bluuebunny/crossref_metadata_2025 huggingface dataset:
Determinants of maternal autonomyin Nigeria
Authors: Olubusola W Awe , Yetunde OM Oladokun , Kemisola O Adenegan
Published: May 2021

Utilization of health care services by maternal women has been shown to prevent most maternal deaths and health issues faced by women in Nigeria. Therefore, this study examined the level of maternal autonomy and the determinants of maternal autonomy in utilizing health care services in Nigeria. Data on 10193 married women, living in Nigeria were sourced from Nigeria Demographic and Health Survey 2013. Data were disaggregated into six Geo–political zones (North Central, North West, North East, South East, South–South, and South West). Information on socio–economic characteristics, level of maternal autonomy, and factors influencing maternal autonomy were obtained. Data were analysed using descriptive statistics, composite score analysis, ordered probit regression.The mean age was 30 years. 54.61% of the maternal women have low level of autonomy, 42.92% of the respondents have intermediate autonomy and 2.46% of the respondents have high autonomy. Majority of the respondents have low autonomy. About determinants of maternal autonomy, age of respondents was significant and positively related to maternal autonomy at 1% that is, increase in age leads to increase in maternal autonomy. The household size of respondents was significant at 1% and negatively related to maternal autonomy. Respondents who are working have higher autonomy than respondents who are not working. Respondents who have husbands that are working have lower autonomy when compared to those whose husbands are not working. Also, respondents who have husbands with formal education have high autonomy than those whose husbands are not working. Respondents in north–east and north–west have lower autonomy when compared to north–central while respondents in south–east, south–south and south–west have higher autonomy when compared to respondents in north–central. Efforts should be made by governmental and non–governmental organisations to orientate the women and their spouses on the need for women to be autonomous on issues relating to their health.
Breaking the Silence and Healing Trauma for Incarcerated Women: Peer-facilitated Delivery of a Brief Intervention
Authors: Messina Nena , Zwart Elizabeth
Published: May 2021

Peer-facilitated programs in corrections can be a cost-effective strategy to provide more opportunity for program services in prison. Brief interventions are also a valuable way to introduce programs to those assigned to short-term housing, while preparing them for lengthier programming once placed in permanent housing. The usefulness of brief interventions in substance use treatment has been extensively researched in the literature; however, the evidence regarding peer-facilitated programs with a trauma focus is less available. Given the extensive prevalence of lifelong trauma in the lives of justice-involved women, there is a vital need for trauma-specific interventions and research assessing both content and models of delivery. This pilot study assesses the effectiveness of a brief peer-facilitated, trauma-specific intervention among participants incarcerated at two women’s facilities in California. Healing Trauma1 is a 6-session brief intervention that was designed for women who have experienced trauma associated with adverse childhood experiences. The peer-facilitated intervention was delivered twice a week with two-hour long sessions in closed groups of 6 - 8 participants. The sample consisted of 682 participants who volunteered for the program and study. Data were collected prior to the start of the first session and upon completion of the last session on ten primary outcomes: depression, anxiety, PTSD, mental health symptoms, aggression, anger expression, anger representation, empathy, social connectedness, and emotional regulation. The results demonstrated strong support for the efficacy of Healing Trauma and a peer-facilitated model of program delivery. Participants exhibited significant improvement across 90% of the outcomes measured. Effect sizes were small to moderate in size, with the largest impact on depression, PTSD, and feelings of anger (Cohen’s d ranged from .51, .41, .42 respectively). The findings provide a knowledge base to create more rigorous studies for further exploration of outcomes.
Generational change: an influential factor in the context of curricular innovation. a qualitative study
Authors: Gutiérrez Rita Avendaño
Published: May 2021

The objective of this study is to explore teachers’ perceptions of the didactic changes related to curricular innovation in theoretical Nursing modules of Obstetrics and Child Care. We used a qualitative methodological design with a phenomenological approach. The study group consisted of 20 teachers from Nursing. The instruments used to collect the information were in-depth interviews, participant observation and documentary analysis. Our results indicate that generational change in students is an influential factor for teaching staff to try innovative didactics. On the other hand, teacher training incorporates student-centered methodologies, as required in curricular innovation. Regarding facilitating factors, the study group recognizes that the teacher, due to their motivation and disposition, is the main protagonist in the implementation of changes in teaching strategies, during the curricular innovation process. Among the impeding factors are: lack of resources; academic load; and inadequate infrastructure. We conclude that there is constant concern within the academic community to implement methodological innovations in response to student generational change, nurturing competences such as teamwork and critical thinking. A novelty of this study is that generational change influences the way students learn and communicate, as well as staff decision-making when it comes to didactic strategies in the teaching-learning process. As a contribution, the motivation and dedication of the teaching staff, translated into their continuous improvement and updates in education-related topics, emerges as a key factor in the generation and implementation of changes that are coherent with curricular innovation.
Pulmonary embolism in the first trimester of pregnancy
Authors: Irene M Orfanoudaki
Published: May 2021

