Journal of Women's Health and Development
Journal of Women's Health and Development is an international, peer-reviewed, open access, online journal. Journal publishes original research, reviews, reports, editorials, and commentaries on all aspects of women's healthcare including Woman Cancer, Woman Diabetes, Woman Disorders, Woman Hormones, Woman Mental Health, Woman Psychology, Women's Fitness, Women's Health, Gynecology and Obstetrics.
Antimicrobial Resistance Pattern and Phenotypic Characterization of Staphylococcus Aureus and Escherichia Coli Isolated from High Vaginal and Urethral Swab Specimens
Background: Antimicrobial resistance (AMR) among urogenital bacterial pathogens is an increasing global public health concern, particularly in low- and middle-income countries. High vaginal and urethral infections are commonly associated with Staphylococcus aureus and Escherichia coli, which frequently exhibit multidrug resistance. Monitoring antimicrobial susceptibility and phenotypic characteristics of these pathogens is essential for effective treatment and infection control. Objective: This study aimed to determine the antimicrobial resistance patterns and phenotypic characteristics of Staphylococcus aureus and Escherichia coli isolated from high vaginal and urethral swab specimens and to assess factors associated with multidrug resistance. Methods: A hospital-based cross-sectional study was conducted among 240 clinically suspected patients at a tertiary care hospital from March 2025 to November 2025. High vaginal and urethral swab specimens were collected aseptically and processed using standard microbiological procedures. Bacterial identification was performed through colony morphology, Gram staining, and biochemical characterization. Antimicrobial susceptibility testing was carried out using the Kirby–Bauer disk diffusion method according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Multidrug resistance (MDR), methicillin-resistant Staphylococcus aureus (MRSA), and resistant Escherichia coli isolates were determined phenotypically. Statistical analyses including chi-square test and logistic regression were performed, with p < 0.05 considered statistically significant. Results: Among the 240 specimens collected, 168 (70.0%) demonstrated significant bacterial growth, while 60 (25.0%) showed no growth and 12 (5.0%) revealed mixed growth. Of the culture-positive isolates, Escherichia coli was the predominant pathogen accounting for 80 (47.6%) isolates, followed by Staphylococcus aureus comprising 64 (38.1%) isolates. The highest culture positivity was observed among patients aged 26–35 years (79.6%), which showed a statistically significant association with bacterial infection (χ² = 9.85, p = 0.020). Phenotypic characterization demonstrated that 93.8% of S. aureus isolates were coagulase-positive and 87.5% fermented mannitol, whereas 93.8% of E. coli isolates showed lactose fermentation and 90.0% were indole-positive. Antimicrobial susceptibility analysis revealed high resistance of E. coli against ampicillin (81.2%), cotrimoxazole (56.2%), and ceftriaxone (42.5%), while high sensitivity was observed for imipenem (95.0%) and nitrofurantoin (85.0%). Similarly, S. aureus exhibited marked resistance to penicillin (78.1%), erythromycin (37.5%), and ciprofloxacin (34.4%), whereas vancomycin (96.9%) and gentamicin (75.0%) demonstrated high effectiveness. Multidrug resistance was detected in 38 (47.5%) E. coli isolates and 24 (37.5%) S. aureus isolates. MRSA prevalence among S. aureus isolates was 34.4%. A significant association was identified between previous antibiotic exposure and MDR infection (χ² = 15.37, p < 0.001). Inpatient participants showed significantly higher MRSA prevalence compared to outpatients (54.5% vs. 23.8%; p = 0.009). Logistic regression analysis further demonstrated that previous antibiotic use (AOR = 3.54, 95% CI: 1.89–6.61, p < 0.001) and inpatient admission status (AOR = 2.11, 95% CI: 1.14–3.89, p = 0.017) were independent predictors of MDR infection. Conclusion: The study demonstrated a high burden of antimicrobial resistance among urogenital bacterial pathogens, with Escherichia coli and Staphylococcus aureus as the predominant isolates. The notable prevalence of multidrug resistance and MRSA highlights the need for continuous antimicrobial surveillance, rational antibiotic use, and effective infection prevention strategies to reduce resistant urogenital infections.
Copyright (c) 2026 Journal of Womens Health and Development
In Vitro Pro-Inflammatory Cytokine Inhibition by Exogenously Generated Nitric Oxide; Potential Complimentary Clinical Application to Bacterial Rhinosinusitis Management
Background: Recurrent acute rhinosinusitis (RARS) is characterized by episodic inflammation of the nasal and paranasal sinus mucosa and is frequently triggered by viral infection, with secondary bacterial involvement contributing to symptom persistence and antimicrobial use. Nitric oxide (NO) exhibits antimicrobial and immunomodulatory properties that may be therapeutically advantageous in this setting. This study evaluated the in vitro anti-inflammatory effects of NO generated from a nitric oxide–releasing solution (NORS) and explored the clinical efficacy and safety of a nitric oxide nasal spray (NONS) in adults with RARS. Methods: In vitro experiments assessed NO-mediated cytokine modulation in primary human monocytes and THP-1 cells following lipopolysaccharide stimulation, measuring TNF-α, IL-1β, IL-6, and IL-8 secretion and cytotoxicity across graded NO exposures. Clinically, a multicenter, randomized, double-blind, placebo-controlled phase 2 trial compared the NO generated from NONS to a saline placebo nasal spray in adults with a history of RARS. Participants (68.4% of which were women) initiated a two week (5 doses/day) treatment regimen at the onset of symptoms and were followed for 4 weeks. The primary endpoint was clinical success (cured or much improved) at Day 8; secondary outcomes included quality of life (SNOT-22), intranasal corticosteroid use, antibiotic rescue and safety. Results: In vitro, low NO exposures consistently inhibited TNF-α, IL-1β, and IL-6 secretions from baseline by approximately 40–60%, while IL-8 inhibition was not observed at tolerated non-cytotoxic concentrations. Clinically, 53.6% of NONS-treated participants achieved clinical success at Day 8 compared with 46.3% receiving saline (absolute difference 7.3%; p=0.391), with trends favoring NONS for improved quality of life, lower intranasal corticosteroid use and reduced antibiotic rescue. NONS was well tolerated with adverse events comparable to saline, with no treatment-related serious adverse events observed. Conclusions: NO generated from NORS demonstrates biologically plausible anti-inflammatory activity in monocytic models, and when delivered as NONS shows favorable efficacy trends and good tolerability in RARS. Although statistical significance was not achieved, likely due to the limited evaluable sample size, these findings support further adequately powered trials to define the clinical role of NO-based nasal therapy in RARS management. NONS may have the potential to reduce the duration of each RARS episode, decrease the severity of symptoms of each episode and decrease the number of episodes/year.
