Medical Specialties Commons^™

Neurodevelopmental Milestones And Associated Behaviours Are Similar Among Healthy Children Across Diverse Geographical Locations, José Villar, Michelle Fernandes, Manorama Purwar, Eleonora Staines-Urias, Paola Di Nicola, Leila Cheikh Ismail, Roseline Ochieng, Fernando Barros, Maria Carvalho, Elaine Albernaz

Paediatrics and Child Health, East Africa

It is unclear whether early child development is, like skeletal growth, similar across diverse regions with adequate health and nutrition. We prospectively assessed 1307 healthy, well-nourished 2-year-old children of educated mothers, enrolled in early pregnancy from urban areas without major socioeconomic or environmental constraints, in Brazil, India, Italy, Kenya and UK. We used a specially developed psychometric tool, WHO motor milestones and visual tests. Similarities across sites were measured using variance components analysis and standardised site differences (SSD). In 14 of the 16 domains, the percentage of total variance explained by between-site differences ranged from 1.3% (cognitive score) to 9.2% …

Patient Perceptions Of Planned Organ Removal During Hysterectomy, Zeinab Kassem, Chad M. Coleman, Andrew S. Bossick, Wan-Ting Su, Roopina Sangha, Ganesa Wegienka

Journal of Patient-Centered Research and Reviews

Purpose: Previous reports indicate many women may not have a firm grasp on likely outcomes of different hysterectomy procedures. This study aimed to assess women’s self-reported expectations of how they think their anatomy will change after hysterectomy.

Methods: Women scheduled for hysterectomy at a tertiary care hospital, for non-oncological reasons, reported their planned procedure type and the organs they understood would be removed 2 weeks prior to surgery. Patient reports and electronic medical records were reviewed, and kappa statistics (κ) were calculated to assess agreement for all women and within subgroups.

Results: Most of the 456 study participants (mean age: …

A Systematic Review Of Level I Evidence In The Treatment Of Uterine Fibroids, Varun Singh, Geogy Vatakencherry, Md

Student Papers, Posters & Projects

Purpose

To systematically review randomized controlled trial data to compare the efficacy of uterine artery embolization (UAE), highintensity focused ultrasound (HIFU), hysterectomy, and medical therapy in the management of symptomatic uterine fibroids

Factors Associated With A Positive Depression Screen After A Miscarriage, Steve Mutiso, Alfred Murage, Abraham Mukaindo

Obstetrics and Gynaecology, East Africa

Introduction: Miscarriages are a common pregnancy complication and positive depression screen after a miscarriage has been shown to be high in our population. Various factors are associated with an increased risk of developing depression after a miscarriage. However, these factors vary across populations studied with no studies existing in our region. We set out to determine the factors associated with a positive depression screen among post-miscarriage women at the Aga Khan University hospital, Nairobi.

Methods: Patients were recruited at the 2 weeks clinic review after a miscarriage in the gynaecological clinics. They were screened using the Edinburgh postnatal depression scale …

Septin 9 Isoforms Promote Tumorigenesis In Mammary Epithelial Cells By Increasing Migration And Ecm Degradation Through Metalloproteinase Secretion At Focal Adhesions, J. Marcus, M. Bejerano-Sagie, N. Patterson, S. Bagchi, V. V. Verkhusha, D. Connolly, G. L. Goldberg, A. Golden, V. P. Sharma, C. Montagna, +1 Additional Author

Journal Articles

© 2019, The Author(s), under exclusive licence to Springer Nature Limited. The cytoskeletal interacting protein Septin 9 (SEPT9), a member of the septin gene family, has been proposed to have oncogenic functions. It is a known hot spot of retroviral tagging insertion and a fusion partner of both de novo and therapy-induced mixed lineage leukemia (MLL). Of all septins, SEPT9 holds the strongest link to cancer, especially breast cancer. Murine models of breast cancer frequently exhibit SEPT9 amplification in the form of double minute chromosomes, and about 20% of human breast cancer display genomic amplification and protein over expression at …

12-Month Outcomes Of The Us Patient Cohort In The Sonata Pivotal Ide Trial Of Transcervical Ablation Of Uterine Fibroids., Joseph Hudgens, D. Alan Johns, Andrea S. Lukes, David A. Forstein, Dipak Delvadia

Touro College of Osteopathic Medicine (New York) Publications and Research

Objective: The prospective SONATA pivotal Investigational Device Exemption (IDE) trial was performed in the United States (US) and Mexico to examine the safety and effectiveness of transcervical fibroid ablation (TFA) in the treatment of symptomatic uterine fibroids. This is an analysis of 12-month clinical outcomes in the US cohort.

