Ayman Shaamash - Academia.edu (original) (raw)

Papers by Ayman Shaamash

Saudi Medical Journal, Aug 31, 2023

European journal of obstetrics, gynecology, and reproductive biology/European journal of obstetrics & gynecology and reproductive biology, Mar 1, 2024

Clinical and Experimental Obstetrics & Gynecology, 2017

Isolated descended inguinal ovary is a rarity, but it should be considered as a differential diag... more Isolated descended inguinal ovary is a rarity, but it should be considered as a differential diagnosis of an inguinal mass at any age; in particular during female infancy and up to adulthood. Herein the authors report a case of asymptomatic isolated left descended inguinal ovary, with ipsilateral left ectopic pelvic kidney that was accidentally discovered a few years after menarche.

Background: Caesarean Scar Pregnancy (CSP) is a very rare form of an abnormal pregnancy that impl... more Background: Caesarean Scar Pregnancy (CSP) is a very rare form of an abnormal pregnancy that implants in a Cesarean section scar. The incidence is mainly increasing due to increasing number of Cesarean sections. This condition is associated with substantial morbidity and even mortality. Case presentation: Because of its rarity, currently, there is no consensus on the preferred mode of treatment or follow up of CSP. Herein we report our experience with a case of first trimester CSP which was successfully managed with dilatation, evacuation and curettage (D&C), under ultrasound guidance, after failed local Methotrexate (MTX) treatment. Mini review: We included an updated mini review of literature targeted for such lines of treatment (local MTX and D&C). The first authoritative recommendations on the CSP, by the Society for MaternalFetal Medicine, are summarized. Conclusion: Operative intervention as D&C to treat CSP after failed local MTX treatment is a viable option characterized by ...

Pog In Press, 2021

Objective: This study evaluates the effect of esomeprazole on the maternal serum levels of solubl... more Objective: This study evaluates the effect of esomeprazole on the maternal serum levels of soluble fms-like tyrosine kinase-1 (sFlt-1) and soluble endoglin (sEng) in patients with early-onset preeclampsia.Methods: A randomized, double-blind, placebo-controlled trial was carried out in a tertiary University hospital between March 2018, and September 2019 (Clinical Trials.Gov: NCT03213639). The study included women between 28 and 31+6 weeks gestational age who had been diagnosed as preeclampsia without severe features. They were randomly assigned in a 1:1 ratio into an esomeprazole group, which received esomeprazole 40 mg orally once a day, and a placebo group, which received one placebo tablet daily. Blood samples were obtained to assess levels of serum sFlt-1and sEng using ELISA testing. The primary outcome was the difference between the mean serum level of sFlt-1 and sEng at the start of treatment and at the termination of pregnancy in both groups.Results: Eighty-eight patients wer...

The Egyptian Heart Journal, 2021

The management of hypertensive disorders of pregnancy (HDP) during hospitalization requires an ac... more The management of hypertensive disorders of pregnancy (HDP) during hospitalization requires an accurate blood pressure (BP) measurement, mainly by invasive intra-arterial reading. Nevertheless, little is known about the precision of non-invasive (NI) central BP measurements in HDP. We aimed to assess the accuracy of NI central BP assessment in comparison to invasive BP measurement in HDP. This cross-sectional study included all patients with HDP that were admitted to university hospitals for high BP control, from December 2018 till December 2019, and 10 healthy matched non-hypertensive controls. Patients were compared for demographic, anthropometric, and echocardiographic data. In all subjects, invasive BP assessment was done by radial arterial cannulation and NI assessment of BP was performed by an oscillometric automated device (Mobil-O-Graph); the comparison was done after initial control of BP. One hundred patients were included and divided into 3 groups (pre-existing hypertensi...

Journal of Ultrasound in Medicine, 2020

Objectives-(1) To study the predictors of pregnancy continuation up to 28 weeks in first-trimeste... more Objectives-(1) To study the predictors of pregnancy continuation up to 28 weeks in first-trimester threatened miscarriage after a single clinical and ultrasound (US) evaluation. (2) To assess the role of both clinical and US predictors in counseling and decreasing repeated emergency follow-up scans. Methods-A prospective observational study that included a cohort of 241 patients with threatened miscarriage (≥6-12 weeks) was conducted. They had a single clinical and US evaluation, and then they were contacted by weekly phone calls until completing 28 weeks' gestation or reporting miscarriage. Independently, all patients were followed by the recommended routine US scanning with or without emergency visits. Results-Two hundred thirty-three patients completed the study, of whom 193 patients continued up to 28 weeks' gestation, and 40 miscarried (17.1%). Only spotting/mild bleeding episodes and progesterone treatment were the clinical predictors of fetal viability. The embryonic/fetal heart rate (E/FHR) was the best single US predictor, with a specificity and positive predictive value of 95.3% and 97.2%, respectively. Combining 3 US parameters, at their best cutoff points (E/FHR >113 beats per minute, crown-rump length >13.9 mm, and gestational sac diameter >27.3 mm), had a specificity and positive predictive value of 98% and 99% (first-trimester US triad of fetal viability). Conclusions-[1] In first-trimester threatened miscarriage, clinical parameters that could predict fetal viability included shortspotting/ mild bleeding and progesterone treatment. [2] After a single US scan, the presence of at least an E/FHR of greater than 113 bpm or the suggested first-trimester US triad appeared as a simple, measurable, and effective predictor of pregnancy continuation up to 28 weeks. [3] These US predictors are not to replace the recommended scheduled scanning during pregnancy. [4] This can improve patients' counseling and decrease the need for repeated emergency follow-up scans. Otherwise, there is an indication for repeating US scans at a 1-week to 10-day interval.

