Journal of Obstetrics and Gynaecology Canada Jogc Journal D Obstetrique Et Gynecologie Du Canada Jogc, Sep 1, 2009
A43-year-old woman presented with a three-year history of intermittent right lower quadrant pain ... more A43-year-old woman presented with a three-year history of intermittent right lower quadrant pain and a right simple adnexal cyst. She had presented to the emergency department on several occasions over the preceding three years because of the pain, but no intervention ...
The physiological and biochemical status of two groups of neonates with patent ductus arteriosus ... more The physiological and biochemical status of two groups of neonates with patent ductus arteriosus (PDA) requiring surgical ligation were compared. One group (n = 14) had ductus ligation in the operating room (OR) and the other group (n = 14) had the same operation in an isolation room in the Neonatal Intensive Care Unit (NICU). The groups were closely matched in terms of gestational age and weight. Nursing time and disposable equipment savings were significantly different. We have confirmed that PDA ligation can be done safely in the NICU and is more cost efficient than ligation in the OR.
Canadian journal of anaesthesia = Journal canadien d'anesthesie, Jan 28, 2015
In 2011, the hysterectomy enhanced recovery (HER) pathway, a multi-disciplinary, evidence-based c... more In 2011, the hysterectomy enhanced recovery (HER) pathway, a multi-disciplinary, evidence-based care plan designed to improve recovery after open gynecologic surgery for non-malignant lesions, was introduced at The Ottawa Hospital (TOH). This before-and-after study examined the impact of the HER pathway on postoperative day (POD) 1 hospital discharge. Ethical approval was obtained. This retrospective cohort study included patients who had undergone open abdominal gynecologic surgery for non-malignant lesions at TOH Civic Campus between July 2010 and September 2012 (the year before and year after HER implementation). Patients were analyzed in either a pre-HER or post-HER group depending on their surgery date. Patients with chronic pain and emergent surgery were excluded. Data were obtained via medical chart review. Our primary outcome was the percentage of POD 1 discharges before and after HER implementation. Secondary outcomes included return to hospital within 30 days of discharge,...
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstétrique et gynécologie du Canada : JOGC, 2009
A43-year-old woman presented with a three-year history of intermittent right lower quadrant pain ... more A43-year-old woman presented with a three-year history of intermittent right lower quadrant pain and a right simple adnexal cyst. She had presented to the emergency department on several occasions over the preceding three years because of the pain, but no intervention ...
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstétrique et gynécologie du Canada : JOGC, 2013
To review the indications for, and the associated pathology and complications of, appendectomy pe... more To review the indications for, and the associated pathology and complications of, appendectomy performed during gynaecologic surgery in a tertiary academic health sciences centre. We performed a retrospective review of appendectomy cases performed from September 2007 to December 2011 in a tertiary level gynaecologic surgical practice. Cases were reviewed using a standardized intake sheet with surgical reports, history, and pathologic findings. A total of 71 appendectomies were performed during gynaecologic surgery in the study period. All cases were primary gynaecologic surgical cases; the most common diagnoses were endometriosis, pelvic pain, and pelvic mass. Overall, 42 (59%) of the study cases had abnormal histopathology in the appendix. Of the 44 women with a primary diagnosis of endometriosis, 28 (64%) had positive appendiceal pathology. In women with chronic pelvic pain, three of eight (38%) had pathology within their appendix. Of all appendixes removed that appeared normal on...
Journal of minimally invasive gynecology, Jan 9, 2014
To evaluate the feasibility and success rate of treating Asherman's syndrome in an outpatient... more To evaluate the feasibility and success rate of treating Asherman's syndrome in an outpatient hysteroscopy unit. Review of Asherman's syndrome treated in the outpatient hysteroscopy clinic at the Ottawa Hospital from November 26, 2008 to January 31, 2014. Classification Retrospective case series (Canadian Task Force classification III). Patients Patients undergoing treatment for Asherman's syndrome. Intervention All cases of hysteroscopic adhesiolysis were reviewed. Demographic data were collected by a retrospective chart review, including patients' age, obstetrical history, referring complaint, etiology of Asherman's, antecedent treatment, and outcome measures when available. Severity of Asherman's syndrome was determined based on the March classification, by the operating surgeon. Analgesia used during the procedure was recorded. Twenty patients were treated for Asherman's syndrome in the outpatient hysteroscopy suite. There were a total of thirty-eight...