Since the US Supreme Court 2022 Decision on Abortion
The Preamble to the US Constitution says, “We the people of the United States, in order to form a more perfect Union, … establish this Constitution for the United States of America.” The meaning of these lines, with regard to what is and is not included in the constitution, has evolved over time while we have inexorably expanded individual freedom, increased equity and equality, and striven to ensure equal voting rights for all. The people who devised the original details of the Constitution were all white men of property. Some of them were wealthy. Some owned other people. They restricted voting rights to property-owning white men like themselves. Indeed, it was not until 1856 that white men without property were permitted to vote in every state. Until the election of Abraham Lincoln, more than half of Supreme Court appointees were slaveowners, and all were white men. Not until 1981 was a woman appointed to the Court. When the Constitution was written, there were only thirteen states. Technology and logistics were far more primitive than they are today. The economy was integrated only loosely, while limited communications and mobility between states ensured that society was considerably less integrated.
The Burden of Anemia: A Study of SC Women's Health in Haryana
One of the significant global public health issues that exists, especially among reproductive-age women and children in underdeveloped nations, is anemia, which has serious repercussions for survival, economic growth, and overall health. Poor nutritional status, especially the decline in coarse cereals in the Indian diet, which lowers iron intake, is the main reason for the high incidence of anemia among Indian women. Women who suffer from anemia are severely impacted because it impairs their ability to perform physical labour and stunts their growth, making them ill-prepared to handle the challenges of pregnancy and parenting. The present study explores the socioeconomic risk factors of anemia among women of the scheduled caste in Haryana. The SCs are the most disadvantaged group in India. They occupy the lowest status in the hereditary and hierarchical caste system of India and have been subjected to oppression and untouchability by the upper castes. The present attempt is based on the Demographic Health Survey data from the 4th and 5th National Family Health Survey editions. The study's findings suggest that anemia among women (15-49) has slightly decreased from 62.7 per cent in NFHS-4 to 60.4 per cent in NFHS-5. The severity of anemia among SCs, OBC, and other women has increased from NFHS-4 to NFHS-5. The government should frame new policies to improve the overall nutritional status of women of reproductive age and all socio-economic subgroups.
Seroprevalence and Risk Factors for Chlamydia Trachomatis Infection among HIV-AIDS Positive Women in the Soa District Hospital, Cameroon
Background: Chlamydia trachomatis infection is the most common bacterial sexually transmitted infection (STI) globally. A high prevalence of C. trachomatis has been consistently reported among people living with HIV/AIDS. This study aimed to determine the seroprevalence and identify risk factors for C. trachomatis infection in women living with HIV/AIDS. Methods: We conducted a cross-sectional study involving 80 women living with HIV/AIDS. Data on socio-demographic characteristics and intravaginal practices were collected using a structured questionnaire. Serological testing for anti-Chlamydia trachomatis IgG and IgM antibodies was performed using an enzyme-linked immunosorbent assay (ELISA). Results: The overall seroprevalence of Chlamydia trachomatis infection was 50%. The highest prevalence was observed in the 30-40 years age group (18.75%). A lower prevalence of infection was associated with higher education; women with a university education had a prevalence of 8.75%. Intravaginal practices were identified as a significant risk factor, with 32.5% of infected women reporting this practice. Conclusion: The high seroprevalence of Chlamydia trachomatis in this cohort suggests that HIV infection increases the risk of co-infection. We recommend that women living with HIV/AIDS undergo regular screening for other sexually transmitted infections, particularly C. trachomatis.
Green Walls, Emotional Well-Being, and Women’s Positive Body Image: Evidence from a Multicultural University Campus
Background: Exposure to urban green environments is consistently associated with improved emotional well-being and psychological restoration. However, limited evidence exists on whether micro-scale greening interventions such as green walls yield comparable benefits across social groups within shared institutional environments. Drawing on environmental justice perspectives, this study examines whether exposure to a campus-based green wall differentially influences women’s emotional well-being and state positive body image (SPBI) across ethnic groups. Methods: We conducted a within-subject quasi-experimental field study among Jewish and Arab female students at the Hebrew University of Jerusalem. Participants were exposed to two campus conditions: a vegetated green wall and a visually comparable non-vegetated gray wall. Outcomes included positive affect (PANAS) and SPBI (SBAS-2). We estimated condition effects using linear mixed-effects models and tested ethnic differences via exposure-by-ethnicity interaction terms. Moderated mediation models assessed whether positive affect mediated the association between green wall exposure and SPBI and whether the indirect effect varied by ethnicity. Results: Green wall exposure was associated with higher positive affect and SPBI among women overall. The magnitude of these effects was substantially stronger among Arab women than Jewish women, as indicated by significant exposure-by-ethnicity interactions. Positive affect partially mediated the association between green wall exposure and SPBI, with a larger proportion of the effect mediated among Arab women, consistent with stronger affective responsiveness to green exposure. Conclusions: Campus green walls may function as equity-relevant restorative features, disproportionately benefiting women from environmentally disadvantaged backgrounds. These findings highlight the importance of equity-oriented design in academic environments and support the integration of micro-scale greening interventions into campus well-being and inclusion strategies.
