Survey of iodized salt coverage in areas with different water iodine concentrations and the iodine status of local women

PURPOSE

There were only two definitions of iodine-deficient (water iodine concentration < 10 μg/L) and iodine-excess areas (water iodine concentration > 100 μg/L) in China before 2020. Areas with water iodine concentration between 10 and 100 μg/L implement the same policy as iodine-deficient areas to provide iodized salt. The definition of iodine-adequate areas was formulated in 2020 for the first time. The paper aims to investigate the coverage rate of iodized salt (CR) in different areas defined according to the latest national standards, evaluate the iodine status of local women, and provide a basis for the revision and improvement of relevant policies.

METHODS

A total of 1948 women aged 18-60 were recruited from the iodine extra-high areas (IEHA), iodine-excess areas (IEA), iodine-adequate areas (IAA), inland iodine-deficient areas (IIDA), and coastal iodine-deficient areas (CIDA). Information on daily diet was collected with the Food Frequency Questionnaire. Drinking water, salt, food, and urine samples were collected and tested in our laboratory. Based on the recommended daily iodine intake, we assessed whether the subjects' daily iodine intake levels were adequate.

RESULTS

The CR and the median urinary iodine concentrations (UICs) were 4.02% and 98.03 μg/L in CIDA, 89.74% and 144.93 μg/L in IIDA, 26.55% and 178.60 μg/L in IAA, 8.78% and 446.5 μg/L in IEA, 3.95% and 605.4 μg/L in IEHA, respectively. The differences among these five areas were statistically significant (P < 0.0001). The daily dietary iodine intakes were mainly from drinking water in IAA (63.92%), IEA (92.29%), and IEHA (92.93%), and were mainly from iodized salt in IIDA (59.22%) and food in CIDA (86.6%).

CONCLUSION

Women in IAA and IIDA were in an adequate iodine state. Women in IEA and IEHA were in an iodine-excess state, and it is necessary to carry out water improvements projects. Women in CIDA were in a slight iodine-deficient state, and health education on scientific iodine fortification should be strengthened to increase iodine intake.

Menstrual cycle symptoms are associated with nutrient intake: Results from network analysis from an online survey

BACKGROUND

Less is understood about female's nutrient intake's impact on the severity of the menstrual cycle (MC) symptoms, which consequently interferes with their life quality.

OBJECTIVES

The goal of this study is to look at the relationship between female nutrient consumption and the severity of MC symptoms to better understand how food affects women's quality of life during their MCs.

DESIGN

To investigate this impact among healthy adult women, a self-administered, cross-sectional online questionnaire was obtained from 204 regularly menstruating women aged between 18 and 40.

METHODS

The questionnaire included questions on sociodemographic characteristics, a semi-food frequency questionnaire (FFQ), Arabic Premenstrual Syndrome Scale (A-PMS-S) for MC symptoms.

RESULTS

Results showed intake of polyunsaturated fatty acids (PUFAs) was associated with lower no to mild versus moderate to severe physical symptoms (odds ratio (OR): 0.71, 95% confidence interval (CI): 0.59-0.85; p < 0.001), psychological symptoms (OR: 0.87, 95% CI: 0.77-0.99; p < 0.05), and functioning symptoms (OR: 0.92, 95% CI: 0.83-1.02; p > 0.1). Thiamine prevented psychological symptoms (OR: 0.02, 95% CI: 0.02-0.02; p < 0.001), physiological symptoms (OR: 0.59, 95% CI: 0.58-0.60; p < 0.001), and functioning symptoms (OR: 0.47, 95% CI: 0.47-0.48; p < 0.001). Saturated fat, iron, and niacin intakes increased the risk of experiencing MC psychological symptoms.

CONCLUSION

Our findings suggest that MC symptoms were correlated with some nutrient intake from food sources, which is considered an external controllable factor more than demographic characteristics. Therefore, women should be aware of the type of food consumed during their monthly MC phase.

