Medicine and Health Sciences Commons^™

Association Between Dialysate Sodium Concentration And Interdialytic Weight Gain In Patients Undergoing Twice Weekly Haemodialysis, Soraiya Manji

Theses & Dissertations

Background: Chronic kidney disease is highly prevalent in the world with more than two million people worldwide requiring renal replacement therapy. Interdialytic weight gain is the change in body weight between two sessions of haemodialysis. Higher interdialytic weight gain has been associated with an increase in mortality and adverse cardiovascular outcomes. It has long been questioned whether using a lower dialysate sodium concentration during dialysis would reduce the interdialytic weight gain and hence prevent these adverse outcomes.

Objective: The primary objective of this study was to determine the association between the dialysate sodium concentration and interdialytic weight gain …

Utility Of Glasgow-Blatchford Scoring System In Identification Of Low Risk Patients With Upper Gastrointestinal Bleeding In Emergency Departments In Dar Es Salaam Hospitals, Tanzania, Selestin D. Mpiri

Theses & Dissertations

Background: Acute upper gastrointestinal bleeding (UGIB) remains a common cause of visits to the Emergency Department (ED). To stratify the risk of complications, rebleeding, need for clinical intervention, or death, several clinical scores are in use. Glasgow-Blatchford Score (GBS) is an excellent risk assessment tool and has shown to accurately identify patients with a low risk of death or requiring intervention. In urban Tanzania, there is a lack of standardized protocol and a well-validated risk assessment tool for analyzing patients presenting with UGIB symptoms. Good performance of GBS score and its use will help to reduce unnecessary emergency endoscopies …

Effect Of Unmaskes On Delivering Difficult News Among Residents, Karishma Sharma

Theses & Dissertations

Background: Effective delivery of difficult news to patients and family has been shown to improve the physician-patient relationship, quality of care, and overall patient satisfaction. However, delivery of difficult news (DDN) remains a challenging task for even the most experienced providers. Little has been studied about delivery of difficult news by resident physicians in the sub-Saharan setting. We developed a 4-minute, easily accessible, graphic video using the mnemonic UNMASKES to help improve delivery of difficult news by resident physicians at our institution and their patients.

Objective: To determine the impact of a short training video called UNMASKES in helping resident …

The Clinicodemographic Profile Of Multiple Sclerosis At Aga Khan University Hospital (Nairobi), Imran Jamal

Theses & Dissertations

Background: Multiple sclerosis (MS) is the leading cause of nontraumatic disability in young adults and is the most common immune-mediated inflammatory demyelinating disease of the CNS. MS was initially considered to be rare in sub-Saharan Africa (SSA). However, there have been reports of rising trends of MS in regions with previously low prevalence.

Objective: The primary objective of this study was to describe the demographic and clinical characteristics of MS patients at AKUHN.

Methods: Medical records of patients with MS at the AKUHN were obtained using the ICD 10 code search at the medical records section of …

Profile Of Cardiac Arrhythmia In Acute Stroke Patients, Julius Stephen Nkhondeya Msukuya

Theses & Dissertations

Introduction: Cardiac arrhythmias are common and can be fatal in acute strokes, but they are often under-recognized. The presence of cardiac arrhythmia in acute stroke doubles the mortality.

Objectives: This study aimed to determine the types of cardiac arrhythmia in acute stroke patients admitted in two urban hospitals in Dar es Salaam, The Aga Khan Hospital, Dar es Salaam and Muhimbili National Hospital. The secondary objectives were to determine the associations between the characteristic of stroke and cardiac arrhythmias as well as to determine the impact of cardiac arrhythmia on 30- days stroke outcomes.

Methods: This was a prospective longitudinal …

Outcomes Of Inpatients Hospitalized With Community Acquired Pneumonia, Jamila Nambafu

Theses & Dissertations

Background: The morbidity from lower respiratory tract infections has varied between age groups and from region to region. In sub-Saharan Africa, pneumonia remains the most frequent reason for adult hospitalization, with approximately 4 million episodes and about 200,000 deaths every year. Some of the attributable factors have been HIV pandemic, pulmonary tuberculosis, and poor socio-economic status.

Objective: The main objective was to determine the morbidity of community-acquired pneumonia in patients admitted to a tertiary hospital in Nairobi, Kenya, between May 2019, and March 2020. The results are anticipated to help in informing protocols for the evaluation and treatment …

Occult Hepatitis B Virus Infection In A Cohort Of Hiv Infected Antiretroviral Therapy Naïve Adults, Adil Suleiman Salyani

Theses & Dissertations

Background: Human immunodeficiency virus (HIV) and hepatitis B virus (HBV) are endemic to sub-Saharan Africa (SSA) with co-infection being common. Infection with HIV is a risk factor for occult hepatitis B virus infection (OBI), defined as presence of HBV deoxyribonucleic acid (DNA) in the absence of hepatitis B surface antigen (HBsAg). Occult hepatitis B virus infection is further classified based on HBV DNA level as true (/mL) or false (≥200 IU/mL). Presence of OBI is associated with development of liver cirrhosis and hepatocellular carcinoma (HCC).

Objectives: The primary outcome was to determine the prevalence of OBI in anti-retroviral therapy …