Methods: TFA with the Sonata System was performed on women with symptomatic uterine fibroids. The 12-month co-primary endpoints were reduction in menstrual blood loss and freedom from surgical reintervention. Symptom severity, quality of life, patient satisfaction, safety, and reductions in uterine and fibroid volumes were also evaluated.

Results: One hundred twenty-five …

Pelvic Examinations For Ovarian Cancer Screening In Asymptomatic Adult Women, Riann Collar

Physician Assistant Scholarly Project Posters

There is discrepancy amongst organizations and the medical community whether bimanual pelvic examinations should be performed in asymptomatic women for routine screening. The purpose of this literature review was to determine whether bimanual pelvic examinations are beneficial for screening for ovarian cancer in comparison to no screening. In addition, research was conducted to see if healthcare providers’ professional beliefs align with the evidence and national recommendations, to determine women’s thoughts and beliefs regarding pelvic examinations, and identify other screening methods if bimanual pelvic exams are determined to be an invalid screening tool. Throughout reviewing peer reviewed articles and high-quality evidence, …

Direct Genetics Referral Pathway For High-Grade Serous Ovarian Cancer Patients: The "Opt-Out" Process, Jacob Mcgee, Teresa M. Peart, Norine Foley, Monique Bertrand, Michel Prefontaine, Akira Sugimoto, Helen Ettler, Stephen Welch, Karen Panabaker

Obstetrics & Gynaecology Publications

Purpose. In order to meet a clinical need for better pathways to access genetic testing for ovarian cancer patients, we implemented and reviewed an opt-out referral process for genetic consultation whereby a referral is automatically sent to genetics following a pathological diagnosis of HGSC. Methods. Following implementation of the opt-out referral process, each month a list of new cases of HGSC was generated from the synoptic pathology report and forwarded directly to the Cancer Genetics clinic. Using an advanced directive, patients were automatically referred for genetic counselling two months after surgery. If the patient declined genetic counselling (opted-out) after discussion …

Barriers To Sexual And Reproductive Health Care Access In Central America With A Focus On Modern Contraception, Maria Mccoshen

Theses and Graduate Projects

Reproductive health is an important indicator of overall population health and is a priority of international organizations such as the United Nations (UN) and the World Health Organization (WHO). The UN includes the right to sexual and reproductive health (SRH) in their international covenant on rights stating, “...a woman’s reproductive option is considered a basic human right”. This paper will evaluate whether SRH, specifically modern contraceptive access, is met throughout areas of Central America, with a focus on the country of Costa Rica.

Maternal Health Interventions In Rural, Resource-Limited Countries, Katherine Tilton

Theses and Graduate Projects

Pregnant women are continuing to die at unacceptable rates around the globe. According to the World Health Organization, complications during pregnancy and childbirth are the leading cause of death and disability among reproductive age women in developing countries. Maternal mortality is often a reflection of a combination of causes: medical conditions while giving birth (ie. hemorrhage, eclampsia, and sepsis); other pre-existing medical conditions (ie. malaria, diabetes, HIV/AIDS); and socio-economic factors (ie. access to contraception, religious beliefs, and political agendas) that when combined, largely compromise health care, most often in the poor, rural and marginalized communities. Nearly all maternal deaths (99%) …

Portable Pelvic Exam Positioning Device For Enhanced Workflow And Patient Comfort, Hannah Levy, Elliott Perow, Sean Haynie

Phase 1

Background: Pelvic exams are often performed in settings other than designated obstetrics and gynecology suites. In these other settings, the equipment that is traditionally used to position the patient, such as a bed fitted with stirrups, may not be available. Therefore, physicians often improvise a solution to elevate the pelvis, such as using inverted bedpans, pillows or blankets. However, the lack of an appropriate device to position patients decreases patient and physician comfort, causes workflow inefficiency and leads to suboptimal examination due to inadequate provider visualization.

