Pub Date : 2022-04-19DOI: 10.33552/wjgwh.2022.05.000622
Katherine J Kramer, M. E. Rhoads-Baeza, S. Sadek, C. Chao, Capricia M Bell, Maurice-Andre Recanati
Medicine in general, and particularly women's health, is rapidly evolving. This brief communication exposes some of the changes in Obstetrics and Gynecology but are relevant to all areas of medicine. As medical knowledge grows exponentially, there may be a greater sub-specialization of physicians, residency education must adapt, physician burnout remains an issue and clinician-scientists are becoming a dying breed. In addition, healthcare delivery systems and technological innovations, such as intelligent-EMRs, promise to support physician and prevent medical errors.
{"title":"Trends and Evolution in Women's Health Workforce in the First Quarter of the 21st Century.","authors":"Katherine J Kramer, M. E. Rhoads-Baeza, S. Sadek, C. Chao, Capricia M Bell, Maurice-Andre Recanati","doi":"10.33552/wjgwh.2022.05.000622","DOIUrl":"https://doi.org/10.33552/wjgwh.2022.05.000622","url":null,"abstract":"Medicine in general, and particularly women's health, is rapidly evolving. This brief communication exposes some of the changes in Obstetrics and Gynecology but are relevant to all areas of medicine. As medical knowledge grows exponentially, there may be a greater sub-specialization of physicians, residency education must adapt, physician burnout remains an issue and clinician-scientists are becoming a dying breed. In addition, healthcare delivery systems and technological innovations, such as intelligent-EMRs, promise to support physician and prevent medical errors.","PeriodicalId":87379,"journal":{"name":"World journal of gynecology & womens health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46947510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-07DOI: 10.33552/wjgwh.2021.05.000614
Nicole Pepe
{"title":"Post-Coital Seepage - A Rarely-Discussed, Yet Common Inconvenience for Most Women: A Main Systematic Review","authors":"Nicole Pepe","doi":"10.33552/wjgwh.2021.05.000614","DOIUrl":"https://doi.org/10.33552/wjgwh.2021.05.000614","url":null,"abstract":"","PeriodicalId":87379,"journal":{"name":"World journal of gynecology & womens health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41808387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-01Epub Date: 2021-09-07DOI: 10.33552/WJGWH.2021.05.000609
Katherine Jennifer Kramer, Capricia Bell, Maurice-Andre Recanati
Mass vaccination against COVID-19 is ever urgent as the incidence of infection with the more contagious and severe Delta variant continues to rise. Though the COVID-19 vaccination is recommended for eligible individuals over the age of twelve and has become widely available to all, it remains elusive for poorly document individuals.
{"title":"For Those with Inadequate Legal Documents, COVID-19 Vaccination Remains Challenging.","authors":"Katherine Jennifer Kramer, Capricia Bell, Maurice-Andre Recanati","doi":"10.33552/WJGWH.2021.05.000609","DOIUrl":"https://doi.org/10.33552/WJGWH.2021.05.000609","url":null,"abstract":"<p><p>Mass vaccination against COVID-19 is ever urgent as the incidence of infection with the more contagious and severe Delta variant continues to rise. Though the COVID-19 vaccination is recommended for eligible individuals over the age of twelve and has become widely available to all, it remains elusive for poorly document individuals.</p>","PeriodicalId":87379,"journal":{"name":"World journal of gynecology & womens health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8560004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39585583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-28DOI: 10.33552/wjgwh.2021.05.000601
Heba Harras
Background: Supra-cervical hysterectomy (SCH) is widely common and has many complications either immediate or delayed, including bleeding, infection, and chronic pelvic pain. Clinical studies evaluating histopathological findings in these patients are few. Objective: To study the underlying pathological changes in the cervical stump after supracervical hysterectomy in symptomatizing patients. Patients and Methods: This cross-section study was conducted at Tanta University. All patients (n=132) underwent cervical stump biopsy for histopathological examinations. Immunohistochemical expression of P16 was also performed in all patients with cervical pathological abnormalities as a recommended biomarker for cervical lesions. Results: Vaginal bleeding was the most common presentation of enrolled patients (54/132). Endometriosis was the commonest