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Obstetrics and Gynecology

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Full-Text Articles in Medicine and Health Sciences

Contemporary Analysis Of Reexcision And Conversion To Mastectomy Rates And Associated Healthcare Costs For Women Undergoing Breast-Conserving Surgery, Youngran Kim, Cecilia Ganduglia-Cazaban, Nina Tamirisa, Anthony Lucci, Trudy Millard Krause Jun 2024

Contemporary Analysis Of Reexcision And Conversion To Mastectomy Rates And Associated Healthcare Costs For Women Undergoing Breast-Conserving Surgery, Youngran Kim, Cecilia Ganduglia-Cazaban, Nina Tamirisa, Anthony Lucci, Trudy Millard Krause

Journal Articles

PURPOSE: This study was designed to provide a comprehensive and up-to-date understanding of population-level reoperation rates and incremental healthcare costs associated with reoperation for patients who underwent breast-conserving surgery (BCS).

METHODS: This is a retrospective cohort study using Merative™ MarketScan

RESULTS: The commercial cohort included 17,129 women with a median age of 55 (interquartile range [IQR] 49-59) years, and the Medicare cohort included 6977 women with a median age of 73 (IQR 69-78) years. Overall reoperation rates were 21.1% (95% confidence interval [CI] 20.5-21.8%) for the commercial cohort and 14.9% (95% CI 14.1-15.7%) for the Medicare cohort. In both cohorts, …


The Effectiveness Of Dexmedetomidine As An Adjunct In Spinal Anesthesia For Pain Relief In Cesarean Patients: A Scoping Review, Tyler Polanco Bsn, Rn, William Riley Bsn, Rn, Michelle Russell Bsn, Rn, Christina Samson Bsn, Rn, Bria Sharp Bsn, Rn, Dwayne Accardo Dnp, Ccrna, Faana Apr 2024

The Effectiveness Of Dexmedetomidine As An Adjunct In Spinal Anesthesia For Pain Relief In Cesarean Patients: A Scoping Review, Tyler Polanco Bsn, Rn, William Riley Bsn, Rn, Michelle Russell Bsn, Rn, Christina Samson Bsn, Rn, Bria Sharp Bsn, Rn, Dwayne Accardo Dnp, Ccrna, Faana

Doctor of Nursing Practice Projects

No abstract provided.


Evidenced-Based Strategies To Increase Cervical Cancer Screening Rates, Tuong Cat Vo Bsn-Rn, Nada Salloukh Bsn-Rn, Tatiana Elena Swanson Bsn-Rn, Xiao Mie Cindy Zhu Bsn-Rn, Laura Taylor Reed Dnp, Aprn, Fnp-Bc Apr 2024

Evidenced-Based Strategies To Increase Cervical Cancer Screening Rates, Tuong Cat Vo Bsn-Rn, Nada Salloukh Bsn-Rn, Tatiana Elena Swanson Bsn-Rn, Xiao Mie Cindy Zhu Bsn-Rn, Laura Taylor Reed Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Cervical cancer is the fourth leading cause of cancer affecting women worldwide (Staley et al., 2021). With cervical cancer being a preventable disease, an effective method of reducing healthcare costs and mortality is primary prevention, such as screenings. Financial burdens and barriers to accessing medical care may result due to the lack of proper cervical cancer screenings. Detecting cervical cancer includes screening women 21 to 65 years old with a Papanicolaou (PAP) test every three years. Women aged 30 to 65 years old can extend the screening of cervical cancer by having a Human Papillomavirus (HPV) test along with …


Case Report: Low-Risk Hpv Associated Verruco-Papillary Squamous Cell Carcinoma Of The Cervix, Olivia Nicolais, Mackenzie Cummings, Tommy R. Buchanan Apr 2024

Case Report: Low-Risk Hpv Associated Verruco-Papillary Squamous Cell Carcinoma Of The Cervix, Olivia Nicolais, Mackenzie Cummings, Tommy R. Buchanan

Abington Jefferson Health Papers

•Cervical cancer plays a large role in morbidity and mortality for gynecologic cancer.•Most cases are involved with high-risk HPV, rare cases of low-risk HPV associated cancer exists.•Low risk HPV associated cervical cancers have increased difficulty in diagnosis.•No distinction exists in treatment between low and high risk HPV associated cervical cancer.


