Gynaecology

Background: Violence against women has long been considered a hidden health burden. Questions about violence have not been included in health surveys; hence, little is known about prevalence and the consequences for health in the general population. No national study has been conducted in Norway. Aims: To estimate the prevalence of partner violence in Norway and the relationship between victimization and somatic health and depression and anxiety and post-traumatic stress symptoms. Methods: Data collection was performed by Statistics Norway. Among a random sample of women aged 20—55 years, 2,407 women returned the questionnaire (63.3%), of whom 2,143 were ever-partnered. Selected demographic characteristics were obtained from registers. Results: In total, 26.8% of 2,143 ever-partnered women had experienced any violence by their partner during their lifetime, and 5.5% in the year before the study. Low educational level, being unmarried, separated or divorced, currently being unemploye...

Vulvar squamous cell carcinoma (VSCC) is a rare female genital neoplasm. Although numerous molecular changes have been reported in VSCC, biomarkers of clinical relevance are still lacking. On the other hand, there is emerging evidence on the use of mtDNA as a diagnostic tool in oncology. In order to investigate mtDNA status in VSCC patients, haplogroup distribution analysis and D-loop sequencing were performed. The results were compared with available data for the general Polish population, cancer free-centenarians as well as patients with endometrial and head and neck cancer. The obtained data were also compared with the current status of mitochondrial databases. Significant differences in haplogroup distribution between VSCC cohort, general Polish population and cancer-free centenarians cohort were found. Moreover, a correlation between the VSCC patients haplogroup and HPV status was observed. Finally, a specific pattern of mtDNA polymorphisms was found in VSCC. Our results suggest that the mitochondrial genetic background may influence the risk of VSCC occurrence as well as susceptibility to HPV infection.

Nausea and vomiting in pregnancy also known as "Morning Sickness" usually begins between the 4 th and 7 th weeks in 80% of pregnant women and resolves by the 20 th week of gestation. It is usually a mild, self limited condition which is often controlled by conservative measures. The etiology of nausea and vomiting in pregnancy remains unknown. There are different factors and theories believed to cause this. Management includes non-pharmacological (e.g. assurance/counselling, acupressure, dietary measures and music therapy) and pharmacological therapy (like medication, antiemetics, antihistamines & anticholinergics, motility drugs and corticosteroids).

Ce septième numéro des Cahiers Intégrés de Médecine Égyptienne (CIME – VII ) correspond également à la septième des Newsletters attachées au blog « Histoire de la médecine égyptienne ancienne » (ISSN 2270-2105). Il ne comprendra, pour cette fois encore, que la liste des principales études déjà publiées à ce jour dans la revue électronique. Ce fascicule est cependant augmenté des titres de l’année en cours, dont ceux consacrés à la quatrième partie de la Clinique Obstétricale. Soit, un total immédiatement accessible de plus de 2170 pages, avec un nombre considérable de figures détaillées et en couleurs sous cette présentation.

Planning for a Baby:  https://youtu.be/2iwLh6XCnq8

Pregnancy with IBD: https://youtu.be/br0kciD8xJk

Motherhood with IBD: https://youtu.be/TQjt8pnMv4I


Our aim is to provide an understanding of the experience of women with inflammatory bowel disease (IBD) who have made the transition to motherhood. A total of 22 mothers with IBD were recruited from around the United Kingdom. Semi-structured interviews were conducted and analyzed using thematic analysis. The central concept—Blurred Lines—offers a novel frame for understanding the transition to motherhood with IBD through identifying parallels between having IBD and becoming, and being, a mother. Parallels clustered into three main themes: Need for Readiness, Lifestyle Changes, and Monitoring Personal and Physical Development. Hence, women with IBD are in some ways well prepared for the challenges of motherhood even though, as a group, they tend to restrict their reproductive choices. We recommend health professionals initiate conversations about reproduction early and provide a multidisciplinary approach to pregnancy and IBD in which women have confidence that their ongoing treatment will be integrated successfully with their maternity care.

