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Home > The Impact of the Introduction of the Pecarn Head Ct Rules on the Utilisation of Head Ct Scans for Children With Mild Head Injury at the Aga Khan University Hospital, Nairobi.

The Impact of the Introduction of the Pecarn Head Ct Rules on the Utilisation of Head Ct Scans for Children With Mild Head Injury at the Aga Khan University Hospital, Nairobi.

Thesis Info

Author

Kobe, Isaac Oluoch

Department

General Surgery (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2016

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728071898

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Background: Head injury is the most common cause of childhood morbidity and mortality worldwide. Mild head injury comprises 90% of cases of head injury in children. Head CT scans are few, expensive and have the side effect of ionizing radiation whose effect is potentiated in children and also associated risk of sedation that is often required when doing CT scans in young children. The decision to order CT scans of the head is thus made on the basis of clinical decision rules of which the PECARN CT head rule has been found to be most sensitive and useful. Objectives: Primary: To determine the proportion of head CT scans done for children with mild head injury after the introduction of PECARN head CT rules compared to the period before. Secondary: To determine disposition of patients from casualty after introduction of the PECARN head CT rules as compared to the period before and to determine the probability of neurosurgical intervention in patients under 18 years with mild head injury at AKUH (N). Methodology: Study design: A before and after quasi experimental study with a study population including all children under 18 years presenting to the AKUH (N) with mild head injury and a Glasgow coma scale of 14 and above on presentation. Sample size was 85 Results: A total of 42 patients files were analyzed in the before study while 43 patients were selected for the after study. The median age was 5 years. The proportion of head CT scans reduced from 56% in the before group to 33% in the after group with no missed clinically significant traumatic brain injury. More patients were discharged home after evaluation in the after group (81%) than in the before group (58%). Conclusions: The number of head CT scans ordered for children with mild head injury reduced after the introduction of the PECARN head CT rule, without missing any clinically significant traumatic brain injury.
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فرخندہ رضوی کا اختصاص

فرخندہ رضوی کا اختصاص
شاعری کسی کی ذاتی جاگیر اور میراث نہیںیہ اللہ تبارک و تعا لیٰ کا تحفہ عظیم ہے۔یہ امیری غریبی کو دیکھ کر نہیں ہوتی بلکہ یہ عطائے رحیمی ہے۔فیضان الٰہی ہے۔ اردو شاعری کا کارواں جس نے اپنا سفر بارہویں صدی سے شروع کیا تھا اب اکیسویں صدی میں داخل ہونے والا ہے، اور شاعری کے اس سفر میں کئی اصناف شاعری مثلاً حمد،نعت،قطعہ،مرثیہ، رباعی، مخمس،مسدس،مثنوی، گیت، نظم، آزاد نظم ،نظم مصریٰ اور غزل شامل ہو چکی ہیں۔ ان تمام اصناف شاعری میں سے کوئی صنف بھی ایسی نہیں جو اردو زبان ادب کی اپنی پیداوار ہو۔ یہ تمام اصناف فارسی، عربی اور انگریزی زبان و ادب سے ہئیت اور موضو ع سمیت مستعار لی گئی ہیں۔ ایک ادیب کی تشنگی چاہے وہ شاعر ہو یا افسانہ نگار قلم میں چھپی ہوتی ہے۔ لفظوں کے یہ خزانے ان لکھاریوں کے لیے اتنی ہی اہمیت کے حامل ہیںجتنے انسانوں کے لیے رشتے ، کہتے ہیں کہ رشتے ٹوٹتے ہیں مگر گزرے وقت کے پل پھر بھی ساتھ ہی رہتے ہیں ، پھر لکھنے والوں کا جو وقت لفظوں کی مالا بننے میں صرف ہوتا ہے وہ کہاں بھولتا ہے پھر یہ شاعری شاعروں کا سرمایہ اور ادب کا حصہ بن جاتی ہے۔عہد حاضر کی اردو شاعری میں ایک جانا پہچانا نام فرخندہ رضوی کا ہے۔
ہمارے یہاں باقاعدہ طور پر شاعری کی عمر بڑی طویل ہے جو تقریبا تین سو سال ہے شاعری ہر دور میں مقبول عام رہی ہے تاریخ ادب میں مرد شعرا کی تو فہرست بڑی طویل ہے۔ لیکن شاعرات میں سے سب سے پہلے مہ لقاہ چندہ پہلی شاعرہ کے روپ میں سامنے آتی ہیں اس کے بحیثیت شاعرہ زہرہ نگاہ شعر و سخن میں اپنی دھاک بٹھانے آئیں۔
عصر حاضر میں خواتین فن شعروسخن کی جانب کچھ زیادہ...

