44 research outputs found
Adequacy of Hemodialysis and Its Associated Factors among Patients Undergoing Chronic Hemodialysis in Dar es Salaam, Tanzania
No full textThe worldwide prevalence of maintenance hemodialysis continues to rise. An adequate delivery of hemodialysis dose as measured by Kt/V or urea reduction ratio is a crucial determinant of clinical outcome for chronic hemodialysis patients. )e aim of this study was to assess the adequacy of hemodialysis and its associated factors among patients undergoing chronic hemodialysis in Dar es Salaam. )is was a cross-sectional study done on patients undergoing chronic hemodialysis in four dialysis centers in Dar es Salaam. Sociodemographic information and treatment characteristics were collected. Urea reduction rate and single-pool Kt/V were calculated to determine the adequacy of hemodialysis. )e data were analyzed and any associated factors for inadequate hemodialysis were determined using a chi-square test and a logistic regression analysis. A total of 143 patients participated in the study. Males represented 65.7% of the study population. )e mean age (±SD) was 51.7 ± 1.2 years. Only 34.3% (based on urea reduction ratio (URR)) and 40.6% (based on Kt/V) of patients received adequate hemodialysis. )e univariate analysis showed that males were more likely to have inadequate dialysis (65.6% versus 48.0%, p = 0.048 based on Kt/V). Patients using hemodialyzers with dialyzer surface area less than 1.4 m2 received significantly less hemodialysis dose than those with more than 1.4 m2 (69.0% versus 41.2%, p = 0.02, by URR) (62.7% versus 35.3%, p = 0.03, by Kt/V criteria). Patients who had hemoglobin \u3c10 g/dl received significantly inadequate hemodialysis dose as compared to patients with hemoglobin ≥10 g/dl by Kt/V criteria (69.8% versus 51.3%, p = 0.03). None of the factors acquired significance in the multivariate analysis. )e proportion of patients receiving an adequate hemodialysis dose is low (34.3% based on URR and 40.6% based on Kt/V). Male gender, dialyzer surface area of \u3c1.4 m2 , and hemoglobin level of \u3c10 g/dl were associated with an inadequate delivered dose of hemodialysis in the univariate analysis but not in the multivariate analysis. )is study can increase awareness about the importance of measuring hemodialysis adequacy and giving the correct hemodialysis dose to achieve the intended benefit
Left out: essays on suburbia
No full textThis collection of essays examines the aesthetic of uniformity and order prevalent in planned, suburban housing developments. It utilizes both personal experience and research to examine the effect this aesthetic has on the suburbanite. It relates stories from the author�s childhood that attempt to illustrate the homogenizing effects of the suburban aesthetic and relates the author�s current sensibilities, attempting to relate them to his upbringing.Autobiographical essays
Managing diversity and gender equality in the workplace
No full textNow a day’s world is growing globalization which require more interaction among people from the diverse range of backgrounds (Green et al., n.d.). Diversity management is a method which is intended to create and helps to maintain a positive work environment where similarities and differences of people are respected and valued (Patrick and Kumar, 2012). The literature on diversity management has mostly emphasized on organization performance and organizational context of diversity related pressures, expectation, requirements and organizational outcomes in managing employee diversity and related issues (Patrick and Kumar, 2012). Diversity and equality are interconnected to each other; the main objectives of diversity and gender equality is every individual have set of rights, opportunity and fair treatment in the workplace (Diversity Inc, 2016). Moreover, the objective of the author is to highlight the importance of managing diversity and equality in the workplace. Organization capabilities to welcome managing diversity and equality (Sharma, 2016). It describes the benefits of learning policies and procedures which will ensure that an organization is optimizing the best learning capacity in the workplace (Moss, 2010). Whereas, working in diverse group or team help in achieving the goals and objectives of the workplace. The diverse workforce provide organization with competitive advantage and enhance organizational adaptability to accept change in the organization (Zanoni et al., 2010). Diversity and gender equality which define as giving equal rights to all men and women who shares the same workplace. The working style of men and women are different, but they can come with different innovative ideas and perspective at a same point. To implementing diversity; organization has faced many challenges which should be overcome to implement effective diversity in the workplace. Diversity can be improving employee performance and organization effectiveness. However, it is difficult to manage diverse work population which involves recognizing the value of differences, promote inclusiveness and battling with discrimination (Green et al., n.d.). And the challenges faced by women in the workplace. The study concludes that successful managing diversity can leads to better satisfied, more committed and better performance of the organization and would be helpful for producing an effective output (Patrick and Kumar, 2012). The study is focusing on the questions why and how a managing diversity and equality can improve the performance of any workplace. What could be the potential benefits of managing diversity in any workplace. What are challenges faced by women in the workplace. To answer these questions, author has chosen this research topic:
“Managing diversity and gender equality in the workplace
Frequency, predictors and outcomes of intradialytic complications in patients on maintenance haemodialysis in Dar es Salaam: Prospective longitudinal study.