In addition to higher risks of various obstetric and gynaecological illnesses among women with obesity or who are overweight, maternal adiposity threatens the lifetime health of their offspring. Diverse treatments are provided, including complementary and alternative medicine such as Chinese medical practices. Acupuncture, a traditional Chinese medicinal method, is increasingly being applied to this health problem. This literature review analyses 25 clinical studies, involving 2407 participants aged 13-65 in Africa, Asia, the Middle East and North America. This illustrates the use of acupuncture alone or with other approaches to control body weight, obesity-induced diseases, and gynaecological health. Although positive indicators are presented, this study offers recommendations for enhancing reliability and validity in further research. It therefore suggests the use of acupuncture in dealing with obesity due to its efficacy, and economic
and safety benefits.

Ovarian cancer is characterized by the highest mortality rate among gynecologic malignancies. Therefore, there is a growing need for innovative therapies and techniques for monitoring and prevention of this disease. The exact cause of most ovarian tumors usually remains unknown. Ovarian cancer is believed to be caused by a range of different variables. This review is an attempt to summarize some genetic factors involved in the disruption of certain signaling pathways responsible for ovarian tumor transformation and development. Those factors considerably contribute to accurate diagnostics, treatment and prognosis in ovarian cancer.

The compilers of the Hippocratic gynaecological treatises often recommend sexual intercourse as part of treatments for women’s diseases. In addition, they often prescribe the use of ingredients that are obvious phallic symbols. This paper argues that the use of sexual therapy in the Hippocratic gynaecological treatises was more extended than previously considered. The Hippocratic sexual therapies involve a series of vegetable ingredients that were sexually connoted in antiquity, but have since lost their sexual connotations. In order
to understand the sexual signification of products such as myrtle and barley, one must turn to other ancient texts, and most particularly to Attic comedies. These comedies serve here as a semiotic guide in decoding the Hippocratic gynaecological recipes. However, the sexual connotations attached to animal and vegetable ingredients in these two genres have deeper cultural and religious roots; both genres
exploited the cultural material at their disposal.

Purpose: This study was piloted to understand the effects of Kaya Kalpa with Deer Exercise and Suryanamaskaram for the college students on abdomen strength. Methodology: For the study, 60 college girls in and around Coimbatore were selected as subjects. The age of the subject is from 18 to 23 years. The subjects have been divided into three groups each involving of 20 members. The Experimental Group I went on Kaya Kalpa and Deer Exercise; The Experimental Group II went on only Suryanamaskaram for 10 weeks. The Control Group were not given any practices or exercise. Results: The study showed a substantial improvement in the abdomen strength of the Experimental Groups I, II subjects than the Control group. Through the kaya Kalpa and Deer Exercise practice has improved the abdomen strength a lot in the college girls. Conclusion: It has been recognized that Kaya Kalpa and Deer Exercise helps in improving the abdomen strength and reduce mensural problems. Introduction Yoga is a priceless gift of ancient Indian practice. It symbolizes unity of mind and body; thought and action; restraint and fulfilment; harmony between man and nature and a common approach to health and well-being. Yoga is not about workout but to discover the sense of oneness with ourselves, the world and Nature. It improves the potential aspects to its fullness and makes the mind passive and fresh. Healthy body is the first step to lead a blissful and better life and by having a healthy body it helps have a better faculty of Mind. The body has a vital role in the process of self-improvement.

In this article I intend to elucidate the extent to which medieval western Jewish and Christian women shared customs, knowledge and practices regarding health care, a sphere which has been historically considered as part of women's daily domestic tasks. My study aims to identify female agency in medical care, as well as women's interaction across religious lines, by analysing elusive sources, such as medical literature on women's health care, and by collating the information they provide with data obtained from other textual and visual records. By searching specific evidence of the dialogues that must have occurred between Christian and Jewish women in transmitting their knowledge and experiences, I put forward the idea (developed from earlier work by Montserrat Cabré i Pairet) that medical texts with no clear attribution can be used as sources to reconstruct women's authoritative knowledge.

Chapter 3 The role of medicine: dream, mirage, or nemesis? Thomas McKeown Doctors have always tended to overestimate the effectiveness of their inter- vention and to underestimate the risks, whether removing large quantities of blood, under mistaken notions of the blood ...

