Medicine and Health Sciences Commons^™

Development Of A Men’S Health Course For First-Year Undergraduates Using Culturally Responsive Teaching Strategies, Ania A. Majewska, Johnasha D. Stuart, Kelsey M. Gray, Pearl V. Ryder, Ethell Vereen

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Purpose

A novel first-year experience course was developed using culturally responsive teaching strategies at an undergraduate liberal arts college in the southeastern USA to promote health advocacy and to provide students with an overview of male health. The course focuses on the biological, sociocultural, economic and gender influences that shape men's health beliefs and practices. It also emphasizes health disparities in the USA among Black/African American men compared to other racial groups and intervention strategies to improve health outcomes.

Design/methodology/approach

The lecture and laboratory components of the course were designed as a blended learning environment with a modified flipped class …

Knowledge, Attitude And Practices Of Pregnant Women Related To Covid-19 Infection: A Cross-Sectional Survey In Seven Countries From The Global Network For Women's And Children's Health, Farnaz Naqvi, Seemab Naqvi, Sk Masum Billah, Sarah Saleem, Elizabeth Fogleman, Nalini Peres Da-Silva, Lester Figueroa, Manolo Mazariegos, Ana L. Garces, Sana Yousaf

Community Health Sciences

Objective: We sought to understand knowledge, attitudes and practices (KAP) regarding COVID-19 in pregnant women in seven low and middle-income countries (LMIC).
Design: Population-based prospective, observational study.
Settings: Study sites in DRC, Kenya, Zambia, Bangladesh, India (two sites), Pakistan and Guatemala.
Population and sample: Pregnant women in the Global Network's Maternal and Neonatal Health Registry (MNHR).
Methods: A KAP questionnaire was administered in face-to-face interviews with pregnant women from September 2020 through October 2021 in the MNHR.
Main outcome measures: KAP regarding COVID-19 during pregnancy.
Results: In all, 25 260 women completed the survey. Overall, 56.8% of women named ≥3 …

Intouch February 14, 2022, New York Medical College

InTouch

• 26th Annual Medical Student Research Forum Features Record Number of Participants
• Mary Petzke, Ph.D., Fulfills Her Lifelong Dream of Teaching
• Actor and Comedian, Frank Vigliotti, SLP Class of 2023, Prepares for New Role as a Speech-Language Pathologist
• Donate Life Club Set to Surpass Donation Goal After Another Successful Drive

Machine Learning To Predict Sports-Related Concussion Recovery Using Clinical Data, Yan Chu, Gregory Knell, Riley P. Brayton, Scott O. Burkhart, Xiaoqian Jiang, Shayan Shams

Faculty Research, Scholarly, and Creative Activity

Objectives
Sport-related concussions (SRCs) are a concern for high school athletes. Understanding factors contributing to SRC recovery time may improve clinical management. However, the complexity of the many clinical measures of concussion data precludes many traditional methods. This study aimed to answer the question, what is the utility of modeling clinical concussion data using machine-learning algorithms for predicting SRC recovery time and protracted recovery?
Methods
This was a retrospective case series of participants aged 8 to 18 years with a diagnosis of SRC. A 6-part measure was administered to assess pre-injury risk factors, initial injury severity, and post-concussion symptoms, including …

Effect Of Covid-19 On The Wellbeing Of Healthcare Professionals In Public Isolation Hospitals In Egypt, Shaimaa Sabbah

Theses and Dissertations

One of the most vulnerable groups severely hit by the COVID-19 pandemic has been the Healthcare Professionals (HCPs), especially the physicians, pharmacists, and nurses who work in public Isolation hospitals. The Egyptian medical syndicate declared the death of more than 600 physicians from February 2020 till January 2022. In the meantime, the Egyptian government has worked on different policies for relieving the negative effects of the pandemic on this vulnerable group; however, easing restrictions, no total lockdown implementation, and monitoring bureaucracy has negatively affected the wellbeing of those HCPs. The study aims to figure out recommended policies to protect HCPs’ …

Does A School Snack Make A Difference? An Evaluation Of The World Food Programme Emergency School Feeding Programme In Lebanon Among Lebanese And Syrian Refugee Children, Zeina Jamaluddine, Chaza Akik, Gloria Safadi, Sara Abou Fakher, Nehmat El-Helou, Soha Moussa, Dominique Anid, Hala Ghattas Ph.D.

