Failure In Women Research Articles

Gallic acid reduces inflammatory cytokines and markers of oxidative damage in a rat model of estradiol-induced polycystic ovary

Hormonal disorders, oxidative stress, and inflammation in ovarian tissue cause ovulation failure in women with polycystic ovary syndrome. Considering the antioxidant properties of gallic acid (GA), the aim of this study was to investigate the effect of GA on pro-inflammatory cytokines, antioxidant enzyme activity, and DNA oxidative damage of ovarian tissue in a rat model of estradiol-induced polycystic ovary (PCO). In this experimental study, 32 female Wistar rats were divided into four groups. These included control (saline solution, orally), PCO+saline (estradiol valerate + saline solution, orally), PCO+GA50, and PCO+GA100 (estradiol valerate +50 and 100 mg/kg gallic acid, orally), respectively. The PCO model was induced by a single intramuscular injection of estradiol valerate (EV, 4 mg/kg). Twenty-four days after PCO modeling, tissue concentration of tumor necrosis factor alpha (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6) and also the activity level of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPX), malondialdehyde (MDA), and 8-oxo-2′-deoxyguanosine (8-OHdG) in ovarian tissue were measured through ELISA technique. Compared with the PCO+saline, in the GA-treated group, the concentration of TNF-α, IL-1β, and IL-6 in a dose-dependent manner significantly decreased (p > 0.05). In addition, the activity level of SOD, CAT, and GPX enzymes significantly increased (p 0.05) in a dose-dependent manner. GA is an anti-inflammatory and an antioxidant polyphenol which reduces the concentration of inflammatory cytokines, oxidative stress, lipid peroxidation, and DNA oxidative damage of ovarian tissue in a rat’s model of PCO.

Antibiotics for treating urogenital Chlamydia trachomatis infection in men and non-pregnant women.

Antibiotics for treating urogenital Chlamydia trachomatis infection in men and non-pregnant women.

G Protein-Coupled Estrogen Receptor 1 Inhibits Angiotensin II-Induced Cardiomyocyte Hypertrophy via the Regulation of PI3K-Akt-mTOR Signalling and Autophagy.

Estrogen has been demonstrated to protect the heart against cardiac remodelling and heart failure in women. G protein-coupled estrogen receptor 1 (GPER1) is a recently discovered estrogen receptor (ER) that is expressed in various tissues. However, the mechanisms by which estrogen protects the heart, especially the roles played by ERs, are not clear. In this study, we explored the effect of GPER1 activation on angiotensin II (Ang II)-induced cardiomyocyte hypertrophy and the involved signalling pathways and mechanisms. Our data demonstrated that GPER1 is expressed in cardiomyocytes, a GPER1 agonist, G1, attenuated Ang II-induced cardiomyocyte hypertrophy and downregulated the mRNA expression levels of atrial natriuretic factor (ANF) and brain natriuretic peptide (BNP). Bioinformatics analysis revealed that five proteins, including RAP1gap, might be the key proteins involved in the attenuation of Ang II-induced cardiomyocyte hypertrophy by GPER1. G1 increased the protein level of p-Akt, p-70S6K1 and p-mTOR but decreased p-4EBP1 expression. All these effects were inhibited by either G15 (a GPER1 antagonist) or MK2206 (an inhibitor of Akt). Autophagy analysis showed that the LC3II/LC3I ratio was increased in Ang II-treated cells, and the increase was inhibited by G1 treatment. The effect of G1 on autophagy was blocked by treatment with G15, rapamycin, and MK2206. These results suggest that GPER1 activation attenuates Ang II-induced cardiomyocyte hypertrophy by upregulating the PI3K-Akt-mTOR signalling pathway and inhibiting autophagy.

Glass Ceiling on Women in Institutional Mechanism: Triggering and Elevating a Professional Diarchy?

This article aims to uncover how and in what ways glass ceiling on women constitutes a diarchal situation in all the phases of an institutional set-up from planning to implementation. Different studies in recent times have explicated that gender barriers are playing a segregating role in the successes or failures of women in their workplace. Everyone is informed and experienced about plenty of glass ceilings or gender barriers but it is also observed that less attention has been paid into an institutional set-up to discover whether a duality is persisting in there or not. The age-old thinking of women being ineffectual to take ‘serious decisions’ and better to do their ‘jobs only’ rather being the decision making executives yet dwells in our modern institutional arena, although its intensity may vary. So, this study was performed on the working women in different places of Bangladesh to experiment the reality.

