In Indonesia target of exclusive breastfeeding is 80% and this target is very difficult to accomplish. The scope of exclusive breastfeeding in West Sumatera (75%), in Padang (70.7%) and in the work area of Andalas Health Center (55.17%). This study aim is to determine factors associated with exclusive breastfeeding in the work area of Andalas Health Center. This type of study is analytic with cross sectional design.The participant of this study is 90 mothers who have infants 6-12 months in the work area of Andalas Health Center. Sampling was proportional random sampling. Data collected using questionnaires. Data analysis using univariate and bivariate with chi square test and significant if p value < 0,05. The study showed exclusive breastfeeding (21,1%), mother have a good knowledge (48.9%), secondary education (51.1%) , unemployed (65.6%), not having breast problem (51.1%), and interested in infant formula promotion (57.8%). The results of bivariate analysis showed a significant relationship between education (p=0.048) and breast problems (p=0,000) and no significant relationship between work (p=0.98) with exclusive breastfeeding. There is a tendency all mothers who have less knowledge and interested in infant formula promotion to not exclusive breastfeeding From the result of this study it can be conclude there is a significant relationship between education, and breast problems with exclusive breastfeeding, no significant relationship between work and exclusive breastfeeding, there is a tendency all mothers who have less knowledge and interested in infant formula promotion to not exclusive breastfeeding. For the next research can add other variables, for health workers to more diligent give counseling and for the community to follow more counseling.
{"title":"Factors Associated With Behavior of Exclusive Breastfeeding to Women Have Baby 6-12 Months in the Work Area of Andalas Health Center","authors":"Yollanda Vonitania, Yulizawati Yulizawati, Fitrisia Amelin","doi":"10.31579/2642-9756/062","DOIUrl":"https://doi.org/10.31579/2642-9756/062","url":null,"abstract":"In Indonesia target of exclusive breastfeeding is 80% and this target is very difficult to accomplish. The scope of exclusive breastfeeding in West Sumatera (75%), in Padang (70.7%) and in the work area of Andalas Health Center (55.17%). This study aim is to determine factors associated with exclusive breastfeeding in the work area of Andalas Health Center. This type of study is analytic with cross sectional design.The participant of this study is 90 mothers who have infants 6-12 months in the work area of Andalas Health Center. Sampling was proportional random sampling. Data collected using questionnaires. Data analysis using univariate and bivariate with chi square test and significant if p value < 0,05. The study showed exclusive breastfeeding (21,1%), mother have a good knowledge (48.9%), secondary education (51.1%) , unemployed (65.6%), not having breast problem (51.1%), and interested in infant formula promotion (57.8%). The results of bivariate analysis showed a significant relationship between education (p=0.048) and breast problems (p=0,000) and no significant relationship between work (p=0.98) with exclusive breastfeeding. There is a tendency all mothers who have less knowledge and interested in infant formula promotion to not exclusive breastfeeding From the result of this study it can be conclude there is a significant relationship between education, and breast problems with exclusive breastfeeding, no significant relationship between work and exclusive breastfeeding, there is a tendency all mothers who have less knowledge and interested in infant formula promotion to not exclusive breastfeeding. For the next research can add other variables, for health workers to more diligent give counseling and for the community to follow more counseling.","PeriodicalId":93058,"journal":{"name":"Women health care and issues","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47658001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zahra Naeiji, Shahrzad Zademodares, Masoumeh Abbaspour, Maryam Anbarluei, N. Rahmati, M. Fathi
Objective: to evaluate the impact of pre-gestational maternal age and body weight on the outcome of IVF in women with PCOS. Design: a retrospective study on women with PCOS undergoing IVF. Methods: Medical records of 200 known cases of polycystic ovary syndrome women treated in a third level referral center by the same therapeutic protocol were evaluated retrospectively. Demographic data, maternal body mass index, hormonal profile (LH, FSH, estradiol, anti-mullerian), IVF cycle parameters and outcome were documented. Patients were classified to three groups based on their body mass index (Normal: 18.5-24.9, overweight: 25-30, obese≥30). IVF cycle parameters and outcome were compared in these 3 groups. Effect of age was also evaluated by comparing the results in patients aged <35 and ≥35. Results: Mean age of patients was 32.5 (±5.2). 72 patients had normal BMI, 85 patients were overweighed and 43 cases were obese. Baseline hormonal profile was similar in 3 groups. Total dose of administered FSH were similar in 3 groups. Number of retrieved oocytes was statistically significant higher in patients with BMI>30 but the number of mature oocytes and number of embryos were statistically lower in this group. Size of follicles showed no statistically significant difference in 3 groups. Clinical pregnancy rate was statistically significant lower in patients with BMI>30 kg/m2 and age>35 years old. Conclusions: BMI>30 and age >35 years old has a statistically significant negative impact on IVF success rate.
