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Kumari J, Hogan J, Farah N, Anglim M. Medical management of miscarriage - Old versus new regimens. Ir Med J 2023; 116:829. [PMID: 37791648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
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Shah A, Farah N, McNamee E, Lindow SW, O'Connell M. Demographic changes in primiparae of Irish ethnicity between 2000 and 2020. Eur J Obstet Gynecol Reprod Biol 2022; 278:137-140. [PMID: 36174435 DOI: 10.1016/j.ejogrb.2022.09.015] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/05/2022] [Accepted: 09/12/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Trends in maternal demographic changes linked to lifestyle and socio-economic conditions reflect greatly on maternal, perinatal and infant mortality rates. Hospital data reflect a heterogenous population where specific demographic changes may not be obvious. OBJECTIVES To report yearly demographic changes in Irish primiparae from 2000 to 2020, specifically looking at age, BMI, smoking and marital status of patients attending the Coombe Women and Infant's University Hospital (CWIUH). METHODS Retrospective report of demographic details contemporaneously documented on the CWIUH data base. FINDINGS In the years 2000 to 2020 inclusive there were 47,659 primiparous women of Irish ethnicity delivered at the CWIUH (70.2% of the total primiparae), of those 99.3% were Caucasian. There was a significant rise in mean age at first delivery in Irish mothers; 26.0 years old in the 2000 to 30.9 years old in 2020 associated with a rise in mean BMI of 9.1%. Smoking rates (ever smoked) showed a significant reduction from 53.9% in 2000 to 39.3% in 2020. There was a significant decrease in rates of marriage, with 61.9% married in 2000 compared to 46.3% in 2020. Birth weight and prematurity rates remained unchanged, with fall in mean gestational age at first delivery from 279.3 days in 2000 to 275.8 days in 2020. CONCLUSION This study highlights that Irish primiparae are older, heavier, less likely to smoke and to be married than they were 20 years ago. These trends are an interesting glimpse into changing economic and cultural climate over just the past 2 decades.
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Affiliation(s)
- A Shah
- The Coombe Women and Infants' University Hospital, Cork Street, Dublin, Ireland.
| | - N Farah
- The Coombe Women and Infants' University Hospital, Cork Street, Dublin, Ireland
| | - E McNamee
- The Coombe Women and Infants' University Hospital, Cork Street, Dublin, Ireland
| | - S W Lindow
- The Coombe Women and Infants' University Hospital, Cork Street, Dublin, Ireland
| | - M O'Connell
- The Coombe Women and Infants' University Hospital, Cork Street, Dublin, Ireland
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Naeem F, Tuck A, Mutta B, Dhillon P, Thandi G, Kassam A, Farah N, Ashraf A, Husain MI, Husain MO, Vasiliadis HM, Sanches M, Munshi T, Abbott M, Watters N, Kidd SA, Ayub M, McKenzie K. Protocol for a multi-phase, mixed methods study to develop and evaluate culturally adapted CBT to improve community mental health services for Canadians of south Asian origin. Trials 2021; 22:600. [PMID: 34488853 PMCID: PMC8419942 DOI: 10.1186/s13063-021-05547-4] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 08/17/2021] [Indexed: 11/17/2022] Open
Abstract
Background Canadians of South Asian (SA) origin comprise the largest racialized group in Canada, representing 25.6% of what Statistics Canada terms “visible minority populations”. South Asian Canadians are disproportionately impacted by the social determinants of health, and this can result in high rates of mood and anxiety disorders. These factors can negatively impact mental health and decrease access to care, thereby increasing mental health inequities. Cognitive Behavioural Therapy (CBT) in its current form is not suitable for persons from the non-western cultural backgrounds. Culturally adapted Cognitive Behavioural Therapy (CaCBT) is an evidence-based practice. CaCBT is more effective than standard CBT and can reduce dropouts from therapy compared with standard CBT. Thus, CaCBT can increase access to mental health services and improve outcomes for immigrant, refugee and ethno-cultural and racialized populations. Adapting CBT for growing SA populations in Canada will ensure equitable access to effective and culturally appropriate interventions. Methods The primary aim of the study is to develop and evaluate CaCBT for Canadian South Asian persons with depression and anxiety and to gather data from stakeholders to develop guidelines to culturally adapt CBT. This mixed methods study will use three phases: (1) cultural adaptation of CBT, (2) pilot feasibility of CaCBT and (3) implementation and evaluation of CaCBT. Phase 1 will use purposive sampling to recruit individuals from four different groups: (1) SA patients with depression and anxiety, (b) caregivers and family members of individuals affected by anxiety and depression, (c) mental health professionals and (d) SA community opinion leaders. Semi-structured interviews will be conducted virtually and analysis of interviews will be informed by an ethnographic approach. Phase 2 will pilot test the newly developed CaCBT for feasibility, acceptability and effectiveness via quantitative methodology and a randomized controlled trial, including an economic analysis. Phase 3 will recruit therapists to train and evaluate them in the new CaCBT. Discussion The outcome of this trial will benefit health services in Canada, in terms of helping to reduce the burden of depression and anxiety and provide better care for South Asians. We expect the results to help guide the development of better services and tailor existing services to the needs of other vulnerable groups. Trial registration ClinicalTrials.gov NCT04010890. Registered on July 8, 2019
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Affiliation(s)
- Farooq Naeem
- Department of Psychiatry, University of Toronto, Toronto, Canada. .,Centre for Addiction and Mental Health, 33 Ursula Franklin St., Toronto, Ontario, M5S 2S1, Canada.