Methods: Over the course of five months, input from patients and providers alike was …

Incidence And Contributing Factors Of Glucose Intolerance In Saudi Postpartum Women: Sub-Group Analysis From Rahma Study, Hayfaa Wahabi, Amel Fayed, Safaa M. S. T Tunkar, Ali Al-Hazmi, Amna R. Siddiqui

Community Health Sciences

Objectives: The objectives of this study were to determine incidence and risk factors of glucose intolerance one year after delivery in a sub-cohort of Riyadh Mother and Baby Cohort Study (RAHMA) study.
Methods: This is a follow-up study of a sub-cohort from RAHMA study from King Khalid University Hospital (KKUH). All women from RAHMA database who completed one year since delivery at KKUH were contacted by phone to participate in the study. Previously collected data from RAHMA registry for each participant were linked to this study data. Clinical data measured for each participant included current weight and height to calculate …

Folic Acid Intake, Fetal Brain Growth, And Maternal Smoking In Pregnancy: A Randomized Controlled Trial, Korede K. Yusuf, Hamisu M. Salihu, Roneé Wilson, Alfred K. Mbah, William Sappenfield, Karen Bruder, Usman J. Wudil, Muktar H. Aliyu

Obstetrics & Gynecology Faculty Publications

Background: Folic acid supplementation during pregnancy plays an important role in fetal growth and development. To our knowledge, no experimental study has examined the effect of folic acid on fetal brain growth in women who smoke cigarettes during pregnancy. Objectives: The aim of this study was to investigate the efficacy of higher-dose compared with standard-dose folic acid supplementation on prenatal fetal brain growth, measured by head circumference, brain weight, and brain-body weight ratio (BBR). Design: In this randomly assigned, double-blind, controlled clinical trial, we recruited 345 smoking pregnant women attending a community health center in Tampa, FL between 2010 and …

Fmic Annual Report 2019 | Pashto (پشتو), French Medical Institute For Mothers And Children

French Medical Institute for Mothers and Children (FMIC) Archives

No abstract provided.

Fmic Annual Report 2019 | Dari (دری), French Medical Institute For Mothers And Children

French Medical Institute for Mothers and Children (FMIC) Archives

No abstract provided.

Fmic Annual Report 2019 | English, French Medical Institute For Mothers And Children

French Medical Institute for Mothers and Children (FMIC) Archives

No abstract provided.

Comparing Screening And Treatment Of Bacterial Vaginosis And Pregnancy Outcomes, Stephanie Severson

Physician Assistant Scholarly Project Papers

Despite evidence that bacterial vaginosis can lead to poor perinatal outcomes the consensus remains against a screening and treatment protocol for all pregnant women. Due to variability in a multitude of factors, a generalized recommendation is difficult to make. There are inconsistencies among stage of gestation that screening took place and treatment selection. The multiple variables in demographics also make providing best practice recommendations difficult. Lack of recommendations are largely due to harm of treatment in those who were misdiagnosed. The development of polymerase chain reaction (PCR) has the capability to reduce misdiagnosis. Newer studies have shown benefit of early …

Uncommon Misconceptions: Holding Physicians Accountable For Insemination Fraud, Jody L. Madeira

Articles by Maurer Faculty

No abstract provided.

Risk Factors For Gestational Diabetes In Upstate New York Women & Implications For Practice, Margaret Versteegen

Legacy Theses & Dissertations (2009 - 2024)

Gestational diabetes mellitus (GDM) is a form of diabetes, or abnormal blood glucose (sugar) metabolism, diagnosed during pregnancy. Pregnant, non-diabetic women who are initially noted to experience high blood glucose levels during their pregnancy are considered to have GDM (ADA, 2016b). GDM has significant implications for infant and maternal morbidity and mortality, with adverse pregnancy outcomes such as infant macrosomia, difficult birth requiring cesarean section, and postpartum hemorrhage (Kamana, Shakya, & Zhang, 2015). In the majority of cases, GDM goes away once the baby is born, but around 5-10% of women with GDM go on to have type 2 diabetes …

Does Botulinum Toxin A Injections Into The Pelvic Floor Muscles Of Women With Chronic Genitopelvic Pain And Vaginal Spasm Improve Pain And Sexual Functioning?, Emily R. Broadbent

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this evidenced based medicine review is to determine whether or not botulinum toxin A injections into the pelvic floor muscles of women with chronic genitopelvic pain and vaginal spasm improve pain and sexual functioning.

