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The Effects Of Continuous Insulin Pump Therapy On Glycemic Control In Pregnant Type 1 Diabetics, Kimberly Kelsey 2017 Dominican University of California

The Effects Of Continuous Insulin Pump Therapy On Glycemic Control In Pregnant Type 1 Diabetics, Kimberly Kelsey

Senior Theses and Capstone Projects

Type 1 Diabetics have various ways of managing their diabetes that have been studied for their effectiveness. Pregnancy in the Type 1 Diabetic has been understudied. It is known that Diabetics in general have poorer pregnancy outcomes because of poor glycemic control. This coupled with the fact that the body needs 3-4 times more insulin as pregnancy comes to an end makes managing blood glucose levels challenging for diabetics (Lowdermilk, 2016, p. 689). For the Type 1 Diabetic, there are two main ways to control diabetes: multiple daily injections using at least two type of insulin and continuous subcutaneous insulin ...


The Psychological Influence Of The Diagnosis Of Breast Cancer On Therapeutic Options Selection, Razvan V. Scaunasu, Stefan Voiculescu, Bogdan Popescu, Cristina Cozma, Radu Jecan, Cristian Balalau 2017 Carol Davila University, Colțea Clinical Hospital, Department of General Surgery, Bucharest, Romania

The Psychological Influence Of The Diagnosis Of Breast Cancer On Therapeutic Options Selection, Razvan V. Scaunasu, Stefan Voiculescu, Bogdan Popescu, Cristina Cozma, Radu Jecan, Cristian Balalau

Journal of Mind and Medical Sciences

The therapeutic management decision-making process for breast cancer is complex, and is influenced by multiple factors including patient age, comorbidities, ethnicity, education, and availability of immediate or delayed reconstruction options. Our study analysed 276 patients diagnosed with breast cancer in the “Colțea” Clinical Hospital between 2014 and 2015. Mean patients age was 61.24, median 62, with a range of 31 to 89 years. Younger age was associated with a less advanced local disease and younger patients were more likely to choose and benefit from conservative surgery. Most patients (61.76%) came from rural areas. Place of origin had a ...


Cesarean Scar Defects And Placental Abnormalities – A 3 Year Survey Study, Denisa Oana Bălălău, Nicolae Bacalbașa, Anca D. Stănescu 2017 Carol Davila University, Bucur Maternity Hospital, Department of Obstetrics & Gynecology, Bucharest, Romania

Cesarean Scar Defects And Placental Abnormalities – A 3 Year Survey Study, Denisa Oana Bălălău, Nicolae Bacalbașa, Anca D. Stănescu

Journal of Mind and Medical Sciences

The placenta is an essential organ for embryonic and fetal development, ensuring nutrient uptake, gas exchange (via the mother's blood supply), waste elimination, thermo-regulation, immunological and hormonal factors, etc. The most common placental abnormalities are represented by placenta previa, and a morbidly adherent placenta (in the form of accreta, increta, and percreta placenta). This study was performed on a sample of 99 patients diagnosed with abnormalities of placentation who underwent cesarian delivery during a period of 3 years in Bucur Maternity Hospital. Seven patients were diagnosed with morbidly adherent placenta (5 accreta and 2 percreta subtypes), the others having ...


Projecting The Potential Impact Of The Cap-Score™ On Clinical Pregnancy, Live Births, And Medical Costs In Couples With Unexplained Infertility., Joseph B Babigumira, Fady I Sharara, Louis P Garrison 2017 George Washington University

Projecting The Potential Impact Of The Cap-Score™ On Clinical Pregnancy, Live Births, And Medical Costs In Couples With Unexplained Infertility., Joseph B Babigumira, Fady I Sharara, Louis P Garrison

Obstetrics and Gynecology Faculty Publications

Purpose

The Cap-Score™ was developed to assess the capacitation status of men, thereby enabling personalized management of unexplained infertility by choosing timed intrauterine insemination (IUI), versus immediate in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) in individuals with a low Cap-Score™. The objective of this study was to estimate the differences in outcomes and costs comparing the use of the Cap-Score™ with timed IUI (CS-TI) and the standard of care (SOC), which was assumed to be three IUI cycles followed by three IVF-ICSI cycles.

