WorldWideScience

Sample records for circumcision female

  1. The International Student: Female Circumcision Issues.

    Science.gov (United States)

    Bengston, Barbara; Baldwin, Cynthia

    1993-01-01

    Describes the process and practice of female circumcision, the impact it may have on circumcised female international college students, and some counseling strategies for the college counselor who works with this population. Explains variety of reasons for performing female circumcision, different types of female circumcisions, and psychological…

  2. Moi bans female circumcision.

    Science.gov (United States)

    Nakalema, R

    1990-06-01

    A recent survey by the Inter-African Committee for Traditional Practices Affecting the Health of Women and Children found that 75-85 million women in Africa have undergone some form of female genital mutilation (FGM). FGM has long been practiced in Kenya. The ethnic groups which practice it, including the Kikuyu, Kamba, Kisii, Kalenjin, Maasai, and people of Somali origin, have a death rate of 170/1000 of their female populations. Approximately half of these deaths are the result of FGM, a practice which also contributes to the poor health of mutilated women. The adverse health consequences of FGM have led Kenya's President Daniel arap Moi to ban the practice in his country. In announcing the ban, President Moi advised Kenyans to discontinue cultural practices and customs which have no place in modern society and which will otherwise retard development. A number of prominent Kenyans have come forth in support of Moi's move. PMID:12293761

  3. Circumcision

    Science.gov (United States)

    ... and discomfort. previous continue Caring for a Circumcised Penis Following circumcision, it is important to keep the ... easily treated. previous continue Caring for an Uncircumcised Penis As with a penis that's circumcised, an uncircumcised ...

  4. Circumcision

    Directory of Open Access Journals (Sweden)

    Puri Poonam

    2010-01-01

    Full Text Available Circumcision is one of the oldest and the most controversial surgical procedures performed worldwide and is almost universal among Muslim and Jewish men. Most medical institutions in various countries agree that although there may be health benefits, there is no medical justification for routine circumcision in neonates or children. It should be performed only for established medical reasons and should not be universally recommended. There are modern techniques that provide safer, simpler, quicker, and cheaper alternatives to the traditional means of circumcision with good functional and cosmetic results. Female genital mutilation (FGM includes procedure that alters or injures female genital organs for nonmedical reasons. Various degrees of FGM are prevalent, the most mutilating one being infibulation. There are numerous gynecologic and obstetrical complications with infibulation. FGM also plays a significant role in facilitating the transmission of HIV infection through numerous mechanisms. Health care providers have an important role to play in the eradication of this practice. Increased professional and public awareness about such a practice is required.

  5. Circumcision

    Science.gov (United States)

    Circumcision is a surgical procedure to remove the foreskin, the skin that covers the tip of the ... AAP), there are medical benefits and risks to circumcision. Possible benefits include a lower risk of urinary ...

  6. Exploration of pathways related to the decline in female circumcision in Egypt

    OpenAIRE

    Modrek, Sepideh; Liu, Jenny X

    2013-01-01

    Abstract Background There has been a large decline in female genital circumcision (FGC) in Egypt in recent decades. Understanding how this change has occurred so rapidly has been an area of particular interest to policymakers and public health officials alike who seek to further discourage the practice elsewhere. Methods We document the trends in this decline in the newest cohorts of young girls and explore th...

  7. Female genital mutilation and male circumcision: toward an autonomy-based ethical framework

    OpenAIRE

    Earp, Brian

    2015-01-01

    Brian D Earp Department of History and Philosophy of Science, University of Cambridge, Cambridge, UK Abstract: The non-therapeutic alteration of children’s genitals is typically discussed in two separate ethical discourses: one for girls, in which such alteration is conventionally referred to as “female genital mutilation” (or FGM), and one for boys, in which it is conventionally referred to as “male circumcision.” The former is typically reg...

  8. To mutilate in the name of Jehovah or Allah: legitimization of male and female circumcision.

    Science.gov (United States)

    Abu-Sahlieh, S A

    1994-01-01

    Female circumcison is practised in Sudan, Somalia, Egypt and a few other Arab and Muslim countries. It has triggered a passionate public debate in the West. This debate has found somewhat of an echo in the Arab and Muslim world, but some Muslim religious circles such as Al-Azhar (Egypt), the most important Islamic centre in the world, try to justify it on the basis of sunnah (that is, to conform with the tradition of the prophet Mohammed). Male circumcision is practised by all Muslims and Jews and also by some Christians in Egypt, in the United States and Canada). For different reasons, the debate on this topic is still taboo in Western and in Arab and Muslim countries. The object of this study is to define the role of Islamic law and Muslim religious leaders in female and male circumcision. On purpose, it avoids any use of the word 'Islam', and concentrates on the written sources of Islamic law and the opinions of contemporary Arab authors, mostly of Egyptian origin. Juridical logic cannot acknowledge the distinction between female and male circumcision, both being the mutilation of healthy organs which is damaging to the physical integrity of the child, whatever the underlying religious motivations. Furthermore, both practices violate the Koran: 'Our Lord, You did not create all this in vain' (3:191), and '[He] perfected everything He created' (32:7). In our opinion, a god who demands that his believers be mutilated and branded on their genitals the same as cattle, is a god of questionable ethics. To mutilate children, boys or girls, under the pretext that it is for their own good, shows the influence of cynicism and fanaticism. PMID:7731348

  9. Excision of an epidermal inclusion cyst: Correction of a long-term complication of female genital circumcision.

    Science.gov (United States)

    Dun, Erica C; Ackerman, Christina; Cutler, Abigail; Lakhi, Nisha A

    2016-06-01

    Epidermal inclusion cysts are a late complication of female genital circumcision, which is a practice that affects 125 million women primarily from Africa and the Middle East. A 30-year-old woman, gravida 4, para 1, presented to our clinic with an 8-year history of a slowly enlarging periclitoral mass. The patient had undergone female genital circumcision at the age of 5 years. We describe and video-illustrate the surgical technique of excising the 8-cm epidermal inclusion cyst. Using this technique, the entire cyst was resected intact, excess vulvar skin removed, and defect repaired. Postoperatively, she had minimal pain, no dyspareunia, and good cosmesis. Restoration of anatomy for this late complication of female genital circumcision is achievable with knowledge of anatomy, adherence to basic surgical principles that include tension-free closure, and close postoperative follow up. PMID:27001220

  10. African women struggling against female circumcision and sexual violence.

    Science.gov (United States)

    Tell, K

    1999-04-01

    In France, Mariatou Koita, a woman born of Malian parents, endured female genital mutilation as a child at the hands of another Malian immigrant. When the mutilator returned years later to perform genital mutilation on Koita's younger sister, Koita took action that resulted in the first case of female genital mutilation tried in France upon the complaint of a victim. The mutilator was sentenced to 8 years in jail for mutilating 48 young girls in the period 1983-94, and 23 mothers and 3 fathers received prison or suspended prison sentences. Women are struggling against another form of sexual violence in South Africa, where Johannesburg is gaining the reputation as the "rape capital" of the world. Surveys by a nongovernmental organization (NGO) have revealed that a third of 4000 women interviewed were raped in the past year and that 25% of the boys in a sample of 1500 school children considered gang rape a recreational activity. In response, the NGO is creating recommendations to address the problem in schools and to raise the role model profile of men who oppose sexual violence. Also, in Wynberg, Western Cape, a special Sexual Offenses Court has been created to mitigate some of the difficulties rape victims have encountered with the legal system. Global studies indicate that most victims of sexual assaults are adolescent girls. PMID:12349047

  11. When female circumcision comes to the West: Attitudes toward the practice among Somali Immigrants in Oslo

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    Gele Abdi A

    2012-08-01

    Full Text Available Abstract Background Female circumcision (FC has lifelong adverse social and health consequences for women, and its abolition will not only enhance the health of children and women, but also promote gender equality. Like many other Western countries, Norway hosts a large proportion of immigrants from FC-practicing countries, though primarily from Somalia, which is the country with the highest prevalence of FC in the world. A behavioral change by the practicing communities has the best chance to successfully and sustainably eliminate this practice. However, FC prevention programs require a behavioral surveillance that monitors the process of change, with this being the first quantitative study since the major migration of the Somali community to Norway began in 1991 to investigate whether or not Somali immigrants’ attitudes toward the practice has improved in favor of its abandonment. Methods A cross-sectional study using a respondent-driven sampling (RDS was conducted in Oslo from April to June of 2011. A sample of 214 persons was interviewed, using structured questionnaires. Results The results show that 70% of Somalis in Oslo support the discontinuation of all forms of FC compared to 30% who support its continuation, with the latter group more likely to be people who lived in Norway ≤ 4 years. Of the 10 girls who came to Norway at the age of ≤ 7 years, only one was circumcised, though whether the circumcision occurred before or after the girl’s arrival in Norway remains unclear. The perception that FC is required by religion was the sole factor to be significantly associated with an ongoing support of FC. Conclusion The study reveals that Somalis in Oslo demonstrate a trend to abandon this practice over time. Nevertheless, the 30% of the people who still support its continuation, and who are primarily newly arrived immigrants, require a targeted intervention that is implemented in the early phase of the immigrants’ arrival.

  12. Attitudes toward female circumcision among Somali immigrants in Oslo: a qualitative study

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    Gele AA

    2012-01-01

    Full Text Available Abdi A Gele1,2, Bernadette Kumar3, Karin Harsløf Hjelde3, Johanne Sundby21The Department of Social Science, Oslo University College, 2Section for International Health, Department of General Practice and Community Medicine, University of Oslo, 3Norwegian Center for Minority Health Research, Oslo, NorwayAbstract: Due to its negative impact on public health, female circumcision (FC has gained increased attention from international communities and the Norwegian public in recent decades. In 1995, the Norwegian government outlawed the practice and simultaneously developed a package of measures aimed at preventing and ultimately eradicating FC in Norway. Like many other Western countries, immigrants of Somali descent constitute the largest immigrant group in Norway from countries with FC traditions. Although this immigrant group is often perceived as a cultural society that supports FC generally as a practice, there appears to be a lack of studies that explore the impact of acculturation and the Western social context on Somali immigrants’ attitudes toward the practice. Against this background, this paper explores the attitudes of Somalis living in Oslo, Norway to the practice of FC. Findings from this qualitative study indicate that Somalis in Oslo have, to a large extent, changed their attitude toward the practice. This was proven by the presence in Oslo of a large number of Somali parents who left their daughters uncut as well as Somali girls, boys, men, and women who attribute being uncircumcised a high status. This study adds to the knowledge of the process of abandonment of FC among immigrants in the Western countries. The study highlights the success that has been achieved in improving attitudes toward the practice of the Somali community in Oslo, Norway, as well as emerging challenges that need to be addressed further.Keywords: female circumcision, attitude, behavior, immigrants, Somalis

  13. Female sex workers, male circumcision and HIV: a qualitative study of their understanding, experience, and HIV risk in Zambia.

    Science.gov (United States)

    Abbott, Sharon A; Haberland, Nicole A; Mulenga, Drosin M; Hewett, Paul C

    2013-01-01

    Several sub-Saharan African countries, including Zambia, have initiated national voluntary medical male circumcision (MC) programs to reduce HIV incidence. In-depth interviews were conducted with twenty female sex workers (FSWs) in Lusaka to examine their understanding of MC and experiences with circumcised clients. Knowledge of MC was derived primarily through informal sources, with very few FSWs reporting exposure to MC educational campaigns. MC was not widely believed to be protective against HIV, however it was viewed by some as protective against STIs. Three FSWs reported having sex with recently circumcised clients, and most reported that men often used their MC status to try to convince FSWs to forego condoms. Findings suggest that FSWs, already at high risk for HIV infection, may face additional pressure toward higher risk behavior as a result of MC. As MC services are expanded, programs should support FSWs' efforts to protect themselves by providing information about what MC can--and cannot--offer for HIV/STI infection prevention. PMID:23349745

  14. Acceptability of medical male circumcision in the traditionally circumcising communities in Northern Tanzania

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    Mshana Gerry

    2011-05-01

    Full Text Available Abstract Background Data from traditionally circumcising communities show that non-circumcised males and those circumcised in the medical settings are stigmatised. This is because traditional circumcision embodies local notions of bravery as anaesthetics are not used. This study was conducted to assess the acceptability of safe medical circumcision before the onset of sexual activity for HIV infection risk reduction in a traditionally circumcising community in Tanzania. Methods A cross-sectional study was conducted among males and females aged 18-44 years in traditionally circumcising communities of Tarime District in Mara Region, North-eastern Tanzania. A face-to-face questionnaire was administered to females to collect information on the attitudes of women towards circumcision and the preferred age for circumcision. A similar questionnaire was administered to males to collect information on socio-demographic, preferred age for circumcision, factors influencing circumcision, client satisfaction, complications and beliefs surrounding the practice. Results Results were available for 170 males and 189 females. Of the males, 168 (98.8% were circumcised and 61 (36.3% of those circumcised had the procedure done in the medical setting. Of those interviewed, 165 (97.1% males and 179 (94.7% females supported medical male circumcision for their sons. Of these, 107 (64.8% males and 130 (72.6% females preferred prepubertal medical male circumcision (12 years or less. Preference for prepubertal circumcision was significantly associated with non-Kurya ethnic group, circumcision in the medical setting and residence in urban areas for males in the adjusted analysis. For females, preference for prepubertal circumcision was significantly associated non-Kurya ethnic group and being born in urban areas in the adjusted analysis. Conclusions There is a shift of preference from traditional male circumcision to medical male circumcision in this traditionally

  15. Libertarianism and Circumcision

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    Patrick Testa

    2014-06-01

    Full Text Available Despite the millenniums-old tradition in Abrahamic circles of removing the foreskin of a penis at birth, the involuntary and aggressive practice of circumcision must not be made an exception to the natural, negative right to self-ownership—a birthright which should prevent a parent from physically harming a child from the moment of birth going forward. This paper will present a natural rights argument against the practice of male child circumcision, while also looking into some of the potential physical and psychological consequences of the practice. It will compare the practice with that of female circumcision, which is banned in developed nations but still practiced in the third world, as well as other forms of aggressive action, some once-prevalent, while disputing arguments made for parental ownership of the child, religious expression, cultural tradition, cleanliness, cosmetics, and conformity.

  16. A Complication of Female Circumcision: Vaginal Stenosis and Total Incontinence Due to Urethral Intercourse

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    Deniz Arslan

    2015-06-01

    Full Text Available Female genital mutilation (FGM is a horrible procedure which may have detrimental physical and pyschological effects on women and mostly performed in the Middle East and African regions. FGM has four different types described in various regions. Total urinary incontinence due to type 3 FGM is described in a 21-year-old female in the present article.

  17. A Complication of Female Circumcision: Vaginal Stenosis and Total Incontinence Due to Urethral Intercourse

    OpenAIRE

    Deniz Arslan; Ozan Bozkurt; Özer Birge; Ömer Demir

    2015-01-01

    Female genital mutilation (FGM) is a horrible procedure which may have detrimental physical and pyschological effects on women and mostly performed in the Middle East and African regions. FGM has four different types described in various regions. Total urinary incontinence due to type 3 FGM is described in a 21-year-old female in the present article.

  18. Attitudes toward Female Circumcision among Men and Women in Two Districts in Somalia: Is It Time to Rethink Our Eradication Strategy in Somalia?

    Science.gov (United States)

    Gele, Abdi A; Bø, Bente P; Sundby, Johanne

    2013-01-01

    Somalia has the highest global prevalence (98%) of female circumcision (FC), and, despite a long history of abandonment efforts, it is not clear as to whether or not these programmes have changed people's positive attitudes toward the practice. Against this background, this paper explores the attitudes of Somalis living in Hargeisa and Galkayo districts to the practice of FC. Methods. A purposive sampling of 24 Somalis, including activists and practitioners, men and women, was conducted in Somalia. Unstructured interviews were employed to explore the participants' knowledge of FC, their attitudes toward the continuation/discontinuation of the practice, and the type they want to continue or not to continue. Result. The findings of this qualitative study indicate that there is a strong resistance towards the abandonment of the practice in Somalia. The support for the continuation of Sunna circumcision is widespread, while there is a quite large rejection of Pharaonic circumcision. Conclusion. Therefore, since the "zero tolerance policy" has failed to change people's support for the continuation of the practice in Somalia, programmes that promote the pinch of the clitoral skin and verbal alteration of status, with the goal of leading to total abandonment of FC, should be considered for the Somali context. PMID:23710186

  19. Attitudes toward Female Circumcision among Men and Women in Two Districts in Somalia: Is It Time to Rethink Our Eradication Strategy in Somalia?

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    Abdi A. Gele

    2013-01-01

    Full Text Available Somalia has the highest global prevalence (98% of female circumcision (FC, and, despite a long history of abandonment efforts, it is not clear as to whether or not these programmes have changed people’s positive attitudes toward the practice. Against this background, this paper explores the attitudes of Somalis living in Hargeisa and Galkayo districts to the practice of FC. Methods. A purposive sampling of 24 Somalis, including activists and practitioners, men and women, was conducted in Somalia. Unstructured interviews were employed to explore the participants' knowledge of FC, their attitudes toward the continuation/discontinuation of the practice, and the type they want to continue or not to continue. Result. The findings of this qualitative study indicate that there is a strong resistance towards the abandonment of the practice in Somalia. The support for the continuation of Sunna circumcision is widespread, while there is a quite large rejection of Pharaonic circumcision. Conclusion. Therefore, since the “zero tolerance policy” has failed to change people’s support for the continuation of the practice in Somalia, programmes that promote the pinch of the clitoral skin and verbal alteration of status, with the goal of leading to total abandonment of FC, should be considered for the Somali context.

  20. Acceptability of medical male circumcision and improved instrument sanitation among a traditionally circumcising group in East Africa.

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    Siegler, Aaron J; Mbwambo, Jessie K; DiClemente, Ralph J

    2012-10-01

    By removing the foreskin, medical male circumcision (MMC) reduces female to male heterosexual HIV transmission by approximately 60 %. Traditional circumcision has higher rates of complications than MMC, and reports indicate unsanitized instruments are sometimes shared across groups of circumcision initiates. A geographically stratified, cluster survey of acceptability of MMC and improved instrument sanitation was conducted among 368 eligible Maasai participants in two Northern Districts of Tanzania. Most respondents had been circumcised in groups, with 56 % circumcised with a shared knife rinsed in water between initiates and 16 % circumcised with a knife not cleaned between initiates. Contrasting practice, 88 % preferred use of medical supplies for their sons' circumcisions. Willingness to provide MMC to sons was 28 %; however, provided the contingency of traditional leadership support for MMC, this rose to 84 %. Future interventions to address circumcision safety, including traditional circumciser training and expansion of access to MMC, are discussed. PMID:22797931

  1. [Medical and legal aspects of genital mutilation and circumcision part I: female genital mutilation (FGM)].

    Science.gov (United States)

    Dettmeyer, Reinhard; Laux, Johannes; Friedl, Hannah; Zedler, Barbara; Bratzke, Hansjürgen; Parzeller, Markus

    2011-01-01

    Female genital mutilation (FGM) is considered to be against the law and against morality not only in Western countries, although a woman of age and able to consent may sometimes think differently. The procedure may have serious physical and emotional consequences for the girl or woman. Nevertheless there are attempts to justify the procedure with medical and hygienic pseudoarguments, ideology, freedom of religion, cultural identity and social adequacy. Outside the Western world, some people claim that religion and culture alone justify the practice. In Germany, parents can lose the right to determine the residence of their daughter, if she is faced with the risk of genital mutilation in order to prevent that the child or girl is taken to her home country. Genital mutilation as a gender-specific threat is recognized as a reason to grant asylum or prevent deportation. Proposals to make genital mutilation a separate punishable offence are presently discussed by the legislator. PMID:21404547

  2. Male circumcision: An overview

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    Bhattacharjee Prosanta

    2008-01-01

    Full Text Available Circumcision is one of the common operations performed worldwide, for various reasons. Controversy exists as to whether circumcision is an operation. This literature review discusses the indications of circumcision, benefits and complications of circumcision, and alternatives to circumcision. Relevant articles on the benefits, complications, indications and alternative to circumcision from 1964 to 2005 were reviewed, from National Library of Medicine′s Pubmed database. Additional articles were obtained from the reference lists of key articles and recent reviews.

  3. Forced circumcision of men (abridged).

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    Glass, Michael

    2014-08-01

    The forced circumcision of men is a widespread human rights abuse that often accompanies other human rights violations. It occurs in clashes between circumcising and non-circumcising cultures, or when individuals in circumcising cultures reject circumcision. This article documents the forced circumcision of men against their will, shows how evidence of forced circumcision has been downplayed and discounted, and outlines and discusses some measures that could help to reduce its prevalence. PMID:24014634

  4. (Im)perishable Pleasure, (In)destructible Desire: Sexual Themes in U.S. and English News Coverage of Male Circumcision and Female Genital Cutting.

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    Carpenter, Laura M; Kettrey, Heather Hensman

    2015-01-01

    Under what conditions do sexual pleasure and desire get addressed in news coverage of sexual health issues like female genital cutting (FGC) and male circumcision (MC)? In this study we employed an embodied ethnosexuality approach to analyze sexual themes in 1,902 items published from 1985 to 2009 in 13 U.S. and 8 English newspapers and news magazines. Journalists' discussions of sexual pleasure, desire, control, problems, and practices differed in quantity and quality depending on the practice and nation to which they pertained. News coverage in both nations presented FGC as impeding female sexual pleasure, desire, and activity in ways that reinforce (hetero)sexist understandings of sexuality. The English press depicted MC as diminishing male sexuality, whereas U.S. papers showed it as enhancing male sexuality. These patterns are influenced by, and serve to reinforce, cultural norms of embodiment and ethnosexual boundaries based on gender, race, and nationality. They may, in turn, shape public understandings of FGC and MC as social problems. PMID:25258244

  5. Benefits and risks of circumcision.

    OpenAIRE

    Warner, E.; Strashin, E.

    1981-01-01

    Circumcisions are performed either prophylactically in the neonatal period or therapeutically at a later age. About 10% of males not circumcised at birth will eventually require circumcision. The present neonatal circumcision rate is about 80% in the United States and 40% in Canada. The single most important determinant of whether a newborn male will be circumcised is the attitude of the attending physician. The literature was reviewed to determine the proven benefits of circumcision and to c...

  6. Male circumcision, HIV and sexually transmitted infections: a review.

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    Larke, Natasha

    Three randomized controlled trials in sub-Saharan Africa have shown that circumcision reduces the risk of acquiring HIV infection in men by approximately 60%. In this paper, we review the evidence that male circumcision protects against infection with HIV and other sexually transmitted infections (STIs) in men and their female partners. Data from the clinical trials indicate that circumcision may be protective against genital ulcer disease, Herpes simplex type 2, Trichomonas vaginalis and human papillomavirus infection in men. No evidence exists of a protective effect against Chlamydia trachomatis or Neisseria gonorrhea. There is weak evidence that circumcision has a direct protective effect on HIV infection in women, although there is likely to be an indirect benefit, since HIV prevalence is likely to be lower in circumcised male partners. Although there is little evidence from the trials of serious adverse events from the procedure and of behavioural risk compensation among circumcised men, essential operational research is being conducted to evaluate these key issues outside the trial setting as circumcision services are expanded. Following the publication of the clinical trial results in early 2007, the World Health Organization/UNAIDS has advised that promotion of male circumcision should be included as an additional HIV strategy for the prevention of heterosexually acquired HIV infection in men in areas of high HIV prevalence. As circumcision services are expanded in settings where resources are limited, non-physician providers including nurses will play an important role in the provision of services. PMID:20622758

  7. Libertarianism and circumcision

    OpenAIRE

    Patrick Testa; Walter E. Block

    2014-01-01

    Despite the millenniums-old tradition in Abrahamic circles of removing the foreskin of a penis at birth, the involuntary and aggressive practice of circumcision must not be made an exception to the natural, negative right to self-ownership—a birthright which should prevent a parent from physically harming a child from the moment of birth going forward. This paper will present a natural rights argument against the practice of male child circumcision, while also looking into some of the potenti...

  8. Circumcision revision in male children

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    Mohammed A. Al-Ghazo

    2006-08-01

    Full Text Available OBJECTIVE: To determine indications for circumcision revision and to identify the specialty of the person who performed unsatisfactory primary circumcision. MATERIALS AND METHODS: The authors reviewed medical records of 52 cases that underwent circumcision revision over a 6-year period (1998 to 2004. Sleeve surgical technique was used for revision in patients with redundant foreskin or concealed penis, penoplasty for partial or complete degloving of the penis and meatotomy for external meatal stenosis. The mean age of children was 32 months (range 6 months to 9 years. RESULTS: Most of unsatisfactory primary circumcisions (86.7% were performed by laymen. All patients who underwent circumcision revision had good to excellent cosmetic results. CONCLUSION: Primary circumcision performed by laymen carry a high complication rate and serious complications may occur. A period of training and direct supervision by physicians is required before allowing laymen to perform circumcision independently.

  9. Complications of Circumcision

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    Aaron J. Krill

    2011-01-01

    Full Text Available In the United States, circumcision is a commonly performed procedure. It is a relatively safe procedure with a low overall complication rate. Most complications are minor and can be managed easily. Though uncommon, complications of circumcision do represent a significant percentage of cases seen by pediatric urologists. Often they require surgical correction that results in a significant cost to the health care system. Severe complications are quite rare, but death has been reported as a result in some cases. A thorough and complete preoperative evaluation, focusing on bleeding history and birth history, is imperative. Proper selection of patients based on age and anatomic considerations as well as proper sterile surgical technique are critical to prevent future circumcision-related adverse events.

  10. Circumcision and 'uncircumcision'.

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    Schneider, T

    1976-03-27

    The origin of circumcision is shrouded in antiquity. Mummies, 6 000 years old, have been reported to show evidence of circumcision but the first definite account appears in Genesis, chapter 17. Many nations practise it as a rite, the time of its performance varying from soon after birth to early manhood. Antiochus Epiphanes prohibited it in Palestine and the introduction of Greek gymnasia where nudity was the practice, led to many seeking to become uncircumcised. Celsus has described such an operation which appears to have been successful. In Rome under Hadrian and in 16th century Spain a heavy funnel-shaped copper tube fitting was used as another method of restoring the prepuce. The debate concerning the value of circumcision has continued up until the present day. PMID:775659

  11. [Ethics and ritual circumcision].

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    Castagnola, C; Faix, A

    2014-12-01

    Circumcision dates back to ancient times, nowadays, this ritual is practiced mainly in the context of Jewish and Muslim religions. The purpose of this article is to give urologists elements of reflection on the act according to the ethical principles of autonomy, beneficence, non-maleficence and justice. According to a Kantian vision, priority should be given to the respect and wishes of the individuals. In contrast, for the utilitarian theory, circumcision can be justified by a contribution to the happiness of the majority of community members at the expense of a given few. In the event of a request for ritual circumcision, urologists find themselves in the middle, uncomfortable for some, questioning the ethics of its meaning. The main pitfall for the surgeon remains in respecting the child's autonomy. PMID:25199723

  12. Behavior change pathways to voluntary medical male circumcision: narrative interviews with circumcision clients in Zambia.

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    Jessica E Price

    Full Text Available As an HIV prevention strategy, the scale-up of voluntary medical male circumcision (VMMC is underway in 14 countries in Africa. For prevention impact, these countries must perform millions of circumcisions in adolescent and adult men before 2015. Although acceptability of VMMC in the region is well documented and service delivery efforts have proven successful, countries remain behind in meeting circumcision targets. A better understanding of men's VMMC-seeking behaviors and experiences is needed to improve communication and interventions to accelerate uptake. To this end, we conducted semi-structured interviews with 40 clients waiting for surgical circumcision at clinics in Zambia. Based on Stages of Change behavioral theory, men were asked to recount how they learned about adult circumcision, why they decided it was right for them, what they feared most, how they overcame their fears, and the steps they took to make it to the clinic that day. Thematic analysis across all cases allowed us to identify key behavior change triggers while within-case analysis elucidated variants of one predominant behavior change pattern. Major stages included: awareness and critical belief adjustment, norming pressures and personalization of advantages, a period of fear management and finally VMMC-seeking. Qualitative comparative analysis of ever-married and never-married men revealed important similarities and differences between the two groups. Unprompted, 17 of the men described one to four failed prior attempts to become circumcised. Experienced more frequently by older men, failed VMMC attempts were often due to service-side barriers. Findings highlight intervention opportunities to increase VMMC uptake. Reaching uncircumcised men via close male friends and female sex partners and tailoring messages to stage-specific concerns and needs would help accelerate men's movement through the behavior change process. Expanding service access is also needed to meet

  13. Sociodemographic Predictors of Genital Mutilation (Circumcision of the Girl Child in Nigeria: A Population-Based Study

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    Donatus Ignatius Chidiebere Osuorah

    2015-07-01

    Full Text Available Objectives: Female circumcision is regarded as mutilation of the external genitalia of women and the girl child. It is entrenched in the cultures of many communities in developing countries particularly in Africa. It has long been recognized internationally as a violation of the right of the woman and the girl child. Material and methods: This study tried to determine the socio-demographic factors that predict circumcision of the girl child. Multivariate logistic regression was used to determine predictors of girl child circumcision. Results: The overall prevalence of the girl child circumcision in Nigeria is 23.9%. When stratified by region, the prevalence was 36.8%, 15.6% and 9.1% in the North-west, North-central and North-east region respectively and 30.8%, 22.8% and 8.0% in the South-west, South-east and South-south region respectively. Within states, the prevalence of female circumcision ranged from 0% in Katsina to 57.9% in Jigawa state. Prevalence was almost twice among Muslim households than other religions. Majority (91.8% of the girl child circumcision was done before the first birthday (0-11 months and 84.6% was performed by a traditional circumciser. Type I (44.1% and II (47.9% were the commonest type of genital mutilation performed. In the final regression model, only mothers opinion about female circumcision, whether she was circumcised and region of residence significantly determined the likelihood of a girl child been circumcised. Conclusions: Appropriate and targeted education of mothers and circumcisers focusing on the undesirable effect of female circumcision will significantly reduce the practice of female genital mutilation across Nigeria.

  14. Ischemic glans penis after circumcision

    Institute of Scientific and Technical Information of China (English)

    Yuan-ShengTzeng; Shou-HungTang; EnMeng; Teng-FuLin; Guang-HuanSun

    2004-01-01

    A 33-year-old male receiving dorsal penile nerve block (DPNB) for circumcision exhibited a postoperative ischemic change over the glans penis. The event occurred nearly 24 hours after the procedure. The patient was treated with intravenous pentoxifyllin and hyperbaric oxygenation. Total reverse of the ischemia was observed. The complications associated with circumcision and DPNB were reviewed and discussed.

  15. Balancing on a knife's edge : an analysis of medicalized circumcision in the construction of self

    OpenAIRE

    2012-01-01

    Abstract The past couple of decades, medicalization of female and male circumcision has become more common in the district of Kajiado in Kenya. Medicalization implies that the procedure is performed by trained health personnel, who use modern equipment and medicine. This thesis analyses how the form, meaning, and legitimization of male and female circumcision among the Maasai in Kajiado District changes with medicalization. Furthermore, it explores which implication these changes have on ...

  16. Circumcision Is Unethical and Unlawful.

    Science.gov (United States)

    Svoboda, J Steven; Adler, Peter W; Van Howe, Robert S

    2016-06-01

    The foreskin is a complex structure that protects and moisturizes the head of the penis, and, being the most densely innervated and sensitive portion of the penis, is essential to providing the complete sexual response. Circumcision-the removal of this structure-is non-therapeutic, painful, irreversible surgery that also risks serious physical injury, psychological sequelae, and death. Men rarely volunteer for it, and increasingly circumcised men are expressing their resentment about it.Circumcision is usually performed for religious, cultural and personal reasons. Early claims about its medical benefits have been proven false. The American Academy of Pediatrics and the Centers for Disease Prevention and Control have made many scientifically untenable claims promoting circumcision that run counter to the consensus of Western medical organizations.Circumcision violates the cardinal principles of medical ethics, to respect autonomy (self-determination), to do good, to do no harm, and to be just. Without a clear medical indication, circumcision must be deferred until the child can provide his own fully informed consent.In 2012, a German court held that circumcision constitutes criminal assault. Under existing United States law and international human rights declarations as well, circumcision already violates boys› absolute rights to equal protection, bodily integrity, autonomy, and freedom to choose their own religion. A physician has a legal duty to protect children from unnecessary interventions. Physicians who obtain parental permission through spurious claims or omissions, or rely on the American Academy of Pediatrics' position, also risk liability for misleading parents about circumcision. PMID:27338602

  17. Erectile function in circumcised and uncircumcised men in Lusaka, Zambia: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Evans Chinkoyo

    2015-02-01

    Full Text Available Background: Evidence from three randomised control trials in South Africa, Uganda and Kenya showing that male circumcision can reduce heterosexual transmission of human immunodeficiency virus (HIV infection from infected females to their male partners by up to 60% has led to an increase in circumcisions in most African countries. This has created anxieties around possible deleterious effects of circumcision on erectile function (EF.Aim: To compare EF in circumcised and uncircumcised men aged 18 years and older.Setting: Four primary healthcare facilities in Lusaka, Zambia.Methods: Using a cross-sectional survey 478 participants (242 circumcised and 236 uncircumcised from four primary healthcare facilities in Lusaka, Zambia were asked to complete the IIEF-5 questionnaire. EF scores were calculated for the two groups, where normal EF constituted an IIEF-5 score ≥ 22 (out of 25.Results: Circumcised men had higher average EF scores compared to their uncircumcised counterparts, (p < 0.001. The prevalence of erectile dysfunction was lower in circumcisedmen (56% compared to uncircumcised men (68% (p < 0.05. EF scores were similar in thosecircumcised in childhood and those who had the procedure in adulthood, (p = 0.59. The groups did not differ significantly in terms of age, relationship status, smoking, alcohol and medication use. A statistically significant difference was observed in education levels, with the circumcision group having higher levels of education (p < 0.005.Conclusion: The higher EF scores in circumcised men show that circumcision does not confer adverse EF effects in men. These results suggest that circumcision can be considered safe interms of EF. A definitive prospective study is needed to confirm these findings.

  18. Circumcision of male children for reduction of future risk for HIV: acceptability among HIV serodiscordant couples in Kampala, Uganda.

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    Kenneth K Mugwanya

    Full Text Available INTRODUCTION: The ultimate success of medical male circumcision for HIV prevention may depend on targeting male infants and children as well as adults, in order to maximally reduce new HIV infections into the future. METHODS: We conducted a cross-sectional study among heterosexual HIV serodiscordant couples (a population at high risk for HIV transmission attending a research clinic in Kampala, Uganda on perceptions and attitudes about medical circumcision for male children for HIV prevention. Correlates of willingness to circumcise male children were assessed using generalized estimating equations methods. RESULTS: 318 HIV serodiscordant couples were interviewed, 51.3% in which the female partner was HIV uninfected. Most couples were married and cohabiting, and almost 50% had at least one uncircumcised male child of ≤18 years of age. Overall, 90.2% of male partners and 94.6% of female partners expressed interest in medical circumcision for their male children for reduction of future risk for HIV infection, including 79.9% of men and 87.6% of women who had an uncircumcised male child. Among both men and women, those who were knowledgeable that circumcision reduces men's risk for HIV (adjusted prevalence ratio [APR] 1.34 and 1.14 and those who had discussed the HIV prevention effects of medical circumcision with their partner (APR 1.08 and 1.07 were significantly (p≤0.05 more likely to be interested in male child circumcision for HIV prevention. Among men, those who were circumcised (APR 1.09, p = 0.004 and those who were HIV seropositive (APR 1.09, p = 0.03 were also more likely to be interested in child circumcision for HIV prevention. CONCLUSIONS: A high proportion of men and women in Ugandan heterosexual HIV serodiscordant partnerships were willing to have their male children circumcised for eventual HIV prevention benefits. Engaging both parents may increase interest in medical male circumcision for HIV prevention.

  19. Inappropriate circumcision referrals by GPs.

    OpenAIRE

    Griffiths, D.; Frank, J D

    1992-01-01

    One hundred and twenty boys were referred by GPs over a 12-month period to a paediatric urologist for circumcision. The reasons for referral were: ballooning in 36, non-retraction in 28, balanoposthitis in 36 or a combination in 15. On examination 53% had a retractile, 21% a partially retractile and 21% a non-retractile foreskin. Six patients had obvious balanitis xerotica obliterans. Only one quarter of the patients required a circumcision. The penis was not examined by the referring doctor ...

  20. A 'snip' in time: what is the best age to circumcise?

    Directory of Open Access Journals (Sweden)

    Morris Brian J

    2012-02-01

    Full Text Available Abstract Background Circumcision is a common procedure, but regional and societal attitudes differ on whether there is a need for a male to be circumcised and, if so, at what age. This is an important issue for many parents, but also pediatricians, other doctors, policy makers, public health authorities, medical bodies, and males themselves. Discussion We show here that infancy is an optimal time for clinical circumcision because an infant's low mobility facilitates the use of local anesthesia, sutures are not required, healing is quick, cosmetic outcome is usually excellent, costs are minimal, and complications are uncommon. The benefits of infant circumcision include prevention of urinary tract infections (a cause of renal scarring, reduction in risk of inflammatory foreskin conditions such as balanoposthitis, foreskin injuries, phimosis and paraphimosis. When the boy later becomes sexually active he has substantial protection against risk of HIV and other viral sexually transmitted infections such as genital herpes and oncogenic human papillomavirus, as well as penile cancer. The risk of cervical cancer in his female partner(s is also reduced. Circumcision in adolescence or adulthood may evoke a fear of pain, penile damage or reduced sexual pleasure, even though unfounded. Time off work or school will be needed, cost is much greater, as are risks of complications, healing is slower, and stitches or tissue glue must be used. Summary Infant circumcision is safe, simple, convenient and cost-effective. The available evidence strongly supports infancy as the optimal time for circumcision.

  1. Parental circumcision preferences and early outcome of plastibell circumcision in a Nigerian tertiary hospital

    OpenAIRE

    Okechukwu Hyginus Ekwunife; Jideofor Okechukwu Ugwu; Okoli, Chinedu C; Victor Ifeanyichukwu Modekwe; Andrew N Osuigwe

    2015-01-01

    Background: Parents are central in decisions and choices concerning circumcision of their male children and plastibell circumcision is a widely practiced technique. This study determined parental preferences for male neonatal and infant circumcisions and evaluate the early outcomes of plastibell circumcisions in a tertiary centre. Patients and Methods: This is a prospective study on consecutive male neonates and infants who were brought for circumcisions at Nnamdi Azikiwe University Teaching ...

  2. Cultural change after migration: Circumcision of girls in Western migrant communities.

    Science.gov (United States)

    Johnsdotter, Sara; Essén, Birgitta

    2016-04-01

    This paper reviews the current knowledge on cultural change after migration in the practice of female circumcision, also named genital cutting or mutilation. Explorative studies show trends of radical change of this practice, especially the most extensive form of its kind (type III or the 'Pharaonic' type). The widespread interpretation that Islam would require circumcision of girls is questioned when, for example, Somalis meet other Muslim migrants, such as Arab Muslims, who do not circumcise their daughters. The few criminal court cases for circumcision of girls that have taken place in Western countries corroborate the conclusion that substantial change in the practice has occurred among migrants. In this literature review, an absence of reports is identified from healthcare providers who have witnessed circumcision after migration. Concurrently, a substantial knowledge exists on how to take care of already circumcised women and girls, and there is a system of recommendations in place regarding best practices for prevention. There is a great potential for healthcare providers to encourage this development towards general abandonment of circumcision of girls. The challenge for the future is how to incorporate culturally sensitive efforts of prevention on the one hand, and the examination of suspicious cases of illegal circumcision on the other. We recommend using--in a cautious way--the existing routines for identifying child abuse in general. Experiences from African contexts show that failure to generate significant change of the harmful practices/tradition may be due to the lack of multidisciplinary collaboration in different sectors of the society. In Western societies, the tendency toward abandonment of the practice could be reinforced by professionals who work toward better inclusion of men and women originally from countries where circumcision is practised. PMID:26644059

  3. The encounters that rupture the myth: contradictions in midwives' descriptions and explanations of circumcised women immigrants' sexuality.

    Science.gov (United States)

    Leval, Amy; Widmark, Catarina; Tishelman, Carol; Maina Ahlberg, Beth

    2004-09-01

    The purpose of the study was to analyze how Swedish midwives (n = 26) discuss sexuality in circumcised African women patients. In focus groups and interviews, discussions concentrated on care provided to circumcised women, training received for this care, and midwives' perceptions of female circumcision. An analytic expansion was performed for discussions pertaining to sexuality and gender roles. Results from the analysis show the following: (1) ethnocentric projections of sexuality; (2) a knowledge paradox regarding circumcision and sexuality; (3) the view of the powerless circumcised women; and (4) the fact that maternity wards function as meeting places between gender and culture where the encounters with men allow masculine hegemonic norms to be ruptured. We conclude that an increased understanding of cultural epistemology is needed to ensure quality care. The encounters that take place in obstetrical care situations can provide a space where gender and culture as prescribed norms can be questioned. PMID:15371079

  4. Seduções e traições de gênero no Islã: a rainha de Sabá e o corpo feminino circuncidado Gender treasons and seductions in Islam: the queen of Sheba and the circumcised female body

    Directory of Open Access Journals (Sweden)

    Mariane Venchi

    2008-06-01

    Full Text Available Este artigo analisa narrativas árabe-islâmicas que tratam de noções de corporalidade e suas conexões com a prática da circuncisão feminina, mostrando que a relação existente entre circuncisão, sexualidade e poder está posta em um cenário que envolve não apenas um idioma religioso de conversão de quem está dentro (crente e fora (descrente e em estados de "poluição", assim como a conversão simbólica entre masculino/feminino subjacente à construção da "comunidade muçulmana" ou califado.This article analises Arab-Muslim narratives dealing with concepts of embodiment in the practice of female circumcision, pointing out that the conection among circumcision, sexuality and power takes place in a setting which involves a religious language of conversion among insiders (believers, outsiders (non-believers and those in state of "pollution" as well as the simbolic conversion between male/female identities subjacent to the idea of "Islamic community" or caliphate.

  5. Circumcision: Perspective in a Nigerian teaching hospital

    Directory of Open Access Journals (Sweden)

    L O Abdur-Rahman

    2013-01-01

    Full Text Available Background: The practice and pattern of male infants circumcised is influenced by culture, religion and socio-economic classification. The debate about the benefits and risks of circumcision has made a hospital-based practice the most acceptable. Objective: The objective of this study is to evaluate the ages, indications, co-morbidity, types and methods of circumcision, usage and mode of anaesthesia and outcome of male circumcision at a tertiary health centre in Nigeria. Materials and Methods: A retrospective review of male circumcision in a paediatric surgery unit was done from January 2002 to December 2007. The data was analysed using SPSS software version 15. Results: There were 438 boys with age ranged between 6 days and 10 years (median 28 days, mean 53.6 days standard deviation 74.2. Neonatal circumcision (<29 days was 201 (46% and 318 (72.6% of the children were circumcised by the 3 rd month of live. Religion or tradition were the major indicators in 384 (87.7% patients while phimosis 38 (8.7%, paraphimosis 4 (1%, redundant post circumcision skin 10 (2.3% and defective prepuce in 2 (0.5% were other indications. Plastibel™ (PD was used in 214 (48.9%, classical circumcision 194 (44.2%, guillotine technique (GT and Gomco™ 10 (2.3% cases each while 10 (2.3% had a refashioning/re-excision post previous circumcision. There was an increase in use of PD, drop in the use of GT; and increase in the number of circumcision done over the years. Only 39.7% had anaesthesia administered and complication rate was 6.7%. Conclusion: Neonatal circumcision was highest in the hospital-based circumcision practice, which allowed the expected ideals in the use of devices in a tertiary health centre. However, the low rate of anaesthetic use is unacceptable.

