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Jul 2020 DOI 10.14302/issn.2328-0182.japst-20-3472
Introduction An adequate nutrition pattern is of major importance for one’s health and well-being, especially during pregnancy when a woman undergoes major biological, physical, psychological and social transformations. Macronutrient and micronutrient deficiencies predispose the fetus to preterm birth, neural tube defects, and low birth weight for gestational age. This study was conducted to determine the nutrition awareness of women in childbearing age in order to provide a greater understanding of the life course perspective (LCP) in relation to nutrition behaviors and pregnancy. Methods A cross-sectional study was conducted on based on our conceptualization of nutrition awareness and questionnaire based studies of a face-to-face interview. The participants were women with age group of 17 years to 45 years participate in studies in Jeddah city. Data collection procedures A Semi-structured questionnaires prepared in English language were translated in to Arabic and then translated back to English to check for consistency. The questionnaires were pretested Human ethical committee; the questions assessed respondents’ nutrition knowledge. Results and Discussion Different questions were asked to 175 selected pregnant women to be included in this study assess knowledge of pregnant mothers on nutrition and determinant factors in the study area. Most of the respondents (34.85.2%) were in 19-25 years of age group.69.1 % (n=121) women says they pay attention to the number of soft drinks they drink each day. There would be fascinating to study awareness of specific nutrients and related issues, like consumption folic acid, non-vegetarian diet, minerals and life style such as mental stress and physical exercise.
Dec 2025 DOI 10.14302/issn.2324-7339.jcrhap-25-5715
Recruitment for research studies focused on communicable diseases such as HIV (Human Immunodeficiency Virus) has historically been challenging, particularly among populations who have been underrepresented in media messaging, yet maintain a significant vulnerability to new HIV cases, like Black women. This study examines the recruitment strategies utilized in Aim 2 of pilot study at the University of Texas Health Science Center (UTHealth) in Houston, Texas that was funded by the Ujima Mentoring Program to develop, implement, and evaluate a video log (vlog)-based intervention. The overarching goal of the pilot study was to promote the uptake of pre-exposure prophylaxis (PrEP) among cisgender Black women in Harris County, Texas. Aim 2 involved the creation of a culturally relevant vlog for use in Aim 3, which sought to educate and motivate participants to consider PrEP as an HIV prevention strategy. With the growing role of digital platforms in public health outreach, social media was employed alongside traditional recruitment methods such as flyers and word-of-mouth referrals. Despite an expanded online reach, engagement remained low, and participation rates did not increase proportionally to the number of individuals who viewed recruitment materials. The reluctance to participate was largely attributed to stigma surrounding HIV and concerns about being publicly associated with an HIV prevention study based on participants feedback to the research team. Even the availability of research incentives to encourage participation did not significantly improve recruitment accrual goals, particularly among healthcare providers who experienced limitations with eligibility due to institutional policies. This study underscores the need to better understand the social and cultural barriers that prevent Black women and healthcare providers from engaging in HIV prevention research. While digital recruitment strategies can enhance visibility to a larger audience, they must be supported with trust-building efforts, community partnerships, and culturally competent messaging to encourage meaningful participation. These findings point to the critical need for multi-faceted recruitment strategies that go beyond social media campaigns and actively build trust within communities, ensuring that HIV prevention research and interventions are both accessible and culturally resonant.
Dec 2025 DOI 10.14302/issn.2381-862X.jwrh-25-5447
Objective This study aimed to explore the respondents’ reproductive health profiles, examining the physiological and psychosocial perimenopausal symptoms affecting productivity, and identifying occupational needs. It also determined the relationship between menopausal symptoms and the productivity and occupational needs of peri-menopausal women. Methodology A descriptive cross-sectional design was used, surveying 50 women over 40 years old with a validated four-point Likert scale instrument. The instrument undergone content validation, reliability test, and ethical approval. Survey was administered personally and online using purposive sampling. Statistical treatments included weighted mean, F-test, T-test, Pearson r correlation, and ranking. Key results The majority of participants had their first menstruation between 11 to 15 years old and experienced regular menstrual cycles. Most had one child, with an equal number of cesarean and normal deliveries, and reported no pregnancy complications. The study found that participants seldom experienced physiological and psychosocial menopausal symptoms. They agreed on the occupational needs during the perimenopausal period. It was found that physiological symptoms were influenced by factors such as early menarche, cesarean delivery, and pregnancy complications. Additionally, psychosocial symptoms varied based on menstrual status, the number of children, and pregnancy complications, with those experiencing earlier menstruation or complications reporting more intense symptoms. The study revealed a significant relationship between both physiological and psychosocial perimenopausal symptoms, which negatively impacted productivity and increased occupational needs. Women with higher menopausal symptoms expressed a greater need for workplace policies that support perimenopausal women, highlighting the need for tailored workplace interventions for this demographic. Future Direction The study recommends including pap smears and mammograms in annual exams for peri-menopausal women, offering awareness seminars on managing perimenopausal symptoms to reduce workplace disruptions, and suggests future research exploring additional variables affecting perimenopausal women’s health and productivity
Dec 2025 DOI 10.14302/issn.2997-2108.jcc-25-5518
Cervical cancer is the fourth most common cancer in women globally, with 660,000 new cases and 350,000 deaths in 2022. The burden is disproportionately high in low- and middle-income countries (LMICs), particularly sub-Saharan Africa. Despite proven interventions like HPV vaccination and screening, uptake remains low. While cervical cancer screening has been studied in the general population, little is known about uptake among refugee women in Uganda, which hosts approximately 1.7 million refugees. This study examines cervical cancer screening uptake and associated factors among refugee women in Uganda. Methods We conducted a cross-sectional secondary analysis of the 2021 Uganda Refugee Population-based HIV Impact Assessment (RUPHIA) survey, focusing on women aged 21–49 in refugee settlements in the West Nile and South-Western regions, which host 90% of Uganda’s refugee population. The primary outcome was self-reported cervical cancer screening status. We used descriptive statistics and logistic regression to identify factors associated with screening uptake. Results Among 731 women, only 72 (9.8%) reported undergoing cervical cancer screening. The mean age of screened women was 37 years (±7), compared to 32 years (±8) for unscreened women. Screening uptake was significantly higher among women aged 31–39 years (AOR = 2.67, 95% CI: 1.32–5.52, p = 0.007), married women (AOR = 12.0, 95% CI: 1.76–163, p = 0.03), and those in polygamous relationships (AOR = 4.76, 95% CI: 1.96–11.1, p < 0.001) Conclusion Cervical cancer screening uptake among refugee women in Uganda is critically low. Integrating culturally sensitive screening programs into refugee health services and addressing socio-economic barriers could improve access and utilization.
Oct 2025 DOI 10.14302/issn.2693-1176.ijgh-25-5626
Background Masculinity remains a dominant phenomenon in the social construction and performance of male roles in society, influencing economic participation, access to essential services, and decision-making at household levels. Research focusing on women's empowerment has been extensively done, with little focus on how masculine support from men impacts the well- being of married women. This study examined how married women perceive male support in the context of economic, emotional, and physical support in Luwero district, Uganda. Methods This was an exploratory qualitative study conducted among married women aged 18 to 49 years. Key informant interviews were conducted with community women aged 30 to 40 years, and village health teams aged 30 to 40 years. The study participants were purposively selected based on the inclusion criteria of the study. Data were analysed using content analysis and the findings were presented using themes/sub-themes along with participant quotes. Results We interviewed married women aged 18 to 49 years old, with the majority falling in the age category of 30 to 39 years (59.1%) and were married for over 6 to 9 years (45.5%). Concerning the key informants, 2 VHTs were aged between 30 to 39 years (66.7%), and the women leaders were aged between 30 to 40 years (60%). About male support among women, nine subthemes emerged, including low engagement in family affairs, lack of financial support and cultural traditions, women’s insecurity, emotional neglect, women as providers of emotional support, lack of emotional responsiveness, emotional support driven by institutional policy, shared domestic responsibilities, and lack of physical presence during sickness. Generally, male support towards women was found to be lacking. Conclusion Male support among married women remains insufficient, contributing to emotional strain and unequally distributed responsibilities. Strengthening community awareness and engaging men through tailored programs can foster a more supportive domestic environment.
