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Testosterone: The Forgotten Female Hormone
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The purpose of this article is to review the current and past use of testosterone as a replacement hormone for women in peri- and early postmenopause. Healthcare providers are often not educated about testosterone as a sex hormone with profound effects on the female body. Yet, clinicians who treat women in the 4th and 5th decades of life should be familiar with the function of testosterone, clinical symptoms associated with declining levels, women’s perceptions about peri- and postmenopause as well as side effects of testosterone, and the implications of its use as a replacement hormone on other body systems. A comprehensive literature review was conducted using PubMed, the MeSH database, and Google Scholar, and over fifty articles were identified to substantiate the purpose of this article.
The results of this literature review reveal that testosterone has been used in various formulations as a replacement hormone in women for over 80 years. Many observational studies and far fewer randomized controlled trials have been conducted. These studies have produced varied recommendations about the indications for exogenous testosterone replacement in women. There is consensus regarding its use in postmenopausal women who suffer from hypoactive sexual desire disorder, but beyond this diagnosis, controversy remains. Additionally, there is currently no Federal Drug Administration-approved formulation of testosterone for women available in the United States. Therefore, women who seek out and receive treatment are utilizing compounded medication as well as dose-adjusted formulations intended for men. The lack of uniform treatment recommendations and availability of products contrasts significantly with women’s desire for clinicians to know and understand testosterone’s role in peri- and postmenopause. This review underscores the need for clinicians to be cognizant of the breadth of research and subsequent opinions regarding the use of testosterone therapy in women to knowledgeably address preventative, acute, and chronic care needs in peri- and early postmenopause. This review also calls for more randomized controlled trials regarding the use of testosterone as a replacement hormone in women to aid in providing more consensus around its use
Assessment of Microbial Contamination on High-Touch Public Surfaces and its Implications for Community Health: A Cross-Sectional Study from Urban South India
No full textObjectives High-contact public surfaces, such as bus seatbacks, mall escalator belts, and theater armrests, may act as reservoirs of opportunistic and antimicrobial-resistant microorganisms, posing a significant but underreported risk to community health. In urban environments like Coimbatore, Tamil Nadu, surface-level microbial surveillance remains poorly characterized. This study aimed to assess the magnitude, composition, and density of microbial contaminants on commonly touched surfaces across transit and commercial hubs.
Methods A total of 30 surface swab samples were collected from five public locations, including intra-city TNSTC buses, inter-state SETC coaches, Brookfields Mall escalator handrails, multiplex theaters and local bus seat-grips. Standardized 25 cm2 areas were swabbed using sterile, saline-moistened swabs and cultured on Nutrient Agar, MacConkey Agar, and Sabouraud Dextrose Agar. Colonies were incubated at 37°C for 24–48 hours. Isolates were identified by Gram staining, colony morphology, and biochemical assays. Antimicrobial susceptibility testing was performed using the Kirby–Bauer disc diffusion method (following Clinical and Laboratory Standards Institute 2021 guidelines.
Results Out of 30 surface samples, 28 (93.3%) were culture-positive, yielding 48 distinct microbial isolates. Gram-negative organisms accounted for 54.2% of isolates, including Escherichia coli (16.7%), Pseudomonas aeruginosa (14.6%), and Klebsiella pneumoniae (12.5%), while Gram-positive bacteria included Staphylococcus aureus (20.8%) and coagulase-negative staphylo-cocci (10.4%). Fungal species such as Aspergillus niger and Candida albicans were also detected. The highest bioburden was observed on fabric seatbacks in SETC coaches (6.7 × 104 CFU/cm2), exceeding values commonly reported in global literature. Multidrug resistance was noted in P. aeruginosa and S. aureus, particularly to ceftazidime, gentamicin, and cotrimoxazole.
Conclusion This study highlights the significant microbial load and presence of potential pathogens on high-touch public surfacesin Coimbatore. Findings suggest a plausible risk for fomite-mediated transmission, especially in enclosed environments like buses and theaters. The detection of multidrug-resistant strains supports the urgent need for improved surface sanitation protocols, public awareness on hand hygiene, and routine environmental surveillance programs that include antimicrobial resistance profiling
Commemorative Monograph: Padma Shri Dr. K.M. Cherian – A Life in Cardiac Surgery and Institution-Building
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Telemedicine Benefits for North Carolina Department of Adult Corrections Subspecialty Care
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