Exploring Knowledge, Attitudes, and Practices of Family Planning among Urban Residents in Bayelsa State, Nigeria: Identifying Barriers and Facilitators for Improved Reproductive Health
Background: Family planning was a critical aspect of reproductive health, significantly influencing maternal and child health outcomes. In Bayelsa State, Nigeria, urban residents faced unique barriers and facilitators in accessing family planning services, shaped by demographic, sociocultural, and economic factors. Objective: This study aimed to explore the knowledge, attitudes, and practices of family planning among urban dwellers in Bayelsa State and to identify the barriers and facilitators influencing reproductive health outcomes. Methods: A cross-sectional survey was conducted, utilizing a structured questionnaire administered to 482 urban residents across eight local government areas in Bayelsa State. The data were analyzed using descriptive and inferential statistics, including chi-square tests and logistic regression, to assess associations between demographic variables and family planning knowledge and utilization. Results: The findings revealed significant gaps in knowledge about family planning methods, particularly among younger and unmarried individuals. Positive attitudes towards family planning were observed, with 81% of respondents expressing favourable views. However, barriers such as lack of information, financial constraints, and sociocultural stigma were prevalent. Logistic regression indicated that marital status, awareness of family planning methods, and perceived benefits were significant predictors of service utilization. Conclusion: The study highlighted the need for targeted educational interventions and community engagement strategies to enhance awareness and acceptance of family planning among urban residents in Bayelsa State. Addressing identified barriers while leveraging facilitators was essential for improving reproductive health outcomes and achieving broader public health goals.
Copyright (c) 2025 Journal of Womens Health and Development
Anaplastic Transformation of Papillary Thyroid Carcinoma in Metastatic Lymph Nodes
Background: Anaplastic thyroid cancer (ATC) is a rare but highly aggressive malignancy, accounting for approximately 1–4% of all thyroid cancers and associated with extremely poor prognosis. Although anaplastic transformation most commonly arises within the primary thyroid tumor, transformation occurring in metastatic cervical lymph nodes is exceedingly uncommon. Early recognition of rapid clinical progression is essential, as timely diagnosis may influence management strategies. Case Presentation: We report the case of a 67-year-old woman who presented with a year-long right neck swelling and recent onset of hoarseness. Imaging revealed an enlarged right cervical lymph node with central necrosis and a 3-cm thyroid mass. Fine needle aspiration identified papillary thyroid carcinoma (PTC). The patient underwent total thyroidectomy with right modified radical neck dissection. Histopathology demonstrated conventional PTC in the primary lesion, whereas the metastatic cervical lymph node exhibited spindle cell proliferation with marked nuclear atypia, consistent with anaplastic thyroid cancer. Postoperatively, external radiation therapy was initiated; however, rapid disease progression ensued, with the development of cervical skin metastasis, lung metastases, and pleural involvement. The patient died 57 days after surgery despite treatment. Conclusion: This case highlights the rare occurrence of anaplastic transformation within metastatic cervical lymph nodes of PTC. Even with complete resection and postoperative radiation therapy, the disease course may be fulminant. Clinicians should remain vigilant for rapid morphological or clinical changes in metastatic lesions, as early detection of anaplastic transformation may improve diagnostic accuracy and inform treatment planning.
Long-Term Care for the Elderly is Determined by a Causal Link to Lifestyle, Three Health Factors Based on Socioeconomic Status
Background: Factors influencing the amount of long-term care needed by the elderly, which are more common in women than men, include lifestyle habits, physical, mental, and social health, as well as frailty and decreased exercise frequency. However, the causal relationships, including socioeconomic status as a background factor, remain unclear. In this study, the level of long-term care needs was designated as the dependent variable. A follow-up survey was conducted, utilizing educational background and annual income as underlying factors, to analyze physical, mental, and social health, along with the relationship between preferred diet and lifestyle habits such as exercise to clarify the underlying structure. The treatment status of cerebrovascular accidents will also be examined by sex. Methods: In September 2001, a mail-in survey was carried out among 16,462 elderly residents in the suburbs of Tokyo using a self-administered questionnaire. The cohort study evaluated the long-term care needs after three years for 8,162 individuals confirmed to be alive. The analysis method employed to explore the causal structure of care requirements was covariance structure analysis. Results: The study found that women had a significantly greater need for nursing care compared to men in older age groups. The level of long-term care needed after three years was only slightly affected by lifestyle habits, such as how often they exercised. However, the levels of mental, physical, and social health influenced by lifestyle habits were closely linked. Additionally, positive lifestyle habits and three health factors were influenced by advantageous socioeconomic factors. In other words, lifestyle habits like diet helped maintain the three health factors, reduced the number of diseases needing treatment, and ultimately prevented the need for long-term care. There were no sex differences in the overall relationship of the structure. In this survey, we were able to explain 45% of the variance in the coefficient of determination regarding the long-term care needed after 3 years. Conclusion: The amount of long-term care needed after three years was minimally influenced by socioeconomic factors and lifestyle choices as a direct result. The three health indicators remained the most important factors in preventing diseases, including cerebrovascular accidents, within the framework of socioeconomic status as a structural basis. Future research is likely to focus on the index of perception and cognitive functions related to health and aging, and the causal relationships are expected to become clearer through randomized intervention studies.
