Sexual Reproductive Health and Rights Repository (Aga Khan University)
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Association of short-term changes in menstrual frequency, medication use, weight and exercise on bone mineral density in college-aged women
Get PDFTo evaluate if experiencing a short-term exposure (18-months) to factors such as menstrual irregularities, dieting, changes in exercise or body weight, and medication usage is associated with bone mineral density (BMD) in college-aged females. A retrospective survey assessing health behaviors during a recent 18-month time period and a DXA scan were completed in 641 females. A total of 45.5% of participants reported amenorrhea during the 18-month time period. Those who experienced amenorrhea had lower femoral neck BMD (p = 0.018), trochanter (p = 0.018) and spine BMD (p = 0.022) compared to eumenorrheic women. Lifetime oral contraceptive usage longer than six months was negatively associated with BMD at femoral neck (p = 0.018) and total hip (p = 0.021). Women who lost weight trended towards having the lowest BMD at all sites compared to women who gained weight. Following a very-low calorie diet during the time period was negatively correlated with spine BMD (p = 0.001). Time spent in vigorous and very vigorous activity was weakly correlated with some hip BMD sites but time spent in extremely vigorous activity was not. In conclusion, females who experienced weight loss, amenorrhea, or a very low-calorie diet within an 18-month period of time in young adulthood had lower BMD. Additionally, oral contraceptive usage for longer than six months during their lifetime was associated with lower BMD
Preconception mental health and the relationship between antenatal depression or anxiety and gestational diabetes mellitus: a population-based cohort study
Get PDFBackground:
Antenatal depression and anxiety are highly prevalent conditions that have been associated with increased risk for myriad adverse outcomes. Current literature exploring the connection between antenatal mental health and gestational diabetes mellitus (GDM) is limited, presenting conflicting evidence. We sought to evaluate the association between antenatal depression/anxiety (DEP-ANX) and GDM using population-based, administrative data, accounting for aspects of preconception mental health.
Methods:
In this population-based retrospective cohort study, we included all singleton births in British Columbia, Canada from April 1, 2000, to December 31, 2014. We identified instances of DEP-ANX from outpatient and inpatient records that included relevant diagnostic codes and stratified our cohort by preconception DEP-ANX persistence. Logistic regression models were run to estimate odds of GDM given antenatal DEP-ANX. Models were adjusted for the birthing person’s socio-demographics and pregnancy characteristics. Using an expanded cohort, we ran conditional logistic regression models that matched birthing people to themselves (in a subsequent pregnancy) based on discordance of exposure and outcome.
Results:
Out of the 228,144 births included in this study, 43,664 (19.1%) were to birthing people with antenatal health service use for DEP-ANX. There were 4,180 (9.6%) cases of GDM among those antenatal exposure to DEP-ANX compared to 15,102 (8.2%) among those without exposure (SMD 0.049). We observed an unadjusted odds ratio (OR) of 1.19 (95% CI: 1.15 – 1.23) and fully adjusted OR of 1.15 (95% CI: 1.11 – 1.19) overall. Apparent risk for GDM given antenatal DEP-ANX was highest among the no DEP-ANX history stratum, with a fully adjusted OR of 1.24 (95% CI: 1.15 – 1.34). Associations estimated by matched sibling analysis were non-significant (fully adjusted OR 1.19 [95% CI: 0.86 – 1.63]).
Conclusions:
Results from this population-based study suggest an association between antenatal DEP-ANX and GDM that varied based on mental health history. Our analysis could suggest that incident cases of DEP-ANX within pregnancy are more closely associated with GDM compared to recurring or chronic cases
Gender-based violence during covid-19 lockdown: case study of a community in Lagos, Nigeria
Get PDFBackground: Gender-based violence (GBV) has been identified to be one of the ripple effects of the global pandemic. In countries like Nigeria, the situation is hypothesized to be worse because of widespread poverty and gender inequalities.