Pulmonary embolism in the first trimester of pregnancy without a known medical history is a very rare complication, which if it is misdiagnosed and left untreated leads to sudden pregnancy-related death. The sings and symptoms in this trimester are no specific. The causes for pulmonary embolism are multifactorial but in the first trimester of pregnancy, the most important causes are hereditary factors. Many times the pregnant woman ignores her familiar hereditary history and her hemostatic system is progressively activated for the hemostatic challenge of pregnancy and delivery. The hemostatic changes produce enhance coagulation and formation of micro-thrombi or thrombi and prompt diagnosis is crucial to prevent and treat pulmonary embolism saving the lives of a pregnant woman and her fetus.
Evaluating the impact of preventive interventions against malaria during antenatal care of pregnant women from 2014 to 2018 in Ondo State, Southwest Nigeria
Authors: M Afolabi Bamgboye , Adelusi Victor A , Folayan Waheed , Akinmoladun Oladipo B , Egunjobi Feyijimi , Ozor Lynda , Afolabi Titilola M , Fagbemi Tolulope , M Afolabi Bamgboye
Published: May 2021

Background: Malaria is a major public health burden that is endemic in sub-Saharan Africa. Malaria infection during pregnancy can be deleterious not only to the mother but also the fetus. The objective of this study was to evaluate malaria programme and the utilization of malaria commodities between 2014 and 2018 in Ondo State, Southwest Nigeria. Materials and methods: This study analyzed malaria-related indicators tracked on a routine basis in Ondo State, Nigeria. A retrospective cohort analysis of data retrieved from the District Health Information Management version 2.0 (DHISv2.0) database was conducted. Data was analyzed using Stata 13 statistical software. The prevalence of utilization of ANC and the proportions of pregnant women accessing malaria commodities were assessed using frequency tabulation, means, and analysis of variance (ANOVA). Correlation coefficient for association among some variables was employed. Results: The mean proportion of women who had at least 1 ANC visit during the period of study was 34.3±3.9, highest in 2017 (39.1±14.8) and lowest in 2018 (26.8±12.1). The overall mean proportion of women who had at least 4 ANC visits during pregnancy was 20.3±14.1 (F-statistics=2.88, P-value=0.03), highest in 2015 (25.9±18.9) and lowest in 2018 (14.0±10.6) and the mean proportion of those who had at least 1 ANC visit before 20 weeks of pregnancy was 38.1±10.0 (F-statistics=5.63, P-value=0.0005), highest in 2017 (45.4±10.7) and lowest in 2014 (32.6±9.1). During the study period, significant variations were observed in the mean proportion of pregnant women who received LLIN at first ANC visit (F-statistics=9.52, P-value=0.00001) and those who received IPTs at ANC revisit (F-statistics=5.17, P-value=0.0009) but not in the proportion of pregnant women with anemia. None of the indicators for malaria in pregnancy correlated with anemia rate during the study period. Geographical variations observed in the measured indicators were discussed. Conclusion: This study observed disparity in proportion of pregnant women assessing ANC services and in the proportion of those that utilized malaria commodities from 2014 to 2018. Residential variances, and geographical locations were detected in the consumption of ANC services. Areas farthest from the state capital, such as the Atlantic Ocean coastline in the south and the Savannah ecological zone in the north seemed to have low utilization of ANC. The State Malaria Elimination Program should be supported strongly in terms of technical and financial assistance to improve ANC service utilization throughout the State. The disparity in ANC accessibility in Ondo State will further reduce maternal and infant morbidity and mortality as well as improve the socio-economic living standards of the people.
How does laparascopic lateral suspension affect the quality of life (QOL) and sexual activity?
Authors: Atılgan Adeviye Elçi
Published: May 2021

Background: The affect of Laparascopic Lateral Suspension on quality of life and sexual activity in POP patients. Objective: This study aimed to investigate the quality of life (QOL) and sexual activity after Laparascopic Lateral Suspension (LLS) for pelvic organ prolapse (POP) in Turkish women. The practical success rate and complications related surgery were also analyzed. Study design: Prolapse Quality of Life Questionnaire (P-QOL) was used for investigate QOL in study group. Female Sexual Function Index (FSFI) was wielded for evaluating sexual function. Both tests were asked before the surgery and 12 months later. The results were recorded and retrospectively analyzed. Results: 237 patients were included in this study. Every P-QOL parameter was markedly recovered postoperatively. The complications detected after the surgery were; side pain 13 (5.5%), POP recurrence 4 (1.6%),de novo stress urinary incontinence 2 (0.8%), mesh erosion 1 (0.4%), and de novo dyspareunia 1 (0.4%).Cause of haven’t got any partner, 124 of the 237 patients (52.3%) reject to finish the FSFI. The rest 113 patients fulfilled the FSFI before and 79 patients completed the FSFI after the surgery. While 13 (5.4%) were sexually active before the surgery, 18 (7.5%) were sexually active after the surgery. The significantly increased domain after surgery was sexual function score with arousal. Conclusion: In this study, low frequency of sexual intercourse was found in Turkish POP population before and also after the operation. However, LLS technic proved fine QOL resuts with a high success rate. Its complications rate is also low. LLS is safe and effective for both sexually active and inactive POP patients.
LDH/AST ratio: a futureresourcefor thrombotic microangiopathies differential diagnosis in pregnancy
Authors: Battini Lorella , Federica Mei , Nadia Falchi , Denise Tamaraschi , Pietro Bottone , Alessandra Bertolotto , Cristina Bianchi , Giuseppe Trojano , Tommaso Simoncini
Published: May 2021

