The predictive value of the preoperative diagnostic tests in mature cystic teratomas of the ovary
Published on: 19th December, 2018
OCLC Number/Unique Identifier: 7964734669
Aim: The aim of this study was to determine the sensitivity of the tumor markers and diagnostic methods used in the preoperative period for dermoid cysts, the most common benign neoplasm of the ovary.
Material and Methods: 136 patients who were operated for any reason and reported as ovarian dermoid cyst in the Department of Obstetrics and Gynecology, Ankara Atatürk Training and Research Hospital between January 2004 and September 2005 were included in the study. The medical records of the cases were obtained retrospectively from Ankara-Atatürk Training and Research Hospital, HIS, archive files and patient numbers where necessary.
Results: In the preoperative period, 119 patients underwent ultrasonographic examination, 33 underwent Computed Tomography, and 17 underwent Magnetic Resonance Imaging.10 of the cases only underwent CT, while 3 of the cases underwent only MRI 22 of them underwent both USG and CT, USG and MRI were performed on 13 cases and only 1 case underwent all three of the imaging methods. Tumor markers were CEA, CA 125, CA 19-9, CA 15-3 and AFP.
Conclusions: The reviews of ultrasonography and / or computed tomography and / or magnetic resonance imaging (n = 132) revealed that 103 of the cases were put into operation and the sensitivity of the preoperative screening methods were calculated to be 75.5%. The sensitivity of the tumor marker CA 19-9 was calculated to be 31%.
Immediate postplacental insertion of intrauterine contraceptive device (copper 375) and its complications in term of expulsion, infection and perforation
Published on: 27th December, 2018
OCLC Number/Unique Identifier: 7964701690
Objective: To determine the complications (infection, perforation and expulsion rate) of immediate postplacental insertion of intrauterine contraceptive device (Multiload Copper375) in postnatal patients.
Methods: A case series study was conducted between October 28, 2014 to April 30, 2018 in obstetrics and gynaecology department, Civil Hospital Karachi,-+ Informed consent was taken. Intrauterine contraceptive device (Multiload) was inserted immediately within 10 min after delivery of placenta. These women were observed to determine outcome (infection, perforation and expulsion) at the time of discharge and 6 weeks postpartum. Absence of all these were taken as satisfactory outcome.
Results: A total of 435 women were included in this study. 165 (38%) were delivered through cesarean section and 270 (62%) were delivered through vaginally. There were 36 (8.3%) cases of infection. The cumulative rate of expulsion and perforation at the end of sixth week of post insertion was 39 (9%) and 0% respectively and 360 (82.8%) had satisfactory outcome. Post-placental placements during cesarean delivery are associated with lower expulsion rates than post-placental vaginal insertions without increasing rates of postoperative complications like perforation, slightly increase infection rate following vaginal delivery.
Conclusions: Immediate postpartum insertion of IUCD is an effective, safe and easily reversible method of contraception. Rates of the complications (Infection, expulsion and perforation) are remarkably low.
Utilization of post abortal contraceptive use and associated factors among women who came for abortion service at Debre Berhan Hospital, Debre Berhan, Ethiopia March 2019: Institution based cross sectional study
Published on: 20th June, 2019
OCLC Number/Unique Identifier: 8193601650
Background: Post abortion family planning (PAFP) is the initiation and use of family planning methods immediately after, and within 48 hours of an abortion, before fertility returns. In most women fertility returns on average about two weeks after an abortion; however, ovulation can occur as early as 11 days post-abortion.
Objective: To assess utilization of post abortal contraceptive use and associated factors among women who came for abortion service at Debre Berhan Referral Hospital, Debre Berhan, Ethiopia March 2019.
Methodology: Institutional based cross sectional study design was conducted using hospital data obtained from Gynecology ward in Debre Berhan Referral Hospital, Debre Berhan, Ethiopia, from March 1 -10, 2019. A systematic random sampling technique was used from the abortion register log book. Data was cleaned manually, coded and entered into Epi-data version 3.1 then exported to and analyzed by SPSS version 21 software. Multivariate analysis with AOR, 95% CI and p-value< 0.05 were used to identify variables which have significant association.