{"title":"In-Vitro Fertilization Outcome in Patients with Polycystic Ovary Syndrome: Role of Age and Maternal Body Weight","authors":"Zahra Naeiji, Shahrzad Zademodares, Masoumeh Abbaspour, Maryam Anbarluei, N. Rahmati, M. Fathi","doi":"10.31579/2642-9756/056","DOIUrl":"https://doi.org/10.31579/2642-9756/056","url":null,"abstract":"Objective: to evaluate the impact of pre-gestational maternal age and body weight on the outcome of IVF in women with PCOS. Design: a retrospective study on women with PCOS undergoing IVF. Methods: Medical records of 200 known cases of polycystic ovary syndrome women treated in a third level referral center by the same therapeutic protocol were evaluated retrospectively. Demographic data, maternal body mass index, hormonal profile (LH, FSH, estradiol, anti-mullerian), IVF cycle parameters and outcome were documented. Patients were classified to three groups based on their body mass index (Normal: 18.5-24.9, overweight: 25-30, obese≥30). IVF cycle parameters and outcome were compared in these 3 groups. Effect of age was also evaluated by comparing the results in patients aged <35 and ≥35. Results: Mean age of patients was 32.5 (±5.2). 72 patients had normal BMI, 85 patients were overweighed and 43 cases were obese. Baseline hormonal profile was similar in 3 groups. Total dose of administered FSH were similar in 3 groups. Number of retrieved oocytes was statistically significant higher in patients with BMI>30 but the number of mature oocytes and number of embryos were statistically lower in this group. Size of follicles showed no statistically significant difference in 3 groups. Clinical pregnancy rate was statistically significant lower in patients with BMI>30 kg/m2 and age>35 years old. Conclusions: BMI>30 and age >35 years old has a statistically significant negative impact on IVF success rate.","PeriodicalId":93058,"journal":{"name":"Women health care and issues","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46769663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aim: In some regions of Bayannaoer arsenic concentration in well drinking water is higher than the international standard of 10 μg/L. The purpose of this study is to evaluate the impact of exposures to arsenic in drinking water on generalized anxiety disorder (GAD). Materials and Methods: A survey was conducted in 2016 among villagers in Hangjinhou County, Bayannaoer City, Inner Mongolia. A questionnaire was used to inquire about GAD, arsenic related neurological symptoms. Arsenic concentration in the water was measured and arsenicosis prevalence was assessed. Multinomial logistic regression and ordinal logistic regression were performed to evaluate the association of abnormal arsenic levels on increased GAD symptoms. Results: 446 participants were enrolled. Subjects with exposure to water arsenic levels>10 μg/L were significantly more likely to have mild GAD than controls (adjusted odds ratio [AOR] =2.3, 95% confidence interval [CI], 1.1-4.8). Participants who were diagnosed with arsenicosis were more likely to report mild anxiety than minimal anxiety compared to those who did not (AOR=2.3, 95% CI, 1.3-4.1). Survey respondents with palpitations, forgetfulness, headaches, dizziness, decreased taste, decreased hearing, loss of touch, abnormal warm and cold sensation, blurred vision, numbness and tingling were more likely to report mild, moderate and severe anxiety. Conclusions: Arsenic exposure was associated with a higher risk of GAD. Screening for arsenic exposure should be incorporated into the evaluation of GAD, in areas where arsenic in drinking water is known to be abnormal.
{"title":"Association between Arsenic and Generalized Anxiety Disorder: A Cross-Sectional Study","authors":"Na Wang","doi":"10.31579/2642-9756/054","DOIUrl":"https://doi.org/10.31579/2642-9756/054","url":null,"abstract":"Aim: In some regions of Bayannaoer arsenic concentration in well drinking water is higher than the international standard of 10 μg/L. The purpose of this study is to evaluate the impact of exposures to arsenic in drinking water on generalized anxiety disorder (GAD). Materials and Methods: A survey was conducted in 2016 among villagers in Hangjinhou County, Bayannaoer City, Inner Mongolia. A questionnaire was used to inquire about GAD, arsenic related neurological symptoms. Arsenic concentration in the water was measured and arsenicosis prevalence was assessed. Multinomial logistic regression and ordinal logistic regression were performed to evaluate the association of abnormal arsenic levels on increased GAD symptoms. Results: 446 participants were enrolled. Subjects with exposure to water arsenic levels>10 μg/L were significantly more likely to have mild GAD than controls (adjusted odds ratio [AOR] =2.3, 95% confidence interval [CI], 1.1-4.8). Participants who were diagnosed with arsenicosis were more likely to report mild anxiety than minimal anxiety compared to those who did not (AOR=2.3, 95% CI, 1.3-4.1). Survey respondents with palpitations, forgetfulness, headaches, dizziness, decreased taste, decreased hearing, loss of touch, abnormal warm and cold sensation, blurred vision, numbness and tingling were more likely to report mild, moderate and severe anxiety. Conclusions: Arsenic exposure was associated with a higher risk of GAD. Screening for arsenic exposure should be incorporated into the evaluation of GAD, in areas where arsenic in drinking water is known to be abnormal.","PeriodicalId":93058,"journal":{"name":"Women health care and issues","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45213737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Surgical site infections (SSIs) pose considerable morbidity and account for up to 20% of all nosocomial infections in surgical patients Aim of the Work: to determine the efficacy & safety of irrigation of subcutaneous tissue by Gentamicin for caesarean section Incision in reducing the risk of post-caesarean wound complications among obese women compared with placebo. Patients and Methods: This prospective randomized clinical trial study was conducted on total 132 obese patients who underwent elective cesarean section at Ain Shams University Maternity hospitals. This study was conducted on obese women undergoing caesarean section at Ain Shams University Maternity Hospital with the following inclusion and exclusion criteria. Patients were distributed randomly into 2 groups using a computer based program: Group (A) N = 66: CS with Irrigation of subcutaneous tissue by placebo (200 ml of saline 0.9 %). Group (B) N = 66: CS with irrigation of subcutaneous tissue by Gentamicin solution (1mg/kg gentamicin in 200 ml of saline 0.9%). Results: The results of this study revealed that the rate of SSI was less in gentamycin (3%) (n=2/66) than control group (4.5%) (n=3/66) with no statistical significance between them. Postoperative hospital stay and readmission rate due to SSI for the gentamycin group were also shorter but not statistically different in compared to the control group. Applying local gentamycin antibiotic irrigation during wound closure after cesarean section in obese patients is not recommended. NO role of local gentamycin irrigation in subcutaneous tissue in prevention of wound surgical site infection. Conclusion: as evident from the current study, in obese women undergoing elective CS, wound irrigation with Gentamicin is not superior to wound irrigation with placebo (saline 0.9) regarding efficacy & safety.