  6. Critical evaluation of unscientific arguments disparaging affirmative infant male circumcision policy.

    Science.gov (United States)

    Morris, Brian J; Krieger, John N; Klausner, Jeffrey D

    2016-08-01

    We evaluate recent claims opposing infant male circumcision, a procedure now supported by the evidence-based policy of the American Academy of Pediatrics. We find those criticisms depend on speculative claims about the foreskin and obfuscation of the strong scientific evidence supporting pediatric policy development. An argument that circumcision should be delayed to allow a boy to make up his own mind as an adult fails to appreciate the psychological, scheduling and financial burdens later circumcision entails, so reducing the likelihood that it will occur. In contrast, early infant circumcision is convenient, safer, quicker, lower risk, healing is faster, cosmetic outcome is routinely good and the lifetime benefits accrue immediately. Benefits include reduction in urinary tract infections, inflammatory skin conditions, foreskin problems, and, when older, substantial protection against sexually transmitted infections and genital cancers in the male and his female sexual partners. Some authorities regard the failure to offer parents early infant circumcision as unethical, just as it would be unethical to fail to encourage the vaccination of children. In conclusion, the criticisms of evidence-based infant male circumcision policy are seriously flawed and should be dismissed as unhelpful to evidence-based development and implementation of pediatric policy intended to improve public health and individual wellbeing. PMID:27610340

  7. Prepuce: Phimosis, Paraphimosis, and Circumcision

    Directory of Open Access Journals (Sweden)

    Yutaro Hayashi

    2011-01-01

    Full Text Available Phimosis is a condition in which the prepuce cannot be retracted over the glans penis. Actually, physiologic phimosis is common in male patients up to 3 years of age, but often extends into older age groups. Balanoposthitisis a common inflammation occurring in 4–11% of uncircumcised boys. Circumcision is generally undertaken for three reasons: first, as an item of religious practice, typically neonatally although occasionally transpubertally, as a rite of passage; second, as a prophylactic measure against future ailments for the reduction in the risk of penile cancer, urinary tract infection, and sexually transmitted infection; and third, for immediate medical indication. Balanitisxeroticaobliterans is an infiltrative skin condition that causes a pathological phimosis and has been considered to be the only absolute indication for circumcision. Various kinds of effective alternatives to circumcision have been described, including manual retraction therapy, topical steroid therapy, and several variations of preputioplasty. All of these treatments have the ability to retract the foreskin as their goal and do not involve the removal of the entire foreskin. Paraphimosis is a condition in which the foreskin is left retracted. When manipulation is not effective, a dorsal slit should be done, which is usually followed by circumcision.

  8. Complications of Circumcision: Report of Four Cases

    OpenAIRE

    S Delshad

    1997-01-01

    Circumcision is a common surgical procedure in the world. It seems to prevent phimosis, urinary tract infection, transsexual diseases, adhesion between foreskin and glans, and the possibility of penis and uterus cervical cancer. In addition to Jews and Muslims, who practice circumcision as a religious ritual, a remarkable percentage of Christians also take advantage of the prophylactic effect of the procedure. The complications of circumcision are not numerous but some may be serious. In this...

  9. Modelling the public health impact of male circumcision for HIV prevention in high prevalence areas in Africa

    OpenAIRE

    Moses Stephen; Nagelkerke Nico JD; de Vlas Sake J; Bailey Robert C

    2007-01-01

    Abstract Background Recent clinical trials in Africa, in combination with several observational epidemiological studies, have provided evidence that male circumcision can reduce HIV female-to-male transmission risk by 60% or more. However, the public health impact of large-scale male circumcision programs for HIV prevention is unclear. Methods Two mathematical models were examined to explore this issue: a random mixing model and a compartmental model that distinguishes risk groups associated ...

  10. Prepuce: Phimosis, Paraphimosis, and Circumcision

    OpenAIRE

    Yutaro Hayashi; Yoshiyuki Kojima; Kentaro Mizuno; Kenjiro Kohri

    2011-01-01

    Phimosis is a condition in which the prepuce cannot be retracted over the glans penis. Actually, physiologic phimosis is common in male patients up to 3 years of age, but often extends into older age groups. Balanoposthitisis a common inflammation occurring in 4–11% of uncircumcised boys. Circumcision is generally undertaken for three reasons: first, as an item of religious practice, typically neonatally although occasionally transpubertally, as a rite of passage; second, as a prophylactic me...

  11. Circumcision in Baby Boys (Beyond the Basics)

    Science.gov (United States)

    ... in male infants less than one year old. Studies consistently report that uncircumcised male infants are at higher risk of UTI compared with circumcised male infants. UTIs in infants can result in kidney infection requiring ... suggest that circumcision helps decrease the risk of ...

  12. Factors influencing Chinese male's willingness to undergo circumcision: a cross-sectional study in western China.

    Directory of Open Access Journals (Sweden)

    Xiaobo Yang

    Full Text Available BACKGROUND: Male circumcision (MC has been shown to reduce the risk of female to male transmission of HIV. The goal of this survey was to explore the acceptability of MC among the Chinese and to identify factors associated with circumcision preference. METHODS: A cross-sectional survey was conducted between September 2009 and December 2010. We interviewed 2,219 male community participants, from three high HIV prevalence provinces in western China. A structured questionnaire was used to collect data on MC knowledge, willingness to accept MC, reasons to accept or refuse MC, and sexual behaviors and health. For those who refused MC, a health education intervention providing information on the benefits of circumcision was conducted. We used multiple logistic regression models to identify factors associated with the acceptability of MC. RESULTS: Of the respondents (n = 2,219, 44.6% (989/2,219 reported they would accept MC for the following reasons: promotion of female partners' hygiene (60.3%, redundant foreskin (59.4%, prevention of penile cancer (50.2%, enhanced sexual pleasure (41.4%, and protection against HIV and STDs (34.2%. The multivariable logistic regression showed that five factors were associated with MC willingness: long foreskin (OR = 15.98, residing in Xinjiang province (OR = 3.69, being younger than 25 (OR = 1.60, knowing hazards of redundant foreskin (OR = 1.78, and having a friend who underwent circumcision (OR = 1.36. CONCLUSION: The acceptability of male circumcision was high among the general population in China. Our study elucidates the factors associated with circumcision preference and suggests that more health education campaigns about positive health effects are necessary to increase the MC rate in China.

  13. Knowledge, attitudes and perceptions of pharmacy and nursing students towards male circumcision and HIV in a KwaZulu-Natal University, South Africa

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    Panjasaram V. Naidoo

    2012-02-01

    Full Text Available Background: Male circumcision is currently being promoted in South Africa as a Human Immunodeficiency Virus (HIV prevention method. Effective implementation requires that healthcare providers should believe in the procedure’s efficacy and should possess a positive attitude. A study was undertaken amongst pharmacy and nursing students with different objectives. Objectives: To ascertain students’ knowledge, attitudes and perceptions regarding male circumcision and (HIV prevention.Method: A descriptive cross-sectional study using anonymous questionnaires was undertaken amongst 4th year pharmacy and nursing students studying at a university in KwaZulu-Natal, after obtaining their consent. Data were captured and analysed using SPSS version 15.Results: A response rate of 83.18% and a mean knowledge score of 66.43% with relatively positive attitudes (62.7 were obtained; 85.4% of the respondents felt that promoting male circumcision is appropriate, with all Muslim students (n < 11 supporting the promotion of male circumcision. Even though all Muslim students supported male circumcision, only 3 students were willing to perform the procedure if adequately trained (p < 0.03. The majority of the female students were unwilling to perform the procedure (p < 0.005. A third of the respondents indicated that male circumcision would both undermine existing protective behaviours and strategies as well as increase riskier sexual behaviour. Over 54% of the respondents believed that the South African Health System would be able to cope with the massive male circumcision drive. The majority of the respondents favoured the procedure to be done at birth. Pain was cited as the most important reason for not wanting to be circumcised.Conclusion: Pharmacy and nursing students have a moderate knowledge of male circumcision and HIV prevention with relatively positive attitudes. The majority felt that promoting male circumcision is appropriate and should be encouraged.

  14. Modelling the public health impact of male circumcision for HIV prevention in high prevalence areas in Africa

    Directory of Open Access Journals (Sweden)

    Moses Stephen

    2007-03-01

    Full Text Available Abstract Background Recent clinical trials in Africa, in combination with several observational epidemiological studies, have provided evidence that male circumcision can reduce HIV female-to-male transmission risk by 60% or more. However, the public health impact of large-scale male circumcision programs for HIV prevention is unclear. Methods Two mathematical models were examined to explore this issue: a random mixing model and a compartmental model that distinguishes risk groups associated with sex work. In the compartmental model, two scenarios were developed, one calculating HIV transmission and prevalence in a context similar to the country of Botswana, and one similar to Nyanza Province, in western Kenya. Results In both models, male circumcision programs resulted in large and sustained declines in HIV prevalence over time among both men and women. Men benefited somewhat more than women, but prevalence among women was also reduced substantially. With 80% male circumcision uptake, the reductions in prevalence ranged from 45% to 67% in the two "countries", and with 50% uptake, from 25% to 41%. It would take over a decade for the intervention to reach its full effect. Conclusion Large-scale uptake of male circumcision services in African countries with high HIV prevalence, and where male circumcision is not now routinely practised, could lead to substantial reductions in HIV transmission and prevalence over time among both men and women.

  15. PAIN MANAGEMENT IN CIRCUMCISION: A COMPARATIVE STUDY

    OpenAIRE

    Dr.Khalid Mahmood; Dr. Zahid Mahmood Nagra; Dr.Muhammad Akram Malik; Prof.Sajid Hameed; Dr.Rana Liaqat Ali

    2010-01-01

    Objective: To assess the effectiveness and safety of interventions of reducing pain at neonatal circumcision.Study Design: Quasi-experimental designPlace and Duration of Study: Departments of Pediatric Surgery and Plastic Surgery, Allied Hospital, Madina TeachingHospital, Faisal Hospital, Abdullah Medical Complex, Jail Road, Faisalabad from June 2005 to July 2010.Methodology: Neonates presenting for circumcision during the first month of life were included in the study. A total of 102neonates...

  16. Religious freedom and the German circumcision debate

    OpenAIRE

    Marianne Heimbach-Steins

    2013-01-01

    In May 2012, a German court in Cologne ruled that circumcising young boys represents grievous bodily harm. This decision, which touched upon the questions of freedom of religious practice, identity and children’s rights, was condemned by Jewish and Muslim representatives in Germany, but it was also widely and controversially debated by civil society and politicians. The German Parliament recently passed legislation protecting circumcision as a religious practice, but the debate is likely to c...

  17. Comparison of post circumcision complications and wound

    International Nuclear Information System (INIS)

    The objective of this study is to compare the frequency of post circumcision complications like bleeding and infection along with wound healing in infants by conventional open method and the bone-cutter method. Study Design: Randomized controlled trial. Place and Duration of Study: Combined Military Hospital and Military Hospital Rawalpindi, from March 2009 to March 2010. Patients and Methods: A total of 400 patients were included in the study that underwent circumcision. Patients were randomly allotted to either group A in whom the circumcision was done with conventional open technique (n = 200) or to group B, in whom circumcision was done with bone-cutter (n = 200). Patients were followed up in the surgical OPD after 5 days for assessment and earlier in case of any complication. Outcomes were measured by absence or presence of infection, post operative bleeding and cosmetic acceptance by the parents. Results: Comparison between the two groups showed that the bleeding rate was 8% in group A and 7% in group B (p = 0.704). Infection rate was 6% in group A and 5% in group B (p = 0.661). Delayed wound healing was seen in 4% of circumcisions in group A as opposed to 2% in group B ( p = 0.241). Conclusion: Complication is a part of any surgical procedure. So is the case with circumcision however no significant difference was found between the two procedures in terms of bleeding, infection, trauma to the glans and the cosmetic outcome. (author)

  18. Parental circumcision preferences and early outcome of plastibell circumcision in a Nigerian tertiary hospital

    Directory of Open Access Journals (Sweden)

    Okechukwu Hyginus Ekwunife

    2015-01-01

    Full Text Available Background: Parents are central in decisions and choices concerning circumcision of their male children and plastibell circumcision is a widely practiced technique. This study determined parental preferences for male neonatal and infant circumcisions and evaluate the early outcomes of plastibell circumcisions in a tertiary centre. Patients and Methods: This is a prospective study on consecutive male neonates and infants who were brought for circumcisions at Nnamdi Azikiwe University Teaching Hospital Nnewi, South-East Nigeria and their respective parents between January 2012 and December 2012. Data on demography, parental choices and early outcome of plastibell circumcision were obtained and analysed. Results: A total of 337 requests for circumcisions were made for boys with age range of 2-140 days. Culture and religion were the most common reasons for circumcision requests in 200 (59.3% and 122 (36.2%, respectively, other reasons were medical, cosmesis, to reduce promiscuity and just to follow the norm. Most parents, 249 (73.9% preferred the procedure to be performed on the 8 th day and 88.7% would like the doctors to perform the procedure while 84.6% preferred the plastibell method. Among those who had circumcision, 114 complied with follow-up schedules and there were complications in 22 (19.3% patients. Parents assessed the early outcome as excellent, very good, good and poor in 30.7%, 45.6%, 18.4% and 5.3% of the patients, respectively. Conclusion: Parents request for male circumcision in our environment is largely for cultural and religious reasons; and prefer the procedure to be performed by a physician. Plastibell method is well known and preferred and its outcome is acceptable by most parents.

  19. The ultrasonic harmonic scalpel for circumcision: experimental evaluation using dogs

    OpenAIRE

    Peng, Mou; Meng, Zhe; Yang, Zhong-Hua; Wang, Xing-Huan

    2012-01-01

    Male circumcision is one of the most commonly performed operations worldwide, and many novel techniques have been developed for better postoperative outcomes. The purpose of this study was to explore the feasibility of applying the ultracision harmonic scalpel (UHS) for circumcision by using dogs. Sixteen adult male dogs were divided into two groups: the UHS group and the control group. The dogs were circumcised with either the UHS or a conventional scalpel. The UHS circumcision procedure and...

  20. Circumcision: a refined technique and 5 year review.

    OpenAIRE

    S. C. Tucker; Cerqueiro, J.; Sterne, G.D.; Bracka, A.

    2001-01-01

    The vast majority of circumcisions currently performed in the UK are for phimosis or balanitis and the patients are not looking for the denuded glans appearance of a ritual circumcision. We present a refinement of the sleeve technique of circumcision, which involves Horton's test to define the proximal incision margin, and bipolar electro-dissection. A review of all patients undergoing circumcision at the Wordsley Plastic Surgery Unit, in a 5-year period, has shown this technique to be safe w...

  1. CIRCUMCISION IN MALES WITH BLEEDING DISORDERS

    Directory of Open Access Journals (Sweden)

    Hassan Mansouritorghabeh

    2013-01-01

    Full Text Available Introduction: Male circumcision practice is an invasive procedure that is using worldwide. It makes challenges to haemostatic system and its possible haemorrhagic side effects are more serious in bleeding individuals than normal subjects. In most cases, it can be complete controlled using infusion of appropriate amount of coagulation factors before and post circumcision.Aim: We aim to documentation type of coagulation therapy and post circumcision practice haemorrhagic presentation among 463 bleeder males of both common and rare bleeding disorders in north eastern part of country.Methods: We retrospectively gathered information using evaluation medical records in 3 major hospitals during last 15 years and list of patients with bleeding disorders that obtained from haemophilia center. Also a call phone established for each bleeder person to complete data and updating of them. The survey took time from Sep 2009- Mar 2011. The designed question form included data on doing circumcision or not? types of treatment before and post the procedure and occurrence of bleeding episodes after the surgery.Results: Overall among 424 cases with various common and rare bleeding disorders who had circumcised, 239 cases (56.3% had passed the procedure with bleeding experience, while 185 cases (43.7% had passed it successfully and without noticeable bleeding experience. The types of coagulation therapy in each group have been cited.Conclusion: The circumcision practice in unequipped medical center for bleeder ones may make challenges for them and medical services. Also it needed supervision of expert haematologist for adjusting treatment to ensure control of unwanted bleeding. 

  2. Ketamine-propofol sedation in circumcision

    Directory of Open Access Journals (Sweden)

    Handan Gulec

    2015-10-01

    Full Text Available ABSTRACTBACKGROUND AND OBJECTIVE: To compare the therapeutic effects of ketamine alone or ketamine plus propofol on analgesia, sedation, recovery time, side effects in premedicated children with midazolam-ketamine-atropin who are prepared circumcision operation.METHODS: 60 American Society of Anaesthesiologists physical status I-II children, aged between 3 and 9 years, undergoing circumcision operations under sedation were recruited according to a randomize and double-blind institutional review board-approved protocol. Patients were randomized into two groups via sealed envelope assignment. Both groups were administered a mixture of midazolam 0.05 mg/kg + ketamine 3 mg/kg + atropine 0.02 mg/kg intramuscularly in the presence of parents in the pre-operative holding area. Patients were induced with propofol-ketamine in Group I or ketamine alone in Group II.RESULTS: In the between-group comparisons, age, weight, initial systolic blood pressure, a difference in terms of the initial pulse rate was observed (p > 0.050. Initial diastolic blood pressure and subsequent serial measurements of 5, 10, 15, 20th min, systolic blood pressure, diastolic blood pressure and pulse rate in ketamine group were significantly higher (p < 0.050.CONCLUSION: Propofol-ketamine (Ketofol provided better sedation quality and hemodynamy than ketamine alone in pediatric circumcision operations. We did not observe significant complications during sedation in these two groups. Therefore, ketofol appears to be an effective and safe sedation method for circumcision operation.

  3. Experience of Using Amniotic Membrane After Circumcision

    International Nuclear Information System (INIS)

    It is compulsory, for boys to undergone circumcision before getting adult in Moslem region. It can be done by General Surgeon, General Practitioner, Nurse, Midwife or Quack. The place to carry out the circumcision can be inside or outside hospital. The utmost problems are injections, point for secondary wound covering and delay of using underpants. To overcome those problem amniotic membranes can be used as wound covering, based on : they are soft, easy to shape wound surface, satisfactory adhesive properties, good elasticity and sufficient, transparency which allows wound control without redressing of the wound. From January until December 1999, 165 boys at an age between 6-10 years, which have been carried out circumcision, were evaluated. Radiation sterilized lyophilized amniotic membranes were used in this work as wound covering Result show that amniotic membrane gave a good result in wound healing. All the patients observed, showed early mobilization as well as early using underpants. There is no different result between circumcision which had been done either inside or out hospital, carried out by surgeon or non-surgeon

  4. Paediatric male circumcision and penile hygiene: a Japanese mothers' view.

    Science.gov (United States)

    Castro-Vázquez, Genaro

    2013-01-01

    This paper analyses the views of 20 Japanese mothers concerning paediatric male circumcision and penile hygiene. In Japan, routine male circumcision has never been implemented for newborns and children, and adult males are mostly circumcised at aesthetic clinics. However, media reports indicate a trend of Japanese mothers willing to have their sons circumcised. In discussing penile hygiene and male circumcision, the construct of a 'sexual script' becomes relevant to understanding how linguistic and gender barriers made references to male genitalia and penile hygiene largely appear as 'vulgar' and 'unfeminine' in daily life conversations. Peers were often identified as the main source of information and only mothers who have struggled with their children's penile infections have learnt about male genital hygiene, a domain of knowledge largely transmitted by men. Male circumcision becomes a double-edged sword that could help prevent penile infections but also an embarrassing conversational topic that could elicit discrimination because most Japanese children are uncircumcised. PMID:24152018

  5. Acquired phimosis after plastibell circumcision: a preventable consequence

    OpenAIRE

    Kidger, EA; Haider, N; Qazi, A

    2012-01-01

    INTRODUCTION The plastibell device is used successfully for religious and cultural circumcisions in the community. The aim of this article is to highlight the recognition and management of iatrogenic phimosis. METHODS A retrospective study was performed of outcomes of plastibell circumcision in a community-based circumcision service provided by trained paediatric surgeons. The objective was to assess the complication of slipped plastibell rings and to ascertain the effectiveness of its manage...

  6. Infant Male Circumcision: Healthcare Provider Knowledge and Associated Factors

    OpenAIRE

    Starzyk, Erin J.; Kelley, Michele A; Rachel N Caskey; Schwartz, Alan; Kennelly, Joan F.; Robert C Bailey

    2015-01-01

    Background and Objectives The emerging science demonstrates various health benefits associated with infant male circumcision and adult male circumcision; yet rates are declining in the United States. The American Academy of Pediatrics and the Centers for Disease Control and Prevention recommend that healthcare providers present evidence-based risk and benefit information for infant male circumcision to parent(s) and guardian(s). The purpose of this study was to assess providers’ level of infa...

  7. Urethral fistula following circumcision: salvaged by buccal mucosa graft urethroplasty

    OpenAIRE

    Sinha, Rahul Janak; Dalela, Divakar; S N Sankhwar; Singh, Vishwajeet

    2009-01-01

    Fistula following circumcision and at times accompanied by disfigurement of the glans penis is a common problem in our country, where a large number of circumcision is performed by untrained professionals. These complications may have profound negative psychological impact on the growing child. Herein, we report the successful closure of such fistula using buccal mucosa, which occurred following circumcision (for phimosis) in a 15 year old boy. This resulted in the disfigurement of the glans ...

  8. Infant male circumcision: healthcare provider knowledge and associated factors.

    Directory of Open Access Journals (Sweden)

    Erin J Starzyk

    Full Text Available BACKGROUND AND OBJECTIVES: The emerging science demonstrates various health benefits associated with infant male circumcision and adult male circumcision; yet rates are declining in the United States. The American Academy of Pediatrics and the Centers for Disease Control and Prevention recommend that healthcare providers present evidence-based risk and benefit information for infant male circumcision to parent(s and guardian(s. The purpose of this study was to assess providers' level of infant male circumcision knowledge and to identify the associated characteristics. METHODS: An online survey was administered to healthcare providers in the family medicine, obstetrics, and pediatrics medical specialties at an urban academic health center. To assess infant male circumcision knowledge, a 17 point summary score was constructed to identify level of provider knowledge within the survey. RESULTS: Ninety-two providers completed the survey. Providers scored high for the following knowledge items: adverse event rates, protects against phimosis and urinary tract infections, and does not prevent hypospadias. Providers scored lower for items related to more recent research: protection against cervical cancer, genital ulcer disease, bacterial vaginosis, and reduction in HIV acquisition. Two models were constructed looking at (1 overall knowledge about male circumcision, and (2 knowledge about male circumcision reduction in HIV acquisition. Pediatricians demonstrated greater overall infant male circumcision knowledge, while obstetricians exhibited significantly greater knowledge for the HIV acquisition item. CONCLUSION: Providers' knowledge levels regarding the risks and benefits of infant male circumcision are highly variable, indicating the need for system-based educational interventions.

  9. Parental Decision Making in Male Circumcision

    OpenAIRE

    Sardi, Lauren; Livingston, Kathy

    2015-01-01

    Abstract Purpose: To study which healthcare professionals (HCPs) firstasked parents about their decision regarding circumcision; whether parents felt they were given enough information by their HCP; and what reasons parents cited for their decision. Study Design and Methods: Bilingual questionnaires were administered to parents and expecting parents of boys (N = 60). Close-ended survey responses were analyzed through factor analysis to ascertain what types of beliefs parents used in their dec...

  10. Circumcision - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Chinese - Simplified (简体中文) Chinese - Traditional (繁體中文) French (français) Hindi (हिन्दी) Japanese (日本語) Korean (한국어) Russian (Русский) ... masculine - français (French) Bilingual PDF Health Information Translations Hindi (हिन्दी) Male Circumcision हिन्दी (Hindi) Bilingual ...

  11. Circumcision: The Good, the Bad and American Values

    Science.gov (United States)

    Buie, Mary E.

    2005-01-01

    National statistics estimate that 1.2 million newborn males are circumcised annually in the United States (70% to 80%). Such values as sanctity, equity, fraternity, paternity and liberty affect circumcision rates in America. The value of sanctity allows freedom of religious beliefs and traditions that often overcome medical impetus in…

  12. Circumcision and periurethral carriage of Proteus mirabilis in boys.

    OpenAIRE

    Glennon, J.; Ryan, P J; Keane, C T; Rees, J P

    1988-01-01

    Swabs were taken for culture from the periurethral area and urethral meatus in 124 uncircumcised and 60 circumcised boys. Proteus mirabilis was grown from 28 (22.6%) swabs from uncircumcised boys and from only one (1.7%) swab from circumcised boys. This supports the idea that the prepuce may be the source of proteus urinary tract infection.

  13. Effects of Adult Male Circumcision on Premature Ejaculation: Results from a Prospective Study in China

    OpenAIRE

    Jingjing Gao; Chuan Xu; Jingjing Zhang; Chaozhao Liang; Puyu Su; Zhen Peng; Kai Shi; Dongdong Tang; Pan Gao; Zhaoxiang Lu; Jishuang Liu; Lei Xia; Jiajia Yang; Zongyao Hao; Jun Zhou

    2015-01-01

    The purpose of this study is to investigate the effects of adult male circumcision on premature ejaculation (PE). Therefore, between December 2009 and March 2014, a total of 575 circumcised men and 623 uncircumcised men (control group) were evaluated. Detailed evaluations (including circumcision and control groups) on PE were conducted before circumcision and at the 3-, 6-, 9-, and 12-month follow-up visits after circumcision. Self-estimated intravaginal ejaculatory latency time (IELT), Patie...

  14. Epidemiology of complications of male circumcision in Ibadan, Nigeria

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    Ikuerowo Odunayo S

    2006-08-01

    Full Text Available Abstract Background The number of infants managed for neonatal circumcision injuries in our unit has been on the increase over the past 16 years. In our search for the sources and reasons for these injuries, we were unable to identify any previous studies of circumcision injuries from our environment. We therefore decided to carry out this study in order to shed some light on this growing problem. Methods The patients were made up of 370 consecutive consented children attending our infant welfare clinic for immunization over a period of 3 months. Information on their demographic data, their age at circumcision, where, why and who circumcised them was obtained from their mothers. They were clinically examined for the presence and type of complications of circumcision. Results Our circumcision rate was 87%. Neonatal circumcision had been performed in 270 (83.9% of the children. Two hundred and fifty nine (80.7% were performed in hospitals. The operation was done by nurses in 180 (55.9%, doctors in 113 (35.1% and by the traditional circumcisionist in 29 (9% of the children. Complications of circumcision occurred in 65 [20.2%] of the children. Of those who sustained these complications, 35 (53.8% had redundant foreskin, 16 (24.6% sustained excessive loss of foreskin, 11 (16.9% had skin bridges, 2 (3.1% sustained amputation of the glans penis and 1 (1.5% had a buried penis. One of the two children who had amputation of the glans also had severe hemorrhage and was transfused. Even though the complications tended to be more likely with nurses than with doctors or traditional circumcisionists, this did not reach statistical significance (p = 0.051. Conclusion We have a very high rate of complications of circumcision of 20.2%. We suggest that training workshops should be organized to adequately retrain all practitioners of circumcision on the safe methods available.

  15. Newborn Male Circumcision with Parental Consent, as Stated in the AAP Circumcision Policy Statement, Is Both Legal and Ethical.

    Science.gov (United States)

    Brady, Michael T

    2016-06-01

    Newborn male circumcision is a minor surgical procedure that has generated significant controversy. Accumulating evidence supports significant health benefits, most notably reductions in urinary tract infections, acquisition of HIV and a number of other sexually transmitted infections, penile cancer, phimosis, paraphimosis, balanitis and lichen sclerosis. While circumcision, like any surgical procedure, has risks for complications, they occur in less than 1 in 500 infants circumcised and most are minor and require minimal intervention. The CDC and the American Academy of Pediatrics (AAP) believe that health benefits of circumcision outweigh the risks. For this reason, the AAP believes that parents should be allowed to make the decision concerning circumcision of their male infants after receiving non-biased information on health risks and health benefits. PMID:27338601

  16. Does circumcision alter the periurethral uropathogenic bacterial flora

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    Mushtaq Ahmad Laway

    2012-01-01

    Full Text Available Background: The aim of this study was to assess the pattern of periurethral bacterial flora in uncircumcised boys and to evaluate the effect of circumcision on alteration of periurethral uropathogenic bacterial flora. Materials and Methods: Pattern of periurethral bacterial flora before and after circumcision was studied prospectively in 124 boys. The results were analysed to compare change in bacterial colonisation before and after circumcision. Results: The age range was 6 weeks to 96 months. Most (94.3% of the boys had religious indication and 5.7% had medical indication for circumcision. E. coli, Proteus and Klebsiella were most common periurethral bacterial flora in uncircumcised subjects. Coagulase-negative staphylococcus and Staphylococcus aureus was most common periurethral bacterial flora in circumcised subjects. In 66.1% of circumcised subjects, no bacteria were grown from periurethral region. Conclusion: We conclude that presence of prepuce is associated with great quantity of periurethral bacteria, greater likelihood of the presence of high concentration of uropathogens and high incidence of urinary tract infection (UTI. This study provides circumstantial evidence supporting the idea that early circumcision may be beneficial for prevention of UTI.

  17. Surgical reimplantation of penile glans amputation in children during circumcision

    Directory of Open Access Journals (Sweden)

    Bouassida Khaireddine

    2014-01-01

    Full Text Available Circumcision is one of the oldest and most commonly performed surgical procedures. Unfortunately, various complications may occur during circumcision, ranging from trivial to tragic such as penile amputation which is a serious complication and a challenging injury to treat. We describe two cases of non-microsurgical successful reattachment of a distal penile glans which were amputated during circumcision. In the first case, a 5-year-old child underwent circumcision by an urologist under local anesthesia. In the second one, a 3-year-old child underwent circumcision by a general practitioner who used to make circumcision. In this article, the literature is reviewed; results and potential complications of this surgery are also discussed. Glans sensation was present, early morning erection was maintained, and there was an erectile response during penile manipulation in both cases. Although circumcision is not technically difficult, it should be taken seriously. The use of microsurgical reattachment is not always possible, especially in pediatric cases; it also requires special equipment and training.

  18. Voluntary Medical Male Circumcision collection

    OpenAIRE

    Njeuhmeli, Emmanuel; Forsythe, Steven; Reed, Jason; Opuni, Marjorie; Bollinger, Lori; Heard, Nathan; Castor, Delivette; Stover, John; Farley, Timothy; Menon, Veena; Hankins, Catherine

    2011-01-01

    Editors' Summary Background Every year, about 2.5 million people (mainly in sub-Saharan Africa) become infected with HIV, the virus that causes AIDS. There is no cure for HIV/AIDS. Consequently, prevention of HIV transmission is very important. Because the most common HIV transmission route is through unprotected sex with an infected partner, individuals can reduce their risk of HIV infection by abstaining from sex, by having only one or a few partners, and by using male or female condoms. Th...

  19. "If You Are Not Circumcised, I Cannot Say Yes": The Role of Women in Promoting the Uptake of Voluntary Medical Male Circumcision in Tanzania.

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    Haika Osaki

    Full Text Available Voluntary Medical Male Circumcision (VMMC for HIV prevention in Tanzania was introduced by the Ministry of Health and Social Welfare in 2010 as part of the national HIV prevention strategy. A qualitative study was conducted prior to a cluster randomized trial which tested effective strategies to increase VMMC up take among men aged ≥20 years. During the formative qualitative study, we conducted in-depth interviews with circumcised males (n = 14, uncircumcised males (n = 16, and participatory group discussions (n = 20 with men and women aged 20-49 years in Njombe and Tabora regions of Tanzania. Participants reported that mothers and female partners have an important influence on men's decisions to seek VMMC both directly by denying sex, and indirectly through discussion, advice and providing information on VMMC to uncircumcised partners and sons. Our findings suggest that in Tanzania and potentially other settings, an expanded role for women in VMMC communication strategies could increase adult male uptake of VMMC services.

  20. A study of clinical opinion and practice regarding circumcision

    OpenAIRE

    Farshi, Z; Atkinson, K; Squire, R

    2000-01-01

    AIM—To establish clinical opinion regarding appropriate indications for circumcision and to examine actual clinical practice.
METHODS—A questionnaire was sent to all NHS hospital consultants in the Yorkshire region of the UK identified as having a role to play in the management of boys (under 16 years of age) requiring circumcision. Retrospective data on actual clinical practice during a three month study period were also collected via a simple proforma.
RESULTS—Of 153 quest...

  1. A Salvage Operation for Total Penis Amputation Due to Circumcision

    OpenAIRE

    Bilsev Ince; Ayse Ozlem Gundeslioglu

    2013-01-01

    Circumcision is one of the most common rituals in Jewish and Islamic cultures. It may also be performed for phimosis correction or the treatment of recurrent balanitis. Although circumcision is considered to be a technically easy and safe surgical procedure with no significant risk, it may lead to severe complications such as necrotizing fasciitis or total penis amputation. In this report, we present a case of penis amputation at two levels occurring with third-degree burns due to electrocaut...

  2. Should Male Circumcision be Advocated for Genital Cancer Prevention?

    OpenAIRE

    Morris, Brian J.; Mindel, Adrian; Tobian, Aaron AR; Hankins, Catherine A.; Ronald H Gray; Bailey, Robert C.; Bosch, Xavier; Wodak, Alex D

    2012-01-01

    The recent policy statement by the Cancer Council of Australia on infant circumcision and cancer prevention and the announcement that the quadrivalent human papillomavirus (HPV) vaccine will be made available for boys in Australia prompted us to provide an assessment of genital cancer prevention. While HPV vaccination of boys should help reduce anal cancer in homosexual men and cervical cancer in women, it will have little or no impact on penile or prostate cancer. Male circumcision can reduc...

  3. How do you circumcise a nation? The Rwandan case study

    OpenAIRE

    Mutabazi, Vincent; Forrest, Jamie I; Ford, Nathan; Mills, Edward J

    2014-01-01

    Voluntary medical male circumcision has been conclusively demonstrated to reduce the lifetime risk of male acquisition of HIV. The strategy has been adopted as a component of a comprehensive strategy towards achieving an AIDS-free generation. A number of countries in which prevalence of HIV is high and circumcision is low have been identified as a priority, where innovative approaches to scale-up are currently being explored. Rwanda, as one of the priority countries, has faced a number of cha...

  4. Knowledge, attitudes and perceptions of pharmacy and nursing students towards male circumcision and HIV in a KwaZulu-Natal University, South Africa

    Directory of Open Access Journals (Sweden)

    Panjasaram V. Naidoo

    2012-07-01

    Full Text Available Background: Male circumcision is currently being promoted in South Africa as a HumanImmunodeficiency Virus (HIV prevention method. Effective implementation requires thathealthcare providers should believe in the procedure’s efficacy and should possess a positiveattitude. A study was undertaken amongst pharmacy and nursing students with differentobjectives.Objectives: To ascertain students’ knowledge, attitudes and perceptions regarding malecircumcision and (HIV prevention.Method: A descriptive cross-sectional study using anonymous questionnaires was undertakenamongst 4th year pharmacy and nursing students studying at a university in KwaZulu-Natal,after obtaining their consent. Data were captured and analysed using SPSS version 15.Results: A response rate of 83.18% and a mean knowledge score of 66.43% with relativelypositive attitudes (62.7 were obtained; 85.4% of the respondents felt that promoting malecircumcision is appropriate, with all Muslim students (n < 11 supporting the promotion ofmale circumcision. Even though all Muslim students supported male circumcision, only 3students were willing to perform the procedure if adequately trained (p < 0.03. The majorityof the female students were unwilling to perform the procedure (p < 0.005. A third of therespondents indicated that male circumcision would both undermine existing protectivebehaviours and strategies as well as increase riskier sexual behaviour. Over 54% of therespondents believed that the South African Health System would be able to cope with themassive male circumcision drive. The majority of the respondents favoured the procedure tobe done at birth. Pain was cited as the most important reason for not wanting to be circumcised.Conclusion: Pharmacy and nursing students have a moderate knowledge of male circumcisionand HIV prevention with relatively positive attitudes. The majority felt that promoting malecircumcision is appropriate and should be encouraged.

  5. Traditional Male Circumcision In A Rural Community In Kedah, Malaysia

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    Rashid A K

    2009-12-01

    Full Text Available Background: Circumcision though not mentioned inthe Quran is believed to be a compulsory practiceamong the Muslims. In Malaysia, although there areseveral methods of circumcision available andtraditional circumcision is still popular.Methods: A cross-sectional survey was carried out in asmall fishing village of Kedah to study the methods ofcircumcision available to the villagers. This wasfollowed with an in-depth interview conducted with‘Tok Mudim’, a practitioner of traditional method ofcircumcision.Results: Forty three of the eligible 71 subjectsparticipated in the study giving the response rate as60.5%. The most common age for circumcision was9 years old. Despite private clinics being the mostcommon place of circumcisions, there was an increasingnumber of boys going to the ‘Tok Mudim’ forcircumcision. A Mass Circumcision Ceremony istraditionally practiced. The ‘Tok Mudim’ described theprocedure in detail and was of the opinion that thereason traditional method is still popular was because ofthe fear of injections and impotency among the parents.Most common complication faced by the ‘Tok Mudim’was bleeding and infection.Discussion and Conclusion: Till the community shiftsentirely to using modern medicine, there is a need tointegrate traditional practitioners into the system.Training the ‘Tok Mudim’ to use modern instrumentsand aseptic techniques should be considered.

  6. Paediatric sutureless circumcision-an alternative to the standard technique.

    LENUS (Irish Health Repository)

    2012-01-31

    INTRODUCTION: Circumcision is one of the most commonly performed surgical procedures in male children. A range of surgical techniques exist for this commonly performed procedure. The aim of this study is to assess the safety, functional outcome and cosmetic appearance of a sutureless circumcision technique. METHODS: Over a 9-year period, 502 consecutive primary sutureless circumcisions were performed by a single surgeon. All 502 cases were entered prospectively into a database including all relevant clinical details and a review was performed. The technique used to perform the sutureless circumcision is a modification of the standard sleeve technique with the use of a bipolar diathermy and the application of 2-octyl cyanoacrylate (2-OCA) to approximate the tissue edges. RESULTS: All boys in this study were pre-pubescent and the ages ranged from 6 months to 12 years (mean age 3.5 years). All patients had this procedure performed as a day case and under general anaesthetic. Complications included: haemorrhage (2.2%), haematoma (1.4%), wound infection (4%), allergic reaction (0.2%) and wound dehiscence (0.8%). Only 9 (1.8%) parents or patients were dissatisfied with the cosmetic appearance. CONCLUSION: The use of 2-OCA as a tissue adhesive for sutureless circumcisions is an alternative to the standard suture technique. The use of this tissue adhesive, 2-OCA, results in comparable complication rates to the standard circumcision technique and results in excellent post-operative cosmetic satisfaction.

  7. Circumventing the Urologist: A Case of Poorly Executed Self-Circumcision

    Directory of Open Access Journals (Sweden)

    Timothy Rogers

    2016-06-01

    Full Text Available Circumcision is a relatively brief and safe procedure when performed by a medical professional. Recently, clamp-assisted circumcisions in the adult male have gained increased interest due to potential public health benefits. With the heightened interest has come an increased accessibility to such devices, creating the opportunity for ill-advised home attempts at circumcision by private citizens. To our knowledge, we present the first reported case of poorly executed self-circumcision in an adult male.

  8. The Effect of Health Education Program for Caregivers on Circumcision Outcome in Neonates and Infants

    Science.gov (United States)

    Gafer, Youser abd Elsalam; Nafee, Houda Mohammed; Pal, Kamlish

    2015-01-01

    Circumcision is a surgical excision of the foreskin to the level of the coronal sulcus which may perform in the neonatal period or in later life. Circumcision has many medical benefits such as minimizing urinary tract infection, reduces the incidence of balanitis and enhances of penile hygiene, prevents of penile cancer. However, Circumcision may…

  9. [Ethical Evaluation of Non-Therapeutic Male Circumcision].

    Science.gov (United States)

    İzgi, M Cumhur

    2015-01-01

    Elective circumcision for nonmedical reasons is a surgical approach which is historically long standing and accepted as the most performed procedure. The necessity of the procedure is usually for religious and traditional reasons alongside some medical ground related benefits to enable its social acceptability. The discussion of the subject from the aspect of ethics becomes necessary as there is no consensus about the benefits or harmfulness of nonmedical circumcision. Fundamental ethical discussions about circumcision, which contradicts legal acceptance criteria of any medical application, are related to the basic concepts of the existence of an individual such as sovereignty, the loss of bodily integrity, and privacy. The recent legal processes and the fact that the European Council and the American Academy of Pediatrics have put the issue on their agenda have increased the necessity of these ethical evaluations. The responsibility of consideration and evaluation of ethical permission of every circumcision procedure, besides discussing the necessity of circumcision for improvement and protection of health rests on the shoulders of the physicians because the dignity and intellectual identity of the profession require so. PMID:26364175

  10. AB221. Effects of adult male circumcision on premature ejaculation: results from a prospective study in China

    OpenAIRE

    Gao, Jingjing; Xu, Chuan; Zhang, Xiansheng

    2016-01-01

    Objective The purpose of this study is to investigate the effects of adult male circumcision on premature ejaculation (PE). Methods Therefore, between December 2009 and March 2014, a total of 575 circumcised men and 623 uncircumcised men (control group) were evaluated. Detailed evaluations (including circumcision and control groups) on PE were conducted before circumcision and at the 3-, 6-, 9-, and 12-month follow-up visits after circumcision. Self-estimated intravaginal ejaculatory latency ...

  11. Complications of Circumcision in Childhood and Preventive Strategies

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    Akgun Oral

    2011-10-01

    Full Text Available Circumcision is the most common surgical procedure applied worldwide. Besides the medical necessities, it is also common due to religious and cultural reasons. The frequent performance of this surgical procedure increases the importance of the management of the complications arising during/after the operation. In our country performing this procedure under the improper conditions especially by non-medical persons or inexperienced operators increases the likelihood of complications, which sometimes causes non-recoverable tissue and organ loss. The persons performing this surgical procedure must be well acquainted with the complications which may arise during/after a circumcision procedure. For this reason, the possible complications regarding a circumcision procedure should be classified. Within this context, the required suggestions are presented in this article to reduce the complications to a minimal level. [TAF Prev Med Bull 2011; 10(5.000: 605-610

  12. Perceptions of HIV and Safe Male Circumcision in High HIV Prevalence Fishing Communities on Lake Victoria, Uganda.

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    Paul E Nevin

    Full Text Available In 2010, the Uganda Ministry of Health introduced its Safe Male Circumcision (SMC strategy for HIV prevention with the goal of providing 4.2 million voluntary medical male circumcisions by 2015. Fishing communities, where HIV prevalence is approximately 3-5 times higher than the national average, have been identified as a key population needing targeted HIV prevention services by the National HIV Prevention Strategy. This study aimed to understand perceptions of HIV and identify potential barriers and facilitators to SMC in fishing communities along Lake Victoria.We conducted 8 focus group discussions, stratified by sex and age, with 67 purposefully sampled participants in 4 communities in Kalangala District, Uganda.There was universal knowledge of the availability of SMC services, but males reported high uptake in the community while females indicated that it is low. Improved hygiene, disease prevention, and improved sexual performance and desirability were reported facilitators. Barriers included a perceived increase in SMC recipients' physiological libido, post-surgical abstinence, lost income during convalescence, and lengthier recovery due to occupational hazards. Both males and females reported concerns about spousal fidelity during post-SMC abstinence. Reported misconceptions and community-held cultural beliefs include fear that foreskins are sold after their removal, the belief that a SMC recipient's first sexual partner after the procedure should not be his spouse, and the belief that vaginal fluids aid circumcision wound healing.Previous outreach efforts have effectively reached these remote communities, where availability and health benefits of SMC are widely understood. However, community-specific intervention strategies are needed to address the barriers identified in this study. We recommend the development of targeted counseling, outreach, and communication strategies to address barriers, misconceptions, and community-held beliefs

  13. Barriers and motivators to voluntary medical male circumcision uptake among different age groups of men in Zimbabwe: results from a mixed methods study.

