ris

The study aimed to identify possible environmental risk factors for breast cancer among women in Gaza Strip and conducted in 2010. A case- control study design was used with face to face interviews by structured questionnaire with breast cancer patient women as well as healthy women. Statistical Package of Social Science (SPSS) was used to analyze the collected data. The study population was 288 women, 144 were women with breast cancer (cases) and 144 were healthy women (controls) with response rate 100% for cases as well as controls. The study was carried out in the two main hospitals in Gaza Strip (El-Shifa and European Gaza) and on cases who had a regular follow up in each hospital, while controls have been chosen from women who had no history of breast cancer by mammogram or by self-examination. In this study the main statistically significant risk factors were; marital status, educational status, physical trauma on breast, medication for infertility treatment, eating red meat 500g or more weekly, eating canned food, eating chicken skin, eating raw and cooked vegetables, using oils with saturated fats in cooking, living in or beside a farm, dealing with crops with naked hands, working in a farm during pesticides application or during 24 hours of pesticides application, cleaning pesticides’ equipment, living with people working in a farm or a agricultural field, and application of pesticides personally. In contrary, no statistically significant differences were found between cases and controls in relation to area of residency, exposure to X-ray in the past, having radiation therapy, getting contraceptive pills, using hair dyes, using anti-deodorant underarm, using facial cosmetics, using hair removal ointment, washing vegetables and fruits, buying and transporting pesticides, and wearing protective tools during pesticides mixing and application.

When a woman consults a doctor about Hormone Replacement Therapy (HRT), the first concern is that there is an increased risk of breast cancer with HRT. And this sole reason might be the reason for refusing the offer of HRT. However, this practice has minimal basis and evidence to support it. Although HRT is an umbrella term, women who have no uterus receive oestrogen-only HRT or Estrogen Replacement therapy (ERT). No valid study has linked ERT with an increased risk of breast cancer [1,2].

During the last three decades, there has been an interesting debate on the intake of A1 ‘like” milk and incidence of type 1 diabetes (T1D) in genetically predisposed individuals. The epidemiological, ecological and case-control studies have concrete pieces of evidences in favor of the hypothesis that is further supported by animal trials in mice and rat and in vitro trials on cell lines. But on the other hand, European Food Safety Authority reported that there isn’t sufficient data to draw a final recommendation at this stage in terms of contradictory results, lack of cause-effect relationship and being a mere suggestive evidence [1]. However, the report itself states that these studies are strong enough to formulate a concrete hypothesis and further research is needed to confirm the same. Keeping in view the published data in favor of the hypothesis and the counter-arguments, it is suggested that further research with well-designed animal and in vitro trials with intact proteins and peptides is needed to fully confirm the hypothesis. Until the issue is fully resolved, it’s the personal choice of the individuals at risk to T1D (genetically predisposed) to either remove A1 “like” or increase the A2 “like” milk from their diet. 

Objective: This study aimed to investigating of the epidemiological aspects of infertility and related risk factors in infertile women. Materials and methods: This cross-sectional study, carried out on 330 infertile women referred to two infertility treatment center of Imam Khomeini Hospital and Mother center in Sari, Iran, from April 2015 to March 2017. Results: 54.5% of these women were in the age of 30-39 years, infertility duration in 55.2% was 1-5 years, Body mass index (BMI) in 44.5% of samples was 26-30 kg/m2, 54.5% had diploma and associate degree. 63.6% lived in urban areas. 74.5 % of patients reported primary infertility. History of polycystic ovarian syndrome (PCOs) and pelvic inflammatory disease (PID) and poor ovarian reserve were the most common causes and risk factors for the infertility with prevalence 19.42%, 16.81% and 13.91%, respectively. Most underlying disease was thyroid disorders (54.5%). There was found statistically significant relationship between residents of urban areas and infertility duration, endometriosis and educational levels, miscarriage with thyroid. Data analysis performed using IBM SPSS 21 software and Chi-Square test (p < 0.05). Conclusion: The results showed that women with infertility in north of Iran were more likely to be older, less educated, and also had overweight. They are more possible to have ovarian disorders. In these area, thyroid disease more common like Iodine deficient regions. Future research should be focused on the reasons why majority of women don’t seek treatment for the underline significant diseases that may be effects on ovarian function and fertility.