Objective: To evaluate the clinical approach, the diagnostic method and the most appropriate therapeutic management of thrombotic microangiopathies (TMA) in pregnancy, still leading killers in the obstetric area today. Materials and methods: A large review of the international literature and available clinical studies has been carried out in order to define the current state of the art regarding TMA in pregnancy. In the light of this, 9 clinical cases, among 152 TMA cases, of pregnant women hospitalized and who gave birth in the Pisa University Hospital O.O. U.U. Gynecology and Obstetrics 1 and 2 from 2010 to 2019, were identified, analyzed and re-discussed. Results: Analyzing the diagnostic method and the medical records, we made a critical review of these 9 cases, accurately analyzing the diagnoses made. Among these cases, 6 Thrombotic Thrombocytopenic Purpura (TTP), 2 HELLP Syndrome and 1 Atypical Hemolytic Uremic Syndrome (aHUS) were diagnosed during pregnancy. By analyzing the medical records, the diagnostic method and the therapeutic management of these patients, we questioned the diagnoses made. These diagnoses, from our analytical point of view, are partially not corresponding, being 4 cases of TTP and 5 possible cases of aHUS. Conclusion: From the review of our case history, in the Pisa Obstetric clinics, it is possible to find an under diagnosis of the aHUS cases compared to those of TTP and HELLP syndrome, due both to the unavailability of the ADAMTS13 functionality test and to the unused LDH/AST ratio, which in our opinion could represent a future resource in diagnostic approach to thrombotic microangiopathies in pregnancy.
Diagnosis and treatment of Herlyn Werner Wunderlich syndrome: a case report
Authors: Hernández Silva Ruben Jesús , Hernandez Gabriel Garcia Gerardo , El Carmen José Pérez López , Hernández Clara Magdalena Martínez , Mendez Roberto Pablo Gonzalez , Ramirez Patricia Lopez
Published: May 2021

Background: Herlyn Werner Wunderlich syndrome (HWWS) is a rare female urogenital tract abnormality, isolated by presenting a didelfous uterus, transverse vaginal septum and ipsilateral renal agenesis. Objective: A case report of a patient with Werner Herlyn Wunderlich syndrome. Case report: Female patient of 17 years of age, single, nubile, menarche at 14 years, infrequent menstrual cycles, normal volume, with dysmenorrhea EVA 7/10, attends to present disabling pelvic pain, ultrasound was found finding, hematocolpos and hematometra, is complemented with hysteroscopy, computed tomography (CT) and magnetic resonance imaging (MRI), a diagnosis of HWWS syndrome is integrated by confirming the presence of a didelfo uterus, obstructed right hemivagina and right renal agenesis, with distention of the vagina and cervix secondary to hematometra and hematocolpos, normal ovaries. The approach in this patient was by minimal invasion. Conclusion: Herlyn Werner Wunderlich syndrome is a rare mullerian defect, it is often diagnosed late, the diagnosis is usually made after menarche, associated with chronic pelvic pain or palpable pelvic mass; 2D ultrasound along with physical examination performs the suspected diagnosis; This should be complemented with RM. The treatment of choice is vaginal septum resection assisted by minimally invasive techniques.
Monsel´s solution for first degree perineal bleeding tears treatment: a randomized controlled clinical trial
Authors: Antonio Casale Roberto , Silvana Varela
Published: May 2021

Introduction: During vaginal delivery, tears can occur in different areas of the lower genital tract. The policy of "restrictive episiotomy" increases anterior perineal trauma, mainly paraurethral tears. The topical application of Monsel´s solution in first degree perineal bleeding tears may benefit patients because of less use of anesthetics, sutures and procedure time. Objective: To determine if the Monsel´s solution stops active bleeding in first degree tears compared to traditional suture. Materials and methods: Randomized clinical trial, carried out at Hospital Nacional "Prof. Alejandro Posadas" from January 2011 to December 2013. 330 patients with recent postpartum vaginal delivery were admitted with a diagnosis of first degree bleeding tears. They were randomized to receive the application of Monsel´s solution, until stopping bleeding (intervention group) or traditional suture (control group). The primary outcome was the stoppage of active bleeding. Secondary outcomes were: patient discomfort with the procedure, practicality of the procedure, alterations in the scarring of the tear and wound infections. Crude and adjusted ORs and 95% CI were calculated. Analysis was done by intention to treat. The study was approved by the Bioethics Committee of the Hospital. Results: Monsel´s solution was effective for the stoppage of active bleeding in 86.7% of first degree bleeding tears. Out of 150 patients randomized to the intervention group, 130 met the primary outcome, ORc 0.04 (95% CI 0.01-0.27)/ORa 0.05 (95% CI 0.01-0.34) Monsel´s solution was safe, because it did not interfere with the scarring process It also offered a protective aspect on wound infections. The procedure was practical and simple for the intervening professionals and, despite being an irritant for the mucous; it was well tolerated by the patients. Conclusion: The Monsel´s solution appears effective, practical and safe for treatment of first degree bleeding tears.
Determinants of antenatal care visits and their impact on the choice of birthplace among mothers in Uganda: a systematic review
Authors: Atuhaire Shallon , Mugisha John Francis
Published: May 2021