Faculty Publications

Objective: To investigate the effects of providing a daily healthy school snack on children's nutritional, social and educational outcomes and explore stakeholders' perceptions of an emergency school feeding programme (SFP). Design: Convergence triangulation mixed-methods study design. Associations were examined between receiving the school feeding intervention and children's outcomes using multivariable regression models. Quantitative data were complemented with interviews and focus group discussions with parents and staff. Setting: In vulnerable communities in Lebanon, the World Food Programme has implemented an emergency SFP targeting Lebanese (attending morning sessions) and Syrian refugee children (attending afternoon sessions) in public schools. Participants: Children from ten …

Cerebral Blood Flow And Brain Functional Connectivity Changes In Older Adults Participating In A Mindfulness-Based Stress Reduction Program, Aleeze Sattar Moss, Diane K. Reibel, Nancy Wintering, Faezeh Vedaei, Hannah Porter, Mohsen Khosravi, Justin Heholt, M. Alizadeh, Feroze Mohamed, Andrew B. Newberg

Department of Radiology Faculty Papers

There is a growing interest in the potential beneficial effects of mindfulness meditation training in protecting against age-related physical, emotional, and cognitive decline. The current prospective, single-center, single-arm study investigated if functional magnetic resonance imaging-based changes in cerebral blood flow and brain functional connectivity could be observed in 11 elderly adults (mean age 79) after participation in a Mindfulness-Based Stress Reduction (MBSR) program. The results showed significantly (p < 0.05) altered cerebral blood flow and functional connectivity in the cingulate gyrus, limbic structures, and subregions of the temporal and frontal lobes, similar to findings of other meditation-related studies in younger populations. Furthermore, these changes were also associated with significant improvements in depression symptoms. This study suggests that the MBSR program can potentially modify cerebral blood flow and connectivity in this population.

The Association Between Rest-Activity Rhythms And Glycemic Markers: The Us National Health And Nutrition Examination Survey, 2011-2014, Qian Xiao, Charles E Matthews, Mary Playdon, Cici Bauer

Faculty, Staff and Student Publications

OBJECTIVES: Previous studies conducted in mostly homogeneous sociodemographic samples have reported a relationship between weakened and/or disrupted rest-activity patterns and metabolic dysfunction. This study aims to examine rest-activity rhythm characteristics in relation to glycemic markers in a large nationally representative and diverse sample of American adults.

METHODS: This study used data from the National Health and Nutrition Examination Survey 2011-2014. Rest-activity characteristics were derived from extended cosine models using 24-hour actigraphy. We used multinomial logistic regression and multiple linear regression models to assess the associations with multiple glycemic markers (i.e., glycated hemoglobin, fasting glucose and insulin, homeostatic model assessment of …

Coinfections In Patients With Cancer And Covid-19: A Covid-19 And Cancer Consortium (Ccc19) Study, Gowri Satyanarayana, Kyle T Enriquez, Tianyi Sun, Elizabeth J Klein, Maheen Abidi, Shailesh M Advani, Joy Awosika, Ziad Bakouny, Babar Bashir, Stephanie Berg, Marilia Bernardes, Pamela C Egan, Arielle Elkrief, Lawrence E Feldman, Christopher R Friese, Shipra Goel, Cyndi Gonzalez Gomez, Keith L Grant, Elizabeth A Griffiths, Shuchi Gulati, Shilpa Gupta, Clara Hwang, Jayanshu Jain, Chinmay Jani, Anna Kaltsas, Anup Kasi, Hina Khan, Natalie Knox, Vadim S Koshkin, Daniel H Kwon, Chris Labaki, Gary H Lyman, Rana R Mckay, Christopher Mcnair, Gayathri Nagaraj, Elizabeth S Nakasone, Ryan Nguyen, Taylor K Nonato, Adam J Olszewski, Orestis A Panagiotou, Matthew Puc, Pedram Razavi, Elizabeth V Robilotti, Miriam Santos-Dutra, Andrew L Schmidt, Dimpy P Shah, Sumit A Shah, Kendra Vieira, Lisa B Weissmann, Trisha M Wise-Draper, Ulysses Wu, Julie Tsu-Yu Wu, Toni K Choueiri, Sanjay Mishra, Jeremy L Warner, Benjamin French, Dimitrios Farmakiotis

Department of Medical Oncology Faculty Papers

Background: The frequency of coinfections and their association with outcomes have not been adequately studied among patients with cancer and coronavirus disease 2019 (COVID-19), a high-risk group for coinfection.