STUDY DESIGN: Review of two double blind randomized controlled trials and one case series from peer reviewed journals published between 2006-2011.

DATA SOURCES: Two randomized controlled trials and one case series were found using PubMed, Google Scholar, and Cochrane Library.

OUTCOMES MEASURED: All three studies measured pain and sexual functioning using selfreported surveys including the visual analog scale for pain, Female Sexual …

Relationship Between Gestational Diabetes And A Positive Depression Screen, Onegarach Herbert Ozelle

Master of Medicine in Obstetrics and Gynecology

Introduction: Gestational diabetes mellitus (GDM) and its treatment have a marked effect on women’s lives consequently aggravating psychosocial disruptions of a normal pregnancy. The demand for behavioural adaptation as well as postulated biological interactions are likely to increase the risk of maternal depression in GDM patients. There is however inadequate literature concerning the relationship between GDM and depression. Objective: To compare the proportion of women with GDM who screen positive for depression and the proportion of women without GDM who screen positive for depression at the Aga Khan University Hospital, Nairobi. Socio-demographic factors associated with a positive depression screen were …

Comparison Of Vaginal Microbiota In Women With Spontaneous Preterm Labour Versus Those With Term Labour, Edgar Gulavi

Master of Medicine in Obstetrics and Gynecology

Background: Preterm birth presents a challenge on a global scale with a disease burden that is on the rise. It is a leading cause of perinatal morbidity and mortality worldwide with approximately 15 million preterm births every year. Kenya has a 12% preterm birth rate with about 190,000 babies born preterm every year. The female lower genital tract bacterial community plays a vital role in maternal and neonatal health. An association between altered vaginal microbial composition and preterm birth has been demonstrated in previous studies. However, findings in terms of composition and diversity of these bacteria across the few studies …

Does A History Of Sexual And Physical Childhood Abuse Contribute To Hiv Infection Risk In Adulthood? A Study Among Post-Natal Women In Harare, Zimbabwe, Simukai Shamu, Patience Shamu, Christina Zarowsky, Marleen Temmerman, Tamara Shefer, Naeemah Abrahams

Obstetrics and Gynaecology, East Africa

Background: Sexual and physical abuse in childhood creates a great health burden including on mental and reproductive health. A possible link between child abuse and HIV infection has increasingly attracted attention. This paper investigated whether a history of child physical and sexual abuse is associated with HIV infection among adult women.

Methods: A cross sectional survey was conducted among 2042 postnatal women (mean age = 26y) attending six public primary health care clinics in Harare, Zimbabwe within 6 weeks post-delivery. Clinic records were reviewed for mother’s antenatal HIV status. Participants were interviewed about childhood abuse including physical or …

Clinical-Pathological Presentation, Treatment And Outcomes Of Ovarian Cancer Cases At Moi Teaching And Referral Hospital (Mtrh), Eldoret, Benjamin O. Elly, Elkanah Omenge, Peter Itsura, Philip Tonui, Hellen N. Muliro, Vincent N. Oyiengo, Thomas Achia

Obstetrics and Gynaecology, East Africa

Introduction: Ovarian cancer is the third most frequent cause of death amongst gynecological cancers both locally and globally. It presents with vague nonspecific symptoms and is histologically heterogeneous. Ovarian cancer management is primarily surgical followed by adjuvant chemotherapy depending on the histological type and the surgical stage.

Objectives: To determine the clinical-pathological presentation, treatment and outcomes of ovarian cancer patients at Moi Teaching and Referral Hospital (MTRH), Eldoret.

