Factors associated with Genito-pelvic pain/penetration disorder in women: A review article

Globally, the sexual responses of genito-pelvic pain/penetration disorder-affected women is poorly understood. This deficit is due, in part, to these women being prone to incorrect pathologic rankings in intercourse-related questionnaires, thereby lowering the dependability of results. Although patients with genito-pelvic pain/penetration disorder display sexual intent, they typically avoid sexual circumstances in which penetration is involved. Gynaecological examinations are also frequently avoided, despite medical advice. The factors linked to genito-pelvic pain/penetration disorder identified in this review are; age, educational status, financial status, different relationship patterns, negative cognition, decreased sexual desire, no use of artificial lubricants, insufficient sexual arousal, history of sexual abuse, contraceptive use, and other pelvic related medical conditions. Women\u27s autonomy over their reproductive choices, as well as widespread access to sexual and reproductive health care, are crucial not just for attaining sustainable development, but also for ensuring women\u27s empowerment. Hence, holistically analysing and managing these components of women\u27s sexual health is vital

Study of nonlinear thermal convection of ternary nanofluid within Darcy-Brinkman porous structure with time dependent heat source/sink

The dynamical behaviour and thermal transportation feature of mixed convective Casson bi-phasic flows of water-based ternary Hybrid nanofluids with different shapes are examined numerically in a Darcy- Brinkman medium bounded by a vertical elongating slender concave-shaped surface. The mathematical framework of the present flow model is developed properly by adopting the single-phase approach, whose solid phase is selected to be metallic or metallic oxide nanoparticles. Besides, the influence of thermal radiation is taken into consideration in the presence of an internal variable heat generation. A set of feasible similarity transformations are applied for the conversion of the governing PDEs into a nonlinear differential structure of coupled ODEs. An advanced differential quadrature algorithm is employed herein to acquire accurate numerical solutions for momentum and energy equations. Results of the conducted parametric study are explained and revealed in graphs using bvp5c in MATLAB to solve the governing system. The solution with three mixture compositions is provided (Type-I and Type-II). Al2O3 (Platelet), GNT (Cylindrical), and CNTs (Spherical), Type-II mixture of copper (Cylindrical), silver (Platelet), and copper oxide (Spherical). In comparison to Type-I ternary combination Type-II ternary mixtures is lesser in terms of the temperature distribution. The skin friction coefficient is more in Type-1 compared to Type-2

Swimming dynamics of a micro-organism in a couple stress fluid : a rheological model of embryological hydrodynamic propulsion

Mathematical simulations of embryological fluid dynamics are fundamental to improving clinical understanding of the intricate mechanisms underlying sperm locomotion. The strongly rheological nature of reproductive fluids has been established for a number of decades. Complimentary to clinical studies, mathematical models of reproductive hydrodynamics provide a deeper understanding of the intricate mechanisms involved in spermatozoa locomotion which can be of immense benefit in clarifying fertilization processes. Although numerous non-Newtonian studies of spermatozoa swimming dynamics in non-Newtonian media have been communicated, very few have addressed the micro-structural characteristics of embryological media. This family of micro-continuum models include Eringen’s micro-stretch theory, Eringen’s microfluid and micropolar constructs and V.K. Stokes’ couple-stress fluid model, all developed in the 1960s. In the present paper we implement the last of these models to examine the problem of micro-organism (spermatozoa) swimming at low Reynolds number in a homogenous embryological fluid medium with couple stress effects. The micro-organism is modeled as with Taylor’s classical approach, as an infinite flexible sheet on whose surface waves of lateral displacement are propagated. The swimming speed of the sheet and rate of work done by it are determined as function of the parameters of orbit and the couple stress fluid parameter (α). The perturbation solutions are validated with a Nakamura finite difference algorithm. The perturbation solutions reveal that the normal beat pattern is effective for both couple stress and Newtonian fluids only when the amplitude of stretching wave is small. The swimming speed is observed to decrease with couple stress fluid parameter tending to its Newtonian limit as alpha tends to infinity. However the rate of work done by the sheet decreases with α and approaches asymptotically to its Newtonian value. The present solutions also provide a good benchmark for more advanced numerical simulations of micro-organism swimming in couple-stress rheological biofluids

Patients' satisfaction and opinions of their experiences during admission in a tertiary care hospital in Pakistan – a cross sectional study

<p>Abstract</p> <p>Background</p> <p>It is often felt that developing countries need to improve their quality of healthcare provision. This study hopes to generate data that can help managers and doctors to improve the standard of care they provide in line with the wishes of the patients.</p> <p>Methods</p> <p>It was a cross sectional study carried out at a major tertiary care hospital of Karachi. Patients between the ages of 18 and 80 years admitted to the hospital for at least one day were included. Patients in the maternity, psychiatry and chemotherapy wards and those in the ICU/CCU were excluded. A pretested, peer reviewed translation of a validated patient satisfaction scale developed by the Picker Institute of Europe was administered.</p> <p>Results</p> <p>A total of 173 patients (response rate: 78.6 %) filled the questionnaire. Patient satisfaction was at levels comparable to European surveys for most aspects of hospital care. However, nearly half the patients (48%) felt they had to wait too long to get a bed in the hospital after presenting to the ER. 68.6% of the patients said that they were never asked for views on the quality of care provided. 20% of the patients did not find anyone in the staff to talk to about their worries and fears while 27.6% felt that they were given emotional support to only some extent. Up to one third of the patients said they were not provided enough information regarding their operative procedures beforehand.</p> <p>Conclusion</p> <p>Although several components of patient care equal the quality levels of the west, many sections require considerable improvement in order to improve health care provision. The healthcare team needs to get more involved with the patients, providing them greater support and keeping them informed and involved with their medical treatment. Efforts should be made to get regular feedback from the patients.</p

