Profile of women substance users seeking treatment at tertiary care treatment center in India: A retrospective chart review study

Introduction: Among substance users, women represent a small, unique subpopulation. Studying their socio-demographic and substance-use profile helps us understand their concerns and formulate management strategies. Materials and Methods: In this retrospective chart review, all the available records of outpatient treatment seekers at National Drug Dependence Treatment Centre (NDDTC), All India Institute of Medical Sciences (AIIMS), Ghaziabad, from 1 January 2011 to 31 December 2015 were screened. Data from the women substance users were entered into a specially designed MS Excel format and analyzed. Results: In these 5 years, 217 women (mean age 36.75 ± 11.84 years) sought treatment. Majority were married (75.6%), housewife (53.5%), educated (59.4%), from an urban background (70.0%). Most common primary substance used was opioid (61.3%), including heroin (30.0%) and pentazocine (16.1%). About 20.3% reported injectable opioid use. The mean duration of opioid use was 5.44 ± 4.68 years. History of prior treatment seeking was reported by 4.6% and no prior significant abstinence attempts by 77.4%. Discussion and Conclusion: Majority of female treatment seekers, are young, married urban women and seek treatment for opioid use, particularly heroin (as opposed to pentazocine, suggested by previous studies). Prior treatment seeking and abstinence rates are low. Data indicates the need of specialized services for this population.     

绝经对经皮冠状动脉介入治疗冠心病影响分析

目的探讨绝经对经皮冠状动脉介入治疗冠心病的影响。方法选取2010年1月至2014年12月首次行冠状动脉造影提示冠状动脉病变并行经皮冠状动脉介入治疗(PCI)的绝经女性患者10 746例,分为A组(绝经时间>5年,n=5 573)与B组(绝经时间≤5年,n=5 173)。记录随访期间的主要心脑血管不良事件、死亡、靶血管再次血运重建、出血事件等发生率。采用多因素Logistic回归分析患者死亡的影响因素。结果 A组随访30 d及1年的主要心脑血管不良事件、死亡发生率均高于B组(P<0.05)。多因素Logistic回归分析显示,病变血管支数、肾小球滤过率是影响A组患者死亡的独立危险因素。结论绝经时间>5年的女性患者行PCI治疗冠心病预后差于绝经时间≤5年的女性,病变血管支数、肾小球滤过率是其死亡的独立危险因素。     

百岁女医谈允贤传奇医传——从《女医杂言》细论前明妇科、性医学的进步

2015年中国女医屠呦呦获得诺贝尔生理学及医学奖后,中医借此大善,于今岁再祭前明女医谈允贤氏。岁首电视剧《女医·明妃传》热映,故事情节虽跌宕,然非历史真实之谈允贤也。1999年中国中医研究院医史文献研究所郑金生撰文《明代女医谈允贤及其医案女医杂言》,第一次向世间介绍了这位著名的明朝女医生。此前该人医事且并不为人知,究为何?《女医杂言》在前明出版两次,今仅以后版(万历年版)存世,经初考似曾另著别"医案"(或医著)存世,而今仍无善本见存,内中缘由深矣。今经较详细考证有关史料,发现女医谈允贤或其家族成员,似于500年前曾卷进一桩被《明史》记为"壬寅宫变"的冤案当中。至于这宗晚明时期的杀医要案,久不查者甚矣,今当昭雪于世界,以彰显为医者之正气!     

成都市女性性功能障碍的调查与相关因素的探析

目的:对成都市区FSD的患病情况进行调查,并探寻可能对其造成影响的相关因素。方法:以2015年7月至12月于四川大学华西医院健康体检中心进行体检的女性作为调查对象,应用中文版女性性功能指数量表(CVFSFI)及Beck抑郁问卷第二版(BDⅠ-Ⅱ)进行问卷调查,应用SPSS19.0建立数据库进行统计分析。结果:本次研究共发放问卷1237份,回收完整填写问卷1116份(回收率为90.2%)。女性性功能障碍(FSD)的发生率为26.1%,6个维度出现问题的比例由高到低依次为:性交疼痛23.4%,性满意度低22.6%,性高潮障碍21.5%,阴道润滑困难19.1%,性欲低下17.2%,性唤起困难15.9%。总体CVFSFI平均总分为(25.756±3.878)分。CVFSFI总分及6个维度的得分随着年龄的增长而减小。各个年龄组FSD发生率分别为:20~29岁组16.7%;30~39岁组21.9%;40~49岁组24.6%;≥50岁组64.7%。不同年龄组间,FSD发生率及各维度出现问题的比例差异均有统计学意义(P均0.001),且随着年龄的增长有明显的增加。多因素Logistics回归分析显示,受教育(OR=0.654)是FSD的保护因素;年龄(OR=1.042)、BMI(OR=1.073)、绝经(OR=3.498)以及抑郁(OR=1.033)为FSD的危险因素。结论:成都市女性发生性功能障碍的比例约为26.1%,其中性交疼痛和性满意度低为主要表现。分析得出女性发生性功能障碍可能与年龄、BMI较大,受教育水平较低,以及处于绝经、抑郁状态有关。     

