Female Urogenital Diseases and Pregnancy Complications Commons^™

Making Hospitals Health Promotive, Shelina Bhamani, Areeba Zainab Makhdoom

Department of Obstetrics & Gynaecology

No abstract provided.

Cervical Cancer: Are There Ways To Reduce The Risks?, Madelyn Dorn

Symposium of Student Scholars

History has shown us that when caught early, cervical cancer is curable. Past research has found that the sexually transmitted diseases (STDs), herpes and human papillomavirus (HPV), have been associated with cervical cancer. In contrast, my dataset on 859 women has many more STDs and lifestyle choices compiled on 36 variables. The diagnoses in the dataset are many: cervical condylomatosis, vaginal condylomatosis, vulvo-perineral condylomatosis, syphilis, pelvic inflammatory disease, genital herpes, molluscum contagiosum, acquired immune deficiency syndrome (AIDS), human immunodeficiency virus (HIV), hepatitis B, HPV, and cervical cancer. In addition to the demographic variable on age, there are many lifestyle choice …

Oral Minimal Model For Gestational Diabetes, Sarah Peters

Symposium of Student Scholars

Gestational diabetes is one of the most common issues that a pregnant woman encounters that could result in harm to both the woman and child. Due to this issue, the woman’s glucose and insulin levels should be carefully monitored throughout her pregnancy to assess the need for prescribed diabetic medication to help regulate those levels. In this research, the objectives is to develop a MATLAB computer program of the Oral Minimal Model, which is a model that can be used to estimate a person’s insulin sensitivity from an oral glucose tolerance test (OGTT) where plasma glucose and insulin levels are …

Cohort Profile: The Alliance For Maternal And Newborn Health Improvement (Amanhi) Biobanking Study, Fahad Aftab, Salahuddin Ahmed, Aneeta Hotwani, Muhammad Ilyas, Mohammad Javaid, Fyezah Jehan, Farah Khalid, Usma Mehmood, Muhammad Imran Nisar, Muhammad Sajid

Department of Paediatrics and Child Health

No abstract provided.

An Audit Of Gynae-Oncology Practices In Ovarian Cancer Treatment Based On Enhanced Recovery After Surgery (Eras) Protocol Amongst Two Gynae-Oncology Units, In Uk And In Pakistan, Uzma Chishti, Munazza Akhtar, Aliya Aziz, Amber Ahmed, Desmond Pj Barton

Department of Obstetrics & Gynaecology

Objective: To compare peri-operative practices and complications in ovarian cancer patients undergoing upfront surgery for primary disease under enhanced recovery after surgery protocol and traditional practices.
Methods: The retrospective cross-sectional study was done at the gynaecology departments of St Georges Hospital, United Kingdom, and the Aga Khan Hospital, Pakistan, and comprised data of an equal number of ovarian cancer patients from each centre who underwent ovarian cancer surgery from January 2015 to December 2016. The former centre practiced the enhanced recovery after surgery protocol, while the latter centre followed traditional practices. Data was analysed using SPSS 19.|
Results: Of the …

"When They See Someone Who Is Poor, They Step On Them": The Social Determinants Of Health Among Survivors Of Sex Trafficking In Cambodia, James P. Havey, Glenn M. Miles, Lim Vanntheary, Nhanh Channtha, Hanni Stoklosa

Dignity: A Journal of Analysis of Exploitation and Violence

Social determinants of health (SDH) are defined as the non-medical yet health-affecting conditions of a person’s life. They include such considerations as working conditions, discrimination, and access to health services. The aim of this study was to explore the SDH impacting those who have survived sex trafficking in Cambodia. This study employed a mixed methods, secondary analysis, focusing on 52 survivors of sex trafficking in the Butterfly Longitudinal Research Project from 2010 through 2019. Participants described myriad social determinants of health, including: gender, age, relationship status (marriage), ethnicity, national identification documentation (statelessness), social class, formal education, vocational training, occupation, and …