Ce septième numéro des Cahiers Intégrés de Médecine Égyptienne (CIME – VII ) correspond également à la septième des Newsletters attachées au blog « Histoire de la médecine égyptienne ancienne » (ISSN 2270-2105). Il comprend la liste des principales études déjà publiées à ce jour dans la revue électronique. Ce fascicule est augmenté des titres de l’année en cours, dont ceux consacrés à la quatrième partie de la Clinique Obstétricale. Soit, un total immédiatement accessible de plus de 2170 pages, avec un nombre considérable de figures détaillées et en couleurs sous cette présentation.

The obstetric experience alongside scientific evidences in literature indicate several management techniques during the expulsive period of labour to minimize obstetric complications. Among the various methods that can be used for the protection of the perineum during the expulsive phase, some are performed prepartum (perineum massage), while most are used during childbirth. Among the second group, progressively increasing importance is assumed by the manual techniques to protect the perineum (using the "hands-on" and "hands-off") and by episiotomy. These techniques, when used in accordance to the guidelines, may favour the reduction of adverse outcomes for both the mother and the newborn, both immediately after birth and after a longer time. The midwife should be aware of the evidences in literature so that a critical analysis of the available techniques can be made and put in action during the expulsive phase in order to protect the mother and the foetus from any unfavourable outcomes. Currently, clinical evidence in literature is directing obstetric and medical staff towards a careful analysis of the maternal-foetal parameters, in order to achieve a precise assessment of the risks factors of intrapartum and postpartum outcomes. Increasingly, there is the need for close collaboration between the midwife and medical staff to ensure proper personalized assistance based on the peculiar characteristics of the woman and the fetus.

Our aim was the illustration of the controversies that occur during pregnancy related to the mode of obtaining and interpreting a cervical smear, specific colposcopic features, as well as the approach of diagnosing, following-up and treatment, based on the findings of the Papanicolaou smear. A review of the literature as well as the updated American Society of Colposcopy and Cervical Pathology (ASCCP) guidelines on the management of abnormal Papanicolaou smears known as 2012 Bethesda Consensus Guidelines, was undertaken. The results of the abnormal smears were categorized according to their severity and the current evidence-based diagnostic and therapeutic management has been overviewed. The diagnostic and therapeutic workup is outlined based on the available guidelines to be followed according to the cytology results, the trimester of the pregnancy, and the scheduled mode of the delivery. The interpretation of abnormal cytology smears during pregnancy is similar to those outside pregnancy. However, the effect of the pregnancy in cytology and colposcopy might hamper the discrimination of normal and abnormal epithelium. The arising issues following an abnormal smear are numerous, both from the patient’s and the doctor’s side. The knowledge of optimal cytology management during pregnancy is essential to avoid cases of under- or overtreatment.

This is the abstract for a paper I presented at an invited colloquium held 26-27 July 2017 at the Danish Academy at Rome on the topic of “Transmission of Knowledge in the Late Middle Ages and the Renaissance.” Organized by Outi Merisalo, this is part of the TRALMAR Project (now completed), which sought to re-examine the ways in which textual histories are established, wrestling with the question of whether to privilege the "original" text as it came from an author's pen, or the infinite variety of forms that were actually read by medieval and Renaissance readers: https://staff.jyu.fi/Members/merisalo/Transmission. The essay establishes for the first time that a cluster of gynecological texts were created at the Benedictine abbey of Monte Cassino, perhaps just before the arrival of the famed Arabic translator, Constantine the African. Their editors crafted them out of bits and pieces of several late antique works on women's medicine that had recently been retrieved, part of a larger renewal of medicine going on in southern Italy at the time. Knowledge of this 11th-century revival was, however, lost, leaving the Renaissance editor (who thought he was working with *ancient* texts) quite befuddled. The essay has now been published in revised form as: Monica H. Green, “Recovering ‘Ancient’ Gynaecology: The Humanist Rediscovery of the Eleventh-Century Gynaecological Corpus,” in Transmission of Knowledge in the Late Middle Ages and the Renaissance, ed. Outi Merisalo, Miika Kuha and Susanna Niiranen (Turnhout: Brepols, 2019), pp. 45-54. Feel free to contact me if you would like a copy: monica.h.green@gmail.com.