Project Prevent: A Randomized Controlled Trial Of Preoperative Vaginal Metronidazole To Decrease Patient Issues And Infections After Hysterectomy, Tana Pradhan, Helen Zhang, Amanda Kadesh, Ama Buskwofie, Sonali Patankar, Sharifa Menon, Timothy Ryntz, Cara Grimes Apr 2024

Project Prevent: A Randomized Controlled Trial Of Preoperative Vaginal Metronidazole To Decrease Patient Issues And Infections After Hysterectomy, Tana Pradhan, Helen Zhang, Amanda Kadesh, Ama Buskwofie, Sonali Patankar, Sharifa Menon, Timothy Ryntz, Cara Grimes

Abington Jefferson Health Papers

OBJECTIVES: To evaluate if vaginal metronidazole for 5 days before hysterectomy decreases postoperative infections and patient issues.

DESIGN: This randomized trial compared vaginal metronidazole for 5 days before a scheduled hysterectomy to no intervention. Sample size calculation was based on a 20% difference in issues and infection (30% incidence and 10% in the intervention arm) with 80% power and an alpha error of 0.05 and indicated 62 subjects needed in each arm.

SETTING: Outpatient gynecology clinics at a single academic institution.

PARTICIPANTS: 154 subjects were screened for eligibility between July 2020 and September 2022. 133 underwent hysterectomy including 68 subjects …


Correlation Of Sonographic With Intraoperative Findings In Laparoscopic Managed Ectopic Pregnancies, A 10-Year Synopsis: A Retrospective Observational Study, Steve Mutiso Apr 2024

Correlation Of Sonographic With Intraoperative Findings In Laparoscopic Managed Ectopic Pregnancies, A 10-Year Synopsis: A Retrospective Observational Study, Steve Mutiso

Obstetrics and Gynaecology, East Africa

Background: Ectopic pregnancies (EP) are a common pregnancy complication that's associated with significant morbidity and rarely mortality if not managed properly. Ultrasound examination forms the cornerstone of diagnosis of EP with some sonographic features occasionally not correlating with intraoperative findings. We set out to conduct an audit of EP managed surgically at our hospital for a 10-year period and discern the correlation and prediction of sonographic findings to intraoperative findings.

Methods: This study was designed as a Retrospective Observational Study based at the Aga Khan University Hospital (AKUH). Study population was all women admitted to AKUH with a diagnosis of …


Incidental Actinomycosis In A 44-Year-Old Female During Total Abdominal Hysterectomy For Abnormal Uterine Bleeding: A Case Report, Willbroad Kyejo, Ally Zain Ismail, Abduel Kitua, Gregory Ntiyakunze, Munawar Kaguta, Ally Mwawnga Apr 2024

Incidental Actinomycosis In A 44-Year-Old Female During Total Abdominal Hysterectomy For Abnormal Uterine Bleeding: A Case Report, Willbroad Kyejo, Ally Zain Ismail, Abduel Kitua, Gregory Ntiyakunze, Munawar Kaguta, Ally Mwawnga

Family Medicine, East Africa

Actinomycosis, a rare chronic bacterial infection caused by Actinomyces species, presents diagnostic challenges due to diverse clinical presentations. This report presents a case of peritoneal actinomycosis incidentally discovered during a total abdominal hysterectomy in a 44-year-old female with refractory abnormal uterine bleeding and a history of long-term intrauterine contraceptive device use. The patient presented with persistent abnormal uterine bleeding despite conservative management. Intraoperative findings during total abdominal hysterectomy revealed peritoneal involvement, prompting histopathological evaluation confirming actinomycosis. This case highlights diagnostic complexities associated with actinomycosis, emphasizing the significance of histopathological confirmation. Postoperative management with antibiotics demonstrated favorable outcomes, supporting their efficacy …


Learning Circles: Promoting Inclusive Care Starting In The Classroom, April Graham, Kindsey Gattman, Tobias Johnson Apr 2024

Learning Circles: Promoting Inclusive Care Starting In The Classroom, April Graham, Kindsey Gattman, Tobias Johnson

Articles, Abstracts, and Reports

No abstract provided.