pathological lesion detected in patients with cervical stump bleeding (27/54). After Hematoxylin and eosin staining was applied; 52 cases showed normal cervical tissue, chronic non-specific cervicitis in 11 cases, endometriosis in 27 cases, squamous metaplasia with no atypia in 6 cases, cervical intraepithelial neoplasia in 32 cases, squamous cell carcinoma in 3 cases and adenocarcinoma in only one case. P16 immuno-staining showed negative expression in chronic cervicitis and squamous metaplasia with no atypia, ambiguous p16 expression was observed in 50%, 63.2% and 80% cases of CIN I, CIN II, and III respectively, while 100% of cervical cancer cases showed block positive expression. Conclusion: Pathological lesions of cervical stump following SCH could be screened by p16 immuno-staining as a complementary test for early detection of cervical cancer. Ambiguous expression of p16 should not be neglected as the lesion may have a low possibility of harboring
{"title":"Histopathological Findings in Symptomatizing Patients After Supracervical Hysterectomy: A Cross Sectional Study","authors":"Heba Harras","doi":"10.33552/wjgwh.2021.05.000601","DOIUrl":"https://doi.org/10.33552/wjgwh.2021.05.000601","url":null,"abstract":"Background: Supra-cervical hysterectomy (SCH) is widely common and has many complications either immediate or delayed, including bleeding, infection, and chronic pelvic pain. Clinical studies evaluating histopathological findings in these patients are few. Objective: To study the underlying pathological changes in the cervical stump after supracervical hysterectomy in symptomatizing patients. Patients and Methods: This cross-section study was conducted at Tanta University. All patients (n=132) underwent cervical stump biopsy for histopathological examinations. Immunohistochemical expression of P16 was also performed in all patients with cervical pathological abnormalities as a recommended biomarker for cervical lesions. Results: Vaginal bleeding was the most common presentation of enrolled patients (54/132). Endometriosis was the commonest pathological lesion detected in patients with cervical stump bleeding (27/54). After Hematoxylin and eosin staining was applied; 52 cases showed normal cervical tissue, chronic non-specific cervicitis in 11 cases, endometriosis in 27 cases, squamous metaplasia with no atypia in 6 cases, cervical intraepithelial neoplasia in 32 cases, squamous cell carcinoma in 3 cases and adenocarcinoma in only one case. P16 immuno-staining showed negative expression in chronic cervicitis and squamous metaplasia with no atypia, ambiguous p16 expression was observed in 50%, 63.2% and 80% cases of CIN I, CIN II, and III respectively, while 100% of cervical cancer cases showed block positive expression. Conclusion: Pathological lesions of cervical stump following SCH could be screened by p16 immuno-staining as a complementary test for early detection of cervical cancer. Ambiguous expression of p16 should not be neglected as the lesion may have a low possibility of harboring","PeriodicalId":87379,"journal":{"name":"World journal of gynecology & womens health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45789441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-03-24DOI: 10.33552/wjgwh.2021.04.000599
Shereef Elshwaikh
Objective: To evaluate Intracystic injection of methotrexate in postmenopausal female suffering from simple ovarian cyst with low malignancy index. Methods: Clinical randomized controlled study, two group of post-menopausal females each group had 25 patients with ovarian cyst with low malignancy index (less than 25), group I : underwent ultrasound guided aspiration of the cyst followed by methotrexate injection Group II: had no interference. Both group will be followed up for 6 months . Results: Epidemiological data and the characteristics of the cyst at the beginning of the study showed insignificant relationship between two groups. In group I (study group) the time of the procedure was 12.15±1.035 min., with no complications. After follow up of the cases for 6 month it shows significant difference as regard recurrence / persistence of the cyst ( I case recurred in group1 ,and 15 case persist in group 2) with P value 0.000022 .While there was insignificant relationship as regard new symptoms , presence of complications and need for surgery . Conclusion: This technique is considered a promising technique for its management, but it couldn’t be recommended by our study as this process is invasive and it shows only single advantage over expectant management.