Gabapentin for the hemodynamic response to intubation: systematic review and meta-analysis

Purpose Endotracheal intubation is the gold standard for securing the airway before surgery. Nevertheless, this procedure can produce an activation of the sympathetic nervous system and result in a hemodynamic response which, in high-risk patients, may lead to cardiovascular instability and myocardial ischemia. The aim of this review was to evaluate whether gabapentin can attenuate this response and whether such an attenuation could translate into reduced myocardial ischemia and mortality. Source We searched MEDLINE®, EMBASE™, CINAHL, AMED, and unpublished clinical trial databases for randomized-controlled trials that compared gabapentin with control, fentanyl, clonidine, or beta blockers for attenuating the hemodynamic response to intubation. Primary outcomes were mortality, myocardial infarction, and myocardial ischemia. Secondary outcomes were hemodynamic changes following intubation. Principal findings We included 29 randomized trials with only two studies at low risk of bias. No data were provided for the primary outcomes and no studies included high-risk patients. The use of gabapentin resulted in attenuation in the rise in mean arterial blood pressure [mean difference (MD), −12 mmHg; 95% confidence interval (CI), −17 to −8] and heart rate (MD, −8 beats·min−1; 95% CI, −11 to −5) one minute after intubation. Gabapentin also reduced the risk of hypertension or tachycardia requiring treatment (risk ratio, 0.15; 95% CI, 0.05 to 0.48). Data were limited on adverse hemodynamic events such as bradycardia and hypotension. Conclusion It remains unknown whether gabapentin improves clinically relevant outcomes such as death and myocardial infarction since studies failed to report on these. Nevertheless, gabapentin attenuated increases in heart rate and blood pressure following intubation when compared with the control group. Even so, the studies included in this review were at potential risk of bias. Moreover, they did not include high-risk patients or report adverse hemodynamic outcomes. Future studies are required to address these limitations

Early neonatal vitamin A supplementation and infant mortality: an individual participant data meta-analysis of randomised controlled trials

Background Biannual vitamin A supplementation is a well-established survival tool for preschool children 6 months and older in vitamin A deficient populations but this schedule misses the opportunity to intervene on most young infant deaths. Randomised trials of neonatal vitamin A supplementation (NVAS) in the first few days of life to assess its impact on under 6-month mortality in low/middle-income countries have had varying results. Methods Investigators of 11 published randomised placebo-controlled NVAS trials (n=163 567 children) reanalysed their data according to an agreed plan and pooled the primary outcomes of mortality from supplementation through 6 and 12 months of age using random effects models and meta-regression. One investigator withdrew but allowed use of the data. Findings Overall there was no effect of NVAS on infant survival through 6 (risk ratio (RR) 0.97; 95% CI 0.89 to 1.06) or 12 months of age (RR 1.00; 95% CI 0.93 to 1.08) but results varied by study population characteristics. NVAS significantly reduced 6-month mortality among the trials conducted in Southern Asia (RR 0.87; 95% CI 0.77 to 0.98), in contexts with moderate or severe vitamin A deficiency (defined as 10% or higher proportion of women with serum retinol 32% mothers had no schooling (RR 0.88; 95% CI 0.80 to 0.96). NVAS did not reduce mortality in the first 6 months of life in trials conducted in Africa, in contexts characterised by a low prevalence of vitamin A deficiency, lower rates of infant mortality and where maternal education was more prevalent. There was a suggestion of increased infant mortality in trials conducted in Africa (RR 1.07; 95% CI 1.00 to 1.15). Individual-level characteristics such as sex, birth weight, gestational age and size, age at dosing, parity, time of breast feeding initiation, maternal education and maternal vitamin A supplementation did not modify the impact of NVAS. Conclusion NVAS reduced infant mortality in South Asia, in contexts where the prevalence of maternal vitamin A deficiency is moderate to severe and early infant mortality is high; but it had no beneficial effect on infant survival in Africa, in contexts where the prevalence of maternal vitamin A deficiency is lower, early infant mortality is low

Introductory programming: a systematic literature review

As computing becomes a mainstream discipline embedded in the school curriculum and acts as an enabler for an increasing range of academic disciplines in higher education, the literature on introductory programming is growing. Although there have been several reviews that focus on specific aspects of introductory programming, there has been no broad overview of the literature exploring recent trends across the breadth of introductory programming. This paper is the report of an ITiCSE working group that conducted a systematic review in order to gain an overview of the introductory programming literature. Partitioning the literature into papers addressing the student, teaching, the curriculum, and assessment, we explore trends, highlight advances in knowledge over the past 15 years, and indicate possible directions for future research