Whole-cycle management of women with epilepsy of child-bearing age: ontology construction and application

BACKGROUND

The effective management of epilepsy in women of child-bearing age necessitates a concerted effort from multidisciplinary teams. Nevertheless, there exists an inadequacy in the seamless exchange of knowledge among healthcare providers within this context. Consequently, it is imperative to enhance the availability of informatics resources and the development of decision support tools to address this issue comprehensively.

MATERIALS AND METHODS

The development of the Women with Epilepsy of Child-Bearing Age Ontology (WWECA) adhered to established ontology construction principles. The ontology's scope and universal terminology were initially established by the development team and subsequently subjected to external evaluation through a rapid Delphi consensus exercise involving domain experts. Additional entities and attribute annotation data were sourced from authoritative guideline documents and specialized terminology databases within the respective field. Furthermore, the ontology has played a pivotal role in steering the creation of an online question-and-answer system, which is actively employed and assessed by a diverse group of multidisciplinary healthcare providers.

RESULTS

WWECA successfully integrated a total of 609 entities encompassing various facets related to the diagnosis and medication for women of child-bearing age afflicted with epilepsy. The ontology exhibited a maximum depth of 8 within its hierarchical structure. Each of these entities featured three fundamental attributes, namely Chinese labels, definitions, and synonyms. The evaluation of WWECA involved 35 experts from 10 different hospitals across China, resulting in a favorable consensus among the experts. Furthermore, the ontology-driven online question and answer system underwent evaluation by a panel of 10 experts, including neurologists, obstetricians, and gynecologists. This evaluation yielded an average rating of 4.2, signifying a positive reception and endorsement of the system's utility and effectiveness.

CONCLUSIONS

Our ontology and the associated online question and answer system hold the potential to serve as a scalable assistant for healthcare providers engaged in the management of women with epilepsy (WWE). In the future, this developmental framework has the potential for broader application in the context of long-term management of more intricate chronic health conditions.

Achievements and challenges in the health of Mexican women, 1990 and 2019: ecological analysis based on the global burden of disease data

OBJECTIVES

To describe the burden and causes of disease in Mexican women in 1990 and 2019, based on the data disaggregation by age groups and states. Also, to evaluate the relationship of years of healthy life lost with the Socio-demographic Index (SDI) and with the Healthcare Access and Quality (HAQ) Index.

STUDY DESIGN

This was an ecological descriptive study.

METHODS

Based on the Global Burden of Disease, Injuries, and Risk Factors Study study, the age-standardized and age-specific rates for mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) were reported.

RESULTS

At the national level, the all-cause age-standardized rates for Mexican women decreased in mortality -28.8%; YLLs -39.8%; YLDs -1.3%; and DALYs -26.2%. For 2019, the indicators analyzed had the worst performances in Chiapas and Chihuahua, while women in Sinaloa had the lowest age-standardized rates. In 1990, it is worth noting that there was a remarkable presence of CDs, mainly in YLLs. In all age groups, diabetes mellitus was the leading cause of DALYs in Mexico's 32 states, followed by CKD (in 24 states), and ischemic heart disease (in 18 states). In both 1990 and 2019, a negative and statistically significant correlation between DALYs and the HAQ Index was evident. The correlation between DALYs and the SDI was only significant in 1990.

CONCLUSION

In the last 30 years, the burden of disease on Mexican women has undergone substantial changes that reflect progress in the improvement of their health conditions. However, the current scenario is complex because the convergence of communicable diseases, non-communicable diseases, and injuries is evident, which implies important challenges that must be addressed as soon as possible.

Factors associated with postpartum family planning use in Rwanda

BACKGROUND

Resumption and initiation of contraceptive methods after delivery are of critical importance in ensuring the well-being of the mother and the newborn. However, evidence related with postpartum family planning in Rwanda is scanty. This study employed survival analysis techniques to study the time to resumption or initiation of contraceptive methods after childbirth in Rwandan women and the associated factors.

METHODS

Data were collected from the 2020 Rwanda Demographic and Health Survey (RDHS). Descriptive statistics were obtained after adjusting for study design. Initial analysis was conducted using the Kaplan-Meier method, followed by univariate and multivariable Cox Hazard proportional models to study factors associated with the initiation of contraceptive use after delivery. Cox Model assumptions were tested using scaled Schoenfeld Residuals.

RESULTS

5682 women who delivered in the five years preceding the survey were included in this research. The percentage of women who used modern contraceptives was 32%, 55%, 67%, and 79% at one month, six months, one year and two years respectively. Delivery by cesarean section, access to health insurance, and an increase in the number of children under five years of age were associated with increased chances of utilizing modern contraceptives after delivery. An increase in women's age and in the ideal number of children and women with a history of terminated pregnancy were associated with reduced chances of using postpartum family planning. The influence of religion was highlighted, with Catholic women associated with high contraceptive use.

CONCLUSION

There is a need to strengthen postpartum family planning in Rwanda. Policy makers and clinicians should provide additional customized interventions for women with factors associated with low use.

Effect of COVID-19 lockdown on health of women in Pakistan - Socioeconomic perspective

Objectives

This study investigates the dimensions of women's experiences during the COVID-19 lockdown in Pakistan, considering their historical vulnerability to natural disasters.

Methods

A cross-sectional study was conducted in Pakistan from May to September 2020 at Services institute of medical Sciences, Lahore. An online survey collected socio-demographic data, household responsibilities, and access to medical services using a self-designed questionnaire. Women aged 18 years and above (n=1307) were included through convenience sampling. Data analysis utilized SPSS 20.0.

Results

Of the surveyed women, 10 (14.9%) experienced improved health outcomes, while 39 (58.27%) faced poor health outcomes. Proper access to medical services was reported by 29 (43.3%) participants, while 38 (57.1%) had no access. Two women (3.0%) conceived during the lockdown. 45 (67.2%) women lived in nuclear families, and 21 (31.3%) in joint family systems. Additionally, 46 (68.7%) women were significantly burdened with household chores, while 21 (31.3%) had a normal routine. Among COVID-19-positive respondents, 70% reported weight gain from increased screen time and sedentary lifestyle. Difficulties in managing children's online classes were reported by 34.6% of participants. Moreover, 84% had a monthly income below one hundred thousand PKR. Among women aged 23-28 years, 30.9% had adverse effect on their husband's income, and 4.7% experienced unemployment. Unfortunately, 16% of respondents lost a relative due to COVID-19. Even with access to health facilities.

Conclusion

The COVID-19 lockdown in Pakistan led to adverse socioeconomic and health outcomes for women. These findings highlight the measures needed to address women's challenges amid pandemic impact.

Abortion medical management between 14-16 weeks' amenorrhea after French legislation deadline extension

BACKGROUND

The National French Assembly promoted a law in 2022 allowing an extension of the period of abortion up to 16 week's amenorrhea. Medication protocols vary internationally, and there are no French data on medical management between 14- and 16-weeks' amenorrhea.

OBJECTIVE

To assess effectiveness and feasibility of a medical management abortion between 14 and 16 weeks of amenorrhea.

STUDY DESIGN

We retrospectively collected data from women undergoing medical abortion between 14 and 16 weeks' amenorrhea from April 2022 to April 2023 in Archet's University hospital, Nice, France. Medical protocol consisted in a single dose of oral mifepristone 600 mg and 36-48 h later, vaginal gemeprost 1 mg. Three hours after gemeprost, oral 400 µg of misoprostol were administered every three hours, to a maximum of three doses. Success was defined as fetal expulsion.

RESULTS

Thirty women were enrolled in the study. Twenty-nine (96.7 %) patients aborted successfully. The median dose of misoprostol required was 800 µg (400 µg -1200 µg) and the median induction-to-abortion interval after first prostaglandin administration was 7 h (5.5-11.6). One patient (3.3 %) didn't expulse the fetus after 3 doses of misoprostol. Nine patients (30.0 %) had additional surgical aspiration for retained product of conception within 24 h. We encountered one post-abortum hemorrhage controlled only with surgical intra uterine aspiration. We did not need complementary hemostatic procedure and we reported no immediate or late complication.

CONCLUSIONS

Medical abortion between 14 and 16 weeks of amenorrhea provides a noninvasive and effective management for a daycare mid trimester abortion in 96.7 % of cases, with a 36.7 % of risk of staying in hospital overnight and 30.0 % to have additional surgery for retained product of conception (RPOC).

Revolutionizing the female reproductive system research using microfluidic chip platform

Comprehensively understanding the female reproductive system is crucial for safeguarding fertility and preventing diseases concerning women's health. With the capacity to simulate the intricate physio- and patho-conditions, and provide diagnostic platforms, microfluidic chips have fundamentally transformed the knowledge and management of female reproductive health, which will ultimately promote the development of more effective assisted reproductive technologies, treatments, and drug screening approaches. This review elucidates diverse microfluidic systems in mimicking the ovary, fallopian tube, uterus, placenta and cervix, and we delve into the culture of follicles and oocytes, gametes' manipulation, cryopreservation, and permeability especially. We investigate the role of microfluidics in endometriosis and hysteromyoma, and explore their applications in ovarian cancer, endometrial cancer and cervical cancer. At last, the current status of assisted reproductive technology and integrated microfluidic devices are introduced briefly. Through delineating the multifarious advantages and challenges of the microfluidic technology, we chart a definitive course for future research in the woman health field. As the microfluidic technology continues to evolve and advance, it holds great promise for revolutionizing the diagnosis and treatment of female reproductive health issues, thus propelling us into a future where we can ultimately optimize the overall wellbeing and health of women everywhere.