Tea (Black tea and Green tea) are one of the most widely consumed beverages in the world. However, with the increasing interest in the health properties of tea and a significant rise in scientific investigation, this review covers some of the recent findings on the health benefits of both green and black tea. The mechanisms of action of various black and green tea components have been presented. Green tea contains a unique set of catechins that responsible for its biological activity potentially relevant to the prevention of diseases. Although there has been much focus on the biological property of the major tea catechins, black tea offers major health benefits either due to the presence of the catechins in epimerized form or some other active components of both varieties of tea. Characteristics unrelated to the antioxidant properties of green and black tea might also be responsible for their therapeutic potential in preventing diseases. Synergistic effect of the tea constituents is increasingly recognized as being potentially important to the medicinal benefits of black and green tea. The studies indicate that tea has the potential of being a part of diet for healthy living.

Internet has become an important part of our life, including during pregnancy where it is broadly used to find information (84%). The aims of this study were (1) to describe the proportion of women using Internet Social Networks (ISN) concerning their pregnancy, during pre or postpartum hospital stay, (2) to define how ISN users refer to their pregnancy and delivery on these social networks, (3) to compare anxiety level, social sustain level, sociodemographic characteristics of the both population (4) and to determine profiles of the ISN users with multiple correspondence analysis. Methods: 399 questionnaires were distributed in the postpartum wards of two academic hospitals in Paris, and 258 fully filled were retrieved. Tools: Anxiety scale (STAI- A and B), Cutrona Social Provisions Scale, sociodemographic and obstetrical questionnaire. Results: 76% (n = 195) were ISN users. We compared ISN users versus ISN non users women. Demographically, the two populations were comparable. Anxiety scores were similar in both groups, whereas social support scores showed a statistical difference in social integration. In the global population, 84% use Internet for information concerning pregnancy; this rate is higher for ISN users than ISN non users (tendency 0.058). ISN were used in priority for sharing with relatives, and 10% with other pregnant women. Concerning pregnancy, patients posted in priority the birth announcement (28%), the pregnancy announcement (23%), and the newborn’s pictures (12%). 6% posted their fetuses’ ultrasound pictures. Three clusters of ISN users were extracted with statistically different social support scores (p = 0.019) and comparable anxiety scores. The third one, with at risk profile, used ISN as social support. For all women, but specifically for younger and more socially fragile women, Internet gives to professional new perspectives to develop information and prevention tools during the perinatal period.

Earlier in our laboratory, the role of various individual sperm impairing microorganisms on sperm parameters and female infertility has been elucidated at higher doses. As, multiple bacterial species tend to exert more pathogenic effect in comparison to single organism hence, present study was carried out to evaluate that if consortia of these sperm impairing organisms can lead to infertility in female mice at sub fertility dose. For this, impact of individual bacterial strains of Escherichia coli, Pseudomonas aeruginosa, Pseudomonas aeruginosa, Klebsiella pneumoniae and consortia of Escherichia coli and Pseudomonas aeruginosa, Escherichia coli and Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneumoniae was examined on the motility, viability of mouse spermatozoa and fertility outcome. The results showed that the individual bacterial strains of E. coli, S. marcescens and K. pneumoniae could led to immobilization of spermatozoa by agglutination and P. aeruginosa led to immobilization of spermatozoa without agglutination. Also, all of them led to 100% sperm death in 45 min of incubation. In case of consortia of bacterial strains, the results showed sperm agglutination in all the cases and they were able to induce 100% sperm death at 30 min of incubation time. Further, in vivo studies were carried out to evaluate the impact of individual bacterial strains and consortia of bacterial strains on the fertility outcome in female Balb/c mice. For this, female mice were administered intravaginally with 101 cfu/20µl of individual bacterial strains or consortia of strains for 10 consecutive days or PBS. The results showed that both individual bacterial strains and consortia of bacterial strains were able to efficiently colonize the mouse vagina. Further, control group receiving phosphate buffer saline and groups receiving individual bacterial strains showed all the pregnancy related changes viz. abdominal distension, string of pearls on palpation as well as delivery of pups on completion of gestation period and delivery of pups. The histological examination of reproductive organs viz. uterus and ovary, of the female mice receiving PBS or individual bacterial strains showed the formation of corpus luteum in the ovary and the formation of decidua’s in the uterus, indicative of pregnancy. However, mice receiving consortia of bacterial strains did not show any pregnancy related changes throughout the experiment. Thus, these results indicate that the presence of consortia of sperm impairing microorganisms in vaginal milieu is efficient in provoking infertility even at subfertility doses.