Objective: The utilization of Antenatal Care (ANC) services to the recommended time by WHO is still low in developing countries. In Uganda, about 990,000 women become pregnant annually, 90 to 94% of whom attend at least the first ANC visit while 65% and 58% of them attend four or more times in urban and rural areas respectively with eventual health facility birth at about 62%, homebirth and TBA together at about 38%. The study determined antenatal care attendance and the mother’s choice of birthplace in Uganda. Materials and methods: Using electronic databases mainly Google Scholar, Science Direct, PubMed and African Journals Online, and journal articles of international Website, 70,195 articles were identified but only 19 met the Cochrane review inclusion criteria hence were reviewed. Results: Reviewed studies attribute a decline in antenatal care visits and subsequent choice of birthplace to institutional, demographic and socio-economic factors. The demographic factors are maternal age (mothers less than eighteen years are less likely to utilize maternal health services than those above), marital status, occupation, residency, distance from home to the health facility, and parity. The socio-economic factors are mothers’ and partners’ levels of education (less educated women and their partners are less likely to utilize ANC), household income which affects transportation and medical bills, cultural norms and taboos, patriarchy society, enrollment on ANC in the third trimester, and intrinsic factors of attending ANC such as obtaining ANC card to present in case of emergency. Institutional factors include quality of medical care, availability of logistics and supplies, and health workers’ influence in terms of attitude, referral, competences, and staffing. Conclusion: Pregnant women who attend ANC are more likely to deliver in the health facility than those who do not at all. To enable them to attend ANC to full term and have a health facility delivery, their empowerment for increased self-efficacy through education, sustainable livelihood training and provision of subsidized capital alongside partner involvement. The facilitation of health facilities would also attract them.
Chakra’s energy deficiency as the main cause of infertility in women
Authors: Ling Huang Wei
Published: May 2021

Statement of the problem: Female infertility is defined as the inability to conceive or carry a pregnancy to term after 12 months of unprotected intercourse or six months if the woman is over 35 years old. The purpose of this study is to demonstrate that infertility problems may be associated with Chakras energy deficiency and deficiency of the massive organs in the Five Elements Theory, especially the Kidney, which is the energy responsible for the reproduction. Methodology: Three case reports of three couples, of women with infertility, with all laboratory tests appearing normal and low sperm count in all the men. In the first case report, they had already been trying IVF treatment with no success. From the energy point of view, in the three cases, all their chakras were depleted. All patients were treated with acupuncture, Chinese dietary counseling, and treatment of the chakras’ energy with homeopathy and crystal-based medications. Findings: The three patients were able to achieve pregnancy after the treatment with acupuncture, Chinese dietary nutrition, and replenishment of the chakras’ energy through homeopathy and crystal-based medication. Only the first patient made use of IVF. Conclusion: Normal laboratory fertility exams do not mean the absence of disease. It is important to study in the energy level, which is invisible to the naked eye. The corrections of the chakra’s energy and the Yin, Yang, Qi, and Blood energies, lead to a more successful treatment. The corrections of the energy imbalances improve the blood production, responsible for the fetus's nutrition, and tones the chakras, mainly the second, represented by the Kidney’s energy, leading to an improvement of the conception. Even though infertility may be attributed exclusively to women, the energy of both sides of the couple has to be adequate for achieving pregnancy.
Effect of transcutaneous electrical nerve stimulation with stretching and exercises in restless leg syndrome among pregnant women
Authors: Augustina S Jenifer , Kaviya MG , Indrani D
Published: May 2021

Background: Restless legs syndrome also known as Willis-Ekbom disease is a sensor motor disorder composed of an urge to move with or without associated discomfort that occurs with inactivity and improves with movement. The symptoms occur in leg muscles like calves and thighs. The feet and arms also affected and it causes the functional disability in pregnant women. Sleep disorder is typically the biggest complication of this condition. Unpleasant sensations are deep in the legs. Sensations appear during periods of rest or inactivity particularly in the evening and at night and relived by movement. Prevalence of RLS among pregnant women ranged from 10 to 34%. Aim: The aim of the study is to prove the effect of Transcutaneous Electrical Nerve Stimulation (TENS) with Stretching and Exercises in restless leg syndrome among pregnant women. Objectives: To determine and prove the effectiveness of TENS with stretching to relive pain and improve the functional ability in restless leg syndrome among pregnant women. Materials and Methods: A Quasi-experimental study was conducted on 30 subjects using convenient sampling technique based on inclusion and exclusion criteria. Subjects were allotted into 2 groups i.e., Group A with 15 subjects and Group B with 15 subjects using odd even method of sampling. Experimental group will be treated with TENS and Stretching. Control group will be treated with exercises and massage. Result: Statistical Analysis of Post test for pain and functional performance revealed that patients who received Transcutaneous Electrical Nerve Stimulation (TENS) with Stretching in Group A showed marked improvement compared to patients who received Massage and Exercises in Group B. Conclusion: From the result of the study it concluded that Transcutaneous Electrical Nerve Stimulation (TENS) with Stretching is more effective than massage and exercises in subjects with restless leg syndrome among pregnant women.
Endometriosis and ovarian cancer risk
Authors: Fernández de Vega Javier de la Torre , Sánchez-Iglesias Jose Luis , Perez-Benavente Assumpt , Gil-Moreno Antonio , Begum Dina Rasheda , Uddin Md Zulhash , Fatema Ummul Khair
Published: May 2021

