Publications by authors named "Ajay Rane"

Article Synopsis
  • - The study compares the effectiveness of using a new device called the "Episiometer" against conventional methods for performing episiotomies during instrumental vaginal deliveries, focusing on the angle of incision and incidence of anal sphincter injuries.
  • - Conducted as a randomized controlled trial with 328 women, results showed significantly fewer obstetric anal sphincter injuries (0.61%) in the Episiometer group compared to the conventional group (4.88%), along with a better suture angle post-repair.
  • - The findings suggest that using the Episiometer leads to improved outcomes in terms of incision quality and lower injury rates, although there was no significant difference in perineal pain or incontinence during follow-ups
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Article Synopsis
  • The study focuses on the prevalence of urogenital fistulas among Congolese women after Cesarean sections (CS) due to prolonged obstructed labor and complications arising from those sections.
  • Data from 125 patients was analyzed, revealing that 62% of fistulas were linked to obstructed labor and 38% to complications from CS, with younger age and lower parity being significant factors for those with fistulas from obstructed labor.
  • The findings highlight the need for thorough maternal assessments upon hospital arrival to reduce unnecessary CS procedures and identify women at high risk for developing fistulas.
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Article Synopsis
  • A 35-year-old Congolese woman experienced urinary incontinence and a vaginal tearing sensation due to a genital fistula caused by a lobular capillary hemangioma.
  • The condition involved a suburethral vascular bud and progressed to a larger urethro-vesico-vaginal fistula.
  • Surgical repair successfully closed the fistula, and the patient regained normal urinary function.
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Ambivalence in Australian thought on induction of labour, despite recent evidence, stands out in contrast to ever-increasing rates of this intervention. As consent obligations on information provision have crystallised in maternity care, this article examines whether consumer-led expectations and legal obligations may precipitate change to end the cultural stigma around induction of labour.

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Article Synopsis
  • Enhanced Recovery After Surgery (ERAS) protocols, originally designed for colorectal and gynecologic surgeries, showed benefits like shorter hospital stays and fewer complications.
  • A study at Townsville Day Surgery assessed the impact of a modified ERAS protocol, which excluded carbohydrate-rich fluid intake before surgery, on patients undergoing ambulatory pelvic organ prolapse surgeries from 2008 to 2019.
  • Results indicated that out of 1381 surgeries, complications were low (4.4%) with only 0.4% needing unplanned admissions, suggesting the modified ERAS protocol is effective and safe for outpatient pelvic organ prolapse and urinary incontinence surgeries.
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Background: Prioritising normal birth has led to harm in some instances in the United Kingdom. While Australian organisations also promote normal birth, its negative impact is less well understood here.

Aims: This study explores the problems that may arise from the promotion of normal birth and the quality of clinical incident investigations.

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Introduction: Vaginal laxity or the sensation of vaginal looseness affects anywhere from 24% to 50% of postpartum women.

Aim: To evaluate the efficacy and safety of the ThermiVa (ThermiAesthetics, TX, USA) monopolar radiofrequency device in the treatment of vulvovaginal laxity and sexual dysfunction METHODS: The TIGHT study was a prospective single blinded randomized sham-control trial conducted over 3 sites in Australia and India. The study included parous woman over the age of 18 who complained of vaginal laxity/looseness.

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Enhanced recovery after surgery (ERAS) is a multimodal convention first reported for colorectal and gynecologic procedures. The main benefits have been a shorter length of stay and reduced complications, leading to improved clinical outcomes and cost savings substantially. With increase in life expectancy, recent years has shown a significant rise in advanced age population, and similarly, a rise in age-related disorders requiring surgical management.

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Objective: To demonstrate an outpatient vaginoscopic technique for treating multiple vaginal polyps.

Design: Demonstration of surgical technique using slides, pictures, and video.

Setting: Private hospital.

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Article Synopsis
  • The study investigates the success rates of two types of surgical repairs for obstetric vesicovaginal fistula (VVF), comparing midvaginal and juxtacervical methods, while considering patient demographics, fistula classification, and surgical techniques.
  • Conducted at Panzi Hospital in the Democratic Republic of Congo from 2015 to 2017, the study analyzed data from 420 women who underwent primary VVF repair, using statistical methods to assess outcomes.
  • Results showed high success rates (95.6% for midvaginal and 96.2% for juxtacervical), with significant factors for success linked to preoperative fibrosis and specific surgical techniques, though predicting individual outcomes remains challenging due to
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Background: Despite being an efficacious means of pain relief, there is a broad range of usage rates of epidural analgesia among countries worldwide. Australia sits between common usage in North America and more conservative usage in the UK. The reason for this is unclear, raising the question of whether there is a difference between Australia and other Western countries in pregnant women's attitudes toward epidural use, or the hospital context.