Frequency Of Primiparous Mother Initiated Breastfeeding Earlier After Birth And Factors Associated With It In Sindh, Pakistan: A Secondary Analysis, Asma A. Bham, Sucheta Sharma, Akash Sardool, Umer F. Mujahid, Amrat Ayaz, Komal Valliani, Nawaal Maredia

Community Health Sciences

Background: Initiation of breastfeeding within one hour after delivery plays a vital role in a newborns life by not only increasing their survival rate but also reducing many life-threatening diseases in the newborn. The aim of the study was to determine frequency of early initiation of breastfeeding among primiparous mothers in a rural district of Thatta, Pakistan.
Methods: This study was conducted using survey data extracted from a cross-sectional study conducted in 2019 on prevalence of exclusive breastfeeding and factors associated with it among women in Thatta. The outcome was early initiation of breastfeeding. To determine factors associated with it, …

Does Exercise Prevent Gestational Diabetes Mellitus In Pregnant Women? A Clin-Iq, Olivia Lust, Tana Chongsuwat, Elizabeth Lanham, Ann F. Chou, Elizabeth Wickersham

Journal of Patient-Centered Research and Reviews

Excessive weight gain during pregnancy has been on the rise globally, leading to increased prevalence of gestational diabetes mellitus (GDM). A diagnosis of GDM often leads to pregnancy and infant-related complications. Regular exercise may have the potential to prevent GDM. However, evidence surrounding the utility of exercise during pregnancy as an effective risk reduction intervention has been mixed. This clinical inquiry examined the role of regular exercise during pregnancy in preventing GDM in both obese and normal-weight women and analyzed specific aspects of exercise that make it an effective preventive measure. The review of evidence included 3 meta-analyses, 3 systematic …

Covid-19 Deliveries: Maternal Features And Neonatal Outcomes, Viviana Zlochiver, Blair Tilkens, Ana Cristina Perez Moreno, Fatima Aziz, M. Fuad Jan

Journal of Patient-Centered Research and Reviews

Integrated, data-driven criteria are necessary to evaluate delivery outcomes in pregnancies affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the ongoing COVID-19 pandemic. This study analyzed maternal demographics, clinical characteristics, treatments, and delivery outcomes of 85 ethnically diverse, adult pregnant women who tested positive for SARS-CoV-2 at the time of delivery. Median maternal and gestational ages were 27 years (interquartile range [IQR]: 23–31) and 39 weeks (IQR: 37.3–40.0), respectively. Of the 85 SARS-CoV-2–positive participants, 67 (79%) had no COVID-19 symptoms at the time of routine COVID-19 admission testing, 14 (16%) reported mild COVID-19 symptoms, and 4 (5%) presented …

Surgery For Pelvic Organ Prolapse And Stress Urinary Incontinence And Female Sexual Functions: A Quasi-Experimental Study, Saida Abrar, Raheela Mohsin Rizvi, Huda Saleem

Department of Obstetrics & Gynaecology

Objectives: To assess the effect of pelvic organ prolapse (POP) and/or stress urinary incontinence (SUI) on various domains of female sexual functions in patients before and after reconstructive surgery for these pelvic floor disorders.
Methods: We conducted a quasi-experimental study of 126 women aged 25-65 years, presenting with POP / SUI, from January 1st 2019 to December 31st 2019 at Aga Khan University Hospital. POP surgery was performed only in patients with symptomatic POP ≥ stage 2 according to POP-Q (quantification). Sexual functions were assessed using Female Sexual Function Index (FSFI) questionnaire, among sexually active women at baseline and 18 …

Impact Of Covid-19 On Family Planning, Bakhtawar M H. Khowaja, Quratulain Shalwani

Department of Obstetrics & Gynaecology

No abstract provided.