No full textIntroductionHemodialysis is a crucial renal replacement therapy option for end stage renal disease (ESRD) patients. Currently, there is a rise of patients who require hemodialysis with concurrent rise in intradialytic complications which can potentiate several outcomes some of which are life threatening. This study assessed the frequency, predictors, and outcomes of intradialytic complications amongst ESRD patients on maintenance hemodialysis.MethodologyProspective longitudinal study using self-designed questionnaires including patient's demographic data and relevant past medical history, pre-hemodialysis assessment and intra-dialysis monitoring was done for 2 months at Aga Khan Hospital and Muhimbili National Hospital, in Dar es salaam, Tanzania.Results215 patients were enrolled, of which 138(64.2%) were males with mean age 57(SD 15.37), height 1.64(SD 0.08) and weight 69.27(SD 12.62). Most patients 197(91.6%), were on thrice weekly schedule of which the duration of each session in most patients 206(95.8%) was 4 hours. Diabetes mellitus was the most common etiology of ESRD 126 (58.6%), ArterioVenous fistula (AVF) was the most common vascular access for the procedure 90(41.9%) and mostly, high flux dialyzers were used, FX100 & FX80, (211, 98.2%). There was a statistically significant association between pre-dialysis vital signs, blood flow rate and sex (p value ConclusionHemodialysis is a life-saving procedure with multiple complications of which some have detrimental outcomes. Nonetheless, having a good understanding of the factors associated with the complications, appropriate management and ways of preventing them will remarkably improve the procedure and make it a safer renal replacement modality. Carefully, monitoring pre-dialysis vitals and taking necessary measures when deranged, individualized proper machine settings, sufficient fluid removal and standard blood flow rate may improve the dialysis procedure
Endobronchial Tuberculosis: A Rare Presentation
No full textEndobronchial tuberculosis (EBTB) is an infection of the tracheobronchial tree by Mycobacterium tuberculosis. It is common among young females. Patient can present with fever, cough, wheeze, with or without any constitutional symptoms. It presents as a diagnostic dilemma, as patient sputum smear can be false negative. CT scan may or may not show any abnormality, or any endobronchial lesion. Bronchoscopy with bronchoalveolar lavage and biopsy offers the diagnostic choice. We hereby report a case of a young immunocompetent Asian female who was found to have endobronchial pathology, leading to diagnosis and timely therapy
Sakuntala Narasimhan. Empowering Women: An Alternative Strategy from Rural India. New Delhi: Sage Publications, 1999. Indian Rupees 195.00. (Paperback). 236pp.
No full textThe positive role of women in economic development cannot be
understated; those that are educated and properly empowered can act as
catalysts in the development process. This book is about how to empower
women so that they can become independent and self-sustaining actors in
development. The conventional wisdom is that womens’ empowerment depends
on following a simple strategy—alleviate poverty by spending large
amounts of money. Having followed this strategy in the past the author
feels that it has been far from successful. Monetary inputs by itself is
not a sufficient condition to assist women in improving their status.