    Directory of Open Access Journals (Sweden)

    Karin Hatzold

    Full Text Available BACKGROUND: We conducted quantitative and qualitative studies to explore barriers and motivating factors to VMMC for HIV prevention, and to assess utilization of existing VMMC communication channels. METHODS AND FINDINGS: A population-based survey was conducted with 2350 respondents aged 15-49. Analysis consisted of descriptive statistics and bivariate analysis between circumcision and selected demographics. Logistic regression was used to determine predictors of male circumcision uptake compared to intention to circumcise. Focus group discussions (FGDs were held with men purposively selected to represent a range of ethnicities. 68% and 53% of female/male respondents, respectively, had heard about VMMC for HIV prevention, mostly through the radio (71%. Among male respondents, 11.3% reported being circumcised and 49% reported willingness to undergo VMMC. Factors which men reported motivated them to undergo VMMC included HIV/STI prevention (44%, improved hygiene (26%, enhanced sexual performance (6% and cervical cancer prevention for partner (6%. Factors that deterred men from undergoing VMMC included fear of pain (40%, not believing that they were at risk of HIV (18%, lack of partner support (6%. Additionally, there were differences in motivators and barriers by age. FGDs suggested additional barriers including fear of HIV testing, partner refusal, reluctance to abstain from sex and myths and misconceptions. CONCLUSIONS: VMMC demand-creation messages need to be specifically tailored for different ages and should emphasize non-HIV prevention benefits, such as improved hygiene and sexual appeal, and need to address men's fear of pain. Promoting VMMC among women is crucial as they appear to have considerable influence over men's decision to get circumcised.

  14. Towards a solution concerning female genital mutilation? An approach from within according to Islamic legal opinions

    Directory of Open Access Journals (Sweden)

    Jens Kutscher

    2011-01-01

    Full Text Available Female circumcision is a tradition that is widespread and not restricted to predominantly Muslim countries. It is prevalent among all religious groups in many parts of Africa and Western Asia, whether they are Coptic Christians, Ethiopian Jews, or Arab Muslims. Female genital cutting or—more to the point—female genital mutilation (FGM, generally referred to as circumcision, occurs in at least five different forms. Circumcision is essentially a powerful bodily sign of the human—male and female—covenant with God. In the Quran it is reaffirmed in sura al-Nahl and quoted as example in the fatwas endorsing circumcision. It seems to be true that men are hardly involved in the actual decision in favour of female genital cutting. A man should not interfere in the decision of women to be circumcised. It is practiced and transmitted among women and midwives. Only sometimes is a (male or female physician involved. On the basis of Islamic normativity, mirrored in fatwas, this paper aims to examine a very ambivalent approach concerning female genital mutilation.

  15. Effects of Adult Male Circumcision on Premature Ejaculation: Results from a Prospective Study in China

    Directory of Open Access Journals (Sweden)

    Jingjing Gao

    2015-01-01

    Full Text Available The purpose of this study is to investigate the effects of adult male circumcision on premature ejaculation (PE. Therefore, between December 2009 and March 2014, a total of 575 circumcised men and 623 uncircumcised men (control group were evaluated. Detailed evaluations (including circumcision and control groups on PE were conducted before circumcision and at the 3-, 6-, 9-, and 12-month follow-up visits after circumcision. Self-estimated intravaginal ejaculatory latency time (IELT, Patient-Reported Outcome measures, and 5-item version of the International Index of Erectile Function were used to measure the ejaculatory and erectile function for all subjects. The results showed that, during the one-year follow-up, men after circumcision experienced higher IELT and better scores of control over ejaculation, satisfaction with sexual intercourse, and severity of PE than men before circumcision (P<0.001 for all. Similarly, when compared with the control group, the circumcised men reported significantly improved IELT, control over ejaculation, and satisfaction with sexual intercourse (P<0.001 for all. These findings suggested that circumcision might have positive effects on IELT, ejaculatory control, sexual satisfaction, and PE severity. In addition, circumcision was significantly associated with the development of PE.

  16. The Sutureless Circumcision- An Alternative to the Standard Technique

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    Hiren Dahyabhai Parmar

    2012-08-01

    Full Text Available Introduction: circumcision is a commonly performed surgery. Surgeons have become increasingly interested in the use of adhesive bonds. Recent advances have been made in the use of tissue glue in the circumcision. In this study, we used 2-octyl cyanoacrylate for closing circumcision wounds and we have reported our experience. Material & methods: this was a prospective non-comparative preliminary clinical study involving 30 patients where 2-octyl cyanoacrylate was used as a tissue adhesive for wound closure after formal circumcision at surgery department, Smt S.C.L. Municipal General Hospital from May 2008 to Nov 2010. Result: in this study, the mean time taken for skin closure by 2-octyl cyanoacrylate is much faster in last year of study. There is significant less pain. There is 10% (3 cases of complications are observed. The wound cosmesis score on 90th post-operative day is optimal except in one patient of wound separation. Conclusion: the comparison with criterions of time taken foe skin closure, the post-operative pain, the cosmetic appearance of adhesive glue proves that 2-octyl cyanoacrylate skin closure is significantly better than the traditional skin suturing skin closure. [Natl J of Med Res 2012; 2(4.000: 448-451

  17. Male circumcision in the general population of Kisumu, Kenya: beliefs about protection, risk behaviors, HIV, and STIs.

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    Matthew Westercamp

    Full Text Available Using a population-based survey we examined the behaviors, beliefs, and HIV/HSV-2 serostatus of men and women in the traditionally non-circumcising community of Kisumu, Kenya prior to establishment of voluntary medical male circumcision services. A total of 749 men and 906 women participated. Circumcision status was not associated with HIV/HSV-2 infection nor increased high risk sexual behaviors. In males, preference for being or becoming circumcised was associated with inconsistent condom use and increased lifetime number of sexual partners. Preference for circumcision was increased with understanding that circumcised men are less likely to become infected with HIV.

  18. Evaluation of coagulation tests before newborn circumcision: is it necessary?

    Science.gov (United States)

    Eroğlu, Egemen; Sözmen, Banu Oflaz; Kayiran, Sinan Mahir; Balci, Selvinaz; Gürakan, Berkan

    2016-03-01

    Evaluation of coagulation parameters prior to newborn circumcision is routinely performed in many countries. However, the value of this screening in predicting the bleeding risk is unknown. The aim of this study was to evaluate the correlation between the preoperative prolonged prothrombin time (PT), activated partial thromboplastin time (aPTT) and excessive bleeding after the circumcision in term, healthy newborns without family history of coagulopathy. The medical records of healthy, full term newborns born at VKV American Hospital, in Istanbul, Turkey, between 2009 and 2012 who were circumcised within the first week of life, were reviewed retrospectively. The data for family history of coagulopathy, clinical sign(s) of bleeding during and/or after delivery, preoperative PT, aPTT levels and the amount of bleeding after circumcision were gathered. The most recent medical records of the patients' were also reviewed for any possible, lately diagnosed bleeding disorder. A total of 450 newborns met the above criteria. None had a family history of bleeding disorder or clinical bleeding. A total of 158 (35%) newborns had an aPTT result greater than 54.5 s, 269 (59%) had PT result greater than 15.9 s and 72 (16%) had international normalized ratio result greater than 1.62. Neither of the patients with prolonged PT and/or aPTT had prolonged or excessive bleeding. The evaluation of PT and aPTT before elective newborn circumcision is not necessary in the absence of clinical bleeding or a family history of bleeding disorder. It is rather a habit in general practice and possibly a result of defensive medicine. PMID:26523913

  19. Low frequency of male circumcision and unwillingness to be circumcised among MSM in Buenos Aires, Argentina: association with sexually transmitted infections

    Directory of Open Access Journals (Sweden)

    María A Pando

    2013-06-01

    Full Text Available Objective: The aims of this study were to investigate the frequency of male circumcision among men who have sex with men (MSM in Buenos Aires, Argentina; the association between circumcision and sexually transmitted infections (STIs; and, among those uncircumcised, the willingness to be circumcised. Methods: A cross-sectional study was conducted among 500 MSM recruited through the respondent-driven sampling (RDS technique. Participants underwent a consent process, responded to a Web-based survey that included questions on demographic information, sexual behaviour, and circumcision and provided biological samples. HIV, hepatitis B virus (HBV, hepatitis C virus (HCV, Treponema pallidum, and human papiloma virus (HPV diagnoses were performed using standard methodologies. For all analyses, data were weighted based on participants’ network size. Results: Only 64 (13% of the 500 MSM in our study reported being circumcised. Among uncircumcised men (n=418, 302 (70.4% said that they would not be willing to get circumcised even if the procedure could reduce the risk of HIV infection. When considering all participants, circumcision status was not significantly associated with HIV, HBV, HCV, T. pallidum or HPV infections. However, when we restricted the sample to men who do not practice receptive anal intercourse (RAI and compared circumcised to uncircumcised men, the former (N=33 had no cases of HIV infection, while 34 of 231 (14.8% uncircumcised men were HIV positive (p=0.020. Regarding HPV, uncircumcised men had a significantly larger number of different HPV types compared with circumcised men (mean 1.83 vs. 1.09, p<0.001 and a higher frequency of high-risk-HPV genotypes (47.6% vs. 12.5%, p=0.012. Conclusions: Consistent with international evidence, male circumcision appears to have a partial protective effect among MSM. The efficacy of circumcision in reducing risk of HIV infection among MSM appears to be correlated with sexual practices. Given the

  20. Is phimosis overdiagnosed in boys and are too many circumcisions performed in consequence?

    OpenAIRE

    Rickwood, A M; Walker, J.

    1989-01-01

    Thirty thousand circumcisions are performed annually in England and 70% of these are upon boys under 15 years of age. In the Mersey Region some 950 boys are circumcised each year for medical indications, the commonest being 'phimosis', which accounts for 87% of cases, of whom almost one-half are under 5 years of age. Regional practice is compared with that of our Unit, where the majority of referrals had developmentally non-retractile foreskin rather than true phimosis, where circumcisions fo...

  1. Myiasis as a Rare Complication of Male Circumcision: A Case Report and Review of Literature

    OpenAIRE

    Muhammad Rajib Hossain; Kazi Mazharul Islam; Junaid Nabi

    2012-01-01

    Introduction. Circumcision is a common procedure carried out around the world. Due to religious reasons, it is routinely done in Bangladesh, by both traditional as well as medically trained circumcisers. Complications include excessive bleeding, loss of foreskin, infection, and injury to the glans penis. Myiasis complicating male circumcision appears to be very rare. Case Presentation. In 2010, a 10-year-old boy presented to the OPD of Dhaka Medical College Hospital with severe pain in his pe...

  2. Understanding partial protection and HIV risk and behavior following voluntary medical male circumcision rollout in Kenya

    OpenAIRE

    L’Engle, K.; Lanham, M.; Loolpapit, M.; Oguma, I.

    2013-01-01

    In the midst of scaling up voluntary medical male circumcision (VMMC) in Kenya, there is concern that men do not adequately understand that circumcision provides only partial protection against HIV. The study goal was to determine men’s understanding of partial protection, perceptions of HIV risk before and after VMMC and use of protective measures following VMMC. In-depth interviews with 44 men aged 18–39 years recently circumcised or planning to undergo VMMC were conducted in two urban and ...

  3. Histopathological examination of the prepuce after circumcision: Is it a waste of resources?

    OpenAIRE

    Hussein Naji; Esraa Jawad; Husam A Ahmed; Rajaa Mustafa

    2013-01-01

    Background: The aim of this article is to evaluate the histopathological findings of foreskin after circumcision for medical indications and to find out if analyzing the biopsy is a waste of resources. Material and Methods: This retrospective analysis was carried out of the medical records and histopathological findings of 112 boys who underwent circumcision from June 2002 to June 2005. The study group consisted of 52 boys that were circumcised for medical indications, while the control group...

  4. Towards a gender perspective in qualitative research on voluntary medical male circumcision in east and southern Africa.

    Science.gov (United States)

    Martínez Pérez, Guillermo; Triviño Durán, Laura; Gasch, Angel; Desmond, Nicole

    2015-01-01

    The World Health Organization endorsed voluntary medical male circumcision (VMMC) in 2007 as an effective method to provide partial protection against heterosexual female-to-male transmission of HIV in regions with high rates of such transmission, and where uptake of VMMC is low. Qualitative research conducted in east and southern Africa has focused on assessing acceptability, barriers to uptake of VMMC and the likelihood of VMMC increasing men's adoption of risky sexual behaviours. Less researched, however, have been the perceptions of women and sexual minorities towards VMMC, even though they are more vulnerable to HIV/AIDS transmission than are heterosexual men. The purpose of this paper is to identify core areas in which a gendered perspective in qualitative research might improve the understanding and framing of VMMC in east and southern Africa. Issues explored in this analysis are risk compensation, the post-circumcision appearance of the penis, inclusion of men who have sex with men as study respondents and the antagonistic relation between VMMC and female genital cutting. If biomedical and social science researchers explore these issues in future qualitative inquiry utilising a gendered perspective, a more thorough understanding of VMMC can be achieved, which could ultimately inform policy and implementation. PMID:25727455

  5. Predictive Factors of Postoperative Pain and Postoperative Anxiety in Children Undergoing Elective Circumcision: A Prospective Cohort Study

    OpenAIRE

    Zavras, Nick; Tsamoudaki, Stella; Ntomi, Vasileia; Yiannopoulos, Ioannis; Christianakis, Efstratios; Pikoulis, Emmanuel

    2015-01-01

    Background Although circumcision for phimosis in children is a minor surgical procedure, it is followed by pain and carries the risk of increased postoperative anxiety. This study examined predictive factors of postoperative pain and anxiety in children undergoing circumcision. Methods We conducted a prospective cohort study of children scheduled for elective circumcision. Circumcision was performed applying one of the following surgical techniques: sutureless prepuceplasty (SP), preputial pl...

  6. Cost-effectiveness of newborn circumcision in reducing lifetime HIV risk among U.S. males.

    Directory of Open Access Journals (Sweden)

    Stephanie L Sansom

    Full Text Available BACKGROUND: HIV incidence was substantially lower among circumcised versus uncircumcised heterosexual African men in three clinical trials. Based on those findings, we modeled the potential effect of newborn male circumcision on a U.S. male's lifetime risk of HIV, including associated costs and quality-adjusted life-years saved. METHODOLOGY/PRINCIPAL FINDINGS: Given published estimates of U.S. males' lifetime HIV risk, we calculated the fraction of lifetime risk attributable to heterosexual behavior from 2005-2006 HIV surveillance data. We assumed 60% efficacy of circumcision in reducing heterosexually-acquired HIV over a lifetime, and varied efficacy in sensitivity analyses. We calculated differences in lifetime HIV risk, expected HIV treatment costs and quality-adjusted life years (QALYs among circumcised versus uncircumcised males. The main outcome measure was cost per HIV-related QALY saved. Circumcision reduced the lifetime HIV risk among all males by 15.7% in the base case analysis, ranging from 7.9% for white males to 20.9% for black males. Newborn circumcision was a cost-saving HIV prevention intervention for all, black and Hispanic males. The net cost of newborn circumcision per QALY saved was $87,792 for white males. Results were most sensitive to the discount rate, and circumcision efficacy and cost. CONCLUSIONS/SIGNIFICANCE: Newborn circumcision resulted in lower expected HIV-related treatment costs and a slight increase in QALYs. It reduced the 1.87% lifetime risk of HIV among all males by about 16%. The effect varied substantially by race and ethnicity. Racial and ethnic groups who could benefit the most from circumcision may have least access to it due to insurance coverage and state Medicaid policies, and these financial barriers should be addressed. More data on the long-term protective effect of circumcision on heterosexual males as well as on its efficacy in preventing HIV among MSM would be useful.

  7. Male circumcision: care practices and attitudes in a Muslim community of western Nepal

    Directory of Open Access Journals (Sweden)

    Mohan Paudel

    2011-03-01

    Full Text Available

    Abstract:
    Background: Male circumcision is a removal of the foreskin of the glans penis. There are medical, ritual and religious reasons for male circumcision. The purpose of this study is to explore the current practices, perceptions, future recommendations and health seeking behavior during and after performing male circumcision in a Muslim community of western Nepal. Method: A total of 64 households were sampled by a simple random sampling method. Information was collected using semi-structured questionnaires and focus group discussions. Result: Circumcision was practiced among all Muslim households and the main reason was religious rite and ritual. It was the traditional circumciser, locally known as hazam, who circumcised all male children in the community. Interestingly, in only 5 % of the household children had been circumcised using modern medicines. The rest of the households, i.e. 95%, relied on traditional healing systems, the use of local herbs and homemade ointments (mainly the suspension of ghee and ash.A Non-sterilized knife was the main surgical instrument used during circumcision. The wound healing after circumcision was much longer, even up to 90 days or more. Conclusions: Circumcision is a practice that is still largely carried out outside the domain of the formal health care system in this community. It demands a design of service delivery models from health policy makers in the Ministry of Health, thus bringing circumcision within formal health care systems in those communities. It deserves an urgent attention to provide safe, culturally acceptable and sustainable services from health institutions.

  8. Coping with Aversive Stimulation in the Neonatal Period: Quiet Sleep and Plasma Cortisol Levels during Recovery from Circumcision.

    Science.gov (United States)

    Gunnar, Megan R.; And Others

    1985-01-01

    Determines the time course of circulating cortisol following circumcision in 80 healthy newborns and investigates whether changes in behavioral state following circumcision in anyway paralleled the adrenocortical time course. Adrenocortical and behavioral data indicated that subjects were able to cope with circumcision trauma. Cortisol levels…

  9. Circumcision using CO2 laser: report of 860 cases

    Science.gov (United States)

    Chen, Wen B.; Chen, Zi-Fu; Zhan, Tian-qi; Gao, Xiang-Xun; Huang, Chao

    1993-03-01

    Eight-hundred-sixty cases of circumcision using CO2 laser are reported. The age of patients ranged from 9 - 65 years, with a mean age of 23.8 years. The technique was simple and can be quickly accomplished by a single operator. After local anesthesia the glans penis was protected by a protector. Then, circumcision was performed with a CO2 laser -- HeNe laser combined machine. There was an HeNe laser aiming system in this machine thus the surgeon had a three-dimensional visible indicator of the incision. The focusing CO2 laser beam was used for cutting the prepuce during the operation. There was almost no operative bleeding. All the patients needed no antibiotic postoperatively. Complications were minimal and satisfactory results were achieved.

  10. : Male circumcision as HIV prevention between controversies and scientific investigation

    OpenAIRE

    Harrous-Paicheler, Genevieve

    2010-01-01

    The randomised controlled trial (RCT) is considered the scientific foundation of medical practice in evidence based medicine. Therefore, the evidence it brings should put an end to controversies. But this was not the case if we look at the demonstration of the protective role of male circumcision (MC) against HIV/AIDS infection. Although based on a series of epidemiological investigations, culminating in RCTs, the benefits of MC are a controversial subject in the medical and scientific commun...

  11. Disposable circumcision suture device:clinical effect and patient satisfaction

    Institute of Scientific and Technical Information of China (English)

    BoDong Lv; ShiGeng Zhang; XuanWen Zhu; Jie Zhang; Gang Chen; MinFu Chen; HongLiang Shen; ZaiJun Pei; ZhaoDian Chen

    2014-01-01

    In our experience patients undergoing circumcision are mostly concerned about pain and penile appearances. We conducted a prospective randomized trial to assess the beneifts of a new disposable circumcision suture device (DCSD). A total of 942 patients were equally divided into three groups (conventional circumcision, Shang ring and disposable suture device group). Patients in the DCSD group were anesthetized with compound 5%lidocaine cream, the others with a 2%lidocaine penile block. Operation time, intra-operative blood loss, incision healing time, intra-operative and post-operative pain, the penile appearance and overall satisfaction degree were measured. Operation time and intra-operative blood loss were signiifcantly lower in the Shang ring and suture device groups compared to the conventional group (P<0.001). Intra-operative pain was less in the suture device group compared with the other two groups (P<0.001);whereas post-operative pain was higher in the conventional group compared to the other two groups (P<0.001). Patients in the suture device (80.57%) and Shang ring (73.57%) groups were more satisifed with penile appearances compared with the conventional circumcision group (20.06%, P<0.05). Patients in suture device group also healed markedly faster than the conventional group (P<0.01). The overall satisfaction rate was better in the suture device group (78.66%) compared with the conventional (47.13%) and Shang ring (50.00%) groups (P<0.05). The combination of DCSD and lidocaine cream resulted in shorter operation and incision healing times, reduced intra-operative and post-operative pain and improved patient satisfaction with the cosmetic appearances.

  12. Traumatic neuroma of the penis after circumcision--Case report.

    Science.gov (United States)

    Cardoso, Thaís Abrão; dos Santos, Karen Regina; Franzotti, Aline Martinez; Avelar, Juliana Centofanti Dentello; Tebcherani, Antonio José; Pegas, José Roberto Pereira

    2015-01-01

    Traumatic neuromas are tumors resulting from hyperplasia of axons and nerve sheath cells after section or injury to the nervous tissue. We present a case of this tumor, confirmed by anatomopathological examination, in a male patient with history of circumcision. Knowledge of this entity is very important in achieving the differential diagnosis with other lesions that affect the genital area such as condyloma acuminata, bowenoid papulosis, lichen nitidus, sebaceous gland hyperplasia, achrochordon and pearly penile papules. PMID:26131873

  13. Traumatic neuroma of the penis after circumcision - Case report*

    Science.gov (United States)

    Cardoso, Thaís Abrão; dos Santos, Karen Regina; Franzotti, Aline Martinez; Avelar, Juliana Centofanti Dentello; Tebcherani, Antonio José; Pegas, José Roberto Pereira

    2015-01-01

    Traumatic neuromas are tumors resulting from hyperplasia of axons and nerve sheath cells after section or injury to the nervous tissue1. We present a case of this tumor, confirmed by anatomopathological examination, in a male patient with history of circumcision. Knowledge of this entity is very important in achieving the differential diagnosis with other lesions that affect the genital area such as condyloma acuminata, bowenoid papulosis, lichen nitidus, sebaceous gland hyperplasia, achrochordon and pearly penile papules. PMID:26131873

  14. A Salvage Operation for Total Penis Amputation Due to Circumcision

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    Bilsev Ince

    2013-05-01

    Full Text Available Circumcision is one of the most common rituals in Jewish and Islamic cultures. It may also be performed for phimosis correction or the treatment of recurrent balanitis. Although circumcision is considered to be a technically easy and safe surgical procedure with no significant risk, it may lead to severe complications such as necrotizing fasciitis or total penis amputation. In this report, we present a case of penis amputation at two levels occurring with third-degree burns due to electrocautery during circumcision. Although penile replantation was attempted, it was unsuccessful due to burn damage to the veins. After restoration of the functional structures, the penis was buried in the inguinal area by reepithelization to maintain blood circulation. The recovery of the penis was successful. This case is presented as a novel example of groin flap surgery to achieve a functionally and aesthetically acceptable outcome in a salvage operation for a penis with significant traumatic injury, which has not been previously reported in the literature.

  15. Student Teachers' Perception on Integration of Traditional Circumcision Education into the School Curriculum

    Science.gov (United States)

    Seloana, S. M.

    2011-01-01

    The purpose of this article is to report on the research findings of the views of student-teachers on the integration of some aspects of a traditional circumcision curriculum into higher education. The main question is: Could a traditional circumcision curriculum be integrated into the higher education curriculum? Seventy five participants were…

  16. Need for Physician Education on the Benefits and Risks of Male Circumcision in the United States

    Science.gov (United States)

    Carbery, Baevin; Zhu, Julia; Gust, Deborah A.; Chen, Robert T.; Kretsinger, Katrina; Kilmarx, Peter H.

    2012-01-01

    Physicians may be called upon to counsel male patients or parents of newborn males regarding their decision to circumcise their newborn sons. The purpose of the present study was to describe physicians who do not understand the benefits and risks associated with male circumcision well enough to counsel parents of newborn male infants and adult…

  17. Cultural bias in the AAP's 2012 Technical Report and Policy Statement on male circumcision

    DEFF Research Database (Denmark)

    Frisch, Morten; Aigrain, Yves; Barauskas, Vidmantas;

    2013-01-01

    The American Academy of Pediatrics recently released its new Technical Report and Policy Statement on male circumcision, concluding that current evidence indicates that the health benefits of newborn male circumcision outweigh the risks. The technical report is based on the scrutiny of a large nu...

  18. Histological Correlates of Penile Sexual Sensation: Does Circumcision Make a Difference?

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    Guy Cox, MA, DPhil

    2015-06-01

    Conclusion: Based on histological findings and correlates of sexual function, loss of the prepuce by circumcision would appear to have no adverse effect on sexual pleasure. Our evaluation supports overall findings from physiological measurements and survey data. Cox G, Krieger JN, and Morris BJ. Histological correlates of penile sexual sensation: Does circumcision make a difference? Sex Med 2015;3:76–85.

  19. The when and how of male circumcision and the risk of HIV

    DEFF Research Database (Denmark)

    Rasmussen, Dlama Nggida; Wejse, Christian; Larsen, Olav;

    2016-01-01

    crucial and can increase insight into the HIV epidemic in Africa. Methods: We used data from two retrospective HIV surveys conducted in Guinea- Bissau from 1993 to 1996 (1996 cohort) and from 2004 to 2007 (2006 cohort). Multivariate logistical models were used to investigate the relationships between HIV...... against HIV. Our findings suggest that sexual risk behaviour and traditional circumcision may increases HIV risk. The relationship between circumcision age, sexual behaviour and HIV status remains unclear and warrants further research.......Introduction: Male circumcision (MC) reduces the risk of HIV, and this risk reduction may be modified by socio-cultural factors such as the timing and method (medical and traditional) of circumcision. Understanding regional variations in circumcision practices and their relationship to HIV is...

  20. Voluntary medical male circumcision: strategies for meeting the human resource needs of scale-up in southern and eastern Africa.

    Directory of Open Access Journals (Sweden)

    Kelly Curran

    2011-11-01

    Full Text Available Voluntary medical male circumcision (VMMC reduces female-to-male HIV transmission by approximately 60%; modeling suggests that scaling up VMMC to 80% of men 15- to 49-years-old within five years would avert over 3.3 million new HIV infections in 14 high priority countries/regions in southern and eastern Africa by 2025 and would require 20.33 million circumcisions. However, the shortage of health professionals in these countries must be addressed to reach these proposed coverage levels. To identify human resource approaches that are being used to improve VMMC volume and efficiency, we looked at previous literature and conducted a program review. We identified surgical efficiencies, non-surgical efficiencies, task shifting, task sharing, temporary redeployment of public sector staff during VMMC campaign periods, expansion of the health workforce through recruitment of unemployed, recently retired, newly graduating, or on-leave health care workers, and the use of volunteer medical staff from other countries as approaches that address human resource constraints. Case studies from Kenya, Tanzania, and Swaziland illustrate several innovative responses to human resource challenges. Although the shortage of skilled personnel remains a major challenge to the rapid scale-up of VMMC in the 14 African priority countries/regions, health programs throughout the region may be able to replicate or adapt these approaches to scale up VMMC for public health impact.

  1. 'It brought joy in my home as in the area of my wife.' How recently circumcised adult men ascribe value to and make sense of male circumcision

    DEFF Research Database (Denmark)

    Lundsby, Katrine; Dræbel, Tania; Wolf Meyrowitsch, Dan

    2012-01-01

    The present study used a phenomenological approach to explore the everyday-life experiences of male circumcision (MC) and to learn how recently circumcised men ascribe value to and make sense of MC. Thirteen recently circumcised Zambian men were identified through the snowball technique and inter......The present study used a phenomenological approach to explore the everyday-life experiences of male circumcision (MC) and to learn how recently circumcised men ascribe value to and make sense of MC. Thirteen recently circumcised Zambian men were identified through the snowball technique...... and interviewed using a semi-structured interviewer's guide. Findings indicate that the post-operational experience of adult MC smoothly fits into the everyday-life experience of the men interviewed and is perceived and experienced as a broader social health issue, which largely transcends both the personal HIV...... risk of the individual male and the private sphere. The study provides three important lessons for MC programmes: (1) the broad social aspects of MC put forward by the interviewees suggest the potential for a popular intervention and, consequently, a large uptake of MC; (2) findings suggest...

  2. Impact of psychological disorders after female genital mutilation among Kurdish girls in Northern Iraq

    Directory of Open Access Journals (Sweden)

    Jan Ilhan Kizilhan

    2011-06-01

    Full Text Available Background and Objectives: This study investigated the mental health status of young girls after genital mutilation in Northern Iraq. Although experts assume that circumcised girls are more prone to psychiatric illnesses than non-circumcised girls, little research has been conducted to confirm this claim. For the purpose of this study, it was assumed that female genital mutilation is connected with a high rate of posttraumatic stress disorders (PTSD. Methods: The psychological impact of female genital mutilation was assessed in Northern Iraq with 79 circumcised Kurdish girls who were between 8 and 14 years of age. Thirty uncircumcised girls from the above area and thirty-one uncircumcised girls from other areas of Iraq served as comparison subjects. A psychological interview and further questionnaires were used to assess traumatization and psychiatric illnesses. Results: The circumcised girls showed a significantly higher prevalence of PTSD (44.3%, depression disorder (33.6%, anxiety disorder (45.6% and somatic disturbance (36.7% than the uncircumcised girls. We could not find any significant differences between the two control groups. Conclusions: Within the circumcised group, a mental health problem can be diagnosed that may constitute the first evidence for the severe psychological consequences of juvenile girls´ genital mutilation.

  3. Adult bipolar diathermy circumcision and related procedures in adults – a safe and efficient technique

    Directory of Open Access Journals (Sweden)

    Nalavenkata S

    2014-06-01

    Full Text Available Sunny Nalavenkata, Matthew Winter, Rachel Kour, Nam-Wee Kour, Paul RuljancichDepartment of Urology, Eastern Health, Box Hill Hospital, Box Hill, VIC, AustraliaObjectives: To present our novel technique and step-by-step approach to bipolar diathermy circumcision and related procedures in adult males.Methods: We reviewed our technique of bipolar circumcision and related procedures in 54 cases over a 22-month period at our day procedure center. Bipolar diathermy cutting and hemostasis was performed using bipolar forceps with a Valleylab machine set at 15. Sleeve circumcision was used. A dorsal slit was made, followed by frenulum release and ventral slit, and was completed with bilateral circumferential cutting. Frenuloplasties released the frenulum. Preputioplasties used multiple 2–3 mm longitudinal cuts to release the constriction, with frenulum left intact. All wounds were closed with interrupted 4/0 Vicryl Rapide™.Results: A total of 54 nonemergency bipolar circumcision procedures were carried out from November 2010–August 2012 (42 circumcisions, eight frenuloplasties, and four preputioplasties. Patients were aged 18–72 years (mean, 34 years. There was minimal to no intraoperative bleeding in all cases, allowing for precise dissection. All patients were requested to attend outpatient reviews; three frenuloplasty and two circumcision patients failed to return. Of the remaining 49, mean interval to review was 49 days, with a range of 9–121 days. Two circumcision patients reported mild bleeding with nocturnal erections within a week postoperatively, but they did not require medical attention. Two others presented to family practitioners with possible wound infections which resolved with oral antibiotics. All 49 patients had well-healed wounds.Conclusion: The bipolar diathermy technique is a simple procedure, easily taught, and reproducible. It is associated with minimal bleeding, is safe and efficient, uses routine operating equipment and

  4. Male Circumcision and STI Acquisition in Britain: Evidence from a National Probability Sample Survey.

    Directory of Open Access Journals (Sweden)

    Virginia Homfray

    Full Text Available It is well-established that male circumcision reduces acquisition of HIV, herpes simplex virus 2, chancroid, and syphilis. However, the effect on the acquisition of non-ulcerative sexually transmitted infections (STIs remains unclear. We examined the relationship between circumcision and biological measures of three STIs: human papillomavirus (HPV, Chlamydia trachomatis and Mycoplasma genitalium.A probability sample survey of 15,162 men and women aged 16-74 years (including 4,060 men aged 16-44 years was carried out in Britain between 2010 and 2012. Participants completed a computer-assisted personal interview, including a computer-assisted self-interview, which asked about experience of STI diagnoses, and circumcision. Additionally, 1,850 urine samples from sexually-experienced men aged 16-44 years were collected and tested for STIs. Multivariable logistic regression was used to calculate adjusted odds ratios (AOR to quantify associations between circumcision and i self-reporting any STI diagnosis and ii presence of STIs in urine, in men aged 16-44 years, adjusting for key socio-demographic and sexual behavioural factors.The prevalence of circumcision in sexually-experienced men aged 16-44 years was 17.4% (95%CI 16.0-19.0. There was no association between circumcision and reporting any previous STI diagnoses, and specifically previous chlamydia or genital warts. However, circumcised men were less likely to have any HPV type (AOR 0.26, 95% confidence interval (CI 0.13-0.50 including high-risk HPV types (HPV-16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and/or 68 (AOR 0.14, 95% CI 0.05-0.40 detected in urine.Circumcised men had reduced odds of HPV detection in urine. These findings have implications for improving the precision of models of STI transmission in populations with different circumcision prevalence and in designing interventions to reduce STI acquisition.

  5. Female genital mutilation.

    Science.gov (United States)

    Ladjali, M; Rattray, T W; Walder, R J

    1993-08-21

    Female genital mutilation, also misleadingly known as female circumcision, is usually performed on girls ranging in from 1 week to puberty. Immediate physical complications include severe pain, shock, infection, bleeding, acute urinary infection, tetanus, and death. Longterm problems include chronic pain, difficulties with micturition and menstruation, pelvic infection leading to infertility, and prolonged and obstructed labor during childbirth. An estimated 80 million girls and women have undergone female genital mutilation. In Britain alone an estimated 10,000 girls are currently at risk. Religious, cultural, medical, and moral grounds rationalize the custom which is practiced primarily in sub-Saharan Africa, the Arab world, Malaysia, Indonesia, and among migrant populations in Western countries. According to WHO it is correlated with poverty, illiteracy, and the low status of women. Women who escape mutilation are not sought in marriage. WHO, the UN Population Fund, the UN Children's Fund, the International Planned Parenthood Federation, and the UN Convention on the Rights of the Child have issued declarations on the eradication of female genital mutilation. In Britain, local authorities have intervened to prevent parents from mutilating their daughters. In 1984, the Inter-African Committee Against Harmful Traditional Practices Affecting Women and Children was established to work toward eliminating female genital mutilation and other damaging customs. National committees in 26 African countries coordinate projects run by local people using theater, dance, music, and storytelling for communication. In Australia, Canada, Europe, and the US women have organized to prevent the practice among vulnerable migrants and refugees. PMID:8400925

  6. Comparison of Distal Hypospadias Repair in Circumcised Patients and Uncircumcised Patients

    OpenAIRE

    Fahimeh Kazemi Rashed; Rasool Gholizade

    2013-01-01

    Hypospadias is the most common anomaly in the male genital tract with an incidence of 0.8–8.2 per 1000 live male births. Routinely, hypospadias cases are repaired after one year of age, and it is recommended that a child with hypospadias not to be circumcised until hypospadias repair is completed. This study was conducted to determine whether or not circumcision prior to hypospadias repair increases the risk of complications. 30 circumcised patients and 30 persons without a history of circumc...

  7. Somatosensory evoked potentials assess the efficacy of circumcision for premature ejaculation.

    Science.gov (United States)

    Xia, J-D; Jiang, H-S; Zhu, L-L; Zhang, Z; Chen, H; Dai, Y-T

    2016-07-01

    To assess the efficacy and mechanism of circumcision in the treatment of premature ejaculation (PE) with redundant prepuce, we enrolled a total of 81 PE patients who received circumcision. The patients' ejaculatory ability and sexual performances were evaluated before and after circumcision by using questionnaires (Intravaginal ejaculation latency time (IELT), Chinese Index of PE with 5 questions (CIPE-5) and International Index of Erectile function- 5 (IIEF-5)). Furthermore, somatosensory evoked potentials (SEPs) including dorsal nerve (DNSEP) and glans penis (GPSEP) of the patients were also measured. The mean IELTs of preoperation and post operation were 1.10±0.55 and 2.48±2.03 min, respectively (Pejaculation time improvement after circumcision is so small, and equal to placebo response, therefore it could not be interpreted as a therapeutic method in men with PE. PMID:27193064

  8. Ischemia of the glans penis following circumcision: case report and revision of the literature

    Directory of Open Access Journals (Sweden)

    Pietro Pepe

    2015-03-01

    Full Text Available Ischemic complications of the glans penis are rare and commonly result from trauma, inadvertent administration of vasoconstrictive solutions, diabetes mellitus, circumcision and vasculitis; we refer about a young man with severe ischemia of the glans penis following circumcision. The patient had undergone circumcision 5 days before in a surgery department under local anesthesia (1% mepivacaine hydrochloride. The patient noticed a brownish color and edema of the glans penis at 24 h after he opened the wound dressing, but arrived to our hospital only 5 days after circumcision because these findings had progressed. Physical examination revealed the black color or necrotic appearance of the glans penis, and edema on the dorsal penile skin. The patient underwent antibiotic, antiplatatelet, corticosteroid and iperbaric therapy achieving a complete restitutio ad integrum.

  9. Male Circumcision for HIV Prevention in South Africa: Addressing HIV and Gender Relations

    OpenAIRE

    Fischer-Nielsen, Sara; Møller, Sabrah

    2011-01-01

    The thesis scrutinizes how gender relations and women’s and men’s control of sexual health are influenced by the intervention of male circumcision for HIV prevention in South Africa. The analytical framework combines the theory of therapeutic citizenship, post-development theory and gender theory. We argue that the individual man’s choice to circumcise is being challenged by international HIV prevention methods emphasizing men’s responsibility in HIV prevention. In South Africa, current ...

  10. Removal of foreskin remnants in circumcised adults for treatment of premature ejaculation

    OpenAIRE

    Mohammad Reza Namavar; Boroomand Robati

    2011-01-01

    Background and Aim : Premature ejaculation (PE) is the most prevalent sexual dysfunction in every country. There are many types of treatment, but the main limitation of medical treatment for premature ejaculation is recurrence after withdrawal of medicine. The prepuce is a specific erogenous zone that contains a rich and complex network of nerves. Circumcision radically desensitizes the penis, but incomplete circumcision may cause premature ejaculation. We evaluate the effect of removal of fo...

  11. The Strong Protective Effect of Circumcision against Cancer of the Penis

    OpenAIRE

    Morris, Brian J.; Gray, Ronald H.; Xavier Castellsague; F. Xavier Bosch; Halperin, Daniel T.; Waskett, Jake H; Hankins, Catherine A.

    2011-01-01

    Male circumcision protects against cancer of the penis, the invasive form of which is a devastating disease confined almost exclusively to uncircumcised men. Major etiological factors are phimosis, balanitis, and high-risk types of human papillomavirus (HPV), which are more prevalent in the glans penis and coronal sulcus covered by the foreskin, as well as on the penile shaft, of uncircumcised men. Circumcised men clear HPV infections more quickly. Phimosis (a constricted foreskin opening imp...

  12. Male circumcision and penile cancer: a systematic review and meta-analysis

    OpenAIRE

    Larke, Natasha L.; Thomas, Sara L.; dos Santos Silva, Isabel; Weiss, Helen A

    2011-01-01

    Objective We systematically reviewed the evidence of an association between male circumcision and penile cancer. Methods Databases were searched using keywords and text terms for the epidemiology of penile cancer. Random effects meta-analyses were used to calculate summary odds ratios (ORs) and 95% confidence intervals (CI). Results We identified eight papers which evaluated the association of circumcision with penile cancer, of which seven were case–control studies. There was a strong protec...

  13. Factors Associated with Knowledge of and Willingness for Adult Male Circumcision in Changsha, China

    OpenAIRE

    Zeng, Mingqiang; Wang, Ling; Chen, Caifang; Zeng, Fanchang; Huang, Liang; Xue, Ruizhi; Chen, Junjie; Gao, Benmin; Tang, Zhengyan

    2016-01-01

    Background Male circumcision (MC) has been shown to reduce the risk of male genital diseases. MC is not commonly practiced among Chinese males and little is known about the factors associated with their knowledge of and willingness for MC. This study was to explore the knowledge regarding the foreskin among Chinese males and to identify factors associated with their willingness to undergo circumcision. Methods A total of 237 patients with redundant prepuce/phimosis were interviewed through fa...

  14. Safe male circumcision in Botswana: Tension between traditional practices and biomedical marketing

    OpenAIRE

    Katisi, Masego; Daniel, Marguerite

    2015-01-01

    Botswana has been running Safe Male Circumcision (SMC) since 2009 and has not yet met its target. Donors like the US Centers for Disease Control and Prevention and Africa Comprehensive HIV/AIDS Partnership (funded by the Gates Foundation) in collaboration with Botswana's Ministry of Health have invested much to encourage HIV-negative men to circumcise. Demand creation strategies make use of media and celebrities. The objective of this paper is to explore responses to SMC in relation to circum...

  15. Is Sex Like Driving? Risk Compensation Associated with Male Circumcision in Kisumu, Kenya

    OpenAIRE

    Nicholas Wilson; Wentao Xiong; Christine Mattson

    2011-01-01

    Mass adult male circumcision campaigns for HIV prevention are underway across much of Sub-Saharan Africa. However, concern remains about risk compensation associated with the reduction in the probability of HIV transmission per risky act. This paper examines the be- havioral response to male circumcision in Kisumu, Kenya. Contrary to the presumption of risk compensation, we find that the response due to the perceived reduction in HIV transmission appears to have been a reduction in risky sexu...

  16. Is Sex Like Driving? Risk Compensation Associated with Randomized Male Circumcision in Kisumu, Kenya

    OpenAIRE

    Nicholas Wilson; Wentao Xiong; Christine Mattson

    2011-01-01

    Mass adult male circumcision campaigns for HIV prevention are underway across much of Sub-Saharan Africa. However, concern remains about risk compensation associated with the reduction in the probability of HIV transmission per risky act. This paper examines the be- havioral response to male circumcision in Kisumu, Kenya. Contrary to the presumption of risk compensation, we find that the response due to the perceived reduction in HIV transmission appears to have been a reduction in risky sexu...

  17. Can Routine Neonatal Circumcision Help Prevent Human Immunodeficiency Virus Transmission in the United States?

    OpenAIRE

    Xu, Xiao; Patel, Divya A.; Dalton, Vanessa K.; Pearlman, Mark D.; Johnson, Timothy R.B.

    2009-01-01

    Primary prevention of human immunodeficiency virus (HIV) continues to pose an important challenge in the United States. Recent clinical trials conducted in Kenya, South Africa, and Uganda have demonstrated considerable benefit of male circumcision in reducing HIV seroincidence in males. These results have ignited debate over the appropriateness of implementing routine provision of neonatal circumcision in the United States for HIV prevention. This paper discusses major contextual differences ...

  18. To circ or not to circ: clinical and pharmacoeconomic outcomes of a prospective trial of topical steroid versus primary circumcision

    OpenAIRE

    Yuri D. Nobre; Ricardo G. Freitas; Maria J. Felizardo; Valdemar Ortiz; Antonio Macedo Jr

    2010-01-01

    PURPOSE: To compare the efficacy and costs of circumcision versus topical treatment using a prospective pharmacoeconomic protocol. MATERIALS AND METHODS: We treated 59 patients (3-10 years of age) randomized into two groups: 29 underwent an 8-week course of topical treatment with 0.2% betamethasone-hyaluronidase cream twice a day; and 30 underwent circumcision. Topical treatment success was defined as complete exposure of the glans. In cases of treatment failure, circumcision was performed an...