| | - Andrew Tuck
- Centre for Addiction and Mental Health, 33 Ursula Franklin St., Toronto, Ontario, M5S 2S1, Canada
| | - Baldev Mutta
- Punjabi Community Health Services, Toronto, Canada
| | | | - Gary Thandi
- Moving Forward Family Services, Vancouver, Canada
| | | | - Nimo Farah
- Somerset West Community Health Centre, Ottawa, Canada
| | - Aamna Ashraf
- Centre for Addiction and Mental Health, 33 Ursula Franklin St., Toronto, Ontario, M5S 2S1, Canada
| | - M Ishrat Husain
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Centre for Addiction and Mental Health, 33 Ursula Franklin St., Toronto, Ontario, M5S 2S1, Canada
| | - M Omair Husain
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Centre for Addiction and Mental Health, 33 Ursula Franklin St., Toronto, Ontario, M5S 2S1, Canada
| | - Helen-Maria Vasiliadis
- Department of Community Health Sciences, Faculty of Medicine and Health Science, Université de Sherbrooke, Research Center Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé, Montreal, Canada
| | - Marcos Sanches
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Centre for Addiction and Mental Health, 33 Ursula Franklin St., Toronto, Ontario, M5S 2S1, Canada
| | - Tariq Munshi
- Department of Psychiatry, University of Toronto, Toronto, Canada.,St Michael's Hospital, Toronto, Canada
| | | | | | - Sean A Kidd
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Centre for Addiction and Mental Health, 33 Ursula Franklin St., Toronto, Ontario, M5S 2S1, Canada
| | | | - Kwame McKenzie
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Centre for Addiction and Mental Health, 33 Ursula Franklin St., Toronto, Ontario, M5S 2S1, Canada.,Wellesley Institute, Toronto, Canada
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4
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Sayah R, Felefly T, Zouein L, Khater N, Barouky J, Farah N, Roukoz C, Khoury C, Azoury F, Nasr DN, Nasr E. Switching from AAA to Acuros XB Dose-to-Water or Dose-to-Medium for RapidArc Planning of Nasopharyngeal Carcinomas: Rethinking the Dosimetric Endpoints. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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5
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Felefly T, Achkar S, Khater N, Sayah R, Fares G, Farah N, El Barouky J, Azoury F, El Khoury C, Roukoz C, Nehme Nasr D, Nasr E. Collision prediction for intracranial stereotactic radiosurgery planning: An easy-to-implement analytical solution. Cancer Radiother 2020; 24:316-322. [PMID: 32467083 DOI: 10.1016/j.canrad.2020.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 12/26/2019] [Revised: 01/28/2020] [Accepted: 01/31/2020] [Indexed: 02/05/2023]
Abstract
PURPOSE Gantry collision is a concern in linac-based stereotactic radiosurgery (SRS). Without collision screening, the planner may compromise optimal planning, unnecessary re-planning delays can occur, and incomplete treatments may be delivered. To address these concerns, we developed a software for collision prediction based on simple machine measurements. MATERIALS AND METHODS Three types of collision were identified; gantry-couch mount, gantry-couch and gantry-patient. Trigonometric formulas to calculate the distance from each potential point of collision to the gantry rotation axis were generated. For each point, collision occurs when that distance is greater than the gantry head to gantry rotational axis distance. The colliding arc for each point is calculated. A computer code incorporating these formulas was generated. The inputs required are the couch coordinates relative to the isocenter, the patient dimensions, and the presence or absence of a circular SRS collimator. The software outputs the collision-free gantry angles, and for each point, the shortest distance to the gantry or the colliding sector when collision is identified. The software was tested for accuracy on a TrueBEAM® machine equipped with BrainLab® accessories for 80 virtual isocenter-couch angle configurations with and without a circular collimator and a parallelepiped phantom. RESULTS The software predicted the absence of collision for 19 configurations. The mean absolute error between the measured and predicted gantry angle of collision for the remaining 61 cases was 0.86 (0.01-2.49). CONCLUSION This tool accurately predicted collisions for linac-based intracranial SRS and is easy to implement in any radiotherapy facility.
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Affiliation(s)
- T Felefly
- Department of Radiation Oncology, Hôtel-Dieu de France University Hospital, School of Medicine, Saint Joseph University, Beirut, Lebanon.
| | - S Achkar
- Department of Radiation Oncology, Hôtel-Dieu de France University Hospital, School of Medicine, Saint Joseph University, Beirut, Lebanon
| | - N Khater
- Department of Radiation Oncology, Saint-Louis University, Saint-Louis, MO, USA
| | - R Sayah
- Department of Radiation Oncology, Hôtel-Dieu de France University Hospital, School of Medicine, Saint Joseph University, Beirut, Lebanon
| | - G Fares
- Physics Department, Faculty of Sciences, Saint Joseph University, Beirut, Lebanon
| | - N Farah
- Department of Radiation Oncology, Hôtel-Dieu de France University Hospital, School of Medicine, Saint Joseph University, Beirut, Lebanon
| | - J El Barouky
- Department of Radiation Oncology, Hôtel-Dieu de France University Hospital, School of Medicine, Saint Joseph University, Beirut, Lebanon
| | - F Azoury
- Department of Radiation Oncology, Hôtel-Dieu de France University Hospital, School of Medicine, Saint Joseph University, Beirut, Lebanon
| | - C El Khoury
- Department of Radiation Oncology, Hôtel-Dieu de France University Hospital, School of Medicine, Saint Joseph University, Beirut, Lebanon
| | - C Roukoz
- Department of Radiation Oncology, Hôtel-Dieu de France University Hospital, School of Medicine, Saint Joseph University, Beirut, Lebanon
| | - D Nehme Nasr
- Department of Radiation Oncology, Hôtel-Dieu de France University Hospital, School of Medicine, Saint Joseph University, Beirut, Lebanon
| | - E Nasr
- Department of Radiation Oncology, Hôtel-Dieu de France University Hospital, School of Medicine, Saint Joseph University, Beirut, Lebanon
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Farah N, Carr-White G, McDiarmid A. 3VALIDATING THE USE OF ELECTRONIC FRAILTY INDEX SCORE IN REFERRAL PATHWAYS; A RETROSPECTIVE STUDY OF HEART FAILURE DIAGNOSTIC APPOINTMENTS IN SECONDARY CARE FROM APRIL 2016 TO APRIL 2016. Age Ageing 2019. [DOI: 10.1093/ageing/afy211.03] [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: 11/14/2022] Open
