Help-seeking behaviors for female sexual dysfunction: a cross sectional study from Iran

Background  

Female sexual dysfunctions (FSD) are prevalent multifactor problems that in general remain misdiagnosed in primary health care. This population-based study investigated help-seeking behaviors among women with FSD in Iran.     

Absorption of andrographolides from Andrographis paniculata and its effect on CCl4-induced oxidative stress in rats

A simple and validated high-performance liquid chromatography (HPLC) method with UV detection has been used to determine the content of andrographolide (AP) and 14-deoxy-11,12-didehydroandrographolide (DIAP) in rat plasma after oral dose of methanol extract (1 g/kg body weight) of Andrographis paniculata leaf. An increase in plasma concentration of AP and DIAP was observed from 30 min to 3 h after oral administration of the extract. The maximum plasma concentrations of AP and DIAP were 1.42 ± 0.09 μg/ml and 1.31 ± 0.04 μg/ml, respectively. Fourteen days oral treatment of rats with the methanol extract (1 g/kg body weight) followed by CCl₄ administration preserved catalase (CAT), and superoxide dismutase (SOD) activities in erythrocytes, whereas plasma lipid peroxidation, alanine transaminase (ALT) and aspartate transaminase (AST) activities were restored to values comparable with control values. Treatment of rats with CCl₄ did not showed significant alteration (p > 0.05) in plasma total antioxidant status (TAS) as compare to values of control group.     

Reduced hemoglobin on day of peripheral blood progenitor cell collection is associated with low graft content of vascular progenitors and increased toxicity after autologous hematopoietic stem cell transplantation

BACKGROUND: Tissue damage after hematopoietic stem cell transplantation (HSCT) occurs as a result of high‐dose chemotherapy and radiation. The aim was to determine the importance of pretransplant anemia on toxicity and red blood cell (RBC) transfusion requirements after autologous HSCT. STUDY DESIGN AND METHODS: A total of 350 patients undergoing autologous HSCT were included in the analysis. Patient factors and pretransplant laboratory values of possible relevance were assessed in multivariate regression analysis. RESULTS: Reduced hemoglobin (Hb) on the first day of peripheral blood progenitor cell (PBPC) collection was significantly associated with increased organ toxicity after HSCT, as measured by the Seattle criteria. Lower Hb levels at baseline before transplantation, but not at PBPC collection, were significantly associated with increased RBC transfusion requirements. In a second cohort of 28 patients, higher Hb levels on the day of PBPC collection were significantly associated with increased levels of endothelial‐like vascular progenitor cells in PBPC grafts. CONCLUSION: Our observations suggest that higher Hb levels on the day of PBPC collection may be a marker of reduced toxicity associated with HSCT and increased vascular progenitors in PBPC collections. Further, baseline anemia before transplant may reflect an unfavorable hematopoietic microenvironment that leads to increased RBC transfusion requirements.     

Sonographic gallbladder wall thickness measurement and the prediction of esophageal varices among cirrhotics

Acute variceal bleeding in patients with liver cirrhosis and portal hypertension (PHT) is the most serious emergency complication among those patients and could have catastrophic ‎outcomes if not timely managed. ‎Early screening by esophago-gastro-duodenoscopy (EGD) for the presence of esophageal varices (EVs) is ‎‎currently recommended by the practice guidelines for all cirrhotic patients. Meanwhile, EGD is not readily accepted or preferred by many patients. The literature is rich in ‎studies to investigate and validate ‎ non-invasive markers of EVs prediction aiming at reducing the unneeded endoscopic procedures. Gallbladder (GB) wall thickness (GBWT) ‎measurement has been found promising in many published research ‎articles. We aim to highlight the validity of sonographic GBWT measurement in the ‎prediction of EVs based on the available evidence.‎ We searched databases including Cochrane library, PubMed, Web of Science and many others for relevant articles. GBWT is associated with the presence of EVs in cirrhotic patients with PHT of different etiologies. The cut-off of GBWT that can predict the presence of EVs varied in the literature and ranges from 3.1 mm to 4.35 mm with variable sensitivities of 46%-90.9% and lower cut-offs in viral cirrhosis compared to non-viral, however GBWT > 4 mm in many studies is associated with acceptable sensitivity up to 90%. Furthermore, a relation was also noticed with the degree of varices and portal hypertensive gastropathy. Among cirrhotics, GBWT > 3.5 mm predicts the presence of advanced (grade III-IV) EVs with a sensitivity of 45%, the sensitivity increased to 92% when a cut-off ≥ 3.95 mm was used in another cohort. Analysis of these results should carefully be revised in the context of ascites, hypoalbuminemia and other intrinsic GB diseases among cirrhotic patients. The sensitivity for prediction of EVs improved upon combining GBWT measurement with other non-invasive predictors, e.g., platelets/GBWT.     