Long-Term Health Related Quality Of Life Following Uterine Fibroid Embolization In A Predominantly Black African Population: A Retrospective Cohort Study, Michael Kioko, Marleen Temmerman, Timona Obura, Adelaide Lusambili Apr 2024

Long-Term Health Related Quality Of Life Following Uterine Fibroid Embolization In A Predominantly Black African Population: A Retrospective Cohort Study, Michael Kioko, Marleen Temmerman, Timona Obura, Adelaide Lusambili

Obstetrics and Gynaecology, East Africa

Uterine Fibroid Embolization (UFE) is one of the effective options available for treatment of symptomatic uterine fibroids with documented improvement in the quality of life and reduction in symptoms. The study assessed long-term quality of life post-uterine fibroid embolization in a mostly black population, noting scanty local or African research on this topic despite evidence suggesting a higher fibroid burden among black women. This retrospective study examined patients who underwent UFE from 2009 to 2014. Participants completed online demographic and UFS-QOL surveys. Statistical tests included Wilcoxon signed rank tests for HRQOL score differences and Pearson correlation for associations between independent …


The Effect Of Cervical Pessary On Increasing Gestational Age At Delivery In Twin Pregnancies With Asymptomatic Short Cervix: A Systematic Review And Meta-Analysis Of Randomized Controlled Trials, Amir Hossein Norooznezhad, Nikan Zargarzadeh, Ali Javinani, Seyedeh Maedeh Nabavian, Shohra Qaderi, Shayan Mostafaei, Vincenzo Berghella, Yinka Oyelese, Alireza A. Shamshirsaz Mar 2024

The Effect Of Cervical Pessary On Increasing Gestational Age At Delivery In Twin Pregnancies With Asymptomatic Short Cervix: A Systematic Review And Meta-Analysis Of Randomized Controlled Trials, Amir Hossein Norooznezhad, Nikan Zargarzadeh, Ali Javinani, Seyedeh Maedeh Nabavian, Shohra Qaderi, Shayan Mostafaei, Vincenzo Berghella, Yinka Oyelese, Alireza A. Shamshirsaz

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: The incidence of preterm delivery is much higher in twin pregnancies than in singletons and even higher if a short cervical length is detected in the second trimester. Studies are contradictory regarding the efficacy of a cervical pessary to decrease preterm birth in twin pregnancies and short cervical length. To conduct a systematic review and meta-analysis investigating the efficacy of cervical pessary in prolonging gestation, preventing preterm birth, and reducing adverse neonatal outcomes in twin pregnancies with an asymptomatic short cervix.

DATA SOURCES: PubMed, Scopus, Web of Science, and ClinicalTrials.org were searched for randomized controlled trials from inception to …


Pessary Use In Urology Clinics, Kathy Z. Lu Bs, Emily Brodowsky Md, Alex Stephens Ms, Samantha Raffee Md, Humphrey Atiemo Md Mar 2024

Pessary Use In Urology Clinics, Kathy Z. Lu Bs, Emily Brodowsky Md, Alex Stephens Ms, Samantha Raffee Md, Humphrey Atiemo Md

Medical Student Research Symposium

Introduction: Pessaries are a non-invasive treatment option for patients with pelvic organ prolapse (POP) or stress urinary incontinence (SUI). There is currently limited data regarding pessary usage among urology patients. The aim of this study is to determine the patient characteristics that predict long term pessary usage versus surgical intervention.

Methods: A 10-year retrospective review of pessary usage in women with either SUI or POP was performed. Patients were stratified into pessary longevity of less than or greater than one year. Quality of life measures before and after pessary use included pads per day, incontinence symptom index (ISI) scores, and …


Exploring The Effects Of Amniotic Bladder Therapy On Female Sexual Dysfunction In Interstitial Cystitis/Bladder Pain Syndrome Patients, Jonathan D. Lutchka, Jack Vercnocke Md, David Pearlman Md, Aron Liaw Md, Nivedita Dhar Md Mar 2024

Exploring The Effects Of Amniotic Bladder Therapy On Female Sexual Dysfunction In Interstitial Cystitis/Bladder Pain Syndrome Patients, Jonathan D. Lutchka, Jack Vercnocke Md, David Pearlman Md, Aron Liaw Md, Nivedita Dhar Md

Medical Student Research Symposium

Introduction and Objectives: Female sexual dysfunction (FSD) is commonly associated with Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS). FSD manifests as abnormalities in sexual desire, arousal, orgasm, pain, distress, and satisfaction. Our primary objective was to assess the impact of micronized amniotic membrane injections (AM) on FSD and lower urinary tract symptoms using comprehensive measures, including the multi-domain Female Sexual Function Index (FSFI), the Pain Visual Analog Scale (VAS), and the Interstitial Cystitis Symptom Index (ICSI) and Interstitial Cystitis Problem Index (ICPI).

