European Journal of Medical and Health Sciences

Comparison of Short-Term Outcome between Modified Extraperitoneal Uterosacral Ligament Fixation (MEUSL) and Sacrospinous Ligament Fixation (SSF) for Apical Vaginal Support

Nurul Hikmah Mat Noh, Zalina Nusee, Rozihan Ismail, Riduan Mohd Taha — Fri, 14 Mar 2025 00:00:00 +0100

Prevention of apical prolapse during prolapse surgery is crucial to ensure a good outcome of the surgery. The choice of the best method for apical support remains debatable. This is a study comparing the surgical outcome between modified extraperitoneal uterosacral ligament fixation (MEUSL) and sacrospinous ligament fixation (SSF). This is a case-control study involving 42 patients with stage three and four pelvic organ prolapse (POP) looking into surgical failure, prolapse recurrence, lower urinary tract symptoms (LUTS), and operative complications. The results were analyzed using an independent t-test for normally distributed continuous data and a chi-square test for categorical data. A logistic regression analysis was also performed to predict the outcome. A p-value of <0.05 was deemed significant. MEUSL is less likely to have surgical failure at six months with an OR of 7.25 (p = 0.03, CI 1.24–42.38). There is no difference in terms of lower urinary tract symptoms. Intraoperatively, MEUSL had a significantly higher blood loss as compared to the SSF group. MEUSL is an effective technique for the treatment of apical prolapse as it has a lower risk of surgical failure as compared to SSF. A future study regarding long-term outcomes between the two procedures is recommended to guide surgeons in choosing the best treatment option.

Nurul Hikmah Mat Noh, Zalina Nusee, Rozihan Ismail, Riduan Mohd Taha

Wide Genital Hiatus (GH) and Short Perineal Body (PB) as Risk Factors for Stage III-IV Uterine Prolapse

I. Wayan Megadhana, Kadek Fajar Marta, Dewa Nyoman Krisna Arijaya — Sat, 15 Mar 2025 00:00:00 +0100

Background: Pelvic organ prolapse (POP) is a medical condition characterized by the descent of the uterus and other pelvic organs into the vaginal lumen due to weakened pelvic floor structures, resulting in clinical manifestations such as protrusion through the vaginal canal. The incidence of POP is increasing significantly, particularly among older women. The perineal body and genital hiatus are believed to play roles in the occurrence of POP. The perineal body is a crucial component of the pelvic floor as it supports the vagina and uterus, while a wide genital hiatus is implicated in the progression and association with uterine prolapse. Understanding the dimensions of the perineal body and genital hiatus may provide new insights into the risk factors for POP. This study aims to demonstrate that a wide genital hiatus and short perineal body are risk factors for POP, particularly in cases of stage III-IV uterine prolapse.

Methods: This case-control analytic study assessed the relationship between a wide genital hiatus and a short perineal body with the occurrence of POP. The case group included patients with stage III-IV uterine prolapse, while the control group comprised individuals without prolapse.

Results: A narrow genital hiatus (<5 cm) and a short perineal body (<3 cm) were found to be significant risk factors for POP. A narrow genital hiatus increased the risk of stage III–IV uterine prolapse by fourfold (OR 4.91; 95% CI 3.92–57.28; p <0.004). Similarly, a short perineal body was also identified as a significant risk factor, increasing the risk of uterine prolapse fourfold (OR 4.66; 95% CI 3.75–56.22; p <0.018).

Conclusion: A narrow genital hiatus (<5 cm) and a short perineal body (<3 cm) are significant risk factors for pelvic organ prolapse, increasing the risk by fourfold.

I. Wayan Megadhana, Kadek Fajar Marta, Dewa Nyoman Krisna Arijaya

Hypoxia Inducible Factor-1α in Pulmonary Fibrosis: A Promising Therapeutic Target

Chandru Hanumegowda, Muttanahalli Eraiah Mohan — Sat, 15 Mar 2025 00:00:00 +0100

Pulmonary fibrosis (PF) is a chronic and progressive disease depicted by excessive scarring, which leads to increased tissue stiffness and loss of lung function. The condition is caused by small injuries to the alveolar epithelium, consequential in the formation of fibroblasts, myofibroblasts, and fibroblastic foci areas within the lung tissue. These cells deposit an excessive amount of collagen-rich extracellular matrix (ECM). Hypoxia, along with its transcription factor known as hypoxia-inducible factor-1 alpha (HIF-1α), activates various signaling pathways that can promote to the progression of PF by promoting myofibroblast differentiation and ECM accumulation. HIF-1α plays a significant role in sustaining inflammatory lung micro-injury, stimulating growth factors, and contributing to PF pathogenesis. Therefore, targeting HIF-1α could be a promising approach to inhibit the progression of PF. This review article discusses the various signaling pathways, excessive ECM formation, and related growth factors involved in HIF-1α regulation in PF, as well as explores the potential use of HIF-1α inhibitors to mitigate PF.

