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Medical Management of Cesarean Scar Pregnancy at Latifa Hospital Dubai Health Authority, Dubai, UAE

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Open Journal of Obstetrics and Gynecology 2020年第4期10卷 526-537页

作者： A. Ammar F. Nasrallah H. Adan J. Ali M. Mussa A. B. E. Fazari N. Alsawalhee Latifa Hospital for Women & Children DHA Dubai UAE University of Medical Sciences & Technology Khartoum Sudan

Introduction: Cesarean scar pregnancy (CSP) is defined as implantation of gestational sac at the site of cesarean scar. It’s a serious diagnosis that has become more prevalent in recent years and related to the increasing rate of cesarean sections reported worldwide. Identifying these cases and treating them is challenging, with no agreed upon universal protocol for successful treatment. We aim to evaluate the success rate and outcome of medical management for Cesarean scar pregnancy. Methods: It was a retrospective descriptive study of all cesarean scar pregnancies managed at fetal medicine unit at Latifa Hospital in Dubai, UAE the main obstetrics & Gynecology tertiary hospital in Dubai Emirate, UAE from 2015 to 2017. Certainly, a set of diagnostic criteria were implemented to confirm the diagnosis of CSP. The cases were then offered our proposed management which is systemic methotrexate injections ± KCL. Follow up made by serial βhcg and ultrasound scan. The data were collected used specified data collection sheet for this purpose then analyzed and presented using statistical package for social sciences (SPSS) version 26. Results: 33 cases of cesarean scar pregnancies are confirmed and medically managed during the study period. The study subjects composed of a group of patients who had a viable CSP and received local KCL injection + systemic methotrexate, a second group who had non-viable CSP and received systemic methotrexate 20 cases were viable pregnancies who received combined local potassium chloride plus systemic methotrexate, and 13 were non-viable received systemic methotrexate only. The mean gestational age at diagnosis was 8 weeks (SD ± 1.8). On average our cases had a history of 3 previous cesarean sections (range 1 - 6). Overall, the success rate calculated from our study population for medical management of CSP was 77.8%;this varied between viable CSP which had a success rate of 66.7% and non-viable CSP which had a success rate of 100%. The average period of outpatient follow-up for the patients to

关键词： Caesarean Scar Pregnancy Methotrexate Potassium Chloride Maternal Morbidity

Outcome of Pregnancy after Bariatric Surgery at Latifa Hospital, DHA, Dubai, UAE

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Open Journal of Obstetrics and Gynecology 2019年第4期9卷 442-448页

作者： Laila Yahya A. Alhubaishi Zeinabsadat T. Hakim Farida Adam Zahra S. M. Husain Eiman S. M. O. Al Zahmi Muna Tahlak Amal AlQedrah Atif Bashir Fazari Department of Obstetrics & Gynecology Latifa Hospital DHA Dubai UAE Faculty of Medicine University of Medical Sciences & Technology Khartoum Sudan

Background: Obesity is becoming increasingly prevalent in many populations and has become one of the most commonly occurring risk factors in obstetric practice. In nations of the Gulf Cooperation Council (GCC), the prevalence of overweight adults has been reported to be 35% amongst females, while the prevalence of obesity has been reported to be 40% amongst females. The study aimed to identify the rate and outcome of Pregnancy After Bariatric Surgery at Latifa Hospital (PABS). Method: This is a hospital based cross-sectional study including all patients seen at Latifa Hospital at Dubai Health Authority (DHA), Dubai, UAE between January 2018 and December 2018. The data included demographic details, gestational age, the mode of delivery, medical history, clinical findings, weight before surgery, weight after at antenatal booking, type of performed surgery, type of pregnancy (spontaneous or after assisted reproductive techniques), pregnancy complications, mode of delivery, and neonatal weight. Results: The reported cases of pregnancy after Bariatric surgery are 18 cases that makes rate 0.45%. Half of the performed surgery among the study group is sleeve surgery. Most of them (83.3%) are multiparous women with spontaneous pregnancy. The mean interval of surgery to pregnancy is 5.3 months. The highest weight before surgery is 155 kg and the mean weight of the study cases is 114.5 kg before surgery. After surgery at booking visit the mean weight is 83.9 kg. The mean weight reduction for this group is 30.6 kg. Anemia is the most common antenatal complication among the study group. Lower segment Caesarean section (LSCS) and vaginal delivery (VD) distributed equally between the women. The study showed good expect neonatal outcome. Conclusion: Pregnancy After Bariatric Surgery (PABS) is high-risk pregnancy with many potential complications. Care of pregnancy after bariatric surgery should be organized in multilateral cooperation of various medical disciplines in specialized center.