Methods: Study participants included patients diagnosed with IC/BPS and FSD refractory to traditional therapies. Under general anesthesia, these …


Assessment Of Breastfeeding Education In Medical Training, Saranya Madan, Abigail Kuplicki Mar 2024

Assessment Of Breastfeeding Education In Medical Training, Saranya Madan, Abigail Kuplicki

Medical Student Research Symposium

In 2019, the Academy of Breastfeeding Medicine issued a revised set of educational objectives for medical trainees at various stages of education. In this statement, objectives for medical school were broken down into preclinical and clinical training objectives. In this project, our goal is to assess the degree to which medical training at Wayne State University School of Medicine is addressing these aims.

The assessment of breastfeeding education is accomplished by surveying medical students at various stages of training (M1-M4) and eliciting their level of confidence in and understanding of the topics outlined in the objectives by the Academy of …


Dhea: A Neglected Biological Signal That May Affect Fetal And Child Development, Natasha A. Bailey, Elysia Poggi Davis, Curt A. Sandman, Laura M. Glynn Mar 2024

Dhea: A Neglected Biological Signal That May Affect Fetal And Child Development, Natasha A. Bailey, Elysia Poggi Davis, Curt A. Sandman, Laura M. Glynn

Psychology Faculty Articles and Research

The stress-sensitive maternal hypothalamic–pituitary–adrenal (HPA) axis through the end-product cortisol, represents a primary pathway through which maternal experience shapes fetal development with long-term consequences for child neurodevelopment. However, there is another HPA axis end-product that has been widely ignored in the study of human pregnancy. The synthesis and release of dehydroepiandosterone (DHEA) is similar to cortisol, so it is a plausible, but neglected, biological signal that may influence fetal neurodevelopment. DHEA also may interact with cortisol to determine developmental outcomes. Surprisingly, there is virtually nothing known about human fetal exposure to prenatal maternal DHEA and offspring neurodevelopment. The current study …


Attitudes And Barriers To Breastfeeding Among Women At High-Risk For Not Breastfeeding: A Prospective Observational Study, Jessica Cole, Ateshi Bhatt, Andrew G. Chapple, Sarah Buzhardt, Elizabeth F. Sutton Jan 2024

Attitudes And Barriers To Breastfeeding Among Women At High-Risk For Not Breastfeeding: A Prospective Observational Study, Jessica Cole, Ateshi Bhatt, Andrew G. Chapple, Sarah Buzhardt, Elizabeth F. Sutton

School of Medicine Faculty Publications

Background Rates of breastfeeding are lower among minority and underserved populations in the United States. Our study objective was to assess pregnant persons attitudes and barriers to breastfeeding among a cohort at high risk for not breastfeeding. Methods We disseminated the Iowa Infant Feeding Attitude Scale (IIFAS) to 100 pregnant persons at least 18 years of age attending a prenatal visit in a low-resource, academic practice in south-central Louisiana (Woman’s Hospital). The IIFAS, as well as questions collecting information on breastfeeding experience and sociodemographic characteristics, were administered via interview. Medical records were reviewed to investigate associations between attitudes about breastfeeding …


Editorial: Care During Pregnancy And Early Childhood For Growth And Development In Low- And Middle- Income Countries, Ranadip Chowdhury, Ravi Prakash Upadhyay, Bireshwar Sinha, Nita Bhandari, Sunita Taneja, Jai K. Das Jan 2024

Editorial: Care During Pregnancy And Early Childhood For Growth And Development In Low- And Middle- Income Countries, Ranadip Chowdhury, Ravi Prakash Upadhyay, Bireshwar Sinha, Nita Bhandari, Sunita Taneja, Jai K. Das

Centre of Excellence in Women and Child Health

No abstract provided.


