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Article in press
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The Right to Abortion in North Macedonia
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Abstract [+]
Equitable access to safe abortion is part of the corpus of human rights. Providing women with access to safe abortion means protection and realization of one of their fundamental human rights. However, around the world, even nowadays, women face not only legal obstacles, but as well stigmatization and conviction against fulfillment of the right to abortion. In North Macedonia there a multiple type of barriers and large inequalities related to the accessibility and availability of reproductive healthcare
services. Women with low socio-economic status are mostly affected. The need for contraception has not been met and reproductive healthcare services are unevenly distributed across the country.
Keywords
Laws; Abortion; Safe; Women’s sexual and reproductive rights; Healthcare services.
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Surrogacy: A Novelty Concept in North Macedonia
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Abstract [+]
Surrogacy has existed since ancient times. Depending on the way of creating an embryo, two types of surrogacy differ, traditional and gestational. When it comes to monetary compensation, two types of surrogacy exist, altruistic and commercialized. A lot of questions come to light such as: Is the altruistic surrogacy a humane gesture for all contracted parties? What if the mother changes her mind? Do the babies born of surrogacy mothers have rights? In North Macedonia, surrogacy was introduced for
the first time in 2014 in the amended Law on Biomedicine and Assisted Fertilization. It was a novelty having in mind that in the Law of 2008 the surrogacy as a practice was outlawed. The amended law applies the term gestational mother and provides a
liberal stance, but many provisions are unclear.
Keywords
Laws; Gestational carrier; Commercialization; Altruism; Child rights; Health consequences.
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What is Measured Matters and What Matters should be Measured
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Determining Factors Associated with Sexual Behavior and Undesired Outcomes in Urban,Young, Adult Female Populations: A Comparative Study
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Abstract [+]
Background
Sexually transmitted infections (STIs) and unwanted pregnancies affect adolescent females annually. This study’s objective was to determine factors leading to disproportionate risk of STIs and unplanned pregnancies utilizing a survey to compare a presumed high-risk urban female population with an age-matched expected low-risk urban female population.
Methods
Adolescent women ages 18-24 were surveyed during 2017 utilizing a qualtrics survey. The survey was given at a local urban university and participating students received research credit. The survey was also given at an urban Emergency Department (ED) using an iPad to participants during their visit. The main outcomes measured were STI and unplanned pregnancy rates.
Results
The ED cohort had higher rates of chlamydia (52% vs 5%), gonorrhea (20% vs 0%), trichomoniasis (30% vs 2%), pregnancy (60% vs 2%), and perceived themselves to be a higher-risk for pregnancy (3.4 vs 1.9) than the University cohort. They were younger the first time they had vaginal sex (15.6 vs 16.3-years), though median age of first oral sex was similar between groups. The ED cohort
was older (21.4-years-old vs 19.1-years-old) and more likely to be non-white (64% vs 6%). There were no differences between the cohorts in regard to educational background and sexual orientation. After adjustments were made, the University cohort was more likely to use condoms and had a lower rate of lifetime partners.
Conclusion
Young, urban females use condoms and birth control less frequently and have more male partners than an age-matched university population.
Keywords
Young; Urban; Females; STI; Sexual behavior.
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Current Issue
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Blighted Ovum: A Case Report
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Presenting in her late twenties, this case report examines a G6P2 patient at 11-weeks gestation that was diagnosed with a blighted ovum, as well as the subsequent outcome and methods of additional management. A blighted ovum refers to a fertilized egg that does not develop, despite the formation of a gestational sac. The most common cause of a blighted ovum is of genetic origin. Trisomies account for most first trimester miscarriages, while consanguineous marriages result in recurrent miscarriages due to a blighted ovum. Additionally, a higher percentage of deoxyribonucleic acid (DNA) damage in sperm carries a higher rate of miscarriage. Nutritional factors that may lead to a blighted ovum include low-levels of copper, prostaglandin E2, and anti-oxidative enzymes. High body mass index (BMI), especially in women with a BMI≥30 kg/m2 has been shown to be linked to a blighted ovum. Globally, it has been shown that a blighted ovum is a serious adverse event related to vaccination against dengue fever.
