Efficacy, Practicality, Intimal Health, and Sustainability of Menstrual Cups use among Undergraduate Medical Students: a cross-sectional study.

Introduction: Women need effective, safe, and affordable menstrual hygiene products. The menstrual cup is an alternative method. Objective: To identify the prevalence of menstrual cups among the medical students and the independent variables associated with their use adherence. Methods: a cross-sectional study with an online survey applied to regularly matriculate women from FEMA Medical School in January 2021. Results: Of 277 women, 164 participated. The mean age was 22.26 (SD 3.21). 136 preferred external pads, 60 internal pads, 28 menstrual cups, and 11 did not use. Using a 1-10 scale, price, efficacy, sustain, practice, intimal health status, hygiene, and importance of internal genitalia integrity were questioned. 37 (22,56%) women related the use of menstrual cups in the last year. Using any method to reduce menstruation had an odds ratio adjusted of 0.310 (95%CI 0.122-0.787). Concern about the environmental biodegradation had ORadj of 6.369 (95%CI 1.372-29.562); Intimal Health, ORadj of 1.996 (95%CI 1.183-3.368); internal genital integrity, ORadj of 0.824 (95%CI 0.682-0.995), for menstrual cups use. Conclusion: women using a method to reduce their menstrual flow, concerning about biodegradation, concerning with intimal health, and with no concerns about manipulating their genitalia were significant independent factors for the adherence of menstrual cups. Keywords: Menstrual Hygiene Products; Feminine Hygiene Products; Menstrual cup; Education, Medical, Undergraduate

External endometriosis, effectiveness of laparoscopic surgery

In this article, the analysis of laparoscopic curing 64 patients with external endometriosis is presented. For the assessment of internal genitalia state in the late after-operational period in 41 female patients one performed second-look laparoscopy when that disease recidivating has been revealed in 36% observations. It was marked that the anti-recidive therapy in the after-operational period allows decrease the recidivating quantity from 46.8% (intervention only) upto 25% (combined cure). The authors elaborated and formulated indications for performing second- look laparoscopy in female patients with endometriosis.

Molecular taxonomy and description of a new species of Limnodrilus (Naididae, Clitellata, Annelida) in China

The freshwater annelid worm genus Limnodrilus, including the widely distributed L. claparedianus Ratzel, 1868, is common in Chinese freshwater ecosystems. One species, previously recognized as morphologically intermediate between L. claparedianus and the North American taxon L. cervix Brinkhurst, 1963, is here described as a new species, L. paraclaparedianus Zhou & Cui n. sp., using both molecular and traditional taxonomy. Comparisons of sequences of the Cytochrome Oxidase subunit I (COI) mtDNA in a sample of Limnodrilus species showed that the distances between species were generally higher than the divergences within them. Phylogenetic analysis of COI as well as 16S mtDNA and Internal Transcribed Spacer 2 (ITS2) nDNA confirmed that the new species is an independent lineage. Moreover, morphological differences in the prostomium, characteristics of the chaetae and internal genitalia support the separation of the species.

Up-to-Date Clinical and Biochemical Workup of the Child and the Adolescent with a Suspected Disorder of Sex Development

Background: The suspicion of a disorder of sex development (DSD) often arises at birth, when the newborn presents with ambiguous genitalia, or even during prenatal ultrasound assessments. Less frequently, the aspect of the external genitalia is typically female or male, and the diagnosis of DSD may be delayed until a karyotype is performed for another health issue, or until pubertal age when a girl presents with absence of thelarche and/or menarche or a boy consults for gynaecomastia and/or small testes. Summary: In this review, we provide a practical, updated approach to clinical and hormonal laboratory workup of the newborn, the child, and the adolescent with a suspected DSD. We focus on how to specifically address the diagnostic approach according to the age and presentation. Key Message: We particularly highlight the importance of a detailed anatomic description of the external and internal genitalia, adequate imaging studies or surgical exploration, the assessment of reproductive hormone levels – especially testosterone, anti-Müllerian hormone, 17-hydroxyprogesterone, and gonadotropins – and karyotyping.