The Association Of Symptoms Of Overactive Bladder With Pelvic Organ Prolapse And Its Improvement After Pelvic Reconstructive Surgery, Saida Abrar, Raheela Mohsin Rizvi, Nida Zahid

Department of Obstetrics & Gynaecology

Objectives: This study asseses the association of overactive bladder symptoms and pelvic organ prolapse severity and evaluates the effect of pelvic reconstructive surgery on overactive bladder (OAB) symptoms in women with pelvic organ prolapse (POP). It also looks into any pre and post-operative factors responsible for persistent postoperative OAB symptoms.
Methods: This was a retrospective cross-sectional study conducted at the Aga Khan University Hospital, Karachi between 1st January 2014 and 31st December 2018. In this study women presenting with POP and concommitent OAB who underwent surgery for site specific defects, measured using Pelvic Organ Prolapse Quantification (POP-Q) staging system. OAB …

Metastatic Renal Cell Carcinoma To Pancreas And Gastrointestinal Tract: A Clinicopathological Study Of 3 Cases And Review Of Literature, Jamshid Abdul Ghafar, Nasir Ud Din, Ramin Saadaat, Zubair Ahmad

Department of Pathology and Laboratory Medicine

Background: Renal Cell Carcinoma (RCC) metastasizes in approximately 20-30% cases. The most common sites for metastases are the lungs, bones, liver, and brain. Metastases of RCC in the gastrointestinal tract (GIT) are very rare. Metastatic RCC has a poor prognosis. We herein present a case series of three patients with metastatic disease in the colon, duodenum, and pancreas following complete resection of RCC.
Methods: Hematoxylin and Eosin and immunohistochemical slides of 3 cases of RCC metastatic to GIT were reviewed. These cases were diagnosed between 2002 and 2019 at French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan, and …

The Impact Of Exercise On Pregnant Women Aged 18-40 And Fetal Development, Jinisha Patwa

Rowan-Virtua Research Day

68% of those who performed minimum level exercise prior to pregnancy stopped completely during early pregnancy.

Women stop exercising during pregnancy due to worries about the impact it may have on the development of the fetus.

Starting moderate-intensity, weight-bearing exercise early in pregnancy increases placental growth rate and volume.

Exercise reduces the risks of excess gestational weight gain and high maternal body weight before pregnancy.

Physical exercise reduces the risk of gestational diabetes mellitus.

Assessment Of Factors Preventing Adequate Decline In Cervical Cancer Rates Amongst Minority Women In New Jersey, Rosie Wenrich, Jillian Baker

Rowan-Virtua Research Day

Background

• Nationally declining cervical cancer rates are still high amongst minority women in NJ, with Hispanic women being affected the most.

• The Human Papilloma Virus (HPV) is the most common sexually transmitted infection and can lead to cervical cancer

• Administration of the 9-valent HPV vaccine can prevent infection and progression to cancer

• Regular cervical cancer screenings allow for better outcomes

• Various barriers prevent people with a cervix receiving the vaccine

• Various barriers prevent people with a cervix aged >/= 30 from receiving regular cervical cancer screenings

Conclusions

• Improved physician recommendation is required for the …

Retrospective Analysis Of Post-Operative Sepsis Rates, Stone Composition, And Ureteral Stent Duration After Ureteroscopy And Laser Lithotripsy During Covid-19, Young Son, Julia T. Scali, Ian Madison, Paul Chialastri, Thomas Mueller

Rowan-Virtua Research Day

Ureteroscopy with laser lithotripsy is routinely used to remove stones but results in manipulation of the genitourinary mucosa and has a well-established relationship with post-operative sepsis under certain conditions. Postoperative sepsis represents a significant morbidity and mortality cost to patients and the healthcare system. Several studies to determine risk factors for sepsis after ureteroscopy have been completed. Such risk factors include positive preoperative urine cultures, female gender, prolonged preoperative stent time > 1 month, and patients with sepsis at the time of initial stenting. To improve sepsis rates, procedural alterations such as the use of disposable ureteroscopes have been introduced, as …

Ethnic Differences In Maternal Cytokines And Adipokines And Their Association With Spontaneous Preterm Delivery, Yelizavet D. Lomakova, Xinhua Chen

Rowan-Virtua Research Day

Spontaneous preterm delivery (SPTD, birth at <37 weeks’ gestation) is a leading cause of infant mortality in the United States [1]. Infants born prematurely are more likely to suffer from both short and long-term complications including neurodevelopmental delay, visual and hearing impairment, and chronic diseases such as heart disease, hypertension and diabetes in later life [2-4]. African American women have a 2-fold increased risk of preterm delivery compared to Caucasian women [5].The reasons for this disparity are poorly understood. This limits the ability to predict and prevent preterm delivery in the most high-risk populations.

