Medicine and Health Sciences Commons^™

Utility Of Free To Total Psa Ratio In The Prediction Of Prostate Cancer In Patients With Intermediate Total Psa Levels And Negative Digital Rectal Examination, Muthoni .J .F. Kirimi

Theses & Dissertations

Background: Prostate carcinoma is among the top 5 cancers occurring in Kenyan men. Prostate-specific antigen (PSA) is currently the most important biochemical marker for the diagnosis of prostate cancer and its widespread use as a serum tumor marker has revolutionized the management of patients with prostate cancer. The identification of early prostate cancer is vital in the management of especially men who have mild or vague prostatic symptoms. The most basic and important proxy for determining the need for a biopsy in both symptomatic and asymptomatic(screened) patients is the serum prostatic specific antigen (PSA).If a patients PSA level is above …

Primary Health Care Providers’ Knowledge And Practices On Asthma Management Within Dar Es Salaam Region Health Facilities, John C. Rwegasha

Theses & Dissertations

Background: Asthma is a common chronic health problem worldwide with considerable variation in the way it is managed. In the sub- Saharan Africa there is substantial gaps in asthma care; countries like Tanzania with inadequate health care structure are lagging far behind in both correct diagnosis and management of asthma. The increasing prevalence of asthma within populations is attributed to a number of the following factors; Patient behavior, Health service structure and access, Environmental factors and Provider's knowledge and practices. There is lack of required standard asthma care under provider's factors, hindering effective control of the disease. This could be …

A Randomised Comparative Clinical Trial Of Prokinetic Agents And Proton Pump Inhibitors In H. Pylori Negative Non-Ulcer Dyspepsia, Mzee Ngunga

Theses & Dissertations

Aim: To compare the efficacy of prokinetic agents and proton pump inhibitors in symptom relief of patients with non-ulcer dyspepsia.

Design: Comparative prospective single blind clinical trial.

Patients and setting: Fifty four cases of non-ulcer dyspepsia in whom H. pylori has been eradicated were seen in the specialist gastroenterology clinic of a tertiary care hospital.

Methodology: Patients with dyspepsia and negative endoscopy for peptic ulcer disease, gastro-oesophageal reflux disease, hiatus hernia and upper gastrointestinal malignancy in whom H pylori has been eradicated but still had dyspepsia were assessed and scored using the modified Glasgow dyspepsia severity score (GDSS) at baseline. …

Day Care Surgery At A New University Teaching Hospital: A Review Out Of The Aga Khan University Hospital, Nairobi, Edwin Mogere

Theses & Dissertations

Introduction: Day Care Surgery (DCS) is the surgical care of patients on a planned non-residential basis. The objective of the study was to assess the performance of DCS in the context of a developing country within the private sector. Data from a new DCS unit was compared to internationally accepted indicators of the quality of care.

Methodology: A hospital based retrospective chart review of all patients operated on within 10 surgical subspecialties was performed. The review period was the June 2006 to July 2007(12 months).

Analysis (SPSS version 11.5): Outcome measures included in-patient to DCS ratio in the various specialties; …

Evaluation Of Suspected Renal Colic Patients With Unenhanced Low-Dose Multidetector Computed Tomography (Mdct), Nebayosi Twahirwa

Theses & Dissertations

Acute renal colic is probably one of the most excruciatingly painful event a person can endure. [1]. Though this is typical of urinary tract calculi, it’s important to note that non-calculus and non-genitourinary conditions can present in a similar manner. Unenhanced helical CT (CT KUB), originally described by Smith et al [2] in 1995, is one single radiological test that has proven successful in the valuation of patients presenting with renal colic. This technique has been shown to be more accurate compared to abdominal radiography [3,4], ultrasound and has replaced excretory urography in the detection of urinary tract calculi in …

Prevalence, Risk Factors And Outcome Of Acute Kidney Injury At The Aga Khan University Hospital Nairobi, Peter W. Munyu

Theses & Dissertations

Introduction: Acute kidney failure (acute kidney injury, AKI) is a group of syndromes that result in a decline in the glomerular filtration rate. In 2002, the Acute Dialysis Quality Initiative (ADQI) group proposed the RIFLE criteria to standardize the definitions of AKI severity and outcome. This criterion has been validated in several studies. AKI is frequently encountered in hospitalized patients; it has a negative impact on mortality and morbidity. A lot of work has been done to describe the epidemiology of AKI in developed countries. The same does not apply for developing countries. This study was designed to evaluate AKI …

Diabetes Prevention Education For Mexican American Women With Gestational Diabetes: Pilot Testing A Videotape, Carol Anne Easton

Theses & Dissertations

The purpose of this study was to examine the effect of a culturally sensitive educational videotape on the knowledge of prevention of Type 2 diabetes after pregnancy, in pregnant gestational diabetic (GDM) women over 18 years old, who attended the Diabetes in Pregnancy Program at a university health center in a large southwestern city. Mexican American GDM women have a high risk for Type 2 diabetes, 80% in 5 years if their diabetes status is reclassified pre-diabetes or impaired glucose tolerance during their early postpartum exam (Kjos. 1995). But the return-to-clinic rate for the women who attend this clinic is …

Self-Efficacy In Type 2 Diabetics, Joan M. Hyett

Theses & Dissertations

There are 1.2 million diagnosed diabetics in Texas, 10 % of whom live in Bexar County, Texas. Diabetes is rated as the fifth leading cause of death in the same county. In addition to the diagnosed cases, it is estimated that 125,000 adults in Bexar County have undiagnosed diabetes (Foy, 1999). Diabetic education may prevent complications in some individuals, but sometimes knowledge alone is not enough. Patients often lack motivation or self-confidence in their capacity for self- management of their diabetes. Diabetic educators are often faced with the challenge of not only educating but also motivating patients to be compliant …