Puerperal acute uterine inversion is a rare obstetric condition observed as a serious complication during the third stage of labor. Reported as one of the causes of postpartum haemorrhage, it commonly requires quick diagnosis and surgical treatment in order to reduce morbidity and lethality. The authors describe a case of uterine inversion with hypovolemic shock after home birth, brought to Hospital Leonor Mendes de Barros. The purpose of this article is to describe a case of acute uterine inversion and its management and a review of aetiology, predictive and risk factors, diagnosis and treatment.

During the last few decades painstaking efforts have been made to eliminate iodine deficiency throughout the world. Todays in regions where dietary iodine intake is adequate or borderline, the main focus is increasing dietary iodine supply in the target population during pregnancy and the first years of life. Objective: The aim of this study was to obtain longitudinal data on urinary iodine excretion and the changes of maternal thyroid parameters in two groups of healthy women with mild-to-moderate iodine deficiency and iodine sufficiency residing in an iodine replete area of Tehran capital city of IR Iran, for more than one decade. Research designs and methods: The present study is part of a cohort study, investigating the relative influences of iodine intake on thyroid size and function of mothers and their infants during and after pregnancy. A total of 500 pregnant women enrolled from two mother-child health care centers and was divided into group I, with median urinary iodine excretion (MUIE) < 150 µg/L, and group II with MUIE ≥ 150 µg/L. Sonographic thyroid volume measurement, urinary iodine excretion and thyroid function tests were measured sequentially in all pregnant women during the three trimesters (T) of pregnancy. Results: The mean ± SD age of the participants was 25.1 ± 5.1 years. The MUIE in group I and II in the first, second and third trimester were 123 and 250 µg/L, 127 and 166 µg/L, 120 and 150 µg/L, respectively. The MUIE in the third trimester of pregnancy in group I did not differ significantly from the values in the first and second trimesters (p = 0.67), but it did decline significantly in group II (p < 0.001). The median thyroid volume of subjects, in the first, second and third trimesters were 7.8, 8.2 and 8.1 ml in group I and 7.5, 8.0 and 8.4 ml in group II, respectively. No difference in thyroid volume was found between two groups in each of the three trimesters of pregnancy (p > 0.05). The mean (± SD) TSH concentration of subjects in first, second and third trimester was 2.3(± 2.6), 2.1(± 1.8), 2.3(± 1.7) mIU/L in group I and 2.1(± 3.1), 2.1(± 1.8) and 2.0(± 1.3) mIU/L in group II, respectively. The trend of TSH rising in group I was 26.7% and in group II it was 13.3%. The mean TSH value in three trimesters did not differ significantly in either groups (p > 0.05). The mean (± SD) total T4 concentrations of subjects in first, second and third trimesters were 13.2(± 3.4), 13.8(± 3.3), 13.0(± 2.9) µg/dl in group I and 13.1(± 3.2), 13.7(± 2.9), 13.4(± 3.2) µg/dl in group II, respectively. The mean total T4 value in three trimesters did not differ significantly in either groups (p > 0.05). There was no correlation between the thyroid volume and three observed parameters (UIE, total T4 and TSH) during the pregnancy in either groups. Conclusion: Even in areas with well-established universal salt iodization program, pregnancy could be a risk of having iodine deficiency and systematic dietary fortification needs to be implemented in this vulnerable group.