A Clinical Audit Of Management Of Third And Fourth Degree Perineal Tears, Saida Abrar, Raheela Mohsin Rizvi, Urooj Kashif

Department of Obstetrics & Gynaecology

Objective: To perform a clinical audit of the practices related to the management of third and fourth degree perineal tears.
Methods: The retrorspective study was conducted in 2019 at the Aga Khan University Hospital, Karachi, and comprised medical records from January 2008 to December 2018 of women having singleton term vaginal delivery and sustaining obstetric anal sphincter injuries. The change in practices regarding tear management was compared with a previous audit done at the same institution in 2008. Data was analysed using SPSS 20.
Results: Of the 25,370 deliveries, 142(0.56%) sustained obstetric anal sphincter injuries. There was a significant increase …

Cervical Cancer-Associated Suffering: Estimating The Palliative Care Needs Of A Highly Vulnerable Population, Eric L. Krakauer, Xiaoxiao Kwete, Khadidjatou Kane, Gauhar Afshan, Lisa Bazzett-Matabele, Danta Dona Ruthnie Bien-Aimé, Sarah Byrne-Martelli, Stephen Connor, Raimundo Correa, C R Beena Devi C R Beena Devi

Department of Anaesthesia

Purpose: To enable design of optimum palliative care for women with cervical cancer, we studied the most common types of suffering and their severity, prevalence, and duration.
Methods: We first reviewed the literature on the major types, severity, prevalence, and duration of suffering associated with cervical cancer. We then conducted a modified Delphi process with experts in cervical cancer care to supplement the literature. For each type of suffering, we distinguished between decedents (those who die from cervical cancer in a given year) and nondecedents (those who have cervical cancer in a given year but do not die). By applying …

The Effects Of Progesterone Induced Blocking Factor And 17-Hydroxyprogesterone Caproate On The Pathophysiology Of Preeclampsia, Kyleigh M. Comley

Honors Theses

Preeclampsia (PE) is responsible for about 20% of the 13 million preterm births each year worldwide, including 100,000 cases annually in the United States. Despite being a leading cause of maternal and perinatal morbidity, the mechanisms of pathogenesis are still largely unknown. PE is progesterone deficient state characterized by hypertension, chronic immune activation, endothelial dysfunction and severe forms can lead to seizures. Treatment of seizures includes the administration of magnesium sulfate (MgSO4) though not all PE patients are responsive, and it does not decrease PE-associated hypertension. To resolve these conditions, PE patients are delivered early thereby making PE the leading …

Bibliometric Analysis Of Emerging Technologies In The Field Of Computer Science Helping In Ovarian Cancer Research, Sonali Kothari Dr., Anvita Gupta, Muskaan Agrawal Agrawal, Kajal Jaggi, Adhiraj Dev Goswami, Ketan Kotecha, M. Karthikeyan Dr., Vijayshri Khedkar

Library Philosophy and Practice (e-journal)

This study is carried out to provide an analysis of the literature available at the intersection of ovarian cancer and computing. A comprehensive search was conducted using Scopus database for English-language peer-reviewed articles. The study administers chronological, domain clustering and text analysis of the articles under consideration to provide high-level concept map composed of specific words and the connections between them.