Comparison Of Pre And Post Foley Catheter Bishop’S Score: A Retrospective Record Review At Aga Khan University Hospital Karachi, Pakistan, Ayesha Malik, Sheikh Irfan Ahmed, Farheen Yousuf, Azra Amerjee, Sumaira Naz, Safna Naozer Virji Safna Naozer Virji Jan 2024

Comparison Of Pre And Post Foley Catheter Bishop’S Score: A Retrospective Record Review At Aga Khan University Hospital Karachi, Pakistan, Ayesha Malik, Sheikh Irfan Ahmed, Farheen Yousuf, Azra Amerjee, Sumaira Naz, Safna Naozer Virji Safna Naozer Virji

Department of Obstetrics & Gynaecology

Objective: To compare pre and post Foley's catheter Bishop Score during labour induction.
Methods: This study was a retrospective study conducted at the Aga Khan University Hospital Karachi, Pakistan after approval from ethical review board. All women who underwent induction of labour with Foley's Catheter at gestation of 37 weeks or more from September 2014-October 2015 were included. Data was entered and analyzed in Statistical Package for Social Sciences (SPSS) version 19.0. The comparison between pre and post Foley's catheter Bishop Score during labour induction will be calculated by Wilcoxon sign test.
Results: There were 981 cases of inductions of …


Evaluating The Effect Of Maternal Non-Communicable Disease On Adverse Pregnancy Outcomes And Birthweight In Pakistan, A Facility Based Retrospective Cohort Study, Esther Wainwright, Sheikh Irfan Ahmed, Rahat Qureshi, Sana Yousuf, Raheela Khan, Matthew Elmes Jan 2024

Evaluating The Effect Of Maternal Non-Communicable Disease On Adverse Pregnancy Outcomes And Birthweight In Pakistan, A Facility Based Retrospective Cohort Study, Esther Wainwright, Sheikh Irfan Ahmed, Rahat Qureshi, Sana Yousuf, Raheela Khan, Matthew Elmes

Department of Obstetrics & Gynaecology

Non-communicable diseases (NCDs) claim 74% of global lives, disproportionately affecting lower and middle-income countries like Pakistan. NCDs may increase the risk of preterm birth (PTB), caesarean section (CS), and low birthweight. This study aims to determine whether the high prevalence of NCDs in Pakistan play a role in the high rates of preterm births, and CS. This retrospective cohort study from Aga Khan University Hospital, Pakistan, investigated effects of pre-existing NCDs on pregnancy outcomes of 817 pregnant women. Medical records were used to generate odds ratios for the risk of PTB, labour outcome and birthweight in women with type 1 …


Identifying Opportunities For Prevention Of Adverse Outcomes Following Female Genital Fistula Repair: Protocol For A Mixed-Methods Study In Uganda, Alison El Ayadi, Susan Obore, Fred Kirya, Suellen Miller, Abner Korn, Hadija Nalubwama, John Neuhaus, Monica Getahun, Patrick Eyul, Robert Twine, Erin Andrew, Justus Barageine Jan 2024

Identifying Opportunities For Prevention Of Adverse Outcomes Following Female Genital Fistula Repair: Protocol For A Mixed-Methods Study In Uganda, Alison El Ayadi, Susan Obore, Fred Kirya, Suellen Miller, Abner Korn, Hadija Nalubwama, John Neuhaus, Monica Getahun, Patrick Eyul, Robert Twine, Erin Andrew, Justus Barageine

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Female genital fistula is a traumatic debilitating injury, frequently caused by prolonged obstructed labor, affecting between 500,000-2 million women in lower-resource settings. Vesicovaginal fistula causes urinary incontinence, and other morbidity may occur during fistula development. Women with fistula are stigmatized, limit social and economic engagement, and experience psychiatric morbidity. Improved surgical access has reduced fistula consequences yet post-repair risks impacting quality of life and well-being include fistula repair breakdown or recurrence and ongoing or changing urine leakage or incontinence. Limited evidence on risk factors contributing to adverse outcomes hinders interventions to mitigate adverse events. This study aims to quantify …


Infant Growth And Body Composition From Birth To 24 Months: Are Infants Developing The Same?, Shane A. Norris, Lukhanyo H. Nyati, Alexia Murphy Alford, Nishani Lucas, Ina S. Santos, Caroline S. Costa, Rebecca Kuriyan, V Pujitha Wickranasinghe, Shabina Ariff, Andrew P. Hills Jan 2024

Infant Growth And Body Composition From Birth To 24 Months: Are Infants Developing The Same?, Shane A. Norris, Lukhanyo H. Nyati, Alexia Murphy Alford, Nishani Lucas, Ina S. Santos, Caroline S. Costa, Rebecca Kuriyan, V Pujitha Wickranasinghe, Shabina Ariff, Andrew P. Hills