Affiliation(s)
- N Farah
- Wolfson Medical School, University of Glasgow, Glasgow
| | - G Carr-White
- Department of Cardiology, St Thomas’ Hospital, London
| | - A McDiarmid
- Department of Cardiology, St Thomas’ Hospital, London
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7
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Rajakulasingam RK, Farah N, Huber PAJ, Durham SR, Clark AT, Nasser SM, Krishna MT. Practice and safety of allergen-specific immunotherapy for allergic rhinitis in the UK national health service: A report of “real world” clinical practice. Clin Exp Allergy 2017; 48:89-92. [DOI: 10.1111/cea.13052] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- R. K. Rajakulasingam
- Department of Respiratory Medicine/Allergy; Homerton University Hospital NHS Foundation Trust; London UK
| | - N. Farah
- Department of Respiratory Medicine/Allergy; Homerton University Hospital NHS Foundation Trust; London UK
| | - P. A. J. Huber
- British Society for Allergy and Clinical Immunology; London UK
| | - S. R. Durham
- Department of Allergy; Imperial College London and Royal Brompton Hospital; London UK
| | - A. T. Clark
- Allergy Clinic; Addenbrooke's Hospital; Cambridge UK
| | - S. M. Nasser
- Allergy Clinic; Addenbrooke's Hospital; Cambridge UK
| | - M. T. Krishna
- Department of Allergy and Immunology; Heart of England NHS Foundation Trust; Birmingham & Institute of Immunology and Immunotherapy; University of Birmingham; Birmingham UK
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Li Z, Abraham BJ, Berezovskaya A, Farah N, Liu Y, Leon T, Fielding A, Tan SH, Sanda T, Weintraub AS, Li B, Shen S, Zhang J, Mansour MR, Young RA, Look AT. APOBEC signature mutation generates an oncogenic enhancer that drives LMO1 expression in T-ALL. Leukemia 2017; 31:2057-2064. [PMID: 28260788 PMCID: PMC5629363 DOI: 10.1038/leu.2017.75] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 01/27/2017] [Accepted: 02/24/2017] [Indexed: 12/16/2022]
Abstract
Oncogenic driver mutations are those that provide a proliferative or survival advantage to neoplastic cells, resulting in clonal selection. Although most cancer-causing mutations have been detected in the protein-coding regions of the cancer genome; driver mutations have recently also been discovered within noncoding genomic sequences. Thus, a current challenge is to gain precise understanding of how these unique genomic elements function in cancer pathogenesis, while clarifying mechanisms of gene regulation and identifying new targets for therapeutic intervention. Here we report a C-to-T single nucleotide transition that occurs as a somatic mutation in noncoding sequences 4 kb upstream of the transcriptional start site of the LMO1 oncogene in primary samples from patients with T-cell acute lymphoblastic leukaemia. This single nucleotide alteration conforms to an APOBEC-like cytidine deaminase mutational signature, and generates a new binding site for the MYB transcription factor, leading to the formation of an aberrant transcriptional enhancer complex that drives high levels of expression of the LMO1 oncogene. Since APOBEC-signature mutations are common in a broad spectrum of human cancers, we suggest that noncoding nucleotide transitions such as the one described here may activate potent oncogenic enhancers not only in T-lymphoid cells but in other cell lineages as well.
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Affiliation(s)
- Z Li
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - B J Abraham
- Whitehead Institute for Biomedical Research, Cambridge, MA, USA
| | - A Berezovskaya
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - N Farah
- Department of Haematology, UCL Cancer Institute, University College London, London, UK
| | - Y Liu
- Department of Computational Biology, St Jude Children’s Research Hospital, Memphis, TN, USA
| | - T Leon
- Department of Haematology, UCL Cancer Institute, University College London, London, UK
| | - A Fielding
- Department of Haematology, UCL Cancer Institute, University College London, London, UK
| | - S H Tan
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, Singapore, Singapore
| | - T Sanda
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, Singapore, Singapore
| | - A S Weintraub
- Whitehead Institute for Biomedical Research, Cambridge, MA, USA
| | - B Li
- Department of Hematology and Oncology, Key Laboratory of Pediatric Hematology and Oncology Ministry of Health, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Pediatric Translational Medicine Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - S Shen
- Department of Hematology and Oncology, Key Laboratory of Pediatric Hematology and Oncology Ministry of Health, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Pediatric Translational Medicine Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - J Zhang
- Department of Computational Biology, St Jude Children’s Research Hospital, Memphis, TN, USA
| | - M R Mansour
- Department of Haematology, UCL Cancer Institute, University College London, London, UK
| | - R A Young
- Whitehead Institute for Biomedical Research, Cambridge, MA, USA
- Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - A T Look
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
- Division of Hematology/Oncology, Children’s Hospital, Boston, MA, USA
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Abstract
OBJECTIVE Rational design of next-generation techniques for photo-thermal excitation requires the development of tools capable of modeling the effects of spatially- and temporally-dependent temperature distribution on cellular neuronal structures. APPROACH We present a new computer simulation tool for predicting the effects of arbitrary spatiotemporally-structured photo-thermal stimulation on 3D, morphologically realistic neurons. The new simulation tool is based on interfacing two generic platforms, NEURON and MATLAB and is therefore suited for capturing different kinds of stimuli and neural models. MAIN RESULTS Simulation results are validated using photo-absorber induced neuro-thermal stimulation (PAINTS) empirical results, and advanced features are explored. SIGNIFICANCE The new simulation tool could have an important role in understanding and investigating complex optical stimulation at the single-cell and network levels.