Aug 2025 DOI 10.14302/issn.2693-1176.ijgh-25-5609
Economic masculinity support is paramount in promoting women’s well-being through numerous ways, including enhancing access to healthcare, education, and financial freedom, hence fostering equitable distribution of household responsibilities. However, studies examining the relationship between economic masculinity support and women’s well-being have not been well established in existing research. This study evaluated the relationship between economic masculinity support and the well-being of married women in Luwero district, Uganda. This Cross-Sectional study was conducted among 382 married women aged 18 to 50 years of age, from selected villages in Luwero district. The outcome variable, well-being, was assessed using the Gender Empowerment Measure (GEM). Data were analyzed using the Pearson correlation coefficient and linear regression to ascertain the relationship between economic masculinity support and the well-being of women. The findings show a moderate positive association between economic masculinity support and women's well-being (r = 0.55, p < 0.0001). Regression analysis indicated that economic masculinity support had a significant predictive influence (β = 0.42, p < 0.01) on women’s well-being, accounting for approximately 30% of the variance in well-being outcomes (Adjusted R² = 0.30). Linking economic masculinity supports improved access to essential resources. These results highlight the crucial role of economic support in enhancing women’s welfare, while also emphasizing the need to address socio-cultural barriers to achieve lasting empowerment. The study underscores the significant role of economic masculinity in promoting married women’s well-being. Transforming economic masculinity into a framework of mutual support is essential for advancing gender equity and safeguarding women’s well-being globally
Apr 2025 DOI 10.14302/issn.2379-7835.ijn-25-5463
Iron deficiency is a major public health problem worldwide. It affects a significant proportion of the population, and is responsible for around 50% of anemia cases worldwide. Cameroon in general and Lekie Division in particular, is very highlyaffected by this problem. However, early detection of the problem can prevent the fatalities associated to it. The objective of this study was to provide up-to-date, detailed data on the markers of iron status in these populations, so that treatment can be better targeted. A two-month cross-sectional study was conducted in the Lekie Division in collaboration with local health centres in both urban and rural areas. The study sample consisted of 361 participants of all age groups and sexes. A questionnaire was issued to obtain information of the participants socio-demographic status, then 3 to 5ml of blood were collected and a number of markers of the participants iron status were studied. Of all the hematological markers studied, hemoglobin concentration in the study population was below normal in both men and women. Biochemical markers were good for all socio-demographic parameters. The mean values of biochemical and hematological markers in the population of the Lekie Division were good for all socio-demographic parameters, with the exception of hemoglobin concentration, which remains critical, requiring particular attention in this locality, but above all urgent intervention lest the situation aggravates further.
Dec 2024 DOI 10.14302/issn.2474-9273.jbtm-24-5317
Adolescence in Cameroon, as in many parts of sub-Saharan Africa, is often marked by early childbearing. Studies have shown a national prevalence of adolescent deliveries to be around 14.2% - 14.4%, a higher rate than the average for sub-Saharan Africa This presents a unique challenge for young mothers, who must navigate the complex process of identity reorganization while still navigating their own adolescence with its multiple changes. This article explores the experiences of primiparous (first-time) Cameroonian adolescents as they transition from daughters to mothers. The objective of this article is to understand how identity reorganization takes place among primiparous Cameroonian adolescents who pass without transition from the status of daughter to the status of mother. Drawing on qualitative data from semi-structured interviews, with seven participants chosen on the basis of selection criteria, the article examines the psychological, social, and cultural factors that shape this identity shift. An interview guide with three main themes made it possible to collect verbatim comments from the participants. The thematic analysis highlights the challenges faced by these young mothers, such as navigating social stigma, managing emotional upheaval, and balancing motherhood with their own developmental needs. The findings of this study highlight the complex and multifaceted nature of identity reorganization among primiparous Cameroonian adolescents. The social stigma associated with early childbearing, coupled with the emotional and practical demands of motherhood, can pose significant challenges to these young women. However, a study on a larger sample could reveal the resilience and resourcefulness of some adolescents, who find support within their communities and employ various coping mechanisms to navigate this transition. Finally, the article discusses the implications of these findings for adolescent maternal health interventions and social policy in Cameroon.
Dec 2024 DOI 10.14302/issn.2379-7835.ijn-24-5352
Introduction Adolescent pregnancy has become a global health concern in recent years, with maintaining dietary diversity being essential to ensure the health of both the mother and fetus. This study aimed to understand the dietary diversity and nutritional status among pregnant adolescents attending antenatal clinic and identify the factors influencing these outcomes. Methodology A hospital based cross-sectional study was done at St Francis Regional Referral Hospital at Ifakara, Tanzania. A total of 131 adolescent pregnant women consented to participate. Data was obtained using questionnaire and 24-hour dietary recall. Results The study revealed that 93.1% (n=122) of adolescent pregnant women met the minimum dietary diversity score based on 24-hour recall period. Similar proportions were observed for age group but vary significantly with the number of children born (p< 0.001), marital status (p = 0.032) and education level (p< 0.001). Additionally, 93.9% (n=123) of adolescent pregnant women had a normal Mid-Upper Arm Circumference (MUAC) and 6.1% (n=8) were undernourished. Similar proportions were observed across age, number of children born, marital status, education status, and occupation. Conclusion Most adolescent pregnant women in this study achieved adequate dietary diversity. However, socio-demographic factors such as age, marital status, and education, as well as challenges like illness and loss of appetite, influenced their dietary diversity and overall nutritional status. Future research should adopt a community-based longitudinal approach to better understand these factors and provide a more comprehensive understanding on the dietary patterns of adolescent pregnant women.
Dec 2023 DOI 10.14302/issn.2329-9487.jhc-23-4848
Introduction Rheumatic heart disease is mostly common in low-income or developing parts of the world, such as Sub-Saharan Africa, with a high morbidity and mortality rate. There are few data that are available in Chad on rheumatic heart disease. Our objective was to study the clinical, echocardiographic, therapeutic, and progressive aspects of rheumatic heart disease at the Renaissance University Hospital Center and the National Reference Teaching Hospital in N’Djamena, Chad. Patient and methods This was a prospective, multicenter and observational cohort study, covering a consecutive series of patients consulted and/or hospitalized for rheumatic heart disease, documented by an echocardiogram from January 2015 to January 2021. Results Among the 4456 patients consulted and/or hospitalized, 398 cases of rheumatic heart disease (8.9%) were collected, and 364 patients had met the inclusion criteria. The mean age was 31.2 ± 14.4 years, and 193 patients (53%) were female. On admission, heart failure was present in 214 patients (58.8%), ischemic stroke in 10 patients (2.7%) and supraventricular arrhythmias such as atrial fibrillation in 94 patients (25.8%) and atrial flutter in 6 patients (1.6%). Mitral regurgitation was observed in 49.7% (n=181) of cases, aortic regurgitation in 33.2% (n=121), mitral stenosis in 31.3% (n=114), and aortic stenosis in 7.7% (n=28). At least two valvular disorders were combined in 48.4% of cases. A surgical intervention such as a heart valve replacement and/or valvuloplasty was performed in 80 patients (22.2%). At least one rehospitalization was noted in 56.9% of patients. Forty-two of the 150 patients free of heart failure at inclusion (28%) had experienced the first episode of decompensated heart failure during follow-up. On the other hand, in 119 patients (55.6%), it was the second episode of decompensated heart failure. Other progressive complications included atrial fibrillation (13.8%), thromboembolic complications (6.3%), infective endocarditis (6.0%) and prosthetic valve dysfunction (1.4%). Altogether, the mortality rate was 10.4%. It was 9.9% in non-operated patients compared to 12.5% in operated patients (p=0.49). Conclusion The present study shows that morbidity and mortality of rheumatic heart disease remain high in our context and often affect children, young adults, and women. Treatment is essentially based on cardiac surgery which is not available in Chad.
Sep 2023 DOI 10.14302/issn.2693-1176.ijgh-22-4255
Nutrition during pregnancy is of utmost important to ensure positive pregnancy outcomes after delivery. This study examined the utilization of nutrition services provided at health facilities to pregnant women. A cross sectional study design, involving 105 pregnant women and 5 RCH providers from 2 health facilities was used. Structured questionnaires, and structured observations were used in data collection. SPSS software version 25 was used in data analysis. Results showed that, RCH providers had inadequate nutrition knowledge due to limited nutrition courses during nursing training and on job trainings/seminars. All RCH providers advised that, nutrition knowledge is important to pregnant women hence they were responsible for its delivery. In adequate staff and lack of teaching materials contributed to the poor delivery of quality nutrition education to all pregnant women as it was observed that there is variations in nutrition information given to women. More than a half of all pregnant women (63%) started their ANC clinic during their first trimester where they received all nutrition services including education on importance of nutrition during pregnancy which helped them to be aware of the relationship between diet maternal nutrition and birth outcomes (63.8%). Most common food group that has been consumed more by pregnant women was grains, roots and tubers and plantains, while also there was high consumption of fruits and vegetables by all women as they are being more emphasized during routine clinics to prevent anemia. Also, there are some barriers that were identified by the service providers which makes their work difficult such as inadequate teaching materials like brochures, posters and jobs aids, also shortage of staff was found to be the core cause of services being provided occasionally as it is the RCH nurse who provide the education and counselling as there is no any nutritionist hired by government at the facility. Regional and district nutrition officers should coordinate and conduct on job training to health providers on issues related to nutrition in order to update their nutrition knowledge and facilitate clear, accurate and more evidence based nutrition information delivered.