ABSTRACT Objective: This study was conducted to evaluate patient satisfaction and analgesia prefe... more ABSTRACT Objective: This study was conducted to evaluate patient satisfaction and analgesia preferences in patients undergoing office hysteroscopy. Materials and Methods: The study was a retrospective chart review of 209 cases of patients who underwent hysteroscopy in an office hysteroscopy suite in a tertiary level center-The Ottawa Hospital from November 2008 to January 2013. Data were collected and analyzed for procedures performed, indications for hysteroscopy, analgesia used, and number of failed procedures. Patient satisfaction questionnaires were reviewed evaluating patients' experience with office hysteroscopy and intra-and postoperative pain control. Results: Operative and diagnostic hysteroscopy was performed in 40% and 57% of cases, respectively. Most common indications for hysteroscopy were: abnormal uterine bleeding (21%); postmenopausal bleeding (17%); contraception (10%); and fertility assessment (10%). There were 8 cases of failed office hysteroscopy. Nonsteroidal anti-inflammatory drug pretreatment was administered to >70% of the patients. Less then 5% of patients required intravenous sedation, and 10.5% needed a paracervical block to complete office hysteroscopy. One hundred and sixty-seven patients completed the patient-satisfaction survey. Overall, >85% of patients reported receiving excellent-to-very good care in all aspects of their periprocedural experience. All responders agreed that they would recommend this procedure to a friend. Conclusions: Office hysteroscopy can be performed in a safe and effective manner. Patients are typically highly satisfied with their procedural experience and analgesia control.
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstétrique et gynécologie du Canada : JOGC, 2005
To improve the understanding of chronic pelvic pain (CPP) and to provide evidence-based guideline... more To improve the understanding of chronic pelvic pain (CPP) and to provide evidence-based guidelines of value to primary care health professionals, general obstetricians and gynaecologists, and those who specialize in chronic pain. BURDEN OF SUFFERING: CPP is a common, debilitating condition affecting women. It accounts for substantial personal suffering and health care expenditure for interventions, including multiple consultations and medical and surgical therapies. Because the underlying pathophysiology of this complex condition is poorly understood, these treatments have met with variable success rates. Effectiveness of diagnostic and therapeutic options, including assessment of myofascial dysfunction, multidisciplinary care, a rehabilitation model that emphasizes achieving higher function with some pain rather than a cure, and appropriate use of opiates for the chronic pain state. Medline and the Cochrane Database from 1982 to 2004 were searched for articles in English on subject...
Journal of Obstetrics and Gynaecology Canada Jogc Journal D Obstetrique Et Gynecologie Du Canada Jogc, Sep 1, 2009
A43-year-old woman presented with a three-year history of intermittent right lower quadrant pain ... more A43-year-old woman presented with a three-year history of intermittent right lower quadrant pain and a right simple adnexal cyst. She had presented to the emergency department on several occasions over the preceding three years because of the pain, but no intervention ...
The physiological and biochemical status of two groups of neonates with patent ductus arteriosus ... more The physiological and biochemical status of two groups of neonates with patent ductus arteriosus (PDA) requiring surgical ligation were compared. One group (n = 14) had ductus ligation in the operating room (OR) and the other group (n = 14) had the same operation in an isolation room in the Neonatal Intensive Care Unit (NICU). The groups were closely matched in terms of gestational age and weight. Nursing time and disposable equipment savings were significantly different. We have confirmed that PDA ligation can be done safely in the NICU and is more cost efficient than ligation in the OR.
Canadian journal of anaesthesia = Journal canadien d'anesthesie, Jan 28, 2015
In 2011, the hysterectomy enhanced recovery (HER) pathway, a multi-disciplinary, evidence-based c... more In 2011, the hysterectomy enhanced recovery (HER) pathway, a multi-disciplinary, evidence-based care plan designed to improve recovery after open gynecologic surgery for non-malignant lesions, was introduced at The Ottawa Hospital (TOH). This before-and-after study examined the impact of the HER pathway on postoperative day (POD) 1 hospital discharge. Ethical approval was obtained. This retrospective cohort study included patients who had undergone open abdominal gynecologic surgery for non-malignant lesions at TOH Civic Campus between July 2010 and September 2012 (the year before and year after HER implementation). Patients were analyzed in either a pre-HER or post-HER group depending on their surgery date. Patients with chronic pain and emergent surgery were excluded. Data were obtained via medical chart review. Our primary outcome was the percentage of POD 1 discharges before and after HER implementation. Secondary outcomes included return to hospital within 30 days of discharge,...
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstétrique et gynécologie du Canada : JOGC, 2009
A43-year-old woman presented with a three-year history of intermittent right lower quadrant pain ... more A43-year-old woman presented with a three-year history of intermittent right lower quadrant pain and a right simple adnexal cyst. She had presented to the emergency department on several occasions over the preceding three years because of the pain, but no intervention ...