The Journal of Obstetrics and Gynecology of India, 2019

Objective To investigate the efficacy, safety and tolerability of a home-based extended low-dose ... more Objective To investigate the efficacy, safety and tolerability of a home-based extended low-dose oral misoprostol for management of first-trimester pregnancy loss. Materials and Methods A randomized trial that was conducted in the Woman'

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2019

Background: The current study aims to assess the knowledge, attitude and practice of long acting ... more Background: The current study aims to assess the knowledge, attitude and practice of long acting reversible hormonal contraception (LARHC) among women in urban upper Egypt.Methods: A cross sectional study which included 902 married women, in the reproductive age, attending the outpatient clinics (Gynecology and family planning) of: 1-Assiut University Maternity Hospital, 2- Sohag University Hospital, and 3-Gehina General Hospital (MOH hospital) with current or previous use of any method of LARHC methods. A Questionnaire file was designed to assay knowledge attitude and practice of clients towards contraceptive methods. All data collected from clients reviewed separately to assess knowledge, attitude and practice of women towards contraceptive methods.Results: The most popular contraceptive method is COCs followed by IUD then DMPA. 99% of studied sample heard with good description about different types of LARHC. 54.9% of studied sample most popular/famous LARHC DMPA, most sources of ...

European Journal of Obstetrics & Gynecology and Reproductive Biology, 2017

Middle East Fertility Society Journal, 2015

Objective: To study the patterns of serum bhCG levels on days 1-4 and days 1-7 after single-dose ... more Objective: To study the patterns of serum bhCG levels on days 1-4 and days 1-7 after single-dose methotrexate injection (MTX) for ectopic pregnancy (EP) and to determine the sensitivity, specificity, positive (PPV) and negative predictive values (NPV) of the best cutoff points for the ''percentage of fall'' in serum bhCG levels for predicting a successful outcome. Patients and methods: This is a retrospective cohort study including forty-nine consecutive patients treated with single-dose MTX (50 mg/m 2). We analyzed patterns of falling in bhCG levels on D1, D4 and D7 of follow up. Our main outcome measures included the overall success rate, the ''percentage of fall'' variable of serum bhCG levels on D4 and D7 and the best cutoff point for the ''percentage of fall'' that predicts a successful outcome. Results: The success rate of single-dose MTX treatment in EP was 77.5%. A cutoff ''percentage of fall'' in bhCG serum levels on D1-D7 of P33% has the best sensitivity (96%) and PPV (85%) for predicting a successful outcome. This is out performing any cutoff on days 1-4 and comparable to the standard D4-D7 protocol.

Journal of Clinical Medicine Research, 2011

Background: Initial low maternal serum β-human chorionic gonadotropin (β-hCG) is a good predictor... more Background: Initial low maternal serum β-human chorionic gonadotropin (β-hCG) is a good predictor of early pregnancy demise. Our objective was to determine its predictive value in determining the long-term outcome in ICSI pregnancies. Methods: A retrospective cohort study was designed at the Saudi Center for Assisted Reproduction. Two hundred and sixty-one women with ICSI pregnancies were followed up from initial β-hCG level determination till the end of pregnancy. Accuracy of early β-hCG in predicting the occurrence of a live-birth, ongoing pregnancy, late miscarriage, ectopic pregnancy and early miscarriage following ICSI was measured. Results: β-hCG levels were significantly different in pregnancies that reached the stage of an ongoing pregnancy and live-birth as compared to early pregnancy loss. The ROC curves demonstrated a high sensitivity for identifying patients with ectopic pregnancies and early miscarriage (100% and 93.33% respectively). The remaining results ranged from a sensitivity of 69% to 79% and specificity of 62% to 75%. Conclusions: In ICSI pregnancies, a single early β-hCG may help to identify pregnancies that will reach full-term and delivery.