Result: The finding of the current study showed that among 371 study subjects 170(45.8%) utilized post abortal family planning. There was a significant association between utility of post abortal family planning and post abortion family planning counseling [AOR: 19.245, 95% CI: (10.199, 36.313), p-value= 0.001] and women who were primiparous had 5 times more likely to utilize post abortal family planning as compared to the women who were nullyparous [AOR: 5.314, 95%CI (1.089, 24.210), p value=0.001].
Conclusion and Recommendation: From a total of 371 study subjects 45.8% have utilize contraceptive after abortion service received. This study also showed that parity and counseling’s of family planning were statistically significant associated with utilization of post abortal family planning. We recommend Debre Berhan hospital to scale up activities on post abortal care to increase the number of clients who post abortal family planning.
Anal cytology in immunocompetent patients with high-grade intraepithelial neoplasia (CIN II and CIN III)
Published on: 13th February, 2020
OCLC Number/Unique Identifier: 8550959427
Introduction: Anal cancer is directly related to the presence of high-grade HPV. Immunocompromised patients have defined conducts, something which is not observed in immunocompetent patients.
Objective: To study the anal cytology of patients with high-grade intraepithelial neoplasia (CINII and III) in order to propose a protocol to be followed by the Oncology Gynaecology Service at the Samuel Libânio Clinical Hospital (HCSL).
Methods: Clinical, prospective, transversal and single-centered study. Sampling was by convenience within one year. A total of 150 patients were studied. Out of these, 76 were patients with high-grade cervical intraepithelial lesions diagnosed through histopathological examination of the uterine cervix (Study Group) and 74 without high-grade intraepithelial lesions and with cervical cytology negative for neoplasia (Control Group). The following variables were analyzed: age, sexarc, tobacco use, alcohol consumption, STD history (not HPV), menopause, Hormone Replacement Therapy, anal sex practice, parity, number of sexual partners and contraceptive use.
Results: There was no significant difference between the number of cases in altered anal cancer oncology in the study group, in comparison with the control group.
Conclusion: There were changes in the anal cytology of the study group and these should be evaluated due to the risk of dealing with pre-neoplastic anal lesion. Clinical Trials: NCT03241680.
Trial of labor after cesarean outcomes with excessive gestational weight gain
Published on: 6th May, 2020
OCLC Number/Unique Identifier: 8601973455
The success of vaginal birth after cesarean section (VBAC) has been correlated with a variety of maternal characteristics such as age, ethnicity, and body mass index (BMI, calculated as weight in kilograms divided by height in meters squared). The patient’s BMI just prior to delivery has been shown to be a better prognostic indicator of success than pre-pregnancy BMI. Gestational weight gain was previously associated with a decreased rate of successful VBAC. More recent research has not supported such an association. The objective of our study was to further validate these findings with a larger population.
We performed a retrospective cohort study of women undergoing trial of labor after cesarean (TOLAC) at our institution from January 2010 to December 2019. Women were divided into three groups based on weight gain in pregnancy as compared to the American College of Obstetrics and Gynecology (ACOG) recommendations (i.e. < 25 pounds (lbs), 25-35 lbs, > 35 lbs). We further subdivided the pregnancies between term and preterm deliveries. The primary outcome was a successful VBAC. Of 1087 patients attempting a TOLAC, 772 (71%) were successful and 315 (29%) failed VBAC. When grouped according to ACOG weight gain recommendations, 303 (31%) women were below ACOG guidelines, 318 (33%) met guidelines, and 339 (35%) exceeded guidelines. There was no difference in the rate of VBAC success among the three groups. When counseling patients, providers should still promote healthy dietary habits but should not correlate excess weight gain with chance of TOLAC success.
Pregnancy and childbirth in women aged 40 and over at befelatanana maternity, Madagascar
Published on: 24th December, 2019
OCLC Number/Unique Identifier: 8501548256
Objective: Pregnancy after age 40 remains a concern as it exposes to particular obstetrical complications. Our study aims to determine the risks of complications related to pregnancy and childbirth of women aged 40 and over.