Sep 2023 DOI 10.14302/issn.2381-862x.jwrh-23-4601
Background The novel coronavirus COVID-19 has created massive challenges to public health worldwide. Pregnant women are an immune-depressed status which makes pregnant women generally more vulnerable to COVID-19 infection and severe illness. The present preventive measure practices have gaps. Therefore, the current study aimed to present accurate and latest information regarding preventive measures for COVID-19 infection among pregnant women. Methods and materials Institution-based cross-sectional study design was conducted on 422 pregnant women in public hospitals in Addis Ababa using a pretested structured questionnaire. Face-to-face interview on pretested and structured questions was conducted to collect the data between January 12 and February 15, 2022. The collected data were entered into Epi data version 4.4.2.2 and exported to SPSS window version 25 for analysis. Descriptive statics and multivariable logistic regression were analyzed. Odds ratio with a 95% confidence interval and p-value ≤ 0.05 were declared statistical significance independent variables. Result A total of 418 pregnant women participated, and the response rate was 99.05%. About 417 (99.8%) pregnant women reported never hearing about COVID-19. Of those who heard about COVID-19, only 49% and 54.3% had good knowledge and had good practice towards COVID-19 infection respectively. Age (26-30yrs (AOR=0.46, 95%CI: 0.014,0.12), no education (AOR=0.23, 95%CI: 0.099-0.52), Primary school (AOR=0.199, 95%CI: 0.104-0.4) and Secondary school (AOR=0.282, 95%CI: 0.14-0.55), divorced (AOR=0.15, 95%CI: 0.065-0.34) and widowed (AOR=0.16, 95%CI: 0.024-1.03)) were factors that associated with knowledge towards COVID-19 infection. Age (30-35yrs (AOR=0.334, 95%: 0.115-0.97) and >36yrs (AOR=0.28, 95%CI: 0.11-0.69)), no education (AOR=0.06, 95%CI: 0.019-0.18), being a civil servant (AOR= 0.28, 95%CI: 0.122-0.66), divorced (AOR=0.042, 95%CI: 0.01-0.18), having >4 family size (AOR=0.334, 95%CI: 0.169-0.66), no previous complication of pregnancy outcomes (AOR=0.019, 95%CI: 0.01-0.061), chronic health problem (AOR=14.66, 95%CI: 0.457-39.4) and two ANC visit (AOR=5.704, 95%CI: 2.41-13.5) were factors that associated with the practice towards COVID-19. Conclusion In this study area, only half of pregnant women had good knowledge and good practice about covid-19 infection prevention measures.
Feb 2023 DOI 10.14302/issn.2641-5526.jmid-23-4450
Acute appendicitis is one of the most common surgical emergencies globally, with a lifetime incidence of 8.6% in men and 6.7% in women. While acute appendicitis should be managed promptly to reduce the morbidity associated with perforated appendicitis, morbidity from negative appendicectomy is similar to morbidity from uncomplicated appendicitis. Computer tomography is widely used to aid in the diagnosis of acute appendicitis, however, is costly, often has a slow turn around time, and is associated with exposure to ionising radiation. In contrast, ultrasound is cheap, widely available, requires minimal patient preparation, and does not require exposure to ionising radiation. Ultrasonography is becoming increasingly used for adult patients in emergency settings. The literature has estimated the sensitivity of ultrasound for acute appendicitis in adult patients as between 39-96.4%. The sensitivity and specificity of ultrasound for the diagnosis of acute appendicitis is significantly increased when the appendix is visualised. In cases of a non visualised appendix, indirect ultrasound signs can improve the sensitivity to 93.9% and specificity to 85.7%. The variation in sensitivity and specificity for ultrasound in the diagnosis of acute appendicitis in adults may be due to multiple factors. Ultrasonographer experience, a retrocaecal appendix and obesity have all been described. Given the availability, cost and potential to reduce the rate of negative appendicectomy, ultrasound should be considered as the first line imaging modality for adult patients presenting with suspected AA.
Mar 2022
Dolutegravir suppresses this integration enzyme, so human immune virus can’t create every greater copies of itself, thus ‘’integrase inhibitor.’’ Dolutegravir is hastily absorbed pursuing oral administration. The median maximum plasma concentration is reached 1.5–2.5 hours after oral uptake with a mean half-life of 12–15 hours, rendering feasible for once-daily dosing without the need for pharmacological boosting. The terminal half-life is about 14 hours. The apparent oral clearance is about 1 liter/hour. Fifty three percent of the total oral dose of dolutegravir is excreted unchanged in the feces, thirty two percent through urine as glucuronide (eighteen percent) or alkylated product (three point five percent), and other organic conjugated products sequencing from phase II liver metabolisms. Dolutegravir’s categorized as pregnancy category B (no confirmation of pitfall in humans) means either animal-reproduction inquests have not substantiated a fetal peril but there are no restrained inquests in pregnant women or animal-reproduction inquests have reveal an adverse effect (distinctive than a de-escalate in fertility) that was not inveterate in restrained inquests in women in the first trimester (and there is no confirmation of a pitfall in later trimesters) or there is survey in animal that revealed the medication is safe in pregnant animal, but there is no fetal pitfall confirmation in pregnant women.Antiviral Pregnancy Registry (APR) revealed that as of January 2017, pregnancy outcomes and birth defects were analyzed from 142 pregnancies with reported exposure to DTG during pregnancy. There were 128 live births reported (3 terminations, 11 miscarriages, no stillbirths). Only 4 (3.0%) reported birth defects, which is similar to the expected rate of birth defects in the general population. European Pregnancy and Paediatric HIV Cohort Collaboration (EPPIC) displayed that as of July 2017, 101 pregnancies with exposure to DTG had been identified with 84 birth outcomes. Rates of preterm delivery and “small for gestational age” were identical to outcomes reported from women on alternative regimens (standard of care in the United Kingdom of Great Britain and Northern Ireland).
Feb 2022 DOI 10.14302/issn.2692-1537.ijcv-22-4078
Background The COVID-19 pandemic has had significant impact on healthcare worldwide. Surgeons are at increased occupational risk of contracting COVID-19. The impact of the disease on surgical practice will continue to evolve. We assessed the impact of the disease on surgical practice and training in Nigeria. Method Survey questionnaire was designed, transcribed to Google form and electronically circulated online to surgeons practicing in Nigeria. Surgeons from various subspecialties from the six regions in Nigeria were included. Survey questions pertaining to pre-COVID-19 era surgical practices, impact on current practice and changes occurring in health facilities during this COVID-19 pandemic. Responses were collated and analyzed statistically. Results One hundred and nine (109) surgeons completed the survey, of which 2.8% were women. Majority (68.8%) of the respondents are in the consultant cadre, majority (86.2%) are working in public hospital, 88.1% running their SOPD, 81.7% have isolation wards in their centers, 66.1% have dedicated team for COVID-19 management. Only 48.6% of the frontline health workers have access to personal protective equipment (PPE), and 33.9% had formal training on the use of PPE. Only 11.0% were satisfied with level of preparation of the management. Elective cases were done only in 45% of respondents. 103(94.4 %) confirmed that the numbers of elective cases are less than pre Covid-19 period. Emergency cases were carried out by 93.6% of respondents. Only 1.8% of respondents carried out screening tests for their patients before embarking on emergency surgery. Conclusion COVID-19 has led to reduction in surgical outpatients, significant reduction in elective surgeries in Nigeria. Adequate PPE needs to be provided, there should be guidelines for safety for future. There should be adequate preparation should there be any pandemic in the near future.
Feb 2021 DOI 10.14302/issn.2641-4538.jphi-20-3683
Women in Rwanda are still suffering from overweight and obesity and health-related complications. However, little is known about overweight/obesity prevention knowledge and factors associated with overweight/obesity prevention among women. The aim of this study was to determine knowledge and factors associated with overweight and obesity prevention among women attending Kibagabaga Hospital in Rwanda. A quantitative descriptive cross-sectional design was conducted among women aged 20-45 years that was selected randomly. A structured questionnaire was used to collect data from 384 women seeking health care at the hospital during the study period. SPSS version 21 was used for data analysis; descriptive statistics was used to assess women’s knowledge related to overweight/obesity. Logistic regression was used to determine the factors associated with overweight/obesity prevention, the level of significance was set at 5%. Approval to conduct the study was obtained from the University and Hospital. The majority 35.4% of study participants were aged between 30-34 years. Women who live in urban area dominate the study (76.3%), the majority of study participants were married (60.9%). The study revealed that the 22% and 62% of women had higher level and moderate knowledge respectively. In terms of overweight/obesity prevention practices, we found that 67% mothers had adequate practices towards overweight and obesity prevention. The age of 35-39, and unemployment were found to be significantly associated with overweight/obesity prevention practices. Cost-effective health education focusing on women, physical activity and social support to reduce the socio-cultural constraints that promote overweight/obesity are necessary to combat this epidemic.
Dec 2020
Background In Brunei Darussalam, cancer has been the leading cause of death, and breast cancer as the leading cause of death among women. With a nationally-funded cancer treatment, it is essential to determine the survival rates among breast cancer patients which can serve as a basis for comparison across timelines with the end view of improving healthcare delivery, hence, survival among the patient population. Methods This study was conducted from January – May 2019. Medical records data were abstracted for breast cancer patients treated between years 2011-2016 in a tertiary specialist cancer center. Kaplan-Meier Product Limit estimation was used for the over-all observed survival rates within 5 years after diagnosis. STATA Version 15 was used for statistical analysis. Ethical approval was obtained. Results Over-all, five-year breast cancer survival rates was favorable at 88.89%. . Survival rates according to TNM staging showed lowest at stage IV at 59% five-year survival. Survival rates according to age at the time of diagnosis showed favorable survival across age groups except for age groups 30-39 years and 80 years old and above. Survival rates according to treatment combinations were highest in surgery (mastectomy) and hormonal therapy. Conclusions The Center’s 5-year breast cancer survival rates were relatively high and comparable to survival figures of developed countries. The Center’s high survival rates could have been related to the ‘treatment factors’ due to the following: prompt treatment of early stage breast cancer stages, responsive coordination, government-funded cancer treatment which allowed patients uninterrupted, free access to standard treatment.