背景：手术部位感染（SSIs）具有相当高的发病率，占手术患者所有医院感染的20%。本工作的目的：确定庆大霉素皮下组织冲洗用于剖腹产切口的有效性和安全性。与安慰剂相比，切口在降低肥胖妇女剖宫产后伤口并发症风险方面的作用。患者和方法：这项前瞻性随机临床试验研究对在艾因沙姆斯大学妇产医院接受选择性剖宫产手术的132名肥胖患者进行了研究。这项研究是针对在艾因沙姆斯大学妇产医院接受剖腹产手术的肥胖女性进行的，纳入和排除标准如下。使用基于计算机的程序将患者随机分为两组：组（a）N=66:CS，用安慰剂（200 ml 0.9%生理盐水）冲洗皮下组织。结果：庆大霉素组SSI发生率为3%（N=2/66），低于对照组4.5%（N=3/66），二者无统计学意义。与对照组相比，庆大霉素组的术后住院时间和SSI导致的再入院率也较短，但没有统计学差异。不建议在肥胖患者剖宫产术后伤口闭合时应用局部庆大霉素抗生素冲洗。皮下组织局部庆大霉素冲洗在预防伤口手术部位感染中的作用。结论：从目前的研究中可以明显看出，在接受选择性CS的肥胖女性中，在疗效和安全性方面，庆大霉素伤口冲洗并不优于安慰剂（生理盐水0.9）伤口冲洗。
{"title":"Effect of Amh in Patients with Polycystic Ovarian Syndrome on Pregnancy Rate in Icsi Cycle","authors":"Ahmed Abd El-Hay","doi":"10.31579/2642-9756/068","DOIUrl":"https://doi.org/10.31579/2642-9756/068","url":null,"abstract":"Background: Surgical site infections (SSIs) pose considerable morbidity and account for up to 20% of all nosocomial infections in surgical patients Aim of the Work: to determine the efficacy & safety of irrigation of subcutaneous tissue by Gentamicin for caesarean section Incision in reducing the risk of post-caesarean wound complications among obese women compared with placebo. Patients and Methods: This prospective randomized clinical trial study was conducted on total 132 obese patients who underwent elective cesarean section at Ain Shams University Maternity hospitals. This study was conducted on obese women undergoing caesarean section at Ain Shams University Maternity Hospital with the following inclusion and exclusion criteria. Patients were distributed randomly into 2 groups using a computer based program: Group (A) N = 66: CS with Irrigation of subcutaneous tissue by placebo (200 ml of saline 0.9 %). Group (B) N = 66: CS with irrigation of subcutaneous tissue by Gentamicin solution (1mg/kg gentamicin in 200 ml of saline 0.9%). Results: The results of this study revealed that the rate of SSI was less in gentamycin (3%) (n=2/66) than control group (4.5%) (n=3/66) with no statistical significance between them. Postoperative hospital stay and readmission rate due to SSI for the gentamycin group were also shorter but not statistically different in compared to the control group. Applying local gentamycin antibiotic irrigation during wound closure after cesarean section in obese patients is not recommended. NO role of local gentamycin irrigation in subcutaneous tissue in prevention of wound surgical site infection. Conclusion: as evident from the current study, in obese women undergoing elective CS, wound irrigation with Gentamicin is not superior to wound irrigation with placebo (saline 0.9) regarding efficacy & safety.","PeriodicalId":93058,"journal":{"name":"Women health care and issues","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42675187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Teenage pregnancy is a major threat to adolescent health globally which remains a challenging issue requiring urgent resolution over the world. Objectives: To find out to awareness and attitude regarding teenage pregnancy among adolescent girls. Materials and Methods: A descriptive cross- sectional design was carried out among 334 adolescent girls of school students of Chandannath Municipality, Jumla. Results: More than half of adolescent girls (68%) had inadequate, 26% had moderate and least 6% had adequate awareness regarding teenage pregnancy. However, majority (58.1%) of adolescent girls had favorable attitude, that they believed teenage pregnancy as wrong while only (34.4%) of them had neutral attitude and least (7.5%) of them had unfavorable attitude which support teenage pregnancy. There was no relation between awareness and attitude regarding teenage pregnancy and types of family, level of education of father and mother. Conclusion: In this study, half of respondents had inadequate awareness regarding teenage pregnancy even though majority of them had favorable attitude regarding teenage pregnancy. There was no significant difference between demographic variables with awareness and attitude regarding teenage pregnancy. The study had highlighted the need for awareness program regarding teenage pregnancy in school as well as in community.