关键词： Obesity Bariatric Surgery Pregnancy Comorbidity

Abdominal Pregnancy, Case Report from Latifa Hospital DHA, Dubai, UAE

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Open Journal of Obstetrics and Gynecology 2018年第12期8卷 1198-1204页

作者： Atif Bashir E. Fazari Vidya Raman Hala Bashir Faiqha M. Azim Faiqha M. Azim Sawsan Kh. Halou Latifa Hospital Dubai Health Authority Dubai UAE Faculty of Medicine University of Medical Sciences & Technology Khartoum Sudan

Abdominal pregnancy is a rare form of ectopic pregnancy. A high index of suspicion enables early diagnosis and prompt management. Ultrasound is a gold standard tool for diagnosis and Magnetic Resonance imaging has a l... 详细信息

关键词： Abdominal Pregnancy Ectopic Pregnancy Fetal Morbidity Maternal Mortality

The Impact of Behavioural Insights on Effective Prescription of Antibiotics by Doctors: A Case Study from Latifa Hospital for Women and Children, Dubai Health Authority

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Health 2023年第6期15卷 517-524页

作者： Muna A. Tahlak Atif B. Fazari Fareeda Khan Raid Abukaf Lyla G. Zadeh Alawi Alsheikh Abdulaziz Istaitieh Latifa Hospital for Women and Children Dubai Health Authority Dubai UAE Mohamed Bin Rashid University Dubai UAE Mohammed Bin Rashid School of Government Dubai UAE

Introduction: Wise prescription of antibiotics is an ethical duty of physicians in view of rising antimicrobial resistance in the community, it should be balanced between the health requirements of the patients and resulting long-term antibiotics resistance. Overuse of antimicrobials is a major cause of emerging resistance to antimicrobials. There are multiple factors in the community that influence the physician’s antibiotic prescriptions. Methods: This is a systematic case-control study on antibiotics prescription for paediatric patients attending Latifa Hospital for Women and Children (LWCH), Dubai Health Authority, to know the effects of behavioral interventions on rates of inappropriate antimicrobials prescription by doctors in the Paediatric Emergency Department. Results: The results of our study showed the effectiveness of behavioral insights by peer comparison in antibiotic use among paediatricians in Latifa Hospital had a statistical significance (P = 0.0038). The rate of the prescription decreased from 41% to 21%, a difference of 20%. Conclusion: The study concluded behavioural intervention is an effective measure in reducing the improper prescription of antibiotics in the hospital setting.

关键词： Behavioural Intervention Antibiotics Prescription Behavioral Economics Health Economics Behavioural Insight

Medulloblastoma in Pregnancy, Case Report from Latifa Hospital, DHA, Dubai, UAE

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Open Journal of Obstetrics and Gynecology 2019年第2期9卷 129-135页

作者： Taghrid Gergawi Komal Sundeep Hazari Amel Qadra Noreen A. Dissi Atif Bashir Fazari Department of Obstetrics and Gynecology Latifa Hospital DHA Dubai UAE Department of Histopathology Dubai Hospital DHA Dubai UAE Faculty of Medicine University of Medical Sciences & Technology Khartoum Sudan

Medulloblastoma is a rare brain malignant lesion, reported more in children with less prevalence among adults and rarely seen during pregnancy. The diagnosis of Medulloblastoma is a challenging clinical situation in p... 详细信息

关键词： Medulloblastoma Pregnancy Caesarean Section Craniotomy

Genital and Urinary Tract Obstruction as a Late Complication of Female Genital Mutilation at Latifa Hospital, Dubai, UAE—Case Report

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Open Journal of Obstetrics and Gynecology 2019年第2期9卷 223-228页