Effects of exercise therapy using elastic bands on strength and pain in women with non-specific neck pain: A randomised controlled trial

Background

Cervical pain has a high incidence and worldwide socio-economic effect. Its incidence is lower in men than in women. Conservative and non-pharmacological therapeutic options include strength training. Elastic bands are commonly used in physiotherapy clinics for strength work in patients. Consequently, the objective of this research was to analyse the efficacy of an exercise therapy programme using elastic bands on decreasing pain and increasing strength of the neck flexor musculature, cervical extensor, and scapular stabilizing musculature in women suffering from non-specific cervical pain.

Methods

A randomised clinical trial was carried out with 35 subjects with non-specific neck pain (age = 51.7 ± 9.5 and baseline intensity of pain in Visual Analogue Scale = 52.4 ± 9.6). The experimental group (n = 18) performed the exercise programme with elastic bands, consisting of a total of 16 sessions that lasted 45 min. The control group, consisting of 27 participants, reported that they maintained their usual lifestyle throughout the study. The evaluation tools used in this research included the Visual Analogue Scale, Neck Flexor Endurance Test, Neck Extensor Muscle Endurance Test, and Scapular Muscle Endurance Test.

Results

The experimental group obtained significant improvements in the measurements taken using the Visual Analogue Scale (p < 0.001, d = 4.2), the Neck Flexor Endurance Test (p < 0.001, d = 3.4), the Neck Extensor Endurance Test (p < 0.001, d = 6.3), in the Scapular Muscle Endurance Test (p = 0.016, d = 0.9).

Conclusions

The assessed exercise therapy program utilizing elastic bands demonstrated favorable outcomes in managing non-specific neck discomfort. This intervention resulted in pain reduction and enhanced endurance of the cervical flexor and extensor muscles, along with improved endurance of the scapular stabilizing muscles.Protocol registration in ClinicalTrials.gov: NCT05433649 (registered prospectively, date of registration: June 27, 2022).

What do I do to avoid sexually transmitted diseases? A scale development study: behavioral scale for protection from sexually transmitted diseases

The authors' aim is to develop and confirm a reliable and valid measurement tool that can measure women's behavior to prevent sexually transmitted diseases. The study data were collected from adult women aged 18-47 years (n = 505). Explanatory factor analysis (EFA) was applied to the STD scale consisting of 44 items in a 5-point Likert style. According to the results of EFA, 21 items were defined in the scale. The KMO value of the scale is 90.6%. In the study, the varimax rotation method was used to bring the factors together with the related items. As a result of varimax rotation, two factors with eigenvalues greater than 1 were found in the scale. The overall Cronbach's alpha coefficient of the scale was calculated as 0.911, 0.941 for the first subdimension and 0.889 for the second subdimension. The validity and reliability of this study have been proven according to the results of explanatory factor analysis (EFA) and confirmatory factor analysis (CFA).

Protection of gender health and fight against gender violence during the COVID-19 pandemic: the experience of our street clinic in a disadvantaged suburb of Rome Metropolitan City

OBJECT

In this study, we evaluated health, social inequalities and risk to gender violence of women living in a disadvantaged degraded suburb of Rome Metropolitan City, during COVID-19 pandemic.

METHODS

The study included 779 women referring to primary care services of Medicina Solidale Institute for gynecological/breast examinations (209), medical and support aid for the children (383) and COVID-19 test execution (187).

RESULTS

The data show that most women (68%) were unemployed or had an irregular job. The request of support varied depending on the ethnicity: while healthcare support was requested mostly by African female community, the COVID-19 test, mandatory for public transportation and work, was a need of the east-european community. Both these communities referred to Medical Solidale primary care service for the healthcare and food/clothing support for their children. It is interesting to note that the requests from the Italian women community was elevated in terms of personal healthcare, support for the children and COVID-19 test execution. The access to the national health system (NHS) resulted a complex administrative procedure despite the original social-ethnic communities. The vast majority of women lacked awareness of their crucial role for supporting the family entity, while inadequacy was commonly reported.

CONCLUSIONS

This study confirms a critical condition for women living in disadvantaged neighborhoods, whose vulnerability is further worsened by the limited access to primary care assistance with serious consequences for health and quality of life. Prevention and treatment, especially for the most vulnerable subjects, should be a priority for the public health system.

Examining health literacy and self-efficacy levels and their association with preventive behaviors of urinary tract infection in Iranian pregnant women: across sectional study

OBJECTIVE

Urinary tract infection (UTI) is assumed to be associated with the risk of fetal and maternal mortality and morbidity during pregnancy. The potential effect of health literacy and self-efficacy on UTI preventive behaviors among pregnant women has not yet been fully studied. Our objectives were to determine the level of health literacy, self-efficacy, and UTI prevention behaviors in pregnant women, and whether health literacy and self-efficacy are associated with UTI prevention behaviors in pregnant women.

DESIGN

A cross-sectional study was conducted, from November 2020 to December 2020, through a multi-stage sampling design on 235 pregnant women aged between 18 and 42 years in Mashhad, Iran. Data were collected through valid and reliable questionnaires including the Test of Functional Health Literacy in Adults (TOFHLA), General Self-Efficacy Questionnaire (GSE), and research made-preventive behaviors recommendations for UTI disease.

RESULTS

The level of UTI prevention behaviors scores is moderate (71.39 ± 8.58) among women during their pregnancy. Insufficient health literacy and self-efficacy were observed in 53.6% and 59.3% of participants, respectively. The regression model highlighted that 21.20% of the total variance of UTI preventive behaviors was predicted by sociodemographic characteristics, while 40.81% of the variance of UTI preventive behaviors was predicted by health literacy and self-efficacy.

CONCLUSION

It has been observed that health literacy and self-efficacy are main determinants to improve UTI preventive behaviors. Focusing on an intervention based on health literacy skills may be a practical strategy to promote a healthy lifestyle in this population.

Association between bacterial vaginosis and 25-Hydroxy vitamin D: a case-control study

INTRODUCTION

Bacterial vaginosis (BV) is the most common vaginal dysbiosis among women of reproductive age. Micronutrient deficiencies, including vitamin D deficiency, can increase the risk of BV. The findings of previous studies regarding the relationship between vitamin D deficiency and BV were conflicting. Therefore, this study aimed to evaluate the association between BV and serum level of 25-hydroxy vitamin D.

MATERIALS AND METHODS

This case-control study was conducted in Gonabad County in 2021. One hundred and twenty-five confirmed BV cases and 125 controls who were matched based on age and intercourse frequency (maximum difference of two days per week) enrolled in the study. Data collection was performed using a demographic and reproductive data questionnaire and a checklist for recording Whiff test results, serum 25-hydroxy vitamin D level, litmus paper observation, and microscopic findings (clue cells). Serum level of vitamin D was evaluated based on enzyme-linked immunoassay method (Monobind kit) from 0.5 ml venous blood drawn from each participant. The conditional logistic regression model was used to analyze data.

RESULTS

The BV cases had significantly lower 25-hydroxy vitamin D serum levels than controls. The odds of BV increased with vitamin D deficiency (Adjusted odds ratio (AOR): 4.34, 95% confidence interval (CI): 1.39-13.4, p = 0.011, FDR q-value = 0.051), vitamin D insufficiency (AOR: 3.65, 95% CI: 1.23-10.85; p = 0.020; FDR q-value = 0.053), cigarette/hookah smoking (AOR: 3.65, 95% CI: 1.23, 10.85; p = 0.020; FDR q-value = 0.053) and lower age at first intercourse (AOR: 1.16, 95% CI: 1.05, 1.28; p = 0.004; FDR q-value = 0.048). The odds of BV was 0.80 and 0.78 times lower in participants who had coitus interruptus (AOR: 0.20, 95% CI: 0.06, 0.63; p = 0.006; FDR q-value = 0.048) and condom use (AOR: 0.28, 95% CI: 0.10, 0.79; p = 0.016; FDR q-value = 0.051), respectively, compared to participants who did not use contraceptives.

CONCLUSION

These findings suggested that lower serum vitamin D levels were associated with an increased risk of developing BV. However, further studies are needed to confirm the results of the present study.

Increased body fat, physical inactivity, and hypertension are associated with poor quality of life in patients with type 2 diabetes

BACKGROUND

Diabetes is a significant health problem that affects quality of life in the medium and long term.

OBJECTIVE

To identify the association between quality of life with comorbidity, metabolic control, and lifestyle in patients with type 2 diabetes.

METHOD

A cross-sectional study was performed in 392 patients. Glycosylated hemoglobin, fasting glucose, lipid profile, blood pressure, weight, waist circumference and body composition were measured. Diabetic neuropathy, renal disease, visual health, diet and physical exercise were measured. Health-related quality of life (HRQoL) was measured with the 36-item Short Form survey (SF-36).