Nov 2020 DOI 10.14302/issn.2997-1969.ijhs-20-3580
Introduction This study assessed the awareness of cervical cancer screening test among women in the rural area of Imo State. Cervical cancer is the fourth most common cancer and the cause of death in women. The need to ascertain the level of awareness of cervical cancer screening test and the level of uptake among rural women motivated this study. Materials and Methods The study design was cross sectional descriptive survey. The sample for the study, which was statistically determined by Taro Yamane formula was 420. Administered structured questionnaire was used for data collection. Data were analyzed using frequency distribution tables. Results The result showed that 270(64.3%) of the respondents were aware of cervical cancer screening test and only 135(32.1%) used cervical cancer screening test . Majority of the respondents, 400(95.2%) have never taken vaccination for human papilloma virus . The main place where 234(55.7%) of the respondents learnt about cervical cancer screening was the hospital. A good number of the respondents 225(53.6%), had low uptake services because of the views that cervical cancer screening is mainly for the elderly women, and also 140(33.3%) felt that the investigation process is painful. Conclusion Therefore, adequate and substantial measures should be taken to health educate women on benefits of cervical cancer screening tests.
Sep 2020 DOI 10.14302/issn.2381-862X.jwrh-20-3504
Background Induced abortions are globally sought, whether permitted, or not permitted. Community based information about abortion seeking by rural tribal women is scarce. Objectives Community based study was carried out to know the magnitude, profile, reasons, places, persons performing IA for rural tribal women. Material Methods Study was conducted in 118 villages to get the study subjects . Women from every fourth house were interviewed for desired information. Results and Conclusion Of all abortions, 2.17% in Melghat and 24.38 %in Sewagram were IA. Most women who had IA were young and 19% in Melghat region, 2.6% in Sewagram region were illiterate. Majority of Sewagram region, were housewives of low middle class, in Melghat unskilled workers of low economic class. In Melghat region all women reported seeking IA at health facilities,63% Private hospitals (PH), 18.5% Sub centres (SC), 7.4% Medical College (MC), 7.4% District hospital(DH), 3.7% Primary Health Centres (PHCs) and In Sewagram region 58% PH, 23% MC, 6.7% PHCs, 3.9% DH, 3.9% SCs and 3.9% at home. Most women said they had IA for spacing with no contraceptive use or contraceptive failure, poor health, poverty, IA were done medically in 76.2%, surgically 23%. No sex–selective IA were reported and there was no evidence Many women lacked awareness and had misconceptions, more so in Melghat region. In focus group discussions, common reasons for disfavoring IA were personal beliefs (34%), practice restrictions (19%). There was extreme poverty, still PH were used. Lot of awareness is required.
Aug 2020 DOI 10.14302/issn.2381-862X.jwrh-20-3444
Background In Ethiopia, the levels of maternal and infant morbidity and mortality are among the highest in the world. This is attributed to, among other factors, none use of modern health care services by women. According to the 2011 Ethiopian Demographic Health Survey, more than seven in ten mothers did not receive antenatal care at all. Objectives The objective of this study was to determine level and identify factors influencing maternal antenatal care services utilization among mothers who gave birth in the last twelve months in Gelemso town west Hararghe Oromia, Ethiopia. Methods A community-based cross sectional study design was conducted on 347 study participants in Gelemso town west Hararghe Oromia Ethiopia from July 15, 2017 to August 15, 2017 G.C.A probability to proportional to size sampling technique was used to select the study population in two urban Kebeles. Data were collected using a pre tested structured questionairs. Descriptive results were presented using frequencies, and numerical summary measures. Bivariate analysis was carried out to assess the association between outcome variable and each in dependent variables. Odds ratio with 95% confidence level was estimated to identify factors associated with Antenatal Care (ANC) utilization using multivariable logistic regression. The statistical significance was declared at p- value < 0.05. Result The response rate this study was 98%. The prevalence of antenatal care service utilization was 64.6%. About 146 (42.1%) of the pregnant mother started antenatal care visit during the second trimester of pregnancy and a significant proportion 289(83.3%) had less than the recommended four visits. Educational status (AOR;15.19:CI 95%,6.006,38.417), husband attitude (AOR;1.995:CI 95%,1.016,3.916), marital status(AOR:4.587:CI 95%,1.888,11.146), planned pregnancy (AOR:4.938:CI 95%,2.514,9.702) were major factors associated with antenatal care service utilization. Conclusion Though more than half mother used antenatal care service in the study setting, two in ten of the mothers did not have the minimum number of visits recommended by World Health Organization. Promotion of information, education and communication in the community should be strengthened is to sustain antenatal care service utilization in the community.
Aug 2020 DOI 10.14302/issn.2381-862X.jwrh-20-3439
Background Pregnancy and parturition are events of considerable significance in the life cycle of women. Though it is supposed that the quality of care during labor, birth, and postpartum period plays a great role for adverse outcomes of birth, various reports claimed that cesarean delivery carries a higher maternal and fetal morbidity and mortality compared to vaginal delivery. Therefore, this study assessed the Rate, Maternal and Fetal Outcome of Cesarean delivery performed by IESO at Shenen Gibe General Hospital, Jimma south west Ethiopia. Integrated Emergency surgical officer is a health professional qualified and authorized to perform emergency obstetrical-gynecological and emergency general surgical procedures. The training has started in 2010 in 3 universities and 10 affiliated sites with intake of 43 students. The MSc program in integrated emergency surgery is intended to achieve one of the millennium development goals (MDG): reducing the overwhelming maternal mortality ratio and perinatal mortality rate at the local and national level. (1) Methods Hospital based two-year retrospective descriptive cross-sectional study design was employed and data collected from November to December 2019 in shenen Gibe General Hospital ,Jimma south west Ethiopia. A total of 185 mothers who delivered by cesarean delivery from December 2017 to December 2018 and complete data were included in the study. Data were extracted using structured data collection format and cleaned, and entered into Epi data software version 3.1 and exported into SPSS version 26 for further descriptive analysis. Result Among 2115 deliveries in the two years of retrospective data, a total of 186 mothers were delivered by cesarean section, giving cesarean delivery rate 8.8 %. The leading indication for cesarean delivery was fetal distress (24.2%). Among the total cesarean delivery, 22 neonates were died, giving the proportion of neonate mortality rate 16.8%. One mothers were died following cesarean delivery, giving maternal mortality rate following cesarean delivery 12 per 1000 live births. The leading cause for maternal mortality was hemorrhagic shock Conclusion However, cesarean delivery rate in this study was within the WHO recommended range, the health outcome of mothers and neonates’ following cesarean delivery was not acceptable. The neonatal and maternal mortality following cesarean delivery was 16.8% and12 per 1000 live births respectively. The main cause of neonatal death was birth asphyxia.
Apr 2020 DOI 10.14302/issn.2379-7835.ijn-20-3279
Aim This cross-sectional study assessed the nutritional status of ethnic reproductive women aged between 15-40 years, comprising 85 lactating women (LW) and 86 non-pregnant-non-lactating women (NPNLW) who lived in various parts of three hilly districts (Bandarban, Khagrachari and Rangamati) of the Chittagong Hill Tracts (CHTs) of Bangladesh. Materials and Method Research tool was pretested semi-structured questionnaire for this observational study. Anthropometric indices like weight, height and mid-upper-arm-circumference (MUAC) were used in assessing the nutritional status. Results Most (44.4%) of the ethnic women were Marma, followed by Chakma (39.8%), Bam (8.2%) and Tripura (5.8%). No significant (P>0.05) differences were observed in socio-economic variables between LW and NPNLW. Overall, mean age of the women was 28 (±7.2) years; mean family income was 18,822.2 (±3091) BDT and majority (86%-87%) were reported to be food secured throughout the year. Mean Dietary calorie (2631±798 kcal) intake of both groups were up to the mark according to the recommended dietary allowances (RDAs) and most (80.3%-86%) of them also possessed good nutritional knowledge. However, no significant (P>0.05) differences were observed in dietary calorie intake and nutritional knowledge score between two groups of women. Overall, most (68.4%) of the women had normal body max index (BMI kg/m2), 11.7% were found to be undernourished or thin and 19.9% were overweight. It was noticed that better nutritional status of LW and NPNLW were significantly associated with literacy (P<0.05), occupancy in household chores (P<0.05), better income (P<0.05), food security (P<0.05), recommended calorie intake level (P<0.05) and better nutritional knowledge score (P<0.05). Conclusion This study showed that vast majority of the ethnic reproductive women of CHTs are in better nutritional status with normal BMI (kg/m2) and daily calorie intake according to RDA. Most of them were food secured and their nutritional knowledge score was also up to the mark. Better socio-economic condition, nutritional knowledge and accurate calorie intake play a vital role in achieving healthy nutritional status of the two women groups of CHTs.