Indian Muslim Freedom Fighters Based in Afghanistan and Soviet Russia

At the outbreak of the First Word War, the Indian Muslim freedom fighters headed towards Afghanistan and thence to Soviet Russia to devise a strategy to pulverize the British Indian government through an alliance of the powers that were hostile to the British Imperialism in India such as Germany, Turkey, Czarist Russia and Soviet Russia. The present paper takes into account the life struggle of a few spirited individuals such as Mawlana Abdur Rahim alias Maulv Bashir, Maulvi Muhammad Ali Quāuri, Mawlana Barakatullah Bhopali, Mawlana Ubayd Allah Sindhi and a host of others who found their way towards Afghanistan with the avowed intention of the liquidation of the British Imperialism from India. The activities of these Freedom fighters apparently did not bring about immediate tangible results in terms of the freedom of India; however, they contributed to the complete freedom of Afghanistan and in subsequent years brought the goal of the freedom of their own country nearer.

Processing and Microstructure-Property Microstructure Property Relationship of Low Temperature Environment-Friendly Environment Friendly Piezoelectric Materials

Lead-based electro ceramics like PZT are the most commercially used as sensors, actuators and transducers due to their excellent electromechanical response, however The environmental concerns and the legislation imposed on hazardous materials, lead is considered toxic and its use is banned for many applications. Therefore the alternative lead free electroceramics have become the focus of research in both industry and academia. In our present work among the several families of lead-free, we will focus on the bismuth-based ferroelectric ceramics due to their excellent piezoelectric and ferroelectric properties. In brief this thesis we will emphasize on the improvement of ferroelectric and field-induced strain properties of BNKT-LS ceramic system by different alovilent and isovalent B-site substitutions. The effect of zirconium (Zr+4), niobium (Nb+5) and tantalum (Ta+5) substitution for the B-site in the host perovskite unit cell on the dielectric, electromechanical and piezoelectric properties of lead-free 0.99[Bi1/2(Na0.82K0.18)1/2TiO3]-0.01LiSbO3 (BNKT-LS) piezoceramics has been investigated. The ternary BNKT-LS system was synthesized using low temperature conventional solid state reaction method. Crystal structure, dielectric, ferroelectric and field-induced strain behavior of Zr modified lead-free 0.99[Bi1/2(Na0.82K0.18)1/2(Ti1-xZrx) O3]-0.01LiSbO3 (BNKTZ-LS) ceramics were investigated in composition range x = 0 - 0.040. XRD patterns revealed the formation of pure perovskite phase with no apparent structural phase transition with pseudo cubic symmetry for the compositions at low concentration of dopants although there were some traces of secondary phases at higher concentrations. The temperature-dependent dielectric peaks of the BNKTZ-LS ceramics broadened and ferroelectric polarizations decreased with increasing Zr concentration. Ferroelectric and bipolar field induced-strain curves indicated a disruption of ferroelectric order upon Zr addition into BNKT-LS ceramics. This destabilization of the ferroelectric order was accompanied by an enhanced field-induced strain. A high field-induced strain (S = 0.30%) with a normalized strain (d*33 = Smax/Emax = 500 pm/V) was observed at an applied electric field of 6 kV/mm at x = 0.020. The Ta-modified 0.99[(Bi0.82Na18)TiO3-(Bi1/2K1/2)TiO3]- 0.01LiSbO3 (BNKTT-LS) piezoceramics were also synthesized by a conventional solid-state reaction method. The effect of Ta addition into the BNKT-LS ceramics were studied through X-ray diffraction, dielectric, temperature dependent ferroelectric and field-induced strain characterizations. As the Ta content was increased, the maximum dielectric constant as well as the depolarization temperature (Td) decreased. The polarization and strain hysteresis loops indicate that the addition of Ta significantly disrupts the ferroelectric order of the BNKT-LS ceramics leading to a degradation of the remnant 14 polarization and coercive field. However, the destabilization of the ferroelectric order is accompanied by a significant enhancement in the unipolar strain. A large unipolar field-induced strain of 0.38% with a normalized (d*33 = Smax/Emax = 650 pm/V) at a driving field of 6 kV/mm was obtained at room temperature for x = 0.013. This significant strain enhancement is a result of the reversible phase transition between a NP phase in a zero field and a field-induced ferroelectric phase. 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At high Nb concentrations, BNKNb-LS ceramics shows a typical relaxor behavior. So for all dopants the increase in concentration results in a decrease in the maximum dielectric constant as well as the depolarization temperature Td, the disruption of the long range ferroelectric order, the degradation of remnant polarization, coercive field and piezoelectric coefficient d33. This was also accompanied by enhancement in the electric field induced strain. This abnormal strain enhancement could be attributed to a reversible phase transition between polar and non-polar phase for all systems. For high doping level BNKT-LS ceramics showed a typical relaxor behaviour.