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Endometrial Cancer in the United States: A Review of the Current Literature
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Background
Endometrial cancer is cancer of, or from, the endometrium of the uterus. According to the ACS, it is estimated that, in the United States, about 61,880 cases of cancers of the body of the uterus will be diagnosed in 2019 alone, while about 12,160 women will die from the disease. There are several types and classifications of endometrial cancer based on basic histological or clinical features, or a combination of both. Most of the current interventions have been focused on early detection especially in high-risk women. This is a review of the epidemiology and risk factors, public health actions, and latest interventions in the management of endometrial cancer in the United States.
Keywords
Endometrial cancer; the United States; Review.
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Hysteroscopy Versus Laparoscopy in the Management of Isthmocele: A Review of the Literature
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Preconception Care: Existing Knowledge in Karnataka, India and Need for an Intervention
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Conception of a Fertile Mindset
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Relationship between Tobacco Smoking and Cervical Cancer
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Previous Issue
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A Pilot Study on the Effect of Massage on Stress among Female Japanese University Students
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Hysteroscopy Versus Laparoscopy in the Management of Isthmocele: A Review of the Literature
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Abstract [+]
Objective
Isthmocele is a pouch defect of the anterior uterine wall, detected at the site of the previous cesarean scar. It can be asymptomatic or cause abnormal uterine bleeding, pelvic discomfort and difficulty conceiving. The main objective of this review is to highlight the hysteroscopic and laparoscopic approaches in the management of this disorder.
Main Findings
During the hysteroscopic approach, the superior and inferior edges or just the superior edge of the defect are resected, removing the fibrotic tissue and allowing renewal of the continuous canal between the cervix and the uterine cavity. Whereas, the laparoscopic approach consists of direct visualization and removal of the defect followed by re-approximation of the myometrium. Both methods lead to significant improvement in symptoms and fertility.
Conclusion
While hysteroscopy is a quick non-morbid procedure that allows concurrent removal of other uterine pathology, laparoscopy is characterized by improved visualization and decreased risk of complications with defects less than 3mm as well as the possible correction of uterine retroversion. Definitely, randomized controlled trials are required in this field for better guidance of the diagnosis and management.
Keywords
Isthmocele; Uterine niche; Cesarean scar defect; Cesarean scar syndrome; Hysteroscopy; Laparoscopy.
Preconception Care: Existing Knowledge in Karnataka, India and Need for an Intervention
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Background
Preconception care improves pregnancy outcomes. The aim of preconception care is to identify situation in which the parents particularly mother or the fetus may be in any additional health risk, and to take steps to minimize the risk before pregnancy is possible. But the concept of preconception care is not as popular as in western countries comparing to India where the number of maternal and newborn morbidity and mortality is high.
Objectives
To assess the level of knowledge among married women on preconception care by structured knowledge questionnaire; determine the effectiveness of informational booklet in terms of gain in knowledge scores; find the association between pre-test knowledge score and selected variables like age, education, occupation, type of family and parity.
Materials and methods
The study was carried out among married women between the age group of 18-35 residing in a selected village of Udupi District, Karnataka, India. An evaluative approach with one group pre-test and post-test design was used. Frequency, percentage, paired t-test and Chi-square test were used to analyze the data.
Results
Majority (55%) of the women had poor knowledge and 45% women had average knowledge in pre-test. In the post-test 57% of women had good knowledge and 43% had average knowledge. Mean difference between the pre-test and post-test knowledge score was 7.92, p<0.001 which showed an improvement in knowledge scores among women. An association was found between educational status and knowledge among women which can be inferred that the level of knowledge is dependent on the level of education.
Conclusion
Majority of the married women had poor knowledge on preconception care and an informational booklet on preconception care is an effective intervention in improving the knowledge.
Keywords
Preconception care; Married women; Information booklet; Knowledge level.
Conception of a Fertile Mindset
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Relationship between Tobacco Smoking and Cervical Cancer
PDF 281.91 KB
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Associate Editors
Steven R. Lindheim, MD, MMM
Professor of Obstetrics and Gynecology Program Director, Reproductive Endocrinology & Infertility Wright State University Boonshoft School of Medicine 128 E. Apple Street, Suite 3811 Dayton, OH 45409, USA
Masafumi Koshiyama, MD, PhD
Professor Department of Womens Health Graduate school of human nursing The university of Shiga Prefecture 522-8533, Japan