Sexual Reproductive Health and Rights Repository (Aga Khan University)
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SRSF3 restriction eases cervical cancer cell viability and metastasis via adjusting PI3K/AKT/mTOR signaling pathway
Get PDFObjective:
To investigate the effect of SRSF3 on the viability and metastasis of cervical cancer (CC) SiHa and Hela cells.
Methods:
In vitro, HeLa cells and SiHa cells were cultured. In cervical cancer cells, RNA interference technology was utilized to lessen the SRSF3 level, and via RT-PCR utilization, the SRSF3 level in every group of cells was revealed. By employing the CCK-8 method, the OD value was revealed in every group at 24, 48, 72, and 96 h. On the migration of cervical cancer SiHa and HeLa cells via transwell utilizing, the consequence of SRSF3 was surveyed. Through western blotting utilizing, the PI3K/AKT/mTOR signaling pathway-connected proteins levels was revealed.
Results:
In SiHa cells, contrasted to the NC-SiHa group, the SRSF3 level, the number of invasive cells per unit area, the p-PI3K/PI3K level, the p-AKT/AKT level, and the p-mTOR/mTOR level in the si-SRSF3 group were substantially lessened. The OD value at 490 nm of the si-SRSF3 group had no impressive divergence, contrasted to the NC-SiHa group at 24 h. At 48 h, the OD value of the si-SRSF3 group was impressively lessened than that of the NC-SiHa group. This connection was time-dependent. In HeLa cells, the SRSF3 level, the number of invasive cells per unit area, the level of p-PI3K/PI3K, the level of p-AKT/AKT, and the level of p-mTOR/mTOR in the cells of the si-SRSF3 group in the NC-HeLa group were impressively lessened than those in the NC-Hela group. Between the NC-HeLa group and the si-SRSF3 group at 24 h, there was no impressive divergence in the OD value at 490 nm. At 48 h, the OD value of the si-SRSF3 group was impressively lessened than that of the NC-SiHa group. This connection is time-dependent.
Conclusion:
Reducing the SRSF3 level can restrain the viability and metastasis of cervical cancer cells via restraining the PI3K/AKT/mTOR signaling pathway
Sexually transmitted infections among artisanal miners in Zimbabwe: An urgent need for enhanced preventive measures
Get PDFCurrent situation of menstruation and gynecological diseases prevalence among Chinese women: a cross-sectional study
Get PDFBackground: Gynecological diseases have been taken attention and studied worldwide. Although, no recent studies have delineated the magnitude of gynecological diseases among Chinese women. This study aims to evaluate the current situation of menstruation and gynecological diseases prevalence among Chinese women.
Methods: A cross-sectional study was conducted at a hospital affiliated with Nanjing medical university in Nanjing, China between September 2021 and February 2022. A sample size of 977 women aged 18-52 years participated in a face-to-face interview questionnaire. Logistic regression was performed to determine whether pubertal timing and menstrual characteristics were associated with gynecological diseases.
Results: The most prevalent gynecological disease was dysmenorrhea (45.96%), followed by polycystic ovary syndrome, PCOS (19.04%), uterine fibroids (14.23%), spontaneous abortion (13.20%), trouble conceiving (12.59%), ovarian dysfunction (11.16%) and endometriosis (4.09%). In the adjusted model, heavy bleeding with large clots was associated with an increased risk of dysmenorrhea (odds ratio, OR = 5.01, 95% Confidence interval, CI 2.26, 11.10; p = 0.000), while history of precocious puberty diagnosis was associated with a reduced risk of dysmenorrhea (OR = 0.50, 95%CI: 0.26, 0.94; p = 0.031). Regular menstrual cycle in the past 12 months and regular menstrual periods were associated with decreased risk of PCOS (OR = 0.44, 95%CI 0.30, 0.65; p = 0.000) and (OR = 0.52, 95%CI 0.36, 0.74; p = 0.000), respectively. Histories of early thelarche, early menarche, and precocious puberty diagnosis were associated with increased risk of ovarian dysfunction (OR = 1.96, 95%CI 1.25, 3.08, p = 0.004), (OR = 2.26, 95%CI 1.24, 4.13; p = 0.008) and (OR = 2.79, 95%CI 1.36, 5.74; p = 0.005), respectively. Heavy bleeding and heavy bleeding with large clots were associated with endometriosis (OR = 4.92, 95%CI 1.50, 16.15, p = 0.009) and (OR = 5.67, 95%CI 1.42, 22.56; p = 0.014), respectively.