Department of Paediatrics and Child Health

Background: Given the importance of infancy for establishing growth trajectories, with later-life health consequences, we investigated longitudinal body composition among infants from six economically and ethnically diverse countries.
Methods: We recruited mother-infant dyads using the WHO Multicenter Growth Reference Study criteria. We measured fat-free mass (FFM) in 1393 (49% female) infants from birth to 6 months of age (Australia, India, and South Africa; n = 468), 3-24 months of age (Brazil, Pakistan, South Africa, and Sri Lanka; n = 925), and derived fat mass (FM), fat mass index (FMI), and fat-free mass index (FFMI). Height-for-age (HAZ), weight-for-age (WAZ), and weight-for-length …


Uterine Rupture In The First Trimester: A Case Report And Review Of The Literature., Steve Mutiso, Felix Oindi, Debbie Mundia Jan 2024

Uterine Rupture In The First Trimester: A Case Report And Review Of The Literature., Steve Mutiso, Felix Oindi, Debbie Mundia

Obstetrics and Gynaecology, East Africa

Background: Uterine rupture is a rare complication that can occur in the frst trimester of pregnancy. It can lead to serious maternal morbidity or mortality, which is mostly due to catastrophic bleeding. First trimester uterine rupture is rare; hence, diagnosis can be challenging as it may be confused with other causes of early pregnancy bleeding such as an ectopic pregnancy. We present a case of frst trimester scar dehiscence and conduct a literature review of this rare condition.

Case presentation: A 39-year-old African patient with four previous hysterotomy scars presented with severe lower abdominal pain at 11 weeks of gestation. …


Obstetrics Emergency Labor And Delivery Case Simulations With Normal Vaginal Delivery Demonstration: A Hands-On Simulation For Clerkship Students, Emily A. Young, William A. Winter, Robyn N. D'Agostino, Rose A. Maxwell, Sheela Barhan, Marilyn Kindig Jan 2024

Obstetrics Emergency Labor And Delivery Case Simulations With Normal Vaginal Delivery Demonstration: A Hands-On Simulation For Clerkship Students, Emily A. Young, William A. Winter, Robyn N. D'Agostino, Rose A. Maxwell, Sheela Barhan, Marilyn Kindig

Obstetrics and Gynecology Faculty Publications

Introduction: Simulation is rarely used for medical student education in the field of obstetrics. This method is an effective model of learning for topics that are encountered in clinical situations and for topics that pose significant risk to patients when an untrained individual is involved. Methods: A 2-hour obstetric delivery simulation session was developed and incorporated into the third-year obstetrics and gynecology clerkship rotation at Wright State University Boonshoft School of Medicine. Medical students completed self-guided content reviews with resources provided prior to the session. During the session, each medical student conducted a normal vaginal delivery and one of the …


Impact Of Opioid-Free Analgesia On Pain Severity And Patient Satisfaction After Discharge From Surgery: Multispecialty, Prospective Cohort Study In 25 Countries, Tabish Chawla, Aliya Aziz, Anoosha Marium, Ayesha Akbar Waheed, Faiqa Binte Aamir, Faiza Qureshi, Hammad Ather, Iqra Fatima Munawar Ali, Izza Tahir, Maha Ghulam Akbar, Ronika Devi Ukrani, Sajjan Raja, Sehar Salim Virani, Shahryar Noordin, Saif Ur Rehman, Shalni Golani, Syed Roohan Aamir, Syed Musa Mufarrih, Usama Waqar, Maliha Taufiq Jan 2024

Impact Of Opioid-Free Analgesia On Pain Severity And Patient Satisfaction After Discharge From Surgery: Multispecialty, Prospective Cohort Study In 25 Countries, Tabish Chawla, Aliya Aziz, Anoosha Marium, Ayesha Akbar Waheed, Faiqa Binte Aamir, Faiza Qureshi, Hammad Ather, Iqra Fatima Munawar Ali, Izza Tahir, Maha Ghulam Akbar, Ronika Devi Ukrani, Sajjan Raja, Sehar Salim Virani, Shahryar Noordin, Saif Ur Rehman, Shalni Golani, Syed Roohan Aamir, Syed Musa Mufarrih, Usama Waqar, Maliha Taufiq

Section of General Surgery

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.
Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview …


