Reproductive Age Period Research Articles

Acute Coronary Syndrome in Egyptian Women during their Reproductive Age Period

Background: Young women have low risk of acute coronary syndrome (ACS) during their reproductive period, mainly due to the physiologically protective effect of estrogen hormone on the coronary endothelium. The purpose of this study was to assess the risk factors of ACS in the Egyptian women patients during their reproductive age period, who admitted to Tanta University Cardiovascular department hospital.
 Results: Obesity, hypertension, diabetes mellitus, chronic kidney disease, systemic lupus erythematosus, myocardial bridge, cushion syndrome and radiotherapy for breast cancer were significantly independently ACS risk factors that correlated to the SYNTAX score. There is significance of coefficient of the independent variable in the risk factors (Group A, group B, group C separately and groups A, B, C together) on the severity and level of SYNTAX score in ACS. The regression analysis was significant in groups A and B of ACS risk factors separately. While the regression analysis was significant and there was a clear relationship between ACS risk factors- groups A, B, C. together and SYNTAX score.
 Conclusions: There was a positive relationship between the increase total number of ACS risk factors subgroups (Traditional, Nontraditional and Gynecological) and the severity of coronary artery stenosis that assessed by SYNTAX scorer.

ДИФФЕРЕНЦИАЛЬНЫЙ ПОДХОД В ХИРУРГИЧЕСКОМ ЛЕЧЕНИИ ТРУБНОЙ БЕРЕМЕННОСТИ

Ectopic pregnancy is still actual problem in gynecology nowadays due to its unpredictability and is serious threat for women’s life because in the case of interrupt it’s accompanied massive bleeding. Without contemporary treatment the death is potential. Nowadays there is no common treatment approach for patients with ectopic pregnancy. According to the literature frequency of treatment tactic is dependent of country. The purpose of the work is to assess the validity of the choice of the type of surgery for patients with ectopic pregnancy. The article presents the results of clinical observation of patients with a confirmed diagnosis of tubal pregnancy. The study included 103 case histories of patients whose age corresponded to the reproductive age period, according to WHO criteria (15-49 years) and ranged from 23 to 42 years. Based on the volume of surgical intervention, 5 observation groups were formed. The gynecological anamnesis, complaints of patients when contacting the emergency department, laboratory and instrumental diagnostics performed in dynamics, the choice of treatment tactics (organ-preserving or radical surgery) were analyzed. Based on the data obtained, recommendations for the treatment and follow-up of patients with tubal pregnancy were formed.

The impact of motherhood on the course of women's psychological wellbeing

Having children or being childless is associated with differences in women's psychological wellbeing during the reproductive age period. An individually matched case-control cohort study, measuring psychological wellbeing with the 5-item Mental Health Inventory (MHI-5) was conducted. Repeated measures analysis of variance and chi-square tests were used to measure the across time changes of MHI-5 scores. ANCOVA and Cochran's Q examined the differences between MHI-5 scores of women with children (cases) and of childless women (controls) at three timepoints. Timepoints were determined by the cases’ pre-pregnancy (T1), post-birth (T2), longer-term (T3) moments. Motherhood status has a significant medium effect on psychological wellbeing [F(1.112) 20.99, p<.001, d.47). Psychological wellbeing of cases declines significantly from T2 to T3 (p<.001) and from T1 to T3 (p<.001), while psychological wellbeing of controls remains the same. Cases have significantly more often MHI-5 scores below the cut-off value at T2 compared to T3 (p.05) and at T1 compared to T3 (p<.001). Controls have significantly more often MHI-5 scores below the cut-off value at T1 compared to T2 (p<.001) and at T1 compared to T3 (p<.001). We depended on an existing data set with few predetermined variables. There was insufficient information about the full context of women’s lives such as (in)voluntary childlessness, life-events affecting happiness, or age of children, affecting a comprehensive representation of possible confounders or mediating factors. Psychological wellbeing of mothers declines over time, while childless women’s wellbeing remains stable. Overall, both groups show evidence of good mental health.

Demographics, Clinical Characteristics, and Management of Idiopathic Intracranial Hypertension in Kuwait: A Single-Center Experience.