{"title":"Awareness and Attitude Regarding Teenage Pregnancy among Adolescent Girls of Chandannath Municipality, Jumla","authors":"Shrestha Sharmila","doi":"10.31579/2642-9756/049","DOIUrl":"https://doi.org/10.31579/2642-9756/049","url":null,"abstract":"Background: Teenage pregnancy is a major threat to adolescent health globally which remains a challenging issue requiring urgent resolution over the world. Objectives: To find out to awareness and attitude regarding teenage pregnancy among adolescent girls. Materials and Methods: A descriptive cross- sectional design was carried out among 334 adolescent girls of school students of Chandannath Municipality, Jumla. Results: More than half of adolescent girls (68%) had inadequate, 26% had moderate and least 6% had adequate awareness regarding teenage pregnancy. However, majority (58.1%) of adolescent girls had favorable attitude, that they believed teenage pregnancy as wrong while only (34.4%) of them had neutral attitude and least (7.5%) of them had unfavorable attitude which support teenage pregnancy. There was no relation between awareness and attitude regarding teenage pregnancy and types of family, level of education of father and mother. Conclusion: In this study, half of respondents had inadequate awareness regarding teenage pregnancy even though majority of them had favorable attitude regarding teenage pregnancy. There was no significant difference between demographic variables with awareness and attitude regarding teenage pregnancy. The study had highlighted the need for awareness program regarding teenage pregnancy in school as well as in community.","PeriodicalId":93058,"journal":{"name":"Women health care and issues","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44519935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: It is well known that clear cell carcinoma of the ovary (CCC) demonstrates different clinical behaviors from other epithelial ovarian cancer and has strong association with endometriosis, thromboembolic complication, hypercalcemia, and large pelvic mass. The introduction of cisplatin-based chemotherapy significantly changed the postoperative management of ovarian cancer patients. Different studies showed a better response rate of CCC to chemotherapy with paclitaxel plus carboplatin regime than with the conventional platinum-based regimens. Aim: The purpose of this study was to evaluate the patients’ clinical characteristics and treatment results for clear cell carcinoma (CCC) of the ovary treated in paclitaxel-platinum chemotherapy in comparison with those treated in conventional platinum-based chemotherapy after primary surgery Methods: We retrospectively reviewed the medical records of 40 patients with CCC who received treatment in the department of obstetrics and gynecology, Samsung Medical Center from March, 1996 to April 2006. The clinical characteristics, treatment results and follow-up data were collected from medical records and/or telephone surveys. Results: Mean age was 47 years (range 30–72 years). Patients with age less than 50years were 62.5%. Tumors were 15% (6/40) stage IA, 2.5% (1/40) stage IB, 37.5% (15/40) stage IC, 5% (2/40) stage II, 32.5% (13/40) stage III, and 7.5% (3/40) stage IV. Patients with CCC were more likely to have FIGO stage I & II disease than FIGO stage III & IV (60% vs. 40%). Five-year progression-free survival and overall survival were 91% and 80% in stage I & II, 36% and 55% in stage III & IV, respectively (5-yr PFS; P<0.01, 5-yr OS; P=0.03). With a median follow-up of 45 months (2-112 months), 75% (18/24) of stage I/II patients are alive, while 19% (3/16) of stage III/IV patients are alive. 37.5% (15/40) of the patients presented with endometriosis. Except for one patient who was referred by a local clinic, all patients underwent cytoreductive surgery. The rate of optimal debulking (≤ 1cm residual tumor diameter) was 90% (36/40). Overall, for women treated with platinum-based chemotherapy, 75% (27/36) had clinically complete responses to adjuvant chemotherapy. But there was no survival benefit according to chemotherapeutic differences in the patients who received cytoreductive surgery followed between conventional platinum-based chemotherapy (CAP or CP) and by paclitaxel and platinum-based chemotherapy (P=0.40). Univariate analysis showed that stage was the only favorable prognostic factor for women with clear cell carcinoma of the ovary (P=0.04). Conclusions: Our results suggest that CCC has a distinct clinical behavior, similar to previous studies, that frequently presents at early- stages and is associated with endometriosis. In addition, there was a close correlation between the level of CA-125 and survival, and there was no survival benefit according to chemotherapeutic differences. 〔CAP (CP)
{"title":"The Clinical Characteristics and Treatment Results in the Patients with Clear Cell Carcinoma of the Ovary","authors":"Chul Kim","doi":"10.31579/2642-9756/052","DOIUrl":"https://doi.org/10.31579/2642-9756/052","url":null,"abstract":"Background: It is well known that clear cell carcinoma of the ovary (CCC) demonstrates different clinical behaviors from other epithelial ovarian cancer and has strong association with endometriosis, thromboembolic complication, hypercalcemia, and large pelvic mass. The introduction of cisplatin-based chemotherapy significantly changed the postoperative management of ovarian cancer patients. Different studies showed a better response rate of CCC to chemotherapy with paclitaxel plus carboplatin regime than with the conventional platinum-based regimens. Aim: The purpose of this study was to evaluate the patients’ clinical characteristics and treatment results for clear cell carcinoma (CCC) of the ovary treated in paclitaxel-platinum chemotherapy in comparison with those treated in conventional platinum-based chemotherapy after primary surgery Methods: We retrospectively reviewed the medical records of 