Study design: We carried out a cross-sectional analytical study of a historical cohort comparing the progress and the outcome of pregnancy in women 40 years of age and over to those aged 20 and 35 who gave birth at the University Hospital of Obstetrics and Gynecology in Befelatanana, from 1st January 2010 to 31 December 2013.
Results: The prevalence of childbirth among 40 years old and over was 0.61%. They were multiparous and large multiparous in 88% of the cases. The analysis showed that parturients aged 40 years and older were at significant risk for caesarean section, with three times the risk of emergency caesarean section. The frequency of this emergency caesarean section increased with parity ((RR = 3.04 [2.15-4.30], p = 10-10). Among their neonates, 23.42% were hypotrophic, 22.86% premature, 12% asphyxiated at birth, 13.14% admitted to neonatal resuscitation and 5.71% died in utero, but without significant difference with the group unexposed. Perinatal death was 7.43% in women aged 40 and over vs. 4% in 20 to 35 year olds ((RR = 1.85 [0,89-3,86]; p 0.052).
Conclusion: We found that pregnancies after 40 years were not exposed to pregnancy-related pathologies or specific fetal complications. The use of an emergency cesarean is, however, frequent.
Establishment of a new reference line for 2D transperineal ultrasound in urogynecology
Published on: 8th September, 2020
OCLC Number/Unique Identifier: 8668612645
Background: The purpose of this study was to establish a new, reliable and reproducible reference line for assessing bladder neck descent using 2-dimensional transperineal ultrasound. Therefore, we created a novel line, named Symphysis-Levator Line (SLL) and defined it as the connecting line between the hyperechogenic, dorsocaudal edge of the symphysis pubis and the hyperechogenic anterior margin of the puborectalis muscle, posterior to the anorectal junction.
Methods: A retrospective study was performed including 111 patients, who underwent a transperineal ultrasound as part of an urogynecological examination in the department of Urogynecology at the University Medical Center of the Johannes Gutenberg University Mainz. We calculated the bladder neck decent using the SLL and compared our results with the measurements assessed using a horizontal line through the infero-posterior margin of the symphysis pubis, as previously described by Dietz (Horizontal Symphysis Line, HSL). In addition, we calculated the intra- and interobserver reliability of the two methods and examined the influence of various patient characteristics on the obtained values.
Results: Both methods demonstrated a high intra- and interobserver reliability. Even though the HSL produced slightly higher numerical values for the bladder neck descent, the novel SLL was more precise. Our data support that the 2-point fixation of the SLL on two anatomical structures ensures the stability of the reference plane during the functional changes of the pelvic floor.
Conclusion: The Symphysis-Levator Line could be a useful tool for urogynecologists in the future.
Clinical characteristics, management, maternal and neonatal outcome among seven severe and critically ill pregnant women with COVID-19 pneumonia
Published on: 30th November, 2020
OCLC Number/Unique Identifier: 8812298810
Pneumonia caused by the Novel coronavirus disease 2019 (COVID-19) is a highly infectious disease and the ongoing outbreak has been declared as a Pandemic by the World health organization. Pneumonia is a serious disease in pregnancy and requires prompt attention. Viral pneumonia has higher morbidity and mortality compared to bacterial pneumonia in pregnancy. All efforts are well exerted to understand the newly emerged disease features but still some areas are gray.
The treatment is primarily supportive with antivirals, steroids, anticoagulation and antibiotics for secondary bacterial infection. Severe cases require intensive care monitoring with oxygen support, mechanical ventilation. Investigational therapies include convalescent plasma, cytokine release inhibitors and other immunomodulatory agents like interferons. The mortality appears driven by the presence of severe Adult Respiratory Syndrome (ARDS) and organs failure.
COVID pandemic is a challenging and stressful socio-economic situation with widespread fear of infection, disease and death. In the specialty of obstetrics and gynecology, studies are being conducted to ascertain the manifestation of disease in pregnant women and the fetal outcome.
The aim of our case series is to describe the demographics, clinical characteristics, laboratory and radiological findings, feto- maternal outcome of severe and critical COVID pneumonia in pregnant women in Latifa Hospital.
