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Berg KA, Bullington BW, Gunzler DD, Miller ES, Boozer M, Serna T, Bailit JL, Arora KS. Neighbourhood socioeconomic position, prenatal care and fulfilment of postpartum permanent contraception: Findings from a multisite cohort study. Reprod Female Child Health 2024; 3:e64. [PMID: 38737484 PMCID: PMC11087039 DOI: 10.1002/rfc2.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 10/10/2023] [Indexed: 05/14/2024]
Abstract
Introduction Research suggests neighbourhood socioeconomic vulnerability is negatively associated with women's likelihood of receiving adequate prenatal care and achieving desired postpartum permanent contraception. Receiving adequate prenatal care is linked to a greater likelihood of achieving desired permanent contraception, and access to such care may be critical for women with Medicaid insurance given that the federally mandated Medicaid sterilization consent form must be signed at least 30 days before the procedure. We examined whether adequacy of prenatal care mediates the relationship between neighbourhood socioeconomic position and postpartum permanent contraception fulfilment, and examined moderation of relationships by insurance type. Methods This secondary analysis of a retrospective cohort study examined 3012 Medicaid or privately insured individuals whose contraceptive plan at postpartum discharge was permanent contraception. Path analysis estimated relationships between neighbourhood socioeconomic position (economic hardship and inequality, financial strength and educational attainment) and permanent contraception fulfilment by hospital discharge, directly and indirectly through adequacy of prenatal care. Multigroup testing examined moderation by insurance type. Results After adjusting for age, parity, weeks of gestation at delivery, mode of delivery, race, ethnicity, marital status and body mass index, having adequate prenatal care predicted achieving desired sterilization at discharge (β = 0.065, 95% confidence interval [CI]: 0.011, 0.117). Living in neighbourhoods with less economic hardship (indirect effect -0.007, 95% CI: -0.015, -0.001), less financial strength (indirect effect -0.016, 95% CI: -0.030, -0.002) and greater educational attainment (indirect effect 0.012, 95% CI: 0.002, 0.023) predicted adequate prenatal care, in turn predicting achievement of permanent contraception by discharge. Insurance status conditioned some of these relationships. Conclusion Contact with the healthcare system via prenatal care may be a mechanism by which neighbourhood socioeconomic disadvantage affects permanent contraception fulfilment, particularly for patients with Medicaid. To promote reproductive autonomy and healthcare equity, future inquiry and policy might closely examine how neighbourhood social and economic characteristics interact with Medicaid mandates.
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Affiliation(s)
- Kristen A. Berg
- Center for Health Care Research and Policy, Population Health Research Institute, MetroHealth Medical System, Cleveland, Ohio, USA
- School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Brooke W. Bullington
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Douglas D. Gunzler
- Center for Health Care Research and Policy, Population Health Research Institute, MetroHealth Medical System, Cleveland, Ohio, USA
- School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Emily S. Miller
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Margaret Boozer
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Tania Serna
- Department of Obstetrics and Gynecology, University of California San Francisco, San Francisco, California, USA
| | - Jennifer L. Bailit
- Department of Obstetrics and Gynecology, MetroHealth Medical System, Cleveland, Ohio, USA
| | - Kavita S. Arora
- Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina, USA
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Sabbath EL, McKetchnie SM, Arora KS, Buchbinder M. US Obstetrician-Gynecologists' Perceived Impacts of Post-Dobbs v Jackson State Abortion Bans. JAMA Netw Open 2024; 7:e2352109. [PMID: 38231510 PMCID: PMC10794934 DOI: 10.1001/jamanetworkopen.2023.52109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 11/29/2023] [Indexed: 01/18/2024] Open
Abstract
Importance Following the Dobbs v Jackson Women's Health Organization decision in June 2022, 17 US states have functionally banned abortion except in narrow circumstances, and physicians found in violation of these laws face felony charges, loss of their medical license, fines, and prison sentences. Patient impacts are being studied closely, but less research has focused on the consequences for obstetrician-gynecologists (OB-GYNs), for whom medically necessary care provision may now carry serious personal and professional consequences. Objective To characterize perceptions of the impact of abortion restrictions on clinical practice, moral distress, mental health, and turnover intention among US OB-GYNs practicing in states with functional bans on abortion. Design, Setting, and Participants This qualitative study included semistructured, remote interviews with OB-GYNs from 13 US states with abortion bans. Volunteer sample of 54 OB-GYNs practicing in states that had banned abortion as of March 2023. Exposure State abortion bans enacted between June 2022 and March 2023. Main Outcomes and Measures OB-GYNs' perceptions of clinical and personal impacts of abortion bans. Results This study included 54 OB-GYNs (mean [SD] age, 42 [7] years; 44 [81%] female participants; 3 [6%] non-Hispanic Black or African American participants; 45 [83%] White participants) who practiced in general obstetrics and gynecology (39 [72%]), maternal-fetal medicine (7 [13%]), and complex family planning (8 [15%]). Two major domains were identified in which the laws affected OB-GYNs: (1) clinical impacts (eg, delays in care until patients became more sick or legal sign-off on a medical exception to the ban was obtained; restrictions on counseling patients on pregnancy options; inability to provide appropriate care oneself or make referrals for such care); and (2) personal impacts (eg, moral distress; fears and perceived consequences of law violation; intention to leave the state; symptoms of depression and anxiety). Conclusions and relevance In this qualitative study of OB-GYNs practicing under abortion bans, participants reported deep and pervasive impacts of state laws, with implications for workforce sustainability, physician health, and patient outcomes. In the context of public policies that restrict physicians' clinical autonomy, organization-level supports for physicians are essential to maintain workforce sustainability, clinician health and well-being, and availability of timely and accessible health care throughout the US.