Methods

We developed and parameterized a decision-analytic model of management of unexplained infertility for women ...


Serum Cholesterol In Neonates And Their Mothers. A Pilot Study, S.H. Badruddin, R. Lalani, Mohammad Khurshid, A. Molla, R. Qureshi, M.A. Khan 2017 Aga Khan University

Serum Cholesterol In Neonates And Their Mothers. A Pilot Study, S.H. Badruddin, R. Lalani, Mohammad Khurshid, A. Molla, R. Qureshi, M.A. Khan

Mohammad Khurshid

Reports from the Aga Khan University indicate that 58% of 400 school children studied had undesirably high serum cholesterol levels. The present study was undertaken to determine whether the high cholesterol levels are present at birth and to determine the relationship between cord blood, maternal blood cholesterol and maternal diet. Cord blood from 58 neonates and fasting venous blood form 45 mothers were analyzed for total serum cholesterol. Mothers were interviewed regarding their usual diet during pregnancy. Mean cord blood cholesterol was 56.90 mg/dl (range 26 to 123 mg/dI). Mean maternal blood cholesterol was 232.4mg/dl ...


Anaemia In Pregnancy: Occurrence In Two Economically Different Clinic Populations Of Karachi, Saadiya Aziz Karim, Mohammad Khurshid, Javed H. Rizvi 2017 Dow Medical College & Civil Hospital

Anaemia In Pregnancy: Occurrence In Two Economically Different Clinic Populations Of Karachi, Saadiya Aziz Karim, Mohammad Khurshid, Javed H. Rizvi

Mohammad Khurshid

According to previous WHO standards, anaemia in pregnancy denoted a haemoglobin level of 11.0 gms/dl or less, but this is now considered to be variable1 as it differs from country to country depending on local reference ranges and socio-economic conditions. Each country should “lay down minimal acceptable standards” below which an individual is considered to be anaemic, taking into account the available fmancial and manpower resources and other health needs of the country2. There is a wide divergence in the quoted prevalence of anaemia in Pakistan and neigh­bouring countries.3-6 This study was undertaken to determine a ...


Inadequate Birth Spacing Is Perceived As Riskier Than All Family Planning Methods, Except Sterilization And Abortion, In A Qualitative Study Among Urban Nigerians, Hilary Schwandt, Joanna Skinner, Luciana Estelle Hebert, Lisa Cobb, Abdulmumin Saad, Mojisola Odeku 2017 Western Washington University

Inadequate Birth Spacing Is Perceived As Riskier Than All Family Planning Methods, Except Sterilization And Abortion, In A Qualitative Study Among Urban Nigerians, Hilary Schwandt, Joanna Skinner, Luciana Estelle Hebert, Lisa Cobb, Abdulmumin Saad, Mojisola Odeku

Fairhaven Faculty Publications

Background Fertility is high in Nigeria and contraceptive use is low. Little is known about how urban Nigerians perceive the risk of contraceptive use in relation to pregnancy and birth. This study examines and compares the risk perception of family planning methods and pregnancy related scenarios among urban Nigerians.

Methods A total of 26 focus group discussions with 243 participants were conducted in September and October 2010 in Ibadan and Kaduna. The groups were stratified by sex, age, family planning use, and city. Study participants were asked to identify the risk associated with six different family planning methods and four ...


A Rare Case Of Giant Dermoid Cyst With Ipsilateral Paratubal Cystadenoma During Pregnancy, Ahmed M. Abbas, Yasser Khamis, Armia Michael, Abdelrahman M. Abdelkader 2017 Department of Obstetrics and Gynecology, Faculty of Medicine; Assiut University, Assiut, Egypt

A Rare Case Of Giant Dermoid Cyst With Ipsilateral Paratubal Cystadenoma During Pregnancy, Ahmed M. Abbas, Yasser Khamis, Armia Michael, Abdelrahman M. Abdelkader

POG In Press

Dermoid cysts are considered the most common ovarian cysts in adolescents and pregnant women. In rare cases, they can attain a huge size. Paratubal cysts are also common in adolescents. They are usually simple cysts present in the broad ligament. In this case, we report a giant dermoid cyst with ipsilateral paratubal serous cystadenoma discovered during pregnancy of a 20-year-old primigravida. Both cysts were managed conservatively, and then removed successfully at the time of cesarean section by cystectomy.