Methods: We included adult (≥18 years) patients with active or prior hematologic or invasive solid malignancies and laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection, using data from the COVID-19 and Cancer Consortium (CCC19, NCT04354701). We captured coinfections within ±2 weeks from diagnosis of COVID-19, identified factors cross-sectionally associated with risk of coinfection, and quantified the association of coinfections with 30-day mortality.

Results: Among 8765 patients (hospitalized or not; median …

Fungal Mycobiome Drives Il-33 Secretion And Type 2 Immunity In Pancreatic Cancer, Aftab Alam, Eric Levanduski, Parker Denz, Helena Solleiro Villavicencio, Maulasri Bhatta, Lamees Alhorebi, Yali Zhang, Eduardo Cortes Gomez, Brian Morreale, Sharon Senchanthisai, Jun Li, Steven G Turowski, Sandra Sexton, Sheila Jani Sait, Prashant K Singh, Jianmin Wang, Anirban Maitra, Pawel Kalinski, Ronald A Depinho, Huamin Wang, Wenting Liao, Scott I Abrams, Brahm H Segal, Prasenjit Dey

Faculty, Staff and Student Publications

TH2 cells and innate lymphoid cells 2 (ILC2) can stimulate tumor growth by secreting pro-tumorigenic cytokines such as interleukin-4 (IL-4), IL-5, and IL-13. However, the mechanisms by which type 2 immune cells traffic to the tumor microenvironment are unknown. Here, we show that oncogenic KrasG12D increases IL-33 expression in pancreatic ductal adenocarcinoma (PDAC) cells, which recruits and activates TH2 and ILC2 cells. Correspondingly, cancer-cell-specific deletion of IL-33 reduces TH2 and ILC2 recruitment and promotes tumor regression. Unexpectedly, IL-33 secretion is dependent on the intratumoral fungal mycobiome. Genetic deletion of IL-33 or anti-fungal treatment decreases TH2 and ILC2 infiltration and increases …

Intranasal Dexamethasone: A New Clinical Trial For The Control Of Inflammation And Neuroinflammation In Covid-19 Patients, Graciela Cárdenas, María Chávez-Canales, Ana María Espinosa, Antonio Jordán-Ríos, Daniel Anica Malagon, Manlio Fabio Márquez Murillo, Laura Victoria Torres Araujo, Ricardo Leopoldo Barajas Campos, Rosa María Wong, Juan Carlos Lopez Alvarenga

School of Medicine Publications

Background: By end December of 2021, COVID-19 has infected around 276 million individuals and caused over 5 million deaths worldwide. Infection results in dysregulated systemic inflammation, multi-organ dysfunction, and critical illness. Cells of the central nervous system are also affected, triggering an uncontrolled neuroinflammatory response. Low doses of glucocorticoids, administered orally or intravenously, reduce mortality among moderate and severe COVID-19 patients. However, low doses administered by these routes do not reach therapeutic levels in the CNS. In contrast, intranasally administered dexamethasone can result in therapeutic doses in the CNS even at low doses.

Methods: This is an approved open-label, multicenter, …

Ideas To Action: Using Curriculum Design To Develop A “Roadmap To Wellness” Curriculum, Christine R. Stehman, Kelly Williamson, Erin Dehon, Al'ai Alvarez, Manish Garg, Michelle D. Lall

Journal of Wellness

Introduction: Physician burnout, well-being, and professional fulfillment are deeply intertwined topics that are increasingly recognized as affecting the lives of physicians, health care workers, and patients alike. The Accreditation Council for Graduate Medical Education (ACGME) mandates that all residencies address wellness within the context of residency training without providing much guidance on how to do so. Emergency Medicine organizations such as the American College of Emergency Physicians, the American Academy of Emergency Physicians, the Society for Academic Emergency Medicine, and the Council of Residency Directors of Emergency Medicine (CORD) suggest that one method to address wellness is in the …

