Medical Specialties Commons^™

Family Planning Knowledge, Attitude And Practice Among Married Couples In Jimma Zone, Ethiopia, Tizta Tilahun, Gily Coene, Stanley Luchters, Wondwosen Kassahun, Els Leye, Marleen Temmerman, Olivier Degomme

Population Health, East Africa

Background: Understanding why people do not use family planning is critical to address unmet needs and to increase contraceptive use. According to the Ethiopian Demographic and Health Survey 2011, most women and men had knowledge on some family planning methods but only about 29% of married women were using contraceptives. 20% women had an unmet need for family planning. We examined knowledge, attitudes and contraceptive practice as well as factors related to contraceptive use in Jimma zone, Ethiopia.

Methods: Data were collected from March to May 2010 among 854 married couples using a multi-stage sampling design. Quantitative data based on …

The Evolution Of Comprehensive Cancer Care In Western Kenya, R. M. Strother, F. C. Asirwa, N. B. Busakhala, E. Njiru, Elkanah Omenge, F. Njuguna, J. Skiles, J. Carter, A. Mega, G.J.L. Kaspers

Obstetrics and Gynaecology, East Africa

In the next 20 years, it is expected that 70% of incident cancers will be diagnosed in the developing world. There exist very few models of cancer care delivery in resource constrained settings. We present a model of cancer care delivery that developed as a result of a multi-institutional collaboration between high-income country academic medical centers and a Kenyan medical school and governmental referral hospital. Based on the infrastructure provided by a successful HIV care program, AMPATH-Oncology presently offers a range of clinical services across the continuum of care, including cervical cancer and breast cancer screening, palliative care, and oncology …

Comparison Of Vaginal Cuff Closure Outcomes In Patients Having Robotic-Assisted Total Laparoscopic Hysterectomy: V-Loc Vs. Vicryl (Poster), Martin A. Martino Md, R Melody Reynolds Md, A Ei Haraki Md, Rachel Morcrette Pa-C, Kyle M. Langston Pa-C, Gregory F. Kainz Md, Richard Boulay Md, M Bijoy Thomas Md

Department of Obstetrics & Gynecology

No abstract provided.

Curatedovariandata: Clinically Annotated Data For The Ovarian Cancer Transcriptome, Benjamin Frederick Ganzfried, Markus Riester, Benjamin Haibe-Kains, Thomas Risch, Svitlana Tyekucheva, Ina Jazic, Xin Victoria Wang, Mahnaz Ahmadifar, Michael J. Birrer, Giovanni Parmigiani, Curtis Huttenhower, Levi Waldron

Publications and Research

This article introduces a manually curated data collection for gene expression meta-analysis of patients with ovarian cancer and software for reproducible preparation of similar databases. This resource provides uniformly prepared microarray data for 2970 patients from 23 studies with curated and documented clinical metadata. It allows users to efficiently identify studies and patient subgroups of interest for analysis and to perform meta-analysis immediately without the challenges posed by harmonizing heterogeneous microarray technologies, study designs, expression data processing methods and clinical data formats. We confirm that the recently proposed biomarker CXCL12 is associated with patient survival, independently of stage and optimal …

Prevalence Of Genital Chlamydia Infection In Urban Women Of Reproductive Age, Nairobi, Kenya, Ruchika Kohli, Walter P. Konya, Timona Obura, William Stones, Gunturu Revathi

Pathology, East Africa

Background: Chlamydia trachomatis is one of the major causes of sexually transmitted infections throughout the world. Most infections are asymptomatic and remain undetected. Burden of disease in the Kenyan population is not well characterised. This study was done to define the prevalence of genital Chlamydia infection in a representative female population.

Findings: A cross-sectional study design was employed. All women attending out-patient clinics (antenatal, gynaecology, family planning) and accident and emergency departments at two study sites over a five month period were invited to consent to completion of a questionnaire and vaginal swab collection. A rapid point-of-care immunoassay based test …

Sickle Cell Disease In Pregnancy: Trend And Pregnancy Outcomes At A Tertiary Hospital In Tanzania, Projestine S. Muganyizi, Hussein Kidanto