Severe preeclampsia at the University Hospital Center of Mother and Child (UHCMC) in N’djamena: Epidemiology and prognosis
Published on: 28th January, 2022
OCLC Number/Unique Identifier: 9406521355
Introduction: Preeclampsia constitutes a public health problem in our region. According to the WHO, it is the third cause of maternal mortality after severe hemorrhages, infections and is responsible for morbidity and high fetal mortality. The aim of this study was to improve on the management of severe preeclampsia at the University Hospital Center of Mother and Child (UHCMC) in N’Djamena.Patients and method: It was a prospective and descriptive survey of 3 years duration, from January 01st, 2017 to December 31st, 2019. Included in our study were, all patients admitted for severe preeclampsia and agreed to participate in the study. Epidemiological, clinical, therapeutic and prognostic studies were conducted. The data collected was analyzed using SPSS 18.0 software.Results: During the study period, 13599 pregnant and parturients were admitted to the Gynecology-Obstetrics department of the UHCMC, among whom 406 cases of severe preeclampsia, with a frequency of 2.9%. The patients were young (23.2 years), married (96.3%), primipara (61.3%), referred (64.3%) without antenatal care in 47.9% of cases. Functional signs were dominated by headaches with 34.0% of cases. The proteinuria was ≥ 3 crosses in 83.7% of cases. Patients had received magnesium sulfate in 98.3%, the delivery mode was cesarean in 64.0% of cases. Principal morbidity was eclampsia (40.8%) and fetal was prematurity (36.4%). Maternal lethality was 11.1% and fetal mortality was 19.9% cases.Conclusion: Severe preeclampsia is frequent in the UHCMC in N’Djamena. It is responsible for high maternal and fetal mortality. The practice of quality antenatal care, could prevent the occurrence of complications and improve the maternal-fetal prognosis.
Ecology of vital activity as an element of antistress therapy on the example of the organization of the work of a medical center with industrial enterprises under the VMI program
Published on: 29th November, 2022
The pandemic the new Coronavirus infection has brought changes in the health status of a large number of our citizens. The consequence of this has been a higher rate of employees seeking medical care and subsequent sick leave. Crisis phenomena in the economic and social life of society are associated with the consequences of the pandemic, moreover, the stress burden on the population increases with the consequences of the pandemic. All this affects the level of performance. The transferred COVID-19 has increased the number of patients with complaints of pain in joints and muscles, with the phenomena of cardiovascular pathology, as well as in breathing, increased frequency of asthma attacks, etc. That is, complications affected a wide range of diseases [1-4]. All this is the consequence, including neurological pathology, which is closely related to stress. According to surveys of several large industrial enterprises, 31.7% of those seeking medical help report anxiety, sleep problems, and a feeling of fatigue [5]. Exacerbation of chronic diseases was recorded in more than 50% of patients with COVID-19. The figures show that more than 1/3 of the population is chronically unwell, and more often than usual they apply for sick leave, which inevitably leads to a decrease in economic indicators [6-10].
Spin supercurrent in ecology
Published on: 3rd April, 2023
Background: This work aims to show that the process of transfer of angular momentum ‑ spin supercurrent ‑ may provide the fulfillment of the fundamental law of ecology: “Everything is connected to everything else”.Results: The conducted investigations are based on the following properties of spin supercurrent: the equalization of the characteristics of interacting objects’ spins; dissipation-free; inertia-free (it is not accompanied by the emergence of kinetic mass); superluminal speed (there is no contradiction with Special Relativity, as Special Relativity postulates the speed limit only for an inertial process). The spin supercurrent emerges between virtual photons having a spin and being created by quantum objects of different types: living and non-living, electrically charged and neutral, magnetized and non-magnetized, having non-zero rest mass and having zero rest mass (such as photons). Conclusion: It is shown in this work that the properties of spin supercurrent may determine the following phenomena in ecology: the mimicry of animals and plants; the contactless (without living pathogenic microorganisms) spread of epidemics; the influence of the terrain relief on the population longevity; the use of water as information matrix; the stabilization of energy in the Earth’s core. Since the spin supercurrent possesses such properties as dissipative-free, superluminal speed, the non-electric and non-magnetic nature, it may perform interaction (quantum teleportation) of quantum objects between the Earth and Cosmic bodies. Thus, the extension of the biosphere’s border to Outer Space is possible.