RESULTS

The mean age was 54.6 years, 68 % were women, median years of diabetes diagnosis was 7 years. Eighty percent had a good HRQoL (SF-36 ≥ 50). The dimension with the highest score was physical function (81.0), and vitality the lowest (46.5). Body fat was associated with more impairments in the SF-36 dimensions (p < 0.05). Factors associated with worse HRQOL are physical inactivity (odds ratio [OR]: 2.7; 95% confidence interval [95%CI]: 1.10-6.62; p = 0.009), arterial hypertension (OR: 1.78; 95% CI: 1.05-3.02; p = 0.032) and being female (OR: 2.7; 95% CI: 1.45-5.27; p = 0.002).

CONCLUSIONS

Poor quality of life is associated with higher fat percentage, physical inactivity and hypertension in patients with type 2 diabetes.

Prevalence of urinary incontinence and other pelvic floor disorders in women with myotonic dystrophy type 1

Myotonic dystrophy type 1 (DM1) is a neuromuscular disease that can affect the pelvic floor muscles but few studies have investigated pelvic floor disorders, including urinary incontinence. The main purpose of this study was to document the prevalence, characteristics, and impacts of urinary incontinence and other pelvic floor disorders in women with DM1. Associations between pelvic floor disorders and phenotypes, considering age and parity, were explored. Eighty adult women aged 47,1±13,7 years old participated in a cross-sectional study using validated questionnaires, including the International Consultation Incontinence Questionnaire - Urinary Incontinence short form (ICIQ-UI-SF)), the Pelvic Floor Disorder Inventory (PFDI), and the Pelvic Floor Impact Questionnaire short form (PFIQ-SF). The mean score for the ICIQ-UI-SF was 4.3. The mean scores for the subscales of the PFDI were 36.8 for the urinary distress inventory, 74.1 for the colorectal-anal distress inventory, and 43.8 for the pelvic organ prolapse distress inventory. A total of 60% of women reported urinary incontinence and 56.3% anal incontinence. Pelvic prolapse symptoms (>1 symptom) were reported by 25% of women. Findings reveal high prevalence and significant related impacts of these disorders. This provides evidence regarding the importance of screening for these disorders in a clinical setting and the need to explore treatment approaches.

Knowledge of HIV/AIDS among married women in Bangladesh: analysis of three consecutive multiple indicator cluster surveys (MICS)

Married women have a higher risk of contracting human immunodeficiency virus (HIV) or develop acquired immune deficiency syndrome (AIDS) than men. Knowledge of HIV/AIDS contributes significantly to describing the prevalence and consequences of such virus/disease. The study aimed to investigate the level of HIV/AIDS knowledge and the socio-demographic variables that influence HIV/AIDS knowledge among married women in Bangladesh. We used three waves of Multiple Indicator Cluster Survey (MICS), which included 33,843, 20,727, and 29,724 married women from 2006, 2012, and 2019 MICS. A score was prepared through their interrogation to determine the level of knowledge and logistic regression models were used for analyzing the data. This study found that the prevalence of knowledge level of HIV/AIDS in different questions increased from 55.20% in 2006 to 58.69% in 2019. In our study, respondents having highest education had 4.03 (95% CI 3.50-4.64) times more chance to obtain "High Score" in 2019 MICS which is 5.30 times in 2012 MICS (95% CI 4.41-6.37) and 2.58 times in 2006 MICS (95% CI 2.28-2.93) compared to illiterate married women. Moreover, respondents from urban area were 1.13 times more likely to obtain "High Score" in 2019 MICS which is 1.14 times in 2012 MICS and 1.16 times in 2006 MICS, respectively than the rural married women. This study also found respondent's age, division, mass media access, and wealth status have played an important role in HIV/AIDS knowledge. Although a significant proportion of women had adequate knowledge of HIV/AIDS, more knowledge is still required to protect against such viruses/diseases. Thus, we advocate for the implementation of educational program in the curriculum, counselling, particularly in rural areas, and mass media access to ensure quality knowledge throughout the country.

Impact of anti-oestrogen therapy on lipoprotein(a) in postmenopausal women: a systematic review and meta-analysis of double-blind placebo-controlled clinical studies

PURPOSE

The potential mechanisms of endocrine therapy for thrombosis remain currently unclear, and more studies are warranted for further investigation and elucidation. However, high plasma concentration of lipoprotein(a) (Lp(a)) is a recognized prothrombotic factor. The aim of our study was to systematically evaluate the effect of different anti-oestrogen therapy on plasma Lp(a) level in postmenopausal women.

METHODS

A systematic literature search was conducted in multiple electronic databases to identify the randomized, double-blind, placebo-controlled clinical studies on this topic. Effect size for changes in Lp(a) was expressed as mean difference (MD) and 95% confidence intervals (CI).

RESULTS

Data were pooled from 10 clinical trials comprising 24 treatment arms, which included 2049 women (1128 women in the active-treated arms and 921 women in the control arms). Meta-analysis of data suggested that anti-oestrogen therapy in women significantly reduced Lp(a) [MD = -5.92% (95%CI: -9.05%,-2.8%)].

CONCLUSIONS

This observation is of both clinical and pathophysiological relevance, also in view that the identification of molecular determinants and cellular pathways implicated in Lp(a) synthesis and metabolism is still of concern as a critical issue in lipidology and CV prevention.

Health gender gap in Uganda: do weather effects and water play a role?

BACKGROUND

Vulnerabilities of men and women to adverse health effects due to weather variability and climate change are not equal. Uganda was among the countries in the world most affected by extreme weather events during the last decade. However, there is still limited gendered empirical evidence on the links between weather variability and health and the possible pathways through which these health effects occur. Therefore, this study analyses the effect of weather variability on illness, and the extent to which water collection 'time burden' mediates the relationship between weather anomalies and illness among men and women of working age in Uganda. The study also quantifies the health inequalities to be eliminated if resources are equalized.

METHODS

Socioeconomic, health and time use data were obtained from the World Bank Living Standards Measurement Studies - Integrated Surveys on Agriculture (LSMS -ISA), combined with high resolution remotely-sensed weather data. Two-parts and non-linear decomposition regression analysis were used on the national representative pooled dataset from the four household survey waves collected between 2009 to 2014, comprising a total of 22,469 men and women aged between 15 and 64 years.

RESULTS

Empirical results show that low rainfall below the long-term mean increased the likelihood of illness by at least 8 and 6 percentage points for women and men, respectively. The indirect effect of low rainfall on illness through water access pathway was estimated at 0.16 percentage points in women. Decomposition results reveal that health inequalities among women and men would have been narrowed by 27-61%, if endowments were equalized.

CONCLUSIONS

Strategies that promote women empowerment (such as education, labor force participation, access to financial services and clean water), health adaptation and time poverty reduction strategies (such as rain water harvesting and improved access to quality health care) would reduce gender-based health inequalities in Uganda despite changing climatic conditions.

Impacts of food consumption on biochemical markers and anthropometric variables of women with metabolic syndrome

BACKGROUND

Metabolic syndrome (MetS) is a group of diseases characterized by insulin resistance. MetS has high prevalence among women, which is impacted by food intake. MetS is related to high level of inflammation; however, the impacts of whole diets on biochemical and anthropometrical markers and the effects on MetS need to be further elucidated. In this case, the objective of this study was to assess the relationship between food intake, biochemical and anthropometrical markers in women with MetS.

METHODS

This is a cross-sectional study, in which 1 hundred and 22 women participated in the assessment of biochemical (glycated hemoglobin, glycaemia, insulin, uric acid, total cholesterol, HDL-c, LDL-c, triglycerides, C-reactive protein) and anthropometrical (body mass, height, waist circumference - WC) variables. Participants also performed blood pressure and 24-hour dietary recall assessments. Out of the 122 participants, 44 (36%, age: 59 ± 11 years) had MetS and were included in the analysis.

RESULTS

The consumption of monounsaturated fats had direct relationship with glycaemia (b = 7.48), whereas the consumption of fibers had inverse relationship with body mass (b = - 0.71) and WC (b = - 0.56).

CONCLUSION

The intake of monounsaturated fats and fiber was related to higher blood sugar levels and lower body mass and WC, respectively. These relationships elucidate and highlight the significance and importance of adequate diet in women with MetS.

Prevalence of sarcopenia was higher in women than in men: a cross-sectional study from a rural area in eastern China

Background

There were limited studies specifically evaluating whether the difference of the prevalence of sarcopenia exists in men and women in older adults from rural areas in China. The aim of this study was to compare the prevalence of sarcopenia between men and women in a rural area in eastern China and to explore the underlying causes.

Methods

This study included 1,105 participants aged 60-89 years. Muscle mass was measured by bio-electrical impedance analysis. Hand grip strength was measured by Jamar Hydraulic Hand Dynamometer. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia-2019 Consensus. Data were analyzed using log-binomial and linear regression.

Results

The prevalence of sarcopenia was 21.7% in women and 12.9% in men among the study cohort. After adjusting for age, education level, number of diseases, income level, smoking, drinking, and eating habits, proportion of people with sarcopenia was 1.49-fold greater in women than in men (PR = 1.49, 95% CI [1.01-2.26], P = 0.055).

Conclusions

The prevalence of sarcopenia in elderly women in this rural area of eastern China is higher than in men, suggesting that women in rural areas in China seem to be more vulnerable for sarcopenia, thus early screening and prevention need to be provided for them to address such gender disparity in health.

