Sexual Reproductive Health and Rights Repository (Aga Khan University)
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Women’s political representation and intimate partner violence
Get PDFRecent studies demonstrate that female leaders can improve gender-specific outcomes along multiple dimensions through better provision of public goods and legislative changes that benefit women. Using quasi-random exposure to female leaders elected to state legislatures in India, this paper shows that there may also be an unintended effect: an increase in rural women’s reported experience of physical spousal abuse. We find that a plausible channel underlying this effect is an increase in women’s modern contraceptive use—potentially resulting from improvements in public provision of health services—which leads to marital conflict, especially when the husband’s son preference is stronger than the wife’s
Clinicopathological characteristics and prognostic risk factors of cervical cancer patients aged ≤35 years old
Get PDFWe aimed to explore the clinicopathological characteristics and prognostic risk factors of cervical cancer in patients aged ≤35 years. A total of 256 cervical cancer patients treated at Anhui Medical University Affiliated Maternity and Child Health Hospital and The First Affiliated Hospital of Anhui Medical University from January 2016 to October 2018 were divided into ≤35-year-old (n = 136) and >35-year-old (n = 120) groups. Their clinicopathological characteristics and 3-year cumulative disease-free survival (DFS) and overall survival (OS) rates were compared. The factors influencing the 3-year cumulative DFS rate of patients in the ≤35-year-old group were analyzed using univariate and multivariate Cox regression models. The human papillomavirus (HPV) infection rate, incidence rate of contact vaginal bleeding, depth of cervical interstitial infiltration, and incidence rates of parametrial metastasis and vascular infiltration were all significantly higher in the ≤35-year-old group than in the >35-year-old group. The 3-year cumulative DFS rates of all patients and those with HPV infection and contact vaginal bleeding were significantly lower in the ≤35-year-old group than in the >35-year-old group (69.12% vs. 77.50%, 68.29% vs. 80.85%, and 66.04% vs. 81.48%) (log-rank χ2 = 7.429, 4.339, and 4.276, P 4 mm, parametrial metastasis, lymph node metastasis, and vascular infiltration were independent risk factors for the prognosis of cervical cancer patients aged ≤35 years (P 35 years, which is affected by the depth of cervical interstitial infiltration >4 mm, parametrial metastasis, lymph node metastasis, and vascular infiltration. Therefore, it is necessary to identify more effective treatment methods for young patients with cervical cancer to improve the therapeutic effect and reduce the risk of recurrence and metastasis
Menstrual hygiene management in public high schools in Ghana
Get PDFin the ten (10) regions of Ghana. The findings showed that most girls in Public Senior High Schools in Ghana had prior knowledge about menstruation from their mothers and sisters prior to menarche. It was revealed that majority of the girls mentioned hormones as the cause of menstruation, whilst others mentioned the uterus, bladder, vagina, and other parts of the female reproductive system. A few of them had no idea what causes menstruation. The findings again revealed that most girls use sanitary pads, while some use other materials during menstruation. Less than half of the sample of girls in this study were able to change their pads twice daily or more. About half of the girls cleansed their genital parts only when bathing during menstruation using soup and water mostly. Half of the schools used pblic tap/standpipe as their main source of water and the rest used other sources of water. Also, most schools have toilet facilities. Some useful recommendations are proffered with the aim of improving MHM in public high schools in Ghana
Comparison of side effects of covid-19 vaccines: sinopharm, astrazeneca, sputnik v, and covaxin in women in terms of menstruation disturbances, hirsutism, and metrorrhagia: a descriptive-analytical cross-sectional study
Get PDFPresent study assessed whether Sinopharm, AstraZeneca, Sputnik V, and Covaxin's vaccinated womenreveal a distinct incidence of menstruation disturbances, hirsutism, and metrorrhagia.Materials and Methods: Data collection was performed from June to August 2021, and 427 women working in sevenselected hospitals in Tehran were studied in this descriptive-analytical cross-sectional study. All of these women hadreceived one or both doses of the vaccines with one of the assessed vaccines. Required data was collected via questionnaireand imported to SPSS 16 for further assessment and analysis. Fisher's Exact Test and Chi-Squared test weremain statistical tests used to understand whether any significant relation exists or not.Results: The participant's mean age and body mass index (BMI) were 29.78 ± 10.55 and 23.27 ± 3.82, respectively.Three hundred ninety-five cases (92.4%) had received both doses of the vaccines. Also, 154 cases (36.1%) had a historyof COVID-19. A total of 38 cases (8.8%) of menstruation disturbances, 20 cases (4.6%) of metrorrhagia, and 7cases (1.6%) of hirsutism were reported after receiving the vaccines. There was a significant difference among thevaccinated groups with the vaccines as mentioned earlier in terms of menstruation disturbances (hypermenorrhea,dysmenorrhea, Amenorrhea) (P=0.01). The highest and the lowest incidence of menstruation disturbances were recordedin the group vaccinated with Covaxin (17.6%) and Sputnik V (5%), respectively. There was also no significantdifference amongst the vaccinated groups with the four vaccines regarding the incidence of metrorrhagia andhirsutism (P=0.10 and P=0.12, respectively). There was no significant relationship between all three complicationsincidence with the previous infection concerning all vaccines (coefficient=0.46, 1.27, -0.15 respectively for menstruationdisturbances, metrorrhagia, and, hirsutism).Conclusion: Seemingly, Covaxin revealed the most side effects in terms of menstruation disturbances. As a result, professionalsmust carry out several studies with reasonable samples to recommend the vaccine to those women confidently
High burden of self-reported sexually transmitted infections among female sex workers in Togo in 2021
Get PDFBackground:
Sexually Transmitted Infections (STI) remain a public health challenge, especially for Female Sex Workers (FSW) who are particularly vulnerable. In sub-Saharan Africa where the overlapping epidemics of STI and HIV are concentrated among key populations, epidemiological data are needed in order to better understand STI trends in this population. The aim of this study was to assess the prevalence of self-reported STI symptoms and their risk factors among FSW in Togo in 2021.