Faculty of Health Sciences, East Africa

SCD in pregnancy is associated with increased adverse fetal and maternal outcomes. In Tanzania where the frequency of sickle cell trait is 13% there has been scanty data on SCD in pregnancy. With progressive improvement in childhood survival the burden of SCD in pregnancy will increase. We analyzed all deliveries at Muhimbili National Hospital (MNH) from 1999 to 2011. Fetal and maternal outcomes of SCD deliveries were compared with non-SCD. Data were analyzed using IBM SPSS statistics version 19. Chi square and Fisher Exact tests were used to compare proportions and the independent t-test for continuous data. To predict risks …

Characteristics, Sexual Behaviour And Risk Factors Of Female, Male And Transgender Sex Workers In South Africa, Marlise L. Richter, M. Chersich, Marleen Temmerman, Stanley Luchters

Obstetrics and Gynaecology, East Africa

Background. In South Africa, information on sex workers’ characteristics, sexual behaviour and health needs is limited. Current social, legal and institutional factors impede a safe working environment for sex workers and their clients.

Objectives. To describe characteristics and sexual behaviour of female, male and transgender sex workers, and assess their risk factors for unprotected sex.

Methods: Repeat cross-sectional surveys among sex workers were conducted in Hillbrow, Sandton, Rustenburg and Cape Town in 2010. Sex workers were interviewed once; any re-interviews were excluded from analysis. Unprotected sex was defined as any unprotected penetrative vaginal or anal sex with last two clients. …

Evaluating Audio Computer Assisted Self-Interviews In Urban South African Communities: Evidence For Good Suitability And Reduced Social Desirability Bias Of A Cross-Sectional Survey On Sexual Behaviour, Roxanne Beauclair, Fei Meng, Nele Deprez, Marleen Temmerman, Alex Welte, Wim Delva, Niel Hens

Obstetrics and Gynaecology, East Africa

Background: Efficient HIV prevention requires accurate identification of individuals with risky sexual behaviour. However, self-reported data from sexual behaviour surveys are prone to social desirability bias (SDB). Audio Computer-Assisted Self-Interviewing (ACASI) has been suggested as an alternative to face-to-face interviewing (FTFI), because it may promote interview privacy and reduce SDB. However, little is known about the suitability and accuracy of ACASI in urban communities with high HIV prevalence in South Africa. To test this, we conducted a sexual behaviour survey in Cape Town, South Africa, using ACASI methods.

Methods: Participants (n = 878) answered questions about their sexual relationships on …

Soluble Human Epidermal Growth Factor Receptor 2 (Sher2) As A Potential Risk Assessment, Screening, And Diagnostic Biomarker Of Lung Adenocarcinoma, Abby L. Cosentino-Boehm, Jacqueline M. Lafky, Tammy M. Greenwood, Kimberly D. Kimbler, Marites C. Buenafe, Yuxia Wang, Adam J. Branscum, Ping Yang, Nita J. Maihle, Andre T. Baron

Obstetrics and Gynecology Faculty Publications

Lung cancer is the leading cause of cancer-related death in the United States. Here, we evaluated the potential clinical utility of soluble human epidermal growth factor receptor 2 (sHER2) for the risk assessment, screening, and diagnosis of non-small cell lung cancer (NSCLC) using an unmatched case-control study design. Serum sHER2 concentrations were measured by immunoassay in 244 primary NSCLC cases and 218 healthy controls. Wilcoxon rank-sum tests, logistic regression models, and receiver operating characteristic plots were used to assess whether sHER2 is associated with lung cancer. Median serum sHER2 concentrations are higher in patients with adenocarcinoma than squamous cell carcinoma …

Iud Discontinuation Rates, Switching Behavior, And User Satisfaction: Findings From A Retrospective Analysis Of A Mobile Outreach Service Program In Pakistan, Syed Khurram Azmat, Waqas Hameed, Ghulam Mustafa, Wajahat Hussain, Aftab Ahmed, Mohsina Bilgrami

Community Health Sciences

Background: In Pakistan, the uptake rate for the intrauterine device (IUD) is very low at 2.5%. The most popular modern contraceptive methods in Pakistan are female sterilization and use of condoms. The Marie Stopes Society established its mobile outreach service delivery program with the aim of increasing use of modern quality contraceptive services, including the long-term reversible IUD, by women living in hard-to-reach areas. The present study attempts to assess IUD discontinuation rates and associated factors, including switching behavior and level of satisfaction with this type of service delivery.
Methods: Using a cross-sectional approach, we contacted 681 women who had …

Loss Of Dok2 Induces Carboplatin Resistance In Ovarian Cancer Via Suppression Of Apoptosis, E. Lum, M. Vigliotti, N. Banerjee, N. Cutter, K. O. Wrzeszczynski, S. Khan, S. Kamalakaran, D. A. Levine, N. Dimitrova, R. Lucito