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Affiliation(s)
- Y Weissler
- The Faculty of Biomedical Engineering and Russel-Berrie Nanoscience and Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, Israel
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Azoury F, Nasr D, El Khoury C, Khater N, Barouky J, Sayah R, Farah N, Achkar S, Nasr E. EP-1621: Intrafraction errors in cranial radiotherapy with standard VMAT mask: implications for SRS/SRT. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)32056-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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11
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Felefly T, Azoury F, El Khoury C, Barouky J, Farah N, Sayah R, Khater N, Nehme Nasr D, Nasr E. EP-1663: A tool for collision prediction in linac-based intracranial radiosurgery planning. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32914-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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12
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Felefly T, Khoury CE, Azoury F, Farah N, Barouky J, Sayah R, Khater N, Nasr DN, Nasr E. EP-1629: A novel method for electron beam geometry optimisation. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32880-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Nusrat H, Batool F, Tayyeba K, Farah N, Ann M. Change your life with seven sheets of paper: A pilot randomized controlled trial for postnatal depression (CREATOR). Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.1496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
IntroductionPrevalence of Common Mental Disorders (CMD) is high in low and middle-income countries. The prevalence rate of postnatal depression in Pakistani women and its effect on the growth and development of young children and child mortality is very high. Despite availability of interventions to improve maternal health, the major issue in implementation of those interventions is because of limited availability of trained health professionals.AimsThe aim of this study is to deliver CBT based intervention called “change your life with 7 sheets of paper” to women with mild to moderate PND through trained Traditional Birth Attendants (TBAs).MethodsDuring first stage of this rather blind feasibility randomized control trial 5 TBAs were trained to deliver CBT. Total 36 participants with PND having child between the ages 0–12 months will be recruited from community. Participants will be assessed using Edinburgh Postnatal Depression Scale, Patient Health Questionnaire (PHQ-9) and World Health Organization Quality of Life scale at baseline and then at 3 months. Eight group sessions of CBT will be delivered by trained TBAs.ResultsOutcome assessments will be done after completion of intervention of intervention i.e., 3 months after baseline. Preliminary findings will be presented in the conference.ConclusionFindings from this trial will help us to understand how the involvement of TBAs can help in overcoming the challenge of non-availability of trained health professionals and in attainment of millennium development goals of reducing mother and child mortality.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Abstract
The aim of the study was to analyse gestational weight gain (GWG) according to body mass index (BMI) category and to explore the relationship between GWG and pregnancy complications. Women were recruited in the 1st trimester. Weight and height were measured and BMI calculated. Weight was measured at 38 weeks' gestation and GWG calculated. Clinical details were obtained prospectively. Of the 604 women recruited, 45.5% were primigravidas and 25.2% were obese. The overall mean GWG was 11.6 kg (SD 6.0). In obese women, the mean GWG was 10.4 kg (SD 7.5) compared with 12.6 kg (SD 5.7) in the normal BMI category (p < 0.001). Maternal obesity but not increased GWG was associated with an increased risk of induction of labour, caesarean section and pre-eclampsia. It was concluded that obese women were more likely to exceed GWG recommendations, despite lower GWG than non-obese women. Maternal obesity and not GWG increased the risk of pregnancy complications.
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Affiliation(s)
- V O'Dwyer
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital , Dublin , Ireland
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Abstract
Loss of reduction remains an important problem after treatment of distal radius fractures, whatever the type of bone fixation. We assessed retrospectively the rate of secondary displacement after external fixation of distal radius fractures in order to identify possible risk factors for instability. We reviewed the pre-operative and serial post-operative radiographs of a retrospective series of 35 distal radius fractures treated by bridging external fixation. When classified according to the Société Française d'Orthopédie et Traumatologie (SOFCOT) criteria, the rate of secondary displacement was 48.5%. At final follow up, the reduction was anatomical in 12% and acceptable in 83%. There was malunion in 5%. The loss of reduction concerned primarily the distal radius palmar tilt and was moderate. No correlation was found with age, gender, type of fracture, degree of initial displacement, associated ulnar fracture, or seniority of the treating surgeon.
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Affiliation(s)
- N Farah
- 1Service d'Orthopédie-Traumatologie, Cliniques Universitaires de Bruxelles, Hôpital Erasme, Brussels, Belgium
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Saed N, Hakim M, Nijim Y, Farah N, Jamalia J, Nuser T, Ismael K, Ghantous R, Amer J, Safadi R. O121 SCI-B-VAC IS SUPERIOR TO ENGERIX-B FOR PREVENTING HBV VERTICAL TRANSMISSION. J Hepatol 2014. [DOI: 10.1016/s0168-8278(14)60123-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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17
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Azoury F, Nehme Nasr D, Khater N, Barouki J, Farah N, Samaha C, Felfely T, Nasr E. EP-1560: Potential role of VMAT and DIBH in the locoregional irradiation of left breast cancer. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)31678-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Farah N, Gorrela R, Bhowmik A, Bothamley GH, Menon M, Devalia K, Koak Y, Agrawal S, Mannur K, Rajakulasingam K. P255 Improvement of sleep apnoea severity in obese patients pre and post bariatric surgery-is there more to it? Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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O'Dwyer V, Bonham S, Mulligan A, O'Connor C, Farah N, Kennelly MM, Turner MJ. Antenatal rubella immunity in Ireland. Ir Med J 2013; 106:232-235. [PMID: 24282891] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The objective of the study was to identify those women attending for antenatal care who would have benefited from prepregnancy rubella vaccination. It was a population-based observational study of women who delivered a baby weighing < or = 500 g in 2009 in the Republic of Ireland. The woman's age, parity, nationality and rubella immunity status were analysed using data collected by the National Perinatal Reporting System. Of the 74,810 women delivered, the rubella status was known in 96.7% (n = 72,333). Of these, 6.4% (n = 4,665) women were not immune. Rubella seronegativity was 8.0% (n = 2425) in primiparous women compared with 5.2% (n = 2239) in multiparous women (p < 0.001), 14.7% (n = 10653) in women < 25 years old compared with 5.0% (n = 3083) in women < or = 25 years old (p < 0.001), and 11.4% (n = 780) in women born outside the 27 European Union (EU27) countries compared with 5.9% (n = 3886) in women born inside the EU27 countries (p < 0.001). Based on our findings we recommend that to prevent Congenital Rubella Syndrome, the health services in Ireland should focus on women who are young, nulliparous and born outside the EU.