Epithelial ovarian cancer presents different histological subtypes, mainly serous, mucinous, endometriod, clear cell, mixed and undifferentiated cell. Molecular genetic studies have led to a new paradigm based on a dualistic model of ovarian carcinogenesis. There is a causal association between endometriosis and specific types of ovarian carcinomas, but the magnitude of the risk is low and endometriosis is not considered a premalignant lesion. Among the endometriosis-associated ovarian tumors adenocarcinoma is the most common (Endometrioid and clear cell) (70%), sarcoma is the second most common malignancy (12%) and rare cell types 6%. The gynecologist should pay special attention to identify patients with endometriosis who may be at an increased risk for ovarian cancer.
Risk factors of recurrence of stress urinary incontinence after single-incision sling at 5 years
Authors: Manso Sonia de Miguel , García E García , Tejedor J Gobernado , Cuaresma D Viruega , Bercebal CE Badillo , Martín JI González
Published: May 2021

Introduction and hypothesis: Stress urinary incontinence (SUI) affects 5-35% of women, especially at menopause. In severe cases or when conservative treatment fails, a tensión-free suburethral band is indicated. Similar short-medium term cure rates have been reported with mini-sling (SIS) compared to retropubic and transobturator band. But the long-term information is scarce and it seems that the risk of recurrence is not negligible (4-37%). There is little literatura that studies the posible predisposing factors for the recurrence of SUI after SIS. The objective is to identify factors associated with the risk of relapse of SUI at 5 years, after SIS. Methods: A prospective five-years follow-up observational study (2015-2019) was performed in women who underwent SUI using SIS. The sample was 115 patients with relapse of SUI. Statistics: T-Student or U-Mann and ROC for quantitative variables, Chi-Squared and OR for qualitative variables. Results: L25 patients (21.74%) had recurrence during the study period. Of all the variables analyzed, they only showed a significant association with the recurrence of SUI: height, weigth and BMI, a history of fetal macrosomia and the number of compresses used. The patients who presented recurrence of SUI had a lower heigth, greater weight, and therefore a higher BMI. The obstetrics history of a vaginal delivery with a fetus >4 kg, was associated with a higher risk of recurrence (OR: 4.05, IC 95%=1.09-15.03), and the use of a greater number of compresses was also associated with an increased risk of relapse, obtaining an area under the curve of 0.659. Conclusion: The 5-year recurrence rateo f SUI after mini-sling in our setting was 21.74%. A lower height, a greater weight and BMI, macrosomic delivery and greater number of purses have shown a significant association with the risk of relapse of SUI after mini-sling at 5 years. Therefore, it is essential to adecuately advise patients according to their personal factors of the potencial risk of recurrence after SIS.
Maternal and neonatal consequences in women with severe preeclampsia and patients with HELLP syndrome: a comparative study
Authors: Rashwan Ahmed SSA
Published: May 2021

Background: The (HELLP) syndrome is a severe health hazard in pregnancy described by elevated liver enzymes, low platelet count and hemolysis. It happens in 0.4 to 0.7% of all gestations and in 10-12% of cases with severe preeclampsia. Patients and methods: The present study was a prospective observational study that was made at Department of Obstetrics and Gynecology, Kasr Al-Ainy University Hospital, Cairo University, from September 2018 – March 2019. It included One Hundred and Thirty pregnant women diagnosed with hypertension in the current pregnancy complicated with severe preeclampsia, or HELLP Syndrome associated with abdominal ascites, recruited from the attendees of the Obstetric Emergency Department. The study was approved by the local institutional review board of the Faculty of Medicine, Cairo University. All ladies signed an informed consent. Results: There were statistically significant differences between the HELLP group and the severe preeclamptic group regarding maternal ICU admission and the need of multiple drugs to control the blood pressure being less in severe preeclampsia group. The need for ICU admission was much higher in the HELLP group (43.1%) compared to the severe preeclampsia group (9.2%) showing statistical significance (P<0.001). Conclusion: Maternal and neonatal sicknesses are elevated between cases with HELLP syndrome. So, early diagnosis and definitive treatment can be made to enhance maternal and neonatal results.
Adolescent sexuality: practices and contraceptive problems in Douala (Cameroon)
Authors: Henri Essome , Charlotte Eposse Ekoube , Koum DC Kedy , Thomas Egbe Obinchemti , Gregory Halle Ekane , Théophile Nana Njamen , Merlin Boten , Grace Tocki Toutou , Calixte Penda Ida , Pascal Foumane
Published: May 2021

Introduction: According to the World Health Organization (WHO), adolescence is the period of growth between 10 and 19years of age. Complications from pregnancy are the second leading cause of death for adolescent girls aged 15 to 19 worldwide. Objective: Our objective was to study the sexual practices of adolescent girls in secondary schools in the Douala 3rd district as well as their contraceptive attitudes towards precocious pregnancies. Methodology: We conducted a case-control analytical study from November 8th, 2018 to June 26th, 2019 in ten secondary schools in the Douala 3rd district. We matched, around the obstetric variable, a case group with this history to a control group who declared not to have had one and studied the different strategies used to avoid the occurrence of pregnancy. Data analysis was done using SPSS 20.0 software. The significance threshold was set at p<0.05. Results: A total of 445 consenting adolescent girls were selected, including 89 cases and 356 controls. The multivariate analysis of the results showed that the factors associated with the occurrence of teenage pregnancies were: an age greater than 17years (aOR=1.91; CI=1.64-2.33), being single with a boyfriend (aOR=6.48; CI=3.33-12.60), the use of the male condom and the after pill (aOR=6.73; CI=3.53-12.83, aOR=4, 34; CI=1.86-10.11), find out about sexuality from your sexual partner or on social networks (aOR=2.24; IC=1.11-4.54, aOR=1.78; IC=1.01-3.13), do not ask your parents (aOR 2.20; IC=1.31-3.70), alcohol consumption (aOR=2.01; IC=1, 23-3.29), multi sexual partnership (aOR=2.89; CI=1.24-6.69), an age difference of more than 5years with partner (aOR=2.24; CI=1.16-4.35). Conclusion: The teenager of the 3rd district of Douala is subject to early and unsafe sexuality and underuses family planning services which lead to precocious pregnancy.
Surgical oophorectomy or GnRH plus tamoxifen adjuvant therapy for breast cancer in low-risk premenopausal women: comparative benefits and risks
Authors: Love Richard R
Published: May 2021