Background: Idiopathic intracranial hypertension (IIH) affects predominantly obese females during their reproductive age period. The demographics of this condition has not been studied in Kuwait before.Objectives: To determine the demographics, clinical features, risk factors, and treatment modalities of IIH in the main neurology tertiary referral hospital in Kuwait and to compare our data with literature.Methods: A retrospective study was conducted to identify cases of IIH seen between January 1, 2018, and December 31, 2018. Patients were diagnosed in and referred from the neurology and neuro-ophthalmology clinics.Results: Our cohort consisted of 139 patients. We estimated a crude annual incidence rate of IIH of 3.28 per 100,000 population. Female-to-male ratio was 9.6:1. Mean age was 32.1 ± 10.8 years. Mean age of males was 31.46 ± 12.63 and that of females was 32.11 ± 10.67. The median of the duration from the first symptoms till diagnosis was 6 weeks (2–10 weeks). Headache was the most common symptom in 134 (96.4%) patients, followed by visual disturbances in 85 (61.2%) patients, transient visual obscurations (TVOs) in 84 (60.4%) patients, pulsatile tinnitus in 72 (51.8%) patients, diplopia in 22 (15.8%) patients, other symptoms (e.g., nausea, vomiting, radicular neck, and back pain) in 19 (13.7%) patients, and 1 (0.7%) patient had facial weakness. High body mass index (BMI) was seen in 89.9% of patients, either overweight or obese, and it was the most common risk factors in both males (46.2%) and females (61.1%). Anemia was found in 38.1%; 21.6% of patients used OCPs and 7.9% used vitamin A. Bilateral transverse sinus stenosis (BTSS) was detected in 47 (33.8%) patients. Only 2 (1.4%) patients developed “fulminant IIH” characterized by rapidly progressive disease. All the patients received medical treatment and only 12 (8.6%) needed surgical management.Conclusion: Incidence of IIH in Kuwait is similar to other regional studies but higher than Western studies. Demographics and clinical features of IIH in our study are comparable to international and regional figures. Most of our patients had a benign course. IIH is more prevalent in females and strongly associated with obesity.

THE SPECIFICITY OF THE OVARIAN RESERVE OF WOMEN WITH CHRONIC SALPINGOOPHORITIS

Aim. The research was conducted for the assessment of the impact of chronic salpingoophoritis on the ovarian reserve of women in various phases of reproductive age.Materials and methods. A prospective, controlled and open cohort study was performed in 2013-2018 (n=202). The main group consisted of women with chronic salpingoophoritis (ChrSO) who applied for preconception consultation (n=138). In accordance with the reproductive age phase, the main group was divided into subgroups: the early reproductive age period (ERP, n=44), the peak reproductive age period (PRP, n=56), the late reproductive period (LRP, n=38). The control group consisted of conditionally healthy women of reproductive age (n=64). The ovarian reserve (OR) was estimated on the basis of the serum level of antimullerian hormone (AMH), inhibin B, estradiol, follicle stimulating hormone (FSH), an ultrasoundbased assessment of the number of antral follicles (AF), and the ovarian volume. Results. The age of women ranged from 18 to 40 years. Based on the discriminant analysis, it was found that the main indicators determining the specificity of the OR in ChrSO, depending on the phase of reproductive age, are the number of antral follicles, estradiol level and AMH (Wilks’ lambda = 0.35503, p&lt;0.0001). The specificity of the OR of women with ChrSO (difference from the control group), regardless of the phase of reproductive age, initially and when evaluated after 6 months, is determined by the number of AF and the level of estradiol and AMH; the number of AF and AMH is determined with a similar estimate after 12 months. The specificity of the OR in ChrSO, which is dependent on the reproductive age phase, has been proved through the analysis with the neural networks training(the proportion of correct answers is more than 80%). The linear relationships were established between the values of each OR parameter in women with ChrSO. Initially, when estimating after 6 and 12 months, linear regression equations were calculated, allowing the values of individual OR parameters to be calculated over 6 and 12 months.Conclusion. Chronic salpingoophoritis (ChrSO) is associated with a decrease in ovarian reserve in women of reproductive age. The effect of ChrSO on some parameters of the ovarian reserve depends on the age phase of the reproductive period, which increases with time (after 6, 12 months). The presence of ChrSO in women planning future pregnancies requires preventive and therapeutic measures aimed at preserving the ovarian reserve and the preferred implementation of fertility in early reproductive age before the ovarian reserve starts to decline.

Impact of Bariatric surgery on antimularian hormone in reproductive age women

Abstract Background Obesity affects fertility negatively, antimullerian hormone represents a good index of fertility, and it is considered a marker of ovarian reserve and could be affected by Bariatric surgery. Objective To assess the levels of antimullarian hormone in obese women before and after Bariatric surgery performed during their reproductive age period. Methods This study was designed as a cohort study. We evaluated antimullarian hormone serum level in obese women (n = 60), who attended the Al Hilla Teaching Hospital in Babylon and Al Hussein Medical Teaching City in Karbala/ Iraq, through the period from October 2016–May 2017. The female’s age range from 18 to 40 years, Body mass index, waist circumference, hip circumference, waist hip ratio were calculated and serum samples for antimullarian hormone were estimated before and after Bariatric surgery. Result There is a significant decline in serum level of antimullarian hormone after Bariatric surgery when compared with levels of hormone before surgery (p value .05 ∗ ), also body mass index, the waist circumference, the hip circumference, and the waist hip circumference ratio were significantly lower. Conclusion The results of study suggest that antimullarian hormone decreases after Bariatric surgery in reproductive age women, and there is improvement in cycle regularity.