Jul 2019 DOI 10.14302/issn.2690-6759.jpar-19-2971
Toxoplasmosis is one of the most important zoonotic diseases worldwide caused by Toxoplasma gondii that leads to abortion or hydrocephalus during pregnancy. It’s a comparative cross-sectional one designed to assess immunoglobulins and cytokines in pregnant women. A total of 300 venous blood samples were collected from each pregnant woman and centrifuged to obtain serum. Patient’s information was recorded in a questionnaire previously designed for the purpose of analysis. In addition, 40 uninfected women were enrolled in the study as control group to assess the level of IL8 and IL17 cytokines. The overall seropositive rate of Toxoplasma gondii infection was 22.6%. Within the positive cases of study population, only 16 and 13 showed positive results of IL8, IL17 respectively. The results showed highly significant increase in the mean serum level of IL8 (210.25pg/ml) and IL17 (203.15 pg/ml) when compared to the control group who showed 68.9 pg/ml and 54.8 pg/ml respectively. The serum level of proinflammatory cytokines investigated in this study seems to be increased in patients with serological evidence of Toxoplasma gondii infection. Our study concludes that IL-17 and IL-8 involved in the induction of inflammation and toxoplasmosis disease.
Apr 2019 DOI 10.14302/issn.2379-7835.ijn-19-2579
Objective Postmenopausal women are at an increased risk of Cardiovascular Disease. We aimed to investigate whether this risk differed between individuals with a naturally occurring and other reasons for menopause within a large population-based Iranian sample. Study Design A total number of 1763 postmenopausal women (defined by amenorrhea for more than a year, or FSH > 30-40 mIU/ml), 900 of them with a natural menopause and 863 of them with other reasons for menopause caused by (hysterectomy without oophorectomy or one side oophorectomy, hysterectomy with oophorectomy or two side oophorectomy without hysterectomy) were recruited as part of the Mashhad Stroke and Heart Atherosclerotic Disorders (MASHAD) cohort study. Biochemical and hematological risk factors were measured in all the subjects and the data were analyzed by SPSS software version 20 Results There was a significant difference in the presence of cardiovascular disease in the natural menopause group compared with other reasons for menopause group (p<0.05). There was also a meaningful difference between the prevalence of depression and anxiety in the natural menopause individuals compared with other reasons for menopause group (p<0.05). Discussion High prevalence of CVD, depression and anxiety in other reasons in menopause women were observed among Mashhad urban females. It should be considered as a noticeable message. Furthermore, studies are necessary to determine different parameters between evaluating CVD, depression and anxiety among menopauses women.
Feb 2019
Objectives This study was designed to assess the demographic characteristics, prevalence of metabolic syndrome (MetSy) among patients with schizophrenia in Saudi Arabia. Methods This is a disease-oriented and observational study. Schizophrenia was defined by DSM-IV criteria. MetSy were assessed based on the international criteria (NCEP-ATP III and AHA/NHLB). Results 90% of the participants are without a university degree and 56.4% are single. Chronic and acute cases of schizophrenia were 95% and 5%, respectively. The treatment of schizophrenia was combination therapy and monotherapy with percentages of 56% and 44%, respectively. Systolic and diastolic blood pressures were 121.92±11.07 mmHg and 77.29±0.45 mmHg, respectively. Surprisingly, all patients have abnormal HDL. A mean waist circumference of 90.23±14.88 cm for men, and 93.38±15.28 cm for women. The analysis of 101 patients showed a prevalence of the MetSy is 15.8%. Chi-square test of independence showed lack of independency of MetSy on type of therapy. Modeling of MetSy and risk factors was also conducted. Conclusion The metabolic syndrome is greatly established among schizophrenic patients. It signifies a vital hazard for metabolic and cardiovascular ailments. Evaluation of the incidence and examining of the related threats of the metabolic syndrome should be an element of the clinical managing of patients cured with antipsychotics.
Jan 2019 DOI 10.14302/issn.2641-4538.jphi-18-1973
Introduction Adherence to ART is a challenge among pregnant women living with HIV/AIDS. This has an effect on the health of the mother and the unborn child. While studies have been done, it has shown that adherence during pregnancy is a challenge Virological and clinical success depend critically on high adherence to ART because with low adherence. The success of expanded ART coverage in improving health outcomes depends on adherence to treatment. During pregnancy, a compromised Virological response to ART also increases risk of mother-to-child transmission (MTCT) of HIV. This study was carried out to determine factors that influence adherence to antiretroviral therapy among HIV positive pregnant women in Lusaka district of Zambia. Methodology This was a qualitative study which used a case study approach. Data was collected through in-depth interviews. The collected data was analysed using a thematic analytical approach. Results 17 pregnant women living with HIV /AIDS in Lusaka had Challenges with adherence to ART. The study explored factors related to adherence to ART among pregnant women living with HIV/AIDS. ART adherence was found to be low. The findings call for the need to reduce on social stigma. The results confirmed that there is low adherence to ART among pregnant women living with HIV /AIDS in Lusaka. Conclusion Adherence to ART among pregnant women living with HIV/AIDS is a challenge for Zambian pregnant women. Improved levels of adherence to ART is hampered by fear of social stigma, and fear of being blamed by partners if they disclosed their status. Stigmatisation needs to be addressed because nearly all the participants expressed this factor. There is need to address the HIV/AIDS stigma very seriously in order for society to look at HIV/AIDS like any other illness.
Jan 2019 DOI 10.14302/issn.2470-5020.jnrt-18-2555
Introduction: Tension-type headache (TTH) is very common, with a lifetime prevalence in the general population ranging in different studies between 30% and 78%. TTH, divided into episodic and chronic types, introduced in the manual "International Classification of Headache Disorders"(ICHD-I), is of practical importance. Infrequent episodic headaches (no more than once a month) may not require drug therapy, but, on the contrary, frequent forms may require expensive treatment. Objective: To study the state of cerebral hemodynamics and cerebrovascular reactivity in patients with Tension-type headache and evaluate the efficacy of treatment with Phenibite using Doppler ultrasound. Materials and Methods: A retrospective analysis of the results of ultrasound dopplerography of the anterior, middle and posterior cerebral arteries (ACA, MCA and PCA), Vertebral and Basal (VA, BA) arteries was performed in 188 patients with TTH. Among them are infrequent episodic TTH - 68 (36,2%) patients, frequent episodic TTH - 64 (34,0%) patients, chronic TTH - 56 (29,8%) patients. The age of the subjects was 18-45 years, among them 85 (45.2%) men and 103 (54.8%) women. The maximum systolic velocity (Vs), the end diastolic velocity (Vd), the resistance and pulsativity indexes (RI, PI) in all vessels were determined. Patients were given consent to participate in the study. Results: Infrequent episodic (IFE) TTH were recorded in 86.4% of cases, frequent episodic (FE) — in 88.9%, and chronic (Ch) TTH — in 81.6% of cases. Bilateral TTH was noted in 39.2%, frontal localization - in 35.6%, in the occipital region - in 25–7% of cases. The asymmetry of the maximum systolic blood flow velocity (Vs) in the paired arteries within 20-30% was considered a violation of cerebral hemodynamics, which was detected in 38.7% of patients. An increase in Vs was noted in all cerebral vessels, especially in patients with FE TTH and chronic Ch TTH compared with the control group. In patients with IFE TTH the average value of RcFMt was 1.24±0.03, in patients with FE TTH - 1.25±0.02, in patients with Ch TTH - 1.27±0.03. In patients with TTH, hyper-responsiveness to hypercapnic test was detected: RcCO2 was 1.43±0.05 in the group with FE TTH; 1.39±0.07 in the group of Ch TTH and 1.37±0.04 in the group of IFE TTH, which indicates a tendency for the tension of the vasodilator regulation mechanism even in clinically insignificant forms of TTH. In the study of reactivity to the O2-test, a hyporeactive response was observed in the groups with FE TTH and Ch TTH (0.38±0.04 and 0.35±0.05, respectively. The treatment with Phenibut carried out in a step-by-step manner - during the first week the drug was applied at a dose of 250 mg 2 times a day, over the next 6 weeks the dose increased to 500 mg 2 times a day, then the dose was reduced back to 250 mg 2 times a day. Among patients with FE TTH, the frequency of headache decreased from 5.7±2.3 to 3.6±2.1 days/month, and in patients with Ch TTH - from 22.8±1.7 to 17.7±1,3 days/month (P<0,05). Influence of the drug was manifested at the initially increased RcFMt and RcCO2. A decrease in initially elevated RcCO2 was noted in all (FE TTH, ChTTH, IFETTH) clinical groups. However, this decrease was not statistically significant. Conclusion: In patients with TTH, an increase in the Vs is more often recorded, their asymmetry in the middle cerebral artery. Hyperreactivity on CO2-load is typical for patients with chronic TTH, and reflects the mobilization of metabolic regulation of cerebral blood flow. Conducting FMt was the most informative method for detecting autoregulatory disorders mainly in patients with IFE TTH. FE TTH in patients is characterized by the presence of a hyperactive reaction to hypercapnic and orthostatic tests, probably due to mobilization of humoral-metabolic and neurogenic links of regulation. In the group of patients with chronic TTH prevails hyporeactivity for hyperventilation test, reflecting the depletion of vasoconstriction reserve. The use of Phenibut(Noophen® (JSC Olainfarm Latvia in the treatment of TTH is accompanied by a decrease in the frequency of pain, and of pericranial muscle tone, most pronounced in patients with FE TTH. It's effectiveness is evident in the normalization of the coefficients of cerebrovascular reactivity in a patients with chronic TTH. The minimal statistical significance was observed on the dynamics of blood flow only in the VA.