Ambiguous genitalia: clinical management of adult female with male assigned gender: a case report

BACKGROUND

Disorders of sex development are anomalies in which the development of urogenital ridge is undifferentiated for the male and female child. Imaging plays a vital role in investigating the gross anatomy and associated anomalies. Ultrasonography, such as genitography and magnetic resonance, is the primary modality for demonstrating internal gonads and genitalia. Early multidisciplinary approach in the management of ambiguous genitalia including early surgical intervention is the predominant practice, with few current considerations on deferral of genital reconstruction until adolescent age.

CASE PRESENTATION

We report the rare case of a 24-year-old adult female from a majority ethnic group of the Volta region, Ghana who was diagnosed and raised as male, now requiring surgical restoration to the female gender. The surgical team decided to assign external genitalia to correspond with the already intact internal organs, thus constructing the vulva. Consent was given by the client and her family members for management and surgical intervention. The surgery was scheduled and duly performed with a successful outcome. Understanding and consent was sought from the patient for the purpose of using her images for teaching, scientific publication, and demonstrations.

CONCLUSION

The advantages of deferring surgical reconstruction with psychological counseling after early assessment need to be considered to prevent inappropriate gender assignment.

Adult female acne: A cross-sectional study of diet, family history, body mass index, and premenstrual flare as risk factors and contributors to severity

Background

The risk factors for adult female acne (AFA) and their influence on severity are unclear. The aim of this study was to document the role of diet, body mass index (BMI), premenstrual flare, and family history of acne as risk factors and cause of severity of AFA.

Methods

This was a prospective, cross-sectional, case-control study of 112 women age ≥25 years. The women were clinically evaluated. Sociodemographic data (age, family history of acne, premenstrual flare, weight, and height) and dietary habits were documented. Age, weight, height, and dietary habits of controls were also documented. Data were analyzed using SPSS, version 22.

Results

The mean age of the 56 patients with AFA was 33.4 ± 8.2 years (controls: 24.5 ± 4.4 years). Premenstrual flare of acne was noted in 58.9% of patients, a family history of acne was present in 51.8% of patients, and the mean BMI was 25.2 ± 4.9 (32.1%). A risk factor for AFA was a family history of acne (p ≤ 0.001). Dietary habits (chicken, p = 0.457; beef, p = 0.845; cakes and sweets, p = 0.956; starchy food, p = 0.361; and type of milk, p = 0.919) and BMI (p = 0.486) were not risk factors for AFA. Premenstrual flare (p = 0.178), BMI (p = 0.206), family history of acne (p = 0.592), and diet did not contribute to the severity of AFA.

Conclusion

Diet and BMI are not risk factors for AFA, but a family history of acne is. Severity of AFA is independent of premenstrual flares, diet, BMI, and a family history of acne.

Incidental discovery of Amyand's hernia in an adult female: A case report

Introduction and importance

Amyand's hernia is a rare type of inguinal hernia with an incidence of about 0.1% of all inguinal hernias with most in occurring in childhood. It is characterized by the presence of the vermiform appendix within the hernia sac.

Case presentation

We report the case of 40-year-old female who underwent inguino-labial hernia repair with an incidental finding of a normal appendix within the sac; this was not predicted by the pre-operative ultrasound scan.

Clinical discussion

We recommend that a detailed ultrasound scan be done for all patients with an inguinal hernia to help to manage the patient timeously and safely.

Conclusion

We present a rare condition in a 40-year-old female with a right inguinal hernia, an Amyand's hernia.

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We report a case of Amyand's hernia in a 40-year-old female who underwent inguinal hernia repair.

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A normal appendix was found in the sac and reduced without appendicectomy. Hernia repair without mesh was then performed.

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Ultrasound scan is an excellent technique to evaluate the inguinal region but remains operator dependent.

Laparoscopic hydrocelectomy of the canal of Nuck in adult female: Case report and literature review

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A very rare case of hydrocele of canal of Nuck in elderly lady.

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This case expands the clinical and intraoperative potential differential diagnosis of adult female groin masses.

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Hydrocele of canal of Nuck must be considered one of the differential diagnosis in ladies with inguinal masses.

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Laparoscopic TAPP is superior to open approach in managing such cases.