Prothrombotic states as risk factor of in vitro fertilization failures in women with infertility and psychosomatic disorders.

Failures of in vitro fertilization (IVF) may be associated with prothrombotic states, the circulation of antiphospholipid antibodies (APA). 93 women with infertility were screened: 1 group - 32 women without severe psychosomatic disorders; 2 group - 61 women with psychosomatic disorders. The control group consisted of 30 fertile women. The level of AFA to membrane phospholipids (phosphatidylethanolamine, phosphatidylserine, cardiolipinum), antibodies to β2-glycoprotein (β2-GPI), hemostasis (platelet count, ADP-induced platelet aggregation index, fibrinogen concentration, prothrombin index, activated partial thromboplastin time - APTT, test for soluble fibrin-monomeric complexes, D-dimer), homocysteine in the blood serum was defined. The frequency of significant AFA titres in the group of women without psychosomatic disorders was 18.9%, and if they were present - 44.3%, the rate of β2-GPI 9.6% versus 24.5%, respectively. Only in 11.5% of women in 2 groups, elevated levels of APA were associated with β2-GPI and/or one or more clinical criteria for antiphospholipid syndrome (APS). In patients with infertility and psychosomatic disorders, increased platelet aggregation in the context of relative thrombocytopenia, higher fibrinogen levels, soluble fibrin-monomeric complexes, and prolonged APTT with elevated D-dimer levels was revealed. Some patients have hyperhomocysteinemia. Factors that adversely affect the efficiency of IVF in the patients with psychosomatic disorders were noted: elevation of APA; reduction in the number of platelets; growth of the ADP-induced aggregation index; extension of APTT; increase of fibrinogen, D-dimer; homocysteine. The presence of prothrombotic states associated with APS should be taken into account when preparing for IVF and perform their appropriate correction.

Caractérisation des rechutes locorégionales chez des patientes atteintes d’un cancer du sein traité par irradiation pariétale par électrons : expérience monocentrique de l’institut Curie

PurposeThe purpose of this study was to evaluate locoregional control and describe the patterns of locoregional failure in women with breast cancer irradiated by a previously described post-mastectomy highly conformal electron beam radiotherapy technique. Material and methodsWe included all women irradiated by post-mastectomy highly conformal electron beam radiotherapy technique for non-metastatic breast cancer between 2007 and 2011 in our department. All cases of bilateral breast cancer were excluded. All patients who experienced locoregional recurrence have been studied. Mapping patterns of regional recurrences was also performed and compared with the European Society for Radiotherapy and Oncology (ESTRO) and Radiotherapy Oncology Group (RTOG) guidelines of volume definition and delineation guidelines. ResultsWith a median follow-up of 64 months (range: 6–102 months), 5-year locoregional recurrence-free and overall survival probabilities were 90 % (95 % confidence interval [95 %CI]: 88.1–92.4) and 90.9 % (95 %CI: 88.9–93), respectively. Among the 796 patients included in the study, 23 patients (2.9 %) presented locoregional recurrences of them only 13 (1.6%) were presented with local recurrence. The majority of them presented aggressive biological features with grade III tumours in 17 patients (74 %) with high mitotic index in 16 cases (70 %) and triple negative tumours in 12 (52 %). Lymphovascular invasion was observed in 11 cases (48 %). In 14 cases the locoregional recurrences were diagnosed at the same time as the metastatic disease whereas 4 patients presented distant metastases secondarily. Locoregional recurrences occurred in 11 cases “in field” although adequate doses and volumes were used and in 12 cases “outfield”, out of irradiated volume. Local recurrences occurred in 13 patients with 12 recurrences within the irradiated volumes. Regional recurrences occurred in 13 patients with 15 lymph nodes metastases identified. Four nodal recurrences occurred outside the ESTRO clinical target volume and within the RTOG clinical target volume and two occurred outside both RTOG and ESTRO clinical target volumes. ConclusionIn presented series, the local recurrence resulted mostly from of biologic radio resistance whereas regional recurrences were caused by geographical miss. A number of nodal recurrences could occur outside the target volumes defined by ESTRO and RTOG.