Jan 2019 DOI 10.14302/issn.2574-4496.jtc-18-2473
This study aimed to investigate the trend of patients with thyroid cancer undergoing thyroidectomy and those undergoing fine needle aspiration (FNA) and its relationship with thyroid cancer, using a large-scale, real-world database established based on the employment-based health insurance claims data in Japan. In this retrospective descriptive study, annual incidence rates of patients with thyroid cancer undergoing thyroidectomy and FNA from 2005 to 2014 were calculated. Among the 3,130,757 enrollees, 926 patients were diagnosed with thyroid cancer and underwent thyroidectomies. The annual incidence of patients with thyroid cancer undergoing thyroidectomy increased from 5.4 (95% confidence interval 95% CI, 3.4–8.5) in 2005 to 11.7 (10.1–13.5) per 100,000 patient-years in 2013, with a gradual increase among patients in their 20s and 30s and with the most notable increase among those in their 40s and 50s. The annual FNA rate also increased during those years, whereas no noticeable change was observed in the thyroid cancer detection rate. The incidence rates of patients with thyroid cancer undergoing thyroidectomy and those undergoing FNA were strongly correlated, with Pearson’s correlation coefficients of 0.935 for men and 0.886 for women. In conclusion, an increasing trend in the incidence of patients with thyroid cancer undergoing thyroidectomy was observed from 2005 to 2013 among a large group of Japanese employees of working age and their dependents. These results provide useful information on the impact of patients with thyroid cancer undergoing thyroidectomy on the working population.
Sep 2018 DOI 10.14302/issn.2328-0182.japst-18-2281
The role that Vitamin D plays in human health is no more hidden in this modern age where every individual carries the knowledge treasure in the pocket (The internet) but the unjustified deficiency or insufficiency is still a research question waiting for the answer from research community all over the world. Normal levels (30-50 ng/ml) are necessary for the development of teeth and bones in children and bone mineralization in adults. The deficiency or insufficiency causes rickets, arthralgia, arthritis, osteoporosis and Osteomalacia. Study Design: Observational study. Study Setting: Department of Orthopedic LUMHS Jamshoro. Study Duration: from April 2017 to Oct 2017. Sampling: 600 patients were selected through Consecutive sampling. Statistical Analysis: Descriptive statistics like mean, Standard deviation, minimum, and maximum were calculated Using SPSS version 22.Mean of two genders was compared using t-test setting <0.05 as level of significance. Results: Mean serum vitamin –D level was 16.11+10.07ng/ml in men while it was 16.63+11.73 ng/ml in women. 62% of the study population was found deficient (<20ng/ml) while 16.33% were having insufficient levels (<30ng/ml) and only 12% showed normal levels (30-50ng/ml). There was no significant difference between the two genders, p value 0.59 Conclusion: Vitamin –D deficiency is very common in both genders with no significant difference between males and females.
May 2018 DOI 10.14302/issn.2643-6655.jcap-18-2086
In 1979, a study conducted by Ehrhardt et al. retrospectively examined childhood behavioral patterns of 30 adults; 15 identified as lesbian women and 15 identified as transmen. All 30 adults had been assigned female at birth, and, as children, all were regarded as “tomboys.” The study found several key factors that distinguished the two cohorts. The goal of this study was to replicate and extend the 1979 study, utilizing a larger sample size and including a reference group of heterosexual women. Given the major social, technological, medical, and legal paradigm shifts that have occurred over the past four decades, we sought to determine if the previous findings still differentiate the cohorts. In light of the exponential rise in the number of gender diverse and dysphoric youth who request treatment, providing optimal, affirmative care and education is paramount, especially since many of these young people seek social and/or medical transition. Exploration of the early behavioral indices of the diverse trajectories may help to inform best practices for optimal care for these young people and their families.
Apr 2018 DOI 10.14302/issn.2640-6403.jtrr-18-2054
Cellulite is a very frequent clinical condition that, despite not being serious, constitutes one of the greatest aesthetic concerns of a large number of women. In recent years, some of the technologies that have allowed the development of devices and key tools in aesthetic medicine treatments have been consolidated. The aim of this article is to test the effectiveness of CoolCell®, a new treatment for cellulite that is administered with Coolifting® technology. We included 24 women who received 8 sessions of Coolifting® CoolCell®, one per week. Thermographic measurements were taken and satisfaction questionnaires were completed. Thermographic analysis showed a statistically significant color variation and self-assessment reports revealed that more around 75% of the subjects witnessed great or spectacular changes on their skin.
Jan 2018
Breast cancer is the most common cancer in women worldwide. In the United States, is the second leading cause of cancer deaths in women. In Puerto Rico between 2008 and 2012, breast cancer was the most diagnosed type of cancer and the leading cause of cancer deaths among women. This is a case of 54 years old female diagnosed with stage IV right breast carcinoma. The patient complaints were weakness and a right breast ulcer. She started a metabolic correction therapy, which consisted of high intravenous vitamin C infusions, a nutritional supplementation plan, and Paleolithic diet. During treatment, both Glycohemoglobin and Carcinoembryonic Antigen levels decreased significantly, the right breast ulcer decreased in size, and the patient’s quality of life improved. Over the years, vitamin C studies have demonstrated a cytotoxic action against malignant cells. Based on the results from this case, we advocate continue studying possible adjuvant treatments for cancer patients, involving IV infusions of vitamin C and metabolic correction plans.
Dec 2017
This paper aims to examine the challenges and implications of the Village and Commune Safety Policy (VCSP) on harm-reduction programs and describe lessons learned from a harm-reduction program within the context of the VCSP in Cambodia. Data were collected from a monitoring and evaluation database and reports of a drop-in center that provides a wide range of harm-reduction services. In addition, qualitative data were collected through key informant interviews and focus group discussions with 38 participants including people who use drugs (PWUD) and people who inject drugs (PWID). Desk reviews and consultative meetings with key stakeholders were also conducted. In total, 496 PWUD were registered into the program between 2010 and 2012, of which 22.4% were PWID, and 15.0% were women. The mean age of participants was 26 years old. HIV prevalence among PWUD was 1.0% compared to 16.2% among PWID. Remarkable achievements were observed such as high uptake of services by PWUD and PWID with active referrals to methadone maintenance treatment (MMT) and voluntary HIV confidential counseling and testing (VCCT). However, distribution of clean needles and syringes in communities was limited. Also, the newly initiated needle and syringe program (NSP) based in pharmacies failed to reach PWUD and PWID. Appropriate coordination and collaboration with law enforcement and authorities were observed given the complexity of the VCSP. However, the implementation of the VCSP poses challenges including NSP and accessibility to harm reduction services. For future successes of harm-reduction programs, it is important to maintain close coordination and collaboration between program implementers and local authorities with mutual understanding and flexibility.
Oct 2017 DOI 10.14302/issn.2381-862X.jwrh-17-1750
Background The prevalence of obesity and type 2 diabetes is escalating at an alarming rate in many developed as well as developing countries. Irisin is a novel muscle and adipose drived chemokine that is, proteolytically processed from the product of the FNDC5 (fibronectin type ш domain containing 5) gene. The purpose of this study is to examine the effect of three kind of training on irisin in sedentary obese women. METHODSː33 obese women (medium age: 37.99 ± 3.7 year, height: 1.55 ± 0.03 meter, BMI: 34.6 ± 5.07 kg/m2) participated in the study, on three groups, including endurance, resistance and concurrent. Results After 8 weeks exercise we did not find significant differences in fasting glucose, insulin, HOMA-IR and irisin between the groups (P>0.05), but glucose and insulin in resistance groups and irisin in all groups had significant changes (P<0.05). Conclusions In summery in this study in contrast to hypothesis there were no difference between groups of training. It can be hypothesise that the increase of irisin in obese people is one of the preventing ways against of obesity's side effects. Exercise could improve the signaling pathways and consume the fat accumulations, therefore at the end of exercise duration, irisin decreased.
Aug 2017 DOI 10.14302/issn.3070-2313.jeh-17-1552
Introduction. Obesity often coexists with insulin resistance, which is related to cardiometabolic risk. However, some obese individuals exhibit comparable insulin sensitivity (IS) to that of normal-weight subjects, a state associated with a reduced cardiometabolic risk. We aimed to determine the efficacy of a panel of surrogate markers of insulin sensitivity (IS) for the identification of insulin sensitive obese (ISO) vs. insulin resistant obese (IRO) with similar total fat mass (FM) and body mass index (BMI). Methods. This is a cross-sectional analysis among 144 overweight and obese post-menopausal women. IS was determined by the hyperinsulinemic-euglycemic clamp (HEC) and by surrogate indices such as Matsuda index, the simple index assessing insulin sensitivity using oral glucose tolerance test (SIisOGTT), Abdul-Ghani liver IS index, HOMA-IR and Abdul-Ghani muscle IR index. Results. When using upper and lower quartiles values or the median as cut-off for IS determined by the reference HEC to define ISO vs. IRO, Matsuda index, SIisOGTT and Abdul-Ghani indices classification identified ISO vs. IRO individuals with similar FM and BMI. With HOMA-IR, the two groups were similar for FM and had borderline significant difference in BMI. Using, receiver operating characteristic curves, Matsuda index AUC was similar to that of SIisOGTT and both indices AUCs were significantly higher than Abdul-Ghani indices AUCs. The best cut-off value for the Matsuda index was 2.5 (83.1% specificity, 54.2% sensitivity) and 0.25 for SIisOGTT (64.8% specificity, 70.8% sensitivity). Conclusion. Whole body IS indices, Matsuda and SIisOGTT indices seem to be reliable indices for the identification of ISO vs. IRO individuals.