Assessment of anti-Mullerian hormone level in reproductive age group women with diabetes mellitus type one

Objective To assess the levels of anti-Mullerian hormone in women with type I diabetes mellitus during their reproductive age period.

Gender Inequalities in Remote Settings: Analysis of 105,025 Medical Records of a Rural Hospital in Ethiopia (2005-2015).

Gender inequalities in Sub-Saharan Africa are deemed relevant but data to support this view are scanty. Retrospective analysis of a large dataset of 105,025 patients admitted to an Ethiopian rural private, non-for-profit hospital over a 11years period (2005-2015). Since 2001, the hospital and the local community are involved in a long-term, comprehensive and externally-supported health care intervention. The total number of admissions was higher for females (61.9% of the total) mainly because of the high frequency of admissions for obstetrics conditions. The total male-to-female ratio (M:F) was 0.6. Except for malaria, men had more admissions for the other leading causes, with the highest M:F being found for injuries (2.7) and musculoskeletal diseases (1.7). Overall, excluding admissions for pregnancy-related issues, the M:F was 1.4. The frequency of admissions changed with age and gender. Female admissions prevailed in the reproductive age period (from 15 to 44years of age) while males admissions prevailed in the younger and older age groups. The case fatality rate was higher for men (M:F = 2.0). The total M:F and the M:F excluding pregnancy-related admissions did not change during the study period. Gender inequalities do exist in rural remote setting but tend to affect women differently during their lifespan. Even if gender inequalities generally favor males, the substantial proportion of admissions for pregnancy-related situations is encouraging.

Anaemia prevalence and nutrient intake among women in peri-urban settlements in Accra, Ghana

Anaemia among women is a major public health concern globally. In developing countries, nutritional anaemia may be due to poor bioavailability of dietary iron, haemoglobinopathies, or intestinal parasites. The study objectives were to determine the prevalence of anaemia and current nutrient intakes essential to erythropoiesis among women of reproductive age (WRA) in peri-urban settlements in the Ga-East Municipality, Accra, Ghana. This cross-sectional study assessed the nutrient intake, sickling and haemoglobin levels of 134 women aged 15-49 years enrolled in a peanut-based field trial at baseline. A pretested semi-quantitative food frequency questionnaire was used to assess energy and nutrient intake using the Food Processor (ESHA) software. Whole blood was used to determine full blood count using the haematology automated analyser. Sickling was determined by blood staining. Anaemia was classified based on recommended cut-offs. Chi-square analysis was used as a test of independence between anaemia and age groups. Linear regression was used to determine predictors of haemoglobin concentration. The mean age of the women was 29 ± 8 years. The mean total caloric intake was 2315 ± 915 kcal, whilst protein and fat intakes were 67 ± 27g and 68± 30g, respectively. Almost three-quarters of the women met the recommended dietary allowance (RDA) for iron and vitamin C. However, only a third met the RDA for fat, and about two-thirds met their needs for energy and protein. None of the women met the RDA for folate which is integral for haem formation. Also 17% (23/134) of the women were sickle cell anaemia positive. Mean haemoglobin concentration was 12.1 ± 1.8 g/dL. Mild, moderate and severe anaemia due to iron deficiency was present in 35.8%, 6.7% and 1.5%, of the women respectively. All categories of anaemia was present in 44% of the women. Anaemia, prevalence increased during the early stages of the reproductive age (15-29 years) and declined towards the end of the reproductive age period (40-49 years). An increase in age of one year was significantly associated with a 0.056 g/dL rise in haemoglobin level (p=0.014). Anaemia due to iron deficiency exists as a public health problem among women in peri-urban settlements in the Ga-East Municipality, Accra, Ghana. Dietary diversity to include green leafy vegetables which are rich in folate and pro-vitamin A may reduce the current level of prevalence. Key words: Anaemia, Nutrients, Peri-urban, Women, RDA, sickling test, Food Processor software

Risk factors of early onset of MS in women in reproductive age period: survival analysis approach.