Developing Microbial Co-Culture System For Enhanced Polyhydroxyalkanoates (Pha) Production Using Acid Pretreated Lignocellulosic Biomass, Rijuta Ganesh Saratale, Si-Kyung Cho, Avinash Ashok Kadam, Gajanan Sampatrao Ghodake, Manu Kumar, Ram Naresh Bharagava, Sunita Varjani, Supriya Nair, Dong-Su Kim, Han-Seung Shin, Ganesh Dattatraya Saratale

Faculty, Staff and Student Publications

In the growing polymer industry, the interest of researchers is captivated by bioplastics production with biodegradable and biocompatible properties. This study examines the polyhydroxyalkanoates (PHA) production performance of individual Lysinibacillus sp. RGS and Ralstonia eutropha ATCC 17699 and their co-culture by utilizing sugarcane bagasse (SCB) hydrolysates. Initially, acidic (H2SO4) and acidified sodium chlorite pretreatment was employed for the hydrolysis of SCB. The effects of chemical pretreatment on the SCB biomass assembly and its chemical constituents were studied by employing numerous analytical methods. Acidic pretreatment under optimal conditions showed effective delignification (60%) of the SCB biomass, leading to a maximum hydrolysis …

A Mediation Analysis Of The Role Of Girl Child Marriage In The Relationship Between Proximity To Conflict And Past-Year Intimate Partner Violence In Post-Conflict Sri Lanka, Ruvani W. Fonseka, Lotus Mcdougal, Anita Raj, Elizabeth Reed, Rebecka Lundgren, Lianne Urada, Jay G. Silverman

Faculty Research, Scholarly, and Creative Activity

Background
Studies from many contexts indicate that proximity to conflict is associated with increased likelihood of intimate partner violence (IPV), and girl child marriage is associated with both proximity to conflict and increased IPV. In this study, we consider whether girl child marriage acts as a mediator of the association between proximity to conflict and IPV in the context of Sri Lanka, which sustained long-term conflict until 2009.
Methods
We analyzed responses of currently partnered women between ages 18 and 49 in the 2016 Sri Lankan Demographic and Health Survey (N = 13,691). Using logistic regression analyses, we measured associations …

Prevention Is Political: Political Party Affiliation Predicts Perceived Risk And Prevention Behaviors For Covid-19, Marc T Kiviniemi, Heather Orom, Jennifer L Hay, Erika A Waters

2020-Current year OA Pubs

BACKGROUND: Many US politicians have provided mixed messages about the risks posed by SARS-CoV-2/COVID-19 and whether and to what extent prevention practices should be put in place to prevent transmission. This politicization of the virus and pandemic may affect individuals' risk perceptions and willingness to take precautions. We examined how political party affiliation relates to risk perception for one's own and other people's likelihood of SARS-CoV-2 infection/COVID-19 illness.

METHODS: We surveyed members of a nationally-representative, probability-sampling based survey panel (N = 410) to examine their risk perceptions, precautionary behaviors, and political party affiliation.

RESULTS: The more strongly one identified as …

Reviewer Acknowledgments, F. Douglas Scutchfield Md, Charlotte S. Seidman, Robert M. Shapiro Ii

Journal of Appalachian Health

We offer these reviewers our heartfelt thanks for a task that usually goes unrewarded in the academic environment. This year, we are especially grateful for those people listed below. They have assisted us in reaching the start of our 4th year, by guiding our decisions with your knowledge and capabilities.

Review Of: Wide Neighborhoods: A Story Of The Frontier Nursing Service, Tauna Gulley Phd

Journal of Appalachian Health

The Journal of Appalachian Health is committed to reviewing published media that relates to contemporary concepts affecting the health of Appalachia. Access to care remains one of the biggest challenges to Appalachian Health. The book, Wide Neighborhoods: A Story of the Frontier Nursing Service by Mary Breckinridge, is a well-known title that seems as relevant today as it was in 1952.

Prevalence And Types Of Drugs Used Among Hepatitis A Patients During Outbreaks Associated With Person-To-Person Transmission, Kentucky, Michigan, And West Virginia, 2016–2019, Megan G. Hofmeister, Alice Asher, Christopher M. Jones, Ryan J. Augustine, Cole Burkholder, Jim Collins, Monique A. Foster, Shannon Mcbee, Erica D. Thomasson, Doug Thoroughman, Mark K. Weng, Philip R. Spradling

Journal of Appalachian Health

Background: People who use drugs are at increased risk for hepatitis A virus infection. Since 1996, the Advisory Committee on Immunization Practices has recommended hepatitis A vaccination for people who use drugs. Since 2016, the U.S. has experienced widespread hepatitis A outbreaks associated with person-to-person transmission.

