Abdulrahim Gari

Bio: Abdulrahim Gari is an academic researcher from Umm al-Qura University. The author has contributed to research in topics: Medicine & Hysterectomy. The author has an hindex of 3, co-authored 9 publications receiving 19 citations.

Placental site trophoblastic tumor and choriocarcinoma: an unusual presentation.

Abstract: Mixed trophoblastic tumor composed of choriocarcinoma and placental site trophoblastic tumor was diagnosed on histopathology slides review, is a very rare mixed tumor and cured after adjuvant chemotherapy. Twenty-nine years old, Para 2 female presented with 4 months history of irregular vaginal bleeding after an uncomplicated vaginal delivery. Abdominal examination showed 14 weeks uterus with β-hCG level of 14,889 mIU/ml. Slides review confirmed the diagnosis of placental site trophoblastic tumor (PSTT). Patient underwent total abdominal hysterectomy and resection of anterior vaginal wall mass. Post operative (48 h) β-hCG level was 6016 mIU/ml. Final pathology showed mixed trophoblastic tumor composed of choriocarcinoma (CC) and PSTT. Adjuvant chemotherapy started and continued for three cycles after achieving normal β-hCG. PSTT is a rare disease and potentially curable. Differential diagnosis in women presented with vaginal bleeding and a uterine mass in the post partum period must include gestational trophoblastic disease.

Mclndoe Neovagina in patients with Mullerian Agenesis: A single center experience.

Abstract: OBJECTIVES To evaluate the surgical feasibility and the long-term anatomical and functional results and complication rates in patients with Mullerian aplasia who underwent vaginal reconstruction. METHODS A retrospective observational case series study over 8 years was conducted in King Faisal Specialist Hospital & Research Centre - Jeddah, Saudi Arabia. All cases diagnosed as Mullerian aplasia and who underwent surgical correction were included. Painless and satisfactory vaginal intercourse after surgery were the main outcome measured. RESULTS A total of 19 patients were diagnosed with Mullerian agenesis and underwent vaginal reconstruction by Mclndoe technique with minor modification. All of our patients who were sexually active and were compliant with mold use postoperatively were able to achieve 100% painless and satisfactory sexual intercourse. CONCLUSIONS Minor modification in McIndoe technique provides easier, safer and deeper dissection that minimizes the complications and helps in maximizing the vaginal length. It provides satisfactory and functional vagina in the majority of the patients.

Comparison of performance of medical students between two teaching modalities “Flip the classroom” and traditional lectures: A single center educational interventional study

Abstract: Objectives: This study aims to compare the students’ performance in Obstetrics and Gynecology by using two teaching modalities, ie, Flip the classroom (FTC) compared to Traditional lectures (TL) among final year medical students and assessment of the students’ satisfaction towards FTC as learning modality Methods: An educational interventional study was conducted on 136 females final year medical students at Umm Al-Qura University, Makkah, Saudi Arabia from September to December; 2017 Out of 40 core topics of Obstetrics and Gynecology, eight were chosen for FTC and eight for TL The performance in each teaching modality was assessed by comparing the score of the students in multiple choice question (MCQ) and objective structured clinical examination (OSCE) in the final examination The final performance was compared between the FTC and TL selected topics The data was analyzed by using SPSS version 16 (SPSS Inc, Chicago, IL, USA) Results: MCQ and OSCE grades of students (n=136) were significantly higher in FTC versus TL topics, ie, mean ± standard deviation (134 ± 27 vs 123 ± 24; p < 0001) and (339 ± 43 vs 304 ± 47; p < 0001), respectively Almost 60% of the students expressed their satisfaction with FTC modality Conclusion: Scores were significantly high for Flip the classroom topics compared to Traditional lectures doi: https://doiorg/1012669/pjms3652730 How to cite this:Tahir F, Hafiz B, Alnajjar T, Almehmadi B, Besharah B, Gari A, et al Comparison of performance of medical students between two teaching modalities “Flip the classroom” and traditional lectures: A single center educational interventional study Pak J Med Sci 2020;36(5):958-964 doi: https://doiorg/1012669/pjms3652730 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommonsorg/licenses/by/30), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

[Placental-site trophoblastic tumour].

