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The Effect of Use of a Structured Data Collection Form on the Accuracy of Diagnosing Causes of Acute Abdominal Pain

Thesis Info

Author

Makanga, Winston

Department

General Surgery (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2012

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728069912

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Background: Initial assessment of acute abdominal pain by a clinician is the cornerstone to appropriate management since it determines rapidity and appropriateness of intervention. A poor initial assessment may lead to incorrect assumptions about diagnosis. Standardized forms have been suggested as one way of harmonizing the initial assessment therefore improving diagnostic accuracy of acute abdominal conditions and reducing over-reliance on investigations. Objectives: To determine the extent to which use of a structured data collection form (SDCF) affected the diagnostic accuracy of acute abdominal pain, time to disposition from the accident and emergency, hospital stay and cost of investigations. Methodology: A before and after study carried out from October 2011 to March 2012 of patients aged 13 and above presenting with acute abdominal pain in the emergency department (ED) of Aga Khan University hospital. Patients clerked by ED physicians using conventional history taking and examination between October and December 2011 were compared to a second group clerked after the introduction and by use of a structured data collection form (January – March 2012) for proportion of correct diagnosis at initial encounter and time to disposition from the ED. Data were compiled in MS-Excel spreadsheets and analyzed using SPSS v16. P value of <0.05 was considered significant Results: The diagnostic accuracy was 58% and 43% before and after the introduction of the structured data collection form respectively (p=0.088). For surgical patients, diagnostic accuracy was 77% before and 31% after the introduction of the form (p=0.018). The emergency department disposition time (EDt) was 2½ hours before the introduction of the form and 2 hours 42 minutes after its introduction (p 0.452). The negative appendectomy rate was 18% before the intervention and nil after.The number of investigations averaged 3.25 and 3.49 (p=0.542) while the cost of tests averaged KShs 4315 vs. 6530 (p=0.368) in Period 1 and 2 respectively. Conclusions: The structured form did not improve the accuracy of diagnosing the causes of acute abdomen, the disposition time from the ED or the cost of investigations.
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حد کا لغوی معنی

حد ایک کثیر المعنی لفظ ہے ۔ ماہرین لغت ، محدثین اور فقہائے کرام نے اس کے کئی معنی بیان کیے ہیں ، جیسا کہ مشہور لغت دان ابن فارس(م:395ھ) حد کی تعریف بیان کرتے ہوئے لکھتے ہیں
"الحد: الحاء والدال أصلان: الأوّل المنع، والثاني طَرَف الشيء.فالحدّ: الحاجز بَيْنَ الشَّيئين. وفلان محدودٌ، إذا كان ممنوعاً. و"إنّه لَمُحارَفٌ محدود"،كأنه قد مُنِع الرِّزْقَ.ويقال للبوَّاب حَدّاد،لمنْعِه النَّاسَ من الدخول۔"1
"مادہ " حا اور دال " اس کی دو اصل ہیں پہلے کا معنی ہے روکنا اور دوسرے کا معنی ہے کسی شے کا کنارہ ، پس حد کا معنی ہے دو چیزوں کے درمیان آڑ ۔ جیسے کہا جاتا ہے کہ "وفلان محدودٌ "جب کہ اس شخص کو روک دیا گیا ۔ " إنّه لَمُحارَفٌ محدود "جیسا کہ وہ رزق سے روک دیا گیا ہے اور دروازے پر کھڑے ہونے والے کو حداد کہا جاتا ہے اس لیے کہ وہ لوگوں کو اندر آنے سے روکتا ہے۔ "
حد آڑ کے معنی میں بھی استعمال ہوتا ہے، جیسا کہ ابن منظور افریقی (م:711ھ)نے بیان کیا ہے
"الحَدُّ الفصل بين الشيئين لئلا يختلط أَحدهما بالآخر أَو لئلا يتعدى أَحدهما على الآخر وجمعه حُدود وفصل ما بين كل شيئين حَدٌّ بينهما۔"2
"حد دو چیزوں کی درمیانی آڑ کو کہتے ہیں تاکہ دونوں آپس میں خلط ملط نہ ہو جائیں۔ یا ان دونوں میں سے ایک دوسری پر زیادتی نہ کرے اور حد کی جمع حدود ہے۔ دو چیزوں کی درمیانی آڑ ان کے لیے حد ہوتی ہے۔ "
لفظ حد بطور روکنا بھی لیا جاتا ہے، راغب ا صفہانی(م:502ھ) اس حوالے سے بیان کرتے ہیں
"الحد الحاجز بین الشیئین الذی یمنع اختلاط احدھمابالاخر۔"3
" حدسے مراد وہ شے ہے جو دو اشیا کو باہم ملنے سے روک دے۔ "
دو چیزوں کی درمیان آڑ کو حد کہتے ہیں ، جیسا...