Jan 2017 DOI 10.14302/issn.2379-7835.ijn-16-1411
Background: Isoflavones are phytoestrogens present in natural sources, and they resemble estradiol in structure and manner of action. The aim of the study was to assess the effects of soy-milk on serum tHcy levels and to assess the glycemic and lipidemic status of Bangladeshi postmenopausal women. Methods: Thirty-six women (aged 50 ±5.16 years, M ±SD) participated in a randomized, un-blinded, open-ended, crossover study design for 52 days. The soy-milk group consumed 350 mL of milk twice a day for 21- day; the milk contained ~30 mg of isoflavones. FBG, PPG, HbA1c, TC, TG, HDL-C, NEFA, and tHcy were measured on day 0, day 21, day 31, and day 52 with a 10- day washout period. Results: After the consumption of soy-milk, the level of HDL-C significantly (p=0.005) increased on day 21 in the subjects. No significant changes were observed between the groups. After crossover, significant changes in FBG (p=0.005) and TG (p=0.049) were observed on day 52 in the soy-milk group. Significant improvement in TG (p=0.001) and HDL-C (p=0.032) was also seen at the end-point. Conclusions: Soy isoflavones is to some extent favorable to reduce CVD risk factors among Bangladeshi postmenopausal women.
Jan 2017 DOI 10.14302/issn.2381-862X.jwrh-16-1292
Objective: A cross-sectional study was designed to collect socio-demographic and obstetric data about female teenagers who have pregnancy and visiting primary health care centers for antenatal care. Subjects and methods: Data were collected by a trained 60 medical students of the 6th level in Hadramout University during their post in primary health care centers from 20 May – 10 June 2008. A convenience sample of 237 teenagers who were attending the 12 PHC centers for antenatal care checking constituted the study subjects. Results: Fifty-one out of 237 (21.5%) pregnant women were of age 17 years or less. Most of them were from rural areas with statistically significant difference in both age groups (p-value <0.002),they were housewives (232/237 97.8%) and their husband’s mostly had non-professional jobs with a significant difference between both age groups (p-value <0.005). A high prevalence of anemia in teenage pregnant women was reported (76.7% of them had Hb level less than 11 g/dl) but there were no significant difference between mean Hb level in those at age of 17 years or less (9.9 SD=1) and those at age >17-<20 years (10.1 SD=1.18) p-value >0.05 About one-third of pregnant teenagers were second or multigravida (81/237 pregnant women 34.2%) but only 66 of them were delivered before. The majority of second/multigravida were delivered normally (57/66 pregnant women 86.4%) while only 31 of them (47%) gets their births in a health facility where LSCS was done for 9 pregnant women. The outcome of the pregnancy in teenage multigravida are 67 children; three of them were stillbirth and other 6 babies died within the first week of their life indicating the total children died during the perinatal period as 9 children ; so the perinatal mortality rate was very high in teenagers (9/67*1000 = 134/1000 births). Conclusions: Teenage pregnancy is common and accepted in Hadramout in Yemen; the main consequences are a high prevalence of anemia and high perinatal mortality rate.
Dec 2016 DOI 10.14302/issn.2379-7835.ijn-16-1360
Energy intake has been decreasing these ten years in Japan, and low energy intake is remarkable especially among young women. We attempted to show the dietary habits and physiological function including glucose tolerance and stamina for endurance-running in contemporary young Japanese women who take insufficient energy. 85 healthy women aged 20.5±1.1 years were enrolled in the present study. Subjects were categorized in two groups; Group I (n=70) with higher energy intake, and Group II (n=15) with lower energy intake than the basal metabolic rate (BMR). Actual energy intake in Group I was 1598.8±282.1 kcal/day, and it was 1019.9±127.1 kcal/day in Group II (p<0.01). Standard 75-g oral glucose-tolerance test was performed, and the capillary glucose value was measured at the fingertip. In Group I, glucose values at fasting, 30, 60 and 120 min were 75.0±9.1, 132.1±25.2, 120.5±27.4, 105.3±19.5 mg/dl, and those in Group II were 78.9±7.7, 155.8±26.6, 142.2±26.6, 112.3±16.0 mg/dl, respectively. The values of Group II at 30 and 60 min showed significantly high (p< 0.01). Stamina and the intake of protein in Group II were significantly lower than those in Group I (p<0.05), and muscle mass and grip strength were less in Group II than in Group I, though there was no significant difference. We indicated with these results that low skeletal muscle was considered to be responsible for the impairment of glucose regulation in Group II. This study showed that young women with low energy intake should take sufficient energy and build skeletal muscle to prevent the impairment of glucose regulation.
Jul 2016 DOI 10.14302/issn.2474-3585.jpmc-16-1114
Campylobacter infection has been detected in poultry processors at live bird markets in Sokoto, however the prevalence of Campylobacter species in more diverse group of the population is uncertain. For this purpose, 292 human fecal swabs from patients in four Government Hospitals in Sokoto State were analyzed for Campylobacter species using culture and phenotypic typing method. The prevalence rate of 55% was revealed in the tested samples while 56% and 55% were for males and females respectively. Campylobacter jejuni, C. coli and C. lari had 20%, 40% and 40% in males and 38%, 35% and 27% in females respectively. The prevalence rates of 60%, 52%, 45%, 41% and 80%,were revealed in age range of (less than 1-6, 7-13, 14-20, 21-55 and 56-76) yrs respectively. Furthermore, 70% and 43% prevalence rates were recorded in pregnant and non-pregnant women of reproductive age respectively. There was no statistical significant association (P>0.05) between Campylobacter infection and age range and sex, but the statistical association between infection and pregnancy was significant (P<0.05). The prevalence of Campylobacter species in patients as found in the various hospitals has revealed the level of environmental contamination in different homes in the state and the need to include Campylobacter in screening routine laboratory diagnosis of gastroenteritis in humans for appropriate treatment and management especially in young children, old adult and pregnant women.
Jul 2016 DOI 10.14302/issn.2379-7835.ijn-16-986
Abstract: Several researchers have suggested that a targeted diet for reducing theadipose tissue may interfere with the severity of cellulite. Others emphasize that the diet composition seems to play a more relevant role than the calorie profile for weight loss and cellulite control. Objective: The aim of this study was to evaluate the influence of a controlled diet on body composition and cellulite improvement in adult women. Methods: Thirty two healthy women, aged from 25 to 40 were included. They receivedan orientation for a controlled diet to be followed for 3 months. Assessments were performed at the baseline and the end of the study which included four parameters: 1) Photonumeric cellulite severity scale; 2) Anthropometric measuremets 3) Skin elasticity (Cutometer®) and 4) Collagen density or echogenicity and length of the dermis-hypodermis interface line (ultrasonography - DermaScan®). The data was compared with the Paired T-test, Wilcoxon and Pearson's correlation for statistical analyses. Results: Only 14 completed the study. Although the scores of photonumeric scalereduced, there was no difference in the grade of cellulite severity. There were significant reductions in body measurement. The skin elasticity showed no significant change. On the other hand, the dermal density or echogenicity showed a significant increase in the right and left sides (p = 0.05 and p = 0.005, respectively); however, no difference was observed in the lenght of dermis-hypodermis line. Conclusion: the controlled diet was effective for the reduction of weight and body composition, but despite the increase in dermal collagen density, no clinical effect on cellulite could be detected.
Jul 2016 DOI 10.14302/issn.2381-862X.jwrh-15-806
Background and Objectives: The prevalence of abnormal cervical cytology in morbidly obese women using ThinPrep® liquid-based Pap Test™ and HPV DNA Test™ is unknown. We aimed to investigate whether women with morbid obesity have a higher frequency of abnormal Pap smears compared with nonobese women, and to explore the rate of Pap smear screening in morbidly obese women. Design and Setting: We conducted a retrospective study over five years in two general government hospitals in Dubai. Patients and Methods: We screened ThinPrep slides and HPV DNA of morbidly obese women and nonobese women. The age, ethnicity, demographic and socioeconomic backgrounds of the two groups were matched. We studied hypertension (HTN), diabetes (DM), infertility, sexually transmitted diseases (STD), connective tissue disease (CTD), immunosuppression and oral contraceptive pills (OCP) as potential risk cofactors. Results: Only 90 (29%) out of 310 morbidly obese women had had Pap tests. They showed more prevalence (P<0.05) of ASC-US, high-risk HPV DNA and LSIL 16 positive (18%) (95% CI: 7.0, and of endometrial AGCs {4 positive (4.5%) (95% CI: 0.3-13.5)} than the nonobese women (n=8175), {279 positive (3%) (95% CI: 3.0-3.8} , and {2 positive (0.024%) (CI:0.01-0.09)}. There were no endocervical AGCs, HSIL or squamous cancer in morbidly obese women. DM, HTN, OCPs, CTD and STD were more common in morbidly obese women having abnormal Pap smears. Conclusions: Low-grade squamous abnormalities, high-risk HPV, and endometrial AGCs are more frequent in morbidly obese women than in nonobese women. Women with morbid obesity have a low rate of cervical screening. This, among other factors, could increase the risk of these women to abnormal cervical cytology. This vulnerable group should benefit from more frequent cervical cytology screening. Appropriate clinical and educational measures should be implemented to encourage compliance to Pap smears. Weight reduction might help.