Brief Of Amici Curiae In Support Of The United States: Moyle & Idaho V. United States, David S. Cohen, Greer Donley, Rachel Rebouché Jan 2024

Brief Of Amici Curiae In Support Of The United States: Moyle & Idaho V. United States, David S. Cohen, Greer Donley, Rachel Rebouché

Amici Briefs

This amicus brief, submitted to the Supreme Court in Moyle v. United States, argues that Moyle, and the impending circuit split surrounding it, is a symptom of a larger workability problem with the Dobbs v. Jackson Women’s Health Organization framework. Dobbs is already proving, in its brief existence, to be unworkable, and must be overturned. In short order, the Dobbs ruling has ushered in an era of unprecedented legal and doctrinal chaos, precipitating a fury of disorienting legal battles across the country. The Dobbs framework has created destabilizing conflicts between federal and state authorities, as in the current …


The Analgesic Efficacy Of Ultrasound-Guided Transversus Abdominis Plane Block Vs. Local Anesthetic Infiltration Technique In Major Gynecologic Surgery: A Randomized Controlled Trial, Samina Ismail, Akbar A. Mistry, Ali S. Siddiqui, Aliya Aziz, Nadeem Zuberi Dec 2023

The Analgesic Efficacy Of Ultrasound-Guided Transversus Abdominis Plane Block Vs. Local Anesthetic Infiltration Technique In Major Gynecologic Surgery: A Randomized Controlled Trial, Samina Ismail, Akbar A. Mistry, Ali S. Siddiqui, Aliya Aziz, Nadeem Zuberi

Department of Anaesthesia

Background and aim: Transversus abdominis plane (TAP) block and local anesthetic infiltration (LAI) technique are used as part of the multimodal analgesic regimen after abdominal surgery. Postoperative opioid consumption and analgesic efficacy was compared using TAP and LAI techniques in patients undergoing gynecologic surgery in a randomized, controlled clinical trial.
Material and methods: Total of 135 patients scheduled for major gynecological surgeries were allocated into three groups: group T received bilateral TAP block with bupivacaine 0.25%; group I received LAI with 0.25% bupivacaine with epinephrine 5 μ/mL in the peritoneum and abdominal wall, and group C was control group. Anesthesia …


Protocol For Intervention Development To Improve Adolescent Perinatal Mental Health In Kenya And Mozambique: The Inspire Project, Kethakie Lamahewa, Sally Griffin, Nadine Seward, Marleen Temmerman, Jonathan West, Málica De Melo, Elizabeth Raby, Aline Alonso, Bethan Burnside, Fernando Chissale Dec 2023

Protocol For Intervention Development To Improve Adolescent Perinatal Mental Health In Kenya And Mozambique: The Inspire Project, Kethakie Lamahewa, Sally Griffin, Nadine Seward, Marleen Temmerman, Jonathan West, Málica De Melo, Elizabeth Raby, Aline Alonso, Bethan Burnside, Fernando Chissale

Obstetrics and Gynaecology, East Africa

Introduction: Mental health interventions have traditionally been developed by clinicians and researchers without the meaningful engagement and partnership with those who would receive, deliver, and fund them. Recent progress has highlighted the importance of the co-design of interventions, through stakeholder participation, as a means of increasing the integration of mental health interventions into existing health, education, and social care systems. This protocol describes the pre-implementation phase of the INSPIRE (Innovative approaches to adolescent perinatal wellbeing) project which aims to identify challenges, and design and test interventions to promote mental wellbeing and good mental health of adolescent girls during pregnancy and …


Characteristics And Outcomes Of Patients With Pregnancy-Related End-Stage Kidney Disease., Lauren Kucirka, Ana Angarita, Tracy Manuck, Kim Boggess, Vimal Derebail, Mollie Wood, Michelle Meyer, Dorry Segev, Monica Reynolds Dec 2023

Characteristics And Outcomes Of Patients With Pregnancy-Related End-Stage Kidney Disease., Lauren Kucirka, Ana Angarita, Tracy Manuck, Kim Boggess, Vimal Derebail, Mollie Wood, Michelle Meyer, Dorry Segev, Monica Reynolds

Department of Obstetrics and Gynecology Faculty Papers

IMPORTANCE: The incidence of pregnancy-related acute kidney injury is increasing and is associated with significant maternal morbidity including progression to end-stage kidney disease (ESKD). Little is known about characteristics and long-term outcomes of patients who develop pregnancy-related ESKD.