  19. The Strong Protective Effect of Circumcision against Cancer of the Penis

    Directory of Open Access Journals (Sweden)

    Brian J. Morris

    2011-01-01

    Full Text Available Male circumcision protects against cancer of the penis, the invasive form of which is a devastating disease confined almost exclusively to uncircumcised men. Major etiological factors are phimosis, balanitis, and high-risk types of human papillomavirus (HPV, which are more prevalent in the glans penis and coronal sulcus covered by the foreskin, as well as on the penile shaft, of uncircumcised men. Circumcised men clear HPV infections more quickly. Phimosis (a constricted foreskin opening impeding the passage of urine is confined to uncircumcised men, in whom balanitis (affecting 10% is more common than in circumcised men. Each is strongly associated with risk of penile cancer. These findings have led to calls for promotion of male circumcision, especially in infancy, to help reduce the global burden of penile cancer. Even more relevant globally is protection from cervical cancer, which is 10-times more common, being much higher in women with uncircumcised male partners. Male circumcision also provides indirect protection against various other infections in women, along with direct protection for men from a number of genital tract infections, including HIV. Given that adverse consequences of medical male circumcision, especially when performed in infancy, are rare, this simple prophylactic procedure should be promoted.

  20. Innovative Methods of Male Circumcision for HIV Prevention-Getting the Right Evidence.

    Science.gov (United States)

    Samuelson, Julia; Hargreave, Timothy; Ridzon, Renee; Farley, Tim

    2016-06-01

    World Health Organization recommends that countries with hyperendemic and generalized HIV epidemics implement voluntary medical male circumcision programs for HIV prevention. Innovative methods of male circumcision including devices have the potential to simplify the procedure, reduce time and cost, increase client acceptability, enhance safety, and expand the numbers of providers who may perform circumcision. We describe work led by World Health Organization and supported by global partners to define a pathway for the evaluation of efficacy and safety of male circumcision devices, to set priority criteria, and to establish a process to guide the use of devices in publicly funded voluntary medical male circumcision programs for HIV prevention. A device classification scheme, an expert Technical Advisory Group on Innovations in Male Circumcision, and a formal prequalification program have also guided considerations on safe use of devices. A rigorous approach was deemed appropriate given the intervention is for use among healthy men for public health purposes. The pathway and processes led to coordinated research, better standardization in research outcomes, and guidance that informed the research, introduction and implementation phases. The lessons learnt from this case study can inform evaluation and use of future public health innovations. PMID:27331591

  1. 'Boys will be boys': traditional Xhosa male circumcision, HIV and sexual socialisation in contemporary South Africa.

    Science.gov (United States)

    Vincent, Louise

    2008-06-01

    Ritual male circumcision is among the most secretive and sacred of rites practiced by the Xhosa of South Africa. Recently, the alarming rate of death and injury among initiates has led to the spotlight of media attention and government regulation being focused on traditional circumcision. While many of the physical components of the ritual have been little altered by the centuries, its cultural and social meanings have not remained unchanged. This paper attempts to understand how some of these cultural and social meanings have shifted, particularly with respect to attitudes towards sex and the role that circumcision schools traditionally played in the sexual socialisation of Xhosa youth. Ritual circumcision is often defended on the basis of its usefulness as a mechanism for the maintenance of social order, particularly in relation to the perceived crisis in youth sexuality marked by extremely high levels of gender-based violence as well as HIV infection. However, the paper suggests two key ways in which traditional Xhosa circumcision has changed. These include the erosion of the role which circumcision schools once played in the sexual socialisation of young men and the emergence of the idea that initiation gives men the unlimited and unquestionable right to access to sex rather than marking the point at which sexual responsibility and restraint is introduced into the lifestyle of young men. PMID:18568868

  2. Male circumcision as strategy for HIV prevention and sexually transmitted diseases: the potential role of traditional birth attendants in neonatal male circumcision

    Directory of Open Access Journals (Sweden)

    Catia Dini

    2010-12-01

    Full Text Available In developing countries, it would be advisable to give priority to human immunodeficiency virus (HIV prevention strategies, because of the high mortality caused by the rapid spread of the pandemic. Furthermore, HIV prevention could contribute to the mitigation of tuberculosis (TB propagation, which is tightly correlated to acquired immune deficiency syndrome (AIDS. As demonstrated, male circumcision (MC confers protection against HIV and sexually transmitted diseases (STD. The suggested strategy considers the neonatal MC advantageous, since it is safer, feasible, culturally more acceptable and less costly than adult MC. This approach is based on the assumption that, if newborn males are circumcised, within the next 15-20 years the sexually active population will be almost entirely circumcised and, consequently, the HIV transmission will be reduced. The employment of retrained traditional birth attendants is considered in order to implement the MC after the child birth and to facilitate its acceptance in those contexts where it is not traditionally performed.

  3. 'If you are circumcised, you are the best': understandings and perceptions of voluntary medical male circumcision among men from KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Humphries, Hilton; van Rooyen, Heidi; Knight, Lucia; Barnabas, Ruanne; Celum, Connie

    2015-01-01

    While the uptake of voluntary medical male circumcision (VMMC) is increasing, South Africa has only attained 20% of its target to circumcise 80% of adult men by 2015. Understanding the factors influencing uptake is essential to meeting these targets. This qualitative study reports on findings from focus-group discussions with men in rural KwaZulu-Natal, South Africa, about what factors influence their perceptions of VMMC. The study found that VMMC is linked to perceptions of masculinity and male gender identity including sexual health, sexual performance and pleasure, possible risk compensation and self-identity. Findings highlight the need to understand how these perceptions of sexual health and performance affect men's decisions to undergo circumcision and the implications for uptake of VMMC. The study also highlights the need for individualised and contextualised information and counselling that can identify, understand and address the perceptions men have of VMMC, and the impacts they believe it will have on them. PMID:25567140

  4. AB221. Effects of adult male circumcision on premature ejaculation: results from a prospective study in China

    Science.gov (United States)

    Gao, Jingjing; Xu, Chuan; Zhang, Xiansheng

    2016-01-01

    Objective The purpose of this study is to investigate the effects of adult male circumcision on premature ejaculation (PE). Methods Therefore, between December 2009 and March 2014, a total of 575 circumcised men and 623 uncircumcised men (control group) were evaluated. Detailed evaluations (including circumcision and control groups) on PE were conducted before circumcision and at the 3-, 6-, 9-, and 12-month follow-up visits after circumcision. Self-estimated intravaginal ejaculatory latency time (IELT), patient-reported outcome measures, and 5-item version of the International Index of Erectile Function were used to measure the ejaculatory and erectile function for all subjects. Results The results showed that, during the 1 year follow-up, men after circumcision experienced higher IELT and better scores of control over ejaculation, satisfaction with sexual intercourse, and severity of PE than men before circumcision (Pejaculation, and satisfaction with sexual intercourse (P<0.001 for all). These findings suggested that circumcision might have positive effects on IELT, ejaculatory control, sexual satisfaction, and PE severity. Conclusions In addition, circumcision was significantly associated with the development of PE.

  5. Acceptability of early infant male circumcision among chinese parents: strategy implications of HIV prevention for china

    Directory of Open Access Journals (Sweden)

    Pan Lianjun

    2012-09-01

    Full Text Available Abstract Background Recent evidence has confirmed that circumcision can be performed as a preventive strategy for HIV and early infant male circumcision (EIMC is regarded to be safer than circumcision in adulthood; however, limited data are available in the literature about EIMC in China. Therefore, the present study was designed to determine the willingness and attitudes of Chinese parents on newborn male circumcision so as to provide data for exploring the feasibility of implementing EIMC as an HIV prevention strategy in China. Methods Simple random sampling was used to draw participants from parents who had a newborn son delivered at Nanjing Maternity and Child Health Care Hospital, which is affiliated to Nanjing Medical University, between March and December 2010. A questionnaire was used to determine general medical knowledge or information about circumcision, attitudes about EIMC, and level of decision-making on circumcision for the newborn son. Results Data derived from 558 responses were analyzed and the ratio of respondents was 56.3% for fathers and 43.6% for mothers. Of the respondents, 34.4% agreed to circumcise their newborn son, and the level of agreement was 3.25 ± 1.17 (range, 1–5 with “1” being “reluctantly agree” and “5” being “very strongly agree”. The major reason for EIMC was for health (44.8%, followed by doctor’s advice (31.2%. The major reason not to agree to EIMC was concern about pain (50.5%, followed by the risk of the procedure (23.5%. Conclusion The willingness and acceptability of EIMC in China is low and the parents of newborn sons are usually not very affirmative when making a decision on such a procedure, suggesting that significant effort will be needed if EIMC is to be implemented as an HIV prevention strategy for China.

  6. 'It brought joy in my home as in the area of my wife.' How recently circumcised adult men ascribe value to and make sense of male circumcision.

    Science.gov (United States)

    Lundsby, Katrine; Dræbel, Tania; Wolf Meyrowitsch, Dan

    2012-01-01

    The present study used a phenomenological approach to explore the everyday-life experiences of male circumcision (MC) and to learn how recently circumcised men ascribe value to and make sense of MC. Thirteen recently circumcised Zambian men were identified through the snowball technique and interviewed using a semi-structured interviewer's guide. Findings indicate that the post-operational experience of adult MC smoothly fits into the everyday-life experience of the men interviewed and is perceived and experienced as a broader social health issue, which largely transcends both the personal HIV risk of the individual male and the private sphere. The study provides three important lessons for MC programmes: (1) the broad social aspects of MC put forward by the interviewees suggest the potential for a popular intervention and, consequently, a large uptake of MC; (2) findings suggest that in addition to emphasising the HIV protective effect of MC, MC promotion should also highlight the social, sexual and romantic values perceived and experienced by the interviewees of this study; (3) the analysis reveals potentially harmful misconceptions about the health benefits of MC, demonstrating the importance of proper pre- and post-circumcision counselling as well as public health messages related to MC. PMID:22087766

  7. Jews, Muslims and the Ritual Male Circumcision Debate: Religious Diversity and Social Inclusion in Germany

    Directory of Open Access Journals (Sweden)

    Gökçe Yurdakul

    2016-04-01

    Full Text Available On 7 May 2012, the Cologne regional court ruled that circumcising young boys was a form of previous bodily harm (körperverletzung. Although both Muslims and Jews circumcise infant boys as a religious practice, the Cologne court found that the child’s “fundamental right to bodily integrity” was more important than the parents’ rights, leaving Muslim and Jewish parents under suspicion of causing bodily harm to their children. After heated public discussions and an expedited legal process, legal authorities permitted the ritual circumcision of male children under a new law. However, the German debates on religious diversity are not yet over. On the third anniversary of the Court decision in 2015, thirty-five civil society organisations organised a rally in Cologne for “genital autonomy”, calling for a ban on ritual male circumcision. In this article, I will focus on religious diversity, which is undergoing changes through minority and immigrant claims for religious accommodation. Analysing the ongoing controversies of ritual male circumcision in Germany, I argue that this change is best observed with Muslim and Jewish claims for practicing their religion. By using political debates, news reports and information provided by lawyers and medical doctors who were involved in the public debate, I show that religious diversity debates are a litmus test for social inclusion: Muslims and Jews, in this context, are both passive subjects of social inclusion policies and active participants in creating a religiously diverse society in Germany.

  8. Exposé of fallacious claims that male circumcision will increase HIV infections in Africa

    Directory of Open Access Journals (Sweden)

    Brian J. Morris

    2011-09-01

    Full Text Available Despite over two decades of extensive research showing that male circumcision protects against heterosexual acquisition of HIV in men, and that includes findings from large randomized controlled trials leading to acceptance by the WHO/UNAIDS and the Cochrane Committee, opponents of circumcision continue to generate specious arguments to the contrary. In a recent issue of the Journal of Public Health in Africa, Van Howe and Storms claim that male circumcision will increase HIV infections in Africa. Here we review the statements they use in support of their thesis and show that there is no scientific basis to such an assertion. We also evaluate the statistics used and show that when these data are properly analyzed the results lead to a contrary conclusion affirming the major role of male circumcision in protecting against HIV infection in Africa. Researchers, policy makers and the wider community should rely on balanced scholarship when assessing scientific evidence. We trust that our assessment may help refute the claims by Van Howe and Storms, and provide reassurance on the importance of circumcision for HIV prevention.

  9. Safe male circumcision in Botswana: tension between traditional practices and biomedical marketing.

    Science.gov (United States)

    Katisi, Masego; Daniel, Marguerite

    2015-01-01

    Botswana has been running Safe Male Circumcision (SMC) since 2009 and has not yet met its target. Donors like the US Centers for Disease Control and Prevention and Africa Comprehensive HIV/AIDS Partnership (funded by the Gates Foundation) in collaboration with Botswana's Ministry of Health have invested much to encourage HIV-negative men to circumcise. Demand creation strategies make use of media and celebrities. The objective of this paper is to explore responses to SMC in relation to circumcision as part of traditional initiation practices. More specifically, we present the views of two communities in Botswana on SMC consultation processes, implementation procedures and campaign strategies. The methods used include participant observation, in-depth interviews with key stakeholders (donors, implementers and Ministry officials), community leaders and men in the community. We observe that consultation with traditional leaders was done in a seemingly superficial, non-participatory manner. While SMC implementers reported pressure to deliver numbers to the World Health Organization, traditional leaders promoted circumcision through their routine traditional initiation ceremonies at breaks of two-year intervals. There were conflicting views on public SMC demand creation campaigns in relation to the traditional secrecy of circumcision. In conclusion, initial cooperation of local chiefs and elders turned into resistance. PMID:25866013

  10. Impact of Health Insurance Type on Trends in Newborn Circumcision, United States, 2000 to 2010

    Science.gov (United States)

    Cox, Shanna; Whiteman, Maura; Jamieson, Denise J.; Macaluso, Maurizio; Bansil, Pooja; Kuklina, Elena; Kourtis, Athena P.; Posner, Samuel; Barfield, Wanda D.

    2015-01-01

    Objectives. We explored how changes in insurance coverage contributed to recent nationwide decreases in newborn circumcision. Methods. Hospital discharge data from the 2000–2010 Nationwide Inpatient Sample were analyzed to assess trends in circumcision incidence among male newborn birth hospitalizations covered by private insurance or Medicaid. We examined the impact of insurance coverage on circumcision incidence. Results. Overall, circumcision incidence decreased significantly from 61.3% in 2000 to 56.9% in 2010 in unadjusted analyses (P for trend = .008), but not in analyses adjusted for insurance status (P for trend = .46) and other predictors (P for trend = .55). Significant decreases were observed only in the South, where adjusted analyses revealed decreases in circumcision overall (P for trend = .007) and among hospitalizations with Medicaid (P for trend = .005) but not those with private insurance (P for trend = .13). Newborn male birth hospitalizations covered by Medicaid increased from 36.0% (2000) to 50.1% (2010; P for trend families who desire but have less financial access to the procedure. PMID:26180994

  11. Wimbo: implications for risk of HIV infection among circumcised fishermen in Western Kenya.

    Science.gov (United States)

    Ombere, Stephen Okumu; Nyambedha, Erick Otieno; Bukachi, Salome Atieno

    2015-01-01

    Medical male circumcision has been shown to reduce the risk of heterosexual transmission of HIV infection in men by up to 60% in three randomised controlled trials. However, not much anthropological literature exists to provide a holistic understanding of sexual behaviour among migrating fishermen who have been circumcised. This qualitative study used cultural ecology theory and anthropological methods to develop a more holistic understanding of Luo fishermen's sexual behaviour after circumcision when they migrate (wimbo) to islands in western Kenya. Results from focus-group discussions show that during wimbo there is a deviation from community norms governing sexual expression, influenced by the belief that circumcision provides protection against HIV infection. Through the exchange of sex for fish, circumcised men access new sexual partners in the destination beaches and engage in risky sexual behaviours without any HIV prevention measures. The processes and practices associated with wimbo may therefore help explain why rates of HIV infection are increasing among fisherfolk despite new interventions to combat HIV. These results have relevant implications for HIV-related intervention and policy in sub-Saharan Africa. PMID:25774858

  12. Efficient and equitable HIV prevention: A case study of male circumcision in South Africa

    Directory of Open Access Journals (Sweden)

    Verguet Stéphane

    2013-01-01

    Full Text Available Abstract Background We determine efficient, equitable and mixed efficient-equitable allocations of a male circumcision (MC intervention reducing female to male HIV transmission in South Africa (SA, as a case study of an efficiency-equity framework for resource allocation in HIV prevention. Methods We present a mathematical model developed with epidemiological and cost data from the nine provinces of SA. The hypothetical one-year-long MC intervention with a budget of US$ 10 million targeted adult men 15–49 years of age in SA. The intervention was evaluated according to two criteria: an efficiency criterion, which focused on maximizing the number of HIV infections averted by the intervention, and an equity criterion (defined geographically, which focused on maximizing the chance that each male adult individual had access to the intervention regardless of his province. Results A purely efficient intervention would prevent 4,008 HIV infections over a year. In the meantime, a purely equitable intervention would avert 3,198 infections, which represents a 20% reduction in infection outcome as compared to the purely efficient scenario. A half efficient-half equitable scenario would prevent 3,749 infections, that is, a 6% reduction in infection outcome as compared to the purely efficient scenario. Conclusions This paper provides a framework for resource allocation in the health sector which incorporates a simple equity metric in addition to efficiency. In the specific context of SA with a MC intervention for the prevention of HIV, incorporation of geographical equity only slightly reduces the overall efficiency of the intervention.

  13. Women's Perceptions and Misperceptions of Male Circumcision: A Mixed Methods Study in Zambia.

    Science.gov (United States)

    Haberland, Nicole A; Kelly, Christine A; Mulenga, Drosin M; Mensch, Barbara S; Hewett, Paul C

    2016-01-01

    Women's perceptions of male circumcision (MC) have implications for behavioral risk compensation, demand, and the impact of MC programs on women's health. This mixed methods study combines data from the first two rounds of a longitudinal study (n = 934) and in-depth interviews with a subsample of respondents (n = 45) between rounds. Most women correctly reported that MC reduces men's risk of HIV (64% R1, 82% R2). However, 30% of women at R1, and significantly more (41%) at R2, incorrectly believed MC is fully protective for men against HIV. Women also greatly overestimated the protection MC offers against STIs. The proportion of women who believed MC reduces a woman's HIV risk if she has sex with a man who is circumcised increased significantly (50% to 70%). Qualitative data elaborate women's misperception regarding MC. Programs should address women's informational needs and continue to emphasize that condoms remain critical, regardless of male partner's circumcision status. PMID:26937971

  14. Histopathological examination of the prepuce after circumcision: Is it a waste of resources?

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    Hussein Naji

    2013-01-01

    Full Text Available Background: The aim of this article is to evaluate the histopathological findings of foreskin after circumcision for medical indications and to find out if analyzing the biopsy is a waste of resources. Material and Methods: This retrospective analysis was carried out of the medical records and histopathological findings of 112 boys who underwent circumcision from June 2002 to June 2005. The study group consisted of 52 boys that were circumcised for medical indications, while the control group consisted of 60 boys who underwent circumcision for religious belief. Results: The mean (range age of children in the study group was six (2-12 years. 36 boys had phimosis, 15 had recurrent balanoposthitis and one had paraphimosis as an indication for circumcision. Balanitis xerotica obliterans (BXO was diagnosed in eight out of 52 biopsies (15%. In five of the eight BXO, the histopathological examination revealed focal lichenoid infiltrate which was considered as early form of BXO. There was no suspicion of BXO in the physical examination of those five patients. Chronic inflammation was reported in seven patients, while minor changes in the form of minimal inflammation and oedema were found in another 15 patients. The rest of the biopsies (22 patients showed normal preputial pathology. The histopathological examinations of the control group revealed chronic inflammation in three patients and acute inflammation with cellular oedema in another three patients. Conclusions: There is a place for routine biopsy after circumcision for medical indications. The clinical examination failed to suspect 5 of the 8 cases of BXO that were diagnosed by histopathology.

  15. Acceptability of early infant male circumcision as an HIV prevention intervention in Zimbabwe: a qualitative perspective.

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    Webster Mavhu

    Full Text Available BACKGROUND: Early infant male circumcision (EIMC is simpler, safer and more cost-effective than adult circumcision. In sub-Saharan Africa, there are concerns about acceptability of EIMC which could affect uptake. In 2009 a quantitative survey of 2,746 rural Zimbabweans (aged 18-44 indicated that 60% of women and 58% of men would be willing to have their newborn son circumcised. Willingness was associated with knowledge of HIV and male circumcision. This qualitative study was conducted to better understand this issue. METHODS: In 2010, 24 group discussions were held across Zimbabwe with participants from seven ethnic groups. Additionally, key informant interviews were held with private paediatricians who offer EIMC (n = 2 plus one traditional leader. Discussions were audio-recorded, transcribed, translated into English (where necessary, coded using NVivo 8 and analysed using grounded theory principles. RESULTS: Knowledge of the procedure was poor. Despite this, acceptability of EIMC was high among parents from most ethnic groups. Discussions suggested that fathers would make the ultimate decision regarding EIMC although mothers and extended family can have (often covert influence. Participants' concerns centred on: safety, motive behind free service provision plus handling and disposal of the discarded foreskin. Older men from the dominant traditionally circumcising population strongly opposed EIMC, arguing that it separates circumcision from adolescent initiation, as well as allowing women (mothers to nurse the wound, considered taboo. CONCLUSIONS: EIMC is likely to be an acceptable HIV prevention intervention for most populations in Zimbabwe, if barriers to uptake are appropriately addressed and fathers are specifically targeted by the programme.

  16. Early Infant Male Circumcision in Cameroon and Senegal: Demand, Service Provision, and Cultural Context

    Science.gov (United States)

    Kenu, Ernest; Sint, Tin Tin; Kamenga, Claude; Ekpini, Rene

    2016-01-01

    ABSTRACT Background: Male circumcision is almost universal in North and West Africa, and practiced for various reasons. Yet there is little documentation on service delivery, clinical procedures, policies, and programmatic strategies. The United Nations Children’s Fund (UNICEF) commissioned country program reviews in 2014 to shed light on the delivery of male circumcision services for infants in Cameroon and Senegal. Methods: We conducted a policy desk review, key informant interviews, and focus group discussions at health centers and in communities. Between December 2014 and January 2015, we conducted 21 key informant interviews (13 with regional and district officers, 5 with national officers, and 3 with UNICEF officials) and 36 focus group discussions (6 with men, 6 with women, 12 with adolescent boys, and 12 with service providers). Some of the men and women were parents of the adolescents who participated in the focus group discussions. In the French-speaking areas, the focus group discussions were conducted in French through an accredited translator, audio recorded, and transcribed into English. Results: All of the facilities we visited in Cameroon and Senegal offer medical male circumcision, with 10 out of 12 performing early infant male circumcision (EIMC) routinely. Neither country has policies, guidelines, or strategies for EIMC. The procedure is done mainly by untrained service providers, with some providers using modern circumcision devices. There are no key messages on EIMC for families; the increasing demand for EIMC is led by the community. Conclusion: Despite the absence of national policies and strategies, EIMC is routinely offered at all levels of the health care system in Cameroon and Senegal, mainly by untrained service providers. Improving circumcision services will require guidelines for EIMC and improvements in training, equipment, supply chains, recordkeeping, and demand creation. PMID:27413080

  17. Factors contributing to the low uptake of medical male circumcision in Mutare Rural District, Zimbabwe

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    Irene O. Chiringa

    2016-03-01

    Full Text Available Background: Medical male circumcision (MMC has become a significant dimension of HIV prevention interventions, after the results of three randomised controlled trials in Uganda, South Africa and Kenya demonstrated that circumcision has a protective effect against contracting HIV of up to 60%. Following recommendations by the World Health Organization, Zimbabwe in 2009 adopted voluntary MMC as an additional HIV prevention strategy to the existing ABC behaviour change model.Purpose: The purpose of this study is thus to investigate the factors contributing to the low uptake of MMC.Methods: The study was a quantitative cross-sectional survey conducted in Mutare rural district, Zimbabwe. Questionnaires with open- and closed-ended questions were administered to the eligible respondents. The target population were male participants aged 15–29 who met the inclusion criteria. The households were systematically selected with a sample size of 234. Statistical Package for the Social Sciences was used to analyse the data.Results: Socioculturally, circumcised men are viewed as worthless (37%, shameful (30% and are tainted as promiscuous (20%, psychological factors reported were infection and delayed healing (39%, being ashamed and dehumanised (58%, stigmatised and discriminated (40.2% and fear of having an erection during treatment period (89.7% whilst socio-economic factors were not having time, as it will take their time from work (58% and complications may arise leading to spending money on treatment (84%.Conclusion: Knowledge deficits regarding male medical circumcision lead to low uptake, education on male medical circumcision and its benefits. Comprehensive sexual health education should target men and dispel negative attitudes related to the use of health services.Keywords: Factors, Low uptake, Medical Male Circumcision (MMC

  18. Free nerve ending density on skin extracted by circumcision and its relation to premature ejaculation.

    Science.gov (United States)

    Malkoc, Ercan; Ates, Ferhat; Tekeli, Hakan; Kurt, Bulent; Turker, Turker; Basal, Seref

    2012-01-01

    Many studies have shown that skin tissue extracted by circumcision can cause differences in sexual function, especially at the time of ejaculation. Sensitivity changes in penile skin and sexual satisfaction deriving from circumcision starting from premature ejaculation (PE) are discussed. Furthermore, most of these studies rely on questionnaires. Extracted free nerve endings (FNE) on the foreskin, which can detect temperature, mechanical stimuli (touch, pressure, stretch) or pain (nociception), have not been researched. Our aim is to determine FNEs in foreskin and the affects on sexual function, especially PE. This prospective study was done on adults who voluntarily applied to be circumcised between September 2010 and October 2011. The ejaculation latency times (ELT) before circumcision have been assessed, and a PE diagnostic tool (PEDT) form was filled out by the urologist according to the answers given by the volunteers. The proximal and distal ends of the foreskin were marked before circumcision, and the extracted foreskin was sent to the pathology department to determine FNEs. Twenty volunteers (average age 21.25 ± 0.44 years) were included in the study. The average ELT was 103.55 ± 68.39 seconds, and the average PE score was 4.35 ± 3.13. Proximal, middle, and distal tip nerve densities were compared. Proximal and distal (P = .003) and proximal and middle (P = .011) segments differed from each other, whereas middle and distal were similar (P = .119). There were not any correlations between PEDT scores and total nerve endings number (r = .018, P = .942). Also there were not any correlations between mean ELT and PEDT scores (r = .054, P = .822). The tissue extracted by circumcision has intensive FNEs, yet FNE intensity has no relation to PE. PMID:22604629

  19. Complications of traditional circumcision amongst young Xhosa males seen at St Lucy’s Hospital, Tsolo, Eastern Cape, South Africa

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    Ugochukwu Anike

    2013-01-01

    Full Text Available Background: Traditional circumcision of males is common amongst many societies in sub-Saharan Africa. Circumcision amongst the Xhosa people of South Africa represents a rite of passage to manhood. Traditional male circumcision has an increased risk for complications that include sepsis, genitalmutilation, gangrenous penis, excessive bleeding, dehydration, renal failure and death. The aim of this study was to describe the complications of traditional circumcisions amongst Xhosa men as seen at St. Lucy’s Hospital in the Eastern Cape Province.Method: A cross-sectional descriptive quantitative study was conducted in 2008. Records of 105 malesadmitted to St. Lucy’s Hospital with complications following traditional circumcision were reviewed. Data collected included age, education level, race, reasons for circumcision, complications, the period of circumcision, duration of hospital stay and the outcomes. Descriptive data analysis was performed using statistical software SPSS 17.0.Results: The ages ranged from 15–35 years with 68 (64.8% between 15–19 years. 83 (79% had a secondarylevel of education, 16 (15.2% primary, 5 (4.8% tertiary and 1% had no education. 60 (57% werecircumcised as initiation to manhood, 21 (20.0% due to peer pressure, 20 (19.0% for cultural reasons, and 1(1.0% was forced. The complications were sepsis (59 [56.2%], genital mutilation (28 [26.7%], dehydration(12 [11.4%] and amputation of genitalia (6 [5.7%].Fifty-nine (56.2% patients were circumcised in winter.79 (75.2% were circumcised in the forest, and 25 (23.8% in initiation centres. Fifty-eight (55.2% werecircumcised by traditionalists, and 47 (44.8% by tribal elders (initiators. Hospital stays ranged from 8 to28 days. 66% were healed and discharged, and 29 (27.6% were referred to higher centres of care.Conclusion: Genital sepsis was the most common complication of traditional male circumcision.Complications were related to the circumciser, advanced age of the patient

  20. Voluntary medical male circumcision in resource-constrained settings.

    Science.gov (United States)

    Tobian, Aaron A R; Adamu, Tigistu; Reed, Jason B; Kiggundu, Valerian; Yazdi, Youseph; Njeuhmeli, Emmanuel

    2015-12-01

    Throughout East and Southern Africa, the WHO recommends voluntary medical male circumcision (VMMC) to reduce heterosexual HIV acquisition. Evidence has informed policy and the implementation of VMMC programmes in these countries. VMMC has been incorporated into the HIV prevention portfolio and more than 9 million VMMCs have been performed. Conventional surgical procedures consist of forceps-guided, dorsal slit or sleeve resection techniques. Devices are also becoming available that might help to accelerate the scale-up of adult VMMC. The ideal device should make VMMC easier, safer, faster, sutureless, inexpensive, less painful, require less infrastructure, be more acceptable to patients and should not require follow-up visits. Elastic collar compression devices cause vascular obstruction and necrosis of foreskin tissue and do not require sutures or injectable anaesthesia. Collar clamp devices compress the proximal part of the foreskin to reach haemostasis; the distal foreskin is removed, but the device remains and therefore no sutures are required. Newer techniques and designs, such as tissue adhesives and a circular cutter with stapled anastomosis, are improvements, but none of these methods have achieved all desirable characteristics. Further research, design and development are needed to address this gap to enable the expansion of the already successful VMMC programmes for HIV prevention. PMID:26526758

  1. Gendered Identity and Anti-Female Genital Cutting (FGC Activism among the Ejaghams, Cameroon

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    Vitalis Pemunta Ngambouk

    2010-01-01

    Full Text Available This paper is a critical appraisal of NGO activism against female genital cutting (FGC practices among Ejagham communities in SouthwestCameroon. The paper argues that by framing female circumcision as a ‘‘harmful traditional practice’’, local anti-female circumcision activists(NGOs and their external allies, using educational, health, legal awareness and human rights-based approaches, have produced mixed results,thereby re-inforcing resistance among cultural hardliners. Their demonization of culture and failure to address the local context of thesepractices tends rather, to reify and re-inscribe the practice as central to Ejagham cultural identity, personhood and femininity. Although tensionis absolutely central not only to any attempt to stop the practice but probably to the processes involved in the practices themselves, I maintainthat a community-led, ‘Positive Deviance Approach’ could be a way forward towards the eventual eradication of FGC.

  2. What nurses need to know about female genital mutilation.

    Science.gov (United States)

    Momoh, Comfort; Olufade, Olamide; Redman-Pinard, Patrice

    Female genital mutilation, also known as female circumcision (FGM/C) is a deep-rooted practice in some countries that needs to be addressed if the health needs of women and girls are to be met. FGM/C has no medical or health benefits. This article will discuss the different types of FGM/C, the law and legal implications and urological complications. Urology nurses need to be aware of what their medical roles and legal responsibilities are so that they are able to sensitively and holistically care for girls and women living with or at risk of FGM/C. PMID:27172505

  3. Circumcision of the Female Intellect: 19th Century Women Who Opposed Scholarly Education

    Science.gov (United States)

    Holmes, Marbeth

    2009-01-01

    In 19th century America, some women decried the opportunity for scholarly education as rebellion against religion and predicted a grim decline in the quality of life, home, and hearth for American families and for American culture and politics. In particular, women who opposed scholarly education argued that God had not created men and women…

  4. Universelle kramper og respirationsstop som komplikation i forbindelse med lokalanalgesi ved circumcision

    DEFF Research Database (Denmark)

    Heiberg, Ida Louise; Nebrich, Lars; Pedersen, Pernille

    2015-01-01

    We present two cases in which two boys of four weeks and four and a half months, respectively, experienced seizures and respiratory insufficiency as complications to the local anaesthesia administered for ritual circumcision. They both needed intubation and anticonvulsive therapy and acquired an...

  5. Transfer of the Kenyan Kikuyu Male Circumcision Ritual to Future Generations Living in the United States

    Science.gov (United States)

    Mbito, Michael N.; Malia, Julia A.

    2009-01-01

    This phenomenological research report from analysis of interviews with 18 participants focuses on the theme of transferring an age-old initiation-into-manhood circumcision ritual to future generations of Kenyan Kikuyu who are living in the US. We identified three subthemes and found a strong indication that, while personally meaningful to the…

  6. Penile injury due to blunt trauma after circumcision in a male child: A case report

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    Hulya Ozturk

    2014-08-01

    Full Text Available Injury in the case presented here is different from the cause of penile trauma. Our case has been exposed to blunt trauma after circumcision. Type developments of the penile trauma, treatment, and precautions have been discussed with the literature.

  7. Traditional male circumcision in Uganda: a qualitative focus group discussion analysis.

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    Amir Sabet Sarvestani

    Full Text Available BACKGROUND: The growing body of evidence attesting to the effectiveness of clinical male circumcision in the prevention of HIV/AIDS transmission is prompting the majority of sub-Saharan African governments to move towards the adoption of voluntary medical male circumcision (VMMC. Even though it is recommended to consider collaboration with traditional male circumcision (TMC providers when planning for VMMC, there is limited knowledge available about the TMC landscape and traditional beliefs. METHODOLOGY AND MAIN FINDINGS: During 2010-11 over 25 focus group discussions (FGDs were held with clan leaders, traditional cutters, and their assistants to understand the practice of TMC in four ethnic groups in Uganda. Cultural significance and cost were among the primary reasons cited for preferring TMC over VMMC. Ethnic groups in western Uganda circumcised boys at younger ages and encountered lower rates of TMC related adverse events compared to ethnic groups in eastern Uganda. Cutting styles and post-cut care also differed among the four groups. The use of a single razor blade per candidate instead of the traditional knife was identified as an important and recent change. Participants in the focus groups expressed interest in learning about methods to reduce adverse events. CONCLUSION: This work reaffirmed the strong cultural significance of TMC within Ugandan ethnic groups. Outcomes suggest that there is an opportunity to evaluate the involvement of local communities that still perform TMC in the national VMMC roll-out plan by devising safer, more effective procedures through innovative approaches.

  8. Case of a congenital urethral duplication being unmasked following circumcision for balanitis xerotica obliterans.

    Science.gov (United States)

    Boyd, Matthew; Woodward, Mark; Lambert, Anthony

    2010-07-01

    We present the case of an 11-year-old boy diagnosed with an Effmann Type II A1 urethral duplication after routine circumcision for balanitis xerotica obliterans (BXO). We discuss the pathophysiology, investigation and management both of BXO and urethral duplication. PMID:20529516

  9. Mathieu repair of distal and midshaft hypospadias: risks and benefits of foreskin reconstruction versus circumcision

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    Moslemi MK

    2011-06-01

    Full Text Available Mohammad Kazem Moslemi1, Mohammad Ali Sadighi Gilani2, Hossein Shahrokh31Department of Urology, Kamkar Hospital, School of Medicine, Qom, University of Medical Science, Qom, Iran; 2Department of Urology, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; 3Department of Urology, Hasheminejad Kidney Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, IranBackground: The purpose of this study was to compare the risks and benefits of Mathieu repair of hypospadias with or without circumcision in consecutive operated cases.Methods: Eighty-six children with midshaft or distal hypospadias were randomly divided into two groups and underwent circumcision (Group A or preputial reconstruction (Group B during hypospadias repair. Postoperative complications, outcomes, and parental satisfaction were assessed for circumcised and uncircumcised patients. All patients with midshaft or distal hypospadias with or without minimal chordee were included.Results: No statistically significant differences in urethral complications were found between the two groups. Meatal stenosis occurred in one case in Group A and one case in Group B. Fistulae occurred in five cases in Group A and six cases in Group B. Urethral dehiscence occurred in no case in either group. No case of phimosis was seen in Group B. After a mean follow-up of 6 months, all parents of Group A cases stated that they were satisfied with the circumcision for religious and/or social reasons, but no parents of Group B cases were satisfied with preputioplasty (P ≤ 0.05. No case of hypospadias repair failure was seen in our operated cases. Finally, no cases in Group B required redo hypospadias surgery.Conclusion: Mathieu repair with synchronous circumcision is feasible in all patients with distal or midshaft hypospadias with or without minimal chordee, and should be considered in accordance with surgeon preference. In the case of prepuce

  10. Triggering the decision to undergo medical male circumcision: a qualitative study of adult men in Botswana.

    Science.gov (United States)

    Wirth, Kathleen E; Semo, Bazghina-Werq; Ntsuape, Conrad; Ramabu, Nankie M; Otlhomile, Boyce; Plank, Rebeca M; Barnhart, Scott; Ledikwe, Jenny H

    2016-08-01

    In 2007, the World Health Organization endorsed voluntary medical male circumcision (VMMC) as part of comprehensive HIV-prevention strategies. A major challenge facing VMMC programs in sub-Saharan Africa remains demand creation; there is urgent need for data on key elements needed to trigger the decision among eligible men to seek VMMC. Using qualitative methods, we sought to better understand the circumcision decision-making process in Botswana related to VMMC. From July to November 2013, we conducted 27 focus group discussions in four purposively selected communities in Botswana with men (stratified by circumcision status and age), women (stratified by age) and community leaders. All discussions were facilitated by a trained same-sex interviewer, audio recorded, transcribed and translated to English, and analyzed for key themes using an inductive content analytic approach. Improved hygiene was frequently cited as a major benefit of circumcision and many participants believed that cleanliness was directly responsible for the protective effect of VMMC on HIV infection. While protection against HIV was frequently noted as a benefit of VMMC, the data indicate that increased sexual pleasure and perceived attractiveness, not fear of HIV infection, was an underlying reason why men sought VMMC. Data from this qualitative study suggest that more immediate benefits of VMMC, such as improved hygiene and sexual pleasure, play a larger role in the circumcision decision compared with protection from potential HIV infection. These findings have immediate implications for targeted demand creation and mobilization activities for increasing uptake of VMMC among adult men in Botswana. PMID:26754167

  11. Factors contributing to the low uptake of medical male circumcision in Mutare Rural District, Zimbabwe

    Science.gov (United States)

    Chiringa, Irene O.; Mashau, Ntsieni S.

    2016-01-01

    Background Medical male circumcision (MMC) has become a significant dimension of HIV prevention interventions, after the results of three randomised controlled trials in Uganda, South Africa and Kenya demonstrated that circumcision has a protective effect against contracting HIV of up to 60%. Following recommendations by the World Health Organization, Zimbabwe in 2009 adopted voluntary MMC as an additional HIV prevention strategy to the existing ABC behaviour change model. Purpose The purpose of this study is thus to investigate the factors contributing to the low uptake of MMC. Methods The study was a quantitative cross-sectional survey conducted in Mutare rural district, Zimbabwe. Questionnaires with open- and closed-ended questions were administered to the eligible respondents. The target population were male participants aged 15–29 who met the inclusion criteria. The households were systematically selected with a sample size of 234. Statistical Package for the Social Sciences was used to analyse the data. Results Socioculturally, circumcised men are viewed as worthless (37%), shameful (30%) and are tainted as promiscuous (20%), psychological factors reported were infection and delayed healing (39%), being ashamed and dehumanised (58%), stigmatised and discriminated (40.2%) and fear of having an erection during treatment period (89.7%) whilst socio-economic factors were not having time, as it will take their time from work (58%) and complications may arise leading to spending money on treatment (84%). Conclusion Knowledge deficits regarding male medical circumcision lead to low uptake, education on male medical circumcision and its benefits. Comprehensive sexual health education should target men and dispel negative attitudes related to the use of health services.

  12. Factors associated with the acceptability of male circumcision among men in Jamaica.

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    Melonie M Walcott

    Full Text Available OBJECTIVES: To determine the prevalence of male circumcision (MC among men in the western region of Jamaica, and to identify factors associated with acceptability of MC for self, infants (<1 year and older sons (1-17 years. METHODS: A cross-sectional, interviewer-administered questionnaire survey of 549 men aged 19-54 years was conducted in the western region of Jamaica. The survey included questions about the acceptance of MC for self, infants, and sons before and after an information session about the benefits of MC in preventing HIV/STI transmission. Logistic regression models were used to identify factors that were associated with acceptability of MC. Adjusted odds ratios (AOR and 95% confidence intervals (CI were calculated from the models. RESULTS: Fourteen percent of the men reported that they were circumcised. In the multivariable model, which adjusted for age, education, religion and income, there were increased odds of accepting MC for infants/sons among uncircumcised men who accepted MC for self (AOR=8.1; 95% CI = 4.1-15.9, believed they would experience more pleasure during sex if circumcised (AOR=4.0; 95% CI = 2.0-8.2, and reported having no concerns regarding MC (AOR=3.0; 95% CI = 1.8-4.8. Similarly, uncircumcised men who reported no concerns about MC or who believed that they would experience more pleasure during sex if circumcised were more likely to accept MC for self. CONCLUSION: Providing men with information about MC increased acceptance of MC for self, infants (<17 years and sons (1-17 years. Since targeted education on the benefits of male circumcision for prevention of HIV/STI can be effective in increasing acceptability of MC, health professionals should be trained, and willing to discuss MC with men in healthcare facilities and in the community.

  13. Scaling-up voluntary medical male circumcision - what have we learned?

    Science.gov (United States)

    Ledikwe, Jenny H; Nyanga, Robert O; Hagon, Jaclyn; Grignon, Jessica S; Mpofu, Mulamuli; Semo, Bazghina-Werq

    2014-01-01

    In 2007, the World Health Organization (WHO) and the joint United Nations agency program on HIV/AIDS (UNAIDS) recommended voluntary medical male circumcision (VMMC) as an add-on strategy for HIV prevention. Fourteen priority countries were tasked with scaling-up VMMC services to 80% of HIV-negative men aged 15-49 years by 2016, representing a combined target of 20 million circumcisions. By December 2012, approximately 3 million procedures had been conducted. Within the following year, there was marked improvement in the pace of the scale-up. During 2013, the total number of circumcisions performed nearly doubled, with approximately 6 million total circumcisions conducted by the end of the year, reaching 30% of the initial target. The purpose of this review article was to apply a systems thinking approach, using the WHO health systems building blocks as a framework to examine the factors influencing the scale-up of the VMMC programs from 2008-2013. Facilitators that accelerated the VMMC program scale-up included: country ownership; sustained political will; service delivery efficiencies, such as task shifting and task sharing; use of outreach and mobile services; disposable, prepackaged VMMC kits; external funding; and a standardized set of indicators for VMMC. A low demand for the procedure has been a major barrier to achieving circumcision targets, while weak supply chain management systems and the lack of adequate financial resources with a heavy reliance on donor support have also adversely affected scale-up. Health systems strengthening initiatives and innovations have progressively improved VMMC service delivery, but an understanding of the contextual barriers and the facilitators of demand for the procedure is critical in reaching targets. There is a need for countries implementing VMMC programs to share their experiences more frequently to identify and to enhance best practices by other programs. PMID:25336991

  14. A fast, easy circumcision procedure combining a CO2 laser and cyanoacrylate adhesive: a non-randomized comparative trial

    OpenAIRE

    Gorgulu, Tahsin; Olgun, Abdulkerim; Torun, Merve; Kargi, Eksal

    2016-01-01

    ABSTRACT Background Circumcision is performed as a routine operation in many countries, more commonly for religious and cultural reasons than for indicated conditions, such as phimosis and balanitis. There are many techniques available, and recently electrocautery and both Nd:YAG and CO2 lasers, instead of blades, have been used for skin and mucosal incisions. However, the infection risk in circumcisions performed using a CO2 laser was 10% higher. There are also reports of sutureless procedur...