True Knot Of The Umbilical Cord In Advanced Weeks Of Pregnancy: A Case Report, Sinan Karakecili, Mert Ulas Barut, Guler Cakmak, Engin Ozturk, Murat Bozkurt, Mustafa Demir 2017 Harran University Faculty of Medicine, Department of Obstetrics and Gynecology, Sanliurfa, Turkey

True Knot Of The Umbilical Cord In Advanced Weeks Of Pregnancy: A Case Report, Sinan Karakecili, Mert Ulas Barut, Guler Cakmak, Engin Ozturk, Murat Bozkurt, Mustafa Demir

POG In Press

True knot of the umbilical cord is a very rare condition. Usually a true knot is noticed after delivery and does not lead to problems. It is relatively less common than the other umbilical cord anomalies. Most authors agree that there is little that can be done to prevent fetal death in undiagnosed true knot. In our case, the patient gave birth to a healthy male baby weighing 2700 grams by normal vaginal delivery after an ultrasound was suggestive of intrauterine growth restriction (IUGR). The baby’s Apgar scores were 8 at one minute and 9 at five minutes. The ...


Maternal And Fetal Complications Of Antiphospholipid Syndrome: A Case Report With Long-Term Follow-Up, Tahira Naru, Mohammad Khurshid, Zafar Nazir 2017 Aga Khan University

Maternal And Fetal Complications Of Antiphospholipid Syndrome: A Case Report With Long-Term Follow-Up, Tahira Naru, Mohammad Khurshid, Zafar Nazir

Zafar Nazir

We report a case of a 26- year old woman having antiphospholipid syndrome in pregnancy with long-term follow up. She presented with recurrent miscarriages, venous thrombosis, avascular necrosis of femoral head, mid-cerebral artery infarction and skin ulcers. Antiphospholipid syndrome is a recognized disorder of pregnancy. Diagnosis requires a high index of suspicion when evaluating women with recurrent pregnancy losses and vascular thrombosis. A low dose aspirin combined with heparin can reduce morbidity and improves the pregnancy outcome.


Validation Of Verbal Autopsy Tool For Ascertaining The Causes Of Stillbirth, Sidrah Nausheen, Sajid B. Soofi, Kamran Sadiq, Atif Habib, Ali Turab, Zamir Suhag, Zaid Bhatti, Imran Ahmed, Zulfiqar A. Bhutta, Zahid Memon, Rajiv Bahl, M. Imran Khan, Shireen Bhutta 2017 Aga Khan University

Validation Of Verbal Autopsy Tool For Ascertaining The Causes Of Stillbirth, Sidrah Nausheen, Sajid B. Soofi, Kamran Sadiq, Atif Habib, Ali Turab, Zamir Suhag, Zaid Bhatti, Imran Ahmed, Zulfiqar A. Bhutta, Zahid Memon, Rajiv Bahl, M. Imran Khan, Shireen Bhutta

Atif Habib

Objective: To assess performance of the WHO revised verbal autopsy tool for ascertaining the causes of still birth in comparison with reference standard cause of death ascertained by standardized clinical and supportive data. Methods: All stillbirths at a tertiary hospital in Karachi, Pakistan were prospectively recruited into study from August 2006- February 2008. The reference standard cause of death was established by two senior obstetricians within 48 hours using the ICD coding system. Verbal autopsy interviews using modified WHO tool were conducted by trained health workers within 2- 6 weeks of still birth and the cause of death was assigned ...