Particular features of heart failure in women (series of 3652 patients)

The global prevalence of heart failure worldwide is increased by aging populations and the better prognosis of diseases that lead to, when women and men have been compared, significant differences appeared in the etiology of the disease, expression, outcome, response to therapy, and prognosis. To study the epidemiological, clinical and therapeutic particularities of HF in women. All the patients followed in the cardiology department (CHU ibn rochd) from 01/01/2008 to 31/12/2017 for heart failure are included retrospectively with data provided by the software cardioreport used in our training. Data have been collected from medical files as well as the follow-up books. statistical data were done by SPSS 20. (1) Women accounted for 43.89% with an average age of 62.51 ± 10.61 years for women versus 60.41 ± 10.94 years for men ( P = 0.025). (2) Women had a significantly higher prevalence of hypertension, diabetes, obesity and dyslipidemia. (3) However, men have a higher incidence of MI, COPD and peripheral arterial disease with P < 0.05. (4) Among women, a predominant hypertensive etiology (31, 50%) was the main cause, followed by valvular heart diseases (22.88%), whereas among men, ischemic cardiomyopathy was the main cause (61,5%). (5) Hospital mortality was higher among men (8.7% vs. 4.57%) ( Fig. 1 ). Despite the low inclusion of women in randomized clinical trials, it has been highlighted a more frequent association with hypertension or diabetes and less coronary heart disease with a survival that is better within the female population.

Gender differences among patients with arterial hypertension and heart failure with preserved left ventricular ejection fraction

The aim – assessment of gender differences in the frequency of comorbidities, structural and functional state of the heart, arterial stiffness, pulse load and ventricular-arterial interaction in patients with hypertension and heart failure with preserved left ventricular ejection fraction.Material and methods. 115 patients were diagnosed with HFpEF II A or II B stage, II or III NYHA FC, with LV EF ≥ 50 % and signs of LV diastolic dysfunction by TTE, and were divided into 2 groups by gender (group 1 – women with AH and HFpEF, and group 2 – men with hypertension and HFpEF). The control group consisted of 58 patients matched for age, gender composition, with AH 1–2 degrees, without heart failure; they were also divided into 2 groups (groups 3 and 4, respectively). Results. The examined groups of patients did not statistically differ regarding age and, among patients with HF, men and women did not differ in frequency of II or III FC (NYHA); among men, earlier MI was noted more frequently than in women – 23 (37.1 %) vs 4 (7.5 %) (P&lt;0.001). BMI among women with or without HF was higher (30.3±5.4 vs. 29.8±4.6 and 32.0±4.5 vs. 30.0±3.2, P&lt;0.05), without differences in the frequency of obesity. In women, the average GFR was lower – 61.2±13.5 vs. 74.4±15.2 and 70.6±1.3 vs. 86.1±17.9 (by 13.3 % and 18 %, respectively, P&lt;0.001) Among patients with HFpEF, the prevalence of anemia was higher in women (16 (30.2 %) vs. 7 (11.3 %), P&lt;0.05). The distance of the 6-minute walk test was significantly less in the group of patients with HF of both genders compared with the control group (353.4±91.6 vs. 553.2±56.6 and 384.3±83.5 vs. 569.8±33.7, P&lt;0.01), with a slightly worse result among women (by 8 %, P&lt;0.01). In women with HF, compared with men, there were elevated rates of both arterial elastance Ea — 2.3±0.6 vs.1.9±0.4, P&lt;0.05 (by 17.4 %), and end-systolic stiffness Ees – 3.3±1.3 vs. 3.0±1.1, P&lt;0.05 (by 9.1 %). Despite similar values of brachial BP and central BP in women with HF, compared to men, larger PWWc-f was noted by 9.5 % (12.8±1.5 vs. 12.2±1.4, P&lt;0.05) and AIx75 by 9.2 % (37.7±12 1 vs. 34.7±8.9, P&lt;0.05).Conclusions. In the population of the examined patients with AH and HFpEF there is a tendency towards more pronounced diastolic LV dysfunction, severity of clinical manifestations of heart failure in women, in comparison with men, in the absence of gender differences. Women with HFpEF have a higher resistive and pulsative load on LV. Thus, in women with hypertension, there is an increased tendency to develop HFpEF compared to men.

FOXO1 regulates uterine epithelial integrity and progesterone receptor expression critical for embryo implantation.