The incidence of multiple sclerosis (MS) has doubled in over the last decades in women, whereas it has been almost unchanged in men. The purpose of this study was to investigate the risk factors of early onset multiple sclerosis in women during reproductive years. A retrospective longitudinal study conducted on 200 women aged 15 to 50years with MS, registered by the MS Society in Isfahan. Data gathering was fulfilled by standard questionnaire including variables about reproductive period, demographic characteristics, and history of diseases. Kaplan-Mayer with log-rank test and Cox regression models were used in predicting of the age of effective factors in onset of MS. P values less than 0.05 were considered statistically significant. The mean age of studied women was 31.77 ± 8.13years and the mean and median age of onset the symptoms of MS was 26.79 ± 7.77 and 26years, respectively. Based on the cox results occurring menarche at 15years and higher increase the risk of MS 2.8-fold than those their menarche occurred at 12years and lower (HR: 2.81, 95% CI; 1.58-4.98).In addition, having only one pregnancy is related to higher risk of MS than other parities and increase the risk of MS 4.5-fold comparing to without parities. Age of menarche and parity numbers was the most important reproductive factors of MS in women. Nevertheless, history of autoimmune diseases, animal bite, childhood disease, family history of MS, regional area (tropical), and living in rural area were not related to early onset of MS.

Antimüllerian hormone: correlation with age and androgenic and metabolic factors in women from birth to postmenopause

To study the age-specific distribution of antimüllerian hormone (AMH) and describe the association of AMH with androgenic and metabolic profiles at different ages. Cross-sectional study. University hospital. A total of 6,763 Chinese women from birth to menopause. None. Anthropometric parameters (height, weight, and blood pressure), and levels of AMH and testosterone, glucose metabolism, and lipid profiles. According to the level of AMH, four age phases were established: childhood (0-10years), adolescence (11-18years), reproductive age (19-50years), and advanced age (≥51years). During childhood and adolescence, AMH levels increased, reaching a peak at 18years. A decline occurred thereafter during the reproductive-age period until the age of 50years, and it remained at a low level above 0 onward. We found that AMH was negatively correlated with testosterone in childhood (r = -0.25), but was positively correlated with testosterone and the free androgen index in adolescence (r = 0.30; r = 0.26, respectively) as well as during the reproductive phases (r = 0.28; r = 0.31, respectively). No correlation was observed between AMH and body mass index, fasting blood glucose, fasting insulin, the homeostasis model assessment, total cholesterol, triglycerides, low-density lipoprotein, or high-density lipoprotein at any phase. From birth to 18years, AMH increases, then it declines thereafter, indicating changes of ovarian maintenance. A positive relationship between androgenic profiles and AMH during adolescence and reproductive years implies a synchronism between androgens and ovarian reserve.

Fertility preservation and minimizing reproductive damage in cancer survivors

Recent advances in oncology have helped in the survival and cure of increasing numbers of childhood cancer patients and those during their reproductive age period. This has increased the need to improve existing technology, and prompted the search for new technologies, to minimize the gonadotoxic effects of cancer treatment and preserve human fertility. Conservative surgical approaches for cancer treatment have been widely accepted following progress in early detection of cancer and accumulating long-term outcome safety data. Gonadal suppression to increase resistance to cancer treatment by gonadotropin analogues and sex hormones has been suggested. However, while this is unlikely to be effective in males, there is no general consensus on its success in the female. Fertility preservation options for both male and female patients include cryopreservation of embryos, gametes and gonads. While embryo cryopreservation is a well-established and successful technique, there are several obvious limitations. Gamete cryopreservation is very successful in males (sperm freezing) while still experimental in females (oocyte freezing), with growing evidence suggesting its potential success. Gonadal cryopreservation is still in its early stages of experimental development, both in males (testicular tissue cryopreservation and in vitro spermatogenesis) and female (ovarian tissue cryopreservation and in vitro follicular maturation).

CONCENTRATION OF PYRUVIC ACID IN THE BLOOD OF THE NEWBORN INFANT

THERE are several aspects of carbohydrate metabolism in the newborn infant which are peculiar to that age group. The normal, full-term newborn exhibits concentrations of glucose in the blood between 15 and 120 mg/100 ml.1 Concentration of glycogen in the liver may be as high as 10 gm/100 gm wet-weight immediately after birth and then there is a precipitous decrease.2 There is a relative resistance of the fetus and newborn to anoxia.3-4 This phenomenon has been attributed to the preponderance of anaerobic over aerobic metabolism in the tissues of the newborn.5 Further data seemed desirable concerning the concentrations of intermediates in the blood, other than glucose, in the carbohydrate metabolism of the newborn. Accordingly a study was made of the normal concentration of pyruvic acid in the newborn for the first 5 days of life. Data on concentration of pyruvic acid in the blood have also been obtained in normal adults, pregnant and parturient women, and on venous and arterial blood from the umbilical cord. PATIENT MATERIAL AND METHODS The control or normal adult group was predominantly composed of white females and consisted of hospital employees and student nurses in the reproductive age period. Previous studies by others showed no significant difference between males and females6 or between whites and Negroes.7 The controls were divided into a group which supplied venous blood and another group which supplied capillary blood. Minimal squeezing proximal to the site of puncture was applied during all collections. The group of pregnant women consisted of both private and clinic patients, while the parturient group consisted of clinic patients only.