OBJECTIVES: To examine the characteristics and clinical outcomes of patients with pregnancy-related ESKD and to investigate associations between pre-ESKD nephrology care and outcomes.

DESIGN, SETTING, AND PARTICIPANTS: This was a cohort study of 183 640 reproductive-aged women with incident ESKD between January 1, 2000, and November 20, 2020, from the US Renal Data System and maternal data from births captured in the …


Sars-Cov-2 Seroprevalence In Pregnant Women In Kilifi, Kenya From March 2020 To March 2022, Angela Koech, Geoffrey Omuse, Alex Mugo, Isaac Mwaniki, Joseph Mutunga, Moses Mukhanya, Onesmus Wanje, Grace Mwashigadi, Geoffrey Katana, Marleen Temmerman Dec 2023

Sars-Cov-2 Seroprevalence In Pregnant Women In Kilifi, Kenya From March 2020 To March 2022, Angela Koech, Geoffrey Omuse, Alex Mugo, Isaac Mwaniki, Joseph Mutunga, Moses Mukhanya, Onesmus Wanje, Grace Mwashigadi, Geoffrey Katana, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background: Seroprevalence studies are an alternative approach to estimating the extent of transmission of SARS-CoV-2 and the evolution of the pandemic in different geographical settings. We aimed to determine the SARS-CoV-2 seroprevalence from March 2020 to March 2022 in a rural and urban setting in Kilifi County, Kenya.

Methods: We obtained representative random samples of stored serum from a pregnancy cohort study for the period March 2020 to March 2022 and tested for antibodies against the spike protein using a qualitative SARS-CoV-2 ELISA kit (Wantai, total antibodies). All positive samples were retested for anti-SARS-CoV-2 anti-nucleocapsid antibodies (Euroimmun, ELISA kits, NCP, …


Microbiota Dynamics, Metabolic And Immune Interactions In The Cervicovaginal Environment And Their Role In Spontaneous Preterm Birth, Stanely Onyango, Jia Dai Mi, Anjela Koech, Patricia Okiro, Marleen Temmerman, Peter Von Dadelszen, Rachel Marie Tribe, Geoffrey Omuse Dec 2023

Microbiota Dynamics, Metabolic And Immune Interactions In The Cervicovaginal Environment And Their Role In Spontaneous Preterm Birth, Stanely Onyango, Jia Dai Mi, Anjela Koech, Patricia Okiro, Marleen Temmerman, Peter Von Dadelszen, Rachel Marie Tribe, Geoffrey Omuse

Pathology, East Africa

Differences in the cervicovaginal microbiota are associated with spontaneous preterm birth (sPTB), a significant cause of infant morbidity and mortality. Although establishing a direct causal link between cervicovaginal microbiota and sPTB remains challenging, recent advancements in sequencing technologies have facilitated the identification of microbial markers potentially linked to sPTB. Despite variations in findings, a recurring observation suggests that sPTB is associated with a more diverse and less stable vaginal microbiota across pregnancy trimesters. It is hypothesized that sPTB risk is likely to be modified via an intricate host-microbe interactions rather than due to the presence of a single microbial taxon …


Support, Networks, And Relationships: Findings From A Mixed-Methods Evaluation Of A Mentorship Programme For Early Career Women Researchers In Sexual And Reproductive Health And Rights, Muhammad Asim, Peter Muriuki Gatheru, Joy J. Chebet, Mehr G. Shah, Anna Thorson, Vanessa Brizuela Dec 2023

Support, Networks, And Relationships: Findings From A Mixed-Methods Evaluation Of A Mentorship Programme For Early Career Women Researchers In Sexual And Reproductive Health And Rights, Muhammad Asim, Peter Muriuki Gatheru, Joy J. Chebet, Mehr G. Shah, Anna Thorson, Vanessa Brizuela

Community Health Sciences

Low research output among women researchers in health research has been linked to inadequate mentorship opportunities for early career women researchers and particularly in sexual and reproductive health and rights (SRHR) field. Mentorship has been recognized as a contributor to strengthening research capacity and as beneficial for both mentors and mentees. Women researchers oftentimes experience negative impacts of organizational and structural gender inequities related to formal and informal mentoring. In 2020, the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction at WHO launched a mentorship programme for early career SRHR women researchers from low- and …