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstétrique et gynécologie du Canada : JOGC, 2013
To review the indications for, and the associated pathology and complications of, appendectomy pe... more To review the indications for, and the associated pathology and complications of, appendectomy performed during gynaecologic surgery in a tertiary academic health sciences centre. We performed a retrospective review of appendectomy cases performed from September 2007 to December 2011 in a tertiary level gynaecologic surgical practice. Cases were reviewed using a standardized intake sheet with surgical reports, history, and pathologic findings. A total of 71 appendectomies were performed during gynaecologic surgery in the study period. All cases were primary gynaecologic surgical cases; the most common diagnoses were endometriosis, pelvic pain, and pelvic mass. Overall, 42 (59%) of the study cases had abnormal histopathology in the appendix. Of the 44 women with a primary diagnosis of endometriosis, 28 (64%) had positive appendiceal pathology. In women with chronic pelvic pain, three of eight (38%) had pathology within their appendix. Of all appendixes removed that appeared normal on...
Journal of minimally invasive gynecology, Jan 9, 2014
To evaluate the feasibility and success rate of treating Asherman's syndrome in an outpatient... more To evaluate the feasibility and success rate of treating Asherman's syndrome in an outpatient hysteroscopy unit. Review of Asherman's syndrome treated in the outpatient hysteroscopy clinic at the Ottawa Hospital from November 26, 2008 to January 31, 2014. Classification Retrospective case series (Canadian Task Force classification III). Patients Patients undergoing treatment for Asherman's syndrome. Intervention All cases of hysteroscopic adhesiolysis were reviewed. Demographic data were collected by a retrospective chart review, including patients' age, obstetrical history, referring complaint, etiology of Asherman's, antecedent treatment, and outcome measures when available. Severity of Asherman's syndrome was determined based on the March classification, by the operating surgeon. Analgesia used during the procedure was recorded. Twenty patients were treated for Asherman's syndrome in the outpatient hysteroscopy suite. There were a total of thirty-eight...
ABSTRACT Objective: This study was conducted to evaluate patient satisfaction and analgesia prefe... more ABSTRACT Objective: This study was conducted to evaluate patient satisfaction and analgesia preferences in patients undergoing office hysteroscopy. Materials and Methods: The study was a retrospective chart review of 209 cases of patients who underwent hysteroscopy in an office hysteroscopy suite in a tertiary level center-The Ottawa Hospital from November 2008 to January 2013. Data were collected and analyzed for procedures performed, indications for hysteroscopy, analgesia used, and number of failed procedures. Patient satisfaction questionnaires were reviewed evaluating patients' experience with office hysteroscopy and intra-and postoperative pain control. Results: Operative and diagnostic hysteroscopy was performed in 40% and 57% of cases, respectively. Most common indications for hysteroscopy were: abnormal uterine bleeding (21%); postmenopausal bleeding (17%); contraception (10%); and fertility assessment (10%). There were 8 cases of failed office hysteroscopy. Nonsteroidal anti-inflammatory drug pretreatment was administered to >70% of the patients. Less then 5% of patients required intravenous sedation, and 10.5% needed a paracervical block to complete office hysteroscopy. One hundred and sixty-seven patients completed the patient-satisfaction survey. Overall, >85% of patients reported receiving excellent-to-very good care in all aspects of their periprocedural experience. All responders agreed that they would recommend this procedure to a friend. Conclusions: Office hysteroscopy can be performed in a safe and effective manner. Patients are typically highly satisfied with their procedural experience and analgesia control.
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstétrique et gynécologie du Canada : JOGC, 2005
To improve the understanding of chronic pelvic pain (CPP) and to provide evidence-based guideline... more To improve the understanding of chronic pelvic pain (CPP) and to provide evidence-based guidelines of value to primary care health professionals, general obstetricians and gynaecologists, and those who specialize in chronic pain. BURDEN OF SUFFERING: CPP is a common, debilitating condition affecting women. It accounts for substantial personal suffering and health care expenditure for interventions, including multiple consultations and medical and surgical therapies. Because the underlying pathophysiology of this complex condition is poorly understood, these treatments have met with variable success rates. Effectiveness of diagnostic and therapeutic options, including assessment of myofascial dysfunction, multidisciplinary care, a rehabilitation model that emphasizes achieving higher function with some pain rather than a cure, and appropriate use of opiates for the chronic pain state. Medline and the Cochrane Database from 1982 to 2004 were searched for articles in English on subject...
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Papers by Hassan Shenassa