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Thirteen years after the last supplement on obstetric fistula, the authors challenge the progress achieved. Citing the ongoing need for a standardized classification system, uniform surgical training and certification, evaluation, follow-up, and research, we emphasize the need for improved communication and coordination between government and nongovernment entities invested in ending obstetric fistula. Struck by the call by the United Nations to end obstetric fistula by 2030, we stress the need for increased and targeted funding of programs that are of the highest quality and impact.

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The present study was undertaken at the Port Moresby General Hospital, Papua New Guinea, to evaluate the ease of use and acceptability of a perineal measuring device (Episiometer) for giving a correct length and angle of a mediolateral episiotomy. An Episiometer was placed on the perineum to guide the angle and length immediately before giving an episiotomy. A feedback survey was collected and the angle and length of the episiotomy were measured at the time of delivery and at 6 weeks postpartum.

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International standards for clinical staffing of delivery care in maternity units are currently lacking, with resulting gaps in provision leading to adverse outcomes and very poor experiences of care for women and families. While evidence‐informed modelling approaches have been proposed based on population characteristics and estimated rates of complications, their application and outcomes in low‐resource settings have not been reported. Here, FIGO's Safe Motherhood and Newborn Health Committee proposes indicative standards for labor wards as a starting point for policy and program development.

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The management of vaginal delivery appears to offer an opportunity to reduce the morbidity of pelvic floor dysfunction (PFD) which is very common in the postpartum period. Research by the authors suggests that an episiotomy is protective against PFD, in particular urinary incontinence. The aim of this subsequent audit was to see if educational intervention can alter the common medical practice of episiotomy and in turn reduce postpartum PFD.

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Obstetric fistula is a devastating childbirth injury caused by unrelieved obstructed labor. Obstetric fistula leads to chronic incontinence and, in most cases, significant physical and emotional suffering. The condition continues to blight the lives of 1-2 million women in low-resource settings, with 50 000-100 000 new cases each year adding to the backlog.

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Rising rates of caesarean section (CS) have been attributed, in part, to maternal-choice CS (MCCS). There are few published data regarding maternal and perinatal risks comparing MCCS with planned vaginal birth (VB) in uncomplicated first pregnancies to inform choice. We report the results of a pragmatic patient-preference cohort study of private patients in Australia: 64 women planning MCCS and 113 women planning VB.

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Female genital mutilation (FGM) is a traditional practice where female genital organs are altered for non-medical reasons. The custom is outlawed in Australia and associated with an array of medical consequences. Due to the recent influx of migrants from regions endemic to FGM, the practice is becoming a growing concern locally.

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Human childbirth has been described as an "obstetrical dilemma". Evolution favours enlargement of the foetal brain, whilst bipedal locomotion demands a reduction in pelvic breadth for improvements in biomechanical efficiency. The result of this conflict is a human pelvis incongruous with the dynamics of childbirth.

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Introduction And Hypothesis: Australian Medicare data show that the rates of cosmetic labiaplasty have tripled over the last decade; however, there is little understanding about the social factors that contribute to the popularity of female genital cosmetic surgeries (FGCS). The aim of this study was to investigate male perception of female genitalia and to assess men's awareness of FGCS and whether these surgeries are viewed as a positive and acceptable option.

Methods: A cross-sectional study of male adults in the Townsville region was conducted via an online questionnaire.

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Background: Pelvic floor dysfunction (PFD) is the most common complication of childbirth. Assumptions have been made that perineal trauma increases the risk of PFD compared to an intact perineum, however the evidence for this is lacking. The aim of this study was to explore the relationship between perineal outcome and postpartum PFD.

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This case report describes the formation of a very large urinoma 1 day after vaginal surgery. A 59-year-old woman was diagnosed with a urinoma measuring 30.5 cm in length, 23 cm in the transverse plane and 12 cm in the anteroposterior dimension on day 1 after a vaginal hysterectomy and prolapse repair surgery.

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Background And Aim: Mesh reinforcement is considered an effective method for anterior compartment prolapse repair. Two common methods of mesh reinforcement involve either transobturator fixation (eg Perigee™) or lateral and apical anchoring (eg Anterior Elevate™). The aim of this study was to assess subjective and objective outcomes after Anterior Elevate and Perigee mesh kit surgery.

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