Pubertal development in 46,XY patients with NR5A1 mutations

Purpose Mutations in the NR5A1 gene, encoding the transcription factor Steroidogenic Factor-1, are associated with a highly variable genital phenotype in patients with 46,XY differences of sex development (DSD). Our objective was to analyse the pubertal development in 46,XY patients with NR5A1 mutations by the evaluation of longitudinal clinical and hormonal data at pubertal age. Methods We retrospectively studied a cohort of 10 46,XY patients with a verified NR5A1 mutation and describe clinical features including the external and internal genitalia, testicular volumes, Tanner stages and serum concentrations of LH, FSH, testosterone, AMH, and inhibin B during pubertal transition. Results Patients who first presented in early infancy due to ambiguous genitalia showed spontaneous virilization at pubertal age accompanied by a significant testosterone production despite the decreased gonadal volume. Patients with apparently female external genitalia at birth presented later in life at pubertal age either with signs of virilization and/or absence of female puberty. Testosterone levels were highly variable in this group. In all patients, gonadotropins were constantly in the upper reference range or elevated. Neither the extent of virilization at birth nor the presence of Müllerian structures reliably correlated with the degree of virilization during puberty. Conclusion Patients with NR5A1 mutations regardless of phenotype at birth may demonstrate considerable virilization at puberty. Therefore, it is important to consider sex assignment carefully and avoid irreversible procedures during infancy.

Definitions of two species groups of Stenothemus Bourgeois (Coleoptera, Cantharidae), with descriptions of three new species from China

Two new species-groups of the cantharid genus Stenothmeus Bourgeois are defined, S. laterophysus species-group and S. notaticollis species-group. The S. laterophysus species-group is composed of two species, including S. laterophysus Švihla, 2004 and a new species, S. nigritibius Y. Yang et H. Liu, sp. nov., and characterized by the pitch black elytra and bicolored legs, the subrounded pronotum with widely rounded anterior angles and projecting posterior angles, male genitalia with slender ventral processes of parameres which are slightly bent inwards at apical parts, laterophyses tilting ventrally at an angle of more than 45° with dorsal plates, compressed at apical parts, as well as the slender spermathecal duct, extremely long spermatheca and diverticulum. The S. notaticollis species-group consists of five species, including S. notaticollis (Gorham, 1895), S. bourgeoisi Wittmer, 1974, S. tamil Švihla, 2011 and two new species, S. parameratus Y. Yang et S. Ge, sp. nov. and S. acutiapicis Y. Yang et X. Yang, sp. nov., which is differentiated from the S. laterophysus species-group by the more variable body coloration, elytra pitch black or black brown or pale-yellow, male genitalia with thick or flattened ventral processes of parameres which are diverging apically, laterophyses parallel to dorsal plates, expanded at apices, as well as the stout spermathecal duct, moderately long spermatheca and diverticulum. The above species are illustrated with photographs of habitus, male genitalia, abdominal sternites and internal genitalia of female. A key for the identification of these species is provided and a distribution map is presented.

Characteristics of Obstetric Patients at RSU Cut Meutia North Aceh During the 2020 Covid-19 Pandemic

Obstetrics is a medical science that specializes in the study of pregnancy and childbirth. This includes the process before during and after a woman gives birth. The scope of obstetrics includes, antepartum bleeding, postpartum hemorrhage, preterm pregnancy problems, complications in vaginal delivery, pregnancy with gastrointestinal disorders, hypertension in pregnancy, bleeding in the external and internal genitalia, and other diseases. Abortion was the most common disease group in this study, which was 71.4%. Abortion is the termination of pregnancy before the fetus can live outside the uterus at the age of <20 weeks or weight <500 grams. The incidence of abortion is roughly estimated to be 15-20% and 80% occur in the first trimester. This research is a descriptive study with the research design used is a cross-sectional study conducted in the Obstetrics Inpatient Room at the Cut Meutia Hospital, North Aceh. The study was carried out in June 2021 with a population and sample of all patients in the Obstetric Inpatient Room at the Cut Meutia Hospital, North Aceh in 2020. The variables of this study were types of obstetric diseases based on the size group. Univariate analysis was used to describe the characteristics of the types of obstetric diseases that existed in the Obstetric Inpatient Room at the Cut Meutia Hospital North Aceh in 2020. The patients treated in the Obstetric Inpatient Room at the Cut Meutia Hospital North Aceh in 2020 were 244 patients. The percentage of antepartum bleeding was the highest group of diseases in the Obstetrics Inpatient Room at RSU Cut Meutia in 2020, while post-partum bleeding and bleeding in the external and internal genitalia were the least group of diseases. The second most common disease in the Cut Meutia General Hospital in 2020 was hyperemesis gravidarum, then premature rupture of membranes, followed by retained placenta, blighted ovum and preeclampsia.