Chandru Hanumegowda, Muttanahalli Eraiah Mohan

Breast Cancer Characteristics in Young Women Under 50 Years Old in Mankweng Hospital, South Africa

Mirza Mohamod Zahir Uddin Bhuiyan — Tue, 11 Mar 2025 00:00:00 +0100

Background: Breast cancer is a diverse disorder, commonly occurs in elderly women in Europe and America. However, in Africa, it happens often among younger women. Main aim of the study is to have better understand the characteristics of breast cancer in women under 50 years and to identify any differences exist between HIV positive and negative groups of breast cancer patients.

Method: Retrospective descriptive quantitative study intended to analyse the profile of women under 50 years old with breast cancers who attended Breast Oncology Clinic, Mankweng Hospital from July 2020 to December 2021.

Results: Total 109 breast cancer patients evaluated. Mean age in HIV negative 40.6 and HIV positive 39 years. HIV status: HIV Positive 28(25.7%). HIV Negative 81(74.3%). HIV positive group: Molecular subtype: Luminal A:5(24%), Luminal B:8(38%), HER2+ overexpression:3(14%), Triple negative:5(24%). Stage: Early stage 6(21%), late stage 22(79%). HIV negative group: Molecular subtype: Luminal A:16(22%), Luminal B:41(58%), HER2+ overexpression:7(10%), Triple negative:7(10%). Stage: Early stage 16(20%), late stage 65(80%).

Conclusion: Majority of breast cancer patients presented in advance stage in both HIV positive and negative group. Mean age of HIV positive slightly younger than HIV negative (39-year vs 40.6 years). Triple negative molecular subtype was proportionately more in HIV-positive group in compared to HIV-negative patients. Initiative of Routine breast cancer screening should take place on this population of women under 40-year age.

Mirza Mohamod Zahir Uddin Bhuiyan

Prevalence and Risk Factors for Postpartum Depression in eThekwini District of KwaZulu-Natal Province of South Africa

Akm Monjurul Hoque, Maariyah Hoque, Rafiul Hoque, Somaya Buckus — Mon, 17 Feb 2025 00:00:00 +0100

Despite being a global public health issue, postpartum depression (PPD) is comparatively more common in underdeveloped nations, notably those in Sub-Saharan Africa. In South Africa (SA), primary healthcare facilities do not regularly screen for PPD, despite reports that it compromises the health of mothers and children. Finding the prevalence of PPD and its contributing factors in a sample of clinic attendees in a subdistrict of eThekwini, SA was the aim of this study. A sample of 399 women in a health facility participated in a cross-sectional, quantitative study. Information on socio-demographics and obstetric history was gathered using a self-administered questionnaire. Data on depression symptoms were gathered using the Edinburgh Postnatal Depression Scale (EPDS). Women who gave birth to infants after ten days were asked to complete the (EPDS) questionnaire. A score of 13 out of a possible 30 was the cut-off point for the EPDS. Most of the women (60.9%) had scores of 13 or higher, indicating symptoms of PPD. Mode of delivery was significantly linked to PPD on logistic regression (OR = 2.287, p-value 0.007, 95% CI of 1.25 to 4.16), with Caesarean section deliveries being associated with a higher risk of depressed symptoms than normal vaginal delivery. Full-time working women were shown to be protective, as evidenced by their low OR of 0.45 (p = 0.02 and 95% CI of 0.23 to 0.88). The findings support the necessity of routine screening for PPD symptoms in a Primary Health Care facility in SA as they demonstrated the larger percentage of women who suffer from PPD yet go undiagnosed and untreated.

Akm Monjurul Hoque, Maariyah Hoque, Rafiul Hoque, Somaya Buckus