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Affiliation(s)
- V O'Dwyer
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Cork St, Dublin 8
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Khader J, Salem A, Abuodeh Y, Almousa A, Farah N, Abdelrahman F. Stage I seminoma: Treatment outcomes in a low-income country. Gulf J Oncolog 2013; 1:20-27. [PMID: 23996863] [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] [Accepted: 05/26/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE The aim of this report is to address treatment outcomes of patients with early-stage seminoma in a developing country with special reference to patients with history of surgical violation of the scrotum and the potential predictors of disease relapse. PATIENTS AND METHODS Seventy four patients with pure seminoma were treated at King Hussein Cancer Center (Amman, Jordan) between 2003 and 2010. All patients underwent orchiectomy. All but 3 patients received adjuvant radiotherapy. Patients who underwent surgical violation of the scrotum prior to referral were managed by further excision or irradiation of the scrotal scar. The follow-up ranged from 1 to 200 months (mean, 33 months). RESULTS At the time of follow-up; all but one patient remain alive. The 3-year relapse-free survival for the entire cohort was 95.9%. Three patients were burdened by relapse, all of whom received adjuvant irradiation following inguinal orchiectomy and initially harbored tumors larger than 4cm upon pathological examination. Median time to relapse was 14 months (range, 8-25 months). None were associated with elevated tumor markers prior to detection of relapse. All but one patient were successfully salvaged by chemotherapy. CONCLUSIONS Our results confirm the excellent prognosis for patients with early-stage seminoma treated by orchiectomy and adjuvant radiotherapy in a developing country. Although all patients burdened by relapse demonstrated adverse pathological findings upon initial assessment, no consistent predictor of relapse was found. Scrotal scar re-excision or irradiation in patients with prior history of surgical violation of the scrotum is effective in preventing local failure. KEYWORDS Seminoma, stage I, radiotherapy, scrotal violation, developing country, management.
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Affiliation(s)
- J Khader
- Jamal Khader, MD, Department of Radiation Oncology, King Hussein Cancer Center, Queen Rania Alabdulla Street, Amman, Jordan, Tel. +962788305344, Fax: +96265857323,
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O’Dwyer V, Layte R, O’Connor C, Farah N, Kennelly MM, Turner MJ. International variation in caesarean section rates and maternal obesity. J OBSTET GYNAECOL 2013; 33:466-70. [DOI: 10.3109/01443615.2013.772128] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Ali FM, Farah N, O'Dwyer V, O'Connor C, Kennelly MM, Turner MJ. The impact of new national guidelines on screening for gestational diabetes mellitus. Ir Med J 2013; 106:57-59. [PMID: 23472391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Gestational diabetes mellitus (GDM) has important maternal and fetal implications. In 2010, the Health Service Executive published guidelines on GDM. We examined the impact of the new guidelines in a large maternity unit. In January 2011, the hospital replaced the 100 g Oral Glucose Tolerance Test (OGTT) with the new 75 g OGTT. We compared the first 6 months of 2011 with the first 6 months of 2010. The new guidelines were associated with a 22% increase in women screened from 1375 in 2010 to 1679 in 2011 (p < 0.001). Of the women screened, the number diagnosed with GDM increased from 10.1% (n=139) to 13.2% (n=221) (p<0.001).The combination of increased screening and a more sensitive OGTT resulted in the number of women diagnosed with GDM increasing 59% from 139 to 221 (p = 0.02).This large increase has important resource implications but, if clinical outcomes are improved, there should be a decrease in long-term costs.
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Kennelly MM, Farah N, Hogan J, Reilly A, Turner MJ, Stuart B. Longitudinal study of aortic isthmus Doppler in appropriately grown and small-for-gestational-age fetuses with normal and abnormal umbilical artery Doppler. Ultrasound Obstet Gynecol 2012; 39:414-420. [PMID: 21674659 DOI: 10.1002/uog.9076] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To establish reference ranges using longitudinal data for aortic isthmus (AoI) Doppler indices in appropriate-for-gestational-age (AGA) fetuses and to document the longitudinal trends in a cohort of small-for-gestational-age (SGA) fetuses with normal umbilical artery Doppler and in fetuses with intrauterine growth restriction (IUGR) and abnormal umbilical artery Doppler. METHODS AoI Doppler reference ranges were established from longitudinal data on 72 AGA singleton fetuses. Reliability of AoI Doppler flow measurements at two different sites and reproducibility between two operators was reviewed. A prospective longitudinal study of AoI Doppler indices in 48 SGA fetuses with normal umbilical artery Doppler and 10 IUGR fetuses was performed. RESULTS The AoI pulsatility index (PI) and peak systolic velocity (PSV) in AGA fetuses showed a significant increase with gestational age. Analysis of intra- and interoperator variability revealed no significant mean difference in measurements of AoI-PI or AoI-PSV. Observations of AoI-PI and AoI-PSV from SGA fetuses did not differ significantly from those of AGA or IUGR fetuses. Retrograde flow in the AoI did not predate changes in the ductus venosus in IUGR fetuses. CONCLUSIONS Reference ranges for fetal AoI Doppler parameters in AGA fetuses constructed using longitudinal data are consistent with those obtained from cross-sectional data. The AoI Doppler parameters in SGA fetuses did not differ from those in AGA fetuses. Preterm IUGR fetuses did not manifest alterations in AoI-PI or AoI-PSV prior to changes in biophysical profile or ductus venosus Doppler. Further large-scale prospective studies are needed to determine whether AoI Doppler parameters are of any value in timing delivery or reducing adverse neurodevelopmental outcome.
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Affiliation(s)
- M M Kennelly
- Ultrasound and Fetal Medicine Centre, Coombe Women and Infants University Hospital, Dublin, Ireland.
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Kennedy C, O'Dwyer V, O'Kelly S, Farah N, Kennelly M, Turner MJ. Thromboprophylaxis for women undergoing caesarean section. Ir Med J 2012; 105:56-57. [PMID: 22455243] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Thromboprophylaxis for women undergoing caesarean section (CS) was introduced in the hospital in 1995. This study audited the use of tinzaparin prophylaxis in a nested cohort of women who screened negative for diabetes mellitus at 28 weeks gestation. All the women had their weight measured and BMI calculated at the first antenatal visit. Of the 284 women, 68 (24%) had a CS and all received tinzaparin. Of the 68, however, 94% received a dose lower than recommended. Compliance with prophylaxis was complete but compliance with the recommended dosage was suboptimal, which may result in venous thromboembolism after CS despite thromboprophylaxis.