Successful embryo implantation requires a receptive endometrium. Poor uterine receptivity can account for implantation failure in women who experience recurrent pregnancy loss or multiple rounds of unsuccessful in vitro fertilization cycles. Here, we demonstrate that the transcription factor Forkhead Box O1 (FOXO1) is a critical regulator of endometrial receptivity in vivo. Uterine ablation of Foxo1 using the progesterone receptor Cre (PgrCre) mouse model resulted in infertility due to altered epithelial cell polarity and apoptosis, preventing the embryo from penetrating the luminal epithelium. Analysis of the uterine transcriptome after Foxo1 ablation identified alterations in gene expression for transcripts involved in the activation of cell invasion, molecular transport, apoptosis, β-catenin (CTNNB1) signaling pathway, and an increase in PGR signaling. The increase of PGR signaling was due to PGR expression being retained in the uterine epithelium during the window of receptivity. Constitutive expression of epithelial PGR during this receptive period inhibited expression of FOXO1 in the nucleus of the uterine epithelium. The reciprocal expression of PGR and FOXO1 was conserved in human endometrial samples during the proliferative and secretory phase. This demonstrates that expression of FOXO1 and the loss of PGR during the window of receptivity are interrelated and critical for embryo implantation.

Muscle Activity During a Single Set of Resistance Training to Failure in Women With Chronic Neck and Shoulder Pain Before and After 10 Weeks Training

Muscle Activity During a Single Set of Resistance Training to Failure in Women With Chronic Neck and Shoulder Pain Before and After 10 Weeks Training

GM-CSF (sargramostim) treatment in women with recurrent implantation failure undergoing transfer of single healthy blastocyst after pgs: a randomized controlled trial

The GM-CSF is a cytokine promoting leukocyte growth as well as trophoblast development. We described that this cytokine may be used in the treatment of recurrent abortion. We tested in this randomized controlled trial the use of GM-CSF (sargramostim) in the treatment for recurrent implantation failure in women undergoing IVF. A controlled randomized study conducted on women with Recurrent Implantation Failure. The study was conducted to the CERM, Rome, Italy, from the January 2016 to December 2017 on 73 women with recurrent implantation failure after IVF cycles. This study was approved by IRB. Inclusion criteria were: at least 9 good embryos previously transferred, women less than 38 years old, absence of systemic diseases. These women underwent IVF cycle and PGS on developed blastocysts. Single healthy blastocyst transfer was performed in the next cycle using only chromosomally healthy blastocysts. Patients were randomly divided in two groups: one (36 women) treated with subcutaneous GM-CSF 1.5mg/kg/daily (60-100) from the day of embryo transfer to the day of β-hcg day and if it was positive the treatment was continued for other 40 days: the control group (37 women) was treated with subcutaneous saline solution infusion in the same way of the study group. Primary outcome was the pregnancy rate. Epidemiological data of the two groups did not show statistically significant differences. Pregnancy rate in the group treated with GM-CSF was 75.0% (27/36) whereas in the control group was 43.2% (16/37), P= 0.0087. No side effects were observed. The clinical use of GM-CSF in women experienced implantation failure may be useful, even though more studies are needed to confirm these findings.

Hungry for Equality: A Longitudinal Analysis of Women’s Legal Rights and Food Security in Developing Countries

ABSTRACTAccess to food is one of the most basic human needs, yet undernourishment remains one of the greatest barriers to health and development in the Global South. The entitlement approach to hunger maintains that the real issue is not the overall availability of food, but access to it. This paper specifically highlights the access failures of women by focusing on how gender-based stratification limits command over food, even in light of existing food supply. Going beyond traditionally used indicators of gender inequality, we examine how women’s legal rights affect the depth of hunger in developing countries. In a first-time longitudinal study of its kind, we use the 50 Years of Women’s Legal Rights historical dataset from the World Bank to measure changes in women’s property rights and constitutional rights from 1990 to 2010. A two-way fixed effects regression analysis of 42 low- and middle-income nations demonstrates that improving women’s rights is associated with lower levels of hunger over time, even controlling for the food supply, economic development, and other relevant variables.

Same-day confirmation of intrauterine pregnancy failure in women with first- and early second-trimester bleeding