40 patients with CCC who received treatment in the department of obstetrics and gynecology, Samsung Medical Center from March, 1996 to April 2006. The clinical characteristics, treatment results and follow-up data were collected from medical records and/or telephone surveys. Results: Mean age was 47 years (range 30–72 years). Patients with age less than 50years were 62.5%. Tumors were 15% (6/40) stage IA, 2.5% (1/40) stage IB, 37.5% (15/40) stage IC, 5% (2/40) stage II, 32.5% (13/40) stage III, and 7.5% (3/40) stage IV. Patients with CCC were more likely to have FIGO stage I & II disease than FIGO stage III & IV (60% vs. 40%). Five-year progression-free survival and overall survival were 91% and 80% in stage I & II, 36% and 55% in stage III & IV, respectively (5-yr PFS; P<0.01, 5-yr OS; P=0.03). With a median follow-up of 45 months (2-112 months), 75% (18/24) of stage I/II patients are alive, while 19% (3/16) of stage III/IV patients are alive. 37.5% (15/40) of the patients presented with endometriosis. Except for one patient who was referred by a local clinic, all patients underwent cytoreductive surgery. The rate of optimal debulking (≤ 1cm residual tumor diameter) was 90% (36/40). Overall, for women treated with platinum-based chemotherapy, 75% (27/36) had clinically complete responses to adjuvant chemotherapy. But there was no survival benefit according to chemotherapeutic differences in the patients who received cytoreductive surgery followed between conventional platinum-based chemotherapy (CAP or CP) and by paclitaxel and platinum-based chemotherapy (P=0.40). Univariate analysis showed that stage was the only favorable prognostic factor for women with clear cell carcinoma of the ovary (P=0.04). Conclusions: Our results suggest that CCC has a distinct clinical behavior, similar to previous studies, that frequently presents at early- stages and is associated with endometriosis. In addition, there was a close correlation between the level of CA-125 and survival, and there was no survival benefit according to chemotherapeutic differences. 〔CAP (CP)","PeriodicalId":93058,"journal":{"name":"Women health care and issues","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42161211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diabetes mellitus still represents an important medical problem during pregnancy, causing perinatal morbidity and mortality. Despite improved outcome reflected by a steep decline in perinatal mortality over the past few decades, controversy still exists regarding the care of the pregnant woman with both pre-existing and gestational Diabetes Mellitus. Doppler ultrasound is especially valuable during pregnancy because fetal maternal and placental circulations can be studied. The aim of this work was to study the vascular changes in the uteroplacental and fetoplacental circulations, and to correlate these findings with histopathology of the placenta and placental bed, which may occur in association with diabetic pregnancies. The study was carried out on 100 pregnant women of comparable age and parity. They were divided into 2 groups. The control group comprising 20 normal non-diabetic pregnant women and the normotensive diabetic group comprising 80 pregnant diabetic women. All were singleton pregnancies of 34 weeks or more and were delivered by C.S the control and the study cases were subjected to history taking and thorough physical examination. They were also subjected to ultrasonographic examination for fetal biometric parameters and for Doppler examination. Doppler examination included umbilical artery, uterine arteries fetal middle cerebral artery. At the time of C.S the placenta and placental bed biopsy was obtained. After delivery, the Apgar score of the newborn was assessed at 1 and 5 minutes, the body weight was measured, and the fetus was followed up for any complications. Result: There was a positive correlation between the umbilical artery PI and the mean blood glucose levels indicating that poor diabetic control is probably associated with increased umbilical artery PI. However, there was no significant difference between the mean value of the umbilical artery PI in the diabetic and control groups. The uterine arteries Doppler indices showed no significant findings between the diabetic and the control groups. Neither did the uterine arteries Doppler indices show a correlation with the mean blood glucose levels. There was no significant difference between the middle cerebral artery PI in the diabetic and control groups. This observation indicates that there was no redistribution in the fetal circulation in the fetuses of the diabetic group. There was also non correlation between the MCA Doppler indices and the glycemic control. Histopathologic studies of the placental bed showed marked difference between the diabetic group and the control group as regards lack of physiologic changes and arteriosclerotic changes, which emphasizes the effect of diabetes on the placental bed vasculature. Conclusion: Abnormal umbilical artery waveform analysis is one of significant predictors of fetal compromise in diabetic pregnancy, but fetal compromise can occur in association with normal Doppler waveform analysis. In maternal diabetes the classic redistr