Frequency-related parameters derived from the uterine electromyogram (EMG) signals are widely used in many pregnancy monitoring and preterm delivery prediction studies. Although they are classical parameters, they are well suited for quantifying uterine EMG signals and have many advantages over amplitude-related parameters. The present work aims to compare various frequency-related parameters according to their classification performances (pregnancy vs. labor) using the receiver operating characteristic (ROC) curve analysis. The comparison between the parameters indicates that median frequency is the best frequency-related parameter that can be used for distinguishing between pregnancy and labor contractions. We conclude that median frequency can be the representative frequency-related parameter for classification problems of uterine EMG.

To document the experience at a tertiary referral hospital in India with managing complex and complicated vesicovaginal fistulae (VVF) by the transvaginal route, and to document the complications and the long-term outcome of the patients.The medical records of 102 patients with complex or complicated VVF who underwent transvaginal surgical repair during 2000–2009 were reviewed retrospectively.The mean age of the patients was 24 years and the mean duration of urinary incontinence was 3 years (range 6 months to 12 years). The patients were followed up for a median of 48 months. In total, 78 patients had obstetric fistulae, 20 patients had surgical (gynecologic) fistulae, and 4 patients had postradiation fistulae. The overall success rate for the transvaginal approach was 86.3%. Fourteen patients remained incontinent despite the surgical repair. Early failure of the repair was observed in 11.8% of the patients and delayed failure in 2.0%. Postoperative complications included stress urinary incontinence (9.8%), urge urinary incontinence (7.8%), dyspareunia (5.9%), and chronic labial pain (2.0%).The transvaginal approach to the repair of complex and complicated VVF gives good long-term results with low complication rates.

Auch in der Gynäkologie müssen sich ein neuer Fortschrittsbegriff und eine neue Praxis durchsetzen. Als Fortschritt kann nur gelten, was über den augenblicklichen schnell verwertbaren Erfolg hinaus für Frauen und Männer einen langfristigem Sinn ergibt. Ein neuer Erfolgsbegriff für diese Medizin stellt selbstverständlich auch den Konsumenten dieser Leistung vor neue Beurteilungsmaßstäbe, deren er sich selbst bewusst bedienen muss. Das aktuellste Beispiel ist die weitgehend umstandslos praktizierte Veränderung von Pubertierenden durch Chirurgie und Medikamente in das andere Geschlecht.

Western medicine is seen as universally valid, but in reality it displays a wide range of national and local variability. Our paper focuses on one such case of local variation: the widespread use of progestins in France to treat various pre-menopausal conditions as well as for contraception. The case of progestins allows us to explore how specific styles of research may come to dominate a particular local medical culture, and how they are influenced by changing criteria of scientific validity and wider social relations. We argue that in the 1980s and 1990s a single prestigious research-oriented Parisian hospital service played a dominant role in the transformation of progestins into scientifically validated medical practice. This status was not called seriously into question until recently when foreign research on a different form of hormone therapy suggested that risk was associated with their use. We also propose that both the research around and medical use of progestins in France was shaped by the positive attitude of many French women, including feminists, to hormonal therapies and to the non-surgical specialty most closely associated with hormones, medical gynaecology.

The incidence of cervical glandular lesions has significantly increased during the past two decades especially among young women. This rise in registered cases is predominantly attributed to this entity's rising prevalence as well as recent advances in cytology. Atypical glandular cells (AGC) identified by secondary cervical screening (Papanicolaou) might actually harbor significant underlying pathology. The natural history and progression of cervical glandular lesions comparing to that of their squamous counterparts is less well-understood. High-risk HPV's (HPV16, 18 and 45) have been identified in glandular lesions with high frequency. Cytology and colposcopy illustrate poor sensitivity in the diagnosis of glandular lesions.
Diagnostic excisional procedures are of paramount importance in the management of high-grade glandular lesions. Treatment options are conservative surgery, predominantly conization or definitive therapy (mainly hysterectomy). Cervical conization appears to give satisfactory results especially in young women with high grade glandular lesions who
strongly wish to preserve their fertility potential. However, adequate counseling should be provided to patients before therapeutic decisions. Long-term follow-up is mandatory for women treated for glandular lesions to detect any possible residual disease and early signs of recurrence.