Comparative aspects of the internal reproductive system of males in species of Melolonthinae, Dynastinae, and Rutelinae (Coleoptera: Scarabaeoidea) from Mexico

The anatomy of the internal male reproductive systems of 12 species of Melolonthinae (Phyllophaga, Chlaenobia, Macrodactylus, Isonychus), six species of Dynastinae (Cyclocephala), and three species of Rutelinae (Paranomala) (Coleoptera, Scarabaeoidea) of Mexico are described. A total of 350 male specimens representing 21 species were collected. From each species, the reproductive systems were obtained by micro-dissection, placed in a liquid fixative, stained, and drawn to scale. The internal genitalia of each species was described and compared among the species examined. The reproductive system of the Melolonthinae species is comprised of two testicles, each with six follicles, two deferent ducts, two accessory glands, two glandular ducts, an ejaculatory duct, and the aedeagus (not described for any of the species examined). The number of testicular follicles per testicle is as reported in different species of other Scarabaeoidea subfamilies. The length of the accessory glands and the ejaculatory duct varies in the species studied. The ejaculatory bulb is present in all of the species of Dynastinae and Rutelinae examined but in only three species of Melolonthinae.

Studies on the Stenothemus harmandi species-group (Coleoptera, Cantharidae), with descriptions of two new species from China

The Stenothemus harmandi species-group has 10 species at present. They are S. harmandi (Bourgeois, 1902) (located in N. India, Nepal); S. holosericus Švihla, 2005, S. orbiculatus Švihla, 2005 and S. subnitidus Švihla, 2005 (N. India); S. distortirudis Y. Yang &amp; X. Yang, 2014, S. laticollis Y. Yang &amp; X. Yang, 2014, S. parallelus Y. Yang &amp; X. Yang, 2014 and S. septimus Y. Yang &amp; X. Yang, 2014 (China: Xizang); S. fugongensis Y. Yang &amp; X. Yang, 2014 (China: Yunnan) and S. leishanensis Y. Yang &amp; X. Yang, 2014 (China: Guizhou). In the present study, two previously-known species are classified into this species-group, S. dentatus Wittmer, 1974 and S. alexandrae Švihla, 2004, of which the latter as a subspecies of the former is upgraded to the specific level and another two new species are discovered and described. Two new species of the Stenothemus harmandi species-group are described, S. acuticollis sp. n. (China: Yunnan) and S. nigricolor sp. n. (China: Xizang), which are illustrated with habitus photos and aedeagi of males, abdominal sternites VIII and internal genitalia of females. S. alexandrae Švihla, 2004 stat. n. is upgraded from a subspecies of S. dentatus Wittmer, 1974 and the two species are classified into this species-group. Characters of the female reproductive system are described for the first time for the following species: S. distortirudis Y. Yang &amp; X. Yang, 2014; S. laticollis Y. Yang &amp; X. Yang, 2014; S. leishanensis Y. Yang &amp; X. Yang, 2014; S. orbiculatus Švihla, 2005; S. septimus Y. Yang &amp; X. Yang, 2014 and S. subnitidus Švihla, 2005. Meanwhile, some additional distribution information is added for previously-described species. A key for the identification of all species is updated.