Objective: To examine the exposure of females to GBV during the first 3 months of the COVID-19 lockdown.
Method: This cross-sectional study was conducted in a low-income community in Lagos. Semi-structured questionnaires were administered to 130 respondents selected via systematic random sampling.
Results: The mean age of the respondents was 26.89 ± 8.67 years. Majority worked informal jobs, while only 50% had attained beyond primary education. Within the period, the respondents had been subjected to sexual (54.6%), physical (52.3%), verbal assault (41.5%), and online sexual harassment (45.4%); of which only 30% reported to the police. Furthermore, respondents subjected to sexual (p=0.004) and physical assault (p=0.032) during the period earned significantly less money than other respondents.
Conclusion: The fact that over 1 out of every 2 females was subjected to at least one form of GBV within the short timeframe shows how unsafe girls and women in low-income communities are. This calls for proactive community-level interventions to curb the GBV menace
Impact of polymorphism in base excision repair and nucleotide excision repair genes and risk of cervical cancer: a case-control study
Get PDFBackground:
Last few years, several studies all over the world revealed the association of DNA repair genes with risk of developing different type of cancers, but were ambiguous to support the evidences in case of cervical cancer risk. These differences in earlier studies directed us to study the association of polymorphisms of BER genes (XRCC1, hOGG1, XPC) and NER genes (XPC, XPD) with cervical cancer susceptibility in the women of rural population of Maharashtra.
Materials and Methods:
The genetic polymorphism in BER and NER pathway genes was studied by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method using DNA isolated from intravenous blood samples of patients and normal controls. The study included 400 clinically confirmed cervical cancer patients and 400 healthy women from a tertiary care hospital (Krishna Hospital and Medical Research Centre) of south-western Maharashtra. The association of polymorphisms was confirmed by Odds ratio (OR) with 95% confidence interval.
Results:
The single nucleotide polymorphism (SNP) of BER genes including XRCC1, hOGG1 and APE1 were analyzed and the results were noted that 27466AA (OR=4.88; 95% CI: 3.61- 6.60; p<0.0001) and 28152AA (OR=2.89; 95% CI: 1.57- 5.31; p=0.0005) genotypes of XRCC1 (rs25489, rs25487) were significantly associated with cervical cancer risk. The 1245GG genotype of hOGG1 (rs1052133) (OR=45.30; 95% CI: 3.76- 7.46; p=0.001) also showed significant correlation, whereas 2197GG genotype of APE1 (rs1130409) gene showed negative association with cervical carcinogenesis (OR=0.59; 95% CI: 0.35- 0.97; p=0.005). Similarly when we studied SNPs of NER genes including XPC and XPD genes, 21151TT genotype of XPC (rs 2228000) was positively associated with cervical cancer development and 23591AA genotype of XPD (rs1799793) showed negative association (OR=0.34; 95% CI: 0.17- 0.64; p=0.001).
Conclusion:
The findings from this study supported that rs25489, rs25487SNPs of XRCC1, rs1052133 of hOGG1 and rs2228000 of XPC may increase cervical cancer risk, whereas rs1130409 SNP of APE1 and rs1799793 SNP of XPD gene lower the risk of cervical cancer in the studied population
Information flow as reproductive governance. patient journey analysis of information barriers and facilitators to abortion care in the republic of Ireland
Get PDFBackground:
Information flow – information communication and transmission pathways and practices within healthcare systems – impacts patient journeys. Historically, regulating information flow was a key technology of reproductive governance in the Republic of Ireland. Pre-2018, law and the State sustained informational barriers to and through abortion care in Ireland. An expanded abortion service was implemented in January 2019.
Method:
Patient Journey Analysis (PJA) interrogates informational facilitators and barriers to/through post-2019 abortion care in Ireland. We focus on information flow at the interfaces between the ‘public’ sphere and ‘point of entry’, ‘point of entry’ and primary care, and primary and secondary care.