Validation Of Verbal Autopsy Tool For Ascertaining The Causes Of Stillbirth, Sidrah Nausheen, Sajid B. Soofi, Kamran Sadiq, Atif Habib, Ali Turab, Zamir Suhag, Zaid Bhatti, Imran Ahmed, Zulfiqar A. Bhutta, Zahid Memon, Rajiv Bahl, M. Imran Khan, Shireen Bhutta 2017 Aga Khan University

Validation Of Verbal Autopsy Tool For Ascertaining The Causes Of Stillbirth, Sidrah Nausheen, Sajid B. Soofi, Kamran Sadiq, Atif Habib, Ali Turab, Zamir Suhag, Zaid Bhatti, Imran Ahmed, Zulfiqar A. Bhutta, Zahid Memon, Rajiv Bahl, M. Imran Khan, Shireen Bhutta

Mohammad Imran Khan

Objective: To assess performance of the WHO revised verbal autopsy tool for ascertaining the causes of still birth in comparison with reference standard cause of death ascertained by standardized clinical and supportive data. Methods: All stillbirths at a tertiary hospital in Karachi, Pakistan were prospectively recruited into study from August 2006- February 2008. The reference standard cause of death was established by two senior obstetricians within 48 hours using the ICD coding system. Verbal autopsy interviews using modified WHO tool were conducted by trained health workers within 2- 6 weeks of still birth and the cause of death was assigned ...


Validation Of Verbal Autopsy Tool For Ascertaining The Causes Of Stillbirth, Sidrah Nausheen, Sajid B. Soofi, Kamran Sadiq, Atif Habib, Ali Turab, Zamir Suhag, Zaid Bhatti, Imran Ahmed, Zulfiqar A. Bhutta, Zahid Memon, Rajiv Bahl, M. Imran Khan, Shireen Bhutta 2017 Aga Khan University

Validation Of Verbal Autopsy Tool For Ascertaining The Causes Of Stillbirth, Sidrah Nausheen, Sajid B. Soofi, Kamran Sadiq, Atif Habib, Ali Turab, Zamir Suhag, Zaid Bhatti, Imran Ahmed, Zulfiqar A. Bhutta, Zahid Memon, Rajiv Bahl, M. Imran Khan, Shireen Bhutta

Zahid Ali Memon

Objective: To assess performance of the WHO revised verbal autopsy tool for ascertaining the causes of still birth in comparison with reference standard cause of death ascertained by standardized clinical and supportive data.

Methods: All stillbirths at a tertiary hospital in Karachi, Pakistan were prospectively recruited into study from August 2006- February 2008. The reference standard cause of death was established by two senior obstetricians within 48 hours using the ICD coding system. Verbal autopsy interviews using modified WHO tool were conducted by trained health workers within 2- 6 weeks of still birth and the cause of death was assigned ...


Results Of A Pilot Study In The U.S. And Vietnam To Assess The Utility And Acceptability Of A Multi-Level Pregnancy Test (Mlpt) For Home Monitoring Of Hcg Trends After Assisted Reproduction., Tara Shochet, Ioanna A Comstock, Nguyen Thi Nhu Ngoc, Lynn M Westphal, Wendy R Sheldon, Ly Thai Loc, Jennifer Blum, Beverly Winikoff, Paul D Blumenthal 2017 George Washington University

Results Of A Pilot Study In The U.S. And Vietnam To Assess The Utility And Acceptability Of A Multi-Level Pregnancy Test (Mlpt) For Home Monitoring Of Hcg Trends After Assisted Reproduction., Tara Shochet, Ioanna A Comstock, Nguyen Thi Nhu Ngoc, Lynn M Westphal, Wendy R Sheldon, Ly Thai Loc, Jennifer Blum, Beverly Winikoff, Paul D Blumenthal

Obstetrics and Gynecology Faculty Publications

Background

To evaluate the utility and acceptability of using multi-level pregnancy tests (MLPTs) at home to monitor hCG trends following assisted reproductive technology (ART).

Methods

One hundred and four women presenting for ART at either Stanford Medicine Fertility and Reproductive Health Clinic (Stanford, CA) or Hung Vuong Hospital (Ho Chi Minh City, Vietnam) participated in this pilot study. Women were asked to perform the MLPT at home, primarily on days when they were also scheduled to receive standard clinic-based serum hCG testing. These tests were administered up to 6 times over the 6-week period following embryo transfer or intrauterine insemination ...