Moringa oleifera and Camellia sinensis are widely consumed edible plants in parts of South East, Nigeria. It is used as a beverage and
also used in the treatment of several ailments by alternative medical practitioners because of its medicinal properties medicinal
plant. The histopathological damage repair properties of Moringa oleifera and Camelia sinensis on the brain, liver and kidney organs
were investigated on monosodium glutamate (MSG)-induced oxidative-stressed rats.
Method
Twenty male Wister rats were divided into five groups of four rats each. Rats were administered with 0.6 mg/g body weight
(b.w) dose of MSG solution for 14 days to induce oxidative stress. Control group was given distilled water. A subsequent treatment
with MO, GT and their mixture for a period of 28 days was carried out. One group was left untreated. On day 28 of the
treatment regime, animals were sacrificed and necessary organs (brain, liver and kidney) harvested. These organs were processed
according to paraffin wax embedding technique, stained with haematoxylin and eosin for light microscopy.
Results
The plant samples both showed in vivo nitric oxide scavenging properties. The plant samples also presented an increased
catalase enzyme activity and the lipid profile analyses showed no significant difference at 95% level of probability. Both plants
resulted in reversing the damage that occurred in MSG-induced oxidative stressed rats. This was particularly true for both the
kidney and liver.
Conclusion
The study provides a pharmacological basis for the traditional use of Camellia sinensis and Moringa oleifera extracts in alleviating
common medical conditions.

Project HOPE is a nonprofit healthcare organization that provides wide ranging humanitarian and educational aid to people in underserved and developing countries as well as conducts global health policy research. HOPE's clinical focus includes women and children's health, tuberculosis, HIV/AIDS, diabetes and other chronic and infectious diseases. HOPE has a strong, active technical focus and expertise in building clinical engineering (CE) capacity at all levels in the developing world. It has established and nurtured over 20 sustained CE programs in ten countries, on five continents around the world. These programs cover the broad spectrum of CE, from intra-hospital bench-top medical equipment repair to national educational and training program development. In this paper, we will describe HOPE's CE holistic program model. We will emphasize the importance of the train-the-trainer approach to CE education. We will illustrate HOPE's approach to CE capacity building ...

The female body is a subject of reflection that
has aroused great interest throughout history in many
studies and from a variety of perspectives. In this essay
is intended to present the canonical interpretation of
the female body with the aim of getting to know the
possibilities of the body of the medieval woman. It is
also expected to give the answers to different questions
like how was perceived and studied the body
from a medical and anatomical point of view? Or what
issues related to the sexual organs, motherhood or
the sexual pleasure did women worry about? If you
analyze the medical corpus of books from Antiquity to
the late Middle Ages, you can say that there is a clear
concern about the female body, although the conclusions
reported are far from the reality considering the
evident absence of a medical practice. Likewise, you
can distinguish a dichotomy between the daily routine
and the official theoretical discourse, what allow you
to emphasize the role of female pleasure as a form of
resistance to that speech.

In 2015, the Canadian Paediatric Society (CPS) updated its position statement on newborn male circumcision. Reaching a different conclusion from that of the American Academy of Pediatrics (AAP) in 2012, the CPS did not find that the benefits of the procedure outweigh the risks and harms. In this brief commentary, I discuss some of the main strengths and weaknesses of the latest CPS policy.

Managing orthopedic conditions in pregnant women leads to challenges that must becarefully considered so that the safety of both the mother and the fetus is maintained. Both perioperative and intraoperative considerations must be made based on physiologic changes during pregnancy, risks of radiation, and recommendations for monitoring. Operative timing, imaging, and medication selection are also factors that may vary based on trimester and clinical scenario. Pregnancy introduces unique parameters that can result in undesirable outcomes for both mother and fetus if not handled appropriately. Ultimately, pregnant patients offer a distinct challenge to the orthopedic surgeon in that the well-being of two patients must be considered in all aspects of care. In addition, not only does pregnancy affect the management of orthopedic conditions but the pregnant state also causes physiologic changes that may actually induce various pathologies. These pregnancy-related orthopedic conditions can interfere with an otherwise healthy pregnancy and should be recognized as possible complications. Although the management of orthopedic conditions in pregnancy is often conservative, pregnancy does not necessarily preclude safely treating pathologies operatively. When surgery is considered, regional anesthesia provides less overall drug exposure to the fetus and less variability in fetal heart rate. Intraoperative fluoroscopy can be used when appropriate, with 360° fetal shielding if possible. Lateral decubitus positioning is ideal to prevent hypotension associated with compression of the inferior vena cava.