{"title":"Intracystic Injection of Methotrexate in Postmenopausal Female Suffering from Simple Ovarian Cyst with Low Malignancy Index","authors":"Shereef Elshwaikh","doi":"10.33552/wjgwh.2021.04.000599","DOIUrl":"https://doi.org/10.33552/wjgwh.2021.04.000599","url":null,"abstract":"Objective: To evaluate Intracystic injection of methotrexate in postmenopausal female suffering from simple ovarian cyst with low malignancy index. Methods: Clinical randomized controlled study, two group of post-menopausal females each group had 25 patients with ovarian cyst with low malignancy index (less than 25), group I : underwent ultrasound guided aspiration of the cyst followed by methotrexate injection Group II: had no interference. Both group will be followed up for 6 months . Results: Epidemiological data and the characteristics of the cyst at the beginning of the study showed insignificant relationship between two groups. In group I (study group) the time of the procedure was 12.15±1.035 min., with no complications. After follow up of the cases for 6 month it shows significant difference as regard recurrence / persistence of the cyst ( I case recurred in group1 ,and 15 case persist in group 2) with P value 0.000022 .While there was insignificant relationship as regard new symptoms , presence of complications and need for surgery . Conclusion: This technique is considered a promising technique for its management, but it couldn’t be recommended by our study as this process is invasive and it shows only single advantage over expectant management.","PeriodicalId":87379,"journal":{"name":"World journal of gynecology & womens health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41705153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-03-12DOI: 10.33552/wjgwh.2021.04.000598
Gabkika Bray Madoué
Background: Postpartum contraception is the set of methods designed to prevent pregnancy after a caesarean section [1]. It can be instituted during the caesarean section or in the post-partum period. The aim of this study is to evaluate the knowledge and practice of contraception in patients who have undergone a caesarean section at N’Djamena Mother and Child University Hospital. Patients and method: This were a 3-month cross-sectional and descriptive study from September 1st, 2020 - November 30th, 2020 on knowledge, attitudes and practices about contraception in caesarian section patients. Results: The 20-24 age group was the most represented with 42%.Patientts resided in N’Djamena in 60%.Married women were the most represented with 93.3% . Patients had average knowledge about contraception in 77.3%. Injectable contraceptives were the commonly known of the modern contraceptive methods with 80.7%. Periodic abstinence was the best-known natural method with 61.3%. Implants were the most chosen contraceptive method with 48%. The proposal to use the contraceptive method was made in 79 , 3% of cases by health workers. The most well-known advantages of contraceptives by clients were birth spacing with 82.7%. Infertility was the contraceptive method disadvantage most reported by clients with 54%. Conclusion: The prescription of contraceptive methods in patients who have undergone a caesarean section is part of our common practice. Injectable contraception remains the commonly known hormonal contraception. The desire to avoid pregnancy is the benefit most noted by patients.
{"title":"Knowledge, Attitudes and Practices About Contraception in Patients who had Undergone A Caesarian Section in N’Djamena Mother and Child University Hospital","authors":"Gabkika Bray Madoué","doi":"10.33552/wjgwh.2021.04.000598","DOIUrl":"https://doi.org/10.33552/wjgwh.2021.04.000598","url":null,"abstract":"Background: Postpartum contraception is the set of methods designed to prevent pregnancy after a caesarean section [1]. It can be instituted during the caesarean section or in the post-partum period. The aim of this study is to evaluate the knowledge and practice of contraception in patients who have undergone a caesarean section at N’Djamena Mother and Child University Hospital. Patients and method: This were a 3-month cross-sectional and descriptive study from September 1st, 2020 - November 30th, 2020 on knowledge, attitudes and practices about contraception in caesarian section patients. Results: The 20-24 age group was the most represented with 42%.Patientts resided in N’Djamena in 60%.Married women were the most represented with 93.3% . Patients had average knowledge about contraception in 77.3%. Injectable contraceptives were the commonly known of the modern contraceptive methods with 80.7%. Periodic abstinence was the best-known natural method with 61.3%. Implants were the most chosen contraceptive method with 48%. The proposal to use the contraceptive method was made in 79 , 3% of cases by health workers. The most well-known advantages of contraceptives by clients were birth spacing with 82.7%. Infertility was the contraceptive method disadvantage most reported by clients with 54%. Conclusion: The prescription of contraceptive methods in patients who have undergone a caesarean section is part of our common practice. Injectable contraception remains the commonly known hormonal contraception. The desire to avoid pregnancy is the benefit most noted by patients.","PeriodicalId":87379,"journal":{"name":"World journal of gynecology & womens health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43721922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-05DOI: 10.33552/WJGWH.2020.04.000595
M. Mendoza
Early fetal growth restriction (FGR) is a leading cause of perinatal morbidity and mortality. No therapeutic strategies have proved to be effective in improving fetal and neonatal outcomes either in growth restricted fetuses or any placenta-related disorder such as preeclampsia. Delivery of the fetus and placenta is the only definitive cure. However, recent studies suggest that pravastatin appears to be safe in pregnancy, improves placental perfusion and fetal growth and prevents angiogenic imbalance. Angiogenic (PlGF) and antiangiogenic (sFlt-1) factors and feto-maternal Doppler evaluation are strongly associated with fetal growth restriction prognosis and severity. Thus, pravastatin has been proposed as a promising therapeutic drug for fetal growth restriction. We report the findings of a case of early-onset FGR treated with pravastatin 40mg daily until delivery. During this time, feto-maternal Doppler and angiogenic profile evolution were recorded. Fetal and placental perfusion observed on Doppler and angiogenic imbalance improved after pravastatin was started. sFlt-1 down-regulation was more marked than PlGF up-regulation. The patient developed severe preeclampsia (PE) at 27+6 weeks of gestation, necessitating immediate fetal extraction owing to hypertension refractory to adequate treatment. This report supports further investigation on the use of pravastatin to improve angiogenic profile and feto-maternal circulation in FGR fetuses.