Assessing the cooking oil fume exposure impacts on Chinese women health: an influential mechanism analysis

Oil fume is always considered as a major source of indoor air pollution. This article aims to examine the effects of cooking oil fume as environmental pollution on the health of Chinese women by using the data obtained from China Labor force Dynamic Survey (CLDS). In order to estimate the effect of environmental pollution on the human health, we utilize probit model approach and baseline regression method. The results showed that oil fume has a significant negative impact on the health indicators of "physical pain, health impact on work and injury." By conducting endogeneity analysis, our results show the robustness and indicate that oil fume has a robust effect on the women health. Heterogeneity analysis show that heavier oil fume has a negative impact on the subjective health of middle-aged and young women, while it has  a significant negative impact on the objective health of middle-aged women. Analysis of the impact mechanism reveal that heavier oil fumes will reduce women's sleep quality and will lead to the poorer health. Based on our study findings, this study proposes policy recommendations from the perspectives of the use of smoke extraction equipment, cooking methods, and sleep quality to reduce the negative impact of cooking fumes on women's health.

Biomarkers and Disease Trajectories Influencing Women's Health: Results from the UK Biobank Cohort

Women's health is important for society. Despite the known biological and sex-related factors influencing the risk of diseases among women, the network of the full spectrum of diseases in women is underexplored. This study aimed to systematically examine the women-specific temporal pattern (trajectory) of the disease network, including the role of baseline physical examination indexes, and blood and urine biomarkers. In the UK Biobank study, 502,650 participants entered the cohort from 2006 to 2010, and were followed up until 2019 to identify disease incidence via linkage to the patient registers. For those diseases with increased risk among women, conditional logistic regression models were used to estimate odds ratios (ORs), and the binomial test of direction was further used to build disease trajectories. Among 301 diseases, 82 diseases in women had ORs > 1.2 and p < 0.00017 when compared to men, involving mainly diseases in the endocrine, skeletal and digestive systems. Diseases with the highest ORs included breast diseases, osteoporosis, hyperthyroidism, and deformity of the toes. The biomarker and disease trajectories suggested estradiol as a risk predictor for breast cancer, while a high percentage of reticulocyte, body mass index and waist circumference were associated with an increased risk of upper-limb neuropathy. In addition, the risk of cholelithiasis was increased in women diagnosed with dyspepsia and diaphragmatic hernia. In conclusion, women are at an increased risk of endocrine, skeletal and digestive diseases. The biomarker and disease trajectories in women suggested key pathways to a range of adverse outcomes downstream, which may shed light on promising targets for early detection and prevention of these diseases.

Supplementary Information

The online version contains supplementary material available at 10.1007/s43657-022-00054-1.

The role of adipose tissue analysis on Environmental Pollutants Biomonitoring in women: The European scenario

Humans are exposed every day to assorted environmental pollutants namely, polychlorinated biphenyls (PCB), organochlorine pesticides (OCP), brominated flame-retardants (BFR), polycyclic aromatic hydrocarbons (PAH), synthetic musks, heavy metals (e.g. cadmium) and plastic additives (e.g. bisphenol A, BPA). Besides environmental persistence, biomagnification and bioaccumulative properties, these pollutants are classified as endocrine disruptors (EDs), metabolic disruptors, neurologic disruptors. These compounds affect the normal function of several mechanisms in the human body being linked to human health issues as cancer development (e.g. breast, uterine and endometrial), miscarriage, birth defects, premature delivery and infertility. In order to prevent future health issue of women and possible progeny, the assessment of EDs accumulated is essential, particularly in adipose tissue. These samples have been referred as the ideal matrix to establish over time accumulation and long-term exposure of persistent and non-persistent lipophilic EDs. However, the invasive sample collection procedure and methodology processing discourages the usage of this matrix for biomonitoring studies. In this review, a Web of Science search without any publishing year restriction on the analysis in adipose tissue of PCB, OCP, BPA, cadmium, BFR and synthetic musks was performed. A total of 313 studies were found, 158 were European studies from which the studies with data on women EDs accumulation were selected for detailed analysis (n = 90). The results were structured and presented in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The present paper is an overview on the existent EDs analytical methods and levels accumulated in women adipose tissue, with the correspondent health implications across Europe. The limits of detection and quantification were compared and a discussion with results obtained about the presence of ED was performed.

Insights on Surya namaskar from its origin to application towards health

Suryanamaskar is considered a part of modern-day yogic practices though it was neither considered an asana nor a part of traditional Yoga. Practicing Suryanamaskar before beginning routine activities vitalizes the practitioner and gives a completely energized day. Starting from the Raja of Aundh who first introduced surya namaskar, there is a line of eminent people who popularized this dynamic group of asanas including T Krishnamacharya, Swami Sivananda, Swami Satyananda from Bihar school of Yoga, so on and so forth. Their contributions resulted in this excellent series of Asanas being introduced to the practitioners. Such a miraculous group of postures also involves dynamic breathing patterns at each posture and gives a form of complete practice involving asanas and pranayama. There are a total of 12 postures in Suryanamaskar practice and 24 steps in one round. This is in the form of salutation to the "Sun" along with chanting the twelve names of the sun god. In this review, we accentuate the importance of Suryanamaskar highlighting its effects on physical, psychological and physiological aspects of the body based on published research. In addition, the usefulness of surya namaskar as one complete sadhana for the whole body is emphasized.

Trends and correlates of intimate partner violence experienced by ever-married women of India: results from National Family Health Survey round III and IV

BACKGROUND

The study aims to estimate the prevalence of Intimate partner violence (IPV) in India, and changes observed over a decade as per the nationally representative datasets from National Family Health Surveys (NFHS) Round 3 and 4. We also highlight various socio-demographic characteristics associated with different types of IPV in India. The NFHS round 3 and 4 interviewed 124,385, and 699,686 women respondents aged 15-49 years using a multi-stage sampling method across 29 states and 2 union territories in India. For IPV, we only included ever-married women (64,607, and 62,716) from the two rounds. Primary outcomes of the study was prevalence of the  ever-experience of different types of IPV: physical, emotional, and sexual violence by ever-married women aged 15 to 49 years. The secondary outcome included predictors of different forms of IPV, and changes in the prevalence of different types of IPV compared to the previous round of the NFHS survey.

RESULTS

As per NFHS-4, weighted prevalence of physical, sexual, emotional, or any kind of IPV ever-experienced by women were 29.2%, 6.7%, 13.2%, and 32.8%. These subtypes of IPV depicted a relative change of - 14.9%, - 30.2%, - 11.0%, - 15.7% compared to round 3. Significant state-wise variations were observed in the prevalence. Multivariate  binary logistic regression analysis highlighted women's and partner's education, socio-economic status, women empowerment, urban-rural residence, partner's controlling behaviours as major significant predictors of IPV.

CONCLUSIONS

Our study findings suggest high prevalence of IPV with state-wise variations in the prevalence. Similar factors were responsible for different forms of IPV. Therefore, based on existing evidences, it is recommended to offer adequate screening and counselling services for the couples, especially in health-care settings so that they speak up against IPV, and are offered timely help to prevent long-term physical and mental health consequences.

Menstrual cycle impacts adipokine and lipoprotein responses to acute high-intensity intermittent exercise bout

Due to hormonal fluctuation, the menstrual cycle impacts inflammatory response and lipid metabolism; moreover, the anti-atherogenic and anti-inflammatory effects of exercise in this cycle, mainly high-intensity intermittent exercise (HIIE), need to be examined. Therefore, the aim of the current study was to investigate the influence of menstrual cycle phases on adipokine and lipoprotein responses after acute HIIE sessions in healthy women. Fourteen women (age: 24 ± 2 years; BMI: 22.79 ± 1.89 kg·m²) were recruited to perform two HIIE sessions (10 × 1 min running at 90% of maximum aerobic velocity, with 1 min recovery); one during the follicular phase (FP) and other during the luteal phase (LP), randomly. Blood samples were collected at rest, immediately, and 60 min after HIIE sessions. Macrophage inflammatory protein-1α (MIP-1α), leptin, adiponectin, total cholesterol, triacylglycerol (TAG), HDL-c, and glucose concentrations were analyzed. At rest, higher MIP-1α concentrations were observed during the LP compared to FP (p = 0.017). Likewise, leptin (p = 0.050), LDL-c (p = 0.015), and non-HDL (p = 0.016) were statistically higher in the LP. In contrast, the adiponectin/leptin ratio was lower in the LP compared to the ratio found in the FP (p = 0.032). Immediately post-HIIE sessions, in both menstrual phases, higher TAG (p = 0.001) and HDL-c (p = 0.001) concentrations were found, which returned to resting levels after 60 min. In conclusion, adipokine and lipoprotein responses after a single HIIE session are regulated by the phase of the menstrual cycle, contributing to inflammatory conditions, and demonstrating the importance of considering the phases of the menstrual cycle for the periodization of physical training.

Factors associated with the utilization of reproductive health services among the Bangladeshi married women: Analysis of national representative MICS 2019 data

OBJECTIVES

We calculated the prevalence of reproductive health services utilization among the currently married non-pregnant women in Bangladesh and investigated its association with demographics and socio-economic factors.

