He holds a Medicine degree, medical residences in Family Medicine and Cardiology and Masters Degree in Emergency and Medical Education from the Institute of Medical Sciences, Cuba. He awarded with PhD in Physiologypatology in Clinical Medicine, Faculty of Medicine-UNESP, Brazil. Currently, he is a postdoctoral student at Gynecology and Obstetrics department, Faculty of Medicine-UNESP, Brazil working on Gestational diabetes. He develops research in the area of Cardiology, mainly on the ventricular function and remodeling in experimental models of heart failure. He has experience in medical care and teaching. He published 8 articles in journals and 10 abstracts in conference proceedings.
Gestational diabetes mellitus (GDM) is a risk factor for urinary incontinence (UI) two-year post caesarean section (CS) and clinical findings of high incidence of UI two years after GDM plus SP- UI, role of GDM in the pathophysiological development of UI is unclear. Experimental results on urethral and rectus abdominis muscle (RAM) from diabetic pregnant rats reveal a variety of abnormalities in muscles involved in UI, opened the possibility for human in vivo multidisciplinary research to investigate similar hyperglycaemic myopathy in GDM skeletal muscles. To determine possible adverse effects of hyperglycemia on RAM function in pregnant women with and without GDM using Myography. During CS, 1 cm RAM was collected from 12 primiparous women with and without IU (10 normoglycemics incontient and 2 hyperglycemic-UI) and placed in Krebs solution at 4°C. Changes in isometric tensile strength have been recorded using LabChart-7 software coupled with PowerLab Data Acquisition System (AD Instruments) software for muscular responses capture and storage. The muscle mechanical response was expressed as percentage of maximal contraction induced by electrical stimulation (Grass Model-S48). After electrical stimulation, we obtained results of the RAM function during one hour. We noticed that the RAM of pregnant women did not sustain the electrical response. We do not have enough data to compare the two groups, but it can be confirmed that the myography is effective in evaluating the RAM function. Our primary findings confirmed that myography is a viable technique to analyze the functionally of the RAM in pregnant women, in a controlled way.
Mayada Mubarek is working with Al Wakra Hospital, Qatar
Intrahepatic cholestasis of pregnancy is the most common liver disease in pregnancy with prevalence ranging between 0.3 and 5.6%. Intrahepatic cholestasis of pregnancy (ICP) is a pruritic condition during pregnancy caused by impaired bile flow allowing bile salts to be deposited in the skin and the placenta. The cause is a combination of hormonal, genetic, and environmental factors. ICP may predispose mothers to vitamin K deficiency and the fetus to adverse pregnancy outcomes that may include prematurity, intrauterine fetal demise, and respiratory distress syndrome. The diagnosis of ICP is based upon the presence of pruritus associated with elevated bile acid, elevated aminotransferases, or both and the absence of diseases that may produce similar laboratory findings and symptoms. Thus according to HMC guideline, when bile acids (typically >14 μ mol/l) or ALT are elevated, other causes of pruritus and abnormal LFTs should be excluded by: • Virology Screen (Hepatitis A, B, and C, Epstein Barr and cytomegalovirus • Liver autoimmune screen for chronic active hepatitis and primary biliary cirrhosis (anti-smooth muscle and anti-mitochondrial antibodies • Liver ultrasound scan • Intrahepatic cholestasis of pregnancy is sometimes associated with significant vitamin K deficiency due to malabsorption of fat soluble vitamins from the intestine; therefore the coagulation profile is essential to rule out vitamin K deficiency Furthermore based on HMC cholestasis guideline, it is advised that where the prothrombin time is prolonged, the use of vitamin K in doses of 5–10 mg daily is indicated Apart from causing maternal pruritus, intrahepatic cholestasis of pregnancy (ICP) may lead to fetal distress and stillbirth. In order to make an improvement in the management of intrahepatic cholestasis of pregnancy, we sought in our audit to answer the following questions: “Are we doing the right investigations in diagnosis of cholestasis”? “Is vitamin K given in the right time with the right dose”? “How many stillbirths had occurred due to cholestasis?