Purpose: To describe the prevalence of drug use, route of use, and drugs used among hepatitis A outbreak-associated patients.

Methods: State outbreak and medical records were reviewed to describe the prevalence, type, and route of drug use among a random sample of 812 adult outbreak-associated hepatitis A patients from Kentucky, Michigan, and West Virginia …

Changes In Adolescent Birth Rates Within Appalachian Subregions And Non-Appalachian Counties In The United States, 2012–2018, Nathan Hale, Kathleen Tatro, Sylvester Olubolu Orimaye, Michael Smith, Michael Meit, Kate E. Beatty, Amal Khoury

Journal of Appalachian Health

Background: Adolescent births are associated with numerous challenges. While adolescent birth rates have declined across the U.S., disparities persist and little is known about the extent to which broader declines are seen within Appalachia.

Purpose: The purpose of this study was to examine the extent to which adolescent birth rates have declined across the subregions of Appalachia relative to non-Appalachia.

Methods: We conducted a retrospective study of adolescent birth rates between 2012 and 2018 using county-level vital records data. Differences were examined across the subregions of Appalachia and among non-Appalachian counties. Multiple regression models were used to examine changes in …

Community Strengths And Challenges Related To Opioid Use Disorder In Rural Counties Of East Tennessee, Ashlyn N. Schwartz, Zeruiah V. Buchanan, Laurie L. Meschke

Journal of Appalachian Health

Introduction: Appalachia, particularly Rural East Tennessee, has been and continues to be disproportionately impacted by opioid use disorder and its many tragic ramifications.

Purpose: Community-engaged strategies can inform and support the development of relevant prevention efforts. Hence, people connected to a ten-county rural Appalachian region in East Tennessee were asked to identify and prioritize strengths and challenges related to opioid use disorder (OUD).

Methods: Adult community members (n=577) completed a brief survey administered across 11 days in 2019.

Results: Of the respondents, 85.3% never had been addicted to opioids, but 74.0% had someone close to them with OUD. The most …

They Built My Soul: A Qualitative Analysis Of The Impacts Of Home Repairs In Rural Tennessee, Bethesda O'Connell, Ada Sloop, Nicole Intagliata, Melisa Miller, Megan Quinn

Journal of Appalachian Health

Background: Housing is an important social determinant of health and substandard housing is linked to physical, mental, and social health problems.

Purpose: The purpose of the study was to qualitatively assess the impacts of repairs to substandard housing in rural East Tennessee through twenty-eight interviews.

Methods: Zoom was utilized for recording phone interviews in January– February 2021 and NVivo software was used for thematic analysis in May–July 2021.

Results: Themes that emerged included environmental risk reduction, impacts on physical health, impacts on mental health, impacts on financial well-being, and willingness to receive future assistance from service organizations.

Implications: Further …

That's All She Wrote, Charlotte S. Seidman

Journal of Appalachian Health

With the publication of this issue, I am retiring and formally handing over the reins as managing editor of the Journal of Appalachian Health to Rachel Dixon. I have had a 50+ year career and have been blessed to have had the opportunity to meet and work with the best health professionals in preventive medicine and public health.

Change Happens, F. Douglas Scutchfield Md

Journal of Appalachian Health

The Journal of Appalachian Health is going through some changes that are reflected in the masthead and banner. We say farewell to some colleagues and welcome the new faces.

Aarogya Kaapaduvalli Kai Nairmalyada Mahatva, Reshma Maria Cocess Dsouza Ms

Faculty work

No abstract provided.

More Elevated Fastballs Associated With Placement On The Injured List Due To Shoulder Injury, Austin V. Stone, Brooks N. Platt, Brandon S. Collofello, Aaron D. Sciascia, Timothy L. Uhl, William B. Kibler

Orthopaedic Surgery and Sports Medicine Faculty Publications

Purpose

To evaluate whether impending shoulder injury was associated with changes in pitch location or velocity immediately preceding injury.