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Affiliation(s)
- C Kennedy
- UCD Centre for Human Reproduction, Coombe Women and Infant's University Hospital, Cork St, Dublin 8
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Farah N, Murphy M, Ramphul M, O'Connor N, Kennelly MM, Turner MJ. Comparison in maternal body composition between Caucasian Irish and Indian women. J OBSTET GYNAECOL 2012; 31:483-5. [PMID: 21823843 DOI: 10.3109/01443615.2011.581316] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The use of body mass index (BMI) for the diagnosis of obesity has limitations, especially when comparing ethnic groups with different body proportions. The aim of this prospective study was to compare maternal body composition in early pregnancy between Caucasian Irish and Indian women. A total of 81 Indian women and 81 Irish Caucasian women were matched for age, parity and BMI. Maternal weight and height were measured, and body composition analysed using bioelectrical impedance. The Irish women were taller and weighed more than the Indian women (p<0.001). At any given BMI, the Indian women had a higher total body fat percentage, visceral fat level and high fat percentage than the Irish women (p=0.024, 0.001 and 0.001, respectively). Our findings suggest that lower BMI cut-offs should be used for screening for gestational diabetes mellitus in Indian women attending our antenatal services.
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Affiliation(s)
- N Farah
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin, Ireland.
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Hogan JL, Anglim B, O'Dwyer V, Farah N, Stuart B, Turner MJ. Body mass index and hypertensive disorders of pregnancy. Pregnancy Hypertens 2012; 2:28-31. [PMID: 26104986 DOI: 10.1016/j.preghy.2011.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 05/31/2011] [Accepted: 09/20/2011] [Indexed: 11/20/2022]
Abstract
OBJECTIVES We compared the incidence of the hypertensive disorders of pregnancy in obese women with women of a normal body mass index (BMI). STUDY DESIGN Prospective observational study in which BMI was calculated accurately early in pregnancy. Women were enrolled after a sonographic confirmation of an ongoing pregnancy. To reduce confounding variables the study was confined to white European women with a singleton pregnancy. MAIN OUTCOME MEASURES Incidence of pre-eclampsia and gestational hypertension. RESULTS In 2230 women, 16.8% were obese. Pre-eclampsia was diagnosed in 3.3% (n=74) and gestational hypertension in 3.0% (n=67). Both pre-eclampsia (p=0.01) and gestational hypertension (p<0.01) were common in obese women compared with normal weight women. Overall 13.1% of obese women developed a hypertensive disorder during pregnancy. When analysed by parity pre-eclampsia occurred in 2.1% of primigravidas and 0.3% of multigravidas. Pre-eclampsia was increased in obese multigravidas (p=0.001), but not obese primigravidas, suggesting that parity is more influential than obesity in the development of pre-eclampsia. CONCLUSIONS Obese multigravidas are more likely to develop hypertensive disorders in pregnancy and obese primigravidas are more likely to develop gestational hypertension. This is important in clinical practice because maternal weight, unlike parity, is potentially modifiable before or during pregnancy.
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Affiliation(s)
- J L Hogan
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin 8, Ireland.
| | - B Anglim
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin 8, Ireland
| | - V O'Dwyer
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin 8, Ireland.
| | - N Farah
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin 8, Ireland.
| | - B Stuart
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin 8, Ireland.
| | - M J Turner
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin 8, Ireland.
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Slem A, Abu-Hijlih R, Abdelrahman F, Turfa R, Amarin R, Farah N, Sughayer M, Almousa A, Khader J. Eight primary malignancies: case report and review of literature. Hematol Oncol Stem Cell Ther 2011; 4:185-7. [PMID: 22198190 DOI: 10.5144/1658-3876.2011.185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The incidence of multiple primary malignancies has increased over the past years secondary to the long-term survival of cancer patients due to improvements in the early detection and adequate treatment of cancer. We present a patient with eight primary malignant tumors and review the relevant literature. Our patient was a 59-year-old female with Crohn disease with an otherwise non-contributory medical history. Risk factors for multiple primary tumors were not detected in our patient. At a follow-up of 108 months from the time of diagnosis of the first malignancy, our patient was still alive. Similar long-term survival has been reported in the literature. Due to the realistic potential for long-term survival, we recommend aggressive treatment of these patients.
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Affiliation(s)
- A Slem
- King Hussein Cancer Center, Amman Jordan
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Slem A, Abu-Hijlih R, Abdelrahman F, Turfa R, Amarin R, Farah N, Sughayer M, Almousa A, Khader J. Eight primary malignancies: case report and review of literature. Hematol Oncol Stem Cell Ther 2011. [PMID: 22198190 DOI: 10.5144/1658-3876.2011.185.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The incidence of multiple primary malignancies has increased over the past years secondary to the long-term survival of cancer patients due to improvements in the early detection and adequate treatment of cancer. We present a patient with eight primary malignant tumors and review the relevant literature. Our patient was a 59-year-old female with Crohn disease with an otherwise non-contributory medical history. Risk factors for multiple primary tumors were not detected in our patient. At a follow-up of 108 months from the time of diagnosis of the first malignancy, our patient was still alive. Similar long-term survival has been reported in the literature. Due to the realistic potential for long-term survival, we recommend aggressive treatment of these patients.
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Affiliation(s)
- A Slem
- King Hussein Cancer Center, Amman Jordan
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O'Dwyer V, O'Connor N, Fattah C, Farah N, Kennelly MM, Turner MJ. Waist circumference in the first trimester as a predictor of caesarean section. Eur J Obstet Gynecol Reprod Biol 2011; 159:483-4. [PMID: 21992963 DOI: 10.1016/j.ejogrb.2011.09.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2011] [Revised: 08/09/2011] [Accepted: 09/01/2011] [Indexed: 10/16/2022]
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Abstract
UNLABELLED What is already known about this subject • Maternal obesity is associated with an increased use of healthcare resources including medication costs in an outpatient setting. What this study adds • This study shows an increase in inpatient medication usage associated with maternal obesity. This is the case in the antenatal period but not in the peripartum period. SUMMARY Maternal obesity is associated with increased medical and obstetric complications. We compared the inpatient antenatal and peripartum medication usage in obese women to that in women in the normal body mass index (BMI) category. White European women with a singleton pregnancy were enrolled after a glucose tolerance test excluded diabetes mellitus at 28 weeks gestation. Weight and height were measured in the first trimester and BMI calculated. Records of medications administered were collated from patient drug charts. Of the 284 women studied, there were 97, 85 and 102 women in the normal, overweight and obese categories, respectively. Delivery details across the weight categories did not vary significantly and Caesarean section rates were 22.7, 22.4 and 26.5%, respectively. The length of hospital stay postpartum for each category was similar. The administration of antenatal medication showed a trend towards increasing usage with increasing BMI category with increases in analgesic and antibiotic use. There was no difference in peripartum medication usage. The study showed that maternal obesity was associated with an increased inpatient usage of medication in the antenatal period. This has implications for healthcare costs particularly if the prevalence of maternal obesity continues to increase.
