Knowledge and attitudes of rural healthcare providers regarding domestic violence against women: a systematic review

ABSTRACT BACKGROUND: Specific types of violence such as intimate partner sexual violence and intimate partner homicide occur more frequently in rural areas. OBJECTIVE: This study aimed to systematically review the literature on the knowledge and attitudes of rural healthcare providers regarding cases of domestic violence against women. DESIGN AND SETTING: Systematic review developed at Universidade Federal de Uberlândia. METHODS: We conducted an electronic search of six databases, which only included observational studies, regardless of the year, language, or country of publication, except for studies that used secondary data and were exclusively qualitative. Two reviewers performed the selection, data extraction, and risk of bias assessment using a specific Joanna Briggs Institute tool. RESULTS: Six studies met the inclusion criteria. All the studies had a low risk of bias. Approximately 38% of these professionals identified injuries caused by violence in patients. When asked about knowing the correct attitude to take in cases of confirmed violence, between 12% and 64% of rural healthcare providers answered positively; most of them would refer to specialized institutions and promote victim empowerment and counseling. The number of professionals with an educational background in the field ranged from 16% to 98%. CONCLUSIONS: The evident disparity across studies shows that some professionals have suboptimal knowledge and require training to adopt the correct attitude when identifying female victims of domestic violence in clinical practice. SYSTEMATIC REVIEW REGISTRATION: This systematic review was registered in the Open Science Framework Database under the registration http://doi.org/10.17605/OSF.IO/B7Q6S.

Prevalence and spectrum of haemoglobinopathies in females of reproductive age group- A first tertiary care center experience in Punjab, North India

Background: Thalassemia and hemoglobinopathies are a group of inherited conditions characterized by abnormalities in the synthesis or structure of hemoglobin (Hb). According to estimates, approximately 7% of the world population is a carrier of Hb disorders, leading to high morbidity and mortality. To reduce the burden of these highly prevalent monogenic disorders, detecting them in the carrier stage is crucial to prevent disease progression. Aim: We aimed to estimate the prevalence and spectrum of hemoglobinopathies in females in the reproductive (20–40 years) age group. Settings and Design: It was a retrospective observational study carried out for 2.5 years (from January 2018 till June 2020). Materials and Methods: All the females in the age group of 20–40 years age whose blood samples were received in the department for High-Performance Liquid Chromatography (HPLC) were included. The cases with abnormal HPLC findings were analyzed for hematological parameters including hemoglobin, RBC count, and RBC indices [mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), & red cell distribution width - coefficient of variation (RDW-CV)]. Statistical Analysis: Statistical package for social science (SPSS) statistics 21 version for Microsoft Windows (Chicago, USA) was used for statistical analysis of data. The data were described in terms of range, mean ± standard deviation (SD), frequencies (number of cases), and relative frequencies (percentage) as appropriate. Results: During the study period, 72.2% of the females were affected with ?-thalassemia trait, followed by HbD Punjab trait (17.8%), HbQ India trait (2.9%), ?-thalassemia major (1.8%), and two cases (1.2%) each of HbS trait, HbD Iran trait, and compound heterozygous of HbD Punjab and ?-thalassaemia, whereas HbE trait, compound heterozygous of HbQ and ?-thalassemia, compound heterozygous of HbJ-variant and ?-thalassemia had one case each (0.6%). Conclusion: Preventive strategies are cost-effective and include population screening, premarital screening, screening of spouses, genetic counseling, and prenatal diagnosis. Educating the carrier females about the potential risk and various screening methods may help in controlling the disease.

Breast Self-Examination: An Early Familiar Diagnostic Test of Breast Cancer

Background: Among female patients’ breast cancer are a growing threat for over a century. In women, breast cancer is the most common malignancy universally such as 154 of 185 nations. Breast self-examination (BSE) is a simple, very low-cost, non-invasive early detection method used to detect early breast cancer, which involves the woman herself looking at and feeling for any change in their breast as early as possible, which yields a better survival rate. BSE should be done for all women older than 20 years. This study intended to determine knowledge, attitude, and practice (KAP) of breast cancer among medical and non-medical undergraduate students. Material & Methods: A descriptive cross?sectional study was conducted from October to November 2019 to assess the knowledge, attitude, and practice of BSE. The target population consisted of undergraduate female medical and non?medical students. A total of 154 (N=154) undergraduate female students participated in this study. Verbal consent was taken before recruiting the study population. Completed data forms were reviewed, edited, and processed for computer data entry. The data analysis was performed using Statistical Package for the Social Sciences (SPSS) Version 25.0. Results: Among the study population (N=154) with an early familiar diagnosis of breast cancer ”breast self-examination, the mean age of them was 20.434±4.38. Of seventy-eight respondents (n=78), breast cancer screening test was heard by around half of the medical students (42, 53.8%) & of seventy-six non-medical respondents (n=76), around three-fifth of them (46, 60.5%) did not hear about breast cancer screening test. There was no significant relationship between them (p=0.394). Forty medical students (40, 51.3% and twenty-five non-medical students (25, 32.9%) had no idea, twenty-four medical students (24, 30.8%) & forty-three (43, 56.6%) non-medical students had monthly BSE done. Conclusion: Initial diagnosis and treatment of breast cancer have a definite survival benefit. So early detection is an issue of necessity to be uplifted. The results of the present study suggested that knowledge regarding breast cancer, its risk factors, sign symptoms, prevention measures, and performance of BSE is insufficient.