Methods:
A cross-sectional study was completed in June and July 2021 among FSW in two cities of Togo: in Lomé (capital city, south of Togo) and in Kara (north of Togo). A snowball sampling method was used and after consent, a standardized questionnaire was administered by trained research staff to collect information on STI. A multivariate logistic regression model was used to identify factors associated with self-reported STI.
Results:
A total of 447 FSW, 300 in Lomé and 147 in Kara participated in this study. Median age was 30 [IQR: 24–38] and STI symptoms in the previous 12 months were reported by 191 FSW [42.7%, 95% CI: (38.1–47.5)], among whom 116 (60.7%) sought medical care. The most common reported symptoms were abnormal vaginal discharge (n = 78; 67.2%) and vaginal itching (n = 68; 58.6%). Current STI symptoms (at the time of the survey) were reported by 88 FSW (19.7%). In multivariable logistic regression, self-reported STI symptoms in the previous 12 months was negatively associated with living in the Lomé and older age and positively associated with having more than 15 clients in the previous week and being victim of violence.
Conclusions:
Findings from this study reveal that the self-reported STI burden is relatively high among FSW Togo. Additional strategies are needed at the structural, medical, political and social levels to curb this trend and effectively aim at the elimination of STI epidemics by the year 2030
CircCASC15-miR-100-mTOR may influence the cervical cancer radioresistance
Get PDFBackground:
Cervical cancer has ranked the top one in gynecological malignancies for incidence. Radioresistance is now becoming a leading reason of recurrence.
Methods:
Our microRNA array data indicated that the miRNA-100 level decreased significantly during radioresistance. In this study, we up-regulated miR-100 in Hela and Siha cells by using miR-100 mimics and observed proliferation and invasion.
Results:
It turned out that with overexpression of miR-100, the cells had less invasiveness as well as proliferation. It may target gene mTOR, and it deed reduced EMT. To examine the role of miR-100 in radioresistance, there was no significant result showed by BSP. While the circCASC15 has been identified with sponge function according to RNA pull down and ISH.
Conclusion:
The conclusions indicate miR-100 is a tumor suppressor gene and could be a therapeutic target in radio-resistant cervical cancers
Preconception counseling: identifying ways to improve services
No full textObjective: The aim of this retrospective study was to evaluate the maternal conditions for which preconception services are provided and the routine services and recommendations offered through the Maternal Fetal Medicine group at the University of Colorado (CU). The study sought to determine how services and recommendations differ by maternal condition, demographics, and reproductive health history.
Materials and Methods: Charts of patients who received preconception counseling through the CU MFM department during 2018 were reviewed to evaluate maternal conditions and the type of counseling patients received. Patients were grouped by their referral reason and subsequently by counseling recommendations to either proceed with immediate conception, defer immediate conception pending completion of further recommendations or to not conceive.
Results: Of the fifty-nine patients referred to preconception counseling, 52% ( n = 31) of the women were referred for maternal disease, 40% ( n = 24) for infertility, 32% ( n = 19) for previous poor obstetric outcomes, 30% ( n = 18) for advanced maternal age and finally, 15% ( n = 9) for gynecologic anatomic abnormalities.
Conclusion: During the initial evaluation, 58% ( n = 34) of patients were determined to have no concern for immediate conception while 7% ( n = 4) were ultimately advised to not conceive. Using this data, we identified areas of preconception counseling that standardization will improve by ensuring patients receive comparable services and advice
The role of apparent diffusion coefficient (ADC) in the evaluation of lymph node status in patients with locally advanced cervical cancer: our experience and a review
Get PDFPurpose:
To evaluate the role of apparent diffusion coefficient (ADC) value measurement in the diagnosis of meta-static lymph nodes (LNs) in patients with locally advanced cervical cancer (LACC) and to present a systematic review of the literature.