022— Examining P27 Expression And Quiescence In Clobetasol-Exposed Umscv-4 Vulvar Cancer Cells, Nina Mustico, Vincent Scalcione, Jani E. Lewis

GREAT Day Posters

Vulvar cancer is rare, mostly afflicting women aged 60 and older [1]. The cancer is often preceded by a common vulvar rash, lichen sclerosus, that is usually treated with the ultra-potent corticosteroid, clobetasol propionate. This treatment may, in turn, be associated with vulvar carcinogenesis. Our previous findings suggest that clobetasol is causing UMSCV-4 vulvar carcinoma cells to enter a state of quiescence. Quiescence is temporary removal from the cell cycle and can be thought of as a dormant state in which cells are not actively dividing [2]. There is growing evidence suggesting that quiescence may play a role in allowing …

Maternal And Neonatal Morbidity And Mortality Among Pregnant Women With And Without Covid-19 Infection: The Intercovid Multinational Cohort Study, José Villar, Shabina Ariff, Robert B. Gunier, Ramachandran Thiruvengadam, Stephen Rauch, Alexey Kholin, Paola Roggero, Federico Prefumo, Marynéa Silva Do Vale, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Importance: Detailed information about the association of COVID-19 with outcomes in pregnant individuals compared with not-infected pregnant individuals is much needed.
Objective: To evaluate the risks associated with COVID-19 in pregnancy on maternal and neonatal outcomes compared with not-infected, concomitant pregnant individuals.
Design, setting, and participants: In this cohort study that took place from March to October 2020, involving 43 institutions in 18 countries, 2 unmatched, consecutive, not-infected women were concomitantly enrolled immediately after each infected woman was identified, at any stage of pregnancy or delivery, and at the same level of care to minimize bias. Women and neonates were …

Are Underprivileged And Less Empowered Women Deprived Of Respectful Maternity Care: Inequities In Childbirth Experiences In Public Health Facilities In Pakistan, Waqas Hameed, Mudassir Uddin, Bilal Iqbal Avan

Community Health Sciences

Background: Attainment of healthcare in respectful and dignified manner is a fundamental right for every woman regardless of the individual status. However, social exclusion, poor psychosocial support, and demeaning care during childbirth at health facilities are common worldwide, particularly in low- and middle-income countries. We concurrently examined how women with varying socio-demographic characteristics are treated during childbirth, the effect of women's empowerment on mistreatment, and health services factors that contribute to mistreatment in secondary-level public health facilities in Pakistan.
Methods: A cross-sectional survey was conducted during August-November 2016 among 783 women who gave birth in six secondary-care public health facilities …

Serious Adverse Events And 30-Day Hospital Readmission Rate Following Elective Total Knee Arthroplasty: A Systematic Review And Meta-Analysis., Costas Papakostidis, Peter V Giannoudis, J. Tracy Watson, Robert Zura, R. Grant Steen

School of Medicine Faculty Publications

Background: Elective total knee arthroplasty (TKA) is a common surgery which has evolved rapidly. However, there are no recent large systematic reviews of serious adverse event (SAE) rate and 30-day readmission rate (30-dRR) or an indication of whether surgical methods have improved. Methods: To obtain a pooled estimate of SAE rate and 30-dRR following TKA, we searched Medline, Web of Science, Cochrane Library, and Google Scholar databases. Data were extracted by two authors following PRISMA guidelines. Eligibility criteria were defined prior to a comprehensive search. Studies were eligible if they were published in 2007 or later, described sequelae of TKA …

Ovarian Seromucinous Tumors: Clinicopathological Features Of 10 Cases With A Detailed Review Of The Literature, Romana Idress, Nasir Ud Din, Sabeehuddin Siddique, Saira Fatima, Jamshid Abdul Ghafar, Zubair Ahmad