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Affiliation(s)
- C Kennedy
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin, Ireland
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Abstract
This retrospective cross-sectional study examined if the white cell count (WCC) is increased in women with polycystic ovary syndrome (PCOS) and if so, is it due to PCOS or to the associated obesity? Body mass index (BMI) was calculated and body composition was measured using bioelectrical impedance analysis. Of the 113 women studied, 36 had PCOS and 77 did not. The mean WCC was higher in the PCOS group compared with the non-PCOS group (8.9 × 10(9)/l vs 7.4 × 10(9)/l p = 0.002). This increase was due to a higher neutrophil count (5.6 × 10(9)/l vs 4.3 × 10(9)/l; p = 0.003). There was a leucocytosis (WCC >11 × 10(9)/l) present in 19% of the PCOS group compared with 1% in the non-PCOS group (p < 0.001). The neutrophil count was abnormally high (>7.7 × 10(9)/l) in 14% of the PCOS group compared with 4% in the non-PCOS group (p < 0.001). On regression analysis, however, the only independent variable which explained both the increased WCC and the increased neutrophil count was PCOS. We found that PCOS is associated with an increased WCC due to increased neutrophils, which supports the evidence that PCOS is associated with low-grade inflammation. The increase appears to be due to the underlying PCOS, and not to the increased adiposity associated with PCOS.
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Affiliation(s)
- A C Herlihy
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin, Ireland
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Walsh C, Farah N, O'Dwyer V, Hogan J, Kennelly M, Turner MJ. Maternity services for obese women in Ireland. Ir Med J 2011; 104:217-219. [PMID: 21957691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Nearly one in five women booking for antenatal care in Ireland is obese. The purpose of this survey was to audit the services and facilities for obese pregnant women in the country's maternity units. In June 2010, a detailed questionnaire was sent to all 20 units which included questions on services, equipment and facilities for obese women. All 20 units responded: 17 (85%) were calculating and recording Body Mass Index in pregnancy. Only 15 (75%) were screening obese women for gestational diabetes mellitus and 2 (10%) were omitting thromboprophylaxis for caesarean section in obese women. Only 3 (15%) had clinical guidelines for obesity and pregnancy. The facilities and equipment, particularly for severely obese women, were inadequate in the majority of units. This survey showed variations nationally in obstetric practices and facilities. It highlights the need to develop, disseminate and implement standardised guidelines on maternal obesity.
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Abstract
The purpose of this study was to profile sleep patterns during pregnancy according to body mass index (BMI) and to correlate labour outcomes with both BMI and hours sleep. Data were collected from 200 postpartum women detailing sleep characteristics before and during pregnancy. A validated sleep questionnaire was employed, which comprised of questions about sleep apnoea, snoring, subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication and daytime dysfunction. Descriptive analyses were used. With advancing gestation, the mean (SD) number of hours sleep per night declined: pre-pregnancy 8.1 (SD 1.4); 1st trimester 8.3 (SD 1.8); 2nd trimester 7.7 (SD 1.7) and 3rd trimester 6.7 (SD 2.2). In the 18.5-24.9 BMI group, there was a marked difference in hours sleep per night from pre-pregnancy to 1st (8.6 h, p = 0.007), 2nd (7.9 h, p = 0.023) and 3rd (6.4 h, p = 0.000) trimesters in primiparous women. In the 25-29.9 BMI group, there was a difference from pre-pregnancy to 3rd trimester (p = 0.000). These changes were not reflected in a clinically significant difference in birth weight or mode of delivery.
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Affiliation(s)
- M M Kennelly
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin, Ireland.
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Byrne C, Kennedy C, O'Dwyer V, Farah N, Kennelly M, Turner MJ. What models of maternity care do pregnant women in Ireland want? Ir Med J 2011; 104:180-182. [PMID: 22111395] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The introduction of new models of care in the Irish maternity services has been recommended by both advocacy groups and strategic reports. Yet there is a dearth of information about what models of care pregnant women want. We surveyed women in early pregnancy who were attending a large Dublin maternity hospital. Demographic and clinical details were recorded from the hospital chart. Of the 501 women, 351 (70%) (352 (70.3%) of women wanted shared antenatal care between their family doctor and either a hospital doctor or midwife. 228 (45.5%) preferred to have their baby delivered in a doctor-led unit, while 215 (42.9%) preferred a midwifery-led unit. Of those 215 (42.9%), 118 (55%) met criteria for suitability. There was minimal demand (1.6%) for home births. Choice was influenced by whether the woman was attending for private care or not. Safety is the most important factor for women when choosing the type of maternity care they want. Pregnant women want a wide range of choices when it comes to models of maternity care. Their choice is strongly influenced by safety considerations, and will be determined in part by risk assessment.
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Affiliation(s)
- C Byrne
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Cork St, Dublin 8
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Tadesse W, Farah N, Hogan J, D'arcy T, Kennelly M, Turner MJ. Peripartum hysterectomy in the first decade of the 21st century. J OBSTET GYNAECOL 2011; 31:320-1. [DOI: 10.3109/01443615.2011.560300] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Turner MJ, Farah N. Gestational weight gain and birthweight. Ir Med J 2010; 103:293-294. [PMID: 21560497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Abstract
This study reviewed caesarean sections for very low birth weight babies in a tertiary referral maternity hospital. Maternal and neonatal complications were recorded and classified according to uterine incision type. We reviewed medical records of 89 women over a period of 2 years. The indication for the caesarean section influenced the type of uterine incision made (p = 0.004). Women who had antepartum haemorrhage were more likely to need a vertical incision. There was also a higher incidence of vertical incisions for gestations <28 weeks (p = 0.029). Surprisingly, when the computerised discharge summaries were reviewed retrospectively, all the vertical uterine incisions were recorded as lower segment caesarean sections. This would have a clinical impact on those women in future pregnancies, especially in a highly mobile population.
