Medicine and Health Sciences Commons^™

Exploring The Patients’ And Family Members’ Perspectives On Home-Based Palliative Care, Nadia Sultan Ali

Theses & Dissertations

Background: Home health care is considered as a partial substitute for institutional long-term care, because patients and families with known poor prognoses prefer to stay home with their loved ones and people mostly cannot bear the cost of care at the hospital. Therefore, the importance of home-based palliative care is raised via a shared and coordinated model for saving lives through care.
Purpose: To explore patients' and family members' perspectives and experiences of receiving home-based palliative care services.
Method: This was a qualitative exploratory study conducted in Karachi, targeting patients and family members receiving home-based palliative care services. The data …

Epidemiological Characteristics, Ventilator Management, And Clinical Outcome In Patients Receiving Invasive Ventilation In Intensive Care Units From 10 Asian Middle-Income Countries (Provent-Imic): An International, Multicenter, Prospective Study, Luigi Pisani, Anna Geke Algera, Ary Serpa Neto, Areef Ahsan, Abigail Beane, Kaweesak Chittawatanarat, Abul Faiz, Rashan Haniffa, Seyed Mohammadreza Hashemian, Madiha Hashmi

Department of Anaesthesia

Epidemiology, ventilator management, and outcome in patients receiving invasive ventilation in intensive care units (ICUs) in middle-income countries are largely unknown. PRactice of VENTilation in Middle-income Countries is an international multicenter 4-week observational study of invasively ventilated adult patients in 54 ICUs from 10 Asian countries conducted in 2017/18. Study outcomes included major ventilator settings (including tidal volume [V T] and positive end-expiratory pressure [PEEP]); the proportion of patients at risk for acute respiratory distress syndrome (ARDS), according to the lung injury prediction score (LIPS), or with ARDS; the incidence of pulmonary complications; and ICU mortality. In 1,315 patients included, …

Using Theories And Models For Operationalization Of Patient Trust In Doctors In Chronic Disease Response In Low Income Africa: ‘Best Fit Approach’, Kahabi Isangula

School of Nursing & Midwifery, East Africa

Background: Recent evidence suggest that improved patient trust in doctors can facilitate their healthcare seeking, adherence and continuity with care. With the growing burden of chronic disease in low income Africa (LIA) characterized by challenges of poor patient healthcare seeking, non-adherence and poor continuity with care, trust forms an important entry point for addressing these challenges. However, the topic of trust has generally received weaker attention among researchers in LIA contexts. To date, there has been no attempts to generate a clear guide for theory-driven inquiries as a means of operationalization of trust as a public health lens for chronic …

Important Steps To Maintain The Privacy Of Patients In The Hospital, Savera Aziz Ali, Minaz Mawani, Gulshan Bano, Sumera Aziz Ali

School of Nursing & Midwifery

Women are considered as vulnerable groups in our society in spite of their defined women rights by various laws. This shows that unfortunately these laws are not implemented practically in the real life. Society is shaped by the individuals and everyone should be responsible for advocating their own rights as well as the right of others especially of the vulnerable groups within the population.

Care Of The Dying Patient: A Neglected Issue In Pakistani Context, Waris Qidwai

Department of Family Medicine

No abstract provided.

Resistant Thyrotoxicosis In A Patient With Graves Disease: A Case Report, Taimur Saleem, Aisha Sheikh, Qamar Masood

Section of Diabetes, Endocrinology and Metabolism

Background: Conventional management of thyrotoxicosis includes antithyroid drugs, radioactive iodine, and surgery while adjunctive treatment includes beta-blockers, corticosteroids, inorganic iodide and iopanoic acid. Very rarely, patients may be resistant to these modalities and require additional management.

Case Presentation: A 50-year-old lady presented with weight loss and palpitations diagnosed as atrial fibrillation. Her past history was significant for right thyroid lobectomy for thyrotoxicosis. Thyroid functions tests at this presentation showed free T4 of 6.63 ng/dl (normal range: 0.93-1.7) and TSH of <0.005 μIU/mL (normal range: 0.4-4.0). She was given aspirin, propranolol, heparin and carbimazole; however free T4 failed to normalize. Switching to propylthiouracil (PTU) did not prove successful. She was then given high doses of prednisolone (1 mg/kg/day) and lithium (400 mg twice daily) which prepared the patient for radioactive iodine treatment by reducing free T4 levels (2.82 ng/dl). Two doses of radioactive iodine were then administered 6 months apart. Subsequently she became hypothyroid and was started on thyroid replacement therapy.

Conclusion: This case highlights management options in patients with resistant thyrotoxicosis. Radioactive iodine and surgery are definitive modes …