Jun 2016
Background: There is a growing scientific interest in the phenomenon of earworms, which are melodies that are heard and re-heard despite the absence of an external stimulus. Aim: The aim of this paper is to determine whether understanding earworms can shed light on mechanisms underlying auditory hallucinations in psychosis. Method: Using recent data sources, this report briefly reviews what is most relevant about musical hallucinations and earworms. Results: Musical hallucinations, like hallucinated voices, are more prevalent in women. In the elderly, they are often associated with hearing impairment. They are most distressing when they first begin, with the degree of distress inversely proportional to the extent to which they can be controlled. Earworms can be provoked both by the memory of past events and by the anticipation of future events. Strong emotion can trigger earworms, but so can boredom. Limitations: The neurobiology potentially involved in the phenomenon of earworms is not explored in this paper. The pertinence of the literature about earworms and musical hallucinations, while interesting, is of unproven relevance to pathological voices in psychotic illness. Conclusions: The clinical relevance, while unproven, is that addressing recurring memories, as well as managing strong emotions and avoiding occupations that lead to boredom are all strategies worth trying when treating pathologicalauditory hallucinations
Feb 2016 DOI 10.14302/issn.2381-862X.jwrh-15-672
The study was conducted in four selected hospitals in the Southern part of India with an aim to determine the support needs of women in early labour as perceived by women. A descriptive design was used to determine the support needs of women in early labour. Following ethical approval, sixty women between 29-40 weeks of gestation with singleton pregnancy were interviewed in early labour, using a validated Labour Support Need Assessment Tool to gather data on background information and perception of women related to need and support needs (physical, emotional and informational support). Results indicated that women perceived all types of support such as physical, emotional and informational as significant factors in their care during labour, regardless of their parity and gestation. The major findings of the study suggested that there was a slightly higher need for support among women for informational (90.33%) and emotional support (88.78%) compared to physical support (80.19%). For primigravid women, and multiparous women who were experiencing labour for the first time (previous birth by caesarean section), the ‘need for support’ was greater than for women who had previous experience of labour. Early labour is the time when most women use their own coping skills and seek support. Determining the quantity and quality of support women need at this phase of labour can help care providers to provide the best comprehensive care to women in early labour. The findings of the study provide a guide on what women feel is helpful in early labour.
Jun 2015 DOI 10.14302/issn.2381-862X.jwrh-14-546
Objective: To assess the efficacy of bupropion therapy for hypoactive sexual desire disorder (HSDD) in women. Methods: A systematic review was performed utilizing the standard databases. Data were abstracted for study quality, characteristics, and outcomes. Due to the small number of studies and lack of consistently reported outcomes, a meta-analysis was not performed. Results: Two studies (289 women) met inclusion criteria. While one study had low risk of bias, the other had areas of high risk of bias. Both trials reported improvement in sexual function domains with treatment ranging from 12 weeks to 112 days. Conclusions: Despite two trials demonstrating benefit with bupropion treatment for premenopausal women with HSDD, the evidence is limited and not of adequate quality to recommend the therapy. More trials are needed in this area.
May 2015 DOI 10.14302/issn.2372-6601.jhor-14-382
Background/Aims: Thyroid disorders are a common, worldwide clinical problem in general practice.It presents predominantly as a thyroid nodule. Each thyroid nodule has a risk of cancer. The incidence of thyroid cancer is much more common in Saudi Arabia in comparison to the West. There is a worldwide increase in the incidence of thyroid cancer. The objective of this study is to highlight in details the wide spectrum of histopathologic diagnosis encountered in patient undergoing thyroid surgery in the population of Riyadh region of Saudi Arabia. Patients and Methods: Retrospective review of all thyroid samples for 256 patients whom underwent thyroid surgery at King Khalid University Hospital, King Saud University, Riyadh, during the period between 2000 and 2009. Of those, 171 cases were non neoplastic and 85 neoplastic lesions. Females constitute 80% of non neoplastic lesions and 79% of all thyroid malignancies. The peak incidence of thyroid cancer was in the third decade. Papillary thyroid carcinoma was the most common cancer (71%). Conclusion: Thyroid cancer is a common cancer in Saudi Arabia; it is the second most common cancer in females. The increasing rates of thyroid cancer occur predominantly in women. Papillary thyroid carcinoma accounted for the bulk of this increase. Additional studies are needed to explain the rise in papillary thyroid carcinoma incidence in Saudi Arab as well as throughout the world and to search potential risk factors that are currently unrecognized.
Nov 2014 DOI 10.14302/issn.2379-7835.ijn-14-475
Osteoporosis prevention among women requires obtaining proper knowledge early in life about the disease, risk factors and treatments. This study compares specific education sources to osteoporosis knowledge and calcium intake. Online survey usinga convenience sampling was performed with women between ages 18 and 40. The survey measured osteoporosis knowledge, calcium consumption, and specific education source within categories of age, school classes, television, radio, newspaper, magazine, Internet, and in-person. Multiple regression analysis determined influential education sources for osteoporosis knowledge and calcium intakes. Osteoporosis knowledge was suboptimal (13.8 ± 3.3, as a score higher than 16 defined as “adequate”) and average daily calcium intake was 1315.1 ± 609.9 mg. Age and newspaper had greatest contribution towards osteoporosis knowledge, while Internet, school classes and radio were most influential resources on calcium intakes. Creating an osteoporosis education initiative utilizing these sources is imperative for increasing disease knowledge and preventive behavior among young women.
Jun 2014 DOI 10.14302/issn.2324-7339.jcrhap-12-158
It is important to measure depressive symptoms in HIV-infected individuals because depressive symptoms have been found to be correlated with faster progression to AIDS. Worldwide, the CES-D has been used to assess depressive symptoms and examined for its construct validity. However, no previous studies have investigated the CES-D’s construct validity among HIV-infected perinatal women. Therefore, the objective of this study was to examine the construct validity of the CES-D using both explanatory and confirmatory factor analysis among HIV-positive perinatal women in Thailand. Results showed that, overall, the CES-D is a 4-factor instrument with good construct validity and can be used to evaluate depressive symptoms among HIV-positive perinatal Thai women. However, some items from our study loaded differently on the 4 factors from Radloff’s model. Finally, the CES-D can be used as a general-factor scale without being compromised.
Jan 2014 DOI 10.14302/issn.2324-7339.jcrhap-13-187
Retention of sufficient numbers of participants in longitudinal research studies is a serious methodological concern, as retention influences the validity of the research findings. An assessment of participant retention or attending all study visits was made quarterly during a 12 month follow-up of an HIV incident cohort in Kisumu, Kenya. The study objectives were to determine 1) the proportion of participants attending all study visits and 2) demographic and behavioral factors associated with missing ≥ 1 visit. The Kisumu Incidence Cohort Study (KICoS) was initiated in January 2007 (N=831). Detailed contact information was collected from each participant to enhance retention. Bivariate and multivariable analyses were used to determine factors associated with missing ≥ 1 visit. Overall retention was 90%. Of those enrolled, 46.4% were females. The adjusted odds of missing ≥ 1 study visit were greater for participants who were female (AOR=2.85; CI=1.90-4.28) and who had technical training (AOR=2.51; CI=1.20-5.25) or college/university education (AOR=1.89; CI=1.10-3.24) compared to having no or only primary education. Retention was high in this HIV prevention cohort study. However, studies could benefit by tailoring retention strategies for women. Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the views of their respective institutions.
Nov 2013 DOI 10.14302/issn.2329-9487.jhc-12-154
Objective: To determine whether age at menarche is an independent predictor of common carotid artery intima-media thickness in overweight and obese adult women. Methods: 403 overweight and obese women, aged 18–72 years, were evaluated. We examined the associations among common carotid artery intima-media thickness (CCA-IMT), age at menarche, body mass index, central fat accumulation (indirectly measured by waist circumference), and other well-known cardiovascular risk factors (blood pressure; fasting serum insulin, glucose and lipids concentrations; insulin resistance (estimated by homeostasis model assessment for insulin resistance)). Results: CCA-IMT was significantly and positively correlated with age (r=0.632, p<0.001), age of menarche (r=0.156, p<0.01), waist circumference (r=0.110, p<0.05), systolic (r=0.292, p<0.001) and diastolic (r=0.183, p<0.001) blood pressure, fasting blood glucose (r=0.265, p<0.001), triglycerides (r=0.204, p<0.001) and total cholesterol (r=0.396, p<0.001) levels. Conversely, CCA-IMT was negatively associated with high-density lipoprotein cholesterol (r=-0.111, p<0.05). Age at menarche was associated with CCA-IMT (r=0.156, p<0.01), age (r=0.110, p<0.05) and waist circumference (r=0.121, p<0.05). Multiple linear analysis showed that only age and age at menarche maintained an independent positive relationship with the CCA-IMT. Conclusions: Age at menarche is positively associated with CCA-IMT, independently of common cardiovascular risk factors (adverse glucose and lipid levels, higher blood pressure,insulin resistance, body fatness and central body fat). Late age at menarche can be considered as an independent cardiovascular risk factor in obese subjects.