Journal Articles

Objective. Ovarian cancers are highly heterogeneous and while chemotherapy is the preferred treatment many patients are intrinsically resistant or quickly develop resistance. Furthermore, all tumors that recur ultimately become resistant. Recent evidence suggests that epigenetic deregulation may be a key factor in the onset and maintenance of chemoresistance. We set out to identify epigenetically silenced genes that affect chemoresistance. Methods. The epigenomes of a total of 45 ovarian samples were analyzed to identify epigenetically altered genes that segregate with platinum response, and further filtered with expression data to identify genes that were suppressed. A tissue culture carboplatin resistance screen was …

Pre-Pregnancy Bmi And Weight Gain: Where Is The Tipping Point For Preterm Birth?, Saba W. Masho, Diane Bishop, Meaghan Munn

Family Medicine and Population Health Publications

Background

Obesity in pregnant women is a major problem affecting both the mother and her offspring. Literature on the effect of obesity on preterm birth is inconsistent and few studies have investigated the influence of weight gain during pregnancy. This study examined the effect of maternal pre-pregnancy BMI and weight gain during pregnancy on preterm birth.

Methods

Data from the Collaborative Perinatal Project (CPP) on 45,824 pregnant women with singleton, live-born infants with no severe congenital anomalies was analyzed. Primary outcome variables included preterm (< 37 weeks of gestation), categorized into spontaneous preterm with and without premature rupture of membrane (PROM) and indicated preterm. Maternal BMI was categorized into underweight (BMI < 18.50), normal weight (BMI =1 8.50 – 24.99), overweight (BMI = 25.00 – 29.99), and obese (BMI ≥ 30.00). Multinomial regression analysis was conducted and OR and 95% CI were calculated.

Results

The rate of spontaneous preterm birth with PROM among overweight women decreased with increasing …

P38 Mapk Regulates Cavitation And Tight Junction Function In The Mouse Blastocyst., Christine E Bell, Andrew J Watson

Obstetrics & Gynaecology Publications

UNLABELLED: Blastocyst formation is essential for implantation and maintenance of pregnancy and is dependent on the expression and coordinated function of a series of proteins involved in establishing and maintaining the trans-trophectoderm ion gradient that enables blastocyst expansion. These consist of Na/K-ATPase, adherens junctions, tight junctions (TJ) and aquaporins (AQP). While their role in supporting blastocyst formation is established, the intracellular signaling pathways that coordinate their function is unclear. The p38 MAPK pathway plays a role in regulating these proteins in other cell types and is required for embryo development at the 8-16 cell stage, but its role has not …

Astrue V. Capato: Forcing A Shoe That Doesn't Fit, Courtney Hannon

Journal of Health Care Law and Policy

No abstract provided.

Silent Uterine Rupture Of Scarred Uterus--An Unusual Presentation As Amniocele, Aisha Syed Wali, Tahira Naru

Department of Obstetrics & Gynaecology

Obstetricians should be aware of the possibility of silent rupture of scarred uterus. Ultrasound has an important role in the diagnosis of silent uterine rupture. A case of silent uterine rupture with foetal demise, that remained undiagnosed for many weeks, is described.

Post-Abortion Care In Pakistan: A National Study, Zeba Sathar, Susheela Singh, Zakir Hussain Shah, Gul Rashida, Iram Kamran, Kanwal Eshai

Reproductive Health

The objectives of this Population Council study were twofold: first to collect information on prevailing practices of abortion and post‐abortion care in Pakistan and, second, to gauge changes in the magnitude and quality of abortion‐related complications and care during the last decade (since the 2002 national study of “Unwanted Pregnancy and Post‐abortion Complications in Pakistan”). The study found that the level of post‐abortion family planning (FP) counseling in both public and private health facilities offering PAC services was inadequate. There has been no improvement over the decade in the level of counseling reported, and, even more disappointingly, only half of …

Unmet Need And Unintended Pregnancy: The Bigger Picture, Ian Askew

Reproductive Health

No abstract provided.

Fmic Annual Report 2013 | English, French Medical Institute For Mothers And Children

French Medical Institute for Mothers and Children (FMIC) Archives

No abstract provided.