Stress Experienced By Respite Care Workers And Family Caregivers When Caring For Alzheimer's Patients, Monica D. Minewiser

Theses & Dissertations

Changing demographics and cost containment in health care in caring for the Alzheimer's Disease (AD) patient has given birth to a growing need for respite care workers. The purpose of the study was to determine whether the stress level of a respite care worker who works with an AD patient in a noninstitutionalized setting on a daily basis will be significantly less than that of a family caregiver when caring for an AD patient. The Revised Memory and Behavior Problem Checklist (RMBPC) was the instrument used to measure stress. This is a questionnaire consisting of 24 questions and allows 5 …

Can Target Volume Breathing Exercises Taught Preoperatively Decrease Postoperative Pulmonary Complications For Cardiac Surgery Patients?, Lea Sol Lopez-Fagin

Theses & Dissertations

Postoperative pulmonary complications and management are recognized as major problems following coronary artery bypass graft and valve repair surgery. Pulmonary complications include hypoxemia, reduction in air volume capacity, atelectasis, fever, tachycardia, tachypnea, and pneumonia. However, little is known about specific therapeutic interventions in nursing related to the amelioration of postoperative pulmonary complications in cardiac surgical patients. The study evaluated the outcomes of preoperative teaching of target volume breathing exercises in the prevention of hypoxemia and reduction of lung volume capacity for coronary artery bypass graft (CABG) and valve repair patients. Thirty-four patients aged 50-77 years undergoing CABG or valve repair …

The Effectiveness Of A Preoperative Patient Education Handbook In Decreasing Anxiety Of Veterans Undergoing Elective Surgery, Garletta White Steen

Theses & Dissertations

The purpose of this experimental, pretest/posttest study was to examine the effectiveness of a preoperative patient education handbook developed by postanesthesia care unit (PACU) nurses in decreasing state anxiety of veterans undergoing minor elective surgery. State anxiety was measured by the State Anxiety Scale of the State-Trait Anxiety Inventory, developed by Spielberger, Gorsuch, Luschene, Vagg, and Jacobs (1983). The population for the study was composed of veterans undergoing elective surgery in a hospital which is part of the South Texas Veterans Healthcare System. The sample consisted of 38 patients admitted to the hospital for a variety of minor elective surgeries. …

The Impact Of A Health Education Program On The Attitudes Of African-American Hypertensive Clients Regarding Adherence To A Prescribed Medical Regimen, Teresa Y. Mcpherson

Theses & Dissertations

This quasi-experimental study examined the effect of an educational program on the attitudes of hypertensive African-American clients regarding their adherence to a prescribed medical regimen.

Despite increased public awareness and improved treatment in hypertension, poorly controlled hypertension continues to be a significant problem especially among blacks and other minority populations in the United States (Shea, Misra, Ehlich, Field, & Francis, 1991). On the basis of different experiences, people may form different beliefs and, therefore different attitudes about the consequences of performing or not performing a behavior (Ajzen & Fishbein, 1980). Studies have indicated that a variety of factors such as …

The Effect Of Cardiac Rehabilitation On Quality Of Life, Anxiety, And Self-Care In Coronary Artery Disease Patients, Susan Susskind Wilkinson

Theses & Dissertations

This study was designed to explore the effect of cardiac rehabilitation program participation on anxiety, quality of life, and self-care among coronary artery disease patients.

Major lifestyle changes are required after a person experiences an acute coronary event. Rehabilitation programs for coronary artery disease patients are designed to assist the patient with these lifestyle changes by altering the survivor's self-care patterns and improve long-term physical and psychological outcomes. By coordinating education, counseling, and exercise programs, the nurse can help individuals move toward a maximal physiological, psychological, social and vocational recovery. This study was designed to explore the effect of cardiac …

Spirituality Among Terminally Ill Hospitalized Adults And Healthy Non-Hospitalized Adults In A Military Environment, Richard M. Holt

Theses & Dissertations

The purpose of this study was to identify whether or not terminally ill hospitalized adults indicated greater spirituality and well-being than healthy non-hospitalized adults. Reed's (1986b & 1987) studies are the bases for this treaty although this is not a replicate study. The conceptual framework of this research is founded on the developmental life-span, and energy field patterns (Rogers, 1980) impacting spirituality and well-being. It was hypothesized that terminally ill hospitalized adults indicate greater spirituality than healthy nonhospitalized adults in a military environment. A terminally ill and healthy adult group of N=30, (n=15 each) were selected for a convenience sample. …

The Effect Of A Self Directed Program On Locus Control And Control Of Diabetes, Mary Elizabeth Boyle

Theses & Dissertations

Does a self directed program have a significant impact on an individual's locus of control and the control of diabetes as measured by glycosolated hemoglobin?

The Effects Of Atropine On The Growth And Respiration Of Two Species Of Bacteria Normally Inhabiting The Human Gastro-Intestinal System, Mary M. Ramos

Theses & Dissertations

It is the purpose of this study to determine whether the drug atropine has an effect on bacteria found normally inhabiting the human body, most specifically the gastrointestinal system. Atropine is one of the oldest drugs in medicine. It is derived from the roots and leaves of solanaceous plants such as henbane and Jimson weed. Atropine is often termed a belladonna alkaloid because it can also be found in the deadly nightshade plant, Atropa belladonna. Atropine is a highly competitive antagonist of acetylcholine at receptor sites in smooth muscles, cardiac muscle, and various glandular cells (5). Therefore, its effects are …