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Home > Uterine Fibroid Embolization for Symptomatic Fibroids; Correlation of Mid-Term Changes in Disease-Specific Symptoms and Magnetic Resonance Imaging Results at a Teaching Hospital in Kenya

Uterine Fibroid Embolization for Symptomatic Fibroids; Correlation of Mid-Term Changes in Disease-Specific Symptoms and Magnetic Resonance Imaging Results at a Teaching Hospital in Kenya

Thesis Info

Author

Mutai, John Kiprop

Department

Imaging and Diagnostic Radiology (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2013

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728074511

Similar


Background: Uterine fibroid embolization, though a widely available option in high income countries in managing symptomatic fibroids is relatively new in the East African region. It is currently offered at only one tertiary facility for the past three years. The symptom and radiological response in these patients, who literature suggests may have bigger fibroid burden and worse symptoms, is the subject of this study. Objective: Characterization of MRI imaging features in women undergoing uterine fibroid embolization and identification of clinical correlates in an African population. Methods: Patients with symptomatic fibroids who are selected to undergo UFE at the hospital formed the study population. The baseline MRI features, baseline symptom score, short term imaging outcome and mid-term symptom scores were analysed for interval changes. Assessment of potential associations between short term imaging features and the mid-term symptom scores were also done. Results: UFE resulted in statistically significant reductions (P< 0.001) of dominant fibroid and uterine volumes and in symptom severity scores of 43.7%, 40.1% and 37.8% respectively. Strong enhancement at baseline was a strong predictor of response to UFE.59% of respondents had more than ten fibroids. The predominant location of the dominant fibroid was intramural. No statistically significant association was found between clinical and radiological outcome. Discussion: UFE is a new treatment option for treatment of uterine fibroids in Kenya. This study was aimed at assessing outcomes to this treatment option compared to other parts of the world. The response of uterine fibroids to embolization in the African population is good but not different from findings reported in other studies in the West. The presence of multiple and large fibroids seen here is consistent with the case mix described in studies of African-American populations. No significant association is seen between radiological and clinical outcomes to UFE. Conclusion: UFE treatment for fibroids has good outcome. Further studies lasting beyond one year are indicated for further detailed outcome in the local African population. Recommendations: Patient counselling should emphasise the independence of volume reduction and symptom improvement. Volume changes are of relevance for the Radiologist in aiding understanding of the evolution of the condition and identifying potential technical treatment failures but should not be the main basis of evaluation of treatment success.
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پروفیسر مشیر الحق

پروفیسر مشیرالحق مرحوم
دارالمصنفین اور پوری علمی دنیا میں جناب پروفیسر مشیر الحق مرحوم وائس چانسلر کشمیر یونیورسٹی کے سانحہ قتل کی خبر نہایت رنج و غم کے ساتھ سنی گئی، ان کو یرغمال بنائے جانے کی خبر ہی باعث تشویش اور اضطراب تھی، لیکن یہ امید نہ تھی کہ ایک حلیم الطبع، نرم شائستہ و شگفتہ مزاج انسان کے خرمن ہستی کو آتش چنار اس طرح جلاکر خاک کردے گی۔
ان کی زندگی ماہ و سال کے لحاظ سے بہت زیادہ نہیں ہے لیکن محنت، صبر، استقلال عزم اور مقصد کی یافت کے لحاظ سے یہ حیات مختصر بڑی قابل قدر اور قابل رشک رہی۔ ان کے علمی سفر کا آغاز دارالعلوم ندوۃ العلماء کی طالب علمی سے اور اختتام کشمیر یونیورسٹی کی وائس چانسلری پر ہوا، حق یہ ہے کہ قدیم و جدید کے خوشگوار اور متوازن امتزاج کی یہ دلکش مثال ہے۔
وہ غازی پور یوپی کے قصبہ بحری آباد میں پیدا ہوئے، کم عمری میں والد کے سایہ عاطفت سے محروم ہوگئے، تعلیم کے لیے دارالعلوم ندوۃ العلماء لکھنؤ آئے، یہاں سے عالمیت کی سند لی، انھوں نے انگریزی تعلیم پر بھی توجہ کی اور بڑے نامساعد حالات اور سخت معاشی پریشانیوں کے باوجود انھوں نے علم و فن کی تحصیل جاری رکھی ان کے علمی شوق و ذوق کو ان کے محبوب و مشفق استاذ مولانا عبدالسلام قدوائی ندوی مرحوم کی حوصلہ افزائی اور سرپرستی کبھی کم نہ ہونے دیتی، جامعہ ملیہ اسلامیہ سے بی اے اور علی گڑھ یونیورسٹی سے ایم اے کیا، ۶۱؁ء میں انھوں نے کناڈا کی میک گل یونیورسٹی سے پی ایچ ڈی کی سند بھی حاصل کی، دوران تعلیم ان کے قلب و نظر پر مولانا عبدالسلام قدوائی ندوی، پروفیسر محمد مجیب، پروفیسر سید عابد حسین اور پروفیسر الفریڈ کینٹویل اسمتھ کے نقوش خاص طور پر...