  15. A fast, easy circumcision procedure combining a CO2 laser and cyanoacrylate adhesive: a non-randomized comparative trial

    OpenAIRE

    Tahsin Gorgulu; Abdulkerim Olgun; Merve Torun; Eksal Kargi

    2016-01-01

    ABSTRACT Background Circumcision is performed as a routine operation in many countries, more commonly for religious and cultural reasons than for indicated conditions, such as phimosis and balanitis. There are many techniques available, and recently electrocautery and both Nd:YAG and CO2 lasers, instead of blades, have been used for skin and mucosal incisions. However, the infection risk in circumcisions performed using a CO2 laser was 10% higher. There are also reports of sutureless proced...

  16. Evaluation of epidemiology, safety, and complications of male circumcision using conventional dissection surgery: experience at one center

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    Moslemi MK

    2011-05-01

    Full Text Available Mohammad Kazem Moslemi1, Mehdi Abedinzadeh2, Mohammad Aghaali11Department of Urology, Kamkar Hospital, School of Medicine, Qom University of Medical Sciences, Qom, Iran; 2Department of Urology, Moradi Hospital, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, IranBackground: Circumcision can be performed for a variety of techniques, including conventional dissection surgery or a Plastibell device, and has religious, ritual, or medical roots. In countries like Iran, circumcision is done purely on religious grounds. In this study, we outline 390 cases in our practice and describe the epidemiology, indications, surgical technique used, and the early complications.Materials and methods: In this retrospective study, the charts for 390 circumcision cases were analyzed for the period March 2005 to August 2010. We reviewed all cases, noting age, indication, type of anesthesia used, technique, cosmetic appearance, and any potential early complications. All cases were followed up 1–4 weeks postoperatively and their notes were evaluated.Results: The age of children who underwent circumcision ranged from 3 weeks to 14 years, with a mean age of 4.25 years. The most common age for circumcision was 4–5 years (14.6%, and the least common age was 11–12 years (1.5%. In 372 cases (95%, the parents had opted for the procedure for religious reasons, and in 18 cases (5%, there was a medical indication, including phimosis (11 cases, 3%, urinary tract infection (5 cases, 1.2%, and balanoposthitis (2 cases, 0.8%. No major early complications were found in our series. Cosmetic appearance was satisfactory in all cases by 4 weeks after the operation.Conclusion: Circumcision was performed for religious reasons in our cases, although medical indications sometimes modified the timing of the procedure. Conventional dissection surgery for circumcision was safe, effective, and without any major complications.Keywords: male circumcision, conventional

  17. Voluntary Medical Male Circumcision: Translating Research into the Rapid Expansion of Services in Kenya, 2008–2011

    OpenAIRE

    Mwandi, Zebedee; Murphy, Anne; Reed, Jason; Chesang, Kipruto; Njeuhmeli, Emmanuel; Agot, Kawango; Llewellyn, Emma; Kirui, Charles; Serrem, Kennedy; Abuya, Isaac; Loolpapit, Mores; Mbayaki, Regina; Kiriro, Ndungu; Cherutich, Peter; Muraguri, Nicholas

    2011-01-01

    Since the World Health Organization and the Joint United Nations Programme on HIV/AIDS recommended implementation of medical male circumcision (MC) as part of HIV prevention in areas with low MC and high HIV prevalence rates in 2007, the government of Kenya has developed a strategy to circumcise 80% of uncircumcised men within five years. To facilitate the quick translation of research to practice, a national MC task force was formed in 2007, a medical MC policy was implemented in early 2008,...

  18. The when and how of male circumcision and the risk of HIV: a retrospective cross-sectional analysis of two HIV surveys from Guinea-Bissau

    OpenAIRE

    Rasmussen, Dlama Nggida; Wejse, Christian; Larsen, Olav; da Silva, Zacarias; Aaby, Peter; Sodemann, Morten

    2016-01-01

    Introduction Male circumcision (MC) reduces the risk of HIV, and this risk reduction may be modified by socio-cultural factors such as the timing and method (medical and traditional) of circumcision. Understanding regional variations in circumcision practices and their relationship to HIV is crucial and can increase insight into the HIV epidemic in Africa. Methods We used data from two retrospective HIV surveys conducted in Guinea-Bissau from 1993 to 1996 (1996 cohort) and from 2004 to 2007 (...

  19. The PrePex Device Is Unlikely to Achieve Cost-Savings Compared to the Forceps-Guided Method in Male Circumcision Programs in Sub-Saharan Africa

    OpenAIRE

    Obiero, Walter; Marisa R Young; Robert C Bailey

    2013-01-01

    Background Male circumcision (MC) reduces the risk of heterosexual HIV acquisition in men by approximately 60%. MC programs for HIV prevention are currently being scaled-up in fourteen countries in sub-Saharan Africa. The current standard surgical technique for MC in many sub-Saharan African countries is the forceps-guided male circumcision (FGMC) method. The PrePex male circumcision (PMC) method could replace FGMC and potentially reduce MC programming costs. We compared the potential costs o...

  20. To circ or not to circ: clinical and pharmacoeconomic outcomes of a prospective trial of topical steroid versus primary circumcision

    Directory of Open Access Journals (Sweden)

    Yuri D. Nobre

    2010-02-01

    Full Text Available PURPOSE: To compare the efficacy and costs of circumcision versus topical treatment using a prospective pharmacoeconomic protocol. MATERIALS AND METHODS: We treated 59 patients (3-10 years of age randomized into two groups: 29 underwent an 8-week course of topical treatment with 0.2% betamethasone-hyaluronidase cream twice a day; and 30 underwent circumcision. Topical treatment success was defined as complete exposure of the glans. In cases of treatment failure, circumcision was performed and its cost imputed to that of the initial treatment. The pharmacoeconomic aspects were defined according to the Brazilian National Public Health System database and the Brazilian Community Pharmacies Index. RESULTS: The two groups were statistically similar for all clinical parameters evaluated. Topical treatment resulted in complete exposure of the glans in 52% of the patients. Topical treatment was associated with preputial pain and hyperemia. However, treatment suspension was unnecessary. Minor complications were observed in 16.6% of the surgical group patients. The mean cost per patient was US$ 53.70 and US$ 125.20, respectively, for topical steroid treatment (including the costs related to treatment failure and circumcision. The total costs were US$ 2,825.32 and US$ 3,885.73 for topical treatment and circumcision, respectively. CONCLUSIONS: Topical treatment of phimosis can reduce costs by 27.3% in comparison with circumcision. Therefore, topical treatment of phimosis should be considered prior to the decision to perform surgery.

  1. Informing the scaling up of voluntary medical male circumcision efforts through the use of theory of reasoned action: survey findings among uncircumcised young men in Swaziland.

    Science.gov (United States)

    Gurman, Tilly A; Dhillon, Preeti; Greene, Jessica L; Makadzange, Panganai; Khumlao, Philisiwe; Shekhar, Navendu

    2015-04-01

    Assessing predictors of intention to circumcise can help to identify effective strategies for increasing uptake of voluntary medical male circumcision (VMMC). Grounded in the theory of reasoned action (TRA), the current study of uncircumcised males ages 13-29 in Swaziland (N = 1,257) employed multivariate logistic regression to determine predictors of VMMC intention. The strongest predictors were strongly disagreeing/disagreeing that sex was more painful for a circumcised man (odds ratio [OR] = 4.37; p = theory to explore young men's intention to circumcise and can help inform interventions aimed at increasing uptake of VMMC. PMID:25915700

  2. A rose by any other name? Rethinking the similarities and differences between male and female genital cutting.

    Science.gov (United States)

    Darby, Robert; Svoboda, J Steven

    2007-09-01

    In this article, we offer a critical examination of the tendency to segregate discussion of surgical alterations to the male and female genitals into separate compartments--the first known as circumcision, the second as genital mutilation. We argue that this fundamental problem of definition underlies the considerable controversy surrounding these procedures when carried out on minors, and that it hinders objective discussion of the alleged benefits, harms, and risks. We explore the variable effects of male and female genital surgeries, and we propose a scale of damage for male circumcision to complement the World Health Organization's categorization of female genital mutilation. The origins of the double standard identified are placed in historical perspective, and in a brief conclusion we make a plea for greater gender neutrality in the approach to this contentious issue. PMID:17937251

  3. Voluntary medical male circumcision: logistics, commodities, and waste management requirements for scale-up of services.

    Directory of Open Access Journals (Sweden)

    Dianna Edgil

    2011-11-01

    Full Text Available BACKGROUND: The global HIV prevention community is implementing voluntary medical male circumcision (VMMC programs across eastern and southern Africa, with a goal of reaching 80% coverage in adult males by 2015. Successful implementation will depend on the accessibility of commodities essential for VMMC programming and the appropriate allocation of resources to support the VMMC supply chain. For this, the United States President's Emergency Plan for AIDS Relief, in collaboration with the World Health Organization and the Joint United Nations Programme on HIV/AIDS, has developed a standard list of commodities for VMMC programs. METHODS AND FINDINGS: This list of commodities was used to inform program planning for a 1-y program to circumcise 152,000 adult men in Swaziland. During this process, additional key commodities were identified, expanding the standard list to include commodities for waste management, HIV counseling and testing, and the treatment of sexually transmitted infections. The approximate costs for the procurement of commodities, management of a supply chain, and waste disposal, were determined for the VMMC program in Swaziland using current market prices of goods and services. Previous costing studies of VMMC programs did not capture supply chain costs, nor the full range of commodities needed for VMMC program implementation or waste management. Our calculations indicate that depending upon the volume of services provided, supply chain and waste management, including commodities and associated labor, contribute between US$58.92 and US$73.57 to the cost of performing one adult male circumcision in Swaziland. CONCLUSIONS: Experience with the VMMC program in Swaziland indicates that supply chain and waste management add approximately US$60 per circumcision, nearly doubling the total per procedure cost estimated previously; these additional costs are used to inform the estimate of per procedure costs modeled by Njeuhmeli et al. in

  4. Male circumcision: towards a World Health Organisation normative practice in resource limited settings.

    Science.gov (United States)

    Hargreave, Tim

    2010-09-01

    There is now grade 1 evidence that male circumcision (MC) reduces the risk of a man acquiring HIV. Modelling studies indicate MC could in the next 10 years save up to 2 million lives in those African countries with high HIV prevalence. Several African countries are now scaling up public health MC programmes. The most effective immediate public health MC programmes in Africa will need to target 18-20 years old men. In the longer term there is a need for infant circumcision programmes. In order to implement more widespread MC there is a need to make the surgical procedures as simple as possible so that safe operations can be performed by paramedical staff. The WHO Manual of Male Circumcision under local anaesthetic was written with these objectives in mind. Included in the manual are three adult techniques and four paediatric procedures. The adult procedures are the dorsal slit, the forceps guided and the sleeve resection methods. Paediatric methods included are the plastibell technique, the Mogen and Gomco shield method and a standard surgical dorsal slit procedure. Each method is described in a step by step manner with photographic and line drawing illustrations. In addition to the WHO manual of surgical technique a teaching course has been developed and using this course it has been possible in one week to train a circumcision surgeon who has had no or minimal previous surgical experience. Further scaling will require training of circumcision surgeons, monitoring performance, training the trainer workshops as well as advocacy at national, international and government meetings. In addition to proceeding with standardised methods work is in progress to assess novel techniques in adults such as stay on ring devices and policies are being formulated as to how to assess new devices. Also work is in progress to explore efficiencies in surgical processing by task sharing. Proper informed consent and safety remain paramount and great care has to be taken as programmes in

  5. Scaling-up voluntary medical male circumcision – what have we learned?

    Directory of Open Access Journals (Sweden)

    Ledikwe JH

    2014-10-01

    Full Text Available Jenny H Ledikwe,1,2,* Robert O Nyanga,1,* Jaclyn Hagon,2 Jessica S Grignon,1,2 Mulamuli Mpofu,1 Bazghina-werq Semo1,2 1International Training and Education Center for Health, Botswana, Gaborone, Botswana; 2Department of Global Health, University of Washington, Seattle, WA, USA*These authors are joint first authorsAbstract: In 2007, the World Health Organization (WHO and the joint United Nations agency program on HIV/AIDS (UNAIDS recommended voluntary medical male circumcision (VMMC as an add-on strategy for HIV prevention. Fourteen priority countries were tasked with scaling-up VMMC services to 80% of HIV-negative men aged 15–49 years by 2016, representing a combined target of 20 million circumcisions. By December 2012, approximately 3 million procedures had been conducted. Within the following year, there was marked improvement in the pace of the scale-up. During 2013, the total number of circumcisions performed nearly doubled, with approximately 6 million total circumcisions conducted by the end of the year, reaching 30% of the initial target. The purpose of this review article was to apply a systems thinking approach, using the WHO health systems building blocks as a framework to examine the factors influencing the scale-up of the VMMC programs from 2008–2013. Facilitators that accelerated the VMMC program scale-up included: country ownership; sustained political will; service delivery efficiencies, such as task shifting and task sharing; use of outreach and mobile services; disposable, prepackaged VMMC kits; external funding; and a standardized set of indicators for VMMC. A low demand for the procedure has been a major barrier to achieving circumcision targets, while weak supply chain management systems and the lack of adequate financial resources with a heavy reliance on donor support have also adversely affected scale-up. Health systems strengthening initiatives and innovations have progressively improved VMMC service delivery, but an

  6. Rural female adolescence: Indian scenario.

    Science.gov (United States)

    Kumari, R

    1995-01-01

    This article describes the life conditions of female adolescents in India and issues such as health, discrimination in nutrition and literacy, child labor, early marriage, juvenile delinquency, and violence against girls in rural areas of India. Data are obtained from interview samples conducted among 12 villages in north India. Female adolescents suffer from a variety of poverty-ridden village life conditions: caste oppression, lack of facilities, malnutrition, educational backwardness, early marriage, domestic burden, and gender neglect. Girls carry a heavy work burden. Adolescence in rural areas is marked by the onset of puberty and the thrust into adulthood. Girls have no independent authority to control their sexuality or reproduction. Girls are expected to get married and produce children. Control of female sexuality is shifted from the father to the husband. There is a strong push to marry girls soon after menstruation, due to the burden of imposing strict restrictions on female sexuality, the desire to reduce the burden of financial support, and the need to ensure social security for daughters. Girls may not go out alone or stay outside after dark. Many rural parents fear that education and freedom would ruin their daughter. Girls develop a low self-image. Rural villages have poor sanitation, toilet facilities, and drainage systems. Girls are ignorant of health and sex education and lack access to education. The neglect of female children includes malnutrition, sex bias, and early marriage. In 1981, almost 4 out of every 100 girls had to work. 5.527 million girls 5-14 years old were child laborers. Girls are veiled, footbound, circumcised, and burnt by dowry hungry in-laws. Female delinquents are subjected to sexual harassment and sometime to sexual abuse while in custody. Cows are treated better in rural India than women. Gender disparity is caused by the perpetuation of patriarchal masculine values. PMID:12158005

  7. Circumcision of male infants and children as a public health measure in developed countries

    DEFF Research Database (Denmark)

    Frisch, Morten; Earp, Brian D

    2016-01-01

    in contrast to the more recent 2015 policy from the Canadian Paediatric Society as well as prior policies (still in force) from medical associations in Europe and Australasia - the CDC suggested that the benefits of the surgery outweigh the risks. In this article, we provide a brief scientific and...... conceptual analysis of the CDC's assessment of benefit versus risk, and argue that it deserves a closer look. Although we set aside the burgeoning bioethical debate surrounding the moral permissibility of performing non-therapeutic circumcisions on healthy minors, we argue that, from a scientific and medical...... perspective, current evidence suggests that such circumcision is not an appropriate public health measure for developed countries such as the United States....

  8. Correlates of male circumcision in Eastern and Southern African countries: establishing a baseline prior to VMMC Scale-up.

    Directory of Open Access Journals (Sweden)

    Khai Hoan Tram

    Full Text Available BACKGROUND: Despite the importance of male circumcision (MC prevalence to HIV prevention efforts in Eastern and Southern Africa, there has been no systematic analysis on the correlates of male circumcision. This analysis identifies correlates of MC in 12 countries in the region with available data. METHODS: Data from the male questionnaire of DHS surveys collected between 2006-2011 in Ethiopia, Kenya, Lesotho, Malawi, Mozambique, Namibia, Rwanda, Swaziland, Tanzania, Uganda, Zambia, and Zimbabwe were analyzed. The dependent variable was self-reported male circumcision status. Independent variables included age, education, wealth quintile, place of residence, ethnicity, religion and region. Bivariate and multivariate analyses were conducted separately for each country. RESULTS: MC prevalence ranged from 8.2 percent in Swaziland to 92.2 percent in Ethiopia. Bivariate analyses showed a consistent positive association between age (being older and male circumcision. Education, wealth quintile, and place of residence were either not significantly related or differed in the direction of the relationship by country. Multivariate logistic regression showed three variables consistently associated with MC status: age (being older, religion (being Muslim and ethnicity. DISCUSSION: These data were collected prior to the scale-up of voluntary medical male circumcision (VMMC programs in 11 of the 12 countries. As the VMMC scale-up intensifies in countries across Eastern and Southern Africa, the correlates of VMMC are likely to change, with (younger age and education emerging as key correlates of VMMC performed in medical settings. The centuries-long tradition among Muslims to circumcise should continue to favor MC among this group. Non-circumcising ethnicities may become more open to MC if promoted as a health practice for decreasing HIV risk.

  9. Plastibell Device Circumcision versus Bone Cutter Technique in terms of Operative Outcomes and Parent’s Satisfaction

    Science.gov (United States)

    Mehmood, Tahir; Azam, Hammad; Tariq, Muhammad; Iqbal, Zafar; Mehmood, Hassan; Shah, Syed Asif Hussain

    2016-01-01

    Objective: To compare the rate of complications of Plastibell and bone cutter circumcision technique and recognition of top worries and satisfaction rate in the mind of parents before and after the procedure of Plastibell device (PD) circumcision in infants less than 6 months of age. Methods: It was a descriptive prospective study conducted at department of surgery Sheikh Zayed Hospital, Rahim Yar Khan. Two hundred parents of infants of less than six months of age were recruited for this study. Infants were divided into two equal groups. Group I included Plastibell circumcision technique and Group II included Bone Cutter Circumcision technique. Data was analyzed using SPSS Version 17. Independent sample t-test and chi-square test was used to compare quantitative and qualitative variables respectively. P-value <0.05 was taken as significant difference. Results: Total number of two hundred infants were included in this study. Most common worries of parents about Plastibell Device circumcision were; fear of fever (42.0%). Fear of pain and bleeding (66.0%). Plastibell Device method was associated with less operation time and bleeding as compared to bone cutter method (P-value <0.0001 and <0.0001 respectively). Incidence of complications other than bleeding and infection was 3.0% in bone cutter method and 1.0% in Plastibell device method. Pain score was significantly less in plastibell device group (p-value <0.0001). Post-operatively, 98% parents showed complete procedural satisfaction in Plastibell group versus 87% parents in bone cutter one month after surgery (P-value 0.003). About 4% parents in bone cutter method group showed cosmetic displeasure versus only 1% parents in plastibell device group. Conclusion: The study concluded that Plastibell Device circumcision is a safer technique for circumcision and is associated with highest level of parent’s satisfaction. PMID:27182237

  10. Community and Healthcare Providers' Perspectives on Male Circumcision: A Multi-Centric Qualitative Study in India

    OpenAIRE

    Sahay, Seema; Nagarajan, Karikalan; Mehendale, Sanjay; Deb, Sibnath; Gupta, Abhilasha; Bharat, Shalini; Bhatt, Shripad; Kumar, Athokpam Bijesh; Kanthe, Vidisha; Sinha, Anju; Chandhiok, Nomita

    2014-01-01

    Background Although male circumcision (MC) is recommended as an HIV prevention option, the religious, cultural and biomedical dimensions of its feasibility, acceptability and practice in India have not been explored till date. This study explores beliefs, experiences and understanding of the community and healthcare providers (HCPs) about adult MC as an HIV prevention option in India. Methods This qualitative study covered 134 in-depth interviews from Belgaum, Kolkata, Meerut and Mumbai citie...

  11. Acceptance of Male Circumcision Among Male Rural-to-Urban Migrants in Western China

    OpenAIRE

    Jiang, Junjun; Huang, Jiegang; Yang, Xiaobo; Ye, Li; Wei, Bo; Deng, Wei; Wei, Suosu; Qin, Bo; Upur, Halmurat; Zhong, Chaohui; Wang, Qianqiu; Wang, Qian; Ruan, Yuhua; Wei, Fumei; Xu, Na

    2013-01-01

    To describe the acceptability of male circumcision (MC) and explore potential factors associated with MC acceptability among male rural-to-urban migrants in western China, a cross-sectional survey of MC acceptability was conducted with 1,904 subjects in three western provinces with high HIV prevalence (Guangxi, Chongqing, and Xinjiang) in China between June 2009 and November 2009. Through face-to-face interviews, the participants completed a self-administered questionnaire about demographics,...

  12. Clinical presentation of genital warts among circumcised and uncircumcised heterosexual men attending an urban STD clinic.

    OpenAIRE

    Cook, L. S.; Koutsky, L A; Holmes, K. K.

    1993-01-01

    INTRODUCTION--A recent study comparing heterosexual men with and without confirmed sexually transmitted diseases (STDs) in an urban STD clinic showed that uncircumcised men were less likely than circumcised men to have genital warts detectable by clinical examination (adjusted odds ratio 0.7, 95% confidence interval 0.4, 0.9). Based on these initial findings we hypothesised that the appearance and anatomic distribution of genital warts, and possibly treatment response, may be different for ci...

  13. Factors Associated with Knowledge of and Willingness for Adult Male Circumcision in Changsha, China.

    Directory of Open Access Journals (Sweden)

    Mingqiang Zeng

    Full Text Available Male circumcision (MC has been shown to reduce the risk of male genital diseases. MC is not commonly practiced among Chinese males and little is known about the factors associated with their knowledge of and willingness for MC. This study was to explore the knowledge regarding the foreskin among Chinese males and to identify factors associated with their willingness to undergo circumcision.A total of 237 patients with redundant prepuce/phimosis were interviewed through face-to-face interviews. The items on the questionnaire included: demographics, an objective scale assessing knowledge about the foreskin, willingness to have MC, the attitudes of sexual partners and doctors toward redundant prepuce/phimosis, and the approaches that patients used to acquire knowledge regarding the prepuce. Univariate analysis and multiple logistic regression analysis were performed to identify factors that are associated with willingness to be circumcised (WTC.A total of 212 patients completed the interview. Multivariable logistic regression showed that three factors were significantly associated with WTC: being married (OR = 0.43, perceiving redundant prepuce/phimosis as a disease (OR = 1.93, and if a patient's partner supported MC (OR = 1.39. 58% (n = 122 had received information about the foreskin from another party: 18% (n = 37 from school, 8% (n = 17 from family, 17% (n = 36 from friends, 27% (n = 57 from health care providers. About 4% (n = 8 believed that their partners disliked their redundant prepuce/phimosis. 20% (n = 42 had received doctors' advice to undergo circumcision.Knowledge about the foreskin was low among Chinese males. Our study elucidates the factors associated with WTC and suggests that more education of the population about the foreskin can help improve the recognition of a correctible abnormality and help patients assess the potential role of MC in their health.

  14. A critical evaluation of arguments opposing male circumcision for HIV prevention in developed countries

    OpenAIRE

    Morris, Brian J.; Bailey, Robert C.; Klausner, Jeffrey D.; Leibowitz, Arleen; Wamai, Richard G; Waskett, Jake H.; Banerjee, Joya; Halperin, Daniel T.; Zoloth, Laurie; Helen A. Weiss; Hankins, Catherine A.

    2012-01-01

    A potential impediment to evidence-based policy development on medical male circumcision (MC) for HIV prevention in all countries worldwide is the uncritical acceptance by some of arguments used by opponents of this procedure. Here we evaluate recent opinion-pieces of 13 individuals opposed to MC. We find that these statements misrepresent good studies, selectively cite references, some containing fallacious information, and draw erroneous conclusions. In marked contrast, the scientific evide...

  15. Routine neonatal circumcision: symbol of the birth of the therapeutic state.

    Science.gov (United States)

    Szasz, T

    1996-04-01

    The religious justification for male circumcision proffered by Jewish and Islamic parents is frequently overlooked in current secular (medical/hygienic) discussions that (1) challenge the moral justification of this ancient practice, and (2) question the decisions of today's parents who are committed, on the basis of their religious beliefs, to continue this practice. This paper reviews critically these conflicting values and arguments and calls for compromise in the face of potential state intervention to coerce parents to abandon this practice. PMID:8739069

  16. Prevalence of complications of male circumcision in Anglophone Africa: a systematic review

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    Mataya Ronald H

    2007-03-01

    Full Text Available Abstract Background There is growing evidence that male circumcision (MC prevents heterosexual acquisition of HIV by males in sub-Saharan Africa, the region of the world heavily affected by the HIV pandemic. While there is growing support for wide-spread availability and accessibility of MC in Africa, there is limited discussion about the prevalence of physical complications of male circumcision on the continent. Methods A systematic literature search and review of articles in indexed journals and conference abstracts was conducted to collect and analyze prevalence of complications of MC in Anglophone sub-Saharan Africa. Information extracted included: indications for MC, complications reported, age of patients and category of circumcisers. Results There were 8 articles and 2 abstracts that were suitable for the analysis. The studies were not strictly comparable as some reported on a wide range of complications while others reported just a limited list of possible complications. Prevalence of reported complications of MC ranged from 0% to 50.1%. Excluding the study with 50.1%, which was on a series of haemophilia patients, the next highest prevalence of complications was 24.1%. Most of the complications were minor. There was no firm evidence to suggest that MCs performed by physician surgeons were associated with lower prevalence of complications when compared with non-physician health professionals. Conclusion The available data are inadequate to obtain a reasonable assessment of the prevalence of complications of MC in sub-Saharan Africa. Some of the available studies however report potentially significant prevalence of complications, though of minor clinical significance. This should be considered as public health policy makers consider whether to scale-up MC as an HIV preventative measure. Decision for the scale-up will depend on a careful cost-benefit assessment of which physical complications are certainly an important aspect. There is

  17. Introduction of male circumcision for HIV prevention in Uganda : analysis of the policy process

    OpenAIRE

    Odoch, Walter Denis; Kabali, Kenneth; Ankunda, Racheal; Zulu, Joseph Mumba; Tetui, Moses

    2015-01-01

    Background: Health policy analysis is important for all health policies especially in fields with ever changing evidence-based interventions such as HIV prevention. However, there are few published reports of health policy analysis in sub-Saharan Africa in this field. This study explored the policy process of the introduction of male circumcision (MC) for HIV prevention in Uganda in order to inform the development processes of similar health policies. Methodology: Desk review of relevant docu...

  18. Intracavernosal metaraminol bitartrate for treatment of priapism resulting from circumcision: a case report

    OpenAIRE

    Tang, Min; Liu, Bianjiang; Jie LI; Lu, Qiang; Song, Ninghong; Wang, Zengjun; Zhang, Wei

    2016-01-01

    Introduction Priapism is an uncommon disorder of involuntary prolonged erection beyond sexual excitement or desire. Herein, we present a rare case of priapism resulting from traditional circumcision under regional anesthesia with dorsal penile nerve block by xylocaine, which was successfully treated by intracavernosal injection of metaraminol bitartrate. Case description A 37-year-old man visited our out-patient department for a penile erection, which had been observed during the surgery, las...

  19. Women's Beliefs about Male Circumcision, HIV Prevention, and Sexual Behaviors in Kisumu, Kenya

    OpenAIRE

    Riess, Thomas H.; Achieng', Maryline M.; Bailey, Robert C.

    2014-01-01

    It is important to understand how women's sexual practices may be influenced by male circumcision (MC) as an HIV prevention effort. Women's beliefs about MC and sexual behaviour will likely influence the scale-up and uptake of medical MC. We conducted qualitative interviews with 30 sexually active women in Kisumu, Kenya. Women discussed MC related to perceived health benefits, condom use, sexual behaviour, knowledge of susceptibility to HIV and sexually transmitted infections (STIs), circumci...

  20. Skin phototype and local trauma in the onset of balanitis xerotica obliterans (BXO) in circumcised patients.

    Science.gov (United States)

    Villa, Massimo; Dragonetti, Emanuele; Grande, Michele; Bove, Pierluigi; Sansalone, Salvatore; Rulli, Francesco; Tambucci, Roberto; Tucci, Gianfranco; Baldi, Alfonso

    2012-01-01

    The association between balanitis xerotica obliterans (BXO) and skin disorders is long established, however, the role of skin phototype and local trauma in its onset has never been investigated in detail. Medical records of all Caucasian children circumcised over a 6-year period were reviewed. The excised skin underwent histological examination for BXO. Children with histological diagnosis of BXO were classified as group A, whereas children without histological diagnosis of BXO were classified as group B. The Fitzpatrick phototype (FT) was obtained in all children performing a personal or family interview with regards to their sunburn and suntan experience. According to their FT, both group A and B patients were divided into two subgroups: FT 1-2, with a higher tendency to sunburn due to their low skin melanin content; and FT 3-4 with a higher tendency to tan due to their higher skin melanin content. Maneuvers of mechanical reduction of the foreskin (MRF) performed at least 5-10 times per month during the year preceding circumcision was also considered. Statistical analysis was performed using univariate and multivariate analysis. A total of 297 patients met the inclusion criteria of our study: 78 patients were classified as group A and 219 as group B. The risk of developing BXO was significantly greater in FT 1-2 patients (n=76) (odd ratio=0.232, 95% confidence interval=0.124-0.435, p<0.0001). Furthermore, those undergoing MRF (n=131) had a significantly higher risk of developing BXO (odds ratio= 5.344, 95% confidence interval=2.860-9.987, p<0.0001). Although the foreskin is not directly exposed to sunlight, this study emphasizes the role of skin phototype on the onset of BXO in circumcised individuals. Moreover, the data produced suggest should the advantages of repeated MRF be weighed against the increased risk of developing BXO, which in turn may increase complication rate of circumcision surgery. PMID:22210729

  1. An Overview of Female Genital Mutilation in Nigeria

    OpenAIRE

    Okeke, TC; Anyaehie, USB; Ezenyeaku, CCK

    2012-01-01

    Nigeria, due to its large population, has the highest absolute number of female genital mutilation (FGM) worldwide, accounting for about one-quarter of the estimated 115–130 million circumcised women in the world. The objective of this review is to ascertain the current status of FGM in Nigeria. Pertinent literature on FGM retrieved from internet services [Google search on FGM in Nigeria, www.online Nigeria, PubMed of the national library of medicine www.medconsumer. Info/tropics/fgm.htm, Bio...

  2. Women’s Perceptions and Misperceptions of Male Circumcision: A Mixed Methods Study in Zambia

    Science.gov (United States)

    Haberland, Nicole A.; Kelly, Christine A.; Mulenga, Drosin M.; Mensch, Barbara S.; Hewett, Paul C.

    2016-01-01

    Women’s perceptions of male circumcision (MC) have implications for behavioral risk compensation, demand, and the impact of MC programs on women’s health. This mixed methods study combines data from the first two rounds of a longitudinal study (n = 934) and in-depth interviews with a subsample of respondents (n = 45) between rounds. Most women correctly reported that MC reduces men’s risk of HIV (64% R1, 82% R2). However, 30% of women at R1, and significantly more (41%) at R2, incorrectly believed MC is fully protective for men against HIV. Women also greatly overestimated the protection MC offers against STIs. The proportion of women who believed MC reduces a woman’s HIV risk if she has sex with a man who is circumcised increased significantly (50% to 70%). Qualitative data elaborate women’s misperception regarding MC. Programs should address women’s informational needs and continue to emphasize that condoms remain critical, regardless of male partner’s circumcision status. PMID:26937971

  3. [Review of clinical experience for a new preputioplasty technique as circumcision alternative].

    Science.gov (United States)

    Binet, A; François-Fiquet, C; Bouche-Pillon, M A

    2016-02-01

    Surgery is required for phimosis with a contracted fibrous ring or when the medical treatment with steroids has been unsuccessful. Surgical teams often opt for circumcision when a conservative technique can be used. This surgery could have some psychologic consequences, and when the circumcision in not according to religious convictions, it cannot be live well for the patient and his family. Furthermore, some surgery procedures for prepuce conservation seem to give some unaesthesics aspects with cutaneous excess. The objective of this study was to evaluate our new preputioplasty technique according to the initial diagnosis (phimosis with scarred foreskin or long and narrow foreskin), in situation where circumcision is required currently. Outcome evaluated was: easy and painless foreskin retraction, absence of postoperative phimosis as well as cosmetic aspects of the penis. In this study, 90 children benefited from this technique and subsequent follow-up. The mean age was 7.9 years for the 32 children in the sclerotic phimosis group and 6.8 years for the 58 children in the long and narrow foreskin group. We observed complete foreskin retraction without any recurrence in 100% of children with a phimosis resistant to medical treatment which consisted of progressive foreskin retraction and application of topical steroids, with a mean postoperative follow-up of 1.4 years. Results showed an excellent cosmetic aspect of the penis with absence of enlarged foreskin in all our subjects. This study underlines the relevance of this surgical technique. PMID:25708731

  4. Awareness and predictors of female genital mutilation/cutting among young health advocates

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    Abolfotouh SM

    2015-02-01

    Full Text Available Sherif M Abolfotouh,1,2 Ahmed Z Ebrahim,1,3 Mostafa A Abolfotouh4 On Behalf of IFMSA-Egypt 1IFMSA-Egypt, Alexandria, Egypt; 2Oulu University Hospital, Oulu, Finland; 3Alexandria Faculty of Medicine, Alexandria, Egypt; 4King Abdullah International Medical Research Center (KAIMRC, King Saud bin-Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia Abstract: The act of female genital mutilation/cutting (FGM/C is considered internationally as a violent act against girls and women and a violation of their human rights. This study sought to assess the awareness and predictors of FGM/C in young Egyptian health advocates. A cross-sectional study of 600 medical students from a total of 2,500 members of the International Federation of Medical Students’ Associations (IFMSA-Egypt, across all Egyptian medical schools, was conducted using a previously validated online Google survey. The overall prevalence of circumcision was 14.7/100 female students, with a significantly higher prevalence in students from rural areas (25% than in non-rural areas (10.8%, P=0.001, and in those residing in Upper (southern Egypt (20.6% than in Lower (northern Egypt (8.7%, P=0.003. The students’ mean percentage score for knowledge about the negative health consequences of FGM/C was 53.50±29.07, reflecting a modest level of knowledge; only 30.5% had a good level of knowledge. The mean percentage score for the overall attitude toward discontinuation of the practice of FGM/C was 76.29±17.93, reflecting a neutral attitude; 58.7% had a favorable attitude/norms toward discontinuation of the practice. Of circumcised students, approximately one-half (46.8% were unwilling to have their daughters circumcised, and 60% reported no harm from being circumcised. After controlling for confounders, a negative attitude toward FGM/C was significantly (P<0.001 in all cases associated with male sex, residency in Upper Egypt, rural origin, previous circumcision, and the preclinical

  5. The perceptions on male circumcision as a preventive measure against HIV infection and considerations in scaling up of the services: a qualitative study among police officers in Dar es Salaam, Tanzania

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    Tarimo Edith AM

    2012-07-01

    Full Text Available Abstract Background In recent randomized controlled trials, male circumcision has been proven to complement the available biomedical interventions in decreasing HIV transmission from infected women to uninfected men. Consequently, Tanzania is striving to scale-up safe medical male circumcision to reduce HIV transmission. However, there is a need to investigate the perceptions of male circumcision in Tanzania using specific populations. The purpose of the present study was to assess the perceptions of male circumcision in a cohort of police officers that also served as a source of volunteers for a phase I/II HIV vaccine (HIVIS-03 trial in Dar es Salaam, Tanzania. Methods In-depth interviews with 24 men and 10 women were conducted. Content analysis informed by the socio-ecological model was used to analyze the data. Results Informants perceived male circumcision as a health-promoting practice that may prevent HIV transmission and other sexually transmitted infections. They reported male circumcision promotes sexual pleasure, confidence and hygiene or sexual cleanliness. They added that it is a religious ritual and a cultural practice that enhances the recognition of manhood in the community. However, informants were concerned about the cost involved in male circumcision and cleanliness of instruments used in medical and traditional male circumcision. They also expressed confusion about the shame of undergoing circumcision at an advanced age and pain that could emanate after circumcision. The participants advocated for health policies that promote medical male circumcision at childhood, specifically along with the vaccination program. Conclusions The perceived benefit of male circumcision as a preventive strategy to HIV and other sexually transmitted infections is important. However, there is a need to ensure that male circumcision is conducted under hygienic conditions. Integrating male circumcision service in the routine childhood vaccination

  6. Acceptability of medical male circumcision among uncircumcised men in Kenya one year after the launch of the national male circumcision program.

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    Amy Herman-Roloff

    Full Text Available BACKGROUND: Numerous studies have demonstrated that male circumcision (MC reduces the incidence of the Type-1 human immunodeficiency virus (HIV among heterosexual men by at least half. METHODS: One year after the launch of a national Voluntary Medical Male Circumcision program in Kenya, this study conducted 12 focus group discussions among uncircumcised men in Nyanza Province to assess the revealed, non-hypothetical, facilitators and barriers to the uptake of MC. RESULTS: The primary barriers to MC uptake included time away from work; culture and religion; possible adverse events; and the post-surgical abstinence period. The primary facilitators of MC uptake included hygiene; social pressure; protection against HIV and other sexually transmitted infections; and improved sexual performance and satisfaction. CONCLUSIONS: Some activities which might increase MC uptake include dispelling MC misconceptions; increasing involvement of religious leaders, women's groups, and peer mobilizers for MC promotion; and increasing the relevance of MC among men who are already practicing an HIV prevention method.

  7. Scaling Up Early Infant Male Circumcision: Lessons From the Kingdom of Swaziland

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    Fitzgerald, Laura; Benzerga, Wendy; Mirira, Munamato; Adamu, Tigistu; Shissler, Tracey; Bitchong, Raymond; Malaza, Mandla; Mamba, Makhosini; Mangara, Paul; Curran, Kelly; Khumalo, Thembisile; Mlambo, Phumzile; Njeuhmeli, Emmanuel; Maziya, Vusi

    2016-01-01

    ABSTRACT Background: The government of the Kingdom of Swaziland recognizes that it must urgently scale up HIV prevention interventions, such as voluntary medical male circumcision (VMMC). Swaziland has adopted a 2-phase approach to male circumcision scale-up. The catch-up phase prioritizes VMMC services for adolescents and adults, while the sustainability phase involves the establishment of early infant male circumcision (EIMC). Swaziland does not have a modern-day tradition of circumcision, and the VMMC program has met with client demand challenges. However, since the launch of the EIMC program in 2010, Swaziland now leads the Eastern and Southern Africa region in the scale-up of EIMC. Here we review Swaziland’s program and its successes and challenges. Methods: From February to May 2014, we collected data while preparing Swaziland’s “Male Circumcision Strategic and Operational Plan for HIV Prevention 2014–2018.” We conducted structured stakeholder focus group discussions and in-depth interviews, and we collected EIMC service delivery data from an implementing partner responsible for VMMC and EIMC service delivery. Data were summarized in consolidated narratives. Results: Between 2010 and 2014, trained providers performed more than 5,000 EIMCs in 11 health care facilities in Swaziland, and they reported no moderate or severe adverse events. According to a broad group of EIMC program stakeholders, an EIMC program needs robust support from facility, regional, and national leadership, both within and outside of HIV prevention coordination bodies, to promote institutionalization and ownership. Providers and health care managers in 3 of Swaziland’s 4 regional hospitals suggest that when EIMC is introduced into reproductive, maternal, newborn, and child health platforms, dedicated staff attention can help ensure that EIMC is performed amid competing priorities. Creating informed demand from communities also supports EIMC as a service delivery priority

  8. Mucosal cuff length to penile length ratio may affect the risk of premature ejaculation in circumcised males.

    Science.gov (United States)

    Yuruk, E; Temiz, M Z; Colakerol, A; Muslumanoglu, A Y

    2016-01-01

    Data regarding the relation between premature ejaculation (PE) and post-circumcision mucosal cuff length are controversial. The aim of this study is to analyze the relation between post-circumcision mucosal cuff length/penile length ratio (MCR) and PE. After exclusion of patients with erectile dysfunction, penile deformity, history of penile surgery and severe lower urinary tract symptoms, 49 circumcised men with PE were included. The control group is constituted of 50 healthy volunteers with normal ejaculatory function. Self-estimated intravaginal ejaculation latency time (IELT) and premature ejaculation profile (PEP) measures of all subjects were recorded, and the MCRs of patients and controls were compared. The mean age of PE patients and controls was 35.82 ± 7.73 (range 23-54) and 38.78 ± 13.42 (range 19-71) years, respectively (P=0.183). Although mucosal cuff length was not associated with either self-estimated IELT (r=-0.185, P=0.067) or PEP (r=-0.098, P=0.336), there was a negative correlation between MCR and self-estimated IELT (r=-0.205, P=0.0001) and PEP measures (r=-0.308, P=0.002). The length of the mucosal cuff after circumcision may have an impact on ejaculatory function. Surgeons should avoid leaving excessive amount of mucosa during circumcision. PMID:26700215

  9. No-needle, single-visit adult male circumcision with Unicirc: a multi-centre field trial.

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    Peter S Millard

    Full Text Available Voluntary medical male circumcision (VMMC is a priority HIV preventive intervention. Current adult circumcision methods need improvement.Field trial in 3 primary care centres. Minimally invasive VMMC using the Unicirc instrument following topical lidocaine/prilocaine anesthetic. Men were followed up at 1 and 4 weeks.We circumcised 110 healthy volunteers. Two men complained of transient burning pain during circumcision, but none required injectable anaesthesia. Median blood loss was 1ml and median procedure time was 9.0 min. There were 7 (6.3% moderate complications (5 (4.5% post-operative bleeds requiring suture and 2 (1.8% post-operative infections affecting 7 men. No men experienced significant wound dehiscence. 90.4% of men were fully healed at 4 weeks of follow-up and all were highly satisfied.Use of topical anaesthesia obviates the need for injectable anesthetic and makes the Unicirc procedure nearly painless. Unicirc is rapid, easy to learn, heals by primary intention with excellent cosmetic results, obviates the need for a return visit for device removal, and is potentially cheaper and safer than other methods. Use of this method will greatly facilitate scale-up of mass circumcision programs.ClinicalTrials.gov NCT02091726.

  10. The When and How of male circumcision and the risk of HIV: a retrosepctive cross-sectional analysis of two HIV surveys from Guiné-Bissau

    DEFF Research Database (Denmark)

    Sodemann, Morten

    2016-01-01

    crucial and can increase insight into the HIV epidemic in Africa. Methods: We used data from two retrospective HIV surveys conducted in Guinea- Bissau from 1993 to 1996 (1996 cohort) and from 2004 to 2007 (2006 cohort). Multivariate logistical models were used to investigate the relationships between HIV...... against HIV. Our findings suggest that sexual risk behaviour and traditional circumcision may increases HIV risk. The relationship between circumcision age, sexual behaviour and HIV status remains unclear and warrants further research.......Introduction: Male circumcision (MC) reduces the risk of HIV, and this risk reduction may be modified by socio-cultural factors such as the timing and method (medical and traditional) of circumcision. Understanding regional variations in circumcision practices and their relationship to HIV is...