Causal Factors Involving Family Physicians And/or Dentists that Affect the Six-Year Survival of Elderly Individuals
Background: Living a long life is a reward for everyone. This study examines socioeconomic factors, physical, mental, and social health, lifestyle, and the prevalence of diseases as related factors in individuals with only a family physician and those with only a family dentist, investigating the causal structure of the survival rate in relation to these factors. Methods: In September 2001, a self-administered questionnaire was sent to 16,462 elderly residents of Tama City, Tokyo. A total of 13,066 responses were received, resulting in a response rate of 79.4%. The Survival Dayss up to 2007 were recorded. Results: Having only a dentist was significantly associated with a more prolonged six-year survival compared to having only a physician for both sexes. Additionally, "Socioeconomic Status" (latent variable) was identified as the primary causal factor of the "Three Health Factors." Regarding the cause and effect of having a [Physician and/or Dentist] (observed variable) on Survival Days, “Socioeconomic Factors," the "Three Health Factors," and ?Treated Diseases? were identified as confounding variables. Conclusions: The main factor influencing survival time was the patient's recommended socioeconomic status, particularly access to a family dentist. Additionally, socioeconomic factors are fundamental drivers that impact the reduction of treatable diseases through lifestyle choices and the maintenance of mental, physical, and social health. Choosing only a family dentist instead of a family physician was significantly linked to longer survival. Trial Registration Data The analytical data from this study are available from the UMIN SYSTEM in Japan as an open system (https://upload.umin.ac.jp/cgi-bin/fileshare/upload.cgi?DELETE=1&on=589518, Accessed July 1, 2025). Personal registration is required for data specifications. Additionally, analytical data and materials can be obtained from the first author via the following email address: star@onyx.dti.ne.jp (T. Hoshi, first author).
Impact of COVID-19 on care homes: A qualitative study of experiences of black carers in UK
15 participants from three UK counties which have a large number of care homes. The analysis of interviews resulted in the development of seven themes: 1) reactions to COVID, 2) infection control in the work environment, 3) workplace discrimination, 4) impact of COVID on well-being, 5) coping mechanisms and impact of deaths, 6) reflection on challenges, and 7) recommendations to care home managers. In conclusion, the black carers reported a substantial impact on their mental and physical health. They recognized the need for timely information, sufficient and fair availability of PPEs, more support, better communication, and equitable work distribution to maintain their mental and physical health.
PDGFR Upregulates HMGA1 Expression in the P53 Pathway to Facilitate Epidermal Differentiation of Adipose-Derived Mesenchymal Stem Cells
Background: During the healing process, platelet-derived growth factor (PDGF) stimulates the regeneration of damaged tissue by interacting with PDGF receptor (PDGFR). This research seeks to investigate how PDGFR promotes the differentiation of adipose-derived mesenchymal stem cells (ADMSCs) into epidermal cells. Methods: ADMSCs were initially induced to differentiate into epidermal cells using an epidermal cell induction medium. Following the induction, cell morphology was examined microscopically, and immunofluorescence was employed to assess the fluorescence intensity of epidermal cell markers CK19 and CK10. Subsequently, cells were transfected with oe-PDGFR and exposed to the PDGF inducer PDGF-BB. Western blot and qPCR were used to determine PDGFR levels in the mRNA and protein. Cell proliferation and migration were evaluated through CCK-8 and Transwell assays.The expression levels of CK19 and CK10 was further analyzed via Western blot. In addition, bioinformatics analysis of RNA sequences were conducted to find out potential downstream targets and elucidate the molecular mechanisms. Results: Upon culturing in the epidermal cell medium, ADMSCs transformed from spindle-shaped to round or oval forms, were arranged in a cobblestone pattern, and exhibited high expression levels of CK19 and CK10. PDGFR expression was significantly increased following transfection with oe-PDGFR. Notably, the increased expression of PDGFR significantly enhanced cell proliferation and migration, elevated the expression levels of CK19 and CK10, and activated the ERK and AKT signaling pathways. The study combined bioinformatics analysis with in vitro rescue experiments, confirming that PDGFR overexpression upregulated HMGA1 expression. The inhibition of p53 activation facilitates differentiation of ADMSCs into epidermal cells. Conclusion: We found that PDGFR activated HMGA1, stimulating differentiation of ADMSCs by modulating the p53 signaling pathway in a way that facilitates their differentiation into epidermal cells.
Laboratory testing of body fluids and tissues is an essential part of diagnostic work-up and monitoring for health and healthcare. About 70% of clinical decisions are driven by laboratory data [1,2]. Most of the time laboratory testing is done to screen for a disorder, diagnose or rule out a disorder, monitor the progress of treatment and disease. This narrative addresses the usual laboratory tests that may be done to monitor the health of the person and is not geared towards screening or diagnosis of specific entities. This issue has gained importance since the availability of laboratory results to patients, via patient portals. Patients/lay persons, may over-react to results labeled as abnormal. At the same time patients may not realize the importance of results with a narrative report, e.g., presence of a monoclonal immunoglobulin on serum protein electrophoresis [3,4]. Laboratory testing results usually include a range of normal values, reference range, in laboratory parlance. A reasonable question is, “Where do normal values/reference ranges, come from?” Classically, at least 120 normal, healthy people, of a given age, gender, ethnicity and geographic area, are tested for the chemical/cell type/ analyte under consideration. The lowest 2.5% and highest 2.5% of the results are discarded and the central 95% results are adopted as the reference range/normal value. Under ideal conditions, the specimen is collected in post-absorptive, recumbent state. At one time, metabolic units in academic centers, admitted healthy people who were kept on a prescribed diet and activity. Body fluid, usually blood was collected on waking up for testing to establish normal values [2]. There are a number of issues with the ideal state of specimen collection and what takes place in real life. Some of the issues are addressed below.
Congenital Hyperinsulinism: A Therapeutical Dilemma
Congenital hyperinsulinism in newborns has a prevalence of 1:28000-50000. Syndromic and non-syndromic, as well as nonketotic and ketotic cases were described. Depending on the degree of extension, histologically focal, diffuse and atypical forms are found. The primary diagnostic criterion is detectable insulin and hypoglycemia in the blood. Early onset and late onset forms do exist. A high variability and complexity in patient phenotype and a significant burden of care in families is present in these children. Cure means a mutation repair of the genetic origin. The chromosomal region 11p15 plays a key role in the disease, especially the K+ ATP channel on region 11p15.1 is of upmost importance. The genetic origin is multifactorial with mutations in about 10 different genes, aggravating the chance to find a curative method for these children.