Materials:
The paper uses data from a mixed-method study. A tool for assessing online abortion service information (ASIAT), desktop research, and qualitative data from 108 in-depth interviews with providers, policy-makers, advocacy groups, and service users informed the analysis.
Results:
Abortion patient journeys vary. Information flow issues, e.g. communication of how to access services, referral systems, and information handover, act as barriers and facilitators. Barriers increase where movement from primary to secondary is needed.
Applications:
The article identifies good practice in information flow strategy, as well as areas for development. It illustrates the significance of information flow in accomplishing reproductive governance
Recent developments on the roles of calcium signals and potential therapy targets in cervical cancer
Get PDFIntracellular calcium (Ca2+) concentration ([Ca2+]i) is implicated in proliferation, invasion, and metastasis in cancerous tissues. A variety of oncologic therapies and some candidate drugs induce their antitumor effects (in part or in whole) through the modulation of [Ca2+]i. Cervical cancer is one of most common cancers among women worldwide. Recently, major research advances relating to the Ca2+ signals in cervical cancer are emerging. In this review, we comprehensively describe the current progress concerning the roles of Ca2+ signals in the occurrence, development, and prognosis of cervical cancer. It will enhance our understanding of the causative mechanism of Ca2+ signals in cervical cancer and thus provide new sights for identifying potential therapeutic targets for drug discovery
Sexual health in Tunisian women after menopause: there is a need to improve it to sustain emotional and mental wellbeing
Get PDFIntroduction:
Maintaining sexuality is important to the well-being of women, particularly after menopause and benefits of sexual satisfaction in terms of emotional well-being and quality of life have been well demonstrated.
Objectives:
This study aims to assess the sexual health behaviors in Tunisian women during and after menopause and the awareness of Tunisian partners about the role of the quality of their sexuality regarding their physical and psychological wellbeing.
Methods:
We comprehensively review the scientific literature using Pubmed database to state Tunisian literature regarding sexual behaviors and function in women during and after menopause. Interviews with twenty Tunisian women after menopause about sexual health have been conducted.
Results:
Our bibliographic research revealed a poor literature with only two papers responding to our inquiry but among a specific female population investigated after experiencing breast cancer “Female sexuality in premenopausal patients with breast cancer on endocrine therapy and sexuality after breast cancer: cultural specificities of Tunisian population”. Interrogated women reported a poor sexual satisfaction as well as sexual difficulties in the partner or with him. In fact, there is an important wrong understanding of the female anatomy and physiology by both partners, for the female sexual satisfaction. There is also many wrong cultural ideas about menopause and sexuality.
Conclusions:
Currently, sexuality in Tunisian women during and after menopause is influenced by ageing, by previous sexual function and experiences, the male domination in partner’s sexual practices and the sexual functioning in the partner. In general, there is an unfavorable body image and disturbed sexual health
Effect of a board game about sexually transmitted infections on imprisoned women’s knowledge: protocol for a quasi-experimental study
Get PDFIntroduction:
The prevalence of sexually transmitted infections in imprisoned women is high. In the prison school context, education in health is one of the best strategies to achieve positive indicators in terms of health promotion and disease prevention. The use of educational technologies, such as board games, can aid in the process of knowledge acquisition on a given subject matter. This article describes the protocol of a health educational intervention that addresses content about sexually transmitted infections directed to imprisoned women in a prison school.
Methods and analysis:
A quasi-experimental study to test the effect of a board game on 64 imprisoned women’s level of knowledge about sexually transmitted infections. The Previna board game was specifically created and validated for these women. The primary outcome will be the level of knowledge on sexually transmitted infections, measured using a score obtained after the assessment conducted during the initial interview, immediately after the intervention and after 15 days.