METHODS

Publicly available secondary country representative 2019 Multiple Indicator Cluster Survey (MICS) dataset was analyzed. A two-stage stratified random sampling technique was followed, and all administrative districts (N=64) of Bangladesh were covered in the MICS 2019. Contraceptive use, antenatal care and skilled birth attendant were considered as utilization of reproductive health services and both crude and adjusted Odd Ratio (OR) were reported using a total of 8917 (weighted) data.

RESULTS

In Bangladesh, 36.9% of married non-pregnant women utilized all three reproductive health services. However, at disaggregated level, contraceptive use (66.9%), antenatal care (83%) and skilled birth attendant (59.3%) were found 2-3 folds higher then cumulative prevalence. Increased likelihood of utilization of reproductive health services (either combined or at individual services) was observed among those women who had higher education [AOR= 2.63, 95% CI 1.99 to 3.47], belong to wealthy families [AOR= 2.46, 95% CI 1.94 to 3.12], residing in urban areas [AOR= 1.33, 95% CI 1.14 to 1.54], having a smaller number of children [AOR= 1.53, 95% CI 1.25 to 1.87], and exposure to media [AOR= 1.44, 95% CI 1.26 to 1.63].

CONCLUSION

Around one-third of Bangladeshi married women received combined contraceptive use, antenatal care and skilled birth attendant reproductive health services; however, variation exist at the individual service level. Targeted public health campaign focusing on women education and media advertisement may increase the utilization.

Combination therapy of curcumin and fecal microbiota transplant: Potential treatment of polycystic ovarian syndrome

Polycystic ovarian syndrome (PCOS) is a combination of various symptoms like anovulation, hirsutism, chronic amenorrhea, infertility, obesity and polycystic ovaries. It affects over 7 million women worldwide. The current strategy to treat this disorder is based on the use of drugs that provide symptomatic relief. Most of these, however, exhibit numerous side effects and are not able to ameliorate all the signs and symptoms of PCOS. As dysbiosis is considered as one of the prime underlying causes of PCOS, restoration of eubiosis was considered as a plausible way to treat it. Bacteriotherpeutics like probiotics, synbiotics and even fecal microbiota transplant (FMT) have shown considerable effectiveness in PCOS. Of these baceteriotherapeutic options, FMT is considered to be the most holistic as it encompasses the bacteriome, virome, fungome, archaeome and even parasitome while both probiotics as well as synbiotics mainly comprise bacteria. Repeated FMT, however, is not a pragmatic option because of its inconvenience, lack of standardization, involved risk and scepticism amongst patients and physicians. If the eubiosis ushered by FMT is sustained for a long time, the repeated administrations of FMT can be avoided and maintenance therapy with any agent that can maintain the eubiotic condition can be adopted. Role of curcumin on gut microbiota is widely known. It is largely attributed to the ability of certain microbes to consume polyphenols as substrates and its positive effect on bacterial consumption of nutrients such as sugars. Based on various mechanisms and studies, a new hypothesis is being proposed wherein FMT and curcumin combination is predicted to be an effective and sustained treatment of PCOS with much lower rates of remission.

Assessment of hand function in women with lymphadenopathy after radical mastectomy

Background

Breast cancer related upper limb lymphedema (BCRL) is a common complication in post-mastectomy patients. It is known to cause upper limb disability, which subsequently may affect the grip strength and hand function. There is little evidence on the objective assessment of functional activities particularly hand function in women with BCRL. Therefore, this study objectively assesses the handgrip strength and hand functions in women with BCRL.

Method

A cross-sectional study design was conducted on a sample of women with (n = 31) and without (n = 31) BCRL. The Handgrip strength and hand functions were measured using a dynamometer and Jebsen-Taylor hand function test, respectively.

Results

The results showed a significantly reduced handgrip strength in women with BCRL as compared to age-matched healthy adult women for both right and left hands (p < 0.05). Similarly, hand functions were significantly impaired in women with BCRL as compared to healthy adult women (p < 0.05). Reduction in handgrip strength and hand function in women with BCRL were clinically meaningful as indicated by moderate to large effect sizes (Cohen’s d = 0.61 to 0.99 and 0.54 to 3.02, respectively) in all outcomes except power handgrip strength in left hand (Cohen’s d = 0.38).

Conclusion

The results of this study indicate a significant reduction of hand grip strength and hand function in women with BCRL. Our findings suggest that objective measures of grip strength and function be included in the assessment of women with BCRL to better guide clinical decision making and patient care, which may include management of impairment associated with hand strength and function. Future studies that evaluate hand grip strength and function in a larger sample which includes a more diverse age group of women with BCRL are warranted to confirm the current findings.

Gender-based disparities on health indices during COVID-19 crisis: a nationwide cross-sectional study in Jordan

Background

COVID-19 has an inevitable burden on public health, potentially widening the gender gap in healthcare and the economy. We aimed to assess gender-based desparities during COVID-19 in Jordan in terms of health indices, mental well-being and economic burden.

Methods

A nationally representative sample of 1300 participants ≥18 years living in Jordan were selected using stratified random sampling. Data were collected via telephone interviews in this cross-sectional study. Chi-square was used to test age and gender differences according to demographics, economic burden, and health indices (access to healthcare, health insurance, antenatal and reproductive services). A multivariable logistic regression analysis was used to estimate the beta-coefficient (β) and 95% confidence interval (CI) of factors correlated with mental well-being, assessed by patients’ health questionnaire 4 (PHQ-4).

Results

656 (50.5%) men and 644 (49.5%) women completed the interview. Three-fourths of the participants had health insurance during the COVID-19 crisis. There was no significant difference in healthcare coverage or access between women and men (p > 0.05). Half of pregnant women were unable to access antenatal care. Gender was a significant predictor of higher PHQ-4 scores (women vs. men: β: 0.88, 95% CI: 0.54–1.22). Among women, age ≥ 60 years and being married were associated with significantly lower PHQ-4 scores. Only 0.38% of the overall participants lost their jobs; however, 8.3% reported a reduced payment. More women (13.89%) were not paid during the crisis as compared with men (6.92%) (P = 0.01).

Conclusions

Our results showed no gender differences in healthcare coverage or access during the COVID-19 crisis generally. Women in Jordan are experiencing worse outcomes in terms of mental well-being and economic burden. Policymakers should give priority to women’s mental health and antenatal and reproductive services. Financial security should be addressed in all Jordanian COVID-19 national plans because the crisis appears widening the gender gap in the economy.

Investigating natural antibiofilm components: a new therapeutic perspective against candidal vulvovaginitis

The rampant emergence of Candida albicans in the vagina and its ability to thrive as a biofilm has outstood the prevalence of candidal vulvovaginitis (CVV), a gender-based fungal infection approximately affecting 75% of the global female population. The biofilm represents a multidimensional microbial population, which often dictates prominent caveats of CVV such as increased fungal virulence, drug resistance and infection relapse/recurrence. Additionally, the conjugated issues of the ineffectiveness of conventional antifungals (azoles), prolonged treatment durations, compromised patient compliance, economic and social burden, exacerbates CVV complications as well. Henceforth, the current hypothesis narrates an investigational proposal for exploration and combination of naturally derived antibiofilm components with luliconazole (imidazole antifungal agent) as a new therapeutic paradigm against CVV. The purported hypothesis unravels a synergistic approach for fabricating Nanostructured Lipid Carriers, NLCs loaded transvaginal gel with dual APIs of natural (antibiofilm) as well as the synthetic (antifungal) origin to target high therapeutic efficacy, delivery, retention, controlled release and bioadhesion in a vaginal milieu. The multipronged effect of antibiofilm and antifungal agents will expectably enhance drug susceptibility thus, maintaining Minimum Inhibitory Concentration (MIC) against cells of C. albicans and targeting its biofilm in planktonic, adherent, and sessile phases. The effective disruption of a biofilm could further lower infection resistance and recurrence as well. In conclusion, the purported hypothesis could speed up the emergence of novel drug combinations and accelerates new product development with solid, synergistic, and complementary activities against C. albicans and its biofilm, making it amenable for generating pre-clinical and clinical results therebycreating a suitableroadmap for commercialization.

The anxious aspects of insecure attachment styles are associated with depression either in pregnancy or in the postpartum period

BACKGROUND

Perinatal depression (PND) is a major complication of pregnancy and many risk factors have been associated with its development both during pregnancy and postpartum. The transition to motherhood activates the attachment system. The aim of our study was to investigate the relationship between women's attachment style (AS) and PND in pregnancy, and 1 month after childbirth, in a large cohort of women. We hypothesized that different patterns of AS were associated with either antenatal or postnatal depression. We, further, explored the role of other possible risk factors such as life-stress events.

METHODS

A final sample of 572 women was enrolled. At the third trimester of pregnancy, clinical data sheet and self-report questionnaires (ASQ, PSS, LTE-Q, and EPDS) were administered. One month after delivery, EPDS was administered by telephone interview.

RESULTS

We found 10.1% of the women with depression during pregnancy and 11.1% in the postpartum period. The first logistic regression showed that ASQ-CONF subscale (OR = 0.876, p < 0.0001), ASQ-NFA subscale (OR = 1.097, p = 0.002), foreign nationality (OR = 2.29, p = 0.040), low education levels (OR = 0.185, p = 0.012), PSS total score (OR = 1.376, p = 0.010), and recent life adversities (OR = 3.250, p = 0.012) were related to EPDS ≥ 14 during pregnancy.The second logistic regression showed that ASQ-PRE subscale (OR = 1.077, p < 0.001) and foreign nationality (OR = 2.88, p = 0.010) were related to EPDS ≥ 12 in the postpartum period.