Sexual and Reproductive Health Service Utilization and its Impact on ART Adherence, Viral Suppression, and Reproductive Health Decisions Among Young People Living with HIV in the Northwest Region of Cameroon
Background: Cameroon has 50,000 YPLHIV and there is limited knowledge on their use of SRH services and its impact on health outcomes. This study investigated the impact of sexual and reproductive health (SRH) service utilization on antiretroviral therapy (ART) adherence, viral suppression, and reproductive health decisions among young people living with HIV (YPLHIV) in the Northwest region of Cameroon. Methods: A cross-sectional study was conducted using a sequential sampling of adolescents and young adults living with HIV. Structured questionnaires were used to collect data between February and April 2022 from 340 participants, aged 15-24 years in 16 HIV care and treatment sites in the Northwest Region of Cameroon. The data was cleaned and analyzed using Stata version 14.0. Results: Our findings revealed that 58% of participants utilized SRH services, with associations found between high SRH service utilization and improved ART adherence (85% adherence among those with good SRH service utilization) and viral suppression (96% suppressed viral load). Barriers to SRH service uptake included being a male, urban residence, and lack of schooling, while good SRH knowledge significantly facilitated access. Additionally, the majority of unmarried participants expressed desires to marry (87%) and have children (90%). Conclusion: This study highlights the crucial role of sexual and reproductive health service utilization in enhancing health outcomes among adolescents living with HIV. The findings indicate that access to SRH services was associated to improved adherence to antiretroviral therapy and higher rates of viral suppression. Additionally, the desire for marriage and children among YPLHIV underscores the need for supportive SRH services tailored to their unique needs. However, barriers such as gender, place of residence, and educational status hindered access to these vital services.
Long-term Bioeffects of Prenatal Doppler Ultrasound Exposure and the Relation to Genetic Defects of the Fetus in Utero
Cardiotocography, fetal heart rate contraction recording, refers to a method for the simultaneous registration and recording of the heart rate of the unborn child and the uterine contractions in the expectant mother. The procedure is used both in pregnancy care and during labor. The fetal heart rate is usually determined using pulsed-wave Doppler ultrasound and recorded in beats per minute. The mother's uterine contractions are simultaneously recorded using a separate uterine contraction sensor, a pressure gauge. There are two methods for this: the rarely used intrauterine direct pressure measurement, which can only be used after the amniotic sac has opened, i.e., during labor, and the more common external pressure measurement using a tocodynamometer. This differential pressure gauge responds to changes in abdominal tension during a contraction, leading to large individual fluctuations in the recording of uterine contractions. The interpretation of a CTG or the calibration of the device must therefore take into account the constitution of the pregnant woman and her reports of the palpability of contractions. The course of changes in the fetal heart rate is interpreted taking into account the uterine contractions and the gestational age in pregnancy care or the progress of labor. In cases of suspected inadequate fetal oxygenation and uteroplacental dysfunction, a contraction stress test with CTG monitoring can be performed. It has many false-positive results and is no longer recommended in the current S3 guideline for vaginal delivery from 2022 and could have pathological influence developing autism spectrum disorder in childhood. Recent studies hypothesis that intermittent fetal heart rate contraction recording could have influence on genetical architecture structure of the fetus in utero.
An International Study on Sensitive Skin Across Continents in Over 20,000 Women: Geographic and Age-Related Differences, Menstrual Regularities and Cycle Phase influence, and Effect on WEMWBS score
The term "sensitive skin"(SS) encompasses the experience of unusual sensations like tingling, burning, or prickling, potentially accompanied by pain or itching, caused by various factors [1,2]. Physical (such as UV rays, temperature extremes, or wind), chemical (like cosmetics, soaps, water, or pollution), psychological (such as stress), or hormonal (related to menstrual cycles) factors have been described [1-4]. While "SS" commonly refers to facial skin, it can also affect other parts of the body like scalp, hands, or genitals. In women, SS can have a significant impact on their lives due to associated discomfort, inconvenience, and potential limitations. Studies on the prevalence of SS in the general population are scarce, and most of them are limited to one region [1-8]. Our objective was to conduct an international study in 20 countries in order to assess the prevalence of SS in women aged 18-55 y.o. A representative sample of women, 18 and 55 y.o, was recruited in 20 countries [United States n=1200; Canada n=1200; France n=1200; Argentina n=750; Brazil n=1200; Chile n=750; China n=1200; Egypt n=1000; Germany n=1200; Greece n=751; Italy n=1200; Mexico n=1200;Nigeria n=500; Poland n=1200; Saudi Arabia n=1200; South Africa n=800; Spain n=1200; Thailand n=750; Turkey n=750;] using a stratified, proportional quota sampling (PQS) with a replacement design. PQS was used based on the distribution of the population according to age, sex, environment (large cities, towns, and rural areas), and income, in each participating country, in order to guarantee national representativeness of the sample.
Use of Magnetic Tracer and Magnetic Resonance Imaging for Sentinel Lymph Node Detection after Breast Cancer Recurrence and Previous Axillary Surgery
Introduction: Preoperative mapping increases the chance of finding the sentinel lymph node (SLN) in breast cancer (BC) patients with earlier axillary surgery. Today preoperative mapping is usually done using Technetium-99m (Tc99), and lymphoscintigraphy. An alternative method has been proposed using superparamagnetic iron oxide nanoparticles (SPIO) and magnetic resonance imaging (MRI). The aim of this study was to evaluate the feasibility of the magnetic technique for SLN mapping and perioperative localization in patients with breast cancer recurrence and previous axillary surgery. Method: Consecutive patients with breast cancer recurrence, earlier axillary surgery, and planned for SLN-biopsy were included. SPIO was injected and axillary MRI was conducted up to four weeks before surgery. Tc99 and lymphoscintigraphy was performed in all according to clinical routine. SLN detection per method was recorded. Results: In total 22 patients received both SPIO and Tc99. SLN mapping was successful by using SPIO/MRI in 73% (16/22) compared to 50% (11/22) by using Tc99/lymphoscintigraphy (p=0.12). Perioperative SLN detection was 17/22 (77%) using SPIO/magnetic probe and 10/22 (45%) using Tc99/gamma-probe (p=0.03). The magnetic technique detected 26 of totally 27 (96%) removed lymph nodes while Tc99/gamma-probe detected a signal in 12 (44%) (p<0.00003). Conclusion: It is feasible, and perhaps preferable, to perform a repeat SLN-biopsy using the magnetic technique in patients with recurrent breast cancer. Advantage with SPIO are the longer time frame that it remains in the lymph nodes which facilitate logistic planning for surgery as well as the less complicated process in handling the material compared to using Tc99.
