Search results for: Ezzaddin Rashid Hussein

Authors: Benjamin J. Kuo, Silvia D. Vaca, Joao Ricardo Nickenig Vissoci, Catherine A. Staton, Linda Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Lydia Nanjula, Christine Muhumuza, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

Abstract:

Background: Traumatic Brain Injury (TBI) is disproportionally concentrated in low- and middle-income countries (LMICs), with the odds of dying from TBI in Uganda more than 4 times higher than in high income countries (HICs). The disparities in the injury incidence and outcome between LMICs and resource-rich settings have led to increased health outcomes research for TBIs and their associated risk factors in LMICs. While there have been increasing TBI studies in LMICs over the last decade, there is still a need for more robust prospective registries. In Uganda, a trauma registry implemented in 2004 at the Mulago National Referral Hospital (MNRH) showed that RTI is the major contributor (60%) of overall mortality in the casualty department. While the prior registry provides information on injury incidence and burden, it’s limited in scope and doesn’t follow patients longitudinally throughout their hospital stay nor does it focus specifically on TBIs. And although these retrospective analyses are helpful for benchmarking TBI outcomes, they make it hard to identify specific quality improvement initiatives. The relationship among epidemiology, patient risk factors, clinical care, and TBI outcomes are still relatively unknown at MNRH. Objective: The objectives of this study are to describe the processes of care and determine risk factors predictive of poor outcomes for TBI patients presenting to a single tertiary hospital in Uganda. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Research Electronic Data Capture (REDCap) was used to systematically collect variables spanning 8 categories. Univariate and multivariate analysis were conducted to determine significant predictors of mortality. Results: 563 TBI patients were enrolled from 1 June – 30 November 2016. 102 patients (18%) received surgery, 29 patients (5.1%) intended for surgery failed to receive it, and 251 patients (45%) received non-operative management. Overall mortality was 9.6%, which ranged from 4.7% for mild and moderate TBI to 55% for severe TBI patients with GCS 3-5. Within each TBI severity category, mortality differed by management pathway. Variables predictive of mortality were TBI severity, more than one intracranial bleed, failure to receive surgery, high dependency unit admission, ventilator support outside of surgery, and hospital arrival delayed by more than 4 hours. Conclusions: The overall mortality rate of 9.6% in Uganda for TBI is high, and likely underestimates the true TBI mortality. Furthermore, the wide-ranging mortality (3-82%), high ICU fatality, and negative impact of care delays suggest shortcomings with the current triaging practices. Lack of surgical intervention when needed was highly predictive of mortality in TBI patients. Further research into the determinants of surgical interventions, quality of step-up care, and prolonged care delays are needed to better understand the complex interplay of variables that affect patient outcome. These insights guide the development of future interventions and resource allocation to improve patient outcomes.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, prospective registry, traumatic brain injury

Procedia PDF Downloads 205

Authors: Muhamad Rosdi Senam, Khairuddin Abdul Rashid, Azila Ahmad Sarkawi, Rapiah Mohd Zaini

Abstract:

Islam is a way of life than merely a religion that covers all facets of Muslim affairs and lifes. It provides the most comprehensive values, principles and guidance that are based on divine sources to all mankind in all spheres including leadership. Islamic leadership is all encompassing and holistic model of leadership that offers the tauhidic paradigm, spiritual and ethical (akhlaq) dimensions that are absent in the modern conventional leadership theories. Islamic leadership has a glorious history of great success from the era of the Prophet S.A.W. and the following caliphs that had conquered almost one third of the world territory during that time, as their leadership was paragon of excellence that followed to the spirits and teachings of the Qur’an and the Sunnah. As the modern civilisation designed by the West takes place, the modern leadership theories has been dominating the world and literature including those in the Muslim countries. However, it is clear that values and principles derived from Islam and the West are distinct, as the Islamic ones are based on divine, the non-Islamics are not indeed as there are based on human rational and judgement. Recent development in business organisations and literature have seen the tendency towards moral, ethical, even spiritual and positive form of leadership such as servant leadership, ethical leadership, authentic leadership and spiritual leadership that found its root in the Islamic model of leadership.This development has surfaced after series of serious ethical dilemma, corporate scandals and leadership crisis in the West. This paper aims to draw a comparative discussions and analysis between the modern conventional leadership theories with the Islamic leadership by highlighting the key dimensions that distinguish the two. It is suggested in this paper that the core dimensions of Islamic leadership are spiritual dimension, moral and ethical dimension and physical dimension which is also paralleled with the roles of khalifah of Allah on earth; relationship with Allah, relationship with human beings and relationship with the environment respectively. Islam is a way of life than merely a religion that covers all facets of Muslim affairs and lifes. It provides the most comprehensive values, principles and guidance that are based on divine sources to all mankind in all spheres including leadership. Islamic leadership is all encompassing and holistic model of leadership that offers the tauhidic paradigm, spiritual and ethical (akhlaq) dimensions that are absent in the modern conventional leadership theories. Islamic leadership has a glorious history of great success from the era of the Prophet S.A.W. and the following caliphs that had conquered almost one third of the world territory during that time, as their leadership was paragon of excellence that followed to the spirits and teachings of the Qur’an and the Sunnah. As the modern civilisation designed by the West takes place, the modern leadership theories has been dominating the world and literature including those in the Muslim countries. However, it is clear that values and principles derived from Islam and the West are distinct, as the Islamic ones are based on divine, the non-Islamics are not indeed as there are based on human rational and judgement. Recent development in business organisations and literature have seen the tendency towards moral, ethical, even spiritual and positive form of leadership such as servant leadership, ethical leadership, authentic leadership and spiritual leadership that found its root in the Islamic model of leadership.This development has surfaced after series of serious ethical dilemma, corporate scandals and leadership crisis in the West. This paper aims to draw a comparative discussions and analysis between the modern conventional leadership theories with the Islamic leadership by highlighting the key dimensions that distinguish the two. It is suggested in this paper that the core dimensions of Islamic leadership are spiritual dimension, moral and ethical dimension and physical dimension which is also paralleled with the roles of khalifah of Allah on earth; relationship with Allah, relationship with human beings and relationship with the environment respectively.

Keywords: conventional leadership, Islamic leadership, comparative, dimensions

Procedia PDF Downloads 497