Difference in liver injury induced by dictamnine between males and females: based on untargeted metabolomics / 中国中药杂志

In recent years, reports of adverse reactions related to traditional Chinese medicine(TCM) have been on the rise, especially some traditionally considered "non-toxic" TCM(such as Dictamni Cortex). This has aroused the concern of scholars. This study aims to explore the metabolomic mechanism underlying the difference in liver injury induced by dictamnine between males and females through the experiment on 4-week-old mice. The results showed that the serum biochemical indexes of liver function and organ coefficients were significantly increased by dictamnine(P<0.05), and hepatic alveolar steatosis was mainly observed in female mice. However, no histopathological changes were observed in the male mice. Furthermore, a total of 48 differential metabolites(such as tryptophan, corticosterone, and indole) related to the difference in liver injury between males and females were screened out by untargeted metabolomics and multivariate statistical analysis. According to the receiver operating characteristic(ROC) curve, 14 metabolites were highly correlated with the difference. Finally, pathway enrichment analysis indicated that disorders of metabolic pathways, such as tryptophan metabolism, steroid hormone biosynthesis, and ferroptosis(linoleic acid metabolism and arachidonic acid metabolism), may be the potential mechanism of the difference. Liver injury induced by dictamnine is significantly different between males and females, which may be caused by the disorders of tryptophan metabolism, steroid hormone biosynthesis, and ferroptosis pathways.

Differences in COVID-19 mortality in males and females: Is estrogen hormone attributing to sex differences?

Objectives: Globally, the case fatality ratio is more in males versus females. Some studies have suggested estrogen hormone decreases susceptibility to SARS CoV-2. We have analyzed the observed sex differences in COVID-19 behavior in males and females and the clinical profiles of females of different age groups of COVID-19 patients and discussed their symptoms, laboratory evaluations, and associated comorbidities. Material and Methods: The patients were tested for COVID-19 through real-time RT-PCR (Reverse Transcription Polymerase Chain Reaction) assay. The data obtained were studied for the epidemiological, clinical, and laboratory characteristics from their medical records. Results: The mortality rate in females was 12.33% (36/292) whereas mortality in males was 19.63% (84/428). In between group analysis, 8.7% (14/161) of females died in the <40 years age group versus 16.8% (22/131) in more than 40 years age group whereas in males, the mortality was 13.7% (21/153) in <40 years versus 22.9%(63/275). The mortality rate in women older than 40 years was greater than mortality in younger females emphasizing the protection provided by estrogen hormone in them. The proportion of patients who expired due to COVID-19 significantly differs by age cutoff of 40 years, X2 (1, n = 428). The difference is statistically significant at P < 0.05. Males more than 40 years are more likely to expire. Conclusion: Sex-related differences in coronavirus pandemic have been found pointing toward the protective role of estrogen hormone and other differences in immunological behavior in males and females. Downregulation of ACE2 expression, thereby reducing viral entry, might also be contributory to decreasing mortality in females.

Variaciones por edad y sexo en las tendencias de infección por el virus de la inmunodeficiencia humana en el Instituto Mexicano del Seguro Social: 2003-2017 / Gender and age-related variations in human immunodeficiency virus infection trends at the Mexican Institute of Social Security: 2003-2017

Resumen Introducción: Hacer el diagnóstico y tratar a portadores del virus de la inmunodeficiencia humana ha llevado a identificar mayor prevalencia de esa infección y, por lo tanto, de un mayor riesgo de transmisión de este virus. Objetivo: Conocer la tendencia en México de los nuevos casos de portadores de infección por el virus de la inmunodeficiencia humana en el Instituto Mexicano del Seguro Social (IMSS) en el periodo 2003-2017. Métodos: Se analizaron pacientes asegurados en el IMSS. Se obtuvieron datos de 42 181 casos recién diagnosticados y se analizaron las variaciones relacionadas con el sexo y la edad. Se obtuvieron las tasas estandarizadas por edad por 100 000 personas. Resultados: El cambio porcentual anual promedio más alto en hombres se documentó en adolescentes varones (13.0, IC 95 % = 9.9, 16.1). Se registraron tendencias heterogéneas en las mujeres, con una disminución total significativa (-2.2, IC 95 % = -3.4, -1.0), pero también se observaron tendencias crecientes en algunos grupos. Conclusiones: Los resultados sugieren que en el IMSS, la epidemia de la inmunodeficiencia humana adquirida se concentra en hombres, con tendencia creciente particularmente en adolescentes.