  11. Male circumcision at different ages in Rwanda: a cost-effectiveness study.

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    Agnes Binagwaho

    2010-01-01

    Full Text Available BACKGROUND: There is strong evidence showing that male circumcision (MC reduces HIV infection and other sexually transmitted infections (STIs. In Rwanda, where adult HIV prevalence is 3%, MC is not a traditional practice. The Rwanda National AIDS Commission modelled cost and effects of MC at different ages to inform policy and programmatic decisions in relation to introducing MC. This study was necessary because the MC debate in Southern Africa has focused primarily on MC for adults. Further, this is the first time, to our knowledge, that a cost-effectiveness study on MC has been carried out in a country where HIV prevalence is below 5%. METHODS AND FINDINGS: A cost-effectiveness model was developed and applied to three hypothetical cohorts in Rwanda: newborns, adolescents, and adult men. Effectiveness was defined as the number of HIV infections averted, and was calculated as the product of the number of people susceptible to HIV infection in the cohort, the HIV incidence rate at different ages, and the protective effect of MC; discounted back to the year of circumcision and summed over the life expectancy of the circumcised person. Direct costs were based on interviews with experienced health care providers to determine inputs involved in the procedure (from consumables to staff time and related prices. Other costs included training, patient counselling, treatment of adverse events, and promotion campaigns, and they were adjusted for the averted lifetime cost of health care (antiretroviral therapy [ART], opportunistic infection [OI], laboratory tests. One-way sensitivity analysis was performed by varying the main inputs of the model, and thresholds were calculated at which each intervention is no longer cost-saving and at which an intervention costs more than one gross domestic product (GDP per capita per life-year gained. RESULTS: Neonatal MC is less expensive than adolescent and adult MC (US$15 instead of US$59 per procedure and is cost

  12. Impact of male circumcision on the HIV epidemic in Papua New Guinea: a country with extensive foreskin cutting practices.

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    Richard T Gray

    Full Text Available The degree to which adult medical male circumcision (MC programs can reduce new HIV infections in a moderate HIV prevalence country like Papua New Guinea (PNG are uncertain especially given the widespread prevalence of longitudinal foreskin cuts among adult males. We estimated the likely impact of a medical MC intervention in PNG using a mathematical model of HIV transmission. The model was age-structured and incorporated separate components for sex, rural/urban, men who have sex with men and female sex workers. Country-specific data of the prevalence of foreskin cuts, sexually transmitted infections, condom usage, and the acceptability of MC were obtained by our group through related studies. If longitudinal foreskin cutting has a protective efficacy of 20% compared to 60% for MC, then providing MC to 20% of uncut males from 2012 would require 376,000 procedures, avert 7,900 HIV infections by 2032, and require 143 MC per averted infection. Targeting uncut urban youths would achieve the most cost effective returns of 54 MC per HIV infection averted. These numbers of MC required to avert an HIV infection change little even with coverage up to 80% of men. The greater the protective efficacy of longitudinal foreskin cuts against HIV acquisition, the less impact MC interventions will have. Dependent on this efficacy, increasing condom use could have a much greater impact with a 10 percentage point increase averting 18,400 infections over this same period. MC programs could be effective in reducing HIV infections in PNG, particularly in high prevalence populations. However the overall impact is highly dependent on the protective efficacy of existing longitudinal foreskin cutting in preventing HIV.

  13. Effects of medical male circumcision (MC on plasma HIV viral load in HIV+ HAART naive men; Rakai, Uganda.

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    Godfrey Kigozi

    Full Text Available BACKGROUND: Medical male circumcision (MC of HIV-infected men may increase plasma HIV viral load and place female partners at risk of infection. We assessed the effect of MC on plasma HIV viral load in HIV-infected men in Rakai, Uganda. METHODS: 195 consenting HIV-positive, HAART naïve men aged 12 and above provided blood for plasma HIV viral load testing before surgery and weekly for six weeks and at 2 and 3 months post surgery. Data were also collected on baseline social demographic characteristics and CD4 counts. Change in log10 plasma viral load between baseline and follow-up visits was estimated using paired t tests and multivariate generalized estimating equation (GEE. RESULTS: Of the 195 men, 129 had a CD4 count ≧ 350 and 66 had CD4 <350 cells/mm3. Men with CD4 counts <350 had higher baseline mean log10 plasma viral load than those with CD4 counts ≧ 350 cells/mm3 (4.715 vs 4.217 cps/mL, respectively, p = 0.0005. Compared to baseline, there was no statistically significant increase in post-MC HIV plasma viral loads irrespective of CD4. Multivariate analysis showed that higher baseline log10 plasma viral load was significantly associated with reduction in mean log10 plasma viral load following MC (coef.  = -0.134, p<0.001. CONCLUSION: We observed no increase in plasma HIV viral load following MC in HIV-infected, HAART naïve men.

  14. Knowledge, attitude and practice of female genital mutilation among doctors and nurses in Bayelsa state, Niger-Delta of Nigeria

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    Oyeyemi A.S; Ibrahim I.A; Ekine A.A

    2013-01-01

    Background: Female genital mutilation (FGM) is a harmful traditional practice that is deeply rooted in Africa. It has been outlawed in Bayelsa state of Nigeria but there is evidence that its performance by traditional circumcisers and health professionals continues. Aim: The study aimed to determine the knowledge, attitude and practice of FGM among doctors and nurses/midwives practising in public secondary and tertiary hospitals in Bayelsa state. Methods: One hundred and ninety seven (197) s...

  15. Age Targeting of Voluntary Medical Male Circumcision Programs Using the Decision Makers’ Program Planning Toolkit (DMPPT) 2.0

    Science.gov (United States)

    Kripke, Katharine; Opuni, Marjorie; Schnure, Melissa; Sgaier, Sema; Castor, Delivette; Reed, Jason; Stover, John

    2016-01-01

    Background Despite considerable efforts to scale up voluntary medical male circumcision (VMMC) for HIV prevention in priority countries over the last five years, implementation has faced important challenges. Seeking to enhance the effect of VMMC programs for greatest and most immediate impact, the U. S. President’s Plan for AIDS Relief (PEPFAR) supported the development and application of a model to inform national planning in five countries from 2013–2014. Methods and Findings The Decision Makers’ Program Planning Toolkit (DMPPT) 2.0 is a simple compartmental model designed to analyze the effects of client age and geography on program impact and cost. The DMPPT 2.0 model was applied in Malawi, South Africa, Swaziland, Tanzania, and Uganda to assess the impact and cost of scaling up age-targeted VMMC coverage. The lowest number of VMMCs per HIV infection averted would be produced by circumcising males ages 20–34 in Malawi, South Africa, Tanzania, and Uganda and males ages 15–34 in Swaziland. The most immediate impact on HIV incidence would be generated by circumcising males ages 20–34 in Malawi, South Africa, Tanzania, and Uganda and males ages 20–29 in Swaziland. The greatest reductions in HIV incidence over a 15-year period would be achieved by strategies focused on males ages 10–19 in Uganda, 15–24 in Malawi and South Africa, 10–24 in Tanzania, and 15–29 in Swaziland. In all countries, the lowest cost per HIV infection averted would be achieved by circumcising males ages 15–34, although in Uganda this cost is the same as that attained by circumcising 15- to 49-year-olds. Conclusions The efficiency, immediacy of impact, magnitude of impact, and cost-effectiveness of VMMC scale-up are not uniform; there is important variation by age group of the males circumcised and countries should plan accordingly. PMID:27410966

  16. Safety, Feasibility, and Acceptability of the PrePex Device for Adult Male Circumcision in Malawi

    Science.gov (United States)

    Tippett Barr, Beth A.; Kang'ombe, Anderson; Hofstee, Carola; Kilembe, Franklin; Galagan, Sean; Chilongozi, David; Namate, Dorothy; Machaya, Medson; Kabwere, Khuliena; Mwale, Mwawi; Msunguma, Wezi; Reed, Jason; Chimbwandira, Frank

    2016-01-01

    Introduction: Nonsurgical adult male circumcision devices present an alternative to surgery where health resources are limited. This study aimed to assess the safety, feasibility, and acceptability of the PrePex device for adult male circumcision in Malawi. Methods: A prospective single-arm cohort study was conducted at 3 sites (1 urban static, 1 rural static, 1 rural tent) in Malawi. Adverse event (AE) outcomes were stratified to include/exclude pain, and confidence intervals (CIs) were corrected for clinic-level clustering. Results: Among 935 men screened, 131 (14.0%) were not eligible, 13 (1.4%) withdrew before placement, and 791 (84.6%) received the device. Moderate and severe AEs totaled 7.1% including pain [95% CI: 3.4–14.7] and 4.0% excluding pain (95% CI: 2.6 to 6.4). Severe AEs included pain (n = 3), insufficient skin removal (n = 4), and early removal (n = 4). Among early removals, 1 had immediate surgical circumcision, 1 had surgery after 48 hours of observation, 1 declined surgery, and 1 did not return to our site although presented at a nearby clinic. More than half of men (51.9%) reported odor; however, few (2.2%) stated they would not recommend the device to others because of odor. Median levels of reported pain (scale, 1–10) were 2 (interquartile range, 2–4) during application and removal, and 0 (interquartile range, 0–2) at all other time points. Conclusions: Severe AEs were rare and similar to other programs. Immediate provision of surgical services after displacement or early removal proved a challenge. Cases of insufficient skin removal were linked to poor technique, suggesting provider training requires reinforcement and supervision. PMID:27331590

  17. Rural Zulu women’s knowledge of and attitudes towards medical male circumcision

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    Joseph N. Ikwegbue

    2015-02-01

    Full Text Available Background: Medical male circumcision (MMC is a key strategy in the South African HIV infection prevention package. Women may have a potentially powerful role in supporting such a strategy. Circumcision is not a traditional part of Zulu society, and Zulu women may have limited knowledge and ambivalent or negative attitudes towards MMC.Aim: This study employs quantitative data to expand insight into rural Zulu women’s knowledge of and attitudes towards MMC, and is important as women could potentially yield a powerful positive or negative influence over the decisions of their partners and sons.Setting: A hospital-based antenatal clinic in rural KwaZulu-Natal.Methods: Participants were 590 pregnant, mostly isiZulu-speaking women. Data on their knowledge of and attitude towards MMC were collected using a questionnaire and were analysed descriptively.Results: The majority of the women supported MMC; however, knowledge of the potential benefits was generally poor. Most would encourage their partners and sons to undergo MMC. The preferred place for the procedure was a hospital.Conclusion: Zulu participants supported MMC and would support their partners and children being circumcised. Knowledge around potential benefits was worryingly poor, and further research into disseminating information is essential. The findings highlight the need for an expanded campaign of health education for women, and innovative means are suggested to enhance information accessibility. Reasons for preferring that MMC be carried out in hospital need to be explored further.

  18. Costs and impacts of scaling up voluntary medical male circumcision in Tanzania.

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    Veena Menon

    Full Text Available BACKGROUND: Given the proven effectiveness of voluntary medical male circumcision (VMMC in preventing the spread of HIV, Tanzania is scaling up VMMC as an HIV prevention strategy. This study will inform policymakers about the potential costs and benefits of scaling up VMMC services in Tanzania. METHODOLOGY: The analysis first assessed the unit costs of delivering VMMC at the facility level in three regions-Iringa, Kagera, and Mbeya-via three currently used VMMC service delivery models (routine, campaign, and mobile/island outreach. Subsequently, using these unit cost data estimates, the study used the Decision Makers' Program Planning Tool (DMPPT to estimate the costs and impact of a scaled-up VMMC program. RESULTS: Increasing VMMC could substantially reduce HIV infection. Scaling up adult VMMC to reach 87.9% coverage by 2015 would avert nearly 23,000 new adult HIV infections through 2015 and an additional 167,500 from 2016 through 2025-at an additional cost of US$253.7 million through 2015 and US$302.3 million from 2016 through 2025. Average cost per HIV infection averted would be US$11,300 during 2010-2015 and US$3,200 during 2010-2025. Scaling up VMMC in Tanzania will yield significant net benefits (benefits of treatment costs averted minus the cost of performing circumcisions in the long run-around US$4,200 in net benefits for each infection averted. CONCLUSION: VMMC could have an immediate impact on HIV transmission, but the full impact on prevalence and deaths will only be apparent in the longer term because VMMC averts infections some years into the future among people who have been circumcised. Given the health and economic benefits of investing in VMMC, the scale-up of services should continue to be a central component of the national HIV prevention strategy in Tanzania.

  19. The potential impact of male circumcision on HIV in Sub-Saharan Africa.

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    Brian G Williams

    2006-07-01

    Full Text Available BACKGROUND: A randomized controlled trial (RCT has shown that male circumcision (MC reduces sexual transmission of HIV from women to men by 60% (32%-76%; 95% CI offering an intervention of proven efficacy for reducing the sexual spread of HIV. We explore the implications of this finding for the promotion of MC as a public health intervention to control HIV in sub-Saharan Africa. METHODS AND FINDINGS: Using dynamical simulation models we consider the impact of MC on the relative prevalence of HIV in men and women and in circumcised and uncircumcised men. Using country level data on HIV prevalence and MC, we estimate the impact of increasing MC coverage on HIV incidence, HIV prevalence, and HIV-related deaths over the next ten, twenty, and thirty years in sub-Saharan Africa. Assuming that full coverage of MC is achieved over the next ten years, we consider three scenarios in which the reduction in transmission is given by the best estimate and the upper and lower 95% confidence limits of the reduction in transmission observed in the RCT. MC could avert 2.0 (1.1-3.8 million new HIV infections and 0.3 (0.1-0.5 million deaths over the next ten years in sub-Saharan Africa. In the ten years after that, it could avert a further 3.7 (1.9-7.5 million new HIV infections and 2.7 (1.5-5.3 million deaths, with about one quarter of all the incident cases prevented and the deaths averted occurring in South Africa. We show that a MC will increase the proportion of infected people who are women from about 52% to 58%; b where there is homogenous mixing but not all men are circumcised, the prevalence of infection in circumcised men is likely to be about 80% of that in uncircumcised men; c MC is equivalent to an intervention, such as a vaccine or increased condom use, that reduces transmission in both directions by 37%. CONCLUSIONS: This analysis is based on the result of just one RCT, but if the results of that trial are confirmed we suggest that MC could

  20. A prospective evaluation of plastibell® circumcision in older children

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    Jose Murillo Bastos Netto

    2013-07-01

    Full Text Available Introduction and Objective Circumcision is one of the oldest surgical procedures and one of the most frequently performed worldwide. It can be done by many different techniques. This prospective series presents the results of Plastibell® circumcision in children older than 2 years of age, evaluating surgical duration, immediate and late complications, time for plastic device separation and factors associated with it. Materials and Methods We prospectively analyzed 119 children submitted to Plastic Device Circumcision with Plastibell® by only one surgeon from December 2009 to June 2011. In all cases the surgery was done under general anesthesia associated with dorsal penile nerve block. Before surgery length of the penis and latero-lateral diameter of the glans were measured. Surgical duration, time of Plastibell® separation and use of analgesic medication in the post-operative period were evaluated. Patients were followed on days 15, 45, 90 and 120 after surgery. Results Age at surgery varied from 2 to 12.5 (5.9 ± 2.9 years old. Mean surgical time was 3.7 ± 2.0 minutes (1.9 to 9 minutes. Time for plastic device separation ranged from 6 to 26 days (mean: 16 ± 4.2 days, being 14.8 days for children younger than 5 years of age and 17.4 days for those older than 5 years of age (p < 0.0001. The diameter of the Plastibell® does not interfered in separations time (p = 0,484. Late complications occurred in 32 (26.8% subjects, being the great majority of low clinical significance, especially prepucial adherences, edema of the mucosa and discrete hypertrophy of the scar, all resolving with clinical treatment. One patient still using diaper had meatus stenosis and in one case the Plastibell® device stayed between the glans and the prepuce and needed to be removed manually. conclusions Circumcision using a plastic device is a safe, quick and an easy technique with low complications, that when occur are of low clinical importance and of easy

  1. Policy environment and male circumcision for HIV prevention: Findings from a situation analysis study in Tanzania

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    Mshana Gerry

    2011-06-01

    Full Text Available Abstract Background Male circumcision (MC has been shown to be effective against heterosexual acquisition of HIV infection and is being scaled up as an additional strategy against HIV in several countries of Africa. However, the policy environment (whether to formulate new specific policy on MC or adapts the existing ones; and the role of various stakeholders in the MC scale up process in Tanzania was unclear. We conducted this study as part of a situation analysis to understand the attitudes of policy makers and other key community and health authority decision makers towards MC, policy and regulatory environment, and the readiness of a health system to accommodate scaling up of MC services. Methods We conducted 36 key informants' interviews with a broad range of informants including civil servants, religious leaders, cultural and traditional gatekeepers and other potential informants. Study informants were selected at the national level, regional, district and community levels to represent both traditionally circumcising and non-circumcising communities. Results Study informants had positive attitudes and strong beliefs towards MC. Key informants in traditionally non-circumcising districts were willing to take their sons for medically performed MC. Religious leaders and traditional gatekeepers supported MC as it has been enshrined in their holy scripts and traditional customs respectively. Civil servants highlighted the need for existence of enabling policy and regulatory environment in the form of laws, regulations and guidelines that will ensure voluntary accessibility, acceptability, quality and safety for those in need of MC services. Majority of informants urged the government to make improvements in the health system at all levels to ensure availability of adequate trained personnel, infrastructure, equipment, and supplies for MC scale up, and insisted on the involvement of different MC stakeholders as key components in effective roll

  2. Circumcision and penile human papillomavirus prevalence in human immunodeficiency virus-infected men: heterosexual and men who have sex with men.

    Science.gov (United States)

    Canadas, M P; Darwich, L; Videla, S; Sirera, G; Coll, J; Rafael, M-L A; Clotet, B

    2013-07-01

    Male circumcision is associated with a lower risk of penile human papillomavirus (HPV) infection in human immunodeficiency virus (HIV) uninfected men. Few studies have evaluated the role of male circumcision in penile HPV infection in HIV-infected men. The aim of this cross-sectional study was to examine the association between male circumcision and the prevalence of penile HPV infection among HIV-infected men-both men who have sex with men (MSM) and heterosexual men. Samples from 706 consecutive men included in the CARH-MEN cohort (overall 24% circumcised: 26% of MSM, 18% of heterosexual men) were examined by Multiplex-PCR. In the overall group (all HIV-infected men included), the prevalence of any penile HPV infection was 22% in circumcised men and 27% in uncircumcised men (OR = 1.0, 95% CI 0.6-1.6, adjusted analysis). In the circumcised group the overall prevalence of HPV infection was 22% in MSM and 24% in the heterosexual men, whereas in the uncircumcised group the prevalence was 26% and 28%, respectively. The prevalence of high-risk HPV types tended to be lower in the circumcised MSM (14% vs 21%, OR = 0.6, 95% CI 0.3-1.1, p 0.088), but it was similar in the heterosexual men (18% in circumcised vs 20% in uncircumcised). These results suggest that male circumcision may be associated with a lower prevalence of oncogenic high-risk penile HPV infection in HIV-infected MSM. PMID:22676057

  3. Comparison of Postoperative Analgesic Efficacy of Penile Block, Caudal Block and Intravenous Paracetamol for Circumcision: A prospective Randomized Study

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    Ahmet Hakan Haliloglu

    2013-07-01

    Full Text Available Purpose To evaluate the postoperative analgesic efficacy of penile block, caudal block and intravenous paracetamol administration following circumcision. Materials and Methods In this prospective randomized study a total of 159 patients underwent circumcision under general anesthesia at urology clinic of Ufuk University Faculty of Medicine and Sorgun State Hospital between May 2012 and September 2012. The patients were randomized to three groups to receive penile block (Group 1, caudal block (Group 2 and intravenous paracetamol administration (group 3. Pain measurement of the patients was done via CHEOPS scoring system at 30,60,120 and 180 minutes postoperatively and compared. Statistical tests were performed with a conventional statistics program and statistical significance was set at a p value of < 0.05. Results The mean age of the patients was 5.7 years. Patients in group 1 had significantly lower pain score at 30 minutes compared to other two groups. At 60 minutes groups 1 and 2 had significantly lower score compared to group 3. At 120 and 180 minutes no difference between the groups was observed. No significant major complications were observed in all 3 groups. Conclusion Penile block and caudal block provide similar pain scores and painless postoperative periods after circumcision under general anesthesia. Intravenous paracetamol is insufficient at the early postoperative period. The three procedures were shown to be safe for analgesia following circumcision.

  4. Voluntary medical male circumcision for HIV prevention and early resumption of sexual activity: a literature review.

    Science.gov (United States)

    Kamath, Veena; Limaye, Rupali J

    2015-01-01

    A number of programs have focused on scale-up and implementation research regarding voluntary medical male circumcision; however, there is limited research with regard to factors and strategies related to abstinence compliance and the effects of resuming sex during the wound healing period (42-day post-circumcision). We searched the literature for peer-reviewed articles examining early resumption of sex during this period. This review identifies factors that may predispose a client to engage in sex during the 42-day postoperative period, examines how early resumption of sex can inhibit wound healing and increase seroconversion, and reviews strategies that may increase adherence to abstinence during the wound healing period. We found that the most common factor that may predispose a client to engage in sex before the end of the postoperative period is marriage or cohabitation with a sexual partner. With regard to the effect of sex during the postoperative period on wound healing and seroconversion, we found that adverse events incurred were mild, and there was an increased risk of seroconversion. The only strategy studied to increase compliance to abstinence during the postoperative period utilized text messaging, and the trial results indicate that text messaging did not increase abstinence compliance. PMID:25738780

  5. The relevance of castration and circumcision to the origins of psychoanalysis: 1. The medical context.

    Science.gov (United States)

    Bonomi, Carlo

    2009-06-01

    In this paper the author outlines and discusses the origins and the decline of castration and circumcision as a cure for the nervous and psychic disturbances in women and little girls between 1875 and 1905. The author argues that the opposition to this medical practice affected the conception of hysteria, promoting a distinction between sexuality and the genital organs, and the emergence of an enlarged notion of sexuality, during the period from Freud's medical education to the publication of the Three Essays on the Theory of Sexuality. The hypothesis is put forward that Freud came directly in contact with the genital theory of the neurosis at the time of his training on the nervous disturbances in children with the paediatrician, Adolf Baginsky, in Berlin, in March 1886. It is hypothesized that this experience provoked in Freud an abhorrence of circumcision 'as a cure or punishment for masturbation', prompting an inner confrontation which resulted in a radical reorganization of the way of thinking about sexuality. It is also suggested that this contributed to Freud developing a capacity to stay with contradictions, something which would become a central quality of the psychoanalytic attitude. PMID:19580597

  6. Psychosocial Results from a Phase I Trial of a Nonsurgical Circumcision Device for Adult Men in Zimbabwe.

    Science.gov (United States)

    Kasprzyk, Danuta; Montaño, Daniel E; Hamilton, Deven T; Down, Kayla L; Marrett, Karl D; Tshimanga, Mufuta; Xaba, Sinokuthemba; Mugurungi, Owen

    2016-01-01

    Male circumcision (MC), an effective HIV prevention tool, has been added to Zimbabwe's Ministry of Health and Child Care HIV/AIDS Prevention Program. A Phase I safety trial of a nonsurgical male circumcision device was conducted and extensive psychosocial variables were assessed. Fifty-three men (18 and older) were recruited for the device procedure; 13 follow-up clinical visits were completed. Interviews conducted three times (before the procedure, at 2 weeks and 90 days post-procedure) assessed: Satisfaction; expectations; actual experience; activities of daily living; sexual behavior; and HIV risk perception. Using the Integrated Behavioral Model, attitudes towards MC, sex, and condoms, and sources of social influence and support were also assessed. Men (mean age 32.5, range 18-50; mean years of education = 13.6; 55% employed) were satisfied with device circumcision results. Men understand that MC is only partially protective against HIV acquisition. Most (94.7%) agreed that they will continue to use condoms to protect themselves from HIV. Pain ratings were surprisingly negative for a procedure billed as painless. Men talked to many social networks members about their MC experience; post-procedure (mean of 14 individuals). Minimal impact on activities of daily living and absenteeism indicate possible cost savings of device circumcisions. Spontaneous erections occurred frequently post-procedure. The results had important implications for changes in the pre-procedure clinical counseling protocol. Clear-cut counseling to manage pain and erection expectations should result in improved psychosocial outcomes in future roll-out of device circumcisions. Men's expectations must be managed through evidence-based counseling, as they share their experiences broadly among their social networks. PMID:26745142

  7. Comparison of eutectic mixture of local anesthetics cream with dorsal penile nerve block using lignocaine for circumcision in infants

    Science.gov (United States)

    Mujeeb, Sabeen; Akhtar, Jamshed; Ahmed, Soofia

    2013-01-01

    Objective: Circumcision is a commonly performed surgical procedure but choice of anesthesia remained an issue of research and debate. This study was conducted to find out the effectiveness of the eutectic mixture of local anesthetic (EMLA) cream with dorsal penile nerve block (DPNB) using lignocaine, for reduction of pain during circumcision. Methodology: This was comparative study carried out in Surgical Unit B of National Institute of Child Health Karachi, from May 2008 to October 2008. Patients under six month of age were randomized in to two groups (EMLA and DPNB) of fifty patients each. The effectiveness of pain control was assessed by measuring the baseline heart rate (HR), respiratory rate (RR) and Neonatal infant Pain Scale (NIPS scale) before the start of procedure and measuring of these parameters for each step of circumcision. Independent sample t -test was used to compare means and repeated ANOVA was used to compare means of HR, RR, oxygen (O2) saturations and NIPS. Results: The mean age in both the groups was 2.3 months. There was no statistically significant difference in baseline parameters in both the groups except the respiratory rate, which was significantly raised in DPNB group (33 breaths/min in EMLA and 38 in DPNB P < 0.04). During circumcision there was significant increase in heart rate in DPNB group, especially in step three and step four (p < 0.04). Oxygen saturation dropped in both the groups (baseline saturation 98% up to 91% in step 4). While assessing NIPS scores in both the groups, statistically significant difference was found between NIPS at step two and step four in two groups (p < 0.04). Conclusions: The overall pain control was equal in both the groups, although NIPS score was higher in DPNB in step two and four of circumcision. There was difference in application and cost. EMLA was easy to apply but has increased cost; while DPNB required expertise. PMID:24353502

  8. Cost analysis of integrating the PrePex medical device into a voluntary medical male circumcision program in Zimbabwe.

    Directory of Open Access Journals (Sweden)

    Emmanuel Njeuhmeli

    Full Text Available BACKGROUND: Fourteen African countries are scaling up voluntary medical male circumcision (VMMC for HIV prevention. Several devices that might offer alternatives to the three WHO-approved surgical VMMC procedures have been evaluated for use in adults. One such device is PrePex, which was prequalified by the WHO in May 2013. We utilized data from one of the PrePex field studies undertaken in Zimbabwe to identify cost considerations for introducing PrePex into the existing surgical circumcision program. METHODS AND FINDINGS: We evaluated the cost drivers and overall unit cost of VMMC at a site providing surgical VMMC as a routine service ("routine surgery site" and at a site that had added PrePex VMMC procedures to routine surgical VMMC as part of a research study ("mixed study site". We examined the main cost drivers and modeled hypothetical scenarios with varying ratios of surgical to PrePex circumcisions, different levels of site utilization, and a range of device prices. The unit costs per VMMC for the routine surgery and mixed study sites were $56 and $61, respectively. The two greatest contributors to unit price at both sites were consumables and staff. In the hypothetical scenarios, the unit cost increased as site utilization decreased, as the ratio of PrePex to surgical VMMC increased, and as device price increased. CONCLUSIONS: VMMC unit costs for routine surgery and mixed study sites were similar. Low service utilization was projected to result in the greatest increases in unit price. Countries that wish to incorporate PrePex into their circumcision programs should plan to maximize staff utilization and ensure that sites function at maximum capacity to achieve the lowest unit cost. Further costing studies will be necessary once routine implementation of PrePex-based circumcision is established.

  9. Awareness and predictors of female genital mutilation/cutting among young health advocates.

    Science.gov (United States)

    Abolfotouh, Sherif M; Ebrahim, Ahmed Z; Abolfotouh, Mostafa A

    2015-01-01

    The act of female genital mutilation/cutting (FGM/C) is considered internationally as a violent act against girls and women and a violation of their human rights. This study sought to assess the awareness and predictors of FGM/C in young Egyptian health advocates. A cross-sectional study of 600 medical students from a total of 2,500 members of the International Federation of Medical Students' Associations (IFMSA)-Egypt, across all Egyptian medical schools, was conducted using a previously validated online Google survey. The overall prevalence of circumcision was 14.7/100 female students, with a significantly higher prevalence in students from rural areas (25%) than in non-rural areas (10.8%, P=0.001), and in those residing in Upper (southern) Egypt (20.6%) than in Lower (northern) Egypt (8.7%, P=0.003). The students' mean percentage score for knowledge about the negative health consequences of FGM/C was 53.50±29.07, reflecting a modest level of knowledge; only 30.5% had a good level of knowledge. The mean percentage score for the overall attitude toward discontinuation of the practice of FGM/C was 76.29±17.93, reflecting a neutral attitude; 58.7% had a favorable attitude/norms toward discontinuation of the practice. Of circumcised students, approximately one-half (46.8%) were unwilling to have their daughters circumcised, and 60% reported no harm from being circumcised. After controlling for confounders, a negative attitude toward FGM/C was significantly (P<0.001 in all cases) associated with male sex, residency in Upper Egypt, rural origin, previous circumcision, and the preclinical medical phase of education. The low level of knowledge among even future health professions in our study suggests that communication, rather than passive learning, is needed to convey the potentially negative consequences of FGM/C and to drive a change in attitude toward discontinuation of this harmful practice. PMID:25759602

  10. A Comparative Study of Circumcision and Preputioplasty in Pediatric Cases of Phimosis: A Prospective Study in a Tertiary Care Hospital, Bhavnagar, Gujarat

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    Verma Arvind Kumar

    2014-12-01

    Conclusion: Preputioplastyis a faster, easier, relatively painless technique with excellent cosmetic results and lesser complications than circumcision, except post-operative edema and adhesions. " [Natl J Med Res 2014; 4(4.000: 326-329

  11. Aspirations and realities in a North-South partnership for health promotion: lessons from a program to promote safe male circumcision in Botswana

    OpenAIRE

    Katisi, Masego; Daniel, Marguerite; Mittelmark, Maurice B.

    2016-01-01

    Background: International donors support the partnership between the Government of Botswana and two international organisations: U.S. Centers for Disease Control and Prevention and Africa Comprehensive HIV/AIDS Partnership to implement Voluntary Medical Male Circumcision with the target of circumcising 80 % of HIV negative men in 5 years. Botswana Government had started integration of the program into its health system when international partners brought in the Models for Optimizing Volume an...

  12. A preliminary study of the sensory distribution of the penile dorsal and ventral nerves: implications for effective penile block for circumcision.

    LENUS (Irish Health Repository)

    Long, Ronan M

    2012-01-31

    OBJECTIVE: To determine the sensory innervation of the penis, as regional anaesthesia is often used either for postoperative analgesia or as the sole anaesthetic technique for circumcision. Since first described in 1978 the dorsal penile nerve block has become the standard technique, but some blocks are ineffective; a better understanding of the sensory innervation of the penis might improve the efficacy of the dorsal penile block technique. PATIENTS AND METHODS: In 13 men undergoing circumcision with local anaesthetic, cutaneous sensation was tested before and after infiltration of the dorsal aspect of the penis, and then again after infiltration of the ventral aspect. The area of anaesthesia was mapped using pin-prick sensation. RESULTS: Ten of the 13 patients showed a similar pattern of sensory distribution. After the dorsal block, the dorsal aspect of the shaft of the penis and glans penis became insensate. The ventral aspect of the shaft remained sensate up to and including the frenulum. After successful ventral infiltration all sensate areas became insensate and circumcision proceeded. In one case the frenulum and distal ventral foreskin was anaesthetized after the dorsal block and ventral infiltration was not required. No patient experienced pain during circumcision. CONCLUSION: For consistently successful regional anaesthesia of the foreskin in circumcision, a dorsal block must be used. This should be combined with ventral infiltration at the site of incision. This method will avoid inconsistencies and allow pain-free circumcision using local anaesthesia in most men.

  13. Voluntary medical male circumcision: an introduction to the cost, impact, and challenges of accelerated scaling up.

    Directory of Open Access Journals (Sweden)

    Catherine Hankins

    2011-11-01

    Full Text Available Scaling up voluntary medical male circumcision (VMMC for HIV prevention is cost saving and creates fiscal space in the future that otherwise would have been encumbered by antiretroviral treatment costs. An investment of US$1,500,000,000 between 2011 and 2015 to achieve 80% coverage in 13 priority countries in southern and eastern Africa will result in net savings of US$16,500,000,000. Strong political leadership, country ownership, and stakeholder engagement, along with effective demand creation, community mobilisation, and human resource deployment, are essential. This collection of articles on determining the cost and impact of VMMC for HIV prevention signposts the way forward to scaling up VMMC service delivery safely and efficiently to reap individual- and population-level benefits.

  14. Effectiveness of and Financial Returns to Voluntary Medical Male Circumcision for HIV Prevention in South Africa: An Incremental Cost-Effectiveness Analysis.

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    Markus Haacker

    2016-05-01

    Full Text Available Empirical studies and population-level policy simulations show the importance of voluntary medical male circumcision (VMMC in generalized epidemics. This paper complements available scenario-based studies (projecting costs and outcomes over some policy period, typically spanning decades by adopting an incremental approach-analyzing the expected consequences of circumcising one male individual with specific characteristics in a specific year. This approach yields more precise estimates of VMMC's cost-effectiveness and identifies the outcomes of current investments in VMMC (e.g., within a fiscal budget period rather than of investments spread over the entire policy period.The model has three components. We adapted the ASSA2008 model, a demographic and epidemiological model of the HIV epidemic in South Africa, to analyze the impact of one VMMC on HIV incidence over time and across the population. A costing module tracked the costs of VMMC and the resulting financial savings owing to reduced HIV incidence over time. Then, we used several financial indicators to assess the cost-effectiveness of and financial return on investments in VMMC. One circumcision of a young man up to age 20 prevents on average over 0.2 HIV infections, but this effect declines steeply with age, e.g., to 0.08 by age 30. Net financial savings from one VMMC at age 20 are estimated at US$617 at a discount rate of 5% and are lower for circumcisions both at younger ages (because the savings occur later and are discounted more and at older ages (because male circumcision becomes less effective. Investments in male circumcision carry a financial rate of return of up to 14.5% (for circumcisions at age 20. The cost of a male circumcision is refinanced fastest, after 13 y, for circumcisions at ages 20 to 25. Principal limitations of the analysis arise from the long time (decades over which the effects of VMMC unfold-the results are therefore sensitive to the discount rate applied, and

  15. Effectiveness of and Financial Returns to Voluntary Medical Male Circumcision for HIV Prevention in South Africa: An Incremental Cost-Effectiveness Analysis

    Science.gov (United States)

    Haacker, Markus; Gorgens, Marelize

    2016-01-01

    Background Empirical studies and population-level policy simulations show the importance of voluntary medical male circumcision (VMMC) in generalized epidemics. This paper complements available scenario-based studies (projecting costs and outcomes over some policy period, typically spanning decades) by adopting an incremental approach—analyzing the expected consequences of circumcising one male individual with specific characteristics in a specific year. This approach yields more precise estimates of VMMC’s cost-effectiveness and identifies the outcomes of current investments in VMMC (e.g., within a fiscal budget period) rather than of investments spread over the entire policy period. Methods/Findings The model has three components. We adapted the ASSA2008 model, a demographic and epidemiological model of the HIV epidemic in South Africa, to analyze the impact of one VMMC on HIV incidence over time and across the population. A costing module tracked the costs of VMMC and the resulting financial savings owing to reduced HIV incidence over time. Then, we used several financial indicators to assess the cost-effectiveness of and financial return on investments in VMMC. One circumcision of a young man up to age 20 prevents on average over 0.2 HIV infections, but this effect declines steeply with age, e.g., to 0.08 by age 30. Net financial savings from one VMMC at age 20 are estimated at US$617 at a discount rate of 5% and are lower for circumcisions both at younger ages (because the savings occur later and are discounted more) and at older ages (because male circumcision becomes less effective). Investments in male circumcision carry a financial rate of return of up to 14.5% (for circumcisions at age 20). The cost of a male circumcision is refinanced fastest, after 13 y, for circumcisions at ages 20 to 25. Principal limitations of the analysis arise from the long time (decades) over which the effects of VMMC unfold—the results are therefore sensitive to the

  16. Removal of foreskin remnants in circumcised adults for treatment of premature ejaculation

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    Mohammad Reza Namavar

    2011-01-01

    Full Text Available Background and Aim : Premature ejaculation (PE is the most prevalent sexual dysfunction in every country. There are many types of treatment, but the main limitation of medical treatment for premature ejaculation is recurrence after withdrawal of medicine. The prepuce is a specific erogenous zone that contains a rich and complex network of nerves. Circumcision radically desensitizes the penis, but incomplete circumcision may cause premature ejaculation. We evaluate the effect of removal of foreskin remnants in adults on PE. Materials and Methods : The sensitive area of penile skin and the remaining parts of foreskin in adult men were recognized in 47 selective patients. Under local anesthesia, the remnant parts of foreskin were incised and removed. They were asked to fill the investigating questionnaire about the changes of intravaginal latency ejaculatory time (IVELT, patients and their sexual partners′ satisfaction with sexual life, control over ejaculation, and penile sensitivity, before and after treatment. Results : There were no signs of inflammation and no serious adverse reactions in all cases after operation. IVELT significantly increased from 64.25 before surgery to 731.49 sec after surgery (P<0.001. The percentage of postoperative satisfaction in both the patient and his partner significantly increased (P<0.001. After surgery, 95.7% of men had better control over their ejaculation. This surgery significantly decreased sensitivity of penis (P<0.001, but it did not change glans penis insensitivity. Conclusions : These results indicate that removal of foreskin remnants in adults is an effective modality in selective patients of PE.

  17. Safety, effectiveness and acceptability of the PrePex device for adult male circumcision in Kenya.

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    Paul J Feldblum

    Full Text Available To assess the safety, effectiveness and acceptability of the PrePex device for adult medical male circumcision (MMC in routine service delivery in Kenya.We enrolled 427 men ages 18-49 at one fixed and two outreach clinics. Procedures were performed by trained clinical officers and nurses. The first 50 enrollees were scheduled for six follow-up visits, and remaining men were followed at Days 7 and 42. We recorded adverse events (AEs and time to complete healing, and interviewed men about acceptability and pain.Placement and removal procedures each averaged between 3 and 4 minutes. Self-reported pain was minimal during placement but was fleetingly intense during removal. The rate of moderate/severe AEs was 5.9% overall (95% confidence interval [CI] 3.8%-8.5%, all of which resolved without sequelae. AEs included 5 device displacements, 2 spontaneous foreskin detachments, and 9 cases of insufficient foreskin removal. Surgical completion of MMC was required for 9 men (2.1%. Among the closely monitored first 50 participants, the probability of complete healing by Day 42 was 0.44 (95% CI 0.30-0.58, and 0.90 by Day 56. A large majority of men was favorable about their MMC procedure and would recommend PrePex to friends and family.The PrePex device was effective for MMC in Kenya, and well-accepted. The AE rate was higher than reported for surgical procedures there, or in previous PrePex studies. Healing time is longer than following surgical circumcision. Provider experience and clearer counseling on post-placement and post-removal care should lead to lower AE rates.ClinicalTrials.gov NCT01711411.

  18. Ritual circumcision and risk of autism spectrum disorder in 0- to 9-year-old boys: national cohort study in Denmark

    Science.gov (United States)

    Simonsen, Jacob

    2015-01-01

    Objective Based on converging observations in animal, clinical and ecological studies, we hypothesised a possible impact of ritual circumcision on the subsequent risk of autism spectrum disorder (ASD) in young boys. Design National, register-based cohort study. Setting Denmark. Participants A total of 342,877 boys born between 1994 and 2003 and followed in the age span 0–9 years between 1994 and 2013. Main outcome measures Information about cohort members’ ritual circumcisions, confounders and ASD outcomes, as well as two supplementary outcomes, hyperkinetic disorder and asthma, was obtained from national registers. Hazard ratios (HRs) with 95% confidence intervals (CIs) associated with foreskin status were obtained using Cox proportional hazards regression analyses. Results With a total of 4986 ASD cases, our study showed that regardless of cultural background circumcised boys were more likely than intact boys to develop ASD before age 10 years (HR = 1.46; 95% CI: 1.11–1.93). Risk was particularly high for infantile autism before age five years (HR = 2.06; 95% CI: 1.36–3.13). Circumcised boys in non-Muslim families were also more likely to develop hyperkinetic disorder (HR = 1.81; 95% CI: 1.11–2.96). Associations with asthma were consistently inconspicuous (HR = 0.96; 95% CI: 0.84–1.10). Conclusions We confirmed our hypothesis that boys who undergo ritual circumcision may run a greater risk of developing ASD. This finding, and the unexpected observation of an increased risk of hyperactivity disorder among circumcised boys in non-Muslim families, need attention, particularly because data limitations most likely rendered our HR estimates conservative. Considering the widespread practice of non-therapeutic circumcision in infancy and childhood around the world, confirmatory studies should be given priority. PMID:25573114

  19. Toward a Systematic Approach to Generating Demand for Voluntary Medical Male Circumcision: Insights and Results From Field Studies

    OpenAIRE

    Sgaier, Sema K.; Baer, James; Rutz, Daniel C; Njeuhmeli, Emmanuel; Seifert-Ahanda, Kim; Basinga, Paulin; Parkyn, Rosie; Laube, Catharine

    2015-01-01

    By the end of 2014, an estimated 8.5 million men had undergone voluntary medical male circumcision (VMMC) for HIV prevention in 14 priority countries in eastern and southern Africa, representing more than 40% of the global target. However, demand, especially among men most at risk for HIV infection, remains a barrier to realizing the program's full scale and potential impact. We analyzed current demand generation interventions for VMMC by reviewing the available literature and reporting on fi...

  20. Evaluation of epidemiology, safety, and complications of male circumcision using conventional dissection surgery: experience at one center

    OpenAIRE

    Moslemi MK; Abedinzadeh M; Aghaali M

    2011-01-01

    Mohammad Kazem Moslemi1, Mehdi Abedinzadeh2, Mohammad Aghaali11Department of Urology, Kamkar Hospital, School of Medicine, Qom University of Medical Sciences, Qom, Iran; 2Department of Urology, Moradi Hospital, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, IranBackground: Circumcision can be performed for a variety of techniques, including conventional dissection surgery or a Plastibell device, and has religious, ritual, or medical roots. In countries like Iran, cir...

  1. Safety and efficacy of a novel disposable circumcision device: A pilot randomized controlled clinical trial at 2 centers

    OpenAIRE

    WANG, JINGEN; Zhou, Yongfei; Xia, Shuxia; Zhu, Zunwei; Jia, Linghua; Liu, Yong; Jiang, Min

    2014-01-01

    Background We evaluated the safety and efficacy of a novel disposable male circumcision (MC) device developed by Jiangxi-Yuansheng-Langhe Medical Instrument Co., Ltd. Material/Methods Adult male patients (n=120; mean age, 26.6 years) with redundant foreskin and/or phimosis were included in a randomized, multicenter pilot clinical trial from October 2011 to February 2012. Patients were divided into 2 groups and subjected to MC with a novel disposable device (Device Group) (n=60) or to conventi...

