Theses and Dissertations

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Browsing Theses and Dissertations by Subject "Amana hospital"

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    Assessment of partogram filling practices and its associated effect on labour outcome to low-risk pregnant women delivering at Amana hospital, ilala Municipality, Dar es salaam, Tanzania. from 1st April 2012 – 31st December 2012.
    (Hubert Kairuki Memerial University, 2012) Bakengesa, Victor K.
    Background: The World Health Organization has been advocating the use of Partograph as a necessary tool in the management of labour and recommends its universal use during labour. However, some health-care practitioners, especially in high-income countries, have questioned its effectiveness. Objective: The aim of this study was to assess Partogram filling practices and its associated effect on labor Outcomes to Low risk Pregnant women. Materials and Methods: This Cross sectional comparative study with a prospective follow up of Labor and Delivery till twenty four hours post delivery was conducted from April to December 2012 to women who delivered at Amana Municipal Hospital, Ilala district, Dar-es-salaam. The Partographs from attached Case Notes and Antenatal Cards were retrieved and reviewed for the necessary information including partogram filling components and the labor outcomes (Maternal and Fetal outcomes). A total of 1249 Patients were recruited in the study and only 702 Patients/Partographs were available for analysis. The rest were lost to follow up, some left before twenty four hours and others had misplaced Partographs. Results: A total of 661 (94.2%) Partographs were incompletely filled. In this study it was revealed that all participants with Bad Maternal Outcomes had incomplete Partograph and result was significant at (p<0.05). This was not true for fetal outcomes which showed no statistical significance. Assessment of Contractions once every four hours intervals 423(60.3%) and taking blood pressure at least once every hour 658(93.7%) were the most Partograph components which were not done. Ninety four percent (94%) with Perineal tears and eighty nine (89%) with Postpartum hemorrhage; the contractions component was not assessed as needed for at least once in 4 hours intervals (p<0.0001). The results also showed that out of 702 Participants, 89(12.7%) crossed the Action Line before delivery. The main clinical decision made after crossing the Action Line was Augmentation 60 (64%) and Caesarean Section 21 (23.6/o). Conclusions and Recommendations: The study revealed that Partograph tool was not properly filled and therefore the outcome of that Malpractice was associated with Bad maternal outcomes though didn't show significant association with fetal outcomes in Low risk Pregnant Women. Despite the above findings the health-care practitioners should not be discouraged from the utilization of the Partograph to reduce poor Maternal outcome and Fetal Outcome as well.
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    Magnitude and factors contributing to occurrence of upper gastrointestinal bleeding at Amana hospital, Dar es Salaam from March 2010 to June 2011.
    (Hubert Kairuki Memorial University, 2012) Muhumba, Erick K.
    OBJECTVE: Very few epidemiological upper gastrointestinal bleeding (UGIB) surveys have been done. However, information about the current epidemiology of UGIB in Tanzania is not known. The aim of this study was to determine the magnitude and factors contributing to occurrence of upper gastrointestinal bleeding. METHODS: From March 2010 to June 2011, 394 participants consecutively attended at endoscopic unit at Amana regional referral hospital were prospectively included. Data were collected prospectively with a standard questionnaire and included demographic as well as specific data relating to UGIB. RESULTS: Among all participants 21.6% presented with UGIB, male patients were most affected by 59.1%. Varices were the commonest cause of UGIB accounting for 36.5% of all causes followed by erosive mucosal disease (esophagitis, gastritis and duodenitis) for 30%. In 10% of patients with UGIB no diagnosis could be made at the endoscopy. CONCLUSIONS: The magnitude and proportional of the causes of UGIB is similar to other African and Indian studies, but different from those for the Europe and United States. Bleeding could have been prevented if people at risk and symptoms do endoscopy early.