Abstract Introduction: Diagnosing and treating human immunodeficiency virus carriers has led to the identification of a higher prevalence of said infection and, therefore, of a higher risk of transmission of the virus. Objective: To find out the trend of new cases of human immunodeficiency virus infection carriers at the Instituto Mexicano del Seguro Social (IMSS) in Mexico within the 2003-2017 period. Methods: Patients affiliated to the IMSS were analyzed. Data from 42,181 newly-diagnosed cases were collected, with variations related to gender and age being observed. Age-standardized rates per 100,000 population were obtained. Results: The highest mean annual percentage change in males was documented in adolescents (13.0, 95% CI = 9.9, 16.1). Heterogeneous trends were recorded for women, with a significant overall decrease (-2.2, 95% CI = -3.4,-1.0), but growing trends were also observed in some groups. Conclusions: Our results suggest that the human immunodeficiency epidemic in patients cared for at the Instituto Mexicano del Seguro Social is concentrated in males, with a growing trend particularly in adolescents.

Is there a correlation between the body condition score and the pregnancy rate of Nelore cows submitted to FTAI in the Eastern Amazon? / ¿Existe correlação entre o escore de condição corporal e a taxa de prenhez de vacas nelores submetidas a IATF na Amazônia Oriental? / ¿Existe una correlación entre el puntaje de condición corporal y la tasa de preñez de las vacas Nelore sometidas a IATF en la Amazonía Oriental?

Abstract The aim was to assess whether there is a correlation between the body condition score (BCS) and the pregnancy rate of cows submitted to fixed-time artificial insemination (FTAI) on Ilha do Marajó, Pará, in the Eastern Amazon. 159 female bovines were analyzed, submitted to FTAI, selected through clinical and gynecological evaluation, being considered clinically healthy and cyclic cows, of the Bos taurus indicus breed, from an extensive system property, in the municipality of Cachoeira do Arari, on Ilha do Marajó, Pará. The qualitative research method was used, with the objective of analyzing the correlation between the pregnancy rate and the BCS of this lot. Of the 159 women submitted to FTAI, 86 had a positive pregnancy diagnosis, obtaining a pregnancy rate of 54.08% and the number of pregnant animals was 73, or 45.92%. There was a positive and significant correlation (r=0.167) between BCS and pregnancy rate (p<0.05). Thus, the study has enabled us to conclude that there was a positive interdependence between BCS and the gestational diagnosis. Thus, the effect of body condition on pregnancy rate in cows raised in the Eastern Amazon is confirmed.

Resumo Objetivou-se avaliar se existe correlação entre o escore de condição corporal (ECC) e a taxa de prenhez de vacas submetidas a inseminação artificial em tempo fixo (IATF) na Ilha do Marajó, Pará, na Amazônia Oriental. Foram analisadas 159 fêmeas bovinas, submetidas à IATF, selecionadas mediante avaliação clínica e ginecológica, sendo consideradas vacas clinicamente saudáveis e cíclicas, da raça Bos taurus indicus, de uma propriedade de sistema extensivo, no município de Cachoeira do Arari, na Ilha do Marajó, Pará. Foi utilizado o método de pesquisa qualitativo, com objetivo de analisar a correlação entra a taxa de prenhez e o ECC, deste lote. Das 159 fêmeas submetidas a IATF, 86 apresentaram diagnóstico de gestação positivo, obtendo-se taxa de prenhez de 54,08% e o número de fêmeas vazias foi de 73, ou seja, 45,92%. Houve correlação positiva (r = 0,167) e significativa entre a ECC e a taxa de prenhez (p<0,05). Desta forma, o estudo permitiu concluir que houve uma interdependência positiva entre a ECC e o diagnóstico gestacional. De modo que constata o efeito da condição corporal sobre a taxa de prenhez em vacas criadas na Amazônia Oriental.