CONCLUSIONS

Different dimensions of anxious insecure AS were, respectively, associated with either antenatal or postnatal depression. These findings support the literature investigating subtypes of perinatal depression. The PND may be heterogeneous in nature, and the comprehension of psychopathological trajectories may improve screening, prevention, and treatment of a disorder which has a long-lasting disabling impact on the mental health of mother and child. We provided a rationale for targeting an attachment-based intervention in this group of women.

Burden of hepatitis E virus infection in pregnancy and maternofoetal outcomes: a systematic review and meta-analysis

Background

There is still a dearth of knowledge on the burden of HEV infection in the global population of pregnant women. Therefore, we conducted a systematic review and meta-analysis to estimate the global burden of HEV infection in pregnancy.

Methods

We searched PubMed, Embase, Web of Knowledge, and Global Index Medicus to identify articles published until January 26, 2020. We considered cross-sectional, case-control, and cohort studies reporting the immunoglobulins M HEV seroprevalence in asymptomatic and symptomatic (jaundice or elevated transaminases) pregnant women or investigating the association between HEV infection and maternofoetal outcomes. We used a random-effects model to pool studies. This review was registered with PROSPERO, CRD42018093820.

Results

For HEV prevalence estimates, we included 52 studies (11,663 pregnant women). The seroprevalence was 3.5% (95% confidence interval: 1.4–6.4) in asymptomatic women (most of whom from high endemic areas). The prevalence in symptomatic women was 49.6% (42.6–56.7) with data only from HEV high endemic countries. In the multivariable meta-regression model, the prevalence was higher in symptomatic women compared to asymptomatic (adjusted prevalence odds ratio [aPOR]: 1.76; 95%CI: 1.61–1.91) and decreased with increasing year of publication (by 10-year) (aPOR: 0.90; 95%CI: 0.84–0.96). The proportion of HEV vertical transmission was 36.9% (13.3–64.2). Risk of bias was low, moderate and high respectively in 12 (23%), 37 (70%), and 4 studies (7%) addressing HEV prevalence estimation. HEV infection was associated with maternal deaths (pooled OR 7.17; 3.32–15.47), low birth weight (OR: 3.23; 1.71–6.10), small for gestational age (OR: 3.63; 1.25–10.49), preterm < 32 weeks (OR: 4.18; 1.23–14.20), and preterm < 37 weeks (OR: 3.45; 2.32–5.13), stillbirth (OR: 2.61; 1.64–4.14), intrauterine deaths (OR: 3.07; 2.13–4.43), and not with miscarriage (OR: 1.74; 0.77–3.90). All studies which assessed the association between HEV infection and maternofoetal outcomes had a moderate risk of bias.

Conclusions

Findings from this study are suggestive of a high burden of HEV infection in pregnancy in high endemic countries, its association with poor maternofoetal outcomes, and a high rate of vertical transmission. This study supports the need for specific strategies to prevent exposure of pregnant women to HEV infection, especially in high endemic areas.

Determinants of household cooking fuels and their impact on women's health in rural Pakistan

Use of biomass with traditional cooking technologies causes indoor air pollution and is responsible for 3.5 million deaths globally. Women play the main role in biomass-based energy systems in developing countries. The current study attempted to estimate determinants of household cooking fuels and impacts of fuels on women's health in rural Pakistan. The results of the study show that 75.5% of the households in the study area use fuelwood, 44.4% use LPG, and 27.9% use crop residues for cooking. Households with LPG spend on average 3.02 h/day for cooking while households with biomass spend almost 4 h. Health expenditures of households using biomass are almost 25% higher than those using LPG. Use of traditional biomass with traditional devices was found to be having negative impacts on rural women's life. Household composition, education, income, access to electricity and LPG, and distance from the market were found to be significant factors affecting the choice of fuels for cooking. Clean energy and technologies and empowerment through education and awareness will help minimize the negative impacts of biomass fuels on women.

Cardiovascular responses to pelvic floor muscle contraction in healthy women: Prospective study

OBJECTIVE

Analyze the acute heart rate and blood pressure responses to two protocols of pelvic floor muscles contractions in premenopausal and postmenopausal women.

METHODS

Fifty-four women without pelvic floor muscles disorders were eligible and allocated into two groups: premenopausal and postmenopausal. The groups underwent two protocols and the pelvic floor muscle endurance, heart rate, and blood pressure values were monitored. Both protocols included 10 pelvic floor muscles contractions; one series contained contractions lasting 5 s with 5 s of rest between each contraction and the other series contained contractions lasting 10 s with 10 s of rest.

RESULTS

In both groups, there was a significant increase in the heart rate during pelvic floor muscles contractions (premenopausal: 71.0 ± 7.3 and 80.3 ± 7.7; postmenopausal: 65.4 ± 6.6 and 73.6 ± 6.6, at rest and contractions peak, respectively) and in systolic blood pressure immediately after the contractions. The observed values during exercise returned to basal values seconds after the contractions. A positive correlation between heart rate and vaginal squeeze pressure (r = 0.45, p = 0.0007 and r = 0.48, p = 0.0003, 5- and 10-s series, respectively) was observed.

CONCLUSION

The proposed protocol of isometric pelvic floor muscles contractions caused an increase in heart rate and blood pressure within the normal range and might not represent a cardiovascular risk for healthy postmenopausal women without urinary incontinence and without cardiovascular dysfunctions.

Factors influencing sexual and reproductive health of Muslim women: a systematic review

BACKGROUND

In Islamic societies, issues related to sexual and reproductive health (SRH) are rarely discussed and considered sensitive subjects. This review aimed to identify any personal, religious, cultural, or structural barriers to SRH service and education among Muslim women worldwide.

METHODS

A search for qualitative and quantitative studies was conducted on seven electronic databases. A narrative synthesis using thematic analysis was conducted.

RESULTS

Fifty-nine studies were included from 22 countries: 19 qualitative, 38 quantitative and two mixed methods. Many Muslim women have poor SRH knowledge, and negative attitudes which influence their access to, and use of SRH services. Barriers to contraception use among Muslim women included a lack of basic reproductive knowledge, insufficient knowledge about contraception, misconceptions, and negative attitudes. Women had negative attitudes towards family planning for limiting the number of children but not for child spacing, which reflected religious views towards family planning. Religious and cultural beliefs were barriers to contraception use and access to SRH services and information. Family and the community have a significant impact on women's contraceptive use and access to SRH services. Husband and family opposition played a significant role in contraception access and use. Fear of stigmatization and being labelled as having pre-marital sexual relations among unmarried women acted as the main barrier to accessing contraception and seeking SRH information and services.

CONCLUSION

The findings reveal that there are multiple levels of factors that influence Muslim women's SRH. Poor SRH knowledge and practices among Muslim women is complex matter that is affected by personal, community, cultural, religious factors and existing policies and regulations. All these factors overlap and are affected by each other. There is an urgent need for interventions addressing modifiable barriers to SRH education and services to improve knowledge, informed choice and access to services to facilitate better sexual and reproductive wellbeing for Muslim women. It is important to note that while this review aimed to report findings on Muslim women, we acknowledge that significant variations exist within every culture and religion.

Personal perception and body awareness of dysmenorrhea and the effects of rhythmical massage therapy and heart rate variability biofeedback-A qualitative study in the context of a randomized controlled trail

OBJECTIVE

The purpose was to involve women's personal experiences of daily life with primary dysmenorrhea (PD) and their body perceptions of the dysmenorrhea-related symptoms in relation to the treatment procedure and to explore the perception of Heart Rate Variability Biofeedback (HRV-BF) or Rhythmical Massage (RM) according to Ita Wegman as a therapeutic intervention within the framework of Anthroposophic Medicine (AM).

DESIGN

From 60 women who participated in our randomized controlled trial analyzing the effects of HRV-BF or RM, we examined 14 women to get an in-depth understanding of this prevalent disease, using a qualitative design. The women drew their body image before and after the 3-month-intervention on body silhouette diagrams and described their body-perceptions. Semi-structured interviews were conducted and analyzed using content analysis.

RESULTS

Women perceive dysmenorrhea as a disturbance of their daily lives. The body images showed the variations of experience, from misbalances of body perception to overwhelming attacks of pain hindering a normal life for several days per month. Perception of therapeutic interventions range from relaxing without effects on complaints to important changes and benefits on the physical, emotional, and/or social level. Both therapies can support stronger self-awareness through enabling a more differentiated sense of body-awareness, sometimes resulting in women experiencing fewer limitations in their daily lives. Effects may be influenced by the readiness to resonate with the therapeutic process. Qualitative interviews and body images can serve as tools to integrate individuality and help to integrate embodied more or less conscious aspects of complaints.

CONCLUSIONS

The body silhouette diagram could be used systematically to include reflections of embodiment in the therapeutic and research settings and help to diagnose in advance the ability of participants to resonate with interventions. RM and HRV-BF influence self-awareness and may enable salutogenic and self-management capacities. For more effective treatment it may be helpful to make treatment suggestions based on an integrative individual history that includes preferences, expectations and a body silhouette diagram.