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Affiliation(s)
- Erika L. Sabbath
- School of Social Work, Boston College, Chestnut Hill, Massachusetts
- Center for Work, Health, and Wellbeing, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | | | - Kavita S. Arora
- Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Mara Buchbinder
- Center for Bioethics, Department of Social Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
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Thomas KN, Malhotra T, Ngendahimana D, Gibson KS, Arora KS. Postpartum contraceptive choice and fulfillment in patients with opioid use disorder. Contraception 2023; 128:110267. [PMID: 37633590 PMCID: PMC10873085 DOI: 10.1016/j.contraception.2023.110267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 08/17/2023] [Accepted: 08/22/2023] [Indexed: 08/28/2023]
Abstract
OBJECTIVE We examined the differences in postpartum contraception between patients with and without opioid use disorder (OUD). STUDY DESIGN We conducted a retrospective, single-institution, cohort analysis assessing differences in desired method of postpartum contraception and plan fulfillment. RESULTS Patients with OUD comprised 200/8654 (2.3%) of our study cohort. After 2:1 matching, method desired (matched odds ratio [mOR] 0.86, 95% confidence interval [CI] 0.60-1.23 for highly vs. moderately effective) and receipt (mOR 0.77, 95% CI 0.53-1.12) of desired method were comparable between groups. CONCLUSION Patients with and without OUD were similar in their choice and fulfillment of postpartum contraception.
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Affiliation(s)
- Kathryn N Thomas
- Department of Obstetrics and Gynecology, MetroHealth Medical Center, Cleveland, OH, USA; Department of Obstetrics, Gynecology & Reproductive Sciences, UPMC Magee-Womens Hospital, Pittsburgh, PA, USA.
| | - Tani Malhotra
- Department of Obstetrics and Gynecology, MetroHealth Medical Center, Cleveland, OH, USA; Department of Obstetrics and Gynecology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - David Ngendahimana
- Office of Mental Health and Suicide Prevention, Veterans Health Administration, Menlo Park, CA, USA
| | - Kelly S Gibson
- Department of Obstetrics and Gynecology, MetroHealth Medical Center, Cleveland, OH, USA
| | - Kavita S Arora
- Department of Obstetrics and Gynecology, MetroHealth Medical Center, Cleveland, OH, USA; Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA
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Stuart GS, Yates L, Crump J, Allison BA, Navarro AL, Tadikonda A, Neal-Perry G, Arora KS. Single-visit insertion of long-acting reversible contraception in a single health system. Contraception 2023:110009. [PMID: 36931546 DOI: 10.1016/j.contraception.2023.110009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 03/05/2023] [Accepted: 03/10/2023] [Indexed: 03/17/2023]
Abstract
OBJECTIVE To identify patient and practice characteristics associated with single-visit placement of long-acting reversible contraception (LARC) across the UNC Health system. STUDY DESIGN We conducted a retrospective observational study using existing electronic health records. We abstracted data from charts of individuals ages 15-50 years who received a LARC device between March 15, 2019, and March 14, 2021. Our primary outcome was whether a patient received LARC at one, or after multiple, outpatient visits. We used descriptive statistics to examine patient, clinician, and practice characteristics. We used bivariate analysis and generalized estimating equation (GEE) to examine relationships between characteristics and single-visit LARC receipt. RESULTS Most of the 4,599 individuals received care at obstetrics and gynecology clinics (3411/4599; 74%), and received their LARC device in a single visit (3163/4599; 69%). The adjusted odds of receiving a LARC in a single visit was highest for those who self-paid (aOR 1.83, 1.19-2.82) and those who received an implant (aOR1.25, 1.07-1.46). Patients seen by advanced practice practitioners (aOR 0.67, 0.56-0.80) or by an internal medicine specialty clinician (aOR 0.13, 0.00-0.35) had lower odds of receiving a single-visit LARC compared to those seen by a specialist obstetrician-gynecologist physician. CONCLUSION Most single-visit LARC placements were performed by clinicians in obstetrician-gynecologist specialty practices. IMPLICATIONS Among individuals seeking long-acting reversible contraceptives from clinics in a single health system in North Carolina, most received a device at a single visit and most single-visit insertions were done by an obstetrician-gynecologist.