Menstrual Cycle Patterns as A Key to Understand Hair and Scalp Disorders: an International Study on 17,009 Women
Introduction: Hair and scalp conditions are significant indicators of overall health and well-being, impacting quality of life in multiple domains, including emotional and social aspects. This international study assessed self-reported hair and scalp disorders in women aged 18–55 years and explored their associations with menstrual cycle regularity and phases. Methods: This cross-sectional observational study was conducted between January 13 and February 20, 2023, across 20 countries. A stratified proportional quota sampling ensured national representativeness. A digital questionnaire collected data on demographics, menstrual cycle characteristics, and 11 hair and scalp disorders, with additional details on the timing and persistence of these disorders. Women without recent menses, peri-menopausal, post-menopausal, and post-partum participants were excluded. Statistical analyses were performed using HARMONIE 1.7 software, with p<0.05 considered significant. Results: Among 20,001 surveyed women, 17,009 with active menses were included. The mean age was 34.49 ± 9.66 years. 58.8% of women reported regular cycles, while 41.2% had irregular cycles. Overall, 83% of participants reported at least one hair or scalp disorder. The most common conditions were itchy scalp (48.8%), dandruff (47.6%), and oily scalp (45.8%). Disorders were more prevalent in women with irregular menses; for instance, itchy scalp (55.9% vs. 46.6%) and dandruff (55% vs. 47.3%) were significantly higher (p<10^-3). Permanent conditions like diffuse hair loss and frontal alopecia were noted, while intermittent disorders showed higher prevalence during premenstrual and menstrual phases than in the peri-ovulatory phase. Conclusion: This study highlights the significant association between menstrual irregularities and hair and scalp disorders, emphasizing hormonal influences. These findings call for further research into targeted treatments addressing hormonal imbalances to improve women’s dermatological and overall well-being.
Copyright (c) 2024 Journal of Womens Health and Development
Alas (Hellas), there is no Hope: It’s not a Crisis, it’s a Culture
The domain of financial crises has provided public rhetoric, along with research and policy, a wide range of leeway for analysis, modelling, and interpretation. In many and diverse cases throughout the world, different strategies for the mitigation of financial crises have presented an array of divergent results. One case of a crisis that is prevalent, is that of Greece. This crisis is standing tall for more than a decade; bailouts have given their place to more bailouts, austerity has brought much of the same, and there seems to be no end in sight. Through the structured comparative results of qualitative research, with the incorporation of dashes of Hellenic realism, a theoretical framework as to the decisive factors of the Hellenic financial crisis is formulated. The framework may be applicable not only for the Greek case; it might be found to hold a more generic dimension, and role, within our global society.
Lifestyle Factors Related to Femoral and Spinal Bone Density in Young Saudi Adult Women
Introduction: Many lifestyle factors are contributors to osteoporosis; a major health problem worldwide that can be measured using Dual-energy X-ray Absorptiometry (DXA). Aim: To evaluate the correlation between some lifestyle factors and Bone Mineral Density (BMD) in young Saudi adult women. Methods: BMD (gm/cm2) measurements in the femoral neck area and the lumbar spine (L2-L4) were performed using DXA in 101 females aged 20–24.9 years. BMD, T-score and Z-score were evaluated. Lifestyle factors were assessed through a questionnaire. Results: Milk & dairy product consumption, sun exposure, calcium & vitamin D supplements and Exercise had a significant positive correlation with some BMD scores. Soft drink consumption was significantly negatively correlated with all DXA parameters. Multiple linear regression demonstrated that; the factor with the strongest significant association with Z-scoren..femur and T-scoren.femur was exercising, followed by calcium and vitamin D supplements in Z-scoren..femur and by BMI in T-scoren.femur. BMI and animal protein consumption were significantly associated with BMDn.femur. Conclusion: Dairy and milk consumption, physical activity and sun exposure were the factors that showed significant association with BMD parameters. Limited calcium and Vitamin D intake and high consumption of soft drinks are the major contributors to low bone density in young females.