Genetic and molecular factors in drug-induced liver injury: a review

The diagnosis of drug-induced liver injury (DILI) is challenging and based on complex diagnostic criteria. DILI falls into two main categories i) intrinsic "dose-dependent" Type A reactions ii) "idiosyncratic" or Type B reactions (which are usually not predictable). Idiosyncratic reactions can be immunoallergic (hypersensitivity), or metabolic, although overlap between categories can occur. The aim of this review is to summarise the general view of underlying mechanisms in DILI and to highlight individual risk factors for developing hepatotoxicity. Polymorphisms of bioactivation/toxification pathways through CYP450 enzymes (Phase I), detoxification reactions (Phase II) and excretion/transport (Phase III) are explored together with immunological factors that might determine DILI. The importance of establishing a multidisciplinary and multi-centric network to promote the understanding and research in hepatotoxicity is underlined. Challenges such as genetic analyses for association studies and whole genome studies, pharmacogenetic testing and future approaches to study DILI are considered. Knowledge regarding these operational mechanisms could provide further insight for the prospective identification of susceptible patients at risk of developing drug-induced hepatotoxicity.     

Antenatal care services utilization and factors associated in Jimma Town (south west Ethiopia)

BACKGROUND: Antenatal care is potentially one of the most effective health intervention for preventing maternal morbidity and mortality particularly in places where the general health status of women is poor. OBJECTIVE: to assess antenatal care service utilization and factors associated with antenatal care non attendance. METHODS: A community based cross-sectional study was conducted among pregnant women from January 26 to February 06, 2006 in Jimma Town, Jimma zonal administration south west Ethiopia. Structured interviewer administered questionnaire was used for data collection. The data collected on study variables were tabulated in frequency tables and significance of association between variables was tested using chi2--test of significance. RESULT: A total of 360 pregnant women were enrolled in the study. The study, revealed that about 76.7% of the women have attended antenatal care and 23.3% have not attended at all. Literacy status, income, Gravidity, Religion and occupation showed statistically significant association (P < 0.05) with utilization of antenatal care. But marital status, Ethnicity and parity showed no statistically significant association (P > 0.05) with antenatal care utilization. The study showed that about 42.8% of the attendants have made their first antenatal visit in the 3rd trimester of pregnancy. Out of the total only 6.5% the studied women had the recommended four visits. Women in the age group 15-24 are more likely to attend ANC 2.75 times larger than that of women in the age group 25-34 (OR = 2.74, 95% CI: 1.37, 4.38). Similarly others (students and farmers) are about four times likely to attend ANC than House wife's (OR = 4.06. 95% CI: 1.50, 11.40). CONCLUSION: Even if there was high antenatal care utilization the pattern of follow up was in appropriate in most cases as the majority of pregnant women started using the service around 7-9 months with decreasing number in the 1st and 2nd trimester of pregnancy. Effective behavior change communication is needed to bring about proper antenatal care services utilization. Improving the quality of the service delivery and effective monitoring at, evaluation is critically important for improving the utilization of antenatal care services.