Objective: This preliminary study focused on the description of some dysfunctional perceptions of the body image and eating habits in a sample of young. Methods: The results obtained by 55 amateur and professional volleyball players belonging to volleyball sports clubs located in the province of Reggio Emilia were examined. The age of the sample is in a range between 11 and 44 years. The participants completed the Pisa Survey for Eating Disorders (PSED), a questionnaire aimed at examining eating behavior and the perception of one’s body image. The athletes’ height and body weight were subsequently detected through direct measurement. Conclusion: The data collected through the self-evaluation questionnaire and the measurements carried out by the study made it possible to analyze the perception of the body image and the eating habits of the volleyball players belonging to the sample and to compare them with the data in the literature. The data, albeit preliminary, allow us to confirm the existence of the discrepancy between the real body image and the desired one, in a group of young athletes, who favors the adoption of non-adaptive coping strategies to control one’s own weight and body shapes typical of the vicious circle - strict diet, bingeing episodes, compensatory behaviors - which characterizes eating disorders (ED). It is therefore considered essential that body image assessment is a practice implemented in the assessment routine of these athletes, especially in consideration of the fact that body image disturbance is a very common feature in this category and is one of the main risk factors of EDs.

Background: Obstetric fistula is a condition that results from obstructed labour, which occurs when the baby cannot pass through the mother’s birth canal because it either does not come head first or is too large for her pelvis. Prompt medical intervention, often including Caesarean section, permits a safe delivery for both mother and child. Despite this possibility, yearly, thousands of women across the country receive no such aid and their labour is a futile agony lasting between three and five days, with uterine contractions constantly forcing the baby, usually head first, against the organs of the pelvic and unyielding pelvic bone resulting in Vesico Vaginal Fistula (VVF). The main thrust of this study was to examine how health system factors affect health seeking behaviour of women with obstetric fistula in Akwa Ibom and Ebonyi States, Nigeria. Methods: Qualitative and descriptive research approaches were adopted for the study and a total sample of two hundred and sixteen (216) respondents comprising of one hundred and fifty (150) post fistula repair operative patients and sixty six (66) health workers were purposively selected using simple random techniques. The data were analyzed using thematic analysis and tables of frequency. Results: The respondents views showed that availability of treatment centre and quality of health care services influenced health seeking behaviour of women with obstetric fistula in Nigeria. Conclusion: The study indicated that health seeking behaviour of women with obstetric fistula is a major challenge in Nigeria. Establishment and proper equipment of obstetric fistula treatment centres as well as subsidization of the cost of treatment to allow women with this health problem to access health care services are strongly recommended. Therefore, government at all level and non-governmental organizations need to educate the women and create awareness on the causes and dangers of VVF.

During the last few decades painstaking efforts have been made to eliminate iodine deficiency through the world. Nowadays in regions where dietary iodine intake is adequate or borderline, the main focus is increasing dietary iodine supply in the target population during pregnancy and the first years of life. Severe iodine deficiency during pregnancy increases the risk of irreversible brain damage, intellectual disability, neurologic abnormalities, stunted growth, increased pregnancy loss, infant mortality, impairments in child development and cretinism. The potential effects of mild-to-moderate iodine deficiency are debated. Results from animal studies and observational human studies indicate that maternal mild-to-moderate iodine deficiency disturbs thyroid function in pregnancy and it also may affects fetal neurodevelopment. The effect of supplementation of iodine on thyroid function of pregnant women and their newborn, neurodevelopment of infants and cognitive performance of children have been investigated using iodine nutrition in pregnancy, based on median urinary iodine concentration. However they have found conflicting results regarding the benefits or harms of iodine supplementation in pregnancy. Although many epidemiological, interventional and clinical studies have supported the association between thyroid function in pregnant women and later psychomotor and mental development of their children, the effect of iodine supplementation in pregnant women on neurodevelopment of children is inconclusive. Even in areas with well-established universal salt iodization program, pregnancy could be at risk of having iodine deficiency and despite WHO/ICCIDD/UNICEF recommendation which believe that dietary iodine fortification during pregnancy depends primarily on the extent of pre-existing iodine deprivation, systematic dietary fortification needs to be implemented in this vulnerable group. However, iodine supplementation of mildly iodine deficient pregnant women may not have beneficial effects in their thyroid function or neurodevelopment of their children.