Conclusions: The prevalence of gynecological diseases is increasing among Chinese women and pubertal timing and menstrual characteristics may be associated with some gynecological diseases, specifically dysmenorrhea, PCOS, ovarian dysfunction, and endometriosis
National survey of us plastic surgeon experience with female genital mutilation
Get PDFBackground:
Female genital mutilation (FGM) is a growing problem in the United States, with the past few decades showing a dramatic increase in prevalence. This study aims to understand the plastic surgeon experience with FGM and inform preparedness for this rising problem.
Methods:
A 26-question survey was developed and electronically distributed to a random cohort of 2,508 active American Society of Plastic Surgeons members. It was sent three times over a 3-week period in 2018. χ2 statistical tests were used to analyze outcomes, assuming a P < 0.05 level for statistical significance.
Results:
There was a 7% survey response rate (n=180). Demographic profiles reflected a range of practice types, geographical distribution, and years of experience. Ninety-five percent of respondents had heard of FGM (n=169). Sixty-seven percent were aware that surgical reconstructive options exist for FGM (n=115), with only 5% reporting any formal training on the topic (n=10). Only 13.6% of those surveyed felt prepared to care for a woman with FGM (n=23).
Conclusions:
After surveying plastic surgeons, responses demonstrate that while the majority are familiar with FGM, very few are comfortable or prepared for the care and surgical management of this patient population. Although this study is limited by a low response rate, we believe that the results reflect an existing knowledge gap and demonstrate the need for formal training. This may help to bridge this gap and prepare surgeons to care for this population
Uptake and correlates of cervical cancer screening among women attending a community-based multi-disease health campaign in Kenya
Get PDFIntroduction:
Despite the increased risk of cervical cancer among HIV-positive women, many HIV-care programs do not offer integrated cervical cancer screening. Incorporating self-collected Human Papillomavirus (HPV) testing into HIV programs is a potential strategy to identify women at higher risk for cervical cancer while leveraging the staffing, infrastructure and referral systems for existing services. Community-based HIV and HPV testing has been effective and efficient when offered in single-disease settings.
Methods:
This cross-sectional study was conducted within a community outreach and multi-disease screening campaigns organized by the Family AIDS Care and Education Services in Kisumu County, Kenya. In addition to HIV testing, the campaigns provided screening for TB, malaria, hypertension, diabetes, and referrals for voluntary medical male circumcision. After these services, women aged 25–65 were offered self-collected HPV testing. Rates and predictors of cervical cancer screening uptake and of HPV positivity were analyzed using tabular analysis and Fisher’s Exact Test. Logistic regression was performed to explore multivariate associations with screening uptake.
Results:
Among the 2016 women of screening age who attended the outreach campaigns, 749 women (35.6%) were screened, and 134 women (18.7%) were HPV-positive. In bivariate analysis, women who had no children (p < 0.01), who were not pregnant (p < 0.01), who were using contraceptives (p < 0.01), who had sex without using condoms (p < 0.05), and who were encouraged by a family member other than their spouse (p < 0.01), were more likely to undergo screening. On multivariable analysis, characteristics associated with higher screening uptake included: women aged 45–54 (OR 1.62, 95% CI 1.05–2.52) compared to women aged 25–34; no children (OR 1.65, 95% CI 1.06–2.56); and family support other than their spouse (OR 1.53, 95% CI 1.09–2.16). Women who were pregnant were 0.44 times (95% CI 0.25–0.76) less likely to get screened. Bivariate analyses with participant characteristics and HPV positivity found that women who screened HPV-positive were more likely to be HIV-positive (p < 0.001) and single (p < 0.001).