Background: While the combination of ovarian suppression or ablation treatment and tamoxifen or an aromatase inhibitor has been demonstrated to provide better outcomes as adjuvant therapies in premenopausal women with hormone receptor positive breast cancer, than treatment with tamoxifen alone, the details of applying these results in clinical practice, and the risks and benefits of the different ovarian treatments, particularly in women at lower risk for disease recurrence and death, have received limited attention. Methods: Details of clinical trials investigating combination hormonal adjuvant therapies, particularly with tamoxifen, were reviewed focusing on issues pertinent to assessment of risks and benefits in clinical practice. Results: Equivalent survival outcomes from surgical oophorectomy (SO) or GnRH agonist treatment plus tamoxifen, for which there are the most data at present, make the major decision issues for individual patients in choosing between these treatments: interest in future pregnancy, availability of data on secondary biological effects, capacity to adhere to a GnRH injection program for 5years, and ability to optimize dental hygiene (for taking bisphosphonate additional treatment). Other considerations applicable in individual patients include comparative secondary treatment effects, financial costs, and psychological impacts. Conclusion: If a patient with low-risk for recurrence breast cancer has interest in a future pregnancy, GnRH treatment is clearly appropriate. Otherwise, all major and minor risks of GnRH treatment are greater than those for SO treatment, when combined hormonal treatment with tamoxifen is taken.
Educational intervention for the prevention of sexually transmitted infections in basic secondary teachers
Authors: Alfaro Alba Cortes , O`farrill Damarys Chacón
Published: May 2021

Introduction: Among the factors that increase sexual infections in adolescence are the early initiation of sexual relations, adolescence is considered a stage of vulnerability and exposure to risky social and/or sexual behaviors that expose them to sexual and reproductive health problems such as unwanted pregnancies and sexually transmitted infections, so it is essential that they are taught in schools comprehensive sexuality education Objective: To assess the effects of educational intervention for the prevention of sexually transmitted infections in teachers of the Antonio José Oviedo Basic Secondary School. San José de las Lajas, Mayabeque during the period: October 2017 to February 2019. Method: A quasi-experimental educational intervention study with a mixed approach to the 40 teachers included in the permanent staff of the center, a survey was applied prior to the intervention that allowed characterizing the teachers according to sociodemographic variables, exploring the level of knowledge, attitudes, perception of risk and beliefs about STIs. 15 work sessions were held and tools were given to facilitate the work on these issues with adolescents. A post-intervention survey was applied to evaluate its effectiveness. Descriptive and inferential statistics (J squared) were applied. Results: female sex predominated (72.5%), with ages between 30 and 40 years (42.5%), in males the perception of lower risk prevailed compared to females. Knowledge, beliefs, attitudes and perception of risk about STIs were inadequate prior to intervention, after intervention they increased significantly in: 92.5%, 65%, 77.5% and 70% respectively. Conclusions: The educational intervention was effective in contributing to the improvement of comprehensive sexuality education in the school environment.
Cerebroplacental ratio in gestational hypertension and its impact on neonatal weight
Authors: Alalfy Mahmoud , Okasha Ahmed , Abdalfatah Omar
Published: May 2021

Background: Pregnancy a physiological process that involves changes in vascular system responsiveness that affects the placental development in direct and indirect methods by hormonal and other signals that are critical in normal blood flow rates within the fetal system. Predicting fetal outcome using sonographic indices is considered a noninvasive valuable protocol to manage cases with hypertensive disorders with pregnancy. Fetal weight is one of the critical issues faced by obstetricians and perinatologists Aim of the study: to determine the value of cerebro placental ratio in predictability of neonatal weight in cases of gestational hypertension. Patients and Methods: A prospective observational cross sectional study that included 100 pregnant women, 50 ladies had gestational hypertension and 50 women as normal control group attending the antenatal care clinic of Algezeera hospital. Ultrasonographic assessment was carried out with evaluation of routine fetal biometry in addition to Middle cerebral artery (MCA), Umbilical artery (UA) Doppler indices. Results: UA PI, MCA PI, CPR, Fetal weight and birth weight were statistically significantly higher among the control research group in comparison to the hypertension with pregnancy research group (p values<0.001). Conclusion: Cerebroplacental ratio is a promising ultrasonographic marker for fetal and neonatal weight that could aid in prediction of neonatal wellbeing and clinical prognosis of hypertensive cases in pregnancy.
Factors that may interfere in estradiol-progesterone plasmatic concentration in the mid-luteal phase of hyperstimulated cycles for IVF/ICSI
Authors: Florêncio Rodopiano de Souza
Published: May 2021