The lumbar epidural analgesia is commonly used for labour analgesia. The “loss of resistance to air” LORA technique is commonly used for recognition of epidural space. One of the rare complications of this technique is Pneumocephalus (PC). We want to present a case of Pneumocephalus which the mother developed during epidural analgesia in labour. The patient complained of severe headache immediately after attempt at epidural catheter insertion. The symptoms progressively worsened following delivery. A postnatal anaesthetic review was performed and an urgent CT scan of the brain was arranged that showed pneumocephalus. A conservative management pathway was followed with liberal analgesia, oxygen inhalation and keeping the patient mostly in supine position. Her symptoms regressed in severity over the next three days and subsided after one week. We believe that the amount of air used for LORA should be minimized; LORA should not be used after dural puncture and the use of normal saline would alleviate the risk.

Introduction: It is estimated that more than 200 million girls and women alive today have undergone female genital mutilation. Female genital mutilation still remains to be a serious problem for large proportion of women in most sub-Saharan Africa countries including Sudan, with a high prevalence of 88%. Objective: The main objective was to identify the factors associated with FGM among daughters of reproductive aged woman. Materials and methods: A community based cross-sectional study was conducted on 200 mothers, the total sample was collected in ACTH based on the number of reproductive age mothers with at least one daughter older than 5 years. A structured and interviewer administered questionnaire was used to collect data. The data obtained was analyzed by the use of the SPSS software. Results: Out of 200 mothers, 113 (56.5%) had at least one circumcised daughter. Knowledge about genital mutilation (AOR = 4.29, 95% CI: 1.13-15.37), attitude (AOR = 48.53, 95% CI: 14.45-198.69) and mothers circumcision status (AOR = 14.03, 95% CI: 2.81- 95.45) were the most significantly associated with FGM. Furthermore, having good knowledge, positive attitude, high socio-economic status, being literate, being of Christian religion and living in urban area had lower odds of having a circumcised daughter. Conclusion: In this study, more than half of the mothers had at least one circumcised daughter. Mothers’ knowledge, attitude, circumcision status, socio-economic status, age, residence, educational level and religion were significantly associated with female genital mutilation.

Objectives: We analyzed the indications of cesarean section (CS) using Robson Ten-Group. Classification Systems (RTGCS) and comparison between private and public health facilities in Addis Abeba hospitals, Ethiopia, 2017. Methods: Facility-based retrospective cross-sectional study was carried out between January 1 and December 31, 2017, including 2411 mothers who delivered by CS were classified using the RTGCS. Data were entered into SPSS version 20 for cleaning and analyzing. Binary logistic regression and AOR with 95% CI were used to assess the determinants of the CS. Results: The overall CS rate was 41% (34.8% and 66.8% in public & private respectively, p < .0001). The leading contributors for CS rate in the private were Robson groups 5,1,2,3 whereas in the public 5,1,3,2 on descending order. Robson group 1 (nulliparous, cephalic, term, spontaneous labor) and group 3 [Multiparous (excluding previous cesarean section), singleton, cephalic, ≥ 37 weeks’ gestation& spontaneous labor], the CS rate was over two-fold higher in the private than the public sector. Women in Robson groups 1, 2, 5 & 9 are two and more times higher for the absolute contribution of CS in private than public. The top medical indications of CS were non-reassuring fetal status (NRFS, 39.1%) and repeat CS for previous CS scars (39.4%) in public and private respectively. Mothers who delivered by CS in private with history of previous CS scar (AOR 2.9, 95% CI 1.4-6.2), clinical indications of maternal request (AOR 7.7, 95% CI 2.1-27.98) and pregnancy-induced hypertension (AOR 4.2, 95% CI 1.6-10.7), induced labor (AOR 2.5, 95% CI 1.4-4.6) and pre-labored (AOR 2.2, 95% CI 1.6-3.0) were more likely to undergo CS than in public hospital. Conclusion: The prevalence of CS was found to be high, and was significantly higher in private hospitals than in a public hospital. Having CS scar [having previous CS scar, Robson group 5(Previous CS, singleton, cephalic, ≥ 37 weeks’ gestation) and an indication of repeat CS for previous CS scar] is the likely factor that increased the CS rate in private when compared within the public hospital. Recommendation: It is important that efforts to reduce the overall CS rate should focus on reducing the primary CS, encouraging vaginal birth after CS (VBAC). Policies should be directed at the private sector where CS indication seems not to be driven by medical reasons solely. 

