islam. During British regime, it has throughout been demand of the Muslim for legislation of Blasphemy Law. During this period, by acceding to Muslims’ demand, it was introduced but with lesser punishment, even lesser than those which was there in the law of England. In this article, history of the blasphemy law and its interpretation, including conformity with Islamic principles as judged by the Federal Shariat Court, has been documented. In the end, its present status, or restatement of this law, has be unearthed with some suggestions, which have though been alluded to in decisions of the courts, but have not been ever discussed.

Leading Role of Political Dynasties of Faisalabad Division in Politics-1985-2015

Faisalabad Division is comprised of four districts namely Chiniot District, Faisalabad District, Jhang District and Toba Tek Singh District Faisalabad,whose old name is Lyallpur, is famous as Manchester of Pakistan being industrial city. The foundation of Lyallpur was laid in 1896 on the direction of the then time Lt. Governor of the Punjab, Sir James Loyal.Before 1880, it was known as Chenab colony. The map of Faisalabad was planned by Sir Ganga-Ram. River Chenab is at a distance 25-miles towards north-west and river Ravi is at about 27-miles towards East. Area in between these rivers was named Sandal Bar. Strong establishment in central government in sub-continent goes to chandar Gupt Moria, Ashoka family, However different tribes like Pehlvi, Parthvi, Satwahan etc, all are note worthy Hindu rulers. Alexandar the great, Muhammad Bin Qasim, Ghaznvi, Ghori, Mir-Taimor, Subsequent rulers and later Ahmad Shah Abdali attacked the northern side of the India and east India company entered from southern side these invaders brought change in civilization, cultural impact and political thinking. Pre-partition Punjab is attractive site due to fertility of the land. So land was devided accordingly to rain fall in this region, namely Sandal Bar, Gunji Bar, Karana Bar, Gondal Bar, Neeli Bar are famous due to agricultural products. Plateau of potohar is famous for oldest civilation of the world. Sandy and deserted area is of cholistan lies in Bahawalpur-Division and Thal in Sindh tributaries. Gordaspur, Amirsar Ferozpur, Lahore, Kasur in upper souty of Bari-tributory is called Majha, peoples of this area are famous for bravery, healthy, lilitary support culture. Old Punjab was partitioned under the act of 3rd June 1947. Which resulted, Lahore division consisting of Gujranwala, Sheikhpura and Sialkot. Second Division was Multan, havingDera Ghazi Khan, Jhang, Lyallpur, Sahiwal and Muzzaffargarh while in third division, Rawalpindi, Attock , Jhelum. Sseikhpura and Mian-wali District were added. After the breakup of west Pakistan, Punjab Province restored back by general Yahya Khan in 1070. Fertility of the land made Punjab Prominent from other provinces whereas it maintained its cultural as well as traditions. Whereas the percentage of Rajpoot, Jatt, and Arains is more than Pathans or Sindhis in Punjab. As compared to Hindu Caste system, every villager has caste that represent his personality and recognition. Present Punjab is the biggest province of Pakistan on the basis of population. Punjab has nine Divisions and Faisalabad is one to them. The main tribes and castes which are settled in Faisalabad division are Jatt, Arain, Gujjar, Rajput, Mughal, Syed, Pathan, Balochi, Bhatti, Awan and Kashmiri. Before the creation of Pakistan there was a difference between locals and settlers. Afterward, Faisalabad division was molded with the arrival of Mahajreen. The agricultural system is the main cause of its prosperity. The main power of influence lies in villages. British rulers, like Mughals, established administrative management basing the landlord’s co-operation. The term Biradary, is used on small scale level while caste is used at broader level. The basic unit of Punjab Biradarism is village. Its social structure has much low-level itself. These are, Arain, Aroray, Awan, Baloch, Pathan, Pakhi-was, peernay, Jutt, Chohray (Khakh-roob) Dogar, Doom, Rajpoot structures are due to political power and influence. The major Biradaries as accepted by British rulers, Sayyed, Sheikh, Bucher, Kamboh, Kanjar, Khoja, Gujjar, Laghari, Mizari, Makhdom, Gillani, Dohay, Noon, Watto, Moakhal, Twanay, Doltany, Ranay, Roy, Cheema, Chatha, Khosa, Sial, Mazari, Bosal, Kharal, Jiwana, Varyo, Niazi, Khawaja Sheikh, Kashmiri. Much has been written about political situation in Punjab but topic is unique and significant for further investigation of reasons of presence/support of Biradary system in politics of Faisalabad Division. Despite huge politics and social changes during last 70-years, the electoral politics in Pakistan has remained largely basing on family enterprises, Yet Biradary/caste system, is very prominent in Faisalabad Division. Biradary system is follow up old Aryas’s Social system. Hindu-Society strictly adhere where as Muslims replace this with Biradary system. In 1970, on slogan of Roti, Kapara Makkan, Biradary system was broken at provincial and national level yet local grouping remained in contact in local bodies election. However in Zia-ul-Haq regime local bodies election, on-party basis, played very crucial role in up-rooting the Biradary system. Never-theless in General election in 1988, 1990, 1996 and in 2002, the political impact of Biradary system lessened in general election in Punjab. Even then Biradary system remained empowered due to the reason of chairman’s election which were held on the baiss of Biradary system is the indicative of fact that Biradary system campaign remain incontact in National/Provincial or local bodies organizations. That is why regionalism got severe in Punjabi politics and the Baradarism engulfed the province of the Punjab with different Baradaries who got more tendancy of the tradition of Baradarism during martial law, because Political parties cound not take part in politics directly. Before independence, Arain and Jutt Biradary was prominent in local bodies election. Major political party was unionist party and afterward Muslim league achieved historical victory due to Jutt and Arain Biradary. Later on due to migrated peoples made sandal Bar prosperous (Faisalabad Div). Peasants of Faisalabad are more powerful than non-peasants due to Biradism. Up to 1970, Jutt, Rajpoot and Arain was in majority. There are 200-political parties registered with election commission of Pakistan. Some active parties are described. Ratio of different Biradarism based memberism National Assembly in Faisalabad division is as Rajputt: Sayyed: Arain: Religious: Baloch: Jutt: Ansari: Gujjar: Khan: Awan: Malik: Sial: Cheema. The average statistical data for Punjab Provincial Assembly is :: 24%: 18% :14%: 6%: 5%: 17%: 4%: 2%: 4%: 2%: 4%: 1%: 1%: 2%: 1%: 1%: for above Biradaries in Faisalabad division. The prescribed ratio has slight variation in this division of winning of seats in general election year 1988, 1990, 1993, 1997, 2002, 2008, 2013 for provincial assemblies. However, no political party formally nominated candidates for district council’s chairmanship in election 2013. So Biradaries nominatedand planned especially for the success of their councilors. No doubt, the factors of urbanization and industrialization slow down the impact of Biradarism but the process is snail paced which has negative effects on national politics. Incapable, vulgar elements, joined politics as profession and idealized traditions like good will, tolerance unanimity are diminished.To eliminate the Baridarism impact in political system. We should impart and expand education system, provision of justice and fairply be made for idealized politics, maturity of people’s political consciousness, rectitude of political parties and finally increasing the representation of low classes of the society in politics.