Gender development and hepatitis B and C infections among pregnant women in Africa: a systematic review and meta-analysis

Background

Although Africa is a region of hyper endemicity to viral hepatitis B (HBV) and C (HCV) infections, there is limited data on their related burden among pregnant women. The present systematic review and meta-analysis aimed to determine the magnitude of these infections among pregnant women living in Africa and investigate its association with gender-related human development indicators.

Main text

We searched PubMed, Embase, Web of Science, Africa Journal Online, and Global Index Medicus, with no language restriction, to identify observational studies on HBV and HCV infections in pregnant women residing in Africa published from January 1, 2000 until December 31, 2017. Eligible studies reported the prevalence of HBV and/or HCV infection(s) (HBs antigen and HCV antibodies) and/or infectivity (HBe antigen or detectable HCV viral load). Each study was independently reviewed for methodological quality. We used a random-effects model meta-analysis to pool studies. In total, 145 studies (258 251 participants, 30 countries) were included, of which 120 (82.8%) had a low, 24 (16.5%) a moderate, and one (0.7%) had a high risk of bias. The prevalence of HBV and HCV infections was 6.8% (95% confidence interval [CI]: 6.1–7.6, 113 studies) and 3.4% (95% CI: 2.6–4.2, 58 studies), respectively. The prevalence of HBe antigen and HCV detectable viral load was 18.9% (95% CI: 14.4–23.9) and 62.3% (95% CI: 51.6–72.5) in HBV positive and HCV positive pregnant women, respectively. The multivariable meta-regression analysis showed that the prevalence of HBV infection increased with decreasing gender development index, males’ level of education and females’ expected years of schooling. Furthermore, this prevalence was higher in rural areas and in western and central Africa. The prevalence of HCV infection increased with decreasing proportion of seats held by women in parliament.

Conclusions

To address the burden of HBV and HCV infections, beyond well-known risk factors at the individual-level, macro-level factors including gender-related human development indicators and dwelling in rural areas should be considered. In Africa, HBV or HCV infected mothers seems to have high potential of transmission to their children.

Electronic supplementary material

The online version of this article (10.1186/s40249-019-0526-8) contains supplementary material, which is available to authorized users.

Impairment of Quality of Life Associated With Lifetime Diagnosis of Post-traumatic Stress Disorder in Women - A National Survey in Italy

Introduction

The aim of the study was to measure the lifetime prevalence of Post-Traumatic Stress Disorder (PTSD) among women of an Italian community sample, the comorbidity of PTSD with mood and anxiety disorders and the burden attributable to PTSD in worsening the Quality of Life (QoL).

Methods

Community survey on a sample of 1961 adult women randomly selected. Tools: psychiatric clinical interview ANTAS partially derived from the SCID-DSM-IV, administered by psychologists or medical doctors; Short Form Health Survey (SF-12); Mood Disorder Questionnaire (MDQ).

Results

Lifetime prevalence of PTSD in women was 1.3%, (1.4% in<45 years aged, 1.3% in >44 years aged; p=0.8). In order of risk of comorbidity, PTSD was associated with: Bipolar Spectrum Disorders (MDQ+), Panic Disorders (PD) and Major Depressive Disorder (MDD). People with PTSD showed an SF-12 mean score lower than women of the same sample without PTSD (standardized by gender and age), with a mean difference (attributable burden) of 3.9±0.9 similarly to MDD and Eating Disorders and higher than PD. Among the analyzed nonpsychiatric diseases, Multiple Sclerosis and Carotid Atherosclerosis showed a higher burden in impairing QoL than PTSD; Wilson's Disease showed a similar burden and Celiac Disease was found less impairing on QoL than PTSD.

Conclusion

The attributable burden in worsening women' perceived QoL due to a lifetime diagnosis of PTSD was found comparable to those caused by MDD, Eating Disorders or by neurological condition such as Wilson's Disease. The comorbidity of PTSD with Bipolar Spectrum Disorders was remarkable, even further studies are needed to clarify the direction of causality.

National Women's Health Plan, Selected Countries Experiences and Necessity of Developing It in Iran: A Narrative Review Article

BACKGROUND

National plans have an important role in defining vision, goals, priorities, and action plans. The present paper examined the international experience in developing upstream documents concerning women's health; it regards the necessity of developing Iranian women's health plan.

METHODS

This review, conducted with search in electronic databases and literature of no limitation in terms of years conducted. The phrases such as "woman health policy", "woman health promotion", "woman health strategy" and "woman health plan" were searched. The criteria based on which the countries were chosen were the degree to which they were developed in health system, health indexes, the accessibility of required information, and the possibility of benchmarking the new methods.

RESULTS

Emphasize on gender as a determinant of health, increasing the economic activities of women, decreasing the violence against women, gender-based researches, and inter-sectorial approach are some common items in the women's health plans in selected countries. The main upstream documents about women health in Iran such as 'Research policies and principles of women issues', "Women Charter of Rights in Iran" were not developed and implemented in form of a comprehensive plan so we need to formulate a full women health national plan that summarizes all previous policies with addition of new needed strategies inclusion.

CONCLUSION

Developing a national plan for Iranian women's health regarding with selected countries experiences makes a long-term vision for health and obtains the institutional and organizational efforts and resources necessary for women health promotion in Iran.

Efficacy of rhythmical massage in comparison to heart rate variability biofeedback in patients with dysmenorrhea-A randomized, controlled trial

BACKGROUND

20-90% of all women suffer from dysmenorrhea. Standard therapy of primary dysmenorrhea (PD) are NSAIDs and oral contraceptives, effective but not without possible side effects.

OBJECTIVE

To examine the efficacy of rhythmical massage (Anthroposophic Medicine) and heart rate variability biofeedback compared to usual care (control group) on pain intensity in women with primary dysmenorrhea.

METHODS

This was a three-arm randomized controlled study. Both interventions (rhythmical massage once a week or HRV biofeedback 15 min daily) were carried out over a period of three months. The third group (control) applied usual care. The primary outcome were between-group differences in mean pain intensity (detected by a Numeric Rating Scale, NRS) during menstruation after three months (post-assessment, t2). Secondary outcomes were the use of analgesics, quality of life (SF-12) and heart rate variability.

RESULTS

The study involved 60 women, mean age 29.7 years, SD 8.0 (n = 23 rhythmical massage, n = 20 biofeedback, n = 17 control). For the primary outcome there was a significant difference between the groups after three months (p = .005). Bonferroni adjusted post-hoc tests revealed a significant difference between rhythmical massage and control group (mean difference: -1.61; 95 CI: -2.77/-0.44; p = .004; ES: -0.80). No significant differences were found between rhythmical massage and biofeedback (mean difference: -0.71; 95 CI: -1.82/ 0.40; p = .361; ES: -0.34) and between biofeedback and control group (mean difference: -0.90; 95 CI: -2.10/-0.30; p = .211; ES: -0.51). For the secondary outcomes no significant differences were found between the groups at t2. The drop-out rate was higher in the biofeedback group (n = 6) than in the massage (n = 2) or the control group (n = 4).

CONCLUSION

Preliminary evidence suggests that rhythmical massage might improve pain intensity after 12 weeks compared to usual care.

[Preeclampsia: A challenge also for cardiologists]

Due to its short-term consequences on perinatal outcome, preeclampsia has been long regarded as an obstetrical disease, strictly confined to a management by OB/GYNs. It has been now widely accepted that preeclampsia is most a systemic inflammatory and systemic vascular disease during pregnancy and then a lifelong risk factor for subsequent cardiovascular event in women's life. The aim of this review is to propose an overview in the current state-of-art in definition, early identification and management of preeclampsia. We will also discuss the growing evidence that support that cardiologists must be fully involved in screening and prevention of preeclampsia during pregnancy and beyond in the subsequent medical follow-up of women who have experienced a preeclampsia.

Limited Understanding of Pap Smear Testing among Women, a Barrier to Cervical Cancer Screening in the United Arab Emirates

Global data indicate that cervical cancer is the fourth most common cancer among women worldwide. Important factors that affect interventions for early diagnosis of cervical cancer include social beliefs and values and poor knowledge. These may contribute to women’s participation in screening for cervical cancer and have a significant impact on decisions to take preventive action. The present study was conducted with 599 women in the UAE between September 2016 and March 2017. A cross-sectional survey was conducted to determine knowledge about cervical cancer and screening, demographic characteristics and perceived barriers. Knowledge about the Pap smear test was limited, and awareness that they should undergo the Pap smear test every three years even with an initial negative/normal Pap smear result was abysmal. In spite of the positive attitude of the women towards the Pap smear test, almost 80% of the women surveyed had no knowledge of precancerous lesions. Having higher income (21/29, 72%, p=0.027) and more miscarriages were associated with better practice of Pap smears (19/26, 73%, p=0.010). Knowledge levels were significantly higher (66.3±22.2,) that values for attitude (60.5±20.9, p= 0.03, 95% CI {0.22-11.3}, Chi-square 4.38) and practice (53.7 24.1, p= 0.001, 95% CI {6.9-18.1}, Chi-square 19.7). A well-designed health education programme on cervical cancer and benefits of screening should increase the awareness among women in UAE. One point to stress is that better communication with health professionals and improvement of access to health care services should increase the rate of cervical cancer screening.