{"title":"Study of Maternal and Fetal Doppler Velocimetry, Histopathology of Placental Bed in Diabetic Pregnancy and Its Correlation to Fetal Outcome","authors":"E. Matar","doi":"10.31579/2642-9756/059","DOIUrl":"https://doi.org/10.31579/2642-9756/059","url":null,"abstract":"Diabetes mellitus still represents an important medical problem during pregnancy, causing perinatal morbidity and mortality. Despite improved outcome reflected by a steep decline in perinatal mortality over the past few decades, controversy still exists regarding the care of the pregnant woman with both pre-existing and gestational Diabetes Mellitus. Doppler ultrasound is especially valuable during pregnancy because fetal maternal and placental circulations can be studied. The aim of this work was to study the vascular changes in the uteroplacental and fetoplacental circulations, and to correlate these findings with histopathology of the placenta and placental bed, which may occur in association with diabetic pregnancies. The study was carried out on 100 pregnant women of comparable age and parity. They were divided into 2 groups. The control group comprising 20 normal non-diabetic pregnant women and the normotensive diabetic group comprising 80 pregnant diabetic women. All were singleton pregnancies of 34 weeks or more and were delivered by C.S the control and the study cases were subjected to history taking and thorough physical examination. They were also subjected to ultrasonographic examination for fetal biometric parameters and for Doppler examination. Doppler examination included umbilical artery, uterine arteries fetal middle cerebral artery. At the time of C.S the placenta and placental bed biopsy was obtained. After delivery, the Apgar score of the newborn was assessed at 1 and 5 minutes, the body weight was measured, and the fetus was followed up for any complications. Result: There was a positive correlation between the umbilical artery PI and the mean blood glucose levels indicating that poor diabetic control is probably associated with increased umbilical artery PI. However, there was no significant difference between the mean value of the umbilical artery PI in the diabetic and control groups. The uterine arteries Doppler indices showed no significant findings between the diabetic and the control groups. Neither did the uterine arteries Doppler indices show a correlation with the mean blood glucose levels. There was no significant difference between the middle cerebral artery PI in the diabetic and control groups. This observation indicates that there was no redistribution in the fetal circulation in the fetuses of the diabetic group. There was also non correlation between the MCA Doppler indices and the glycemic control. Histopathologic studies of the placental bed showed marked difference between the diabetic group and the control group as regards lack of physiologic changes and arteriosclerotic changes, which emphasizes the effect of diabetes on the placental bed vasculature. Conclusion: Abnormal umbilical artery waveform analysis is one of significant predictors of fetal compromise in diabetic pregnancy, but fetal compromise can occur in association with normal Doppler waveform analysis. In maternal diabetes the classic redistr","PeriodicalId":93058,"journal":{"name":"Women health care and issues","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46640131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The transverses abdominis plane block (TAP block) is one of the widely used regional analgesic techniques in cesarean section. There are different variations of the procedure. The aim of the present study was to evaluate the analgesic effect of the modified surgeon assisted bilateral TAP block in patients undergoing cesarean section Patients&Methods: Sixty patients undergoing cesarean section under spinal anesthesia were randomized into two groups to receive either TAP block with 40 ml of bupivacaine 0.25%(study group) or 40 ml normal saline as placebo after obtaining informed consent. All patients will receive intravenous diclofencac75mg every 12 hrs postoperatively. Postoperatively, there was an assessment every 2hrs during the first 24hrs by the visual analogue pain scale (VAPS). Time to the first analgesic request will be measured as primary outcome and all patients will receive opioid on demand or VAPS > 4 with 25mg pethidine intramuscularly. Moreover, total opioid requirement in 24hrs will be measured as secondary outcome along with postoperative complications as nausea, vomiting and abdominal distention. Complications related to the TAP procedure will be also assessed. Results: The median (interquartile range) time to the first analgesic request in the first 24hrs postoperatively was significantly shorter in the placebo group compared to the study group; 4h (4, 6) and 24h (10, 24) with p value < 0.001. Postoperative opioid requirement was significantly higher in the control group (30/30{100%}) than the study group (13/30{43.3%}). The median (interquartile range) number of opioid doses was significantly higher in the placebo group compared with the study group; 2(2, 2) and 0(0, 1) respectively. At all points in the study, pain scores both were lower in the study group (p < 0.0001). Conclusion: The modified surgeon assisted bilateral TAP block is relatively new, safe and cost effective technique which provides adequate postoperative analgesia allowing for better maternal ambulation and better postoperative recovery. Trial registration: Clinicaltrial.gov registration number: NCT04623632
{"title":"Effect of the Modified Surgeon Assisted Bilateral Transversus Abdominis Plane Block on Time Required for First Analgesic Dose after Cesarean Section under Spinal Anesthesia: Randomized placebo-control","authors":"A. Mamdouh","doi":"10.31579/2642-9756/055","DOIUrl":"https://doi.org/10.31579/2642-9756/055","url":null,"abstract":"Background: The transverses abdominis plane block (TAP block) is one of the widely used regional analgesic techniques in cesarean section. There are different variations of the procedure. The aim of the present study was to evaluate the analgesic effect of the modified surgeon assisted bilateral TAP block in patients undergoing cesarean section Patients&Methods: Sixty patients undergoing cesarean section under spinal anesthesia were randomized into two groups to receive either TAP block with 40 ml of bupivacaine 0.25%(study group) or 40 ml normal saline as placebo after obtaining informed consent. All patients will receive intravenous diclofencac75mg every 12 hrs postoperatively. Postoperatively, there was an