Research question: We have demonstrated that plasmatic estradiol in mid-luteal phasel has prognostic value for clinical and ongoing pregnancy rate. This study investigated the possible factors that could interfere in the value of estradiol-progesterone in the mid luteal phase of cycles of IVF/ICSI Design: Retrospective study, including patients ≤39years old and with dosage of estradiol-progesterone and beta hCG 6-7 days after fresh embryo transfer and the influence of several factors or variables upon these hormones. Results: Of 189 cycles of IVF/ICSI with complete hormonal evaluation in mid-luteal phase, we studied the probably influence of ten factors upon plasmatic concentration of estradiol-progesterone. Only four factors had significant influence. Of them, the most important variable was beta hCG concentration (consequence of trophoblastic mass and number of implanted embryos), followed for number collected oocytes, and of litlle importance, scheme of final maturation with luteal phase correction (did not reach statistical difference), and day of transfer. Conclusion: The estradiol-progesterone in the mid-luteal phase, in this research, were influenced by hCG, number of collected oocytes, scheme for final maturation, but the main influence factor was the beta hCG concentration, although not had been a good correlation coefficient between these hormones, due to a large difference in the their concentrations, as seen in the high values observed on the Standard Deviation. The high percentages of clinical and ongoing pregnancies in the ≥500g/ml group, were the result of higher beta hCG levels, due to the larger number of twin pregnancy in this group.
Misoprostol only or in combination with intra cervical Foley’s catheter for termination of the second trimester demise pregnancy in patient with previous caesarean sections
Authors: Saleh Hend S , El Kadosi Mohamed El-Husseny , Kadosi El
Published: May 2021

Objective: Termination of second trimester pregnancy is unique obstetric contest due to its difficulty and risky especially if the condition is associated with prior Caesarean deliveries. Aim of the work: To compare the safety and efficacy of two regimens for termination of the second trimester pregnancy in ladies with scarred uterus by prior Caesarean deliveries either by using sublingual and vaginal misoprostol or sublingual misoprostol in a combination with intra cervical Foley’s catheter. Patients and methods: 163 pregnant ladies with second trimester demise pregnancy at14-24 gestational weeks in scarred uterus (≥ one cesarean sections) participated in this prospective randomized comparative study which was performed in obstetric emergency unit in Zagazig University Hospitals, Egypt from June 2019 to May 2020. 140 patients only far-reached the trial through termination of the pregnancy via induction of abortion by sublingual and vaginal misoprostol Group 1 (GI) or Foley’s catheter with vaginal misoprostol Group 2 G (II). Whichever of those methods sustained for 48 hours else the fetus expulsed formerly .Outcomes was determined by comprehensive expulsion of fetus and placenta, Induction Abortion interval, Incidence of side effects, requirement for surgical intervention and complications" rate. Results: The demographic criteria of both groups revealed no significant difference (P-value>0.05). The mean (SD) of Induction to abortion interval (hours) in GI was significant longer than in G II (51.07±23.84, 45.20±31.28) respectively with (P- value 0.021). Total dose (μg) of misoprostol used in GI (1100.72±23.54) was higher than G II (645.35± 322) with p value 0.001. Admission-termination hospitalization (days) was significant longer in G I (4.11±1.02) than in G II (2.371±1.98) with P value 0.004. No significant difference as regard occurrence of adverse effects between both groups except the incidence of fever (17.1%) in G I and (5.7%) in G II with P value 0.01. Success rate in GI and G II were (80%, 95%) respectively with P-value 0.01. Incomplete expulsion was higher in GI (14.3%) in comparison with G II (4.2%) with P value 0.04. Incidence of haemorrhage was significant higher in G II than in GI P value 0.03. No significant differences between both groups as regard incidence of rupture uterus or occurrence of infection. Conclusion: Practice of inserting Foley’s catheter through cervix with misoprostol sublingually for termination of mid-trimester pregnancy in preceding uterine scar(s) is efficient, inexpensive and safe procedure.
A successful management of acute cholemic nephropathy secondary to acute liver abscess and pylephlebitis associated severe sepsis by ercp, combined cvvhdf and stepwise hemodialysis
Authors: Akl Ahmed , Al-Khatib Nour R , Awil Al Ali , Al-Shobaki Renad , M Bazarah Salem , Hamad Nabih , Tushkandi Wail
Published: May 2021

Cholemic nephrosis or yellow kidneys, is a rare condition and can be associated with acute kidney injury secondary to various etiologies. We are reporting a difficult case presented with fatal severe sepsis associated with hepatic, pancreatic and renal injury secondary to impacted biliary stone at the ampulla of vater and complicated by infection. With proper management and early drainage of biliary system and continuous renal replacement therapy the patient survived. The early recognition and interference leads to reversal of symptoms and improvement of renal and patient survival.
Pengaruh Ekstrak Yeast dan Pisang Raja Terhadap Pertumbuhan Tunas Embrio Vanda hookeriana Rchb.f.
Authors: Rahayu Shilfiana , Utami Edy Setiti Wida , Indraloka Aldy Bahaduri
Published: May 2021