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Probably the first case of hydrocele of canal of Nuck in adult female operated laparoscopically in the Middle East and North Africa (MENA) Region, and the fourth such case worldwide.

Introduction

Among adult females, Hydrocele of Canal of Nuck (HCN) is a very rare condition. The majority of the reported cases of HCN were not conclusively diagnosed until surgery was performed on a suspected inguinal hernia. To the best of our knowledge, this is the first case of laparoscopically operated HCN in adult female in Middle East and North Africa Region, and the fourth such case worldwide.

Presentation of case

A 36-year-old female presented with a painful small swelling in the right groin of 3 months duration. The swelling extended to the right labia majora while standing, and disappeared when the patient was in prone position. There was no lymph node enlargement, no other masses in the abdomen, and no swelling in the contralateral side. Ultrasonography was undertaken and the patient was admitted electively for laparoscopic exploration and repair of non-complicated right inguinal hernia. She was known to have dyslipidemia on medications. Further history and physical examination were unremarkable. Intraoperatively it was diagnosed to be right-sided HCN which was excised and repaired by mesh fixation using transabdominal preperitoneal (TAPP) approach. Her follow up course was unremarkable.

Conclusions

This case expands the clinical and intraoperative potential differential diagnosis of adult female groin masses. Surgeons should consider such cases when they observe such swellings intraoperatively. Laparoscopic TAPP approach in such cases is a superior diagnostic and treatment modality.

Vaginal extrusion of a ventriculo-peritoneal shunt catheter in an adult

Ventriculo-peritoneal shunts (VPS) are commonly used in the treatment of various neurosurgical conditions, including hydrocephalus and pseudotumor cerebri. We report only the second case of vaginal extrusion of a VPS catheter in an adult, and the first case with a modern VPS silastic peritoneal catheter. A 45-year-old female with a history of VPS for pseudotumor cerebri, Behcet's syndrome, and hysterectomy presented to our institution with the chief complaint of tubing protruding from her vagina after urination. On gynecologic examination, the patient was found to have approximately 15 cm of VPS catheter protruding from her vaginal apex. A computed tomography scan of the abdomen and shunt X-ray series demonstrated no breaks in the tubing, but also confirmed the finding of the VPS catheter extruding through the vaginal cuff into the vagina. The patient had the VPS removed and an external ventricular drain was placed for temporary cerebrospinal fluid diversion. Ventricular catheter cultures were positive for diphtheroids. After an appropriate course of antibiotics, a contralateral ventriculo-pleural shunt was placed one week later. Although vary rare, vaginal extrusion can occur in adults, even with modern VPS catheters.

Adult female of Strongyloides stercoralis in respiratory secretions

OBJECTIVE

To communicate the presence of adult females, rabditoid larvae and eggs of Strongyloides stercoralis (S. stercoralis) in the respiratory secretions obtained by tracheal aspirate from a HIV-negative patient who was suffering from polymyositis, and treated with corticoids and amethopterin and assisted by pneumonia.

METHODS

The respiratory secretions submitted to the Parasitology Laboratory of the Muñiz Hospital were made more concentrated by centrifugation (1 500 r/min for 15 seconds). Wet mount microscopy was performed with the pellet.

RESULTS

It revealed adult females, rabditoid larvae and eggs of S. stercoralis. Further parasitological studies performed after the start of the treatment with ivermectin on fresh fecal samples, gastric lavages and tracheal aspirates showed scanty mobile filariform and rabditoid larvae of the same parasite.

CONCLUSIONS

The presence of adult female S. stercoralis which has never been observed before in the clinical samples submitted to our Laboratory for investigation can be considered as an indirect marker of the severe immunosupression of the patient.

Unilateral ectopic breast tissue on vulva in an adult female

Among the ectopic breasts, an ectopic breast tissue on vulva is an extremely rare case, especially in adult period. To our knowledge only 38 cases of ectopic breast tissue on vulva are documented in the world literature, out of which only 10 cases of unilateral ectopic breast tissue on vulva has been reported. Because of its rarity here we report a case of unilateral ectopic breast tissue on vulva in an adult female.