Abstract: Placental-site trophoblastic tumour (PSTT) is the rarest type of gestational trophoblastic tumours It typically occurs in the reproductive age arising weeks to years after any kind of pregnancy Although the pathohistology is benign, it may resemble a malignant tumour with metastases, relapse or even fatal outcome Unlike other types of gestational tumours PSTT is relatively unresponsive to chemotherapy Hysterectomy is the best treatment

Diagnosis and Management of Mixed Gestational Trophoblastic Neoplasia: A Study of 16 Cases and a Review of the Literature

Abstract: Objective: Mixed gestational trophoblastic neoplasia (GTN) is a rare occurrence that refers to the coexistence of choriocarcinoma and/or placental site trophoblastic tumor and/or epithelioid trophoblastic tumor. The diagnosis and management of mixed GTN are challenging. We investigated the clinicopathological characteristics, diagnoses, treatments, and outcomes of patients with mixed GTN. Materials and Methods: The medical records and pathological sections of 16 patients with mixed GTN who were treated at Peking Union Medical College Hospital and The Second Xiangya Hospital of Central South University between January 2012 and December 2018 were reviewed. Results: Pretreatment serum human chorionic gonadotropin (hCG) levels ranged from 180 to 625,024 IU/L, and were >10,000 IU/L in 14 of the 16 patients, none of whom were diagnosed correctly at initial presentation. Two patients were diagnosed with choriocarcinoma coexisting with intermediate trophoblastic tumor (ITT) through dilation and curettage (D&C) before treatment. Another 5 patients were histologically confirmed to have placental site trophoblastic tumor (PSTT) by D&C but final pathological findings showed mixed PSTT and choriocarcinoma at subsequent hysterectomy. Seven post-chemotherapy patients with an initial clinical diagnosis of choriocarcinoma underwent surgery because of chemoresistance and their pathological findings revealed coexisting ITT. The remaining 2 patients were found to have choriocarcinoma coexisting with ITT following cervical biopsy and pulmonary lobectomy. All patients received chemotherapy: 14 underwent surgery combined with chemotherapy and 2 received chemotherapy alone to preserve fertility. Other than 1 patient who died of disease progression, 15 patients (93.8%) achieved complete remission (CR) after treatment, although 5 (33.3%) relapsed. Of these 5 patients with relapse, 3 achieved CR after additional treatment, 1 was receiving an immune checkpoint inhibitor, and 1 was lost to follow-up after refusing further therapy. Conclusion: Mixed GTN is difficult to diagnose on initial presentation. Overlap of the ITT component should be considered in refractory chemoresistant choriocarcinoma. Coexistence of choriocarcinoma should be suspected in ITT patients with high hCG levels. Surgery combined with chemotherapy is optimal treatment for choriocarcinoma mixed with ITT.

Sexual satisfaction in patients with Mayer-Rokitansky-Küster-Hauser syndrome after surgical and non-surgical techniques: a systematic review.

Abstract: The treatment and mental support of patients with Mayer-Rokitansky-Kuster-Hauser syndrome are very important. Many of these patients seek treatment to improve their sexual relationships and the quality of their sexual life. This systematic review sought to evaluate the sexual satisfaction of patients with MRKH syndrome following various types of vaginoplasty and non-surgical procedures over the past 10 years. A systematic review of studies published in English during 2008–2018 was performed. Electronic databases and valid sites, including PubMed, EMBASE, Science Direct, Cochrane Library, SCOPUS, Ovid, and ProQuest, were searched for articles published from the beginning of 2008 to February 2018. Literature restricted to women with Mayer-Rokitansky-Kuster-Hauser syndrome who underwent vaginoplasty surgery or a non-surgical technique was reviewed. Of 195 papers identified, 45 articles were analyzed. All studies that reported sexual and functional outcomes following various vaginoplasty procedures and non-surgical procedures were selected. Greater vaginal length and higher sexual satisfaction were observed following surgical procedures than after non-surgical techniques. A range of complications was reported following the use of different surgical approaches. The Female Sexual Function Index (FSFI) was the most commonly applied tool to measure sexual satisfaction, but its results were not always in agreement with the findings of other research tools. Finally, women who underwent surgical techniques had higher sexual activity levels than those who received non-surgical procedures. The reviewed studies highlighted the need for further quantitative and qualitative research on the sexual performance and outcomes of patients with MRKH syndrome. None.