AbstrakVanda hookeriana Rchb.f. merupakan anggrek yang dilindungi dan keberlangsungan hidupnya di alam terancam punah, sehingga perbanyakan anggrek secara in vitro sangat diperlukan. Penelitian ini bertujuan untuk mengetahui pengaruh ekstrak yeast dan pisang raja terhadap pertumbuhan tunas embrio anggrek V. hookeriana Rchb.f. Desain penelitian ini menggunakan RAL faktorial, faktor pertama adalah ekstrak yeast dengan 3 taraf: 0,5 g/L, 1 g/L, dan 1,5 g/L, faktor kedua adalah buah pisang raja dengan 3 taraf: 50 g/L, 100 g/L, dan 150 g/L. Penelitian dilakukan menggunakan teknik kultur jaringan, pengamatan dilakukan setiap bulan sekali dengan mengamati aspek morfologi plantlet. Media yang digunakan adalah Vacin-Went (VW) + kombinasi ekstrak yeast dan pisang raja. Parameter pengamatan berupa tinggi tunas, berat kering tunas, jumlah daun, diameter daun, panjang daun, berat kering daun, jumlah akar, diameter akar, panjang akar, berat kering akar, dan morfologi tunas. Hasil analisis menunjukkan bahwa perlakuan pisang raja 150 g/L + ekstrak yeast 0,5 g/L merupakan konsentrasi yang paling berperan terhadap parameter pertumbuhan anggrek V. hookeriana Rchb.f. Penelitian ini berhasil membuktikan bahwa penambahan komponen organik dalam media kultur jaringan memberikan respon pertumbuhan dan perkembangan yang baik pada eksplan. Komponen organik membantu proses fisiologis eksplan, karena komponen organik mengandung senyawa potensial yang dibutuhkan selama proses pertumbuhan dan perkembangan. Abstract Vanda hookeriana Rchb.f. is one of protected orchid and its survival in the wild was threatened by extinction, so orchid propagation was needed. This research aimed to determine the effect of yeast and pisang raja extracts to embryonal shoot growth of Vanda hookeriana Rchb.f. Experimental design used factorial RAL, first factor was yeast extract with 3 treatments (0.5 g/L; 1 g/L; & 1.5 g/L). Second factor was pisang raja with 3 treatments (50 g/L; 100 g/L; & 150 g/L). The research was conducted using in vitro culture techniques, observations were made once a month by observing the plantlet morphological parameters. The medium used was Vacin-Went (VW) + combination of yeast and pisang raja extracts. Observation parameters were shoot height, shoot dry weight, leaf number, leaf diameter, leaf length, leaf dry weight, number of roots, root diameter, root length, root dry weight and shoot morphology. The analysis showed that pisang raja treatment 150 g/L + yeast extract 0.5 g/L was the best concentration for the growth parameters of Vanda hookeriana Rchbf. This research were succeeded in proving that the addition of organic components in tissue culture media gave better response to growth and development of the explants. Organic components helps the explants in physiological ways because of  the organic components contain potential compounds needed during the growth and development process.
Effect of Honey, Aloe vera, and MEBO on Collagen Density in Healing Process of Second Degree Burns in Rats
Authors: Yolanda Ovelia , Yuliana Sekar Dorojati , Nugraha Yudhi
Published: May 2021

AbstrakBerbagai penelitian ilmiah telah membuktikan bahwa kolagen merupakan biomaterial ideal dalam aktivitas penyembuhan luka. Senyawa bioaktif pada madu dan Aloe vera dapat membantu meningkatkan pembentukan kolagen. Penelitian ini dilakukan untuk membandingkan pengaruh aplikasi topikal madu, gel Aloe vera, dan Moist Exposed Burn Ointment (MEBO) terhadap kepadatan kolagen pada proses penyembuhan luka bakar derajat dua pada tikus. Luka bakar dibuat pada 28 ekor tikus dan dibagi menjadi empat kelompok yang dipilih secara acak serta dilakukan aplikasi topikal harian dengan NaCl, madu, gel Aloe vera, dan MEBO secara berurutan. Biopsi kulit dilakukan pada hari ke-7, kemudian dilakukan pembuatan sediaan histopatologi kulit dan dihitung kepadatan kolagennya. Uji One Way ANOVA menunjukkan kepadatan kolagen berbeda secara signifikan antar masing-masing kelompok (p= 0,009). Uji Post Hoc Bonferroni menunjukkan terdapat perbedaan yang signifikan antara kelompok NaCl dengan madu (p= 0,024) dan NaCl dengan MEBO (p= 0,024). Penelitian ini menunjukkan bahwa aplikasi madu dan MEBO secara topikal pada luka bakar derajat dua dapat meningkatkan pembentukan kolagen, sehingga dapat mempercepat proses penyembuhan luka. Madu, Aloe vera, dan MEBO dapat dijadikan sebagai terapi alternatif dalam penyembuhan luka bakar. AbstractVarious scientific studies have proven that collagen is an ideal biomaterial in wound healing activities. The bioactive compounds in honey and Aloe vera can help increase collagen formation. This study was conducted to compare the effect of topical application of honey, Aloe vera gel, and MEBO (Moist Exposed Burn Ointment) on collagen density in the healing process of second-degree burns in rats. Burns were made on 28 rats which were further randomly divided into four groups to receive daily topical application of NaCl, Aloe vera, honey, and MEBO respectively. Skin biopsy was carried out on the seventh day, then histopathological preparation of the skin was made and collagen density was calculated. Result of One Way ANOVA test showed that collagen density differed significantly between groups (p= 0.009). The Post Hoc Bonferroni test resulted in significant difference between NaCl with honey group (p= 0.024) and NaCl with MEBO (p= 0.024). This study found that topical application of honey and MEBO to second-degree burns could increase collagen formation, thus accelerating wound healing process. Honey, Aloe vera, and MEBO can be used as alternative therapies for healing burns.