Ethics and disclosure:
This study was approved by the Research Ethics Committee of the Federal University of Pernambuco (Opinion No. 3 986 050 and CAAE: 30035520.7.0000.5208). The results will be presented to the school and to the Federal University of Pernambuco, as part of the activities of a PhD Thesis in Nursing, and will be disclosed in peer-reviewed journals and scientific events
Development of stable liposomal drug delivery system of thymoquinone and its in vitro anticancer studies using breast cancer and cervical cancer cell lines
Get PDFThymoquinone, a well-known phytoconstituent derived from the seeds of Nigella sativa, exhibits unique pharmacological activities However, despite the various medicinal properties of thymoquinone, its administration in vivo remains challenging due to poor aqueous solubility, bioavailability, and stability. Therefore, an advanced drugdelivery system is required to improve the therapeutic outcome of thymoquinone by enhancing its solubility and stability in biological systems. Therefore, this study is mainly focused on preparing thymoquinone-loaded liposomes to improve its physicochemical stability in gastric media and its performance in different cancer cell line studies. Liposomes were prepared using phospholipid extracted from egg yolk. The liposomal nano preparations were evaluated in terms of hydrodynamic diameter, zeta potential, microscopic analysis, and entrapment efficiency. Cell-viability measurements were conducted using breast and cervical cancer cell lines. Optimized liposomal preparation exhibited polygonal, globule-like shape with a hydrodynamic diameter of less than 260 nm, PDI of 0.6, and zeta potential values of −23.0 mV. Solid-state characterizations performed using DSC and XRPD showed that the freeze-dried liposomal preparations were amorphous in nature. Gastric pH stability data showed no physical changes (precipitation, degradation) or significant growth in the average size of blank and thymoquinone-loaded liposomes after 24 h. Cell line studies exhibited better performance for thymoquinone-loaded liposomal drug delivery system compared with the thymoquinone-only solution; this finding can play a critical role in improving breast and cervical cancer treatment management
Socio-demographic determinants of cervical cancer screening uptake among women of child-bearing age in Mangochi, Malawi: a facility-based cross-sectional study
Get PDFBackground:
Cervical cancer (CC) is the number one leading cause of death among women in Malawi. However, it is generally viewed as preventable and treatable if diagnosed in an early stage. Despite the burden, Malawi registers low uptake of cervical cancer screening (CCS). This study examined the socio-demographic determinants of CCS uptake among women of child-bearing age (WCBA) in Mangochi district.
Methods:
A cross-sectional quantitative study was conducted in five health facilities. A total of 482 women between the ages of 18–49 participated and were sampled using a multi-stage sampling method. An interviewer administered structured questionnaire was used to collect data from June to July, 2019. Multivariate logistic regression model was used to identify determinants of CCS uptake among WCBA.
Results:
Few respondents (13.1%) had ever done CCS. Compared to respondents in the age-group of 18–24 years, those in the age-groups of 25–35 years and 36–49 years were 2.63 and 3.90 times more likely to undergo CCS (AOR = 2.63, 95% CI 1.30–5.31 and AOR = 3.90, 95% CI 1.62–9.38), respectively. Respondents who practiced Christianity were 2.77 times more likely to undergo CCS than those who practiced Islam (AOR = 2.77, 95% CI 1.23–6.22). Respondents of the Chewa ethnic group were 71% less likely to undergo CCS as compared to those of Yao ethnicity (AOR = 0.29, 95% CI 0.09–0.95). Respondents who lived in semi-urban areas were 2.57 times more likely to go for CCS than those who were village residents (AOR = 2.57, 95% CI 1.19–5.55).
Conclusion:
Our study showed that CCS uptake was low in Mangochi and the results suggested that age, religion, ethnicity and place of residence were determinants of CCS uptake. We recommend that comprehensive health education on CC should specifically target the young women and Muslim women in places where they meet. We call upon the district health authorities to scale up CCS provision in all Antiretroviral Therapy (ART) and outreach clinics to improve CCS uptake among women residing in the villages and those of the Chewa ethnicity. We, further, call upon all CC program implementers to design programs that address the highlighted socio-demographic determinants of CCS uptake among WCBA in the district