The Journal of Obstetrics and Gynecology of India, 2013

Background Human fertility is determined by many factors such as customs, morals and habits of so... more Background Human fertility is determined by many factors such as customs, morals and habits of social groups with regard to marital obligation of life. Acceptance of family planning methods varies within and between societies and there are many factors which are responsible for such variation at community, family and individual level. Socioeconomic environment, culture and education are few of them that play a vital role. Jammu and Kashmir state in general and Kashmir valley in particular is a Muslimdominated population with traditionally a conservative society. Apart from family customs and influence of the elders, religious background has always been behind the passive resistance, or at the best indifference towards contraception. This study makes an attempt to assess the knowledge, attitude and practice of contraception in rural Kashmir. Objective To assess the knowledge, attitude and practice of contraception in rural Kashmir. Study Design Community-based Cross-Sectional study. Study period December 2006 to May 2008. Participants 1900 currently married women in the age group of 15-49 years of age. Setting Rural households. Methods 1900 currently married women, aged 15-49 years, selected by multi-stage random sampling technique from three districts of Kashmir valley who were interviewed at home using a pretested oral questionnaire. The assessment of various socioeconomic and other variables made as per the available standard procedures and scales. Analysis Percentage, Chi square test and Bivariate analysis. Results Knowledge of the contraceptive methods was fairly good especially for terminal methods i.e. female sterilization (97.7 %). Main source of information on contraception was obtained from mass media (60.4 %). Contraceptive practice was significantly related to number of living children, literacy, socioeconomic status and type of family. Conclusion What is needed is to promote and stress contraceptive methods and their advantages using mass media approach and to explore more and more participation of private sector.

Middle East Fertility Society Journal, 2014

First trimester placenta accreta (PA) is a rare event; there are few reported cases worldwide. He... more First trimester placenta accreta (PA) is a rare event; there are few reported cases worldwide. Herein we report a case of abortion hysterectomy at 11 weeks' gestation due to undiagnosed first trimester placenta accreta. Also, we reviewed medical literatures over the past 20 years for case reports of first trimester PA diagnosed after the occurrence of severe bleeding during abortive curettage or in the post abortive period.

Journal of Obstetrics and Gynaecology Research, 2004

Thermal balloon endometrial ablation (TBEA) is a non-hysteroscopic technique, which relies on a c... more Thermal balloon endometrial ablation (TBEA) is a non-hysteroscopic technique, which relies on a combination of heat and pressure within the uterine cavity to destroy endometrium and superficial myometrium. It is a simple, easy and minimally invasive procedure with an equivalent effectiveness to hysteroscopic endometrial ablation. To evaluate the effectiveness of TBEA in the treatment of menorrhagia and to identify the possible predictive factors for a successful outcome after 2-year follow-up. A prospective study was conducted, including 45 patients suffering from serious menorrhagia. Under local anesthesia with i.v. sedation, the Therma-Choice trade mark (Gynecare, Somerville, NJ, USA) balloon was inserted transcervically and after inflation in the endometrial cavity with 5% dextrose, it was heated to 87 degrees C for an 8-minute treatment cycle. There were no intraoperative complications and postoperative morbidity was minimal. At 2-year follow-up the overall improvement of menstrual pattern was 85%; with reported 29% amenorrhea, 23.5% hypomenorrhea and 32.5% euomenorrhea. Menorrhagia persisted in 15% of patients. Multiple logistic regression analysis of the factors that could affect the outcome showed that the chance for a successful treatment increased significantly with increased age (P = 0.044), shorter uterine depth (P = 0.049) and adequate balloon pressure (P = 0.027). These were the predictive factors for successful outcome. However, parity, uterine volume and endometrial thickness were not predictive factors. At 2-year follow-up, thermal balloon endometrial ablation is effective in menorrhagia treatment. Increased age, shorter uterine depth and adequate balloon pressure can be predictive factors for successful treatment.

International Journal of Gynecology & Obstetrics, 2007

Objectives: To determine whether there is a relationship between the findings of routine postpart... more Objectives: To determine whether there is a relationship between the findings of routine postpartum ultrasonographic scanning and puerperal uterine complications such as heavy delayed postpartum hemorrhage, retained products of conception, and need for uterine curettage; and to estimate the value of both routine ultrasonographic scanning and clinical data in the prediction of these complications. Methods: In this cohort study 265 women were examined ultrasonographically on postpartum Days 1, 14, 42 following uncomplicated vaginal or cesarean deliveries. They were divided into a low-risk (n = 149) and a high-risk (n = 116) group according to predefined risk factors for puerperal uterine complications. The ultrasonographic findings were dichotomized into no masses (endometrial strip, endometrial fluid, or hyperechoic foci) or a definite intrauterine echogenic/heterogeneous mass (IUM, N 15 mm in diameter). Results: The presence of risk factor(s) was significantly associated with uterine subinvolution, IUM, heavy delayed postpartum hemorrhage (PPH), and a need for uterine curettage. Multivariable logistic regression analysis for the risk factor(s) that can predict the occurrence of heavy delayed PPH showed that the presence of an IUM was the most predictive variable. The presence of an IUM and heavy delayed PPH predicted uterine curettage in 61.3% and 37.5% of patients, respectively. Conclusion: Routine uterine scanning on Day 1 and Day 14 postpartum is an easy, inexpensive, valuable method that can be offered to women at high risk for delayed PPH due to subinvolution or the presence of an IUM. Accordingly, it may be predicted which women will benefit from uterine curettage in up to two-thirds of cases.

International Journal of Gynecology & Obstetrics, 2003

International Journal of Gynecology & Obstetrics, 2001

Ž. Ž Objecti¨es: To measure nitric oxide synthase NOS activity and total nitrites levels as an in... more Ž. Ž Objecti¨es: To measure nitric oxide synthase NOS activity and total nitrites levels as an index of nitric oxide 'NO' .