To determine if alpha-fetoprotein (AFP) concentration in vaginal blood, in the setting of dissolved fetal tissue, is significantly higher than its concentration in the maternal serum. A prospective cohort study. Medical center. Four groups of women were evaluated: 1) with missed/incomplete miscarriage with vaginal bleeding; 2) with threatened miscarriage; 3) with vaginal bleeding during cerclage placement; and 4) undergoing dilation and curettage (D&C). None. In each patient, AFP concentration in the vaginal blood or in the liquid component of the evacuated products of conception (POC; D&C group) was compared with the AFP concentration in the maternal serum. The median (range) concentration ratios of AFP in vaginal blood (or POC) to AFP in maternal serum were 24.5 (5.1-8,620) and 957 (4.6-24,216) for the missed/incomplete (n = 30) and the D&C (n = 22) groups, respectively, whereas they were only 1.2 (0.4-13.4) and 1.01 (0.7-1.5) for the threatened miscarriage (n = 15) and cerclage (n = 9) groups, respectively. Receiver operating characteristic (ROC) analysis demonstrated 100% sensitivity and 86.7% specificity for the detection of the passage of fetal tissue (ratio 4.3, area under the ROC curve 0.96). Higher concentrations of AFP in vaginal blood than in maternal serum may indicate the presence of dissolved fetal tissue (i.e., confirming a failed pregnancy).

Acute liver injury following Garcinia cambogia weight-loss supplementation: case series and literature review.

Herbal weight-loss supplements are sold as self-medication products, and are often used under the misconception that their natural origin guarantees their safety. Food supplements are not required to provide any benefit/risk profile evaluation before marketing; however, possible risks associated with use of herbal extracts in food supplements are becoming more and more documented in the literature. Some herbs are listed as the leading cause of herb-induced liver injury, with a severe or potentially lethal clinical course, and unpredictable herb-drug interactions. Garcinia cambogia (GC) extract and GC-containing products are some of the most popular dietary supplements currently marketed for weight loss. Here, we present four cases of acute liver failure in women taking GC extract for weight loss, and a literature review of clinical evidences about hepatic toxicity in patients taking dietary supplements containing GC extract.

Can the 2-hour Glucose Tolerance Test (GTT) Values Predict Metformin Failure in Women with Gestational Diabetes? [14E

INTRODUCTION: To determine if the GTT values have utility in predicting metformin failure in women with gestational diabetes (GDM). METHODS: A retrospective cohort study of women with GDM was conducted from 2013-2016. Included in the study were women with GDM started on metformin after a failed trial of diet therapy. Excluded from the study were women with pre-existing DM, or were started on glyburide or insulin therapy initially. Women were categorized as having adequate glycemic control on metformin (metformin success) or requiring the addition of or transition to an insulin regimen (metformin failure). Maternal demographics and GTT values were collected. The sensitivity and the specificity of the GTT values as a screening test for metformin failure were analyzed and the corresponding ROC curves were plotted to assess the performance of the test. Parametric and nonparametric statistical analyses were performed with a p value of &lt;0.05 as significant. RESULTS: A total of 118 gestational diabetics were identified, 19 (16.1%) women failed metformin therapy. There were no significant differences in maternal demographics between groups. A ROC curve of the fasting GTT value revealed that a value of 103mg/dL was best predictive of metformin failure (AUC 0.653; p 0.04, with a sensitivity and specificity of 42% and 90% respectively. The ROC curves of the 1 hour value and 2 hour value on the GTT were not statistically significant (AUC 0.578, p 0.28; and AUC 0.579, p0.28 respectively). CONCLUSION: An elevated fasting GTT value may help predict metformin failure in women with GDM.

Can Initial Glycemic Control Predict Metformin Failure in Women with Gestational Diabetes? [38B

INTRODUCTION: To determine if glycemic control prior to medication initiation predicts metformin failure in women with gestational diabetes (GDM). METHODS: A retrospective cohort study of women with GDM was conducted from 2013-2016. Included in the study were women with GDM started on metformin after a failed trial of diet therapy. Excluded from the study were women with pre-existing DM. Women were advised to take fasting and 1-hour postprandial finger sticks. Women were categorized as having adequate glycemic control on metformin (metformin success) or requiring the addition of or transition to an insulin regimen (metformin failure). Maternal demographics and average blood glucose (BG) values were collected. The sensitivity and the specificity of BG values as a screening test for metformin failure were analyzed and the corresponding ROC curves were plotted to assess the performance of the test. Parametric and nonparametric statistical analyses were performed with a p value of &lt;0.05 as significant. RESULTS: A total of 118 gestational diabetics were identified, 19 (16.1%) women failed metformin therapy. There were no significant differences in maternal demographics in the groups. Compared to the metformin success group, those in the metformin failure group had significantly higher fasting BG values prior to medical management. Postprandial BG values were not different between groups. A ROC curve of the average fasting BGs revealed that a value of 90mg/dl was best predictive of metformin failure (AUC 0.74; p 0.002), with a sensitivity and specificity of 90% and 79% respectively. CONCLUSION: Elevated fasting BG values may predict metformin failure in women with GDM.