Department of Pathology and Laboratory Medicine

Background: The 2014 WHO Classification of ovarian neoplasms introduced a new entity of seromucinous tumors associated with endometriosis. These tumors encompassed a spectrum from benign to malignant and included seromucinous cystadenoma/ cystadenofibroma, seromucinous borderline tumor/atypical proliferative seromucinous tumor and seromucinous carcinoma. However, the 2020 WHO Classification of Female Genital Tumours removed seromucinous carcinomas as a distinct entity and recategorized them as Endometrioid carcinomas with mucinous differentiation. Here we describe clinico-morphologic features of seromucinous tumors recategorizing cases originally diagnosed as seromucinous carcinoma in light of 2020 WHO classification and present detailed review of literature.
Methods: Slides of seromucinous tumors were reviewed. …

Pregnancy After Embolization For Arteriovenous Malformation: An Uncommon Successful Outcome, Arshia Javed, Sana Sheikh

Department of Obstetrics & Gynaecology

Uterine arteriovenous malformation (AVM) is an uncommon but fatal condition and can cause bleeding from abnormal connection between artery and vein. Pregnancy after embolization of uterine AVM is very uncommon, and there are increased risks of spontaneous abortion and growth retardation. We report a case of pregnancy after bilateral uterine artery embolization for AVM and its successful outcome..

Safety Of Daily Low-Dose Aspirin Use During Pregnancy In Low-Income And Middle-Income Countries, Vanessa L. Short, Matthew Hoffman, Mrityunjay Metgud, Avinash Kavi, Shivaprasad S. Goudar, Jean Okitawutshu, Antoinette Tshefu, Carl L. Bose, Saleem Jessani, Sarah Saleem

Community Health Sciences

Background: The daily use of low-dose aspirin may be a safe, widely available, and inexpensive intervention for reducing the risk of preterm birth. Data on the potential side effects of low-dose aspirin use during pregnancy in low- and middle-income countries are needed.
Objective: This study aimed to assess differences in unexpected emergency medical visits and potential maternal side effects from a randomized, double-blind, multicountry, placebo-controlled trial of low-dose aspirin use (81 mg daily, from 6 to 36 weeks' gestation).
Study design: This study was a secondary analysis of data from the Aspirin Supplementation for Pregnancy Indicated Risk Reduction In Nulliparas …

Does Delay In The Diagnosis Of Rudimentary Horn Pregnancy In Patients With Unicornuate Uteri Impact Treatment Outcomes?, Victoria Webber, Megan Fee, Damla Gonullu, Jessica Rausch, Omosalewa Itauma, Chidinma Abara, Awoniyi Awonuga

Medical Student Research Symposium

OBJECTIVE: Rudimentary horn pregnancy (RHP) is a very rare form of ectopic pregnancy (EP) that tends to rupture in the second trimester. Similar to other EPs, the treatment of RHPs is excision, hence delay in diagnosis (DID) can be detrimental. Our objective is to determine whether DID of RHP in patients with unicornuate uteri (UCU) impacts the treatment outcome.

DESIGN: Retrospective cohort study of published case reports in PubMed database.

MATERIALS AND METHODS: A computerized PubMed search of case reports of RHP from 2007 to 2020 was performed using the key words; unicornuate uterus, rudimentary horn, pregnancy, case. Data was …

The Utility Of Hyperbaric Oxygen Therapy In Post-Transplant Cyclophosphamide-Induced Hemorrhagic Cystitis: A Case Report And Review Of The Literature., Moayed Ibrahim, Kshama Bhyravabhotla, Basil Khalaf, Keith Van Meter, Nakhle S Saba, Hana Safah, Francisco Socola

School of Medicine Faculty Publications

Background: To date, there are only a few case reports of cyclophosphamide (Cy)-induced hemorrhagic cystitis (HC) in adult or pediatric allogeneic stem cell transplant (SCT) patients treated successfully with hyperbaric oxygen (HBO). In all the reported cases, Cy was used as a part of the conditioning regimen, rather than post-transplant for graft-versus-host-disease (GVHD) prophylaxis. More recently, the risk of HC in allogeneic SCT is further increased by the widespread use of post-transplantation cyclophosphamide (PTCy) as a highly effective strategy for GVHD prophylaxis. This is the first case reported of PTCy-induced HC successfully treated with HBO to the best of our …