Biomedical subjects

Ismail Hassan

Publications and source records attributed to Ismail Hassan.

3 recordsLinked to original sources

PubMed2005

One-stop hysteroscopy clinic for postmenopausal bleeding.

OBJECTIVE: To evaluate the role and feasibility of the "1-stop" clinic for management of postmenopausal bleeding, based on the use of transvaginal ultrasound and hysteroscopic examination under local anesthesia. STUDY DESIGN: A retrospective analysis of 308 patients referred to the clinic between October 2000 and May 2002 was carried out. Endometrial thickness of > 4 mm, as measured by transvaginal scan, was considered the cutoff limit for further investigation by hysteroscopy. RESULTS: Three hundred eight patients were seen in the 1-stop clinic. One hundred ten (35.7%) had endometrial thickness < or = 4 mm with no other associated abnormal findings and were discharged without proceeding to hysteroscopy. In 8 patients the scan was not conclusive, and they were offered hysteroscopy. Another 4 had a fluid-filled uterine cavity on sonography and were offered dilatation and curettage under general anesthesia. Eight patients opted to have the hysteroscopy done under general anesthesia, and in 12, hysteroscopyfailed under local anesthesia. Outpatient hysteroscopy was performed in 174 cases; 86 (49.4%) had normalfindings and were discharged. Endometrial polyps were found in 55 (31.6%) patients; in 42 the polyp was successfully removed at the same setting. Twenty patients (11.5%) had submucous fibroids and were discharged. A suspicious lesion was found in 13 (7.5%) patients; histologic examination confirmed endometrial carcinoma. A total of 216 of 308 (70%) patients were totally managed and discharged at the first visit with no further follow-up, and hospital admission was avoided in 258 (83.7%) of cases. CONCLUSION: The 1-stop clinic is effective in reducing the number of hospital visits per patient as well as hospital admissions and the waiting list.

Aged↗

PubMed2004

Prediction of preeclampsia: can it be achieved?

UNLABELLED: In this review, the various biochemical tests that have been proposed for the prediction of preeclampsia are described and evaluated. Placenta hormone markers do not predict future disease. They denounce the early placental changes that are part of the evolving disease and only predict the imminent of preeclamptic syndrome. This explains why tests are better predictors when preeclampsia supervenes shortly, and why screening in the first trimester is unlikely to work as well as in the second trimester. The use of multiple markers in the screening should reflect different aspects of the disease process and could increase the specificity and sensitivity of the screening and work on different etiologic factors. The possible use of second-trimester biochemical screening to predict the risk of preeclampsia remains to be investigated in the high-risk population. TARGET AUDIENCE: Obstetricians & Gynecologists, Family Physicians LEARNING OBJECTIVES: After completion of this article, the reader should be able to list the various theories on the etiology of preeclampsia, to relate the various risk factors for the development of preeclampsia, and to describe the various screening tests for preeclampsia.

Biomarkers↗

PubMed2004

PMS in the perimenopause.

Premenstrual syndrome (PMS) and the perimenopause are each difficult conditions to manage. When they co-exist the difficulty is more than doubled. Understanding and recognising the differences and the similarities between these conditions should enable clinicians to provide appropriate treatment and significantly improve women's quality of life. Distinction between the two can be difficult. Anecdotally women seem more prone to PMS symptoms during the perimenopause, or at least they tolerate the symptoms less well. Symptoms of the perimenopause arise from falling oestrogen levels with irregular ovulation, resulting in symptoms of oestrogen lack and heavy irregular periods. Symptoms of the perimenopause are thus relieved by the administration of oestrogen. Premenstrual syndrome frequently results when ovulation occurs. PMS appears to be due directly to the progesterone produced following ovulation in women who have enhanced sensitivity to this steroid. Treatment can thus be achieved by suppressing ovulation or reducing progesterone sensitivity; the latter seems achievable by the administration of selective serotonin re-uptake inhibitors. Ovulation can be suppressed by a variety of methods and oestrogen is an approach which is frequently employed. This will also effectively treat menopausal symptoms. The main problem with using oestrogen is that a progestogen must be administered to prevent endometrial neoplasia; this can result in a return of the PMS symptoms. This article reviews the difficulties encountered in women with both disorders and provides a suggested management strategy.

Decision Trees↗