Methods: This was a retrospective chart review of ovarian cancer patients managed between January 2010 and August 2017 at MTRH. Data were analyzed using STATA version 15. Survival trends were …

Missed Opportunities In Women's Health: Post-Abortion Care, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Around the world, 56 million induced abortions took place annually in 2010–14, which was about 25% of all pregnancies. Abortion rates vary widely across regions, do not differ significantly by income level or legal status of abortion^,1 and depend on many factors, one of the key ones being a lack of access to modern contraceptives.¹ Safe abortion, however, depends on the legal climate, and countries with restrictive abortion laws are far more likely to have illegal and unsafe abortions. Abortionrelated complications are an important and preventable cause of maternal mortality, accounting for 8–9% of maternal deaths worldwide,^{2 …}

Quality Of Life And Its Determinants In Subfertile Patients Seeking Fertility Care At Two Urban Fertility Centres In Nairobi, Lawrence Makoha Sikuku

Master of Medicine in Obstetrics and Gynecology

Introduction: Subfertility affects one in six couples worldwide with devastating psychosocial consequences impacting on quality of life (QoL). Assessment of QoL and institution of appropriate interventions in subfertility patients complements clinical management by reducing the psycho-social effects of subfertility and its treatment. No local or regional data exist on impact of subfertility on QoL using a fertility-specific QoL assessment tool. Objective: The study sought to determine the QoL of subfertile patients seeking fertility care at two urban fertility centres in Nairobi using the Fertility Quality of Life (FertiQoL) tool. Methods: This was a cross sectional study. Subfertile women of reproductive …

Reducing Barriers To Accessing Fistula Repair: Implementation Research In Uganda, Justus Barageine, Charity Ndwiga, Hassan Kanakulya, Pooja Sripad

Reproductive Health

The Population Council, in collaboration with Fistula Care Plus and EngenderHealth, conducted implementation research to understand whether a comprehensive information, screening, and referral intervention reduces transportation, communication, and financial barriers to accessing fistula screening, diagnosis, and treatment in Uganda. Following a baseline assessment, researchers implemented a multi-pronged intervention utilizing a mobile hotline, transport voucher, and mass media tools to increase community awareness. This brief provides key messages and recommendations for overcoming barriers hindering access to fistula care services. Health systems and external stakeholder support are essential for sustaining trends.

Fertility Options For Women With Endometriosis: In Vitro Fertilization Versus Surgical Excision Or Ablation, Jenny Brown

Physician Assistant Scholarly Project Posters

Endometriosis negatively affects the fertility of many women of reproductive age worldwide. Some women with endometriosis are able to conceive without reproduction assistance, while others require medical intervention. In vitro fertilization and surgical management are available and widely used in the treatment of endometriosis associated infertility. In vitro fertilization has been found to be effective in women with stages I-IV endometriosis, with varying degrees of success at each stage. These varying results may be due to oocyte quality and availability as well as endometriosis location. Surgical excision and/or surgical ablation of endometriosis/endometriomas may also improve chance of successful pregnancy but …

The Experience Of Pregnant Women In Remission From Anorexia Nervosa, Meghan Butcher

Antioch University Dissertations & Theses

This qualitative study explored the subjective experience of pregnant women in remission from Anorexia Nervosa (AN). This subject matter is of importance due to the high relapse rates of AN, the ability for women to become pregnant while in remission from AN, the significant physical and emotional tolls of pregnancy, and the known dangers of AN behaviors during pregnancy. Prior to this study, minimal research had been conducted pertaining to the experience of women who became pregnant while in remission from AN. This study utilized Interpretative Phenomenological Analysis (IPA) to inform interpretation of narrative responses collected through semi-structured interviews. Participants …

The Influence Of Obstetrician And Gynecologists' Avoidance Behaviors On Maternal Morbidities, Nakisha Rene'e Boulware

Walden Dissertations and Doctoral Studies

The prevalence of maternal morbidities continues to increase in U.S. women of lower socioeconomic status and non-Hispanic Black women despite the efforts of health care practitioners to reduce the disparities. Two decades of research has shown that physicians avoid patients based on insurance and socioeconomic status or their malpractice history. Reducing maternal illness and complications is one of the federal government's top 10 maternal health indicators in the Healthy People 2020 initiative. The purpose of this study was to evaluate the influence of malpractice allegations on patients at high-risk for maternal morbidity. Supported by the theoretical foundation of human factor …