assessment every 2hrs during the first 24hrs by the visual analogue pain scale (VAPS). Time to the first analgesic request will be measured as primary outcome and all patients will receive opioid on demand or VAPS > 4 with 25mg pethidine intramuscularly. Moreover, total opioid requirement in 24hrs will be measured as secondary outcome along with postoperative complications as nausea, vomiting and abdominal distention. Complications related to the TAP procedure will be also assessed. Results: The median (interquartile range) time to the first analgesic request in the first 24hrs postoperatively was significantly shorter in the placebo group compared to the study group; 4h (4, 6) and 24h (10, 24) with p value < 0.001. Postoperative opioid requirement was significantly higher in the control group (30/30{100%}) than the study group (13/30{43.3%}). The median (interquartile range) number of opioid doses was significantly higher in the placebo group compared with the study group; 2(2, 2) and 0(0, 1) respectively. At all points in the study, pain scores both were lower in the study group (p < 0.0001). Conclusion: The modified surgeon assisted bilateral TAP block is relatively new, safe and cost effective technique which provides adequate postoperative analgesia allowing for better maternal ambulation and better postoperative recovery. Trial registration: Clinicaltrial.gov registration number: NCT04623632","PeriodicalId":93058,"journal":{"name":"Women health care and issues","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48958809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aliaa M. Maaty, Amr H. Yehia, Mohamed M. Abdelaleem, Mohammed A. Abd El-Fattah
Background: Surgical site infections (SSIs) pose considerable morbidity and account for up to 20% of all nosocomial infections in surgical patients Aim of the Work: to determine the efficacy & safety of irrigation of subcutaneous tissue by Gentamicin for caesarean section Incision in reducing the risk of post-caesarean wound complications among obese women compared with placebo. Patients and Methods: This prospective randomized clinical trial study was conducted on total 132 obese patients who underwent elective cesarean section at Ain Shams University Maternity hospitals. This study was conducted on obese women undergoing caesarean section at Ain Shams University Maternity Hospital with the following inclusion and exclusion criteria. Patients were distributed randomly into 2 groups using a computer based program: Group (A) N = 66: CS with Irrigation of subcutaneous tissue by placebo (200 ml of saline 0.9 %). Group (B) N = 66: CS with irrigation of subcutaneous tissue by Gentamicin solution ( 1mg/kg gentamicin in 200 ml of saline 0.9%). Results: The results of this study revealed that the rate of SSI was less in gentamycin (3%) (n=2/66) than control group (4.5%) (n=3/66) with no statistical significance between them . postoperative hospital stay and readmission rate due to SSI for the gentamycin group were also shorter but not statistically different in compared to the control group. Applying local gentamycin antibiotic irrigation during wound closure after cesarean section in obese patients is not recommended. NO role of local gentamycin irrigation in subcutaneous tissue in prevention of wound surgical site infection. Conclusion: as evident from the current study, In obese women undergoing elective CS , wound irrigation with Gentamicin is not superior to wound irrigation with placebo (saline 0.9) regarding efficacy & safety.
背景:手术部位感染(ssi)的发病率相当高，占手术患者所有医院感染的20%。研究目的:与安慰剂相比，确定庆大霉素用于剖宫产切口皮下组织冲洗降低肥胖妇女剖宫产后伤口并发症风险的有效性和安全性。患者和方法:本前瞻性随机临床试验研究对在艾因沙姆斯大学妇产医院择期剖宫产的132例肥胖患者进行了研究。本研究对在艾因沙姆斯大学妇产医院接受剖腹产手术的肥胖妇女进行，纳入和排除标准如下。采用计算机程序将患者随机分为两组:a组(N = 66): CS加皮下组织灌洗安慰剂(200 ml 0.9%生理盐水)。B组(N = 66):皮下灌注庆大霉素溶液(1mg/kg庆大霉素加入200 ml 0.9%生理盐水中)。结果:本研究结果显示，庆大霉素组SSI发生率为3% (n=2/66)低于对照组4.5% (n=3/66)，差异无统计学意义。庆大霉素组术后住院时间和SSI再入院率也较对照组短，但无统计学差异。不建议肥胖患者剖宫产术后伤口缝合时局部应用庆大霉素抗生素冲洗。皮下组织局部庆大霉素冲洗在预防创面手术部位感染中的作用。结论:从目前的研究中可以看出，在接受选择性CS的肥胖女性中，庆大霉素伤口冲洗在疗效和安全性方面并不优于安慰剂伤口冲洗(生理盐水0.9)。
{"title":"Subcutaneous Antibiotic Irrigation to Prevent Wound Infection in Obese Patients Undergoing Cesarean Section","authors":"Aliaa M. Maaty, Amr H. Yehia, Mohamed M. Abdelaleem, Mohammed A. Abd El-Fattah","doi":"10.31579/2642-9756/060","DOIUrl":"https://doi.org/10.31579/2642-9756/060","url":null,"abstract":"Background: Surgical site infections (SSIs) pose considerable morbidity and account for up to 20% of all nosocomial infections in surgical patients Aim of the Work: to determine the efficacy & safety of irrigation of subcutaneous tissue by Gentamicin for caesarean section Incision in reducing the risk of post-caesarean wound complications among obese women compared with placebo. Patients and Methods: This prospective randomized clinical trial study was conducted on total 132 obese patients who underwent elective cesarean section at Ain Shams University Maternity hospitals. This study was conducted on obese women undergoing caesarean section at Ain Shams University Maternity Hospital with the following inclusion and exclusion criteria. Patients were distributed randomly into 2 groups using a computer based program: Group (A) N = 66: CS with Irrigation of subcutaneous tissue by placebo (200 ml of saline 0.9 %). Group (B) N = 66: CS with irrigation of subcutaneous tissue by Gentamicin solution ( 1mg/kg gentamicin in 200 ml of saline 0.9%). Results: The results of this study revealed that the rate of SSI was less in gentamycin (3%) (n=2/66) than control group (4.5%) (n=3/66) with no statistical significance between them . postoperative hospital stay and readmission rate due to SSI for the gentamycin group were also shorter but not statistically different in compared to the control group. Applying local gentamycin antibiotic irrigation during wound closure after cesarean section in obese patients is not recommended. NO role of local gentamycin irrigation in subcutaneous