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Affiliation(s)
- Gretchen S Stuart
- University of North Carolina School of Medicine, Chapel Hill, North Carolina, 27599-7570.
| | - Lindsey Yates
- UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, 27599
| | - Johanna Crump
- University of North Carolina School of Medicine, Chapel Hill, North Carolina, 27599-7570
| | - Bianca A Allison
- University of North Carolina School of Medicine, Chapel Hill, North Carolina, 27599-7570
| | - Ashley L Navarro
- University of North Carolina School of Medicine, Chapel Hill, North Carolina, 27599-7570
| | - Ananya Tadikonda
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, 27599
| | - Genevieve Neal-Perry
- University of North Carolina School of Medicine, Chapel Hill, North Carolina, 27599-7570
| | - Kavita S Arora
- University of North Carolina School of Medicine, Chapel Hill, North Carolina, 27599-7570
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Roque CL, Morello LE, Arora KS. Postpartum Contraceptive Decision-Making of Parous Teens-A Qualitative Study. J Pediatr Adolesc Gynecol 2022; 35:329-335. [PMID: 34742936 PMCID: PMC9396354 DOI: 10.1016/j.jpag.2021.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 10/05/2021] [Accepted: 10/18/2021] [Indexed: 10/19/2022]
Abstract
STUDY OBJECTIVE Approximately 25% of teens in the United States will become pregnant before the age of 18, and within 2 years, more than 31% will have a repeat pregnancy. Acknowledging that some adolescents might seek or be ambivalent toward rapid repeat pregnancy, compared with their counterparts, not using a long-acting reversible contraception method increases a teen's risk of another pregnancy in 2 years by more than 35 times. We seek to better understand the influences and factors surrounding adolescent postpartum contraceptive decision-making following the index delivery. DESIGN We completed a qualitative study via focused, semistructured interviews during an inpatient postpartum course. The interview guide was modeled after those used in other studies of adolescent contraceptive decision-making, beta tested, and developed iteratively. Interviews were completed, transcribed, coded, and analyzed with the assistance of Dedoose. SETTING The study was conducted at MetroHealth Medical Center in Cleveland, Ohio. PARTICIPANTS Parous adolescents aged 13-19 RESULTS: We performed 12 interviews prior to reaching theoretical saturation. Themes were identified related to the participants' prior experiences with contraception and prior and current pregnancies. The participants' contraceptive choices were influenced by personal relationships, varying levels of autonomy, misperceptions, and changing contraceptive needs. CONCLUSIONS We found that adolescents' contraceptive decision-making was influenced by their social networks and community, including their parents and friends. Mothers played a key role as adolescents transitioned to gaining more autonomy over their reproductive decisions. Providers should consistently present adolescents with comprehensive contraceptive options as a component of preventive health care.
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Affiliation(s)
- Charita L Roque
- Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD.
| | - Laura E Morello
- Department of Bioethics, Case Western Reserve University, Cleveland, Ohio
| | - Kavita S Arora
- Department of Bioethics, Case Western Reserve University, Cleveland, Ohio; Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC
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Abstract
An increasing number of young adolescents who identify as transgender or nonbinary are presenting to the health care system for gender affirmation therapy before the full progression of puberty. Gender-affirming therapy may impair future fertility, but options exist for fertility preservation. This perspective reviews these options for transmasculine and nonbinary youth, and explores related ethical considerations. The authors support the right of transgender and nonbinary youth to utilize available reproductive technologies, provide recommendations for treating health professionals, and advocate for increased research efforts and tools to aid patient decision making.