Improving Quality Of Maternal And Newborn Care In Selected Districts In 3 Sub-Saharan Countries: Baseline Quality Assessment, Els Duysburgh, Wei-Hong Zhang, M. Ye, Adrian Williams, S. Massawe, A. Sie, J. Williams, R. Mpembeni, S. Loukanova, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Objectives: To measure pre-intervention quality of routine antenatal and childbirth care in rural districts of Burkina Faso, Ghana and Tanzania and to identify shortcomings.

Methods: In each country, we selected two adjoining rural districts. Within each district, we randomly sampled 6 primary healthcare facilities. Quality of care was assessed through health facility surveys, direct observation of antenatal and childbirth care, exit interviews and review of patient records.

Results: By and large, quality of antenatal and childbirth care in the six districts was satisfactory, but we did identify some critical gaps common to the study sites in all three countries. Counselling …

Maternal Circulating Leukocytes Display Early Chemotactic Responsiveness During Late Gestation, Nardhy Gomez-Lopez, Satomi Tanaka, Zoya Zaeem, Gerlinde A. Metz, David M. Olson

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Parturition has been widely described as an immunological response; however, it is unknown how this is triggered. We hypothesized that an early event in parturition is an increased responsiveness of peripheral leukocytes to chemotactic stimuli expressed by reproductive tissues, and this precedes expression of tissue chemotactic activity, uterine activation and the systemic progesterone/estradiol shift.

Methods

Tissues and blood were collected from pregnant Long-Evans rats on gestational days (GD) 17, 20 and 22 (term gestation). We employed a validated Boyden chamber assay, flow cytometry, quantitative real time-polymerase chain reaction, and enzyme-linked immunosorbent assays.

Results

We found that GD20 maternal …

Subjective Health Status And Health-Related Quality Of Life Among Women With Recurrent Vulvovaginal Candidosis (Rvvc) In Europe And The Usa, Samuel Aballéa, Florent Guelfucci, Julian Wagner, Amine Khemiri, Jean-Paul Dietz, Jack Sobel, Mondher Toumi

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Recurrent vulvovaginal candidosis (RVVC) is a chronic condition causing discomfort and pain. Health status and health-related quality of life (HRQoL) in RVVC were never previously described using validated questionnaires. The objective of this study is to describe subjective health status and HRQoL and estimate health state utilities among women with RVVC.

Methods

A cross-sectional online survey was conducted among women who reported having suffered four or more yeast infections over the past 12 months, in five European countries (France, Germany, Italy, Spain and the UK) and the USA. Index scores were derived from the EQ-5D, a questionnaire providing …

Limited Effectiveness Of Hiv Prevention For Young People In Sub-Saharan Africa: Studying The Role Of Intervention And Evaluation, Kristien Michielsen, Marleen Temmerman, Van Rossem

Obstetrics and Gynaecology, East Africa

On average, 2,500 young people (15-24 years) get -infected with HIV every day; 80% of which live in sub-Saharan Africa. Since no cure or vaccine is available, reducing sexual risk behaviour in this group is crucial in tackling the epidemic. The general objective of this doctoral study was to improve the effectiveness of HIV prevention interventions for young people in sub-Saharan Africa. First, we assessed the overall effectiveness of such interventions (systematic literature review, meta-analysis). Secondly, we evaluated a school-based peer-led HIV prevention interventions in Rwanda (longitudinal, non-randomized controlled trial), to get insight into how interventions are developed, implemented and …

Prevalence Of Vitamin D Deficiency In An Ethnic African Urban Obstetric Population In An Equatorial City Hospital, Raj Hasmukh Dodia

Master of Medicine in Obstetrics and Gynecology

Introduction: Low Vitamin D levels in pregnancy have been associated with an increased risk of gestational diabetes, pre-eclampsia, bacterial vaginosis, preterm birth, disordered fetal skeletal homeostasis, and impaired offspring lung health. As a result, current public health advice in several countries is to universally supplement Vitamin D during pregnancy. Data regarding the Vitamin D levels of the ethnic obstetric population in Kenya are not available; hence recommendations for Vitamin D supplementation have no scientific basis. Objectives of study: This research was carried out to determine the prevalence of deficiency of Vitamin D in ethnic African obstetric patients who had delivered …

Quality Of Care And Client Willingness To Pay For Family Planning Services At Marie Stopes International In Burkina Faso, Placide Tapsoba, Dalomi Bahan, Emily Forsyth Queen, Gisele Kaboré, Sally Hughes