tissue in prevention of wound surgical site infection. Conclusion: as evident from the current study, In obese women undergoing elective CS , wound irrigation with Gentamicin is not superior to wound irrigation with placebo (saline 0.9) regarding efficacy & safety.","PeriodicalId":93058,"journal":{"name":"Women health care and issues","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48893615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Background: During the first 36 to 38 weeks of normal gestation, the myometrium is in a preparatory yet unresponsive state. Concurrently, the cervix begins an early stage of remodeling yet maintains structural integrity. Induction of labour is a complex process involving cervical ripening which undergo extensive remodeling and dynamic changes controlled by hormonal, inflammatory changes, and other biological processes. Aim of the Work: to assess the effect of intravenous administration of dexamethasone on the induction delivery interval in term patients with prelabour rupture of membranes undergoing induction of labor. Patients and Methods: This randomized control trial was conducted at department of Obstetrics and Gynecology at Ain Shams University Maternity Hospital (ASUMH) in the period between August 2020 and January 2021. Participants of this study were 80 full term pregnant women with pre-labor rupture of membranes attended the labor ward in El Demerdash Maternity Hospital and scheduled for induction of labor by 8 mg dexamethasone IV before starting induction by PGE1, after 4 hours oxytocin was added by 1 IU/hr with the dose increasing by 1 IU every 30 minutes till optimal contractions were reached which were three uterine contractions in 10 minutes and each lasting for 40-50 seconds. Results: Fetal distress, arrest of delivery and indications of CS delivery were non-significantly less frequent among Dexamethasone group. Induction-active phase and active phase durations were significantly shorter among dexamethasone group than among control group. Second and third stages durations were non-significantly shorter among dexamethasone group than among control group. Total induction-delivery duration was significantly shorter and rate of vaginal delivery was significantly higher among dexamethasone group than among control group. Postpartum hemorrhage (PPH), postpartum endometritis, chorioamnionitis were not reported among the studied groups. No significant difference between Dexamaethasone and Control groups regarding neonatal condition Conclusion: Intravenous administration of dexamethasone in addition to labor induction protocol shortened the induction - active phase and active phase durations. It shortened the total induction-delivery duration and increased the rate of successful vaginal delivery. It has no effect on second and third stages durations with no increase in incidence of intrapartum, postpartum nor neonatal complications.
{"title":"Use of Intravenous Dexamethasone for Cervical Ripening and Labor Induction in Term Pregnancies with Pre-labour Rupture of Membranes: Randomized control trial","authors":"S. Safwat","doi":"10.31579/2642-9756/048","DOIUrl":"https://doi.org/10.31579/2642-9756/048","url":null,"abstract":"Abstract Background: During the first 36 to 38 weeks of normal gestation, the myometrium is in a preparatory yet unresponsive state. Concurrently, the cervix begins an early stage of remodeling yet maintains structural integrity. Induction of labour is a complex process involving cervical ripening which undergo extensive remodeling and dynamic changes controlled by hormonal, inflammatory changes, and other biological processes. Aim of the Work: to assess the effect of intravenous administration of dexamethasone on the induction delivery interval in term patients with prelabour rupture of membranes undergoing induction of labor. Patients and Methods: This randomized control trial was conducted at department of Obstetrics and Gynecology at Ain Shams University Maternity Hospital (ASUMH) in the period between August 2020 and January 2021. Participants of this study were 80 full term pregnant women with pre-labor rupture of membranes attended the labor ward in El Demerdash Maternity Hospital and scheduled for induction of labor by 8 mg dexamethasone IV before starting induction by PGE1, after 4 hours oxytocin was added by 1 IU/hr with the dose increasing by 1 IU every 30 minutes till optimal contractions were reached which were three uterine contractions in 10 minutes and each lasting for 40-50 seconds. Results: Fetal distress, arrest of delivery and indications of CS delivery were non-significantly less frequent among Dexamethasone group. Induction-active phase and active phase durations were significantly shorter among dexamethasone group than among control group. Second and third stages durations were non-significantly shorter among dexamethasone group than among control group. Total induction-delivery duration was significantly shorter and rate of vaginal delivery was significantly higher among dexamethasone group than among control group. Postpartum hemorrhage (PPH), postpartum endometritis, chorioamnionitis were not reported among the studied groups. No significant difference between Dexamaethasone and Control groups regarding neonatal condition Conclusion: Intravenous administration of dexamethasone in addition to labor induction protocol shortened the induction - active phase and active phase durations. It shortened the total induction-delivery duration and increased the rate of successful vaginal delivery. It has no effect on second and third stages durations with no increase in incidence of intrapartum, postpartum nor neonatal complications.","PeriodicalId":93058,"journal":{"name":"Women health care and issues","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41574864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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