نبوت و رسالت سے متعلق ”ترجمان القرآ ن“ کے کلامی مباحث کا جائزہ

In this universe, there are countless blessings of ALLAH almighty. All the above among these blessings is the way of guidance chosen for the mankind. The way which is close to the human nature and easily understandable. In this way,  ALLAH the merciful sends his messenger and a divine text as well. There is no discrimination between dark and light, human and animal, good and evil before the arrival of the prophets. The souls of the human beings are at thirst for knowledge or spiritual light and the prophets quenched this thirst. This paper explores all the aspects of prophecy aimed values, specification, need, Norms, sayings, Biography with reference of the Tarjuman ul Quran literature.

Al Fatah Al Muhammadi Fi Alm Al Badi O Al Bayan O Al Maani Lisheikh Esa Al Barha Nabvari Al Mutawafi 1031 Hijri

This thesis is a research manifestation on a great and unique manuscript of Arabic rhetoric entitled: AL-FATH UL MUHAMMADI FI ILM BADEEI WAL BYAN WAL MAA’NI written by SHAIKH EESA AL BURHAN PURI who was an eminent scholar of the Sub continent in Sixteenth Century (1031 A.H.). Shaikh Eesa concentrated on more than fifty books written on this topic mainly by the subcontinent writers, all mainly pivoted on the Quranic Sciences and its modes and styles, like Eloquence, maxims and idiomatic expressions and even the poetry of the ancient Arabs. I strated the research work on this manuscript at the time when I was admitted in Punjab University as a Ph.D scholar in Arabic Department in 2008 and completed this research work in 2015. Keeping in view the above, under the kind but vigilant guidance of advisor from Arabic Department Prof. Dr. Khaliq Dad Malik, chairman Arbic Department; really a man of parts and prestige, I got a golden opportunity to further navigate and explore the gems of knowledge. The research work is done schematically. This thesis is divided into three chapters. The first chapter is about the life and literary services of Shaikh Eesa. This chapter is then sub-divided into two sub sections; one is devoted to the life of Shaikh Eesa and the section portion is an introduction to Shaikh Eesa’s other books on various topics. The second part of my thesis introduces the significance of the manuscript and also describes the rhetoric books in the sub-continent. For it, I also divided the second part of the thesis into two sub-portions. One talks about the eloquent qualities of the manuscript itself and the other portion is like a review of the rhetoric and the books written on the Quranic Eloquence in the subcontinent. The third chapter of thesis is devoted to the edition, research and contents along with the bibliography of the manuscript under my research. Hence the Arabs have rendered unique and unlimited services in the fields of Rhetoric and Eloquence but I found that our Muslim scholars of the sub-continent are also much ahead in such services, even acknowledged by the Arab world but unfortunately, the preservation is neglected. Now, the universities are playing a vital role to promote and preserve such writings for the benefit of the whole humanity. In this regard I also selected a manuscript which is a greatest and splendid work of Shah Eesa Burhanpuri which belongs to 11th hijry. So that the educated people of subcontinent and other countries could take benefit from this manuscript. Because no work has done on this manuscript before it. I am much hopeful that this dissertation will definitely appease the hunger and thirst of the real knowledge searchers of the Quranic Sciences but would also help a common man to aspirate knowledge and understand a know-how of the Quranic supremacy. Moreover, my thesis effort would also attract the others to further promote and outpoint the significance of such topic like Quranic Eloquency and the other relevant divinic literary qualities of the Holy Quran. May Allah Almighty accept my effort. (Ameen)