Does Pregnancy Weight Gain Increase the Risk of Metformin Failure in the Treatment of Gestational Diabetes? [35D

INTRODUCTION: To determine if maternal weight gain is associated with a higher risk of metformin failure in women with gestational diabetes (GDM). METHODS: A retrospective cohort study of women with GDM was conducted from 2013-2016. Included in the study were women with GDM started on metformin after a failed trial of diet therapy. Excluded from the study were women with pre-existing diabetes mellitus. Women were categorized as having adequate glycemic control on metformin (metformin success) or requiring the addition of or transition to an insulin regimen (metformin failure). Metformin failure was defined as the inability to obtain glycemic control despite utilization of the maximum metformin dosage, or provider discretion. Maternal demographics and weight parameters were collected from the medical records and compared between the 2 groups. Parametric and nonparametric statistical analyses were performed with a p value of &lt; 0.05 as statistically significant. RESULTS: A total of 146 women with GDM were identified, of which 21 women (14%) failed metformin therapy. There were no differences in maternal demographics. Although the overall weight gain in pregnancy was not statistically significant between the 2 groups, mothers who failed metformin therapy had significantly less weight gain from pre-pregnancy to GDM diagnosis and higher weight gain from GDM diagnosis to delivery compared to those who did not fail metformin therapy. CONCLUSION: Women who were successfully treated with metformin, gained less weight after GDM diagnosis. Providers should consider weight gain in pregnancy in counseling women regarding their risk of metformin failure in the treatment of GDM.

Can Body Mass Index Predict Metformin Failure in Women with Gestational Diabetes? [38I

INTRODUCTION: To determine if pre-pregnancy body mass index (BMI) predicts metformin failure in the treatment of women with gestational diabetes (GDM). METHODS: A retrospective cohort study of women with GDM was conducted from 2013-2016. Included in the study were women with GDM started on metformin after a failed trial of diet therapy. Excluded from the study were women with pre-existing diabetes mellitus or initiated glyburide or insulin therapy. Women were categorized as having adequate glycemic control on metformin (metformin success) or requiring the addition of or transition to an insulin regimen (metformin failure). Metformin failure was defined as the inability to obtain glycemic control despite utilization of the maximum metformin dosage or provider discretion. Maternal characteristics and BMI were collected from the hospital’s electronic medical record and compared between groups. Parametric and nonparametric statistical analyses were performed with a p value of &lt; 0.05 as significant. The sensitivity and the specificity of BMI as a screening test for metformin failure were analyzed and the corresponding ROC curve was plotted to assess the performance of the test. RESULTS: A total of 139 women with gestational diabetes were identified, of which 21 (15%) failed metformin therapy. There were no differences in maternal demographics, BMI and BMI classifications between groups. The ROC curve revealed an optimal cut-off BMI to predict metformin failure of 38.7kg/m2 with a sensitivity 38.1 % and specificity 81.4% (AUC 0.56, p=0.236). CONCLUSION: Pre-pregnancy BMI may have limited utility in predicting metformin failure.

219 (PB-014) - Patterns of loco-regional failure in women with early stage breast cancer treated by whole breast radiotherapy in lateral position: Large scale single center experience

219 (PB-014) - Patterns of loco-regional failure in women with early stage breast cancer treated by whole breast radiotherapy in lateral position: Large scale single center experience

"Nobody came to help": interviews with women convicted of filicide in Malaysia.

Although filicide is of serious concern, it is poorly understood in Malaysia. Our interviews with health and policy professionals revealed that they attribute responsibility for filicide to women's failure to comply with social norms and religious teachings. This research sought to understand the meaning of and background to filicide from the perspectives of women who have been convicted of filicide in Malaysia. In-depth interviews were conducted in person with all eligible and consenting women convicted of filicide and incarcerated in prisons or forensic psychiatric institutions. Women's accounts were translated into English and analysed using interpretative phenomenological analysis and interpreted using narrative theory. Interviews with nine women convicted of filicide yielded evidence that others were implicated in the crime but punished less severely, if at all, and that the women had experienced lifelong gender-based violence and marginalisation with minimal access to health and social care. These findings illuminate an inadequately understood phenomenon in Malaysia and reveal why existing strategies to reduce filicide, which reflect key stakeholders' views, have had little impact. They reveal the pervasive harm of violence against women and children and its link to filicide.