Effect Of Flibanserin Treatment On Body Weight In Premenopausal And Postmenopausal Women With Hypoactive Sexual Desire Disorder: A Post Hoc Analysis., Susan G Kornstein, James A Simon, Stuart C Apfel, James Yuan, Krista A Barbour, Robert Kissling 2017 George Washington University

Effect Of Flibanserin Treatment On Body Weight In Premenopausal And Postmenopausal Women With Hypoactive Sexual Desire Disorder: A Post Hoc Analysis., Susan G Kornstein, James A Simon, Stuart C Apfel, James Yuan, Krista A Barbour, Robert Kissling

Obstetrics and Gynecology Faculty Publications

Background: Flibanserin, a 5-HT1A agonist and 5-HT2A antagonist, is indicated for the treatment of acquired, generalized hypoactive sexual desire disorder (HSDD) in premenopausal women. This post hoc analysis evaluated the effect of flibanserin treatment on body weight in premenopausal and postmenopausal women with HSDD.

Materials and Methods: This analysis included three 24-week, double-blind, placebo-controlled studies of flibanserin 100 mg each bedtime (qhs) in premenopausal women, a similarly designed study in postmenopausal women, and a 52-week, open-label extension study in premenopausal women.

Results: In a pooled analysis of premenopausal women, mean baseline body mass index (BMI) was 27.0 ...


Estimates Of Burden And Consequences Of Infants Born Small For Gestational Age In Low And Middle Income Countries With Intergrowth-21(St) Standard: Analysis Of Cherg Datasets., Anne Cc Lee, Naoko Kozuki, Simon Cousens, Gretchen A Stevens, Hannah Blencowe, Mariangela F Silveira, Ayesha Sania, Heather E Rosen, Christentze Schmiegelow, Linda S Adair, Abdullah H Baqui, Fernando C Barros, Zulfiqar A Bhutta, Laura E Caulfield, Parul Christian, Siân E Clarke, Wafaie Fawzi, Rogelio Gonzalez, Jean Humphrey, Lieven Huybregts, Simon Kariuki, Patrick Kolsteren, John Lusingu, Dharma Manandhar, Aroonsri Mongkolchati, Luke C Mullany, Richard Ndyomugyenyi, Jyh Kae Nien, Dominique Roberfroid, Naomi Saville, Dianne J Terlouw, James M Tielsch, Cesar G Victora, Sithembiso C Velaphi, Deborah Watson-Jones, Barbara A Willey, Majid Ezzati, Joy E Lawn, Robert E Black, Joanne Katz 2017 George Washington University

Estimates Of Burden And Consequences Of Infants Born Small For Gestational Age In Low And Middle Income Countries With Intergrowth-21(St) Standard: Analysis Of Cherg Datasets., Anne Cc Lee, Naoko Kozuki, Simon Cousens, Gretchen A Stevens, Hannah Blencowe, Mariangela F Silveira, Ayesha Sania, Heather E Rosen, Christentze Schmiegelow, Linda S Adair, Abdullah H Baqui, Fernando C Barros, Zulfiqar A Bhutta, Laura E Caulfield, Parul Christian, Siân E Clarke, Wafaie Fawzi, Rogelio Gonzalez, Jean Humphrey, Lieven Huybregts, Simon Kariuki, Patrick Kolsteren, John Lusingu, Dharma Manandhar, Aroonsri Mongkolchati, Luke C Mullany, Richard Ndyomugyenyi, Jyh Kae Nien, Dominique Roberfroid, Naomi Saville, Dianne J Terlouw, James M Tielsch, Cesar G Victora, Sithembiso C Velaphi, Deborah Watson-Jones, Barbara A Willey, Majid Ezzati, Joy E Lawn, Robert E Black, Joanne Katz

Global Health Faculty Publications

Objectives To estimate small for gestational age birth prevalence and attributable neonatal mortality in low and middle income countries with the INTERGROWTH-21st birth weight standard.

Design Secondary analysis of data from the Child Health Epidemiology Reference Group (CHERG), including 14 birth cohorts with gestational age, birth weight, and neonatal follow-up. Small for gestational age was defined as infants weighing less than the 10th centile birth weight for gestational age and sex with the multiethnic, INTERGROWTH-21st birth weight standard. Prevalence of small for gestational age and neonatal mortality risk ratios were calculated and pooled among these datasets at the regional level ...