Surgical Management of Uterine Fibroids at the Teaching Hospital of Angre Abidjan Cote d’Ivoire: 193 Cases Report
Published on: 20th June, 2023
Objective: To evaluate the surgical management of myomas at the Teaching Hospital of Angré according to the FIGO (International Federation of Gynecology and Obstetrics) classification.Patients and methods: This was a cross-sectional study at the Teaching Hospital of Angre from January 1, 2020, to December 31, 2022. Patients whose operative indication was clearly identified were included in the study. Incomplete files were not included. The variables studied were anthropometric parameters, clinical characteristics of myomas, and surgery. Due to the large size and multifocal location of uterine myomas, the therapeutic option remained surgery by laparotomy.Results: Most patients were over 35 years old (71.5%) and nulliparous (52.8%). The first indication for surgery was menometrorrhagia (88.6%), followed by the desire for motherhood (37.8%) and dysmenorrhoea (20.2%) for myomas most often FIGO type 4 (p = 0.0031). Myomectomy under cervical-isthmic tourniquet was the most common procedure for FIGO type 4 myomas (66.1%; p = 0.0543). Hysterectomy was most frequently performed for FIGO type 7 myomas (43.9%; p = 0.0543). For myomectomy, the first complication was anaemia (3.5%) followed by uterine suture haemorrhage (1.7%) (p = 0.5139).Conclusion: Our surgical practice at the Teaching Hospital of Angre is in accordance with FIGO recommendations. However, an effort should be made to promote the minimally invasive surgical approach (laparoscopic, hysteroscopic, transvaginal ablation) for small fibroids (≤ 5 cm) or FIGO type 0 to 3, which is not very frequent in our current practice.
Emerging One Health Preparedness to Combat National Burden of Diseases in Pakistan: A Comprehensive Insight
Published on: 23rd November, 2023
In order to integrate and enhance the health of people, animals, and the environment, a multidisciplinary “One Health” concept has been coined. However, developing countries have frequently lagged in embracing this innovative vision. Pakistan’s ecology, human health, and animal health have all been severely jeopardized due to a lack of resources. Human health is significantly impacted by the spread and comeback of zoonotic illnesses, especially for people who live in rural regions and frequently interact with domestic or wild animals. More than 75% of zoonotic diseases were transmitted contiguously from animals to humans or indirectly through interactions among agents or vectors (including both humans and other animals). This review article gives critical insights into the most common zoonotic diseases found in Pakistan in addition to underlining the importance of the “One Health” philosophy in the management of these illnesses. Interdisciplinary research efforts are required given the current circumstances in order to politicize sustainable solutions for decreasing the disease burden in human and animal populations simultaneously.
COVID-19 Pneumonia in Pregnancy: A Retrospective Study on Maternal and Neonatal Outcomes
Published on: 8th April, 2024
Objective: To identify risk factors among pregnant with COVID-19 for adverse outcomes related to disease severity, maternal mortality, and morbidity.Materials and methods: In this retrospective study, 45 pregnant patients with COVID-19 pneumonia were confirmed by RT-PCR. The inclusion criteria were pregnant patients diagnosed with COVID-19 confirmed by RT-PCR and hospitalized in the gynecology-obstetrics and intensive care unit. Exclusion criteria were non-pregnant patients and pneumonia cases with unconfirmed COVID-19 causes. The study used SPSS software to analyze the data. Results: Our study recorded 45 cases of SARS-CoV-2 infection in pregnant women over 2.5 years. The age group most affected was 20-35 years, with 75% of cases. 57% of patients had no known comorbidities. 88.8% of patients were symptomatic at diagnosis. Almost 30% of patients required admission to the ICU, with 60% requiring oxygen supplementation. The study recorded 36 live births (80%), of which 26 cases (72.2%) required no further care and had a favorable outcome.Conclusion: Pregnant women with medical conditions are at higher risk of severe COVID-19, which can cause respiratory distress syndrome and impact delivery and neonatal outcomes. Preventive measures are important.
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