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Affiliation(s)
- A Khalifeh
- UCD School of Medicine and Medical Science, Coombe Women and Infants University Hospital, Dublin, Ireland
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Kennelly MM, Farah N, Turner MJ, Stuart B. Aortic isthmus Doppler velocimetry: role in assessment of preterm fetal growth restriction. Prenat Diagn 2010; 30:395-401. [DOI: 10.1002/pd.2474] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Barry S, Fattah C, Farah N, Stuart B, Turner M. P7 Maternal Bioelectrical Impedance Analysis (BIA) is a better predictor of birth weight than Body Mass Index (BMI). Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)61499-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Farah N, Stuart B, Donnelly V, Rafferty G, Turner M. What is the value of ultrasound soft tissue measurements in the prediction of abnormal fetal growth? J OBSTET GYNAECOL 2009; 29:457-63. [DOI: 10.1080/01443610903003209] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
The objective of this study was to review the first 50 clinical pregnancies of women with polycystic ovarian syndrome (PCOS) who had ovulation induced either with metformin alone, or in combination with clomifene. The study was confined to women with PCOS attending our infertility service. A register of clinical pregnancies was maintained of women who conceived after metformin therapy. The metformin was continued throughout the first trimester. The outcome of pregnancy was determined by individual chart review. Of the 50 women, 21 conceived with a combination of clomifene and metformin, and 29 with metformin alone. Seven women had a first trimester loss and 43 had a live birth. There were no perinatal deaths, no neonatal seizures and no congenital malformations. There were also no multiple pregnancies. The overall caesarean rate was 37%, and none of the babies had an Apgar score less than 7, at 5 min. This study found no evidence of any adverse clinical effects when metformin is continued in the first trimester of women with PCOS following ovulation induction. There was also no evidence of an increase in the rate of miscarriage or multiple pregnancy.
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Affiliation(s)
- M J Turner
- Coombe Women's Hospital, Dublin, Ireland.
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Farah N, Fattah C, Barry S, Donnelly V, Stuart B, Turner MJ. Is the antenatal prediction of fetal macrosomia worthwhile? Ir Med J 2009; 102:201-202. [PMID: 19771996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Barry S, Fattah C, Farah N, Broderick V, Stuart B, Turner MJ. The growing challenge of maternal obesity. Ir Med J 2009; 102:5-6. [PMID: 19284007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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de Medeiros CR, Bitencourt MA, Zanis-Neto J, Maluf ECP, Carvalho DS, Bonfim CS, Funke VM, Setubal DC, Farah N, Pasquini R. Allogeneic hematopoietic stem cell transplantation from an alternative stem cell source in Fanconi anemia patients: analysis of 47 patients from a single institution. Braz J Med Biol Res 2006; 39:1297-304. [PMID: 17053839 DOI: 10.1590/s0100-879x2006001000005] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2005] [Accepted: 07/07/2006] [Indexed: 11/22/2022] Open
Abstract
We transplanted 47 patients with Fanconi anemia using an alternative source of hematopoietic cells. The patients were assigned to the following groups: group 1, unrelated bone marrow (N = 15); group 2, unrelated cord blood (N = 17), and group 3, related non-sibling bone marrow (N = 15). Twenty-four patients (51%) had complete engraftment, which was not influenced by gender (P = 0.87), age (P = 0.45), dose of cyclophosphamide (P = 0.80), nucleated cell dose infused (P = 0.60), or use of anti-T serotherapy (P = 0.20). Favorable factors for superior engraftment were full HLA compatibility (independent of the source of cells; P = 0.007) and use of a fludarabine-based conditioning regimen (P = 0.046). Unfavorable factors were > or = 25 transfusions pre-transplant (P = 0.011) and degree of HLA disparity (P = 0.007). Intensity of mucositis (P = 0.50) and use of androgen prior to transplant had no influence on survival (P = 0.80). Acute graft-versus-host disease (GVHD) grade II-IV and chronic GVHD were diagnosed in 47 and 23% of available patients, respectively, and infections prevailed as the main cause of death, associated or not with GVHD. Eighteen patients are alive, the Kaplan-Meyer overall survival is 38% at approximately 8 years, and the best results were obtained with related non-sibling bone marrow patients. Three recommendations emerged from the present study: fludarabine as part of conditioning, transplant in patients with < 25 transfusions and avoidance of HLA disparity. In addition, an extended family search (even when consanguinity is not present) seeking for a related non-sibling donor is highly recommended.
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Affiliation(s)
- C R de Medeiros
- Serviço de Transplante de Medula Ossea, Hospital de Clínicas, Universidade Federal do Paraná, Rua General Carneiro 181, 80060-900 Curitiba, PR, Brazil.
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Medeiros CD, Bitencourt M, Zanis-Neto J, Maluf E, Carvalho D, Bonfim C, Funke V, Setubal D, Farah N, Pasquini R. Allogeneic hematopoietic stem cell transplantation from an alternative stem cell source in Fanconi anemia patients: analysis of 47 patients from a single institution. Braz J Med Biol Res 2006. [DOI: 10.1590/s0100-879x2006005000013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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48
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Leahy M, Farah N, Bolger N, O'Leary JJ, Turner MJ. Should cervical smears be taken at a postnatal visit? Ir Med J 2006; 99:244-5. [PMID: 17120611] [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] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Affiliation(s)
- M Leahy
- Department of Gynaecology, Coombe Women's Hospital, Dolphins Barn, Dublin
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Turner MJ, Langan H, Farah N, Byrne K, Cleary B. Metformin: an advance in ovulation induction. Ir Med J 2005; 98:133-4. [PMID: 16010777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
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50
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Abstract
A melt granulation process designed to obtain a taste-masked acetaminophen using glyceryl palmitostearte (Precirol Ato 5) is described. Melting this lipid material in a high-smear mixer gives granules which can be directly compressed after blending with the required excipients. The phase diagram shows the absence of interaction between the phases of the two components and no effect on acetaminophen polymorphism. A water dispersible tablet formulation is proposed for oral administration of cristallized acetominophen (500 mg) devoid of bitterness of which 90% dissolves within 15 minutes.
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Affiliation(s)
- C Duru
- Laboratoire de Pharmacie galénique, pharmacotechnie et biopharmacie, Université Montpellier I
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