Publications by authors named "Simrit Nijjar"

Intramural pregnancy (IMP) is a rare and potentially life-threatening uterine ectopic pregnancy implanted within the myometrium. Despite its recognition as a distinct clinical entity, diagnostic challenges and a lack of standardized management protocols persist. IMP occurs when a gestational sac implants into the myometrium beyond the endometrial-myometrial junction, often following uterine trauma.

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Background: Caesarean scar ectopic pregnancy (CSEP) is the most common of type of uterine ectopic pregnancy and is associated with significant morbidity. Prompt diagnosis and treatment is therefore of paramount importance. Currently there is no universally agreed treatment option for CSEP supported by any national or international society.

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Lower gestational age (GA) is a risk factor for cognitive and developmental concerns following preterm birth. However, its impact on executive function (EF) is unclear based on conflicting conclusions across the literature. Moreover, as children below 4 years have largely been neglected from previous reviews, the impact of GA on EF within this early developmental period remains unclear.

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Background: Caesarean scar ectopic pregnancy (CSEP) is associated with significant maternal and foetal morbidity. However, the optimal treatment remains unknown.

Objectives: The aim of this study was to review outcomes reported in studies on CSEP treatment and outcome reporting quality.

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Article Synopsis
  • The study focuses on the management of advanced Cesarean scar ectopic pregnancies (CSEPs), which pose significant risks and typically require hysterectomy, while exploring whether conservative treatments such as suction curettage and interventional radiology could be effective.* -
  • Out of 371 cases reviewed over 15 years, 22 women had advanced live CSEPs, with 17 opting for surgery; they underwent procedures that included suction curettage and placement of a cervical suture for hemostasis.* -
  • Results showed that the cervical suture effectively controlled bleeding in 76% of surgical cases, with additional measures like uterine artery embolization used when necessary, marking a significant finding in managing these complex pregnancies.*
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Article Synopsis
  • Researchers are investigating the effectiveness of a new DNA methylation test (WID-qEC) compared to traditional imaging tests for detecting uterine cancer in women experiencing abnormal uterine bleeding.
  • The study, called EPI-SURE, involved women aged 45 and older attending a gynecological diagnostic center and collected cervicovaginal samples alongside standard imaging tests.
  • Out of 474 potential participants, 399 women were included for analysis, and initial findings highlighted that approximately 47% received recommendations for further examination based on the imaging tests.
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Cesarean scar ectopic pregnancy is a rare type of ectopic pregnancy, where the pregnancy implants into a myometrial defect caused by a cesarean scar. Its incidence is predicted to increase, given the global increase in cesarean deliveries. As most cesarean scar ectopic pregnancies present as failing pregnancies or patients choose termination of pregnancy, there are limited data on their natural history.

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Cesarean scar ectopic pregnancy is associated with significant maternal morbidity, including severe hemorrhage, need for the blood transfusion and hysterectomy. Early diagnosis is therefore key in ensuring timely management, with consensus being that treatment before 9 weeks of gestation leads to reduced morbidity. There is no universally adopted management protocol for cesarean scar ectopic pregnancy, but surgical management generally has a higher success rate than medical management.

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Introduction: The natural history of endometriosis is poorly understood, and despite numerous studies, the rate of the disease progression and optimal treatment planning in women who are asymptomatic or experience mild symptoms not requiring treatment are unknown. The aim of this study was to assess the behavior of deep endometriosis in women who are managed expectantly without any medical or surgical intervention.

Material And Methods: A retrospective cohort study of women diagnosed with deep endometriosis on transvaginal ultrasound scan at the Department of Gynecology, University College London Hospitals and The Gynecology Ultrasound Centre, London, UK, from April 2007 to April 2022.

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Objective: To evaluate the value of fetal scalp blood sampling (FBS) as an adjunct test to cardiotocography, to predict adverse neonatal outcomes.

Study Design: A multicentre service evaluation observational study in forty-four maternity units in the UK. We collected data retrospectively on pregnant women with singleton pregnancy who received FBS in labour using a standardised data collection tool.

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Objective: This study investigates excessive mind wandering (MW) in adult ADHD using a new scale: the Mind Excessively Wandering Scale (MEWS).

Method: Data from two studies of adult ADHD was used in assessing the psychometric properties of the MEWS. Case-control differences in MW, the association with ADHD symptoms, and the contribution to functional impairment were investigated.

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Background: The objective of this study is to analyze a set of previously developed and proposed image segmentation protocols for precision in both intra- and inter-rater reliability for in vivo tooth volume measurements using cone-beam computed tomography (CBCT) images.

Methods: Six 3D volume segmentation procedures were proposed and tested for intra- and inter-rater reliability to quantify maxillary first molar volumes. Ten randomly selected maxillary first molars were measured in vivo in random order three times with 10 days separation between measurements.

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We discuss a case of a woman ultimately diagnosed with familial partial lipodystrophy following her fourth pregnancy. In her previous pregnancies she had numerous complications thought to be related to diabetes including recurrent macrosomia and polyhydramnios. In her second pregnancy she underwent emergency caesarean section for fetal tachycardia at 34 weeks' gestation.

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Objective: To evaluate in adolescents and young adults if jackscrew-based maxillary expansion therapies result in external root resorption as measured in vivo via any radiological method.

Methods: The authors conducted a systematic search of several electronic databases (MEDLINE, EMBASE, PubMed, Scopus, CINAHL, Evidence Based Medicine Reviews, LILACS) with the assistance of a senior librarian specialized in Health Sciences database searches through 25 August 2013, as well as a limited grey-literature search (Google Scholar). Human, in vivo studies of adolescents or young adults with transverse maxillary deficiency undergoing non-surgical maxillary expansion therapy through the use of a jackscrew-based maxillary expander with a radiographical assessment of root resorption were selected for full article review.

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