US State Abortion Law in an International Context: Distinguishing Religion and Politics
US states have been adopting a conservative approach to abortion that have far reaching percussions to women. By a conservative approach, I mean a legal framework ascribing personhood to a fetus from the moment of conception. Depending on the state it may mean that women are not able to get access, for example, to certain birth control which contain medicine that thins the wall of the uterus and so helps inhibit pregnancies from forming. In its most extreme some conservative legislation tries to restrict access to medical abortion prescriptions [1]. A conservative turn in the states, whether coming from the federal district court, a state’s court, or legislature, puts women who advocate for their right—some say their human right to control their own bodies in early pregnancy [2], to strategize about the best way to secure those rights. Setting aside self-help options for women seeking abortions, (moving to a state or going across state lines to states with clinics that will prescribe the medication,) the broader question for those seeking to allow for medical abortions in early pregnancy is how to change the law in the state. Is the best advocacy strategy through the courts, or whether it is better for them to use the political process to make their advocacy to the public generally? Should it seek to secure an even more explicit amendment to their state’s Constitution? At the heart of the strategy will be an important question: How best to persuade a court or body politic about the religious aspects of the question. Is the court or legislature or regulatory agency the best institution to be tasked with balancing deep intuitions about the sacredness of potential human life with shared goals of also protecting the health of women during their pregnancies? How can the discussion avoid polarization and demonizing that leads to political deadlock? Regarding the latter questions, some help may come from looking at the international history of jurisdictions with conservative approaches to abortion. Ireland, Poland, Mexico, and Argentina each have had their unique confrontations with more conservative legal-religious settings. All four share a religious Catholic majority in their citizens that needed (and in the case of Poland, still needs) to be addressed [3]. The “religious” setting in a particular US state will likely share some of the “Catholic” perspectives on when human life may begin, but will likely also have some significant differences, especially around the source of its religious authority for criminalizing abortion. On the other hand, a particular US state may share a more “pluralistic” perspective, which balances off strong nonrational religious views against religious freedom concerns of other faiths. As a result, important compromises in Ireland, Mexico and Argentina reveal the more irrational nature of approaches that try to deny abortions after conception, or even at heartbeat, on religious grounds. These jurisdictions then have composed compromises that still do reverence to later stages of fetal development but permit women to control their bodies during the first 12, and in the case of Argentina and Mexico, to 14 weeks. US states may do well to aim for a similar compromise. Ireland and Poland also have European legal settings that are both similar and different, that can help a state see what approach its state supreme court might take to the question of how its constitution will be interpreted. They share decisions from their Constitutional Tribunals that have marked conservative shifts toward giving personhood rights to fetuses in the midterm of pregnancy. They also share a legal umbrella, brought about by the fact they are members of the EU, and as member states have committed to a shared protections of human rights under the authority of the European Court of Human Rights (EHRC), they use the argument of “natural” law to ground rights of women to control early pregnancy. As a result, they present a contrasting legal setting that can amplify the legal setting a particular US state might find itself in. Mexico shares a more “federalist” structure of the US, but also has rejected a criminalizing approach in a particular state’s jurisdiction, that had criminalized abortions before 12 weeks. Mexico, then, shares many of the challenges that US states face, but has in principle, at least, set aside its previous religious based position criminalizing all abortions after conception. Briefly, the situation in each country is as follows: In Ireland, Irish progressives had tried in the European Court of Human Rights (ECHR) to challenge the Irish Constitution. They lost in 2010 at the ECHR, and so turned to a national referendum to bring about change to its Constitution [4]. If progressives in US states adopt the approach that the Irish women did in 2018, they might take their case directly to the electorate and use state referendum provisions to amend the Constitution. An important feature of the Irish approach was that it then was forced politically to “trust” the Irish legislature to regulate abortion according to the majority will. They needed to present the case to the public generally, that “personhood” did not begin at conception. Having made that case to a majority of voters, they repealed a previously enacted 8th amendment to the Irish Constitution, declaring life beginning at conception, and were able to trust the Irish public health regulatory agency to enact health regulations that balanced the rights of women and the unborn. These regulations provide that Irish women have a right to choose during the first 12 weeks of pregnancy [5]. Thereafter, their rights are dependent on a woman’s ability to meet their burden of proof to health providers, regulated by the state, that they meet the exceptions provided by current Irish regulations, according to rape, incest, or, importantly, for health of the mother against the/right of the viable fetus [6]. In contrast to Ireland, in 2020, Polish women learned that their Constitutional Tribunal restricted their right to choose after years where abortion was widely available. The Tribunal found a right of the unborn not to be discriminated against based on “its” disability [7]. The Tribunal treated the fetus, even in early pregnancy, as a “person” for purposes of judging discrimination against it. That ruling has made a Polish right to choose virtually nonexistent, even when a woman’s life is at stake [8]. There seemed little appetite since then to challenge the holding by amending its Constitution. The history of abortion in Poland is made doubly political because of abortion having been linked in the mind of many Poles as being associated with Nazi concentration camps in Poland. It was also linked politically to “permissive” approaches to abortion backed by Soviet law pre-Polish independence. Add to that the Russia Ukraine war at its border, and some observers feel the time is not ripe to create political divisions on abortion rights in Poland [9]. There are also pragmatic worries about making the argument too political. They worry about how to amend the constitution in a way that won’t be interpreted by the Court in a manner that fails to be protective of their rights to control their own bodies. They are caught waiting on the ECHR to decide their case, and while their legal arguments might be strong, (the Court is more open to using Europe’s progressive morals as evidence of the existence of a human right), they are also subject to the court’s go-slow political reasoning when it comes to human rights. They also have brought the case as a class action, which may diminish the individual narratives of the women caught in the Polish legal trap. Those individual narratives demonstrate how protecting the fetus from disability discrimination requires medical providers to wait to determine the health of the fetus while risking the health of the mother. As a class it is harder to avoid the “self-help” possibilities available to women, generally, since abortion is so widely prevalent in other European states.
Predictive Values of Upper Extremity Function and Body Composition Parameters for Upper Extremity Lymphedema Occurring within 12 Months after Breast Cancer Surgery
Purpose: This study aimed to evaluate the values of early postoperative body composition and upper limb function as predictive indicators for the development of breast cancer-related lymphedema (BCRL). Methods: The study included women who underwent axillary lymph node dissection between 2022 and 2024. Extracellular water ratio, low-frequency impedance, and phase angle measurements using segmental multifrequency bioelectrical impedance analysis and shoulder range of motion and grip strength assessments were performed preoperatively and at 1, 3, 6, and 12 months postoperatively. Lymphedema was defined as an increase in limb volume by 10% or more, and the data of the affected and unaffected groups were compared at each time point. Results: The group that developed lymphedema within 6 months had increased extracellular water ratio and decreased low-frequency impedance and phase angle by 3 months relative to the unaffected group. The group that developed lymphedema within 12 months had decreased low-frequency impedance and phase angle by 6 months relative to the unaffected group. The range of external shoulder rotation was only significantly reduced for the lymphedema group at 12 months. The grip strengths of the affected and unaffected groups did not differ at any time point. Conclusion: Body composition changes were observed before an increase in limb volume in patients who developed lymphedema within 12 months after breast cancer surgery. Restriction of shoulder range of motion was likely secondary to lymphedema progression. Body composition measures are useful for predicting lymphedema progression and may facilitate early preventive interventions as screening indicators.