Brain Activity Unique to Orgasm in Women: An fMRI Analysis

BackgroundAlthough the literature on imaging of regional brain activity during sexual arousal in women and men is extensive and largely consistent, that on orgasm is relatively limited and variable, owing in part to the methodologic challenges posed by variability in latency to orgasm in participants and head movement.AimTo compare brain activity at orgasm (self- and partner-induced) with that at the onset of genital stimulation, immediately before the onset of orgasm, and immediately after the cessation of orgasm and to upgrade the methodology for obtaining and analyzing functional magnetic resonance imaging (fMRI) findings.MethodsUsing fMRI, we sampled equivalent time points across female participants’ variable durations of stimulation and orgasm in response to self- and partner-induced clitoral stimulation. The first 20-second epoch of orgasm was contrasted with the 20-second epochs at the beginning of stimulation and immediately before and after orgasm. Separate analyses were conducted for whole-brain and brainstem regions of interest. For a finer-grained analysis of the peri-orgasm phase, we conducted a time-course analysis on regions of interest. Head movement was minimized to a mean less than 1.3 mm using a custom-fitted thermoplastic whole-head and neck brace stabilizer.OutcomesTen women experienced orgasm elicited by self- and partner-induced genital stimulation in a Siemens 3-T Trio fMRI scanner.ResultsBrain activity gradually increased leading up to orgasm, peaked at orgasm, and then decreased. We found no evidence of deactivation of brain regions leading up to or during orgasm. The activated brain regions included sensory, motor, reward, frontal cortical, and brainstem regions (eg, nucleus accumbens, insula, anterior cingulate cortex, orbitofrontal cortex, operculum, right angular gyrus, paracentral lobule, cerebellum, hippocampus, amygdala, hypothalamus, ventral tegmental area, and dorsal raphe).Clinical TranslationInsight gained from the present findings could provide guidance toward a rational basis for treatment of orgasmic disorders, including anorgasmia.Strengths and LimitationsThis is evidently the first fMRI study of orgasm elicited by self- and partner-induced genital stimulation in women. Methodologic solutions to the technical issues posed by excessive head movement and variable latencies to orgasm were successfully applied in the present study, enabling identification of brain regions involved in orgasm. Limitations include the small sample (N = 10), which combined self- and partner-induced stimulation datasets for analysis and which qualify the generalization of our conclusions.ConclusionExtensive cortical, subcortical, and brainstem regions reach peak levels of activity at orgasm.Wise NJ, Frangos E, Komisaruk BR. Brain Activity Unique to Orgasm in Women: An fMRI Analysis. J Sex Med 2017;14:1380–1391.     

Primary malignant melanoma of the female urethra: Report of a rare neoplasm of the urinary tract

IntroductionMelanoma is a malignant tumor that can affect any area of the anatomical economy. Its occurance in the female urethra is extremely rare. We report a case of primary malignant urethral melanoma developed in an elderly female patient.Presentation of caseA 70 years old female presented with dysuria, poor stream, gross haematuria, intermittent blood spots, and a painful mass. On physical examination, there were no suspicious lesions on the skin. On external genital examination, a lesion at the level of the urethral meatus was observed. The mass was removed by wide local excision under spinal anaesthesia. The pathological diagnosis was malignant melanoma of the urethra.DiscussionThe common presentations include bleeding and/or discharge per urethra, voiding dysfunction and the presence of tumor mass. Survival depends on the stage, location and size of the neoplasm at the time of diagnosis. Despite major surgery, radiotherapy or immunotherapy; malignant melanoma usually has a poor prognosis.ConclusionMelanoma of the female urethra is an extremely uncommon pathology leading to paucity of literature and any definite recommendations regarding management. The histological and immunohistochemical findings can be helpful in making an early and accurate diagnosis of malignant melanoma in the urogenital region.     

The reliability and validity of the measurement of lateral trunk motion in two-dimensional video analysis during unipodal functional screening tests in elite female athletes

ObjectiveTo investigate the reliability and validity of the measurement of lateral trunk motion (LTM) in two-dimensional (2D) video analysis of unipodal functional screening tests.DesignObservational study.SettingResearch laboratory.ParticipantsForty-three injury-free female athletes.Main outcome measuresKnee valgus (KV) and lateral trunk motion (LTM) angles were measured with a standard digital camera during the single leg squat and the single leg drop vertical jump (SLDVJ). Three-dimensional motion analysis was used during the SLDVJ to measure peak external knee abduction moment (pKAM). Intraclass correlation coefficients were calculated to assess the intra- and intertester reliability of the LTM angle. Correlations between 2D angles and pKAM were calculated for the SLDVJ.ResultsExcellent intraclass correlation coefficients for the LTM angle were found within (0.99–1.00) and between testers (0.98–0.99). The sum of KV and LTM was significantly correlated with the pKAM during the SLDVJ for the dominant (r = −0.36; p = 0.017) and non-dominant leg (r = −0.32; p = 0.034), while either angle alone was not.ConclusionsLTM can be measured with excellent intra- and intertester reliability. The combination of KV and LTM was moderately associated with pKAM and thus including LTM may aid assessment of movement quality and injury risk.     

Morphometric analysis of nasal shapes and angles in young adults

IntroductionThe size, angle, shape and type of nose are a signature indicating race, age and sex.ObjectiveDescribe and compare nasal angles, nose types, nostril models, and nasal profiles in young Turkish males and females.MethodsThe study group consisted of university students, 56 males and 59 females. Nasal measurements were obtained from all subjects, using anthropometric methods.ResultsThe nose types of females and males were 78% and 70% narrow nose, respectively. The means of females’ nasofrontal, nasal tip, nasolabial, and alar slope angles were 133.16° ± 8.88°; 77.91° ± 9.80°; 98.91° ± 10.01°, and 80.89° ± 8.33°, respectively. The means of males’ nasofrontal, nasal tip, nasolabial, and alar slope angles were 123.85° ± 13.23°; 82.16° ± 9.98°; 97.91° ± 8.78° and 85.98° ± 8.72°, respectively.ConclusionThe average values of the nose in this population may be used as a guide to plan corrective esthetic–cosmetic surgery and for burn scars of the nose.