  2. A fast, easy circumcision procedure combining a CO2 laser and cyanoacrylate adhesive: a non-randomized comparative trial

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    Tahsin Gorgulu

    2016-02-01

    Full Text Available ABSTRACT Background Circumcision is performed as a routine operation in many countries, more commonly for religious and cultural reasons than for indicated conditions, such as phimosis and balanitis. There are many techniques available, and recently electrocautery and both Nd:YAG and CO2 lasers, instead of blades, have been used for skin and mucosal incisions. However, the infection risk in circumcisions performed using a CO2 laser was 10% higher. There are also reports of sutureless procedures using cyanoacrylate, but these have higher risks of hematoma and hemorrhage. We combined a CO2 laser and cyanoacrylate to shorten the operation time and to decrease bleeding complications. Materials and Methods : Circumcisions were performed under general anesthesia with CO2 laser and cyanoacrylate combination in 75 6–9-year-old boys between May 2013 and August 2014 only for religious reasons. As a control, we compared them retrospectively with 75 age-matched patients who were circumcised using the conventional guillotine method in our clinic. Results No hematomas, bleeding, or wound infections were observed. One wound dehiscence (1.33% occurred during the early postoperative period and healed without any additional procedures. The median operating time was 7 (range 6–9 minutes. The conventional guillotine group comprised one hematoma (1.3%, two wound dehiscences (2.6%, and two hemorrhages (2.6%, and the median operating time was 22 (range 20–26 minutes. The difference in surgical time was significant (p<0.001, with no significant difference in the rate of complications between the two groups. Conclusion The combined CO2 laser and cyanoacrylate procedure not only decreased the operating time markedly, but also eliminated the disadvantages associated with each individual procedure alone.

  3. Do men having routine circumcision need histological confirmation of the cause of their phimosis or postoperative follow-up?

    OpenAIRE

    Pearce, I; Payne, S R

    2002-01-01

    OBJECTIVE: To assess the accuracy of pre-operative diagnosis of preputial pathology ainongst urologists and general surgeons. PATIENTS AND METHODS: Data were collected on 460 adult patients having had circumcision performed by either a general surgeon or a urologist over a 10-year period. RESULTS: Pre-operative diagnosis was consistent with final histology in 83% of cases and further management was never altered by the histological result. Re-referral rates were 0% for general surgeons and 2....

  4. Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial.

    Directory of Open Access Journals (Sweden)

    2005-11-01

    Full Text Available BACKGROUND: Observational studies suggest that male circumcision may provide protection against HIV-1 infection. A randomized, controlled intervention trial was conducted in a general population of South Africa to test this hypothesis. METHODS AND FINDINGS: A total of 3,274 uncircumcised men, aged 18-24 y, were randomized to a control or an intervention group with follow-up visits at months 3, 12, and 21. Male circumcision was offered to the intervention group immediately after randomization and to the control group at the end of the follow-up. The grouped censored data were analyzed in intention-to-treat, univariate and multivariate, analyses, using piecewise exponential, proportional hazards models. Rate ratios (RR of HIV incidence were determined with 95% CI. Protection against HIV infection was calculated as 1 - RR. The trial was stopped at the interim analysis, and the mean (interquartile range follow-up was 18.1 mo (13.0-21.0 when the data were analyzed. There were 20 HIV infections (incidence rate = 0.85 per 100 person-years in the intervention group and 49 (2.1 per 100 person-years in the control group, corresponding to an RR of 0.40 (95% CI: 0.24%-0.68%; p < 0.001. This RR corresponds to a protection of 60% (95% CI: 32%-76%. When controlling for behavioural factors, including sexual behaviour that increased slightly in the intervention group, condom use, and health-seeking behaviour, the protection was of 61% (95% CI: 34%-77%. CONCLUSION: Male circumcision provides a degree of protection against acquiring HIV infection, equivalent to what a vaccine of high efficacy would have achieved. Male circumcision may provide an important way of reducing the spread of HIV infection in sub-Saharan Africa. (Preliminary and partial results were presented at the International AIDS Society 2005 Conference, on 26 July 2005, in Rio de Janeiro, Brazil..

  5. A fast, easy circumcision procedure combining a CO2 laser and cyanoacrylate adhesive: a non-randomized comparative trial

    Science.gov (United States)

    Gorgulu, Tahsin; Olgun, Abdulkerim; Torun, Merve; Kargi, Eksal

    2016-01-01

    ABSTRACT Background Circumcision is performed as a routine operation in many countries, more commonly for religious and cultural reasons than for indicated conditions, such as phimosis and balanitis. There are many techniques available, and recently electrocautery and both Nd:YAG and CO2 lasers, instead of blades, have been used for skin and mucosal incisions. However, the infection risk in circumcisions performed using a CO2 laser was 10% higher. There are also reports of sutureless procedures using cyanoacrylate, but these have higher risks of hematoma and hemorrhage. We combined a CO2 laser and cyanoacrylate to shorten the operation time and to decrease bleeding complications. Materials and Methods : Circumcisions were performed under general anesthesia with CO2 laser and cyanoacrylate combination in 75 6–9-year-old boys between May 2013 and August 2014 only for religious reasons. As a control, we compared them retrospectively with 75 age-matched patients who were circumcised using the conventional guillotine method in our clinic. Results No hematomas, bleeding, or wound infections were observed. One wound dehiscence (1.33%) occurred during the early postoperative period and healed without any additional procedures. The median operating time was 7 (range 6–9) minutes. The conventional guillotine group comprised one hematoma (1.3%), two wound dehiscences (2.6%), and two hemorrhages (2.6%), and the median operating time was 22 (range 20–26) minutes. The difference in surgical time was significant (p<0.001), with no significant difference in the rate of complications between the two groups. Conclusion The combined CO2 laser and cyanoacrylate procedure not only decreased the operating time markedly, but also eliminated the disadvantages associated with each individual procedure alone. PMID:27136476

  6. Single-arm evaluation of the AccuCirc device for early infant male circumcision in Botswana.

    Science.gov (United States)

    Plank, Rebeca M; Wirth, Kathleen E; Ndubuka, Nnamdi O; Abdullahi, Rasak; Nkgau, Maggie; Lesetedi, Chiapo; Powis, Kathleen M; Mmalane, Mompati; Makhema, Joseph; Shapiro, Roger; Lockman, Shahin

    2014-05-01

    : Existing devices for early infant male circumcision (EIMC) have inherent limitations. We evaluated the newly developed AccuCirc device by circumcising 151 clinically well, full-term male infants with birth weight ≥2.5 kg within the first 10 days of life from a convenience sample in 2 hospitals in Botswana. No major adverse events were observed. There was 1 local infection, 5 cases of minor bleeding, and 1 case of moderate bleeding. In 3 cases, the device made only partial incisions that were completed immediately by the provider without complications. Parental satisfaction was high: >96% of mothers stated that they would circumcise a future son. The pre-assembled, sterile AccuCirc kit has the potential to overcome obstacles related to supply chain management and on-site instrument disinfection that can pose challenges in resource-limited settings. In our study, the AccuCirc was safe and it should be considered for programmatic EIMC in resource-limited settings. PMID:24594500

  7. Female condoms

    Science.gov (United States)

    ... female condoms at most drugstores, STI clinics, and family planning clinics. You need to plan to have a ... Jensen JT, Mishell DR. Family planning: contraception, ... Katz VL, eds. Comprehensive Gynecology . 6th ed. Philadelphia, ...

  8. The safety of adult male circumcision in HIV-infected and uninfected men in Rakai, Uganda.

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    Godfrey Kigozi

    2008-06-01

    Full Text Available BACKGROUND: The objective of the study was to compare rates of adverse events (AEs related to male circumcision (MC in HIV-positive and HIV-negative men in order to provide guidance for MC programs that may provide services to HIV-infected and uninfected men. METHODS AND FINDINGS: A total of 2,326 HIV-negative and 420 HIV-positive men (World Health Organization [WHO] stage I or II and CD4 counts > 350 cells/mm3 were circumcised in two separate but procedurally identical trials of MC for HIV and/or sexually transmitted infection prevention in rural Rakai, Uganda. Participants were followed at 1-2 d and 5-9 d, and at 4-6 wk, to assess surgery-related AEs, wound healing, and resumption of intercourse. AE risks and wound healing were compared in HIV-positive and HIV-negative men. Adjusted odds ratios (AdjORs were estimated by multiple logistic regression, adjusting for baseline characteristics and postoperative resumption of sex. At enrollment, HIV-positive men were older, more likely to be married, reported more sexual partners, less condom use, and higher rates of sexually transmitted disease symptoms than HIV-negative men. Risks of moderate or severe AEs were 3.1/100 and 3.5/100 in HIV-positive and HIV-negative participants, respectively (AdjOR 0.91, 95% confidence interval [CI] 0.47-1.74. Infections were the most common AEs (2.6/100 in HIV-positive versus 3.0/100 in HIV-negative men. Risks of other complications were similar in the two groups. The proportion with completed healing by 6 wk postsurgery was 92.7% in HIV-positive men and 95.8% in HIV-negative men (p = 0.007. AEs were more common in men who resumed intercourse before wound healing compared to those who waited (AdjOR 1.56, 95% CI 1.05-2.33. CONCLUSIONS: Overall, the safety of MC was comparable in asymptomatic HIV-positive and HIV-negative men, although healing was somewhat slower among the HIV infected. All men should be strongly counseled to refrain from intercourse until full wound

  9. Female genital mutilation of a karyotypic male presenting as a female with delayed puberty

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    Gisselsson D

    2006-03-01

    Full Text Available Abstract Background Female genital mutilation (FGM is commonly practiced mainly in a belt reaching from East to West Africa north of the equator. The practice is known across socio-economic classes and among different ethnic, religious, and cultural groups. Few studies have been appropriately designed to measure the health effects of FGM. However, the outcome of FGM on intersex individuals has never been discussed before. Case presentation The patient first presented as a female with delayed puberty. Hormonal analysis revealed a normal serum prolactin level of 215 Mu/L, a low FSH of 0.5 Mu/L, and a low LH of 1.1 Mu/L. Type IV FGM (Pharaonic circumcision had been performed during childhood. Chromosomal analysis showed a 46, XY karyotype and ultrasonography verified a soft tissue structure in the position of the prostate. Conclusion FGM pose a threat to the diagnosis and management of children with abnormal genital development in the Sudan and similar societies.

  10. A Phase II Randomized Controlled Trial Comparing Safety, Procedure Time, and Cost of the PrePex™ Device to Forceps Guided Surgical Circumcision in Zimbabwe

    Science.gov (United States)

    Tshimanga, Mufuta; Mangwiro, Tonderayi; Mugurungi, Owen; Xaba, Sinokuthemba; Murwira, Munyaradzi; Kasprzyk, Danuta; Montaño, Daniel E.; Nyamukapa, Daisy; Tambashe, Basile; Chatikobo, Pesanai; Gundidza, Patricia; Gwinji, Gerald

    2016-01-01

    Background The World Health Organization (WHO) and the Joint United Nations Program on HIV/AIDS promote MC (male circumcision) as a key HIV prevention strategy where HIV prevalence and incidence are high and MC prevalence is low. In Zimbabwe, to achieve the 1.26 million circumcisions needed to be performed by 2015 to achieve optimal MC coverage, a new approach was needed. The primary objective of the current trial was to assess the performance (safety, procedure time, and cost) of the PrePex device compared to forceps-guided surgical circumcision. Methods and Findings This Phase II, randomized, open-label trial in Zimbabwe involved healthy, non-circumcised adult male volunteers who were randomly assigned to the PrePex device (n = 160) or surgical arm (n = 80). Three doctors and 4 nurses, all certified on both circumcision methods, performed the procedures. The PrePex device procedure involves a plastic ring with a rubber O-ring that necrotizes the foreskin to facilitate easy and minimally invasive removal. Total procedure time was the primary endpoint. Adverse event (AE) data were also gathered for 90 days post-procedure. All 80 participants in the surgical arm and 158 participants in the PrePex arm achieved complete circumcision. The total procedure time for the PrePex device was approximately one-third of the total surgical procedure (4.8 minutes, Standard Deviation [SD]: 1.2 versus 14.6 minutes; SD: 4.2; pcircumcision. The PrePex device has great potential for use in overburdened health systems and in resource-limited settings and is recommended for use in rapid scale-up of adult MC in Zimbabwe. Trial Registration ClinicalTrials.gov NCT01956370 PMID:27227679

  11. Effect of lidocaine-prilocaine eutectic mixture of local anaesthetic cream compared with oral sucrose or both in alleviating pain in neonatal circumcision procedure

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    Reem Al Qahtani

    2014-01-01

    Full Text Available Background: Neonatal circumcision is one of the oldest and most frequently performed surgical procedures on males. Newborns demonstrate strong endogenous reaction to pain and therefore modalities are being explored for optimum pain relief during circumcision. Pediatric nurses have a vital role for the use of these modalities and minimising the pain response during the neonatal minor procedures. Aim: The aim of this study was to assess the effectiveness of eutectic mixture of local anaesthetic (EMLA cream compared with oral sucrose and both in alleviating pain in neonatal circumcision. Materials and Methods: This study was conducted in the Day Care Surgery Department of Maternity and Children Hospital, Dammam City, KSA. 90 full-term newborn males who underwent circumcision were divided randomly into three groups (30 each. Each group was assigned to receive a different type of analgesics such as EMLA cream (Group A, oral sucrose (Group B or combination of EMLA cream and oral sucrose (Group C. Neonatal pain agitation and sedation scale (N-PASS was used 5 min before, during and 5 min after the circumcision procedure to assess the neonatal response to pain. Results: N-PASS scores were significantly lower in Group C (median Group C = 5.2, Group A = 5.8, Group B = 8.5; P< 0.001. The endogenous response to pain in terms of escalation of heart rate and reduction in O 2 saturation were minimal among Group C (P < 0.0001. Duration of crying was comparable among all the groups. Conclusion: The combination of sucrose and EMLA cream revealed a higher analgesic effect and minimal adverse response to pain than either EMLA cream or sucrose alone during neonatal circumcision.

  12. Long-term follow-up for Shang Ring male circumcision

    Institute of Scientific and Technical Information of China (English)

    Cheng Yue; Wu Kerong; Yan Zejun; Yang Shuwei; Li Fang; Su Xinjun

    2014-01-01

    Background Shang Ring male circumcision (MC) is a safe surgery with good short-term effects.This retrospective study was performed to investigate the long-term result of patients who had undergone Shang Ring MC.Methods A total of 103 patients who underwent the surgery were recruited in the study.Before and after the surgery,a questionnaire inquiring sexual function and sexual satisfaction was filled up.Face-to-face interview was executed.Physical examination of the external genitals was performed and complications were evaluated.Results The median follow-up duration was 19.1 months (range from 9 to 28 months).The mean width of penile mucosa was (9.3±2.5) mm.The mean width of scar was (3.7±1.6) mm.No tender pain was found in participants when palpating the penis.No significant or functional complication was observed except of mucosa asymmetry in one case and scar hyperplasia in two cases.The postoperative sexual function did not differ from the preoperative one,although partners showed better satisfaction toward sexual life.Conclusion Shang Ring MC represents a good long-term cosmetic result with no significant complication or adverse effects on sexual function.

  13. Intraperitoneal Bladder Perforation and Life-threatening Renal Failure in a Neonate Following Circumcision With the Plastibell Device.

    Science.gov (United States)

    Dwyer, Moira; Peffer, Nathan; Fuller, Thomas; Cannon, Glenn

    2016-03-01

    We present the case of an infant who suffered intraperitoneal bladder perforation secondary to routine neonatal circumcision with the Plastibell device. On day-of-life 5, the patient presented with abdominal distention, vomiting, diarrhea, and severe acute renal failure. After removal of a distal meatal obstruction caused by the Plastibell device and open repair of the bladder defect, the patient had an uneventful recovery with rapid return of renal function. Despite the relative safety of the Plastibell, this case underscores the importance of careful device placement, parental education, keen clinical judgment, and prompt intervention when indicated. PMID:26657690

  14. Voluntary medical male circumcision: a framework analysis of policy and program implementation in eastern and southern Africa.

    OpenAIRE

    Dickson, Kim E; Tran, Nhan T.; Samuelson, Julia L.; Emmanuel Njeuhmeli; Peter Cherutich; Bruce Dick; Tim Farley; Caroline Ryan; Hankins, Catherine A.

    2011-01-01

    Editors' Summary Background Every year, more than 2.5 million people (mostly in sub-Saharan Africa) become infected with HIV, the virus that causes AIDS. There is no cure for HIV/AIDS and no HIV vaccine. Consequently, global efforts to combat HIV/AIDS are concentrating on evidence-based prevention strategies such as voluntary medical male circumcision (VMMC). Circumcision—the removal of the foreskin, a loose fold of skin that covers the head of the penis—reduced HIV transmission through sexua...

  15. Female sexuality.

    Science.gov (United States)

    Rao, T S Sathyanarana; Nagaraj, Anil Kumar M

    2015-07-01

    Sex is a motive force bringing a man and a woman into intimate contact. Sexuality is a central aspect of being human throughout life and encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy, and reproduction. Sexuality is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behaviors, practices, roles and relationships. Though generally, women are sexually active during adolescence, they reach their peak orgasmic frequency in their 30 s, and have a constant level of sexual capacity up to the age of 55 with little evidence that aging affects it in later life. Desire, arousal, and orgasm are the three principle stages of the sexual response cycle. Each stage is associated with unique physiological changes. Females are commonly affected by various disorders in relation to this sexual response cycle. The prevalence is generally as high as 35-40%. There are a wide range of etiological factors like age, relationship with a partner, psychiatric and medical disorders, psychotropic and other medication. Counseling to overcome stigma and enhance awareness on sexuality is an essential step in management. There are several effective psychological and pharmacological therapeutic approaches to treat female sexual disorders. This article is a review of female sexuality. PMID:26330647

  16. Female infertility

    International Nuclear Information System (INIS)

    Infertility, defined as 1 year of unprotected intercourse without conception, is becoming of increasingly important medical concern. Fertility in both the male and the female is at its peak in the twenties. Many couples today have postponed marriage and/or childbearing into their 30s until careers are established, but at that point fertility may be diminished. The current epidemic of venereal disease has been associated with an increasing incidence of tubal scarring. In addition, the use of intrauterine devices (IUDs) and birth control pills for contraception have let to later problems with pelvic inflammatory disease (PID) and ovulation disturbances. The problem of infertility intensifies as the number of babies available for adoption decreases. Therefore, it is estimated that approximately 10-20% of couples will eventually seek medical attention for an infertility-related problem. Fortunately, marked improvements in the results of tubal surgery are concurrently occurring secondary to refinements in microsurgical techniques, and many medical alternatives to induce ovulation are being developed. The male factor causes infertility in 30-40 % of couples, and the female factor is responsible in approximately 50% of couples. No cause is found in 10-20% of couples. This chapter discusses the role of coordinated imaging in the diagnosis and therapy of infertility in the female

  17. Female sexuality

    Science.gov (United States)

    Rao, T.S. Sathyanarana; Nagaraj, Anil Kumar M.

    2015-01-01

    Sex is a motive force bringing a man and a woman into intimate contact. Sexuality is a central aspect of being human throughout life and encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy, and reproduction. Sexuality is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behaviors, practices, roles and relationships. Though generally, women are sexually active during adolescence, they reach their peak orgasmic frequency in their 30 s, and have a constant level of sexual capacity up to the age of 55 with little evidence that aging affects it in later life. Desire, arousal, and orgasm are the three principle stages of the sexual response cycle. Each stage is associated with unique physiological changes. Females are commonly affected by various disorders in relation to this sexual response cycle. The prevalence is generally as high as 35–40%. There are a wide range of etiological factors like age, relationship with a partner, psychiatric and medical disorders, psychotropic and other medication. Counseling to overcome stigma and enhance awareness on sexuality is an essential step in management. There are several effective psychological and pharmacological therapeutic approaches to treat female sexual disorders. This article is a review of female sexuality. PMID:26330647

  18. Human papillomavirus infection in couples with female low-grade intraepithelial cervical lesion.

    Science.gov (United States)

    Simon, Philippe; Roumeguere, Thierry; Christophe Noël, Jean

    2010-11-01

    Low-grade squamous intraepithelial lesions (LSIL) are frequently found during cervical cancer screening. Usually they are associated with a human papillomavirus (HPV) infection. Does the high-transmission rate of HPV infection to the male partner represent a clinical risk for him? Are preventive measures to be taken to prevent the occurrence of male diseases? More than 80% of all LSIL are associated with HPV infections. The prevalence of HPV infection in males can range up to 40%, with 60% of the male partners of LSIL female patients presenting with penile flat lesions. The spontaneous cure rate for male infections is very high (90% at 5 years) but negative consequences in females (cervical high-grade lesion and cervical cancer) are frequent. Their male counterparts are far rarer but in some patients can require deleterious treatment. Transmission prevention by the use of condoms and circumcision is discussed. The effectiveness of HPV vaccination in this situation has not been validated. PMID:20646823

  19. FEMALE PSEUDOHERMAPHRODITISM

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    AL. Bulotta

    2012-01-01

    Full Text Available Introduction. 21α-hydroxylase deficiency is the most frequent cause of virilization in patients with female karyotype due to exposure of a female fetus to excess of androgen. We report anatomical and cosmetic results of feminizing genital reconstruction of two related patients (second cousin with XX karyotype born with urogenital sinus anomalies (UGS and not treated at birth. Materials and Metods. Patient 1 is 6-years old with ambiguous genitalia graded as Prader V and never undergone therapy or surgery. Patient 2 is 10-years old, graded as Prader IV and subjected to hormonal therapy and clitoral amputation at the age of 6. Mobilization of urogenital sinus, pull-through of vagina and tubulization of urethra was performed in both after placement of Foley chateters in vagina and bladder by cisto-vaginoscopy. Genitoplasty involved refashioning the tissues to create minora and majora labia and, after removal of corpora, partial clitorectomy was carried in patient 1 and clitoridal reconstruction in patient 2. Result. Vaginal introitus was positioned in the vestibule region below urethral meatus. Foley chateters was removed after two weeks in narcosis and the cosmetic and anatomic result was good. Conclusion. Goals of feminizing genitoplasty are to restore, soon as possible, anatomy achieving a more feminine appareance with a vagina for menstruation, to preserve reproductive capacity and to prevent urological sequelae but it’s also important to contribute in a development of a more stable gender identity. This procedure in two stage, based on an accurate diagnosis, is good to create feminine genital appareance in children with female pseudohermaphroditism expecially if not treated at birth.

  20. Cost drivers for voluntary medical male circumcision using primary source data from sub-Saharan Africa.

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    Lori Bollinger

    Full Text Available BACKGROUND: As voluntary medical male circumcision (VMMC programs scale up, there is a pressing need for information about the important cost drivers, and potential efficiency gains. We examine those cost drivers here, and estimate the potential efficiency gains through an econometric model. METHODS AND FINDINGS: We examined the main cost drivers (i.e., personnel and consumables associated with providing VMMC in sub-Saharan Africa along a number of dimensions, including facility type and service provider. Primary source facility level data from Kenya, Namibia, South Africa, Tanzania, Uganda, and Zambia were utilized throughout. We estimated the efficiency gains by econometrically estimating a cost function in order to calculate the impact of scale and other relevant factors. Personnel and consumables were estimated at 36% and 28%, respectively, of total costs across countries. Economies of scale (EOS is estimated to be eight at the median volume of VMMCs performed, and EOS falls from 23 at the 25th percentile volume of VMMCs performed to 5.1 at the 75th percentile. CONCLUSIONS: The analysis suggests that there is significant room for efficiency improvement as indicated by declining EOS as VMMC volume increases. The scale of the fall in EOS as VMMC volume increases suggests that we are still at the ascension phase of the scale-up of VMMC, where continuing to add new sites results in additional start-up costs as well. A key aspect of improving efficiency is task sharing VMMC procedures, due to the large percentage of overall costs associated with personnel costs. In addition, efficiency improvements in consumables are likely to occur over time as prices and distribution costs decrease.

  1. Health complications of female genital mutilation in Sierra Leone

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    Bjälkander O

    2012-07-01

    Full Text Available Owolabi Bjälkander,1 Laurel Bangura,2 Bailah Leigh,3 Vanja Berggren,1 Staffan Bergström,1 Lars Almroth11Division of Global Health, Department of Public Health, Karolinska Institutet, Stockholm, Sweden; 2Inter Africa Committee, Sierra Leone; 3Department of Community Health, College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra LeoneAbstract: Sierra Leone has one of the highest rates of female genital mutilation (FGM in the world, and yet little is known about the health consequences of the practice.Purpose: To explore whether and what kind of FGM-related health complications girls and women in Sierra Leone experience, and to elucidate their health care-seeking behaviors.Patients and methods: A feasibility study was conducted to test and refine questionnaires and methods used for this study. Thereafter, a cross-section of girls and women (n = 258 attending antenatal care and Well Women Clinics in Bo Town, Bo District, in the southern region and in Makeni Town, Bombali District, in the northern region of Sierra Leone were randomly selected. Participants answered interview-administrated pretested structured questionnaires with open-ended-questions, administrated by trained female personnel.Results: All respondents had undergone FGM, most between 10 and 14 years of age. Complications were reported by 218 respondents (84.5%, the most common ones being excessive bleeding, delay in or incomplete healing, and tenderness. Fever was significantly more often reported by girls who had undergone FGM before 10 years of age compared with those who had undergone the procedure later. Out of those who reported complications, 187 (85.8% sought treatment, with 89 of them visiting a traditional healer, 75 a Sowei (traditional circumciser, and 16 a health professional.Conclusion: The high prevalence rate of FGM and the proportion of medical complications show that FGM is a matter for public health concern in Sierra Leone. Girls who

  2. Voluntary Medical Male Circumcision for HIV Prevention in Malawi: Modeling the Impact and Cost of Focusing the Program by Client Age and Geography.

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    Katharine Kripke

    Full Text Available In 2007, the World Health Organization (WHO recommended scaling up voluntary medical male circumcision (VMMC in priority countries with high HIV prevalence and low male circumcision (MC prevalence. According to the Joint United Nations Programme on HIV/AIDS (UNAIDS, an estimated 5.8 million males had undergone VMMC by the end of 2013. Implementation experience has raised questions about the need to refocus VMMC programs on specific subpopulations for the greatest epidemiological impact and programmatic effectiveness. As Malawi prepared its national operational plan for VMMC, it sought to examine the impacts of focusing on specific subpopulations by age and region.We used the Decision Makers' Program Planning Toolkit, Version 2.0, to study the impact of scaling up VMMC to different target populations of Malawi. National MC prevalence by age group from the 2010 Demographic and Health Survey was scaled according to the MC prevalence for each district and then halved, to adjust for over-reporting of circumcision. In-country stakeholders advised a VMMC unit cost of $100, based on implementation experience. We derived a cost of $451 per patient-year for antiretroviral therapy from costs collected as part of a strategic planning exercise previously conducted in- country by UNAIDS.Over a fifteen-year period, circumcising males ages 10-29 would avert 75% of HIV infections, and circumcising males ages 10-34 would avert 88% of infections, compared to the current strategy of circumcising males ages 15-49. The Ministry of Health's South West and South East health zones had the lowest cost per HIV infection averted. Moreover, VMMC met WHO's definition of cost-effectiveness (that is, the cost per disability-adjusted life-year [DALY] saved was less than three times the per capita gross domestic product in all health zones except Central East. Comparing urban versus rural areas in the country, we found that circumcising men in urban areas would be both cost

  3. A Phase II Randomized Controlled Trial Comparing Safety, Procedure Time, and Cost of the PrePex™ Device to Forceps Guided Surgical Circumcision in Zimbabwe.

    Directory of Open Access Journals (Sweden)

    Mufuta Tshimanga

    Full Text Available The World Health Organization (WHO and the Joint United Nations Program on HIV/AIDS promote MC (male circumcision as a key HIV prevention strategy where HIV prevalence and incidence are high and MC prevalence is low. In Zimbabwe, to achieve the 1.26 million circumcisions needed to be performed by 2015 to achieve optimal MC coverage, a new approach was needed. The primary objective of the current trial was to assess the performance (safety, procedure time, and cost of the PrePex device compared to forceps-guided surgical circumcision.This Phase II, randomized, open-label trial in Zimbabwe involved healthy, non-circumcised adult male volunteers who were randomly assigned to the PrePex device (n = 160 or surgical arm (n = 80. Three doctors and 4 nurses, all certified on both circumcision methods, performed the procedures. The PrePex device procedure involves a plastic ring with a rubber O-ring that necrotizes the foreskin to facilitate easy and minimally invasive removal. Total procedure time was the primary endpoint. Adverse event (AE data were also gathered for 90 days post-procedure. All 80 participants in the surgical arm and 158 participants in the PrePex arm achieved complete circumcision. The total procedure time for the PrePex device was approximately one-third of the total surgical procedure (4.8 minutes, Standard Deviation [SD]: 1.2 versus 14.6 minutes; SD: 4.2; p<0.00001. There were 2 AEs for 2 participants (rate of 1.3%, 95% Confidence Interval: 0.0025-4.53%, which were resolved with simple intervention. The AEs were device related, including 1 case of pain leading to device removal and 1 case of removal of the device.The trial supports previous studies' conclusions that the PrePex procedure is safe, quick, easy to apply, and effective in terms of procedure time as an alternative to traditional surgical circumcision. The PrePex device has great potential for use in overburdened health systems and in resource-limited settings and is

  4. The characteristics of circular disposable devices and in situ devices for optimizing male circumcision: a network meta-analysis.

    Science.gov (United States)

    Fan, Yu; Cao, Dehong; Wei, Qiang; Tang, Zhuang; Tan, Ping; Yang, Lu; Liu, Liangren; Liu, Zhenhua; Li, Xiang; Xue, Wenbin

    2016-01-01

    In situ device (ISD) and circular disposable device (CDD) are used for optimizing male circumcision (MC), but evidence to explore the characteristics of these two devices is insufficient. In order to explore this issue systematically and provide reliable evidence, ten published randomized controlled trials (RCTs) exploring the safety and efficacy of ISDs and CDDs were included (involving 4649 men). Moderate quality of the RCTs included was found after assessment. Pairwise meta-analyses and network meta-analyses were processed in stata 13.0 and AIDDS v1.16.6 respectively. According to the outcomes that were statistically significant in both pairwise and network meta-analyses, ISD was found to have less intraoperative blood loss (IB), less operative time (OT) and less incidence of wound bleeding (WB) than conventional circumcision (CC); ISD was found to have less WB but more wound healing time (WHT) than CDD; CDD was found to have less IB and less OT than CC. CDD tended to have the best wound healing condition and least pain experience; ISD tended to have the least IB, least OT, least WB, and highest satisfaction rate. With their own superiorities in many aspects, CDD and ISD are both safe and effective devices for optimizing MC. PMID:27156368

  5. Sutureless Adult Voluntary Male Circumcision with Topical Anesthetic: A Randomized Field Trial of Unicirc, a Single-Use Surgical Instrument.

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    Justin Shenje

    Full Text Available The World Health Organization has solicited rapid and minimally invasive techniques to facilitate scale-up of voluntary medical male circumcision (VMMC.Non-blinded randomized controlled field trial with 2:1 allocation ratio.75 adult male volunteers.Outpatient primary care clinic.Open surgical circumcision under local anesthetic with suturing vs. Unicirc disposable instrument under topical anesthetic and wound sealing with cyanoacrylate tissue adhesive.Intraoperative duration.Intraoperative and postoperative pain; adverse events; time to healing; patient satisfaction; cosmetic result.The intraoperative time was less with the Unicirc technique (median 12 vs. 25 min, p < 0.001. Wound healing and cosmetic results were superior in the Unicirc group. Adverse events were similar in both groups.VMMC with Unicirc under topical anesthetic and wound sealing with cyanoacrylate tissue adhesive is rapid, heals by primary intention with superior cosmetic results, and is potentially safer and more cost-effective than open surgical VMMC.Clinicaltrials.gov NCT02443792.

  6. Knowledge, attitude and practice of female genital mutilation among doctors and nurses in Bayelsa state, Niger-Delta of Nigeria

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    Oyeyemi A.S

    2013-01-01

    Full Text Available Background: Female genital mutilation (FGM is a harmful traditional practice that is deeply rooted in Africa. It has been outlawed in Bayelsa state of Nigeria but there is evidence that its performance by traditional circumcisers and health professionals continues. Aim: The study aimed to determine the knowledge, attitude and practice of FGM among doctors and nurses/midwives practising in public secondary and tertiary hospitals in Bayelsa state. Methods: One hundred and ninety seven (197 structured questionnaires were administered to all available doctors and nurses/midwives in the study hospitals for self-completion. Epi-Info version 3.5.1 was used to analyse data. Results: All the respondents were aware of FGM. A higher proportion of nurses/midwives than doctors had ever been asked and had ever treated patients with complications of FGM. More than 90% of respondents said it was not a good practice. Out of the 70 female respondents, 19 (27.1% said they were circumcised. Only one nurse/midwife admitted to performing FGM presently. Conclusion: Doctors and nurses/midwives practicing in the study hospitals were well aware of FGM and were favourably disposed towards its elimination. Efforts should be made to reinforce this position.

  7. Female Reproductive System

    Science.gov (United States)

    ... Things to Know About Zika & Pregnancy Female Reproductive System KidsHealth > For Parents > Female Reproductive System Print A ... or sperm. continue Components of the Female Reproductive System Unlike the male, the human female has a ...

  8. Prevalence and associated factors of female genital mutilation among Somali refugees in eastern Ethiopia: a cross-sectional study

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    Deressa Wakgari

    2009-07-01

    Full Text Available Abstract Background Eastern Ethiopia hosts a substantial number of refugees originated from Somalia. Female genital mutilation (FGM is a common practice in the area, despite the campaigns to eliminate it. Methods A cross-sectional study was conducted among 492 respondents sampled from three refugee camps in Somali Regional State, Eastern Ethiopia, to determine the prevalence and associated factors of FGM. Data were collected using pre-tested structured questionnaires. Results Although the intention of the parents to circumcise their daughters was high (84%, 42.4% of 288 ≤12 girls were reported being undergone FGM. The prevalence increased with age, and about 52% and 95% were circumcised at the age of 7–8 and 11–12 years, respectively. Almost all operations were performed by traditional circumcisers (81% and birth attendants (18%. Clitoral cutting (64% and narrowing of the vaginal opening through stitching (36% were the two common forms of FGM reported by the respondents. Participation of the parents in anti-FGM interventions is statistically associated with lower practice and intention of the procedures. Conclusion FGM is widely practised among the Somali refugee community in Eastern Ethiopia, and there was a considerable support for the continuation of the practice particularly among women. The findings indicate a reported shift of FGM from its severe form to milder clitoral cutting. More men than women positively viewed anti-FGM interventions, and fewer men than women had the intention to let their daughters undergo FGM, indicating the need to involve men in anti-FGM activities.

  9. Microbial diversity of genital ulcer disease in men enrolled in a randomized trial of male circumcision in Kisumu, Kenya.

    Directory of Open Access Journals (Sweden)

    Supriya D Mehta

    Full Text Available BACKGROUND: Medical male circumcision (MMC reduces the risk of genital ulcer disease (GUD in men by 50%. In Ugandan and Kenyan trials, a sexually transmissible agent was not identified in 50-60% of GUD specimens by polymerase chain reaction (PCR assay. We sought to better define the etiology of GUD in men participating in the Kenyan trial and examine how MMC affects GUD etiology. METHODS: We defined GUD of unknown etiology as negative for HSV (type 1 and type 2, T. pallidum, and H. ducreyi by PCR, and negative for HSV-2 and T. pallidum by serology. We identified bacterial microbiota in a subset of 59 GUD specimens using multitag pyrosequencing of the 16S rRNA gene, and compared results by unknown vs. STI-associated etiology. Statistical analysis employed Bray-Curtis similarity measure of bacterial community by etiology, hierarchical clustering and logistic regression. RESULTS: In 59 GUD specimens from 59 men, 23 (39% had unknown etiology. Bacterial diversity was greater in GUD of unknown than STI etiology (p = 0.01. Fusobacteria (Fusobacterium spp. and Sneathia spp. were more commonly detected in men with GUD of unknown etiology [adjusted OR = 5.67; 95% CI: 1.63-19.8] as were Oxobacter spp. and Anaerovorax spp. [adjusted OR = 3.12; 95% CI: 0.83-11.7]. Sequences from these four anaerobic bacterial taxa were more often detected in uncircumcised men than circumcised men (p<0.05. CONCLUSIONS: Anaerobic bacteria are more common in genital ulcers of uncircumcised men. The specific anaerobic bacteria associated with GUD of unknown etiology have cytotoxic properties that can exacerbate epithelial disruptions leading to ulcer-like appearance. MMC may reduce GUD through a reduction in these anaerobic bacteria.

  10. Vasectomy as a proxy: extrapolating health system lessons to male circumcision as an HIV prevention strategy in Papua New Guinea

    Directory of Open Access Journals (Sweden)

    Tynan Anna

    2012-09-01

    Full Text Available Abstract Background Male circumcision (MC has been shown to reduce the risk of HIV acquisition among heterosexual men, with WHO recommending MC as an essential component of comprehensive HIV prevention programs in high prevalence settings since 2007. While Papua New Guinea (PNG has a current prevalence of only 1%, the high rates of sexually transmissible diseases and the extensive, but unregulated, practice of penile cutting in PNG have led the National Department of Health (NDoH to consider introducing a MC program. Given public interest in circumcision even without active promotion by the NDoH, examining the potential health systems implications for MC without raising unrealistic expectations presents a number of methodological issues. In this study we examined health systems lessons learned from a national no-scalpel vasectomy (NSV program, and their implications for a future MC program in PNG. Methods Fourteen in-depth interviews were conducted with frontline health workers and key government officials involved in NSV programs in PNG over a 3-week period in February and March 2011. Documentary, organizational and policy analysis of HIV and vasectomy services was conducted and triangulated with the interviews. All interviews were digitally recorded and later transcribed. Application of the WHO six building blocks of a health system was applied and further thematic analysis was conducted on the data with assistance from the analysis software MAXQDA. Results Obstacles in funding pathways, inconsistent support by government departments, difficulties with staff retention and erratic delivery of training programs have resulted in mixed success of the national NSV program. Conclusions In an already vulnerable health system significant investment in training, resources and negotiation of clinical space will be required for an effective MC program. Focused leadership and open communication between provincial and national government, NGOs and

  11. Factors Associated With Delayed Healing in a Study of the PrePex Device for Adult Male Circumcision in Kenya

    Science.gov (United States)

    Odoyo-June, Elijah; Bailey, Robert C.; Jou Lai, Jaim; Weiner, Debra; Combes, Stephanie; Hart, Catherine; Fischer, Shelly; Obiero, Walter; Cherutich, Peter

    2016-01-01

    Objectives: To explore factors associated with healing requiring more than 6 weeks after placement of the PrePex device for adult medical male circumcision. Methods: We enrolled 427 men ages 18–49 years in an observational study of PrePex at 1 urban and 2 peripheral clinics in western Kenya. Participants were scheduled for device removal at day 7 and a follow-up visit at day 42 (allowable range, 40–44) at which the provider recorded wound status, with complete healing defined as a dry wound without any scab, later confirmed by site investigator review of digital penile photographs. We performed univariate and multivariate logistic regression to explore associations between selected demographic, surgical, and follow-up factors and delayed healing (not healed by day 42 visit). Results: Of the 427 men, 341 completing a day 42 visit with physical examination and recorded healing status were included. Fifty-four percent of included men were healed by day 42 visit. Factors associated with delayed healing in univariate analysis and remaining significant in the multivariate analysis were as follows: age 25 years or older [odds ratio (OR): 1.8; 95% confidence interval (CI): 1.4 to 2.4], an adverse event by day 44 (OR: 1.4; 95% CI: 1.03 to 2.0), and severe pain during device removal (protective association: OR: 0.7; 95% CI: 0.5 to 0.99). Conclusions: Older age (25+ years), occurrence of an adverse event, and lesser self-reported pain at device removal were associated with delayed wound healing. If confirmed by larger surveillance studies, these results should be incorporated into the counseling given to male circumcision clients. PMID:27331586

  12. Delivering PrePex Medical Male Circumcision Services Through a Mobile Clinic: The Experience From a Pilot Project in North West Province, South Africa.

    Science.gov (United States)

    Kufa, Tendesayi; Chetty-Makkan, Candice; Maraisane, Mpho; Charalambous, Salome; Chihota, Violet; Toledo, Carlos

    2016-06-01

    We describe the implementation of a pilot project to demonstrate the safety and feasibility of providing PrePex circumcision from a mobile clinic. We analyzed available project diary entries and staff meeting minutes to identify challenges encountered. The main challenges identified were (1) daily time constraints because of setting up procedures, (2) transportation logistics for clients when the mobile clinic had moved to a different location, (3) integration and coordination of staff responsibilities, and (4) recruitment for PrePex services in the mobile clinic. The provision of PrePex device circumcision through a mobile clinic was feasible but careful planning and review of operational procedures were needed to resolve the implementation challenges. PMID:27331594

  13. How much does it cost to improve access to voluntary medical male circumcision among high-risk, low-income communities in Uganda?

    Directory of Open Access Journals (Sweden)

    Bruce Larson

    Full Text Available The Ugandan Ministry of Health has endorsed voluntary medical male circumcision as an HIV prevention strategy and has set ambitious goals (e.g., 4.2 million circumcisions by 2015. Innovative strategies to improve access for hard to reach, high risk, and poor populations are essential for reaching such goals. In 2009, the Makerere University Walter Reed Project began the first facility-based VMMC program in Uganda in a non-research setting. In addition, a mobile clinic began providing VMMC services to more remote, rural locations in 2011. The primary objective of this study was to estimate the average cost of performing VMMCs in the mobile clinic compared to those performed in health facilities (fixed sites. The difference between such costs is the cost of improving access to VMMC.A micro-costing approach was used to estimate costs from the service provider's perspective of a circumcision. Supply chain and higher-level program support costs are not included.The average cost (US$2012 of resources used per circumcision was $61 in the mobile program ($72 for more remote locations compared to $34 at the fixed site. Costs for community mobilization, HIV testing, the initial medical exam, and staff for performing VMMC operations were similar for both programs. The cost of disposable surgical kits, the additional upfront cost for the mobile clinic, and additional costs for staff drive the differences in costs between the two programs. Cost estimates are relatively insensitive to patient flow over time.The MUWRP VMMC program improves access for hard to reach, relatively poor, and high-risk rural populations for a cost of $27-$38 per VMMC. Costs to patients to access services are almost certainly less in the mobile program, by reducing out-of-pocket travel expenses and lost time and associated income, all of which have been shown to be barriers for accessing treatment.

  14. A Comparative Study of Circumcision and Preputioplasty in Pediatric Cases of Phimosis: A Prospective Study in a Tertiary Care Hospital, Bhavnagar, Gujarat

    OpenAIRE

    Verma Arvind Kumar; Hathila Tejas N; Bhimani Sachin; Rajan Somani; Rupani Mihir P

    2014-01-01

    "Introduction: Preputioplasty have gained a new interest now days because the retained preputial skin with mucosa after preputioplasty gives good cosmetic appearance and it can be utilized in future for urethral stricture surgery. The aim of this study was to compare the post-operative complications and post-operative hospital stay in patients operated by circumcision and preputioplasty. Methodology: This prospective study included 50 patients (age less than 4 years) having phimosis, treat...

  15. The PrePex device is unlikely to achieve cost-savings compared to the forceps-guided method in male circumcision programs in sub-Saharan Africa.

    Directory of Open Access Journals (Sweden)

    Walter Obiero

    Full Text Available BACKGROUND: Male circumcision (MC reduces the risk of heterosexual HIV acquisition in men by approximately 60%. MC programs for HIV prevention are currently being scaled-up in fourteen countries in sub-Saharan Africa. The current standard surgical technique for MC in many sub-Saharan African countries is the forceps-guided male circumcision (FGMC method. The PrePex male circumcision (PMC method could replace FGMC and potentially reduce MC programming costs. We compared the potential costs of introducing the PrePex device into MC programming to the cost of the forceps-guided method. METHODS: Data were obtained from the Nyanza Reproductive Health Society (NRHS, an MC service delivery organization in Kenya, and from the Kenya Ministry of Health. Analyses are based on 48,265 MC procedures performed in four Districts in western Kenya from 2009 through 2011. Data were entered into the WHO/UNAIDS Decision Makers Program Planning Tool. The tool assesses direct and indirect costs of MC programming. Various sensitivity analyses were performed. Costs were discounted at an annual rate of 6% and are presented in United States Dollars. RESULTS: Not including the costs of the PrePex device or referral costs for men with phimosis/tight foreskin, the costs of one MC surgery were $44.54-$49.02 and $54.52-$55.29 for PMC and FGMC, respectively. CONCLUSION: The PrePex device is unlikely to result in significant cost-savings in comparison to the forceps-guided method. MC programmers should target other aspects of the male circumcision minimum package for improved cost efficiency.