Conclusions:
The low screening uptake may be attributed to implementation challenges including long waiting times for service at the campaign and delays in procuring HPV test kits. However, given the potential benefits of integrating HPV testing into HIV outreach campaigns, these challenges should be examined to develop more effective multi-disease outreach interventions
The incidence of cervical cancer in women with postcoital bleeding and abnormal appearance of the cervix referred through the 2‐week wait pathway in the United Kingdom: a retrospective cohort study
Get PDFAim:
To determine the incidence of cervical cancer in women referred through the 2‐week‐wait pathway for postcoital bleeding and abnormal appearance of the cervix.
Methods:
A retrospective cohort study was conducted of women with postcoital bleeding, or abnormal appearance of the cervix referred to colposcopy clinics through the 2‐week‐wait pathway for suspected cervical cancer at Cambridge University Hospitals in the United Kingdom over 5 years. Women were identified from a departmental database. Clinical and demographic data were collected. Categorical data was analyzed with chi‐squared or Fisher's exact tests and predictive values were calculated.
Results:
Of the 604 women referred, 1.16% were diagnosed with cervical cancer. None of the women who were up‐to‐date with cervical screening were diagnosed with cervical cancer, while 6.25% of women out‐of‐date with cervical screening or outside the screening age group were diagnosed with cervical cancer (p < 0.001). The positive predictive value for diagnosing cervical cancer was 1.70% for postcoital bleeding (95% confidence interval [CI] 0.64–3.7) and 0.31% for abnormal appearance of the cervix (95% CI 0.0008–1.7).
Conclusions:
The incidence of cervical cancer in women referred through the 2‐week‐wait pathway for postcoital bleeding and abnormal appearance of the cervix is low. These referrals have considerable implications for both patients and clinicians, and have a low predictive value for diagnosing cervical cancer. In light of emerging evidence and changing practices, referral guidelines should be reviewed based on up‐to‐date data and current practices
The value of the SUV ratio between lymph node and bone marrow in predicting pelvic lymphatic metastasis of patients with locally advanced cervical cancer: an integrated PET/CT study
Get PDFPurpose:
This study aimed to evaluate the value of the standardized uptake value (SUV) ratio between lymph nodes and bone marrow (BM) measured by Fluorine-18-fluorodeoxyglucose PET and computed tomography (18F-FDG PET/CT) for predicting pelvic lymph node (PLN) metastasis in patients with locally advanced cervical cancer (LACC).
Materials and methods:
A total of 62 patients with pathological stage Ib-IVa cervical cancer who underwent 18F-FDG PET/CT before treatment were reviewed retrospectively. We measured the metabolic and morphological parameters of lymph nodes and primary tumors, bone marrow SUV (SUVBM) and calculated the ratio of lymph nodes maximum SUV (SUVmax) to bone marrow SUV (SUVLN/BM) and the ratio of short-axis diameter to long-axis diameter (Ds/l) of lymph nodes. A receiver operating characteristic (ROC) curve was performed to evaluate the diagnostic efficacy of each parameter.
Results:
There were 180 lymph nodes with pathological evidence included in the study. Our results indicated that Ds/l, SUVmax of lymph nodes (SUVLN) and SUVLN/BM were independent risk factors for PLN metastasis in LACC (P < 0.05), and SUVLN/BM showed the best diagnostic performance by ROC curve analysis. The SUVBM in the anemia group was significantly higher than that in the nonanemia group (3.05 vs. 2.40, P < 0.05); furthermore, false-positive cases decreased when the SUVLN/BM was used as the diagnostic criterion instead of SUVLN, especially in the anemia group. ROC curve analysis showed that the area under the curve value of the combination of SUVLN/BM and Ds/l was 0.884 (P < 0.05), which was higher than Ds/l or SUVLN/BM alone.
Conclusions:
SUVLN/BM could improve the ability to predicting PLN metastasis in patients with LACC, and the diagnostic efficacy of the combination of SUVLN/BM and Ds/l might be better than that of a single parameter
A prospective cohort study of the relationship of female genital mutilation with birth outcomes in Somalia
Get PDFBackground:
Female genital mutilation (FGM) is defined as the partial or complete removal of the external female genitalia for non-medical reasons. There are some complications related to childbirth that concern both the mother and the baby. In this study, we aimed to evaluate the birth outcomes of FGM, which is widely applied in Somalia.