غریب الحدیث پر موجود کتابوں کے اسالیب کا مطالعہ اور ان کے مناہج کا تقابلی جائزہ

Allah the elevated bestowed on prophet Muhammad SAW two basic sources of guidance for Muslim Ummah, The holy Quran and Hadith. Due to this significance of Hadith, Muslims have invented more than five hundred sciences related to Hadith. One of these sciences is Ilm Garb ul Hadith. Sheikh Moaamer bin muthana was the first scholar who has written a book on this topic.  From then on Muslim scholars have researched a lot in this regard. Dozens of scholars spent their time and wealth on it. According to the author of Moaajm ul mua’ajam more than 90 books on the topic have been published but eight of them gained much publicity and famous hood among them. Abu Ubaida, Abu Adnan, Abu Ubaida Qasim bin Salam, Ibrahim bin Ishaq Al Harbi, Abu Ubaida Ahmed bin Muhammad Alhervi, Ibn Jauzi, Muhammad bin Atheer Aljazree, Zemakhsharee. The following article consists of a brief introduction of Ilm Gharib ul Hadith along with a brief history of research about it. Then the eight famous books on Gharib ul Hadith and there way of research are examined in brief along with examples. At last a comparative study of the work done by these eight scholars is given in order to explore the differences and similarities among them.

Impact of Capital Structure and Working Capital Management on the Financial Performance of Selected Non-Financial Firms in Pakistan

Capital structure is the proportions of debt instruments, preferred stock and common stock on company's balance sheet. Business entities choose different combinations of equity, debts and other options for the purpose of financing their assets. Some businesses choose more financing from the equity and less from debts, while others rely more on debts and less on equity financing depending upon nature of their business, industry and risk. Firms mostly go for that combination of debt and equity that optimizes their cost of capital and risk. Perfect combination of capital structure and working capital enhance the profitability and financial performance of the firms. This study is conducted to examine the impact of capital structure and working capital management on the financial performance of selected non-financial firms in Pakistan. For this purpose 78 non-financial firms listed on Karachi Stock Exchange (KSE) have been selected for the period of seven years from 2005 to 2011. The data is obtained from the financial statements analysis published by the statistics department of State Bank of Pakistan. For the purpose of analysis, descriptive, correlation and panel data analysis are used in this research. Twelve panel data (regression) models have been used to investigate the impact of capital structure and working capital management on financial performance of the firms. In these models three proxies are used as independent variables to measure the capital structure i.e. total liabilities to total assets, long-term liabilities to total assets and short-term liabilities to total assets. Three proxies are used as independent variables to measure the management of working capital i.e. receivable conversion ratio, inventory conversion ratio and current ratio while the natural logarithm of sales is used as control variable to measure the size of the firms. In these panel data (regression) models return on total assets, net profitability, return on shareholders' equity and earnings per share are used as dependent variables to quantify the financial performance of the firms listed on Karachi Stock Exchange. The results of the analysis showed that debts lead to decrease the financial performance of the firms while all the measures of working capital management have positive impact on firms' performance. The results also revealed that good combination of capital structure and working capital has significant impact on financial performance of non-financial firms listed on KSE. So these firms have to give due consideration to the financing options and management of working capital to increase their financial performance.