Current Understanding of the Epidemiology and Clinical Implications of BRCA1 and BRCA2 Mutations for Epithelial Ovarian Cancer
Background: BRCA1 and BRCA2 gene mutations are critical genetic factors associated with an increased risk of developing epithelial ovarian cancer (EOC). Understanding the epidemiology and clinical implications of these mutations is essential for effective risk assessment, treatment planning, and patient management. Objectives: To assess the clinical implications of BRCA1 and BRCA2 mutations on the prognosis and treatment outcomes of epithelial ovarian cancer patients. Methods: This cross-sectional study was carried out at BSMMU & lab aid cancer hospital & super specialty center, department of Gynecological Oncology on 130 patients presented at emergency department with open fracture tibia (all Gustilo types) within 24 hours of injury. Three successive cultures were carried out, one at emergency room (surveillance culture), 2nd at emergency theater after debridement and third at ward after 1 week (7 to 10 days). Statistical analyses of the results were be obtained by using window-based Microsoft Excel and Statistical Packages for Social Sciences (SPSS-24). Results: Of the 130 patients, 90 patients were belonged in group of BRCA1 and 40 were in group of BRCA2. Patients with BRCA mutations had a younger median age at diagnosis and were more likely to have a family history of breast or ovarian cancer. BRCA mutation carriers showed a better response to platinum-based chemotherapy, with a higher overall survival rate compared to non-carriers. However, these patients also exhibited a higher risk of developing secondary malignancies, emphasizing the need for ongoing surveillance and tailored treatment strategies. Conclusion: The presence of BRCA1 and BRCA2 mutations in epithelial ovarian cancer patients has significant clinical implications, influencing treatment response and long-term outcomes. The study highlights the importance of genetic testing for BRCA mutations in the management of ovarian cancer, particularly in identifying patients who may benefit from targeted therapies and personalized care. Further research is warranted to optimize treatment protocols and improve survival rates in this high-risk population.
Re-establishing the Reality of the Women-only Amazon Societies by Integrating the Evidence from the Historical Record
The Women-only Amazons were societies where women lived without men on a sustained basis and displayed military prowess. These Amazons were those first described by ancient Greek historians and other authors. Currently, the Women-only Amazons are widely considered to be mythological. This paper and its appendices provide extensive evidence that the Women-only Amazon societies were real. Using internet technologies, this research integrates a vastly expanded sample of documents written about the Women-only Amazons as societies from the ancient authors who were their contemporaries. This research found 78 authors that described where the Amazons lived and when, as well as how. From this unprecedented assemblage of descriptions about the Amazons emerges four related groups of Women-only Amazon societies. Google Earth maps portray where the different Amazon groups lived, and the data show they existed for at least 1700 years. This research finding is relevant to the modern world because descendants of some of the Amazons contributed to the establishment of one of the foundations of modern democracy. This research intends to stimulate and focus archaeological research by identifying and placemarking as precisely as possible the locations of the Women-only Amazons provided by the ancient scholars.
Fetomaternal Outcome of Placenta Accreta Spectrum (PAS) Disorder Managed by Planned Vs. Emergency Management Modality Among Cases Admitted in A Selective Tertiary Level Hospital of Bangladesh
Background: Placenta Accreta Spectrum (PAS) disorder is a complex and potentially life-threatening condition where the placenta attaches too deeply into the uterine wall. This condition can lead to severe complications during delivery, including massive hemorrhage, the need for hysterectomy, and maternal or neonatal morbidity and mortality. Objectives: The aim of the study was to evaluate the fetomaternal outcome of placenta accreta spectrum (PAS) disorder managed by planned vs. emergency management modality among cases admitted in a selective tertiary level hospital of Bangladesh. Methods: This cross-sectional comparative study was carried out in the Department of Obstetrics & Gynaecology, Dhaka Medical College Hospital, Dhaka, during 18th January 2020 to 17th July 2020. A total of 74 patients were participated in the study. Among them Group-A comprised of patients who undergone planned management of PAS disorder and Group-B dealt with patients who undergone emergency management of PAS disorder). Statistical analyses of the results were be obtained by using window-based Microsoft Excel and Statistical Packages for Social Sciences (SPSS-24). Results: The age distribution throughout the categories. The mean ± SD of age was computed as 25.4 ± 5.7 years for Group A and 25.2 ± 5.4 years for Group B. According to the operational definition, patients are divided into three socioeconomic classes. The impoverished class accounted for the majority of patients (44%), followed by the middle class (38%), and the upper class (18%). In addition, the majority of the women (56.0%) had multiple children. Parity 4+ or grand multipara was 14.0% in Group B patients. Conclusion: Planned management with a multidisciplinary team approach has better outcomes without mortality as compared to emergency management of PASD patients. Scheduled or planned management with avoiding attempt to placental removal are associated with reduced maternal morbidity in women with suspected placenta accreta.
Background and Effects of Physical Therapy for Adult Patients with Constipation, A Systematic Review
Constipation is a – often chronic - common and prevalent gastrointestinal motility disorder with high impact on quality of life, daily, sport and work activities of patients. Constipation has been defined as abnormal stool frequency < 3 bowel movements (BMs) per week. Besides this, also other symptoms, such as excessive straining, passage of hard stool, inability to defecate at will, unproductive urges, and sensation of incomplete evacuation, occur. Few systematic reviews have investigated the effectiveness of physical therapy. Several conservative treatment modalities for patients with constipation exist, in many cases up to now without sufficient or convincing scientific or clinical evidence. Often based on limited data about their effect, recommendations, advise, as first-line treatments, before any specific medication is subscribed, the use of general exercises or physical activity, behavioral changes regarding fluid intake and bowel habit and – regimen are mentioned. Next to this, physical therapy is recommended. This systematic review evaluated the effects of physical therapy on constipation, quality of life (QOL), and muscle strength and -relaxation in adult patients with constipation. Six RCTs met our study selection criteria. The PEDro rating score was used to classify the methodological quality, resulting in moderate to high methodological quality of the studies. Current RCT data may indicate positive effects of physical therapy for patients with pelvic floor dysfunction related to constipation, but more high-quality studies are warranted.