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Affiliation(s)
- Leila J Katabi
- Department of Bioethics, Case Western Reserve University, Cleveland, Ohio, USA.,School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Henry H Ng
- Center for LGBT Health, Cleveland Clinic Foundation, Cleveland, Ohio, USA.,Public Health and Science Department, Baldwin Wallace University, Berea, Ohio, USA
| | - Carl G Streed
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA.,Center for Transgender Medicine and Surgery, Boston Medical Center, Boston, Massachusetts, USA
| | - Kavita S Arora
- Department of Bioethics, Case Western Reserve University, Cleveland, Ohio, USA.,Department of Obstetrics and Gynecology, MetroHealth Medical Center, Cleveland, Ohio, USA
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Abstract
OBJECTIVES Clinical rotations are an important aspect of undergraduate medical education. However, as patient satisfaction scores receive increasing attention, the impact of medical student participation on patient satisfaction and perception of quality of care is unclear. Previous studies from the Emergency Department and outpatient settings show that medical students do not negatively impact satisfaction scores. The authors sought to examine the effect of medical student involvement on patient satisfaction in the Labor and Delivery Triage setting. METHODS The authors conducted a survey study of a convenience sample of pregnant patients seen in and discharged from Labor and Delivery between January 2015 and April 2016. Surveys addressed questions about the overall satisfaction with the care patients received, as well as other outcome measures such as comfort with asking questions, time spent with a physician, and politeness of staff. RESULTS 240 total surveys were collected. After excluding surveys from those that were unsure whether a medical student was involved in their care, 168 surveys were used in the final analysis. Of these, 63.7% of subjects reported being seen by a medical student. There was no significant difference (p = 0.76) in overall patient satisfaction between groups. CONCLUSIONS FOR PRACTICE Given the lack of a negative impact of medical student involvement on patient satisfaction, medical students should continue to be active members of the healthcare team, including in specialties such as obstetrics and locations such as Labor and Delivery triage with highly sensitive and time-dependent evaluations.
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Affiliation(s)
- Tani Malhotra
- Department of Obstetrics and Gynecology, MetroHealth Medical Center, 2500 Metrohealth Dr., Cleveland, OH, 44109, USA.
| | - Stephanie Thomas
- Department of Obstetrics and Gynecology, MetroHealth Medical Center, 2500 Metrohealth Dr., Cleveland, OH, 44109, USA
| | - Kavita S Arora
- Department of Obstetrics and Gynecology, MetroHealth Medical Center, 2500 Metrohealth Dr., Cleveland, OH, 44109, USA.,Case Western Reserve University, Cleveland, USA
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Modgil R, Arora KS, Sharma A, Mohapatra S, Pareek S. Cleidocranial Dysplasia: Presentation of Clinical and Radiological Features of a Rare Syndromic Entity. Mymensingh Med J 2018; 27:424-428. [PMID: 29769514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Cleidocranial dysplasia is a developmental anomaly of the skeleton and the teeth. This condition may be inherited and be transmitted as dominant characteristics in either gender, or may appear spontaneously. It presents with skeletal defects of several bones, such as partial or complete absence of clavicles, late closure of the fontanels, presence of open skull sutures and multiple wormian bones. The dental manifestations are mainly delayed exfoliation of primary teeth and delayed eruption of permanent teeth with multiple impacted supernumerary teeth. This case of a 20 year old girl is noteworthy to the dentist as it deals with clinical and radiological features (a high number of impacted and supernumerary teeth as well as brachycephaly, frontal bossing and hypermobility of shoulders) which may come handy in clinical practice.
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Affiliation(s)
- R Modgil
- Dr Richa Modgil, Senior Lecturer, Department of Oral Medicine and Radiology, Eklavya Dental College & Hospital, Kotputli, Jaipur, Rajasthan, India
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O'Rourke-Suchoff DK, Arora KS, Hildebrand VM, Singer ME. Exploring maternal attitudes towards adolescent contraception: implications for use of LARC. Int J Adolesc Med Health 2017; 30:/j/ijamh.ahead-of-print/ijamh-2016-0120/ijamh-2016-0120.xml. [PMID: 28598796 DOI: 10.1515/ijamh-2016-0120] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 12/27/2016] [Indexed: 06/07/2023]
Abstract
Introduction Maternal attitudes have been shown to impact adolescent girls' sexual decision making and attitudes towards contraception. Given the potential for maternal influence on adolescent contraceptive use, we undertook an exploratory study of mothers' perceptions of the maternal role in adolescent contraceptive decision making, and maternal perceptions of long acting reversible contraceptives (LARC) for adolescent girls. Materials and methods We utilized a mixed methods study design. Acceptability of contraceptive methods and attitudes towards adolescent contraceptive use were assessed using a paper survey of 162 mothers of girls aged 11-19 years in Cleveland, Ohio, USA. Seven survey participants completed subsequent semi-structured interviews, which were analyzed using grounded theory methodology. Results Pills, condoms and injections were most frequently selected as acceptable by 55.4%, 55.4%, and 51.6% of women, respectively. One or more LARC methods were selected by 16.6% of the women. Of those (94.4%) agreed or strongly agreed that, "It is expected of me to make sure that my daughter knows about birth control methods." Important themes that emerged during interviews were the responsibility mothers felt to help their daughters navigate contraception options, appreciation of the effectiveness of LARC methods and concerns about the use of those methods by teenagers due to the invasiveness. Conclusion Our data suggest that mothers want to be involved and support adolescent decision making about contraceptives. We also found that mothers viewed LARC as less acceptable than other forms of birth control for adolescents and have specific concerns about LARC. These results suggest directions for future work to better characterize the impact of maternal attitudes on adolescent LARC use.