A study was undertaken during August 2017 to evaluate the effect of salinity on chlorophyll a, chlorophyll b, total chlorophyll, and carotenoid and proline contents of hydroponically grown seedlings of Bruguiera gymnorhizza. The primary aim was to observe its tolerance to changing salinity. The selected seedlings were exposed to five different salinity levels (2,5,10,15 and 20psu) for a period of 30 days and observations were done at a regular interval of 7,14,21 and 30 days respectively. The concentrations of chlorophyll exhibited significant positive correlations with salinity (p<0.01). The chlorophyll a:b ratio in the plant varied between 2.39 to 3.71 throughout the period of investigation. The salinity fluctuation did not affect the carotenoid level and proline content in the leaves of the species as evidenced from the insignificant r values. The results show that Bruguiera gymnorhizza of Indian Sundarbans region can tolerate and adapt to high saline condition as witnessed in the central sector of the deltaic complex around the Matla River.

Red blood cell (RBC) alloimmunization can be a life-threatening complication for patients with thalassemia major and sickle cell disease (SCD) who must receive chronic therapeutic transfusions. Chronic transfusions can lead to erythrocyte alloimmunization, patients continue to develop alloantibodies due to the transference of the immunogenic antigens on the donor RBCs. Many complications are possible. Difficulty in finding compatible match units for the patients can cause transfusion delays delayed, or present alternative risks to the patients from delayed hemolytic transfusion reactions. This review discusses the possible mechanisms, risk factors associated with alloimmunization formation and the hemolytic transfusion reactions and also describe the guideline for transfusion management of these patients, including opportunities and emerging approaches for minimizing this life-threatening complication.

Regenerative medicine is a modern approach of dermatological treatment, using Epidermal Cells of the interfollicular epidermis (ESCs) for their effect in skin regeneration in chronic ulcers and burns, melanoma, vitiligo, junctional epidermolysis bullosa. Intraepidermal injections of autologous epidermal cell suspension can be a new and very promising treatment for many other cutaneous disorders as non-scarring alopecia (Alopecia Areata, Androgenic Alopecia) or scarring alopecia (Lichern Plano Pilaris alopecia, Discoid Lupus Erithematosus alopecia), anti-aging therapies. The intraepidermal injection of an autologous epidermal cell suspension is a simple, fast and safe surgical procedure: a small, thin portion of the epidermis of the patient undergoes a treatment where a suspension with all the cells collected from the epidermis and cultured for 7 days is injected into the skin. Our preliminary study shows that a suspension contains a significant number of viable cells that survive at day 7 in culture. Our research is ongoing and is focusing on the typing of the different cells in the suspension and evaluation of the presence and the nature of stem cells.

When I asked the students in my general Chemistry class whether grade is more important than knowledge, a majority of them opted for grades over knowledge and this answer did not surprise me a bit as the smart phones are available for them to think while their brains are corrupted or unused for most of the time. This brings one to the Einstein’s prediction that technology will develop to the point where there is no human interaction, which will be the day a new generation of idiots will emerge, and we are witnessing everywhere, including in the classrooms all over the world.

Natural killer (NK) cells, the third population of lymphoid cells, comprise 5%-25% of peripheral blood (PB) lymphocytes and represent the first line of defense against infections and tumors [1-7]. They can be derived from: bone marrow, PB, cryopreserved umbilical cord blood (UCB), human embryonic stem cells (hESCs), induced pluripotent stem cells (iPSCs), and various cell lines such as NK-92 and KHYG-1 [1]. NK cells; which have been divided into cytotoxic, tolerant, and regulatory subsets; are classified into: (1) naïve CD56 bright CD 16 dim CD 3 dim cells, (2) mature CD56 dim CD16 bright CD3 dim cells, and (3) lymphoid tissue-resident CD69+/CXCR6+ NK cells [1,2,8-11]. Although NK cells have been traditionally considered as part of the innate immune system, they have recently been shown to exhibit many of the features associated with adaptive immunity [8,12]. The functions of NK cells which are influenced by several cytokines include: elimination of infected cells, destruction of cancer cells, reducing the incidence of graft versus host disease (GVHD) following hematopoietic stem cell transplantation (HSCT), and regulation of pregnancy outcome [10,11,13].