Resumen Objetivo evaluar si existe correlación entre el índice de condición corporal (BCS) y la tasa de preñez de vacas sometidas a inseminación artificial a tiempo fijo (IATF) en Ilha do Marajó, Pará, en la Amazonía Oriental. Fueron analizadas 159 hembras bovinas, sometidas al FTAI, seleccionadas mediante evaluación clínica y ginecológica, siendo consideradas vacas clínicamente sanas y cíclicas, de la raza Bos taurus indicus, de una propiedad de sistema extensivo, en el municipio de Cachoeira do Arari, en Ilha do Marajo, Pará. Se utilizó el método de investigación cualitativo, con el objetivo de analizar la correlación entre los taxones preñados y el CEC, de este lote. De las 159 mujeres sometidas a IATF, 86 tuvieron diagnóstico de embarazo positivo, obteniendo una tasa de embarazo de 54,08% y el número de gestantes fue de 73, o 45,92%. Hubo una correlación positiva y significativa (r=0,167) entre ECC y taxones de preñez (p<0,05). Así, el estudio permitió concluir que hubo una interdependencia positiva entre la CEC y el diagnóstico gestacional. Así, se confirma el efecto de la condición corporal sobre los taxones de gestación en vacas criadas en la Amazonía Oriental.

Incontinencia pigmentaria / Incontinentia pigmenti

RESUMEN La incontinencia pigmentaria es una genodermatosis de rara presentación, que es considerada una alteración hereditaria, ligada al cromosoma X, con carácter dominante. Se presenta con mayor frecuencia en mujeres, y el compromiso principal se observa en tejidos derivados del ectodermo; es decir, puede evidenciarse como anormalidades en piel, dientes, pelos, ojos y sistema nervioso. Se presenta un caso de incontinencia pigmentaria con manifestaciones cutáneas en un recién nacido varón. El caso se confirmó a través de dos biopsias evaluadas en el servicio de anatomía patológica del Hospital Cayetano Heredia. Debido al espectro amplio de presentación clínica de incontinencia pigmentaria, se recomienda considerar a esta entidad en el diagnóstico diferencial cuando nos encontramos frente a lesiones cutáneas, predominantemente vesiculares y que siguen una distribución siguiendo las líneas de Blaschko. La incontinencia pigmentaria es una enfermedad infrecuente en nuestro país, y su diagnóstico requiere de una adecuada correlación clínico patológica, y del conocimiento de las distintas fases de la enfermedad. El diagnóstico y reconocimiento oportuno y temprano de la entidad permitirá prevenir complicaciones asociadas a nivel sistémico.

ABSTRACT Incontinentia Pigmenti is a rare genodermatosis, which is considered a hereditary alteration, linked to the X chromosome, with a dominant character. It occurs more frequently in women, and the main involvement is observed in tissues derived from the ectoderm, that is, it can be seen as abnormalities in the skin, teeth, hair, eyes and nervous system. We report a case of incontinentia pigmenti with cutaneous manifestations in a male newborn is presented. The case was confirmed through two biopsies evaluated in the pathological anatomy service of the Cayetano Heredia Hospital. Due to the broad spectrum of clinical presentation of incontinence pigmenti, it is recommended to consider this entity in the differential diagnosis when we are faced with predominantly vesicular skin lesions that follow a distribution along Blaschko lines. Incontinentia pigmenti is a rare disease in our country, and its diagnosis requires an adequate clinicopathological correlation, and knowledge of the different phases of the disease. The timely and early diagnosis and recognition of the entity will prevent associated complications at the systemic level.

Social Anxiety, Self-Esteem, and Resilience among Young Adult Females

Background: Social anxiety impacts our self-worth and ability to deal with crises. Resilience may serve as a tool to mitigate social anxiety. The study examines the relationship between social anxiety, self-esteem, and resilience among young adult females. Further, it illustrates the role of sexual orientation, education, and employment status on the three variables. Methodology: A purposive sample of 270 participants (233 heterosexual females and 37 LGBTQIA+ females) was obtained using the snowball sampling method. Females were chosen as the prevalence rate of social anxiety is more pronounced among females than males. Statistical analysis was done using R Studio. Results: Findings suggest moderate negative correlations between social anxiety and self-esteem (r = - 0.462, p<0.05), social anxiety and resilience (r=-0.348, p<0.05), and a moderate positive correlation between resilience and self-esteem (r=0.464, p<0.05). LGBTQIA+ females scored high on social anxiety and low on resilience and self-esteem than heterosexual females. Employment status has a significant impact on the three variables however educational qualifications did not produce any difference. Thus, the hypotheses of the study were validated. Conclusion: The findings act as a catalyst in developing psychological interventions to improve the well- being of the youth. Future research can focus on the cultural aspects of social anxiety and its influence on self-esteem and resilience.