{"title":"Pravastatin Improves Angiogenic Factors and Feto- Placental Doppler in Pregnancy with Early Severe Fetal Growth Restriction: A Case Report","authors":"M. Mendoza","doi":"10.33552/WJGWH.2020.04.000595","DOIUrl":"https://doi.org/10.33552/WJGWH.2020.04.000595","url":null,"abstract":"Early fetal growth restriction (FGR) is a leading cause of perinatal morbidity and mortality. No therapeutic strategies have proved to be effective in improving fetal and neonatal outcomes either in growth restricted fetuses or any placenta-related disorder such as preeclampsia. Delivery of the fetus and placenta is the only definitive cure. However, recent studies suggest that pravastatin appears to be safe in pregnancy, improves placental perfusion and fetal growth and prevents angiogenic imbalance. Angiogenic (PlGF) and antiangiogenic (sFlt-1) factors and feto-maternal Doppler evaluation are strongly associated with fetal growth restriction prognosis and severity. Thus, pravastatin has been proposed as a promising therapeutic drug for fetal growth restriction. We report the findings of a case of early-onset FGR treated with pravastatin 40mg daily until delivery. During this time, feto-maternal Doppler and angiogenic profile evolution were recorded. Fetal and placental perfusion observed on Doppler and angiogenic imbalance improved after pravastatin was started. sFlt-1 down-regulation was more marked than PlGF up-regulation. The patient developed severe preeclampsia (PE) at 27+6 weeks of gestation, necessitating immediate fetal extraction owing to hypertension refractory to adequate treatment. This report supports further investigation on the use of pravastatin to improve angiogenic profile and feto-maternal circulation in FGR fetuses.","PeriodicalId":87379,"journal":{"name":"World journal of gynecology & womens health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43928907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-05DOI: 10.33552/WJGWH.2021.04.000596
K. Ghazal
Uterine leiomyomas, also known as myomas or fibroids, are by far the commonest benign uterine tumors. Leiomyomas are not uncommon in the round, ovarian and broad ligaments. They can be misdiagnosed as ovarian tumor even by MRI that can give typical findings of ovarian neoplasm, thereby altering the course of treatment offered. A menopaused 53 years old lady, biparous, presented to our clinic for regular check-up. She is previously healthy and denies any complain. She has however a family history of ovarian cancer. General physical examination was unremarkable. The vagina and cervix appeared healthy on gross visualization without any discharge or vaginal bleed. Ultrasonography of pelvis revealed a well-defined heterogeneous right adnexal mass of 4.3x 3.26 cm. MRI showed a 38x39 mm isointense in both T1 and T2 right adnexal mass with an impression of fibro-thecoma. Serum Ca -125 (cancer antigen) 31 UmL. The family history as well as the aspect of the mass on ultrasound and MRI raised the suspicion of an ovarian tumor. However, Laparoscopy revealed a mass arising from the right broad ligament whose Histopathological examination confirmed a broad ligament leiomyoma that was removed laparoscopically. Laparoscopic approach for broad ligament fibroid can achieve good results. Till present, there is very few data on the ease of imaging of broad ligament leiomyoma as it would not help ruling out the origin of adnexal mass accurately.
{"title":"Is It an Ovarian Tumor or Broad Ligament Leiomyoma?","authors":"K. Ghazal","doi":"10.33552/WJGWH.2021.04.000596","DOIUrl":"https://doi.org/10.33552/WJGWH.2021.04.000596","url":null,"abstract":"Uterine leiomyomas, also known as myomas or fibroids, are by far the commonest benign uterine tumors. Leiomyomas are not uncommon in the round, ovarian and broad ligaments. They can be misdiagnosed as ovarian tumor even by MRI that can give typical findings of ovarian neoplasm, thereby altering the course of treatment offered. A menopaused 53 years old lady, biparous, presented to our clinic for regular check-up. She is previously healthy and denies any complain. She has however a family history of ovarian cancer. General physical examination was unremarkable. The vagina and cervix appeared healthy on gross visualization without any discharge or vaginal bleed. Ultrasonography of pelvis revealed a well-defined heterogeneous right adnexal mass of 4.3x 3.26 cm. MRI showed a 38x39 mm isointense in both T1 and T2 right adnexal mass with an impression of fibro-thecoma. Serum Ca -125 (cancer antigen) 31 UmL. The family history as well as the aspect of the mass on ultrasound and MRI raised the suspicion of an ovarian tumor. However, Laparoscopy revealed a mass arising from the right broad ligament whose Histopathological examination confirmed a broad ligament leiomyoma that was removed laparoscopically. Laparoscopic approach for broad ligament fibroid can achieve good results. Till present, there is very few data on the ease of imaging of broad ligament leiomyoma as it would not help ruling out the origin of adnexal mass accurately.","PeriodicalId":87379,"journal":{"name":"World journal of gynecology & womens health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49173990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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