Maternal Intuition Of Fetal Gender, Michael McFadzen, David P. Dielentheis, Ronda Kasten, Maharaj Singh, Joe Grundle 2017 Obstetrics/Gynecology, Aurora Sheboygan Clinic, Aurora Health Care

Maternal Intuition Of Fetal Gender, Michael Mcfadzen, David P. Dielentheis, Ronda Kasten, Maharaj Singh, Joe Grundle

Journal of Patient-Centered Research and Reviews

Purpose: Fetal gender speculation is a preoccupation of many expecting parents, and pregnant women commonly profess to intuitively know the gender of their unborn babies. This study objectively compared pregnant mothers’ perceptions of fetal gender to sonographically proven gender determinations. Also, success rates from previously published studies, noninvasive prenatal testing and a myriad of gender determination methods were observed and reported for context.

Methods: All pregnant women presenting for second-trimester screening ultrasound (at 17–23 weeks gestation) in the obstetrics department of a single health center were asked to participate. A medical sonographer described the ultrasound examination, obtained appropriate consent ...


The Effect Of Regular Daily Walking On Adverse Pregnancy Outcomes Among Overweight Primigravidas: A Prospective Cohort Study, Nahla W. Shady, Hany F. Sallam, Shymaa S. Ali, Ahmed M. Abbas 2017 Department of Obstetrics & Gynecology, Faculty of Medicine, Aswan University, Aswan, Egypt

The Effect Of Regular Daily Walking On Adverse Pregnancy Outcomes Among Overweight Primigravidas: A Prospective Cohort Study, Nahla W. Shady, Hany F. Sallam, Shymaa S. Ali, Ahmed M. Abbas

POG In Press

Objective: The study aims to evaluate the effect of regular daily walking on the occurrence of adverse pregnancy outcomes among overweight primigravidas.

Materials and Methods: A prospective cohort study conducted at Aswan University Hospital from March 2015 to December 2016. The study included 360 overweight primigravidas, with singleton pregnancies, who were divided into two groups: Group I (control group) and Group II (study group) under supervised regular walking 5 times per week for 30 minutes, starting from 10-12 weeks of gestational age to 38-39 weeks of gestational age. The primary outcome of the study was the rate of gestational weight ...


Traumatic Vulvar Aphthous Ulcers: A Case Series, Alyson R. Pierick, Diane Elas, Colleen K. Stockdale 2017 University of Iowa Carver College of Medicine, Iowa City, Iowa

Traumatic Vulvar Aphthous Ulcers: A Case Series, Alyson R. Pierick, Diane Elas, Colleen K. Stockdale

POG In Press

We present three women who each presented with a vulvar ulcer consistent with aphthous. In each case a biopsy was performed which excluded malignancy and revealed non-specific findings. All women responded following intralesional steroid injections. We initially considered a diagnosis of pyoderma gangrenosum. However, the presentation and clinical findings were more consistent with aphthous ulcer.


Small Bowel Obstruction: A Recurrence Of Melanoma During The Second Trimester Of Pregnancy, Lindsay Goad, Yousef Zakharia, Heather Anaya, 2017 University of Iowa Carver College of Medicine, Iowa City, Iowa

Small Bowel Obstruction: A Recurrence Of Melanoma During The Second Trimester Of Pregnancy, Lindsay Goad, Yousef Zakharia, Heather Anaya,

POG In Press

Background: The incidence of melanoma is on the rise in the United States and is particularly prevalent among women of childbearing age. Obtaining a complete history and understanding the unpredictable behavior of melanoma is essential to make the diagnosis of recurrent disease during pregnancy.

Case: A 35-year-old G2P1 at 23 weeks and 1 days’ gestation with a remote history of (treated) cutaneous melanoma underwent an exploratory laparotomy for small bowel obstruction. Pathology was consistent with recurrent metastatic melanoma.

Conclusion: Metastatic melanoma diagnosed during pregnancy is rare. There are no guidelines on how or when to proceed with treatment of metastatic ...


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