Age at natural menopause and factors affecting its onset: A cross-sectional study among postmenopausal females in District Dehradun

Background: Menopause has become a popular topic of study as life expectancy rises around the world. The average age at menopause in both developed and developing countries ranges from 45 to 53 years. Factors influencing the extent of ovarian follicle reserve dwindling, such as sociodemographic, menstrual, reproductive, and dietary factors. Aim and Objective: The present study aimed to determine the mean age of menopause and to find out the various factors affecting menopause onset. Methods: A community based cross-sectional study conducted in rural and urban areas of District Dehradun for a period of 1 year starting 1st August 2020 to 31st July 2021. Data were collected using multistage stratified random sampling from 211 cases of natural menopause. Chisquare was applied as statistical test of significance and p < 0.05 was considered statistically significant. Results: According to current study, average age menopausal age is 46 years. Variables like sociodemographic characteristics, lifestyle habits, reproductive and menstrual factors were found to have a significant relationship with onset of menopause. Conclusion: Menopause, whether it occurs early or late in life, several factors are responsible for deciding its onset. As a result, it is critical to identify the factors influencing the onset of menopause.

RETROSPECTIVE ANALYSIS OF COVID-19 POSITIVE PARTURIENTS POSTED FOR CAESAREAN SECTION IN TERTIARY CARE CENTRE

Background And Aims: Parturients posted for LSCS present with physiological changes due to pregnancy and gravid uterus, may have associated co-morbidities, superadded by COVID 19 infection poses a real challenge for an anesthesiologist. Urgency in obstetric anesthesia and extreme precautions needed to avoid this contagious disease further increase the burden on the anesthesiologist. This study focuses on perioperative presentation, management, and outcome of patients in a tertiary level hospital. Method: 329 pregnant females with RAT or RTPCR positive for COVID 19 and undergoing cesarean section from 1st May 2020 to 31st July 2021 were included in this retrospective observational study. Data was collected and analyzed from OT, ICU, WARD records, patient medical and electronic records, and maternal mortality data. Results: Amongst 329 parturients, 98.48%(324/329) received spinal anesthesia, one received epidural anesthesia (0.30%) and 1.21%(4/329) required general anesthesia. The incidence of hypotension was 5.77% (19/329), managed with inj. Mephentermine without inotropes. The intraoperative course was uneventful except for one case of CRA, revived successfully. Nine patients (2.73%) required ICU care. Oxygen support by either nasal prongs or face masks was given to 3.95% (13/329) patients. Three patients (0.91%) required NIV support and three patients (0.91%) required invasive ventilation postoperatively.The overall mortality was 0.61% (2/329). The mean duration of hospital stay was found to be 8.2 ± 5.03 days Conclusion: Neuraxial anesthesia remains a technique of choice for LSCS and can be safely employed in the parturients even with moderate pneumonia. General anesthesia can be reserved for patients of severe covid pneumonia

'Gift with a price tag': Nigerian egg donors' knowledge, experiences and motivations

Research around the world has indicated that the demand for egg donation has grown considerably among young females. This study qualitatively examines the knowledge, experiences, and motivations of young egg donors at a Nigerian health facility. Indepth interviews were conducted in Igbo and English with consenting thirty-one egg donors attending a fertility clinic in Anambra State, south-eastern Nigeria. Data were collected and analysed to generate themes with the aid of NVivo 10 software. Three themes were identified from the participants' motivations and include (a) monetary (93.6%), (b) altruistic (3.2%), and (c) both monetary and altruistic reasons (3.2%). Findings highlighted that the differences were based on a variety of reasons in Nigeria. All the participants were literate and single, and the majority received payment. The majority (77.4%) of those who received payment mentioned that the payment was not worth the donation program. The participants preferred to be anonymous because they had not discussed their donation with their family members, and the non-acceptance of egg donation program by the Nigerian society. Given that the market for egg donation has become a common method of infertility management in Nigeria, our findings have important implications for practices, policy actions, and future research. (Afr J Reprod Health 2022; 26[6]:64-79).

Characteristics of intestinal flora in female patients with type 2 diabetes mellitus and coronary heart disease / 中华内分泌代谢杂志

Objective:To explore the characteristics of intestinal flora in female patients with type 2 diabetes mellitus (T2DM) with comorbid coronary heart disease.Methods:Female patients with T2DM from September 2019 to November 2020 were enrolled in this study and divided into 2 groups stratified by coronary heart disease: 22 patients with coronary heart disease(T2DM+ CHD group) and 49 patients with simple T2DM group(T2DM group). Thirty-one healthy females were selected as the normal control group(NC group). The abundance of intestinal flora, the difference in intestinal flora and its relationship with indicators such as glycosylated hemoglobin and fasting blood glucose was analyzed by the real-time fluorescent quantitative PCR detection technology in the three groups.Results:The abundance of Prevotella in the T2DM group was lower, and Roseburia inulinivorans and Faecalibacterium prausnitzii in the T2DM+ CHD group were lower, while Bacteroides and Enterococcus spp in the T2DM+ CHD group were higher compared with NC group, respectively( P<0.05). The abundance of Bacteroides and Enterococcus spp in the T2DM+ CHD group was lower than that in the T2DM group( P<0.05). Spearman correlation analysis showed that the abundance of Faecalibacterium prausnitzii and Eubacterium rectale was negatively correlated with obesity while abundance of Bacteroides and Enterococcus spp was positively correlated with HbA 1C and fasting blood glucose. The abundance of Bacteroides was positively correlated with TCH and TG(all P<0.05). Logistic regression analysis showed that Bacteroides and Enterococcus spp were independent influencing factor of the development of female patients with T2DM and CHD. Conclusion:Female T2DM and T2DM with CHD had intestinal flora imbalance, which was related to a variety of glucose and lipid metabolism indicators, and might be closely related to the occurrence of T2DM and CHD. Bacteroides and Enterococcus spp were independent influencing factors of the development of female patients with T2DM and CHD. Regulating the intestinal flora can provide ideas for the prevention and treatment of T2DM with CHD in female.