Methods:
The study included 268 women who gave birth at 37–42 weeks of gestation with a cephalic singleton, 134 with FGM and 134 without FGM. This study was designed a prospective cohort study and conducted between January 2019 and December 2020. Patients’ ages, duration of delivery, FGM types, caesarean section requirements, before and after birth hemoglobin levels, birth weeks, baby birth weights and perineal tear data were recorded. In addition, we analyzed neonatal intensive care needs and APGAR scores for infants.
Results:
In patients with FGM, it was determined that the outlet obstruction increased 2.33 times, perineal tears increased 2.48 times, the need for caesarean section increased 2.11 times compared to the control group, and the APGAR score below 7 at the 5th minute in the children increased 2 times and the need for neonatal intensive care increased 1.87 times.
Conclusions:
FGM causes increased risk of perineal tear, prolongation in the second stage of labour, increased need for emergency caesarean section, and increased need for NICU for infants. Prevention of FGM will help reduce both obstetric and neonatal complications
Postpartum care visits among commercially insured women in the United States
Get PDFBACKGROUND:
To reduce postpartum morbidity and mortality, optimizing routine outpatient postpartum care has become a focus of national attention and a healthcare priority.
OBJECTIVE:
This study aimed to examine the timing, content, and predictors of routine outpatient postpartum visit attendance within a large, commercially insured patient population.
STUDY DESIGN:
We performed a retrospective cohort study using a national US database of commercial insurance beneficiaries with a delivery hospitalization between 2011 and 2015. We calculated the proportion of patients who had an outpatient postpartum visit within 8 weeks of hospital discharge. Using a multivariable logistic regression model, we identified independent predictors of an outpatient postpartum visit. To gain insight into the nature and extent of any postpartum medical or surgical morbidity, we also identified the most frequent International Classification of Diseases, Ninth Revision, Clinical Modification codes associated with postpartum visits.
RESULTS:
The study cohort comprised 431,969 patients who underwent delivery hospitalization, of whom 257,727 (59.7%; 95% confidence interval, 59.5–59.8) had at least 1 outpatient postpartum visit within 8 weeks of hospital discharge. The distribution of postpartum visits was bimodal, occurring most frequently in the first week (23.2%) and sixth week (21.7%) after hospital discharge. The median period between hospital discharge and the postpartum visit was 28 days (interquartile range, 8–41 days). In our multivariable model, patient-level factors that were most strongly associated with a postpartum visit were preexisting medical morbidities, which included: thyroid disease (adjusted odds ratio, 1.62; 95% confidence interval, 1.40–1.52), seizure disorder (adjusted odds ratio, 1.50; 95% confidence interval, 1.33–1.70), chronic hypertension (adjusted odds ratio, 1.46; 95% confidence interval, 1.58–1.67), and psychiatric disease (adjusted odds ratio, 1.41; 95% confidence interval, 1.36–1.47). Between 29% and 42% of patients with preexisting medical morbidity and between 35% and 41% of patients who experienced peri- or postpartum complications did not attend a postpartum visit.
CONCLUSION:
Our findings indicate that among a large, commercially-insured patient population, postpartum visit attendance was suboptimal. A high proportion with preexisting medical and peripartum morbidities was not evaluated within 8 weeks of hospital discharge. Multifaceted interventions and healthcare reform are suggested to address patients’ concerns and healthcare needs after delivery
Actinomycosis of the cervix mimicking stage ii cervical cancer
Get PDFActinomycosis is a chronic bacterial infection, characterized by suppurative and granulomatous inflammation. In humans, actinomycosis is most frequently caused by Actinomyces israelii. It is a normal commensal which becomes pathogenic upon any breach in the mucosa. We report the case of cervical actinomycosis in a 45-year-old female who had a mass per vagina for 2 years. There was no history of any intrauterine contraceptive device insertion. The radiological diagnosis was a neoplasm as the lesion is extending into the adjacent structures. Surgery was planned and a biopsy was taken which revealed Actinomyces. The patient was administered long-term penicillins and advised follow-up. Pelvic actinomycosis should be included in the differential diagnosis of pelvic masses. Even though actinomycosis can present as a large pelvic mass invading adjacent structures, it can be treated with medications and without any surgical intervention