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Affiliation(s)
- Danielle K O'Rourke-Suchoff
- Case Western Reserve University School of Medicine, 10900 Euclid Ave, Cleveland, OH 44106,USA
- Department of Epidemiology and Biostatistics, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106-4945,USA, Phone: 216-368-3725
| | - Kavita S Arora
- Case Western Reserve University School of Medicine, 10900 Euclid Ave, Cleveland, OH 44106,USA
- Department of Obstetrics and Gynecology, MetroHealth Medical Center, 2500 Metrohealth Dr., Cleveland, OH 44109,USA
- Department of Bioethics, Case Western Reserve University, School of Medicine TA200, 10900 Euclid Ave, Cleveland, OH 44106-4976,USA
| | - Vanessa M Hildebrand
- Department of Anthropology, Case Western Reserve University, Mather Memorial Room 238, 11220 Bellflower Road, Cleveland, OH 44106-7125,USA
| | - Mendel E Singer
- Case Western Reserve University School of Medicine, 10900 Euclid Ave, Cleveland, OH 44106,USA
- Department of Epidemiology and Biostatistics, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106-4945,USA, Phone: 216-368-3725
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Gupta N, Arora M, Sharma R, Arora KS. Peripheral and Central Nervous System Involvement in Recently Diagnosed Cases of Hypothyroidism: An Electrophysiological Study. Ann Med Health Sci Res 2016; 6:261-266. [PMID: 28503341 PMCID: PMC5414436 DOI: 10.4103/amhsr.amhsr_39_16] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Hypothyroidism, one of the most common endocrine disorders, may induce neurological abnormalities at an early stage of the disease. Aim: The study was designed to assess the electrophysiological alterations of some selected variables of nerve conduction, brainstem auditory evoked potentials (BAEPs), and visual evoked potentials (VEPs) in hypothyroid patients. Subjects and Methods: Sixty patients of newly diagnosed hypothyroidism and an equal number of age-matched controls were selected for the study. Nerve conduction studies that included parameters as latencies, conduction velocities, and amplitude of motor nerves, i.e., median, ulnar, common peroneal, tibial nerve, and sensory nerves, i.e., median and sural nerves was performed in both hypothyroid patients and controls. Further, BAEPs and VEPs of all the patients were done. The data were compiled and statistically analyzed using Student's unpaired t-test to observe any electrophysiological alterations in hypothyroid patients as compared to healthy controls. Results: On comparative evaluation, statistically significant increase in latency of median, ulnar, tibial, and sural nerves; decrease in conduction velocities of all the tested nerves and decrease in amplitude of median, tibial, and sural nerves was observed in hypothyroid patients. Statistically significant increase in latencies, interpeak latencies, and decrease in amplitudes of BAEP waves and statistically significant increase in P100 latency of VEP was seen in hypothyroid patients. Conclusion: The results of our study suggest that peripheral and central neuropathy develops in patients of hypothyroidism at an early stage of disease and the electrophysiological investigations of such patients can help in timely detection and treatment of neurological disorders that occur due to thyroid hormone deficiency.
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Affiliation(s)
- N Gupta
- Department of Physiology, Guru Gobind Singh Medical College, Faridkot, Punjab, India
| | - M Arora
- Department of Medicine, Guru Gobind Singh Medical College, Faridkot, Punjab, India
| | - R Sharma
- Department of Physiology, Guru Gobind Singh Medical College, Faridkot, Punjab, India
| | - K S Arora
- Department of Physiology, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
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Jacobs AJ, Arora KS. Response to open peer commentaries on "ritual male infant circumcision and human rights". Am J Bioeth 2015; 15:W1-W4. [PMID: 25786023 DOI: 10.1080/15265161.2015.1000064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Arora KS. Lessons learned in breast cancer surgery (Br J Surg 2014; 101: 145-147). Br J Surg 2014; 101:1032. [PMID: 24915796 DOI: 10.1002/bjs.9558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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