Association between TSH status and prevalence of miscarriages and stillbirth

Thyroid hormones play a significant role in normal human body growth. Abnormalities in thyroid stimulating hormone (TSH) levels can result in pregnancy loss due to miscarriages and intrauterine death (IUD). The objective of the study was to assess the levels of association of thyroid stimulating hormone with miscarriages and IUD. The descriptive study involving 110 samples between 18-40 years of age fulfilling inclusion criteria were sampled for TSH testing (2ml blood) after attaining their written informed consent. The mean age of participants was 29.49±4.26 year. The prevalence of hypothyroidism and hyperthyroidism was 3.64% and 2.73%, respectively. Complications like gestational hypertension, depression and oligomenorrhea were found prevalent in these females. Majority of females were taking high/low iodine than recommended iodine level (150mcg). This work shows that there is a significant association between pregnancy loss and disturbed TSH levels among pregnant females.

A reflection on the role of women in Science, Dentistry and Brazilian Orthodontics

ABSTRACT Introduction: This paper reviews the history of women scientists in the 'Western world', whilst highlighting the persistent socio-structural issues that have led to the hiding and masking of the participation of women in Science. Further, a reflection is made of the situation of Dentistry, specifically in the field of Orthodontics in Brazil. The difference between genders is discussed, with the intention to map the progress of women in management and leadership positions, in both the academic and professional fields. Description: In Brazil, within Dentistry and Orthodontics, despite being in a numerical majority, women are still underrepresented in the area of professional leadership. This is true for Research Groups and Research Productivity; an example being the relatively low authorship of publications in a Brazilian journal of Orthodontics. They are also underrepresented as lead presenters at professional meetings, whilst there are also few female Presidents of professional organizations and associations. Conclusion: Despite being in a numerical majority, it is also important that women act in a more co-ordinated and consistent manner to achieve greater representation in these areas. The necessary changes in the structure in order to achieve this are not only of women and for women, but they must also involve the whole of society so that leadership, rights and duties are equally distributed between the genders.

RESUMO Objetivo: Este estudo objetivou resgatar a história de mulheres cientistas nos principais períodos históricos do mundo ocidental, para realçar a questão socioestrutural persistente que "invisibiliza" e mascara a participação das mulheres na Ciência. A partir disso, realizou-se uma reflexão sobre a situação da Odontologia, especificamente na área de Ortodontia no Brasil, no que tange à diferença de gêneros, com a finalidade de mapear a atuação das mulheres nos cargos de gestão e liderança nos âmbitos acadêmico e profissional. Descrição: No Brasil, na área de Odontologia e Ortodontia, apesar de serem maioria numérica, as mulheres ainda são minoria na liderança de Grupos de Pesquisa, Produtividade em Pesquisa, na autoria de artigos em um periódico nacional da área de Ortodontia, palestrantes de congressos e na presidência de Associações de Classe. Conclusão: Apesar de apresentar maioria numérica, é importante que as mulheres atuem de maneira mais consistente. As mudanças necessárias na estrutura não são apenas da mulher e para a mulher, mas devem envolver toda a sociedade para que direitos e deveres sejam distribuídos de forma igualitária entre os sexos.

Individual niche trajectories in nesting green turtles on Rocas Atoll, Brazil: an isotopic tool to assess diet shifts over time / Trajetórias de nicho individual em tartarugas verdes do Atol das Rocas, Brasil: uma ferramenta isotópica para verificar trocas de dieta ao longo do tempo

Abstract In this study, multi-tissue (yolk and carapace) stable isotope analysis was used to assess individual isotopic niche trajectories of nesting green turtles on Rocas Atoll, off northeastern Brazil, and to reveal a diet shift in the temporal dimension. The diet trajectories of individual green turtles were highly directional, with a stronger component towards decreasing values of δ15N from carapace to yolk. When the green turtles are in their foraging sites (temporal window measured by the yolk samples), they are more herbivores. Conversely, in a broader temporal window, the green turtles demonstrate a carnivore-omnivore strategy, such as represented by heavier δ15N values in the carapace. This finding confirms a temporal diet shift. This is the first study that applies trophic niche trajectories for sea turtles, adding a new isotopic tool to understand the trophic ecology of these migrant animals.