Material and methods:
Magnetic resonance imaging (MRI) exams of patients with LACC were retrospectively eva-luated. Mean ADC, relative ADC (rADC), and correct ADC (cADC) values of enlarged LNs were measured and compared between positron emission tomography (PET)-positive and PET-negative LNs. Comparisons were made using the Mann-Whitney U-test and Student’s t-test. ROC curves were generated for each parameter to identify the optimal cut-off value for differentiation of the LNs. A systematic search in the literature was performed, exploring several databases, including PubMed, Scopus, the Cochrane library, and Embase.
Results:
A total of 105 LNs in 34 patients were analysed. The median ADC value of PET-positive LNs (0.907 × 10-3 mm2/s [0.780-1.080]) was lower than that in PET-negative LNs (1.275 × 10-3 mm2/s [1.063-1.525]) (p < 0.05). rADC and cADC values were lower in PET-positive LNs (rADC: 0.120 × 10-3 mm2/s [–0.060-0.270]; cADC: 1.130 [0.980-1.420]) than in PET-negative LNs (rADC: 0.435 × 10-3 mm2/s [0.225-0.673]; cADC: 1.615 [1.210-1.993]) LNs (p < 0.05). ADC showed the highest area under the curve (AUC 0.808).
Conclusions:
Mean ADC, rADC, and cADC were significantly lower in the PET-positive group than in the PET-negative group. The ADC cut-off value of 1.149 × 10-3 mm2/s showed the highest sensitivity. These results confirm the usefulness of ADC in differentiating metastatic from non-metastatic LNs in LACC
Agenda setting and socially contentious policies: Ethiopia’s 2005 reform of its law on abortion
Get PDFBackground:
In 2005, Ethiopia took a bold step in reforming its abortion law as part of the overhaul of its Penal Code. Unsafe abortion is one of the three leading causes of maternal mortality in low-income countries; however, few countries have liberalized their laws to permit safer, legal abortion.
Methods:
This retrospective case study describes the actors and processes involved in Ethiopia’s reform and assesses the applicability of theories of agenda setting focused on internal versus external explanations. It draws on 54 interviews conducted in 2007 and 2012 with informants from civil society organizations, health professionals, government, international nongovernmental organizations and donors, and others familiar with the reproductive health policy context in Ethiopia as well as on government data, national policies, and media reports. The analytic methodology is within-case analysis through process tracing: using causal process observations (pieces of data that provide information about context, process, or mechanism and can contribute to causal inference) and careful description and sequencing of factors in order to describe a novel political phenomenon and evaluate potential explanatory hypotheses.
Results:
The analysis of key actors and policy processes indicates that the ruling party and its receptiveness to reform, the energy of civil society actors, the “open windows” offered by the vehicle of the Penal Code reform, and the momentum of reforms to improve women’s status, all facilitated liberalization of law on abortion. Results suggest that agenda setting theories focusing on national actors—rather than external causes—better explain the Ethiopian case. In addition, the stronger role for government across areas of policy work (policy specification and politics, mobilization for enactment and for implementation), and the collaborative civil society and government policy relationships working toward implementation are largely internal, unlike those predicted by theories focusing on external forces behind policy adoption.
Conclusions:
Ethiopia’s policymaking process can inform policy reform efforts related to abortion in other sub-Saharan Africa settings
Trends in incidence rates, mortality rates, and age-period-cohort effects of cervical cancer — China, 2003–2017
Get PDFIntroduction:
This study reported the trends and analyzed the age-period-cohort effects on the incidence and mortality rates of cervical cancer in China.
Methods:
The age-standardized incidence rate (ASIR) and mortality rate (ASMR) by Segi’s world standard population were calculated using qualified consecutive data from 22 cancer registries from 2003 to 2017 in China. We performed joinpoint analysis to describe the trends and age-period-cohort analysis to estimate the independent effects of age, period and cohort on trends in incidence and mortality rates of cervical cancer.
Results:
The ASIR and ASMR for cervical cancer in females over 20 years old increased during 2003−2017. For females 50 years, the ASIR and ASMR increased both in urban and rural areas. Age-period-cohort analysis showed increasing period effects on cervical cancer incidence and mortality during the whole period. The cohort effects exhibited a downward-upward-downward pattern for the incidence (1918–1938, 1938–1963, 1963–1993) and mortality rates (1918–1943, 1943–1963, 1963–1993) in urban areas, a fluctuating pattern for incidence rate and a continuing downward pattern for mortality rate (1918–1993) in rural areas.
Conclusions:
The increases in cervical cancer incidence and mortality rates can be mostly explained by period effects. We observed decreases in risk for cervical cancer incidence and mortality in young female generations, which were more obvious in urban areas