作者： Laila Yahya A. Alhubaishi Faiza Badawi Hassan Y. Hotait G. Lakshmiah Atif Bashir Fazari Department of Obstetrics & Gynecology Latifa Hospital DHA Dubai UAE Department of Histopathology & Genetics Dubai Hospital DHA Dubai UAE Faculty of Medicine University of Medical Sciences & Technology Khartoum Sudan

Female genital mutilation (FGM) is partial or total excision of female external genitalia or other deliberate injury to the female genital organs for non-therapeutic purpose. It is cultural and traditional practice. Female genital mutilation may result in immediate complications such as severe pain and bleeding and long-term complications such as: psychological, psychosexual, trauma, infertility, urinary and genital complications.

关键词： Female Genital Mutilation Infibulation Urine Retention Defibulation

Eltrombopag Managed Severe Immune Thrombocytopenic Purpura in Pregnancy: A Case Report, Latifa Hospital, DHA, Dubai, UAE

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Open Journal of Obstetrics and Gynecology 2019年第7期9卷 991-996页

作者： Komal Sundeep Hazari Atif Bashir E. Fazari Taghrid Gergawi Hasan Mohamed A. Aal-Yaseen Nighat Aftab Department of Obstetrics & Gynecology Latifa Hospital DHA Dubai UAE Faculty of Medicine University of Medical Sciences & Technology Khartoum Sudan Department of Medicine Clinical Haematology Dubai Hospital DHA Dubai UAE

Immune thrombocytopenic purpura (ITP) is an acquired autoimmune disorder, defined by a platelet count of less than 100 × 109/L, secondary to impaired production and immune destruction of platelets. Bleeding tendency is the main presentation of this condition. Clinical symptoms and investigations will confirm the diagnosis. Steroid is the first line of treatment. Although Rituximab and Thrombopoietin receptor agonists are useful second line agents in non-pregnant adults, the data about their role in pregnancy are still limited. We present the case of a 30 year old primigravida, who was a known case of chronic ITP since childhood;the course of her disease was fluctuating, for which oral steroids were used accordingly. She presented with gum bleeding and petechial rash with very low platelets count. She was sponsored by the Patient Support Program and was given Eltrombopag during the third trimester. She responded well to Eltrombopag with no noticeable side effects, neither to the mother nor to the baby so far. Eltrombopag has been assigned Category C by the Federal Drugs Agency (FDA) nevertheless there are no well controlled data in the literature about its role in pregnancy.

关键词： Immune Thrombocytopenic Purpura Eltrombopag Pregnancy

Psychological Repercussions of Morbid Adherent Placenta (MAP) Patients

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Open Journal of Obstetrics and Gynecology 2019年第9期9卷 1284-1289页

作者： Laila Yahya A. Alhubaishi Department of Obstetrics & Gynecology Latifa Hospital Dubai Health Authority Duabi UAE

Morbidly adherent placenta (MAP) is a major cause of maternal morbidity and cause of severe fear and stress to the patient, family and the treating staff. Proper counseling and sympathetic case handling and management is of great relief. Detailed explanation for the pathology and the treatment plan will support the psychology of the patient and surrounding.

关键词： Morbid Adherent Placenta Maternal Morbidity Maternal Mortality Psychological Repercussions

Fazari’s Sign in Ultrasound Scan of Morbid Adherent Placenta/Placenta Accreta Spectrum (MAP/PAS) and Fazari’s Triad during (MAP/PAS) Surgery

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Open Journal of Obstetrics and Gynecology 2020年第4期10卷 599-603页

作者： Atif Bashir Eltayeb Fazari Zeinabsadat Tabatabaei Hakim Latifa Hospital Dubai Health Authority Dubai UAE University of Medical Sciences & Technology Khartoum Sudan

Morbid Adherent Placenta (MAP)/Placenta Accreta Spectrum (PAS) is a serious diagnosis which has a risk of complications. Ultrasound scan helps in early diagnosis and has great value in further confirmation and follow ... 详细信息

关键词： Morbid Adherent Placenta (MAP)/Placenta Accreta Spectrum (PAS) Ultrasound Scan Stair Step Sign Fazari’s Triad