Resumo Neste estudo, a análise de isótopos estáveis em múltiplos tecidos (vitelo e carapaça) foi usada para avaliar as trajetórias individuais de nicho isotópico de tartarugas verdes em nidificação no Atol das Rocas, nordeste do Brasil, e para revelar uma mudança de dieta na dimensão temporal. As trajetórias individuais da dieta de tartarugas verdes foram altamente direcionais, com um componente mais forte na direção de valores decrescentes de δ15N da carapaça ao vitelo. Quando as tartarugas verdes estão em seus locais de forrageamento (janela temporal medida pelas amostras de vitelo), elas são mais herbívoras. Por outro lado, em uma janela temporal mais ampla, as tartarugas verdes demonstram uma estratégia carnívora-onívora, representada por valores mais elevados de δ15N na carapaça. Os resultados confirmam uma mudança temporal na dieta. Este é o primeiro estudo que aplica trajetórias de nicho trófico para tartarugas marinhas, adicionando uma nova ferramenta isotópica para entender a ecologia trófica desses animais migrantes.

The association of abnormal thyroid stimulating hormone levels with elevated blood pressure among females of child-bearing potential / 中华内分泌代谢杂志

Objective:To explore the association between abnormal thyroid stimulating hormone (TSH) and elevated blood pressure among females of child-bearing potential.Methods:A total of 294 674 females of child-bearing age who participated in pre-pregnancy health examination in Shenzhen from 2013 to 2019 were selected. Demographic characteristics, blood pressure, TSH, fasting blood glucose and other indexes were collected. Multivariate logistic regression model was used to analyze the association between abnormal TSH levels and elevated blood pressure (including prehypertension and hypertension).Results:This study showed that females of child-bearing potential with prehypertension and hypertension accounted for 21.77% and 2.41%, respectively. Compared with females of child-bearing potential with normal TSH, the risk of prehypertension and hypertension increased by 34.0% ( OR=1.340, 95% CI 1.248-1.438) and 59.6% ( OR=1.596, 95% CI 1.301-1.938) among those with decreased TSH, respectively, whereas the risk of prehypertension and hypertension increased by 13.6% ( OR=1.136, 95% CI 1.076-1.198) and 38.0% ( OR=1.380, 95% CI 1.198-1.581) among those with elevated TSH, respectively. Subgroup analysis showed that abnormal TSH levels in most subgroups, such as age, ethnicity, educational level, occupation, spouse smoking, alcohol drinking, body mass index, and fasting blood glucose, were associated with the risk of elevated blood pressure. Heterogeneity test showed that the association between decreased TSH and elevated blood pressure was higher in females with high school and below or alcohol drinking, and the association between elevated TSH and elevated blood pressure was higher in females with college/bachelor′s degree and above or non-smoking spouse. Conclusion:There is a significant association between abnormal TSH levels and the risk of prehypertension and hypertension in females of child-bearing potential, and the association should be explored with stratified educational level, alcohol drinking, and spouse smoking status.

Caracterización del síndrome coronario agudo en mujeres / Characterization of acute coronary syndrome in women

RESUMEN Introducción: Las mujeres afectadas por síndromes coronarios agudos (SCA) tienen peor pronóstico y son más propensas a presentar complicaciones. Objetivo: Caracterizar las pacientes con SCA ingresadas en el Hospital Dr. Carlos J. Finlay (La Habana, Cuba) entre junio de 2012 y junio de 2018. Método: Estudio descriptivo transversal con 1252 mujeres. Fueron definidos 2 grupos: SCA con (SCACEST) y sin elevación del segmento ST (SCASEST). Las variables de estudio fueron: grupos de edad, factores de riesgo, características angiográficas y complicaciones intrahospitalarias. Resultados: La media de edad fue 66,2 ± 11,9 años, predominó el SCASEST (73,4% vs. 26,6%). La hipertensión arterial (95,2%), el tabaquismo (37,9%) y la diabetes mellitus (36,3%) fueron factores de riesgo más prevalentes, con diferencias significativas a favor del SCASEST (p<0,004). Los valores de glucemia (69,1% vs. 51,5%; p<0,0001) y colesterol total (46,2% vs. 16,6%; p<0,0001) fueron significativamente mayores en el SCASEST. A un 29,3% de los casos se les realizó coronariografía, donde se encontró una alta prevalencia de lesiones significativas (73,3%) y una incidencia de enfermedad de tronco de 4,9%. Un 23% presentó complicaciones, las más prevalentes fueron la insuficiencia cardíaca (35,1%) y el shock cardiogénico (18,1%), esta última predominó como causa de muerte en el SCACEST (45,1 vs. 11,8; p<0,0001). Ambas complicaciones se relacionaron directamente con la mortalidad (3,8%). Conclusiones: En las mujeres con SCA predominó el SCASEST en edades posmenopáusicas. La hipertensión arterial, la diabetes mellitus y el tabaquismo constituyeron las principales características clínicas. La insuficiencia cardíaca y el shock cardiogénico se asociaron frecuentemente a la mortalidad.