Methods

Pitchers placed on the injured list (IL) due to a shoulder injury between 2015 and 2020 were identified in the Major League Baseball transactions database. Four-seam fastball velocity and frequency of pitch location for each pitch type was collected for each player in the season before placement on the IL and within 1 month of placement on the IL with a minimum of 55 pitches thrown of 1 type. Pitch locations were collected as identified by Baseball Savant’s Game-Day Zones. …

Virtual Voices: Examining Social Support Exchanged Through Participant-Generated And Unmoderated Content In A Mobile Intervention To Improve Hiv Antiretroviral Therapy Adherence Among Gbmsm., Christina J. Sun, Thembekile Shato, Ashlynn Steinbaugh, Sharanya Pradeep, K Rivet Amico, Keith Horvath

OHSU-PSU School of Public Health Faculty Publications and Presentations

Antiretroviral therapy (ART) adherence is suboptimal among gay, bisexual, and other men who have sex with men (GBMSM). Online interventions that incorporate social support represent new opportunities to improve adherence. This study focused on how social support was provided and sought within a technology-based ART adherence intervention. We coded and analyzed 1,751 messages. Within the social support messages, half of the time participants sought social support and half of the time they provided social support. Emotional and informational support were the most frequently exchanged forms. The most frequent topic that participants sought support around was interpersonal relationships (29%), followed by …

Preliminary Study Of Application Of A Drug Derived From Commiphora Gileadensisi (Bisham) In Treatment Of Wounds And Burns, Balqees Bin Breek, Salem Bin Salman, Sally Salem Abdullah

Hadhramout University Journal of Natural & Applied Sciences

Bisham (Commiphora gileadensis) is a member of the family Burseraceae. The bark of these trees is known Balsam, mostly for producing fragrant resins of economic, medicinal, and cultural value. It grows wildly today in Yemen. The aim of this study is to investigate the treatment effects of the Commiphora gileadensis (Bisham) on healing burns and wounds based on its application in folk medicine. The preliminary studies reviewed in this work have shown that the C. gileadensis effectively treats many diseases and heals burns and wounds. It is widely used in folk medicine in Hadhramout as a treatment for burns and …

Distal Radius Fractures Treated With Bridging External Fixation And Outcomes, Aden, Yemen, Abdul Fatah Abbas Mansoor Haidarah

Hadhramout University Journal of Natural & Applied Sciences

Distal radius fractures are the most common fracture encountered in clinical practice. The aim of the study was to determine the characteristics of the patients, some aspects of the clinical findings, and the complications. This is a retrospective descriptive study of patients with distal radius fracture and treated by the use of bridging external fixation. It was conducted from January 2016 to December 2018 in Aden. The patients' charts were retrieved, and data was obtained. The total cases were 40, males (87.5%) and females (12.5%). Their mean age was 40 ± 19 years. The age ranged between 13 and 80 …

Clinical Presentation Of Allergic Fungal Sinusitis In Aden, Yemen, Saleh Mohamed Abobaker Alshaiby

Hadhramout University Journal of Natural & Applied Sciences

Allergic fungal sinusitis, or eosinophilic fungal rhinosinusitis, is a barely recognized pathologic entity that belongs to the fungal rhinosinusitis group. It is characterized by pathognomonic eosinophilic mucin-containing hyphae besides other distinctive histological and imaging features that contribute to the diagnosis. The aim of the study was to assess the presentation of allergic fungal sinusitis and to evaluate the different clinical features of this clinical dilemma in Aden, Yemen. We performed a retrospective chart review of 64 patients with allergic fungal sinusitis. They were (64.1%) males and (35.9%) females with ratio male to female 1.8:1. Their mean age was (25.9 ± …

A Rare Type Of Intact Large Ampullary Pregnancy Of Alive Fetus, Asrar Saleh Sayad, Amer Salmen Balafair, Laila Mohammed Bamatraf

Hadhramout University Journal of Natural & Applied Sciences

Ectopic tubal pregnancy is a very rare to progress intact with alive fetus at 12 weeks gestation. The most reported cases of intact tubal pregnancy is between nine to ten weeks gestation. We report a woman of 36 years old from Shihr city, Hadramout governorate, G7P5+1 with previous history of cesarean section complaining from amenorrhea 12 weeks, left iliac fossa pain, slight intermittent vaginal bleeding associated with nausea and vomiting. Transabdominal ultrasonography revealed empty uterine cavity with single alive fetus about 12 weeks gestation in the left adnexa with well developed placenta and no hemoperitoneum. Laparotomy left salpingectomy of ampullary …