The author puts forward an alternate view that the reasons why women are
disadvantaged in India, despite fifty years of development, is due to
their ignorance, powerlessness and vulnerability. This is particularly
so for those women who belong to the Scheduled Castes (Harijans) and
Scheduled Tribes (Girijans or “mountain people”)
Invasive liver abscess syndrome caused by Klebsiella pneumoniae: first Tanzanian experience
No full textOver the past 20 years there has been growing awareness of community-acquired primary liver abscess caused by strains of Klebsiella pneumoniae (K. pneumoniae) especially in patients of Asian descent, a minority of which are characterized by metastatic spread. A common and frequent destructive complication is endophthalmitis as well as the involvement of the central nervous system (CNS), causing suppurative meningitis or brain abscess. Here we report a case of invasive liver abscess caused by K. pneumoniae in an Asian patient who presented to our hospital in Tanzania with bilateral lower limb swelling for 6 weeks with acute onset of difficulty in breathing
Factors Associated with Mortality Among Hospitalized Adults with COVID-19 Pneumonia at a Private Tertiary Hospital in Tanzania: A Retrospective Cohort Study
No full textNadeem Kassam,1 Eric Aghan,2 Omar Aziz,1 Hanifa Mbithe,1 Kamran Hameed,1 Reena Shah,3 Salim Surani,4 James Orwa,5 Samina Somji1 1Internal Medicine, The Aga Khan Hospital, Dar es Salaam, Tanzania & Aga Khan University, Medical College, Dar-es- Salaam, Tanzania; 2Family Medicine, The Aga Khan Hospital, Dar es Salaam, Tanzania & Aga Khan University, Medical College, East Africa, Dar-es-Salaam, Tanzania; 3Infectious Disease & Internal Medicine, The Aga Khan University, Medical College, Nairobi, Kenya; 4Pulmonology & Internal Medicine, Texas a&m University, Texas A&M College Station, TX, USA; 5Population Health, Aga Khan University, Medical College, East Africa, Nairobi, KenyaCorrespondence: Nadeem Kassam Email [email protected]: The emergence of the novel coronavirus disease 2019 (COVID-19) has caused millions of deaths worldwide. There has been paucity of data for hospitalized African patients suffering from COVID-19. This study aimed to identify factors associated with in-hospital mortality in patients suffering from COVID-19 in Tanzania.Methods: This was a single center, retrospective, observational cohort study in adult patients hospitalized with confirmed COVID-19 infection. Demographics, clinical pattern, laboratory and radiological investigations associated with increased odds of mortality were analyzed.Results: Of the 157 patients, 107 (68.1%) patients survived and 50 (31.8%) died. Mortality was highest in patients suffering with severe (26%) and critical (68%) forms of the disease. The median age of the cohort was 52 years (IQR 42– 61), majority of patients were male (86%) and of African origin (46%), who presented with fever (69%), cough (62%) and difficulty in breathing (43%). Factors that were associated with mortality among our cohort were advanced age (OR 1.07, 95% CI 1.03– 1.11), being overweight and obese (OR 9.44, 95% CI 2.71– 41.0), suffering with severe form of the disease (OR 4.77, 95% CI 1.18– 25.0) and being admitted to the HDU and ICU (OR 6.68, 95% CI 2.06– 24.6).Conclusion: The overall in-hospital mortality was 31.8%. Older age, obesity, the severe form of the disease and admission to the ICU and HDU were major risk factors associated with in-hospital mortality.Keywords: COVID-19, factors, hospital, mortality, Tanzani
Prevalence & Factors Associated With Acute Kidney Injury in Patients Undergoing Percutaneous Coronary Intervention at a Tertiary Healthcare Facility in Tanzania
No full textBackground: Coronary artery disease (CAD) is the leading cause of mortality and morbidity globally. Percutaneous coronary intervention (PCI) is a minimally-invasive lifesaving intervention for these patients; however, acute kidney injury (AKI) is a serious complication of the procedure commonly occurring due to radiocontrast-induced nephropathy.
Methods: A retrospective cross-sectional analytical study was carried out at the Aga Khan Hospital, Dar es Salaam (AKH,D), Tanzania. A total of 227 adults who underwent a percutaneous coronary intervention from August 2014 to December 2020 were enrolled. The AKI was defined based on an increase in absolute and rise in percentage creatinine using the Acute Kidney Injury Network (AKIN), and contrast-induced acute kidney injury (CI-AKI) by the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Bivariable and multivariable logistic regression was utilized to analyze factors associated with AKI and the outcomes of these patients.
Results: Twenty-two of the 227 (9.7%) participants sustained AKI. The majority of the study population was male and of Asian ethnicity. No statistically significant factors were associated with AKI. The in-hospital mortality rate was 9% for the AKI versus 2% for non-AKI groups. The AKI group had a longer hospital stay and required ICU care and organ support including hemodialysis.
Conclusions: Nearly 1-in-10 patients undergoing PCI are likely to develop AKI. The in-hospital mortality rate is x4.5 times higher for patients with AKI post-PCI compared to those without AKI. Further larger studies are recommended to determine factors associated with AKI in this populatio
Travelogue "Butterfly Rays and Tornadoes" Intellectual Review
No full textTravel is part of human nature. He wants to get acquainted with the culture and way of life of
the place where he is traveling. The First travelogue is “Ajaibat e Farang” the author of which
is Yousaf Hussain Kambal posh. After him Sir Syed Ahmed khan, Allama Shibli Noumani and
Muhammad Hussain Azad also wrote travelogues. The twinth century remained popolur
because of travel. Travelogues of Shafiq ur Rehman, Ibn e Insha and Begum Akhtar Riaz ud
Din came to light during this period. Women travelogues Sheen Farukh, Bushra Rehman and
Parveen Atif. Parveen Atif wrote two Urdu travelogues “Kiran Titli Or Bagoly” and “Taper
Wasni”.Her travelogues are beautiful gift in intellectual terms.
 