Reproductive Health

Many sexual and reproductive health programs operating in a limited-resource setting face a challenging balancing act between making services accessible and affordable to clients, including those most in need, and remaining financially sustainable. To achieve these dual objectives, the Population Council, with Marie Stopes International in Burkina Faso (MSI BF), launched a willingness-to-pay (WTP) study that examined the current situation and numerous pricing options, proposing optimal prices for products and services. The process of implementing the WTP survey was insightful for MSI BF as it provided evidence on client satisfaction with services and willingness to contribute to the cost of …

Access To Emergency Contraception And Safe Abortion Services For Survivors Of Rape And Defilement In Sub-Saharan Africa: A Regional Overview, Jill Thompson, Chi-Chi Undie, Ian Askew

Reproductive Health

No abstract provided.

Comprendre Les Grossesses Non Désirées Au Sénégal: Rapport Du Profil Pays, Kaila Clarke, Mohamadou Sall, Babacar Mane, Nafissatou Diop, Bocar Mamadou Daff

Reproductive Health

Un profil pays a été préparé pour le Sénégal pour compiler et synthétiser les informations disponibles sur la santé de la reproduction, en particulier les grossesses non désirées et par conséquent les besoins non satisfaits en matière de planification familiale. D’importants efforts ont été consentis par l’Etat sénégalais, mais de nombreux obstacles continuent de freiner les progrès réalisés. Un programme national plus cohérent et ciblé est donc nécessaire pour réduire ces obstacles. Dans le même temps, les acteurs non-gouvernementaux devraient poursuivre leurs efforts pour renforcer leur programmation pour produire des effets plus immédiats, tout en assurant une meilleure coordination entre …

Availability, Use And Quality Of Care For Medical Abortion Services—Preliminary Results Of Two Components: Kiis And The Pharmacy Study, Wilson Liambila, Harriet Birungi, Francis Onyango, Brian Mdawida, Vitalis Akora, Thoai Ngo, Kate Reiss

Reproductive Health

No abstract provided.

Rational Use Of Antibiotics--A Quality Improvement Initiative In Hospital Setting, Sidrah Nausheen, Rabia Hammad, Ambreen Khan

Department of Obstetrics & Gynaecology

Objectives: To minimise irrational use of antibiotics by implementing guidelines for antibiotic usage in obstetrics and Gynaeocology.
Methods: The observational study was conducted from January to December 2010 at the maternity unit of Aga Khan Hospital for Women and children, Kharadar, a secondary care facility in Karachi, Pakistan. Data was collected from medical records related to the study period. Prophylactic antibiotics were given according to the American College of Obstetricians and Gynaecologists recommendation 2009. Surveillance was done by surgical site infection rates and infectious morbidity. Data was analysed on SPSS 13.
Results: Therapeutic antibiotic use was rationalized, reducing the use …

Assessment Of Experimental Animal Model For Training Obstetric Anal Sphincter Injury Techniques, Raheela Mohsin Rizvi

Department of Obstetrics & Gynaecology

The Multiparous Goat Pelvic Model was used to train obstetricians and residents for perineal and anal sphincter anatomy and techniques of repair of Obstetric Anal Sphincter Injuries (OASIs). The purpose of this study was to assess the similarity of this model with human anatomy and the usefulness of goat model for training obstetricians for perineal tears. Six workshops were conducted between June 2009 and December 2010. A total of 90 participants, including 64(70.3%) residents and 26(28.5%) consultants in Obstetrics and Gynaecology, attended hands-on training workshops using experimental goat pelvic model for the repair of perineal tears. Among the consultants, 23 …

A Review Of Comparison Of Complications Of Vaginal Hysterectomy With And Without Concomitant Surgery For Sui: A 5 Years’ Experience At A Tertiary Care Hospital Of Pakistan, Raheela Mohsin Rizvi, Munnazza Akhtar, Nadeem F. Zuberi

Department of Obstetrics & Gynaecology

Objective. The study was performed to review the complications of surgery for POP with or without surgery for SUI. This included the need for second procedure two years after the primary surgery. Study Design. We conducted a retrospective cross-sectional comparative study at the Aga Khan University, Karachi, Pakistan. International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) was used to identify women who underwent vaginal hysterectomy with anterior/posterior repair alone and those with concomitant tension-free vaginal tape surgery for urodynamic stress incontinence. Results. The 28 cases of VH/repair combined with TVT were compared for complications with 430 cases of VH …