Trends and determinants of HIV/AIDS knowledge among women in Bangladesh

BACKGROUND

Globally, women share an indiscriminate burden of the HIV epidemic and the associated socioeconomic consequences. Previous studies have demonstrated a positive correlation between levels of HIV knowledge with its prevalence. However, for Bangladesh such evidence is non-existent. In this study, we aimed to explore the extent of HIV knowledge in relation to the socio-demographic variables such as age, region, area of residence i.e., urban or rural, wealth index and education, and investigate the factors influencing the level of HIV knowledge among Bangladeshi women.

METHODS

We used data from the Bangladesh Demographic and Health Survey (BDHS) survey conducted in 2011. In total 12,512 women ageing between 15 and 49 ever hearing about HIV regardless of HIV status were selected for this study. HIV knowledge level was estimated by analyzing respondents' answers to a set of 11 basic questions indicative of general awareness and mode of transmission. Descriptive statistics, cross-tabulation and multinominal logistic regression were performed for data analysis.

RESULTS

Little over half the respondents had good knowledge regarding HIV transmission risks. The mean HIV knowledge score was -0.001 (SD 0.914). Average correct response rate about mode of transmission was higher than for general awareness. Educational level of women and sex of household head were found to be significantly associated with HIV knowledge in the high score group. Those with no education, primary education or secondary education were less likely to be in the high score group for HIV knowledge when compared with those with higher than secondary level of education. Similarly those with male as household head were less likely to be in the higher score group for HIV knowledge.

CONCLUSIONS

Level of HIV knowledge among Bangladeshi women is quite low, and the limiting factors are rooted in various demographic and household characteristics. Education and sex of the household head have been found to be significantly correlated with the level of HIV knowledge and propound sound grounds for their incorporation in the future HIV prevention strategies. Education of women may also have wider ramifications allowing reduction in gender inequality, which in turn favors higher knowledge about HIV.

The Fallopian Dilemma: African Bodies, Citizenship and Family Planning

In the recent context of the European Union governmental activity-in particular in this time of crisis-immigration-related issues became of pivotal importance. Social healthcare programmes targeting deprived immigrant populations equate reducing social problems with guiding their conduct towards more responsible, healthier habits and life projects. Building upon a set of debates on governing the body and health under advanced liberalism, this paper, focusing on the Portuguese context and on family planning, suggests ideas towards a new research agenda on immigration and public health, claiming that social care interventions are inherently racialized. The insecurities, threats and overall concerns in a time of global crisis create a state of exception, which justifies the deployment of illiberal practices in order to secure collective well-being. In particular, I am interested in how the dominant discourses of the health and social care sectors influence [1] the ways in which "the right thing to do" is constructed and debated and the material effects of these decisions on immigrants lives; [2] the ongoing strategies, micronegotiations of power and truth between different actors; [3] the fading borders of the subject of medical knowledge, which becomes no longer to govern the body merely according to a medical logic, but rather to seek social well-being.

Gender gap in self-rated health in South Korea compared with the United States

Addressing the gender gap issue is a key to the reduction of the health gap between and within nations. This study aimed to describe gender differences in SRH of populations in South Korea and the United States (U.S.). Data on 33,240 eligible participants from the KNHNES and 39,646 participants from the NHNES was included in the study. Multiple logistic regression analysis was performed to identify gender differences in SRH. SRH was rated as poor in 18.8% and 16.3% of the participants in South Korea and in the U.S. The results of this study indicated that South Korean women had a higher risk of poor SRH, differed from women in the U.S. The 20-39 age group had a higher risk for poor SRH in both South Korea and the U.S. It suggested that South Korea's traditional gender roles negatively affect women. Thus, the welfare of South Korean should be improved to reduce these between-country health gaps by applying health-related laws to differentiation of beneficiaries' gender and age group.

Iranian pregnant teenage women tell the story of "fast development": A phenomenological study

BACKGROUND

Teenage pregnancy is a major health problem significantly associated with negative impacts on the health of both teenage mothers and their newborn. However, little is known about teenage pregnancy from teenager's perspective, particularly in developing countries including Iran.

AIM

This study aimed to explore the experience of pregnancy in Iranian teenage women.

METHODS

An interpretive phenomenological study was used as a suitable research design to conduct this research. Data were collected through individual, semi structured and in-depth interview with 11 married teenage women aged between 15 and 19 years old, primigravida with singleton pregnancy. Data were analysed through thematic analysis approach.

FINDINGS

"Fast development" was the main theme that emerged from the participants' experiences. It refers to the unexpected development process that occurs simultaneously with other important development events. Fast development consists of three themes, 'unexpected development', 'development within development', and 'struggle with development'.

CONCLUSION

Teenage pregnant women simultaneously encounter multiple developmental challenges related to adolescence period, marriage, pregnancy, and mothering responsibilities. According to the results, fast development concept should be considered by healthcare providers in order to offer comprehensive and age-appropriate health services to pregnant teenage women for successful transition from the multiple developmental stages. Moreover, this concept will help health care providers, especially midwives, to understand how to deal with pregnant teenagers.

A Study Evaluating Adherence and Compliance of Anti-rheumatic Drugs in Women Suffering from Rheumatoid Arthritis

BACKGROUND

Treatment of Rheumatoid arthritis (RA) has always remained challenging, complex and associated with high level of non adherence, noncompliance in clinical practice.

AIM

To evaluate the satisfaction/adherence/compliance rates of most commonly prescribed anti-rheumatic drugs among Indian women.

MATERIALS AND METHODS

A cross-sectional descriptive obser-vational study was undertaken to evaluate the adherence/compliance rates of most commonly prescribed anti-rheumatic drugs among women in a tertiary care teaching hospital in North India. Hundred women on anti rheumatic treatment for rheumatoid arthritis diagnosed by American College of Rheumatology (ACR) criteria were evaluated at one point analysis for adherence/compliance/satisfaction.

RESULTS

Dissatisfaction rate with the anti rheumatic treatment was significantly high p<0.0001 among 68% of the women. Non compliance/ non adherence rate was also recorded very high among 52% and interrupted compliance rate was noticed among 6% of the women suffering from RA. Switch over rate to other treatment or doctors was also significantly (p<0.0001) very high among 66% of the women. Switch over to alternative treatment, treatment under quacks and intermittent self medication was recorded by 12%, 4% & 16% respectively. Among the self medication 12% of the women took corticosteroids and 4% preferred taking intermittent NSAIDs.

CONCLUSION

Treatment compliance is not very good with anti-rheumatic drugs among women patients of RA due to multi-factorial reasons.

Prevalence and pattern of traumatic limb amputations in female population of Bhimber District, Azad Jammu and Kashmir, Pakistan

Objective:

Traumatic limb amputations (TLA) are structural defects that cause mild-to-severe disabilities and have significant impact on the quality of life of subjects. A recent epidemiological study in Bhimber District, AJK, Pakistan, revealed that TLA had a very high incidence among the young/adult females. The present study aimed at determining the prevalence, pattern, causes and risk factors associated with TLA in that female sample.

Methods:

In a prospective door-to-door survey, 1731 females were randomly enrolled, and clinico-etiological investigations on 19 subjects with TLA were carried out in a follow-up study. Affected subjects were physically examined and phenotypic detail and restriction to normal function were documented.

Results:

There were 19 subjects with TLA, hence the prevalence was estimated to be 10.98/1,000 (0.011%; CI=0.0061-0.0159). TLA mostly involved the upper limbs and right hand. Transphalangeal amputations were most frequent, followed by involvements of middle/upper arm and leg segments. These analyses further revealed that agriculture tools were the leading cause of trauma. TLA were witnessed to be higher in subjects originating from Samahni tehsil (OR:2.71), rural areas (OR:3.33), those who were illiterate (OR:2.65), married, spoke Pahari language (OR:1.73), those who fall in higher age category (OR:16.74), and had certain professions.

Conclusion:

Limb amputations had heavy bearings on the lives of subjects. Curiously, majority of these traumas could be avoided by adopting certain safety measures. Prevalence and risk estimate of TLA across various socio-demographic variables of Bhimber population would be useful in guiding further studies and the public health policy to mitigate the impact of these anomalies.

The interaction between air pollution and diet does not influence the DNA damage in lymphocytes of pregnant women

The aim of the study was to evaluate the risk of DNA damage in lymphocytes of pregnant women with respect to hormonal and nutritional status and to air pollution in Lesser Poland. The study was performed on 39 healthy pregnant women. The oxidative DNA damage, alkali-labile sites and uracil in DNA of lymphocytes were measured by using the comet assay. The concentration of 17beta-estradiol, progesterone, DHEA, cholesterol, vitamin B12 and folates were determined. Dietary data were assembled from food diaries. Voivodeship Inspectorate for Environmental Protection in Krakow using automatic pollution monitoring system provided the air pollution information, such as concentrations of PM10, PM2.5, NO, NO2, SO2, CO and O3. Many statistical correlations between DNA damage and air pollutants concentration were found however their biological meaning is still to be explained. It should be taken under consideration, that the protective effect of air pollutants is a result of hormesis, as the measured amounts of air pollutants during the study did not exceed the admissible levels. There was found no diet-and air pollution interaction.