ABSTARCT Introduction: Women suffering from acute coronary syndromes (ACS) have worse prognosis and are prone to major adverse events. Objective: To characterize female patients with ACS admitted to the Hospital Dr. Carlos J. Finlay (Havana, Cuba) between June 2012 and June 2018. Method: A cross-sectional descriptive study with 1252 women was carried out. Two groups were defined: ST-segment elevation ACS (STE-ACS) and non-ST-segment elevation ACS (NSTE-ACS). Study variables were: age groups, risk factors, angiographic characteristics and in-hospital major adverse events. Results: Mean age was 66.2 ± 11.9 years old, NSTE-ACS predominated (73.4% vs 26,6%). High blood pressure (95.2%), tobacco smoking (37.9%) and diabetes mellitus (36.3%) were the prevailing risk factor, with significant differences in favor of NSTE-ACS (p <0.004). Glycemia values (69.1% vs 51.5%, p <0.00001) and total cholesterol (46.2% vs 16.6%, p <0.00001) were significantly higher in the NSTE-ACS. A 29.3% of cases underwent coronary angiography where a high prevalence of serious lesions of 73.3% and an incidence of left main coronary artery disease of 4.9% were found. A 23% presented major adverse events, heart failure (35.1%) and cardiogenic shock (18.1%) being the most prevalent ones. Cardiogenic shock predominated as cause of death in STE-ACS (45.1 vs 11,8; p<0,0001). Both major adverse events were directly related to mortality (3.8%). Conclusions: There is a predominance of NSTE-ACS in women with ACS in postmenopausal ages. High blood pressure, diabetes mellitus and tobacco smoking were the main clinical characteristics. Cardiogenic shock and heart failure were the major adverse events most frequently associated to mortality.

Impact of coronavirus on pregnant females in India: an observational study

Background: Coronavirus (COVID-19) has emerged as a rampant pandemic and the entire world is struggling against it. The entire nations are trying to device measure like national lockdowns, diverting resources towards fighting coronavirus, extensive media coverage, closing of elective services in hospitals. All this has influences the masses to a deep level. Coronavirus not only is morbid for the sick, but also the healthy pregnant females seeking health care and impacted them more mentally than physically.Methods: In this study 103 pregnant females from the entire nation of India were made to answer a well thought and made questionnaire which aimed at assessing the mental state and impact of coronavirus on the pregnant females.Results: Majority of the females answered that they felt anxious and were undergoing stress due to the coronavirus. They fear impending doom for the child and also are struggling a lot to seek apt healthcare for themselves and their children because of the ongoing pandemic.Conclusions: Coronavirus has not only affected people who are directly affected with the virus, but also who are still not affected but are mentally stressed because of it. National lockdown and alteration in the healthcare services are also stress- inducing for the pregnant females.

Knowledge, attitude and practices regarding smoking amongst young females

Background: Smoking amongst women is increasing in the developing countries like India. There is paucity of data on the knowledge, attitude and practices of smoking amongst females in India. Hence a study was planned to assess the same.Methods: It was a qualitative research using descriptive questionnaire, prepared using the basic protocols available as per WHO Global Adult Tobacco Survey, conducted by self-reporting, from February to March, 2018 in the University Institute of Applied Management Sciences, Panjab University, Chandigarh. It was administered to 111 females aged 18 to 35 years, residing in Chandigarh.Results: Total22.5% of the female respondents were current smokers. Majority of them belonged to the age group of 26-35years; were either employed or were studying and felt that females resorted to smoking for gaining pleasure and relieving stress. Most of them were aware of passive smoking. Majority felt that people who smoke should quit for their own health and for their families and street plays, public awareness camps, television and cinema halls are important mediums for helping to quit. Will power be found to be most important to help smokers quit. Some quoted the role of nicotine replacement therapy, exercise, individual counseling etc also. Majority of the females started smoking early, at an age of 16-25years, consuming 1-10cigarettes per day and had been smoking since more than a year when interviewed. Smoking was primarily introduced by peers. All the smokers were aware of different types of smoking hazards, most commonly reported as cancer and asthma. 16/25 smokers wanted to quit and 14/16 had tried in the past but were unsuccessful.Conclusions: This study gives an indication of rising smoking trend in females. Smoking cessation measures need to be made more gender-sensitive, targeting females in their early ages.