  16. Surgical Efficiencies and Quality in the Performance of Voluntary Medical Male Circumcision (VMMC) Procedures in Kenya, South Africa, Tanzania, and Zimbabwe

    OpenAIRE

    Dino Rech; Bertrand, Jane T; Nicholas Thomas; Margaret Farrell; Jason Reed; Sasha Frade; Christopher Samkange; Walter Obiero; Kawango Agot; Hally Mahler; Delivette Castor; Emmanuel Njeuhmeli

    2014-01-01

    INTRODUCTION: This analysis explores the association between elements of surgical efficiency in voluntary medical male circumcision (VMMC), quality of surgical technique, and the amount of time required to conduct VMMC procedures in actual field settings. Efficiency outcomes are defined in terms of the primary provider's time with the client (PPTC) and total elapsed operating time (TEOT). METHODS: Two serial cross-sectional surveys of VMMC sites were conducted in Kenya, Republic of South Afri...

  17. Normal Female Reproductive Anatomy

    Science.gov (United States)

    ... historical Searches are case-insensitive Reproductive System, Female, Anatomy Add to My Pictures View /Download : Small: 720x756 ... Large: 3000x3150 View Download Title: Reproductive System, Female, Anatomy Description: Anatomy of the female reproductive system; drawing ...

  18. Female Pattern Alopecia

    Science.gov (United States)

    ... rashes clinical tools newsletter | contact Share | Hair Loss, Female Pattern Baldness (Female Pattern Alopecia) Information for adults A A A In female ... balding only, and studies show no effect for female pattern hair loss. Finasteride, spironolactone, and cyproterone should not be used ...

  19. Female genital mutilation/cutting: risk management and strategies for social workers and health care professionals

    Directory of Open Access Journals (Sweden)

    Costello S

    2015-12-01

    Full Text Available Susan Costello School of Global, Urban and Social Studies, RMIT University, Melbourne, VIC, Australia Abstract: Female genital mutilation/cutting (FGM/C is a traditional practice originating in Africa. Its worst forms cause irreparable harm to girls and women and have no medical justification. Based on a literature review of global responses to FGM/C and conversations with Australian women who migrated from FGM/C practicing countries, this paper provides some background on FGM/C and its epidemiology, outlining its prevalence, types, and health risks and complications for women and girls. It discusses risk-prevention strategies, first, for health practitioners in identifying, screening, and supporting women affected by FGM/C and, second, for welfare and social workers and health care professionals to identify, work with, and prevent girls from being cut. Consistent with international trends in addressing the risks of FGM/C, the paper suggests practice responses for coordinated responses between professionals, communities from practicing countries, and governments of different countries. Keywords: female genital mutilation, female genital cutting, female circumcision, child protection, risk management 

  20. Female genital cutting: an evidence-based approach to clinical management for the primary care physician.

    Science.gov (United States)

    Hearst, Adelaide A; Molnar, Alexandra M

    2013-06-01

    The United States has more than 1.5 million immigrants from countries in Africa and the Middle East where female genital cutting (FGC) is known to occur. Often, FGC occurs in infancy and childhood in the countries where it is practiced, but patients of any age can present with complications. Lack of understanding of this common problem can potentially alienate and lower quality of care for this patient population. We provide an introduction to the practice of FGC and practice guidelines for the primary care physician. We reviewed original research, population-based studies, and legal research from PubMed, Scopus, CINAHL plus, PsycINFO, and Legal Trac. The terms searched included female genital cutting, female genital circumcision, and female genital mutilation alone and with the term complications or health consequences; no limit on date published. Legal databases were searched using the above terms, as well as international law and immigration law. Editorials and review articles were excluded. This review discusses the different types of FGC, important cultural considerations for physicians caring for patients with FGC, the common early and late medical complications and their management, and psychosocial issues associated with FGC. Current laws pertaining to FGC are briefly reviewed, as well as implications for patients seeking asylum status in the United States because of FGC. Finally, the article presents evidence-based, culturally sensitive approaches to discussions of FGC with girls and women for whom this is an issue. PMID:23726401

  1. Voluntary medical male circumcision: a framework analysis of policy and program implementation in eastern and southern Africa.

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    Kim E Dickson

    2011-11-01

    Full Text Available BACKGROUND: Following confirmation of the effectiveness of voluntary medical male circumcision (VMMC for HIV prevention, the World Health Organization and the Joint United Nations Programme on HIV/AIDS issued recommendations in 2007. Less than 5 y later, priority countries are at different stages of program scale-up. This paper analyzes the progress towards the scale-up of VMMC programs. It analyzes the adoption of VMMC as an additional HIV prevention strategy and explores the factors may have expedited or hindered the adoption of policies and initial program implementation in priority countries to date. METHODS AND FINDINGS: VMMCs performed in priority countries between 2008 and 2010 were recorded and used to classify countries into five adopter categories according to the Diffusion of Innovations framework. The main predictors of VMMC program adoption were determined and factors influencing subsequent scale-up explored. By the end of 2010, over 550,000 VMMCs had been performed, representing approximately 3% of the target coverage level in priority countries. The "early adopter" countries developed national VMMC policies and initiated VMMC program implementation soon after the release of the WHO recommendations. However, based on modeling using the Decision Makers' Program Planning Tool (DMPPT, only Kenya appears to be on track towards achievement of the DMPPT-estimated 80% coverage goal by 2015, having already achieved 61.5% of the DMPPT target. None of the other countries appear to be on track to achieve their targets. Potential predicators of early adoption of male circumcision programs include having a VMMC focal person, establishing a national policy, having an operational strategy, and the establishment of a pilot program. CONCLUSIONS: Early adoption of VMMC policies did not necessarily result in rapid program scale-up. A key lesson is the importance of not only being ready to adopt a new intervention but also ensuring that factors

  2. Female genital mutilation in African and African American women's literature

    Directory of Open Access Journals (Sweden)

    Darja Marinšek

    2007-12-01

    Full Text Available The article builds on the existing dispute between African and African American women writers on the competence of writing about female genital mutilation (FGM, and tries to determine the existence and nature of the differences between the writings of these two groups. The author uses comparative analysis of two popular African and African American novels, comparing their ways of describing FGM, its causes and consequences, the level ob objectivity and the style of the narrations.This is followed by a discussion on the reasons for such differences, incorporating a larger circle of both African and African American women authors, at the same time analysing the deviance within the two groups. While the differences between African American writers are not that great, as they mostly fail to present the issue from different points of view, which is often the result of their lack of direct knowledge of the topic, African authors' writing is in itself discovered to be ambivalent and not at all invariable. The reasons for such ambivalence are then discussed in greater context, focusing on the effect of the authors' personal contact with circumcision as well as their knowledge and acceptance of Western values. The author concludes by establishing the African ambivalent attitude towards FGM, which includes different aspects of the issue, as the most significant difference between their and African American writers' description of this practice.

  3. An overview of female genital mutilation in Nigeria.

    Science.gov (United States)

    Okeke, Tc; Anyaehie, Usb; Ezenyeaku, Cck

    2012-01-01

    Nigeria, due to its large population, has the highest absolute number of female genital mutilation (FGM) worldwide, accounting for about one-quarter of the estimated 115-130 million circumcised women in the world. The objective of this review is to ascertain the current status of FGM in Nigeria. Pertinent literature on FGM retrieved from internet services [Google search on FGM in Nigeria, www.online Nigeria, PubMed of the national library of medicine www.medconsumer. Info/tropics/fgm.htm, Biomedcentral and African Journal Online (AJOL) (FGM)] and textbooks, journals, and selected references for proper understanding of the topic was included in this review. The national prevalence rate of FGM is 41% among adult women. Evidence abound that the prevalence of FGM is declining. The ongoing drive to eradicate FGM is tackled by World Health Organization, United Nations International Children Emergency Fund, Federation of International Obstetrics and Gynecology (FIGO), African Union, The economic commission for Africa, and many women organizations. However, there is no federal law banning FGM in Nigeria. There is need to eradicate FGM in Nigeria. Education of the general public at all levels with emphasis on the dangers and undesirability of FGM is paramount. PMID:23209995

  4. A Cross Sectional Study of the Prevalence of Preputial and Penile Scrotal Abnormalities among Clients Undergoing Voluntary Medical Male Circumcision in Soweto, South Africa

    Science.gov (United States)

    Mukudu, Hillary; Otwombe, Kennedy; Laher, Fatima; Lazarus, Erica; Manentsa, Mmatsie; Lebina, Limakatso; Mapulanga, Victor; Bowa, Kasonde; Martinson, Neil

    2016-01-01

    Objective Medical device use is currently approved for males without preputial or major penile scrotal abnormalities for voluntary medical male circumcision (VMMC). We determined the prevalence of preputial abnormalities at a busy VMMC centre in Soweto, South Africa. Methods This was a cross-sectional record review at a high-volume VMMC centre in South Africa. We collated pre-circumcision demographic and genital examination findings from clients 8 years and older who had undergone VMMC from 01 May 2013 to 30 April 2014. Logistic regression was used to determine factors associated with preputial abnormalities. Findings During the review period, 6861 circumcisions were conducted and 37.1% (n = 2543) were 8–13 year olds. Median age was 15 years (IQR: 12–23 years). Fifteen percent (n = 1030) had preputial abnormalities or major penile scrotal abnormalities. Age-specific prevalence of preputial or major genital abnormalities were 27.3%, 10.6% and 6.0% in 8–13, 14–18 and > 18 year olds respectively. The odds of preputial or major penile scrotal abnormality were higher in younger clients aged 8–13 years (OR = 5.9; 95% CI = 4.8–7.1) and 14–18 years (OR = 1.9; 95% CI = 1.5–2.4) compared to older clients above18 years and in those testing for HIV outside our clinic network (OR = 1.9; 95% CI = 1.4–2.7). Conclusion The high prevalence of preputial and penile scrotal abnormalities observed suggests a need for VMMC sites to provide for both open surgical and devices methods in the provision of VMMC services. This is especially so among young male subjects presenting themselves for VMMC services at the various sites being developed in sub Saharan African countries. PMID:27253372

  5. Female reproductive disorders

    DEFF Research Database (Denmark)

    Crain, D Andrew; Janssen, Sarah J; Edwards, Thea M;

    2008-01-01

    To evaluate the possible role of endocrine-disrupting compounds (EDCs) on female reproductive disorders emphasizing developmental plasticity and the complexity of endocrine-dependent ontogeny of reproductive organs. Declining conception rates and the high incidence of female reproductive...

  6. Female Reproductive System

    Science.gov (United States)

    ... Tract External Genitalia Female Sexual Response & Hormone Control Mammary Glands Review Quiz Site-specific Modules Resources Archived Modules ... External Genitalia Female Sexual Response and Hormonal Control Mammary Glands « Previous (Male Sexual Response & Hormone Control) Next (Ovaries) » ...

  7. “Man, what took you so long?” Social and individual factors affecting adult attendance at voluntary medical male circumcision services in Tanzania

    OpenAIRE

    Plotkin, Marya; Castor, Delivette; Mziray, Hawa; Küver, Jan; Mpuya, Ezekiel; Luvanda, Paul James; Hellar, Augustino; Curran, Kelly; Lukobo-Durell, Mainza; Ashengo, Tigistu Adamu; Mahler, Hally

    2013-01-01

    ABSTRACT Background: In 2009, the Government of Tanzania embarked on scaling up voluntary medical male circumcision (VMMC) services for HIV prevention in 8 priority regions, with the aim of serving 2.8 million boys and men ages 10–34 years by 2013. By mid-2012, more than 110,000 boys and men in Iringa and Njombe regions had received VMMC. The majority (85%) of these VMMC clients were under 19 years old (average age, 16 years). This study aimed to identify potential barriers and facilitators t...

  8. Female reproductive disorders

    DEFF Research Database (Denmark)

    Crain, D Andrew; Janssen, Sarah J; Edwards, Thea M; Heindel, Jerrold; Ho, Shuk-mei; Hunt, Patricia; Iguchi, Taisen; Juul, Anders; McLachlan, John A; Schwartz, Jackie; Skakkebaek, Niels; Soto, Ana M; Swan, Shanna; Walker, Cheryl; Woodruff, Teresa K; Woodruff, Tracey J; Giudice, Linda C; Guillette, Louis J

    2008-01-01

    To evaluate the possible role of endocrine-disrupting compounds (EDCs) on female reproductive disorders emphasizing developmental plasticity and the complexity of endocrine-dependent ontogeny of reproductive organs. Declining conception rates and the high incidence of female reproductive...... disruptions warrant evaluation of the impact of EDCs on female reproductive health....

  9. Female genital mutilation/cutting and issues of sexuality in Egypt.

    Science.gov (United States)

    Fahmy, Amel; El-Mouelhy, Mawaheb T; Ragab, Ahmed R

    2010-11-01

    Female genital mutilation/cutting (FGM/C), officially referred to as female circumcision and at community level as tahara (cleanliness), is still prevalent in Egypt. This study was designed to examine the role of female sexuality in women's and men's continued support for FGM/C, and their perceptions of its sexual consequences. The study was conducted in 2008-09 in two rural communities in Upper Egypt and a large slum area in Cairo. Qualitative data were collected from 102 women and 99 men through focus group discussions and interviews. The clitoris was perceived to be important to, and a source of, sexual desire rather than sexual pleasure. FGM/C was intended to reduce women's sexual appetite and increase women's chastity, but was generally not believed to reduce women's sexual pleasure. Men and women framed sexual pleasure differently, however. While men, especially younger men, considered sexual satisfaction as a cornerstone of marital happiness, women considered themselves sexually satisfied if there was marital harmony and their socio-economic situation was satisfactory. However, sexual problems, including lack of pleasure in sex and sexual dissatisfaction, for whatever reasons, were widespread. We conclude that political commitment is necessary to combat FGM/C and that legal measures must be combined with comprehensive sexuality education, including on misconceptions about FGM/C. PMID:21111362

  10. Are Female Supervisors More Female-Friendly?

    OpenAIRE

    Steven Bednar; Dora Gicheva

    2014-01-01

    We introduce the idea that easily inferable demographic characteristics such as gender may not be sufficient to define type in the supervisor-employee mentoring relationship. We use longitudinal data on athletic directors at NCAA Division I programs to identify through observed mobility the propensity of top-level administrators to hire and retain female head coaches, above and beyond an organization's culture. We show that supervisor gender appears to be unrelated to female friendliness in t...

  11. Silencing women's sexuality: global AIDS policies and the case of the female condom

    Directory of Open Access Journals (Sweden)

    Anny JTP Peters

    2013-07-01

    Full Text Available Introduction: The female condom is the only evidence-based AIDS prevention technology that has been designed for the female body; yet, most women do not have access to it. This is remarkable since women constitute the majority of all HIV-positive people living in sub-Saharan Africa, and gender inequality is seen as a driving force of the AIDS epidemic. In this study, we analyze how major actors in the AIDS prevention field frame the AIDS problem, in particular the female condom in comparison to other prevention technologies, in their discourse and policy formulations. Our aim is to gain insight into the discursive power mechanisms that underlie the thinking about AIDS prevention and women's sexual agency. Methods: We analyze the AIDS policies of 16 agencies that constitute the most influential actors in the global response to AIDS. Our study unravels the discursive power of these global AIDS policy actors, when promoting and making choices between AIDS prevention technologies. We conducted both a quantitative and qualitative analysis of how the global AIDS epidemic is being addressed by them, in framing the AIDS problem, labelling of different categories of people for targeting AIDS prevention programmes and in gender marking of AIDS prevention technologies. Results: We found that global AIDS policy actors frame the AIDS problem predominantly in the context of gender and reproductive health, rather than that of sexuality and sexual rights. Men's sexual agency is treated differently from women's sexual agency. An example of such differentiation and of gender marking is shown by contrasting the framing and labelling of male circumcision as an intervention aimed at the prevention of HIV with that of the female condom. Conclusions: The gender-stereotyped global AIDS policy discourse negates women's agency in sexuality and their sexual rights. This could be an important factor in limiting the scale-up of female condom programmes and hampering

  12. Withstanding trauma: the significance of Emma Eckstein's circumcision to Freud's Irma dream.

    Science.gov (United States)

    Bonomi, Carlo

    2013-07-01

    The author considers the medical rationale for Wilhelm Fliess's operation on Emma Eckstein's nose in February 1895 and interprets the possible role that this played in Freud's dream of Irma's injection five months later. The author's main argument is that Emma likely endured female castration as a child and that she therefore experienced the surgery to her nose in 1895 as a retraumatization of her childhood trauma. The author further argues that Freud's unconscious identification with Emma, which broke through in his dream of Irma's injection with resistances and apotropaic defenses, served to accentuate his own "masculine protest". The understanding brought to light by the present interpretation of Freud's Irma dream, when coupled with our previous knowledge of Freud, allows us to better grasp the unconscious logic and origins of psychoanalysis itself.(1.) PMID:23824652

  13. Circumcision with “no-flip Shang Ring” and “Dorsal Slit” methods for adult males: a single-centered, prospective, clinical study

    Science.gov (United States)

    Lei, Jun-Hao; Liu, Liang-Ren; Wei, Qiang; Xue, Wen-Ben; Song, Tu-Run; Yan, Shi-Bing; Yang, Lu; Han, Ping; Zhu, Yu-Chun

    2016-01-01

    This paper was aimed to compare the clinical effectiveness and safety of adult male circumcision using the Shang Ring™ (SR) with the no-flip technique compared with Dorsal Slit (DS) surgical method. A single-centered, prospective study was conducted at the West China Hospital, where patients were circumcised using the no-flip SR (n = 408) or the DS (n = 94) procedure. The adverse events (AEs) and satisfaction were recorded for both groups, and ring-removal time and percentage of delayed removals were recorded for the SR group. Finally, complete follow-up data were collected for 76.1% of patients (SR: n = 306; DS: n = 76). The average ring-removal time for the SR group was 17.62 ± 6.30 days. The operation time (P flip SR method was found to be superior to the DS method for its short operation time (<5 min), involving less pain, bleeding, infection, and resulting in a satisfactory appearance. However, the time for recovery from edema took longer, and patients may wear device for 2–3 weeks after the procedure. PMID:26585694

  14. Female Pattern Hair Loss

    OpenAIRE

    Herskovitz, Ingrid; Tosti, Antonella

    2013-01-01

    Context: Female pattern hair loss (FPHL) also known as female androgenetic alopecia is a common condition afflicting millions of women that can be cosmetically disrupting. Prompt diagnosis and treatment are essential for obtaining optimal outcome. This review addresses the clinical presentation of female pattern hair loss, its differential diagnosis and treatment modalities. Evidence Acquisition: A) Diffuse thinning of the crown region with preservation of the frontal hairline (Ludwig’s type)...

  15. Female Athlete Triad

    Science.gov (United States)

    ... periods Learn more about healthy eating habits and healthy lifestyle choices Other Organizations Female Athlete Triad Coalition Questions to Ask Your Doctor ... female athlete triad? How do I strike a balance between my desire to be healthy and my desire to win? Could there be ...

  16. The Female Athlete Triad

    Science.gov (United States)

    Sherman, Roberta Trattner; Thompson, Ron A.

    2004-01-01

    The Female Athlete Triad is a syndrome of the interrelated components of disordered eating, amenorrhea, and osteoporosis. Sometimes inadvertently, but more often by willful dietary restriction, many female athletes do not ingest sufficient calories to adequately fuel their physical or sport activities, which can disrupt menstrual functioning,…

  17. Female Sexuality: An Enigma.

    Science.gov (United States)

    Daniluk, Judith

    1991-01-01

    Describes constructions of sexuality that have occurred within social context in which language, culture, and behavior interact to reinforce male power. Against backdrop of these patriarchal examples of female sexual expression and experience, discusses difficulties of female clients. Addresses critical counseling concerns in terms of contextual…

  18. Female sexual dysfunction in female genital mutilation.

    Science.gov (United States)

    Elneil, Sohier

    2016-01-01

    Female genital mutilation (FGM), otherwise known as female genital cutting (FGC), is currently very topical and has become a significant global political issue. The impact of FGM on the lives of women and girls is enormous, as it often affects both their psychology and physical being. Among the complications that are often under-reported and not always acknowledged is female sexual dysfunction (FSD). FSD presents with a complex of symptoms including lack of libido, arousability and orgasm. This often occurs in tandem with chronic urogenital pain and anatomical disruption due to perineal scarring.To treat FSD in FGM each woman needs specifically directed holistic care, geared to her individual case. This may include psychological support, physiotherapy and, on occasion, reconstructive surgery. In many cases the situation is complicated by symptoms of chronic pelvic pain, which can make treatment increasingly difficult as this issue needs a defined multidisciplinary approach for its effective management in its own right. The problems suffered by women with FGM are wholly preventable, as the practice need not happen. The current global momentum to address the social, cultural, economic and medical issues of FGM is being supported by communities, governments, non-governmental agencies (NGOs) and healthcare providers. It is only by working together that the practice can be abolished and women and girls may be free from this practice and its associated consequences. PMID:26759415

  19. Implementation of adolescent-friendly voluntary medical male circumcision using a school based recruitment program in rural KwaZulu-Natal, South Africa.

    Directory of Open Access Journals (Sweden)

    Carl Montague

    Full Text Available BACKGROUND: Epidemiological data from South Africa demonstrate that risk of human immunodeficiency virus (HIV infection in males increases dramatically after adolescence. Targeting adolescent HIV-negative males may be an efficient and cost-effective means of maximising the established HIV prevention benefits of voluntary medical male circumcision (VMMC in high HIV prevalence-, low circumcision practice-settings. This study assessed the feasibility of recruiting male high school students for VMMC in such a setting in rural KwaZulu-Natal. METHODS AND FINDINGS: Following community and key stakeholder consultations on the acceptability of VMMC recruitment through schools, information and awareness raising sessions were held in 42 high schools in Vulindlela. A three-phase VMMC demand-creation strategy was implemented in partnership with a local non-governmental organization, ZimnadiZonke, that involved: (i community consultation and engagement; (ii in-school VMMC awareness sessions and centralized HIV counselling and testing (HCT service access; and (iii peer recruitment and decentralized HCT service access. Transport was provided for volunteers to the Centre for the AIDS Programme of Research in South Africa (CAPRISA clinic where the forceps-guided VMMC procedure was performed on consenting HIV-negative males. HIV infected volunteers were referred to further care either at the CAPRISA clinic or at public sector clinics. Between March 2011 and February 2013, a total of 5165 circumcisions were performed, the majority (71% in males aged between 15 and 19 years. Demand-creation strategies were associated with an over five-fold increase in VMMC uptake from an average of 58 procedures/month in initial community engagement phases, to an average of 308 procedures/month on initiation of the peer recruitment-decentralized service phase. Post-operative adverse events were rare (1.2%, mostly minor and self-resolving. CONCLUSIONS: Optimizing a high volume

  20. Understanding the female offender.

    Science.gov (United States)

    Cauffman, Elizabeth

    2008-01-01

    Although boys engage in more delinquent and criminal acts than do girls, female delinquency is on the rise. In 1980, boys were four times as likely as girls to be arrested; today they are only twice as likely to be arrested. In this article, Elizabeth Cauffman explores how the juvenile justice system is and should be responding to the adolescent female offender. Cauffman begins by reviewing historical trends in arrest rates, processing, and juvenile justice system experiences of female offenders. She also describes the adult outcomes commonly observed for female offenders and points out that the long-term consequences of offending for females are often more pronounced than those for males, with effects that extend to the next generation. She also considers common patterns of offending in girls, as well as factors that may increase or decrease the likelihood of offending. She then reviews what is known about effective treatment strategies for female offenders. Female delinquents have a high frequency of mental health problems, suggesting that effective prevention efforts should target the mental health needs of at-risk females before they lead to chronic behavior problems. Once girls with mental health problems come into the juvenile justice system, says Cauffman, diverting them to community-based treatment programs would not only improve their individual outcomes, but allow the juvenile justice system to focus on cases that present the greatest risk to public safety. Evidence is emerging that gender-specific treatment methods can be effective for female offenders, especially when treatment targets multiple aspects of offenders' lives, including family and peer environments. But it is also becoming clear that female offenders are not a homogeneous group and that treatment ultimately should be tailored to suit individual needs defined more specifically than by gender alone. Despite myriad differences between male and female offending, many of the primary causes of

  1. 阴茎中部无针麻醉袖套式包皮环切治疗包皮过长%Mid-Penis Sleeve Circumcision with Needle-Free Jet Anaesthesia for the treatment of patients with redundant prepuce

    Institute of Scientific and Technical Information of China (English)

    张伟; 申岩; 杨文增; 穆银静; 崔振宇

    2011-01-01

    Objectives To investigate mid-penis sleeve circumcision with needle-free jet anaesthesia for the treatment of patients with redundant prepuce and observe the therapeutic effect.Methods Methods outpatient circumcision 80 cases with DPNB(dorsal of penis nerve blocked)anaesthesia were randomly divided into two groups,group A(40 cases)was underwent mid-penis sleeve circumcision with needle-free jet anaesthesia,group B(40cases)was done dorsal slit circumcision with traditional DPNB,to study the difference in Anaesthetic Volume,the time of take effect,visual analogue scale(VAS),bleeding voluroue,the condition of foreskin hydropsia,operative incision healing.appearance satisfication percentage.Results Group A has statistical difference to Group B in all ahove mentioned index.Conclusions Mid-penis sleeve circumcision with needle-free jet anaesthesia has many advantages over the dorsal slit circumcision with traditional DPNB,deserving generally clinical application.%目的 探讨阴攀中部无针麻醉袖套式包皮环切治疗包皮过长的效果.方法 选择包皮过长患者105例,随机分成A,B两组,A组40例,行阴茎中部无针麻醉袖套式包皮环切术,8组40例行传统阻滞麻醉及背侧切开环切术.对两组在麻醉剂量、起效时间、视觉模拟麻醉疼痛评分、出血量、水肿、切口愈合、外观满意度等方面进行比较.结果两组所有对比项目在两组之间的差异均有统计学意义.结论 阴茎中部无针麻醉袖套式包皮切除治疗包皮过长比传统阻滞麻醉及背侧切开环切术更具有优越性,值得临床推广.

  2. Fertility Preservation for Female

    Institute of Scientific and Technical Information of China (English)

    Jack Huang; Seang Lin Tan; Ri-Cheng Chian

    2006-01-01

    Preservation of female fertility is an important issue today. However, there are few effective clinical options for preserving female fertility. Firstly, conventional in vitro fertilization (IVF) followed by embryo cryopreservation is an accepted procedure but is not applicable to all women. Embryo freezing is suitable only for women with a male partner and may not be acceptable to some patients due to moral and religious reasons. Ovarian tissue freezing is another option of female fertility preservation but is an invasive procedure and the efficacy of this technique remains to be determined.Oocyte cryopreservation is also method for fertility preservation. Egg freezing is minimally invasive and can avoid the ethical and moral concerns related to cryopreservation of embryos. However, conventional slow freezing/rapid thawing methods are associated with low survival of oocytes. Recent development in vitrification of oocytes appears promising. Therefore, vitrification of unfertilized eggs may be a novel method to preserve female fertility.

  3. Self catheterization - female

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000144.htm Self catheterization - female To use the sharing features on ... incontinence - vaginal sling procedures Patient Instructions Kegel exercises - self-care Multiple sclerosis - discharge Stroke - discharge Urinary catheters - ...

  4. Impact on Females

    Science.gov (United States)

    ... High Blood Pressure Tools & Resources Stroke More CHD's Impact on Females Updated:Apr 19,2016 While most ... Surgery? What is a Stress Test? More The Impact of Congenital Heart Defects • Home • About Congenital Heart ...

  5. Female pattern baldness

    Science.gov (United States)

    Alopecia in women; Baldness - female; Hair loss in women; Androgenetic alopecia in women ... which happens to everyone as time passes. The hair loss rarely progresses to total or near total baldness, ...

  6. Female pattern hair loss

    Directory of Open Access Journals (Sweden)

    İdil Ünal

    2014-06-01

    Full Text Available Female androgenetic alopecia is the commonest cause of hair loss in women. It is characterized by a diffuse reduction in hair density over the crown and frontal scalp with retention of the frontal hairline and a characteristic pattern distribution in genetically predisposed women. Because of the uncertain relationship with the androgens Female Pattern Hair Loss (FPHL is the most preferred definition of the condition. This review has been focused on the clinical features, diagnosis and treatment alternatives of FPHL.

  7. Female pattern hair loss

    OpenAIRE

    İdil Ünal

    2014-01-01

    Female androgenetic alopecia is the commonest cause of hair loss in women. It is characterized by a diffuse reduction in hair density over the crown and frontal scalp with retention of the frontal hairline and a characteristic pattern distribution in genetically predisposed women. Because of the uncertain relationship with the androgens Female Pattern Hair Loss (FPHL) is the most preferred definition of the condition. This review has been focused on the clinical features, diagnosis and treatm...

  8. Postadolescent acne in females.

    Science.gov (United States)

    Holzmann, R; Shakery, K

    2014-01-01

    Acne in the adult female often presents as a chronic condition that can have a considerable negative psychological, social and emotional impact on the affected individual. Estimated prevalence rates of adult female acne vary widely according to study type. Case reports and clinical examinations estimate the prevalence of clinical acne at 10-12%, while survey estimates of physiological disease states are as high as 54%. Two subtypes of adult female acne may be defined according to time of onset: 'persistent' and 'late-onset', accounting for approximately 80 and 20% of cases, respectively. Postadolescent acne is generally mild-to-moderate in severity and presents with more inflammatory lesions and fewer comedones compared to adolescent acne. Furthermore, the impact of acne on the quality of life is often greater in adult females than in younger individuals. Despite these important differences, the key principles of acne treatment in the adult female do not differ significantly from those of other age groups. However, specific characteristics relating to the adult female should be considered when selecting a treatment regimen. PMID:24280643

  9. Female physicist doctoral experiences

    Science.gov (United States)

    Dabney, Katherine P.; Tai, Robert H.

    2013-06-01

    The underrepresentation of women in physics doctorate programs and in tenured academic positions indicates a need to evaluate what may influence their career choice and persistence. This qualitative paper examines eleven females in physics doctoral programs and professional science positions in order to provide a more thorough understanding of why and how women make career choices based on aspects both inside and outside of school and their subsequent interaction. Results indicate that female physicists experience conflict in achieving balance within their graduate school experiences and personal lives and that this then influences their view of their future careers and possible career choices. Female physicists report both early and long-term support outside of school by family, and later departmental support, as being essential to their persistence within the field. A greater focus on informal and out-of-school science activities for females, especially those that involve family members, early in life may help influence their entrance into a physics career later in life. Departmental support, through advisers, mentors, peers, and women’s support groups, with a focus on work-life balance can help females to complete graduate school and persist into an academic career.

  10. Violent female offenders

    Directory of Open Access Journals (Sweden)

    Ismael Loinaz

    2014-12-01

    Full Text Available Female violent offending is an understudied topic in Spanish-speaking countries. This review explores themajor research findings accumulated internationally over the last decade (2003-2013 about women'sviolence and crimes. The focus of the review is the intimate partner violence (IPV and sexual violencecommitted by females, the psychopathy and violence risk assessment, and the treatment and recidivism ofthese female offenders. Although the female offender topic is too wide to review all crime typologies (childphysical abuse is not included, for example the review indicates that: there are legal and police biases inthe treatment of women offenders; women can commit the same IPV and share the motivations of maleoffenders; sexual violence has a low prevalence, but there are many limitations in this research topic;predicting the risk of non-specific violence is feasible with the available tools; psychopathy is less prevalentamong adult female offenders, although there are fewer differences with male offenders among adolescentsamples; research about treatments is very limited and there are not effectiveness evidences; and last,recidivism rates for violent crimes are very low (in cases where information is available. Main implicationsand research lines are discussed.

  11. Female athlete triad update.

    Science.gov (United States)

    Beals, Katherine A; Meyer, Nanna L

    2007-01-01

    The passage of Title IX legislation in 1972 provided enormous opportunities for women to reap the benefits of sports participation. For most female athletes, sports participation is a positive experience, providing improved physical fitness, enhanced self-esteem, and better physical and mental health. Nonetheless, for a few female athletes, the desire for athletic success combined with the pressure to achieve a prescribed body weight may lead to the development of a triad of medical disorders including disordered eating, menstrual dysfunction, and low bone mineral density (BMD)--known collectively as the female athlete triad. Alone or in combination, the disorders of the triad can have a negative impact on health and impair athletic performance. PMID:17241915

  12. Female hair restoration.

    Science.gov (United States)

    Unger, Robin H

    2013-08-01

    Female hair loss is a devastating issue for women that has only relatively recently been publicly acknowledged as a significant problem. Hair transplant surgery is extremely successful in correcting the most cosmetically problematic areas of alopecia. This article discusses the surgical technique of hair transplantation in women in detail, including pearls to reduce postoperative sequelae and planning strategies to ensure a high degree of patient satisfaction. A brief overview of some of the medical treatments found to be helpful in slowing or reversing female pattern hair loss is included, addressing the available hormonal and topical treatments. PMID:24017982

  13. Perspectives on Female Entrepreneurs

    DEFF Research Database (Denmark)

    Kuada, John Ernest; Janulevièienë, Rûta

    2003-01-01

    The aim of this paper is to compare the contents of the academic evidence and debate on female entrepreneurship in the West with the current stream of research and thinking in the Central and Eastern European Countries with a view to identifying similarities and differences in thoughts and findin...

  14. Female Reproductive System.

    Science.gov (United States)

    Hodge, N. J.

    This autoinstructional lesson can be used with health education and/or biology classes in a high school curriculum. It deals with the study of human development with emphasis on the female reproductive organs and cycles. The behavioral objectives are given, and the materials and equipment needed to gain these objectives are itemized. Fifteen…

  15. Female Genital Mutilation

    Science.gov (United States)

    ... problems (depression, anxiety, post-traumatic stress disorder, low self-esteem, etc.). Health complications of female genital mutilation Who is at risk? Procedures are mostly carried out on young girls sometime between infancy and adolescence, and occasionally on adult women. More than 3 ...

  16. Female Genital Cutting: shattering the debate yet still violating human rights

    Directory of Open Access Journals (Sweden)

    Celine Jacquemin

    2010-04-01

    Full Text Available

    Summary: The international fight against the various forms of female circumcision, or the mutilation of the genitals of women and children, has many different aspects. Although no religious text from any religion suggests the practice, still in many countries the torture of young girls and women continue. Even though there is an assumption that the phenomenon is exclusive to the developing world, many practices in the West, such as vaginal and vulvar surgeries, as well as changes to the face and body of women can be included in the same tendency to portray women as impure, incomplete, and in need of improvement so that she can be accepted by prospective husbands.

  17. Intention toward the continuation of female genital mutilation in Bale Zone, Ethiopia

    Directory of Open Access Journals (Sweden)

    Bogale D

    2015-01-01

    Full Text Available Daniel Bogale,1 Desalegn Markos,2 Muhammedawel Kaso1 1Department of Public Health, 2Department of Nursing, College of Medicine and Health Sciences, Madawalabu University, Bale Goba, Ethiopia Background: Female genital mutilation (FGM is a harmful traditional practice that is deeply rooted in Africa. It is associated with health complications and human rights violations. Research on intention for the continuation of FGM and the social determinants underpinning this practice are scarce. Therefore, this study intended to assess the intention of women toward the continuation of FGM among Bale Zone reproductive-age women.Methods: A community-based cross-sectional study design supplemented by qualitative methods was conducted in 2014. A total of 634 reproductive-age women were involved in the quantitative part of the study. The respondents were drawn from five randomly selected districts of Bale Zone. The total sample was allocated proportionally to each district based on the number of reproductive-age women it has. Purposive sampling method was used for qualitative study. Then, data were collected using a pretested and structured questionnaire. The collected data were analyzed by Statistical Package for Social Sciences for Windows version 16.0. Multiple logistic regressions were carried out to examine the existence of a relationship between intentions for the continuation of FGM and selected determinant factors.Results: This study revealed that 26.7% of the respondents had intention for the continuation of FGM. Religion, safeguarding virginity, tradition, and social values were the major reasons for the perpetuation of this practice. Circumcised respondents and those who were not able to read and write were ~3 (adjusted odds ratio = 2.89, 95% confidence interval = [1.33, 6.20] and 7.58 (adjusted odds ratio = 7.58, 95% confidence interval = [3.47, 16.54] times more likely intending the continuation of FGM than uncircumcised and those who

  18. Sequential Cross-Sectional Surveys in Orange Farm, a Township of South Africa, Revealed a Constant Low Voluntary Medical Male Circumcision Uptake among Adults despite Demand Creation Campaigns and High Acceptability

    Science.gov (United States)

    Marshall, Esaie; Rain-Taljaard, Reathe; Tsepe, Motlalepule; Monkwe, Cornelius; Hlatswayo, Florence; Tshabalala, Simphiwe; Khela, Simphiwe; Xulu, Lindo; Xaba, Dumazile; Molomo, Tebogo; Malinga, Thobile; Puren, Adrian; Auvert, Bertran

    2016-01-01

    Background WHO recommends a male circumcision (MC) prevalence rate higher than 80% to have a substantial impact on the HIV-AIDS epidemic in Eastern and Southern Africa. Orange Farm, a township in South Africa, has a free-for-service voluntary medical male circumcision (VMMC) clinic in operation since 2008. Following an intense campaign from 2008 to 2010, MC prevalence rate increased to 55.4% (ANRS-12126). Ongoing and past VMMC campaigns focused on youths, through school talks, and adults at a community level. The main objective of the study was to assess the change in MC prevalence rate among adults aged 18–19 and 18–49 years in the past 5 years. Methods A cross-sectional survey (ANRS-12285) was conducted among a random sample of 522 adult men in 2015. MC status and characteristics of participants were collected through a genital examination and a face-to-face questionnaire. Results MC prevalence rate among young adult men aged 18–19 years increased markedly from 61.2% (95%CI: 57.4% to 65.0%) in 2010 to 87.5% (76.0% to 94.6%) in 2015 (p<0.001). In the same period, among men aged 18–49 years, MC prevalence rate varied slightly from 55.4% (53.6% to 57.1%) to 56.7% (52.4% to 60.9%). In 2015, 84.9% (79.2% to 89.5%) of uncircumcised adult men reported that they were willing to be circumcised. However, we estimated that only 4.6% (11/237; 2.5% to 7.9%) of the uncircumcised men underwent circumcision in 2015, despite 117/185 (63.2%; 95%CI: 56.1% to 69.9%) who reported that they were definitely willing to become circumcised. Conclusions In Orange Farm, VMMC campaigns were successful among the youth and led to a sufficiently high MC prevalence rate to have a substantial impact in the future on the HIV-AIDS epidemic. However, despite high acceptability and a free VMMC service, VMMC campaigns since 2010 have failed to increase MC prevalence rate among adults to above 80%. These campaigns should be revisited. PMID:27427957

  19. Evaluating the cost of adult voluntary medical male circumcision in a mixed (surgical and PrePex site compared to a hypothetical PrePex-only site in South Africa

    Directory of Open Access Journals (Sweden)

    Hae-Young Kim

    2015-12-01

    Full Text Available Background: Several circumcision devices have been evaluated for a safe and simplified male circumcision among adults. The PrePex device was prequalified for voluntary male medical circumcision (VMMC in May 2013 by the World Health Organization and is expected to simplify the procedure safely while reducing cost. South Africa is scaling up VMMC. Objective: To evaluate the overall unit cost of VMMC at a mixed site vs. a hypothetical PrePex-only site in South Africa. Design: We evaluated the overall unit cost of VMMC at a mixed site where PrePex VMMC procedure was added to routine forceps-guided scalpel-based VMMC in Soweto, South Africa. We abstracted costs and then modeled these costs for a hypothetical PrePex-only site, at which 9,600 PrePex circumcisions per year could be done. We examined cost drivers and modeled costs, varying the price of the PrePex device. The healthcare system perspective was used. Results: In both sites, the main contributors of cost were personnel and consumables. If 10% of all VMMC were by PrePex at the mixed site, the overall costs of the surgical method and PrePex were similar – US$59.62 and $59.53, respectively. At the hypothetical PrePex-only site, the unit cost was US$51.10 with PrePex circumcisions having markedly lower personnel and biohazardous waste management costs. In sensitivity analysis with the cost of PrePex kit reduced to US$10 and $2, the cost of VMMC was further reduced. Conclusions: Adding PrePex to an existing site did not necessarily reduce the overall costs of VMMC. However, starting a new PrePex-only site is feasible and may significantly reduce the overall cost by lowering both personnel and capital costs, thus being cost-effective in the long term. Achieving a lower cost for PrePex will be an important contributor to the scale-up of VMMC.

  20. Crossing borders: discussing the evidence relating to the mental health needs of women exposed to female genital mutilation.

    Science.gov (United States)

    Mulongo, Peggy; McAndrew, Sue; Hollins Martin, Caroline

    2014-08-01

    The terms 'Female Circumcision' (FC), 'FG Cutting' (FGC) and 'FG Mutilation' (FGM) refer to procedures involving the partial or total removal of the external female genitalia for non-medical reasons. In practicing countries, FGC/FC is more widely used, as it is believed to be inoffensive, providing more impartial ways of discussing the practice. Positive beliefs about FC/FGC include virginity, marriage prospects, family reputation, or passage to adulthood. Regardless of terminology, the practice exists in at least 28 African counties, and a few Asian and Middle Eastern countries. In Western society, FGM is considered a breach of human rights, being outlawed in a number of countries. With immigration trends, FGC is now prominent in Western society among practicing communities. While the past decade has seen an increase in studies and recommendations for health-care support related to the physical health consequences of FGM, little is known about the psychological impact and its management. For many girls and women, FGC is a traumatic practice, transforming it to FGM and affecting their mental health. This discussion paper focuses on evidence relating to the mental health consequences of FGM, therapeutic interventions, and the mental health nurse's role in addressing the needs of this group of women. PMID:24548699

  1. Female pattern hair loss

    OpenAIRE

    Archana Singal; Sidharth Sonthalia; Prashant Verma

    2013-01-01

    Female pattern hair loss (FPHL) is a common cause of hair loss in women characterized by diffuse reduction in hair density over the crown and frontal scalp with retention of the frontal hairline. Its prevalence increases with advancing age and is associated with significant psychological morbidity. The pathophysiology of FPHL is still not completely understood and seems to be multifactorial. Although androgens have been implicated, the involvement of androgen-independent mechanisms is evident...

  2. FEMALE ENTREPRENEURSHIP IN AFGHANISTAN

    OpenAIRE

    MAGNUS HOLMÉN; THAW TAR MIN; EMILIA SAARELAINEN

    2011-01-01

    This paper analyzes the motivations of eight female Afghan entrepreneurs to start up their own business and the problems they encountered during start-up and operations. Income generation was the most important push factor but pull factors including desire for independence and autonomy were also important. However, in contrast to studies in other countries, the desire for achievement was not emphasized. An unexpected finding was the emphasis on the desire to help non-family members by running...

  3. Hormones and female sexuality

    OpenAIRE

    Bjelica Artur L.; Kapamadžija Aleksandra; Maticki-Sekulić Milana

    2003-01-01

    Introduction In contrast to animal species in which linear relationships exist between hormonal status and sexual behaviour sexuality in human population is not determined so simply by the level of sexual steroids. The article analyses female sexuality in the light of hormonal status. Administration of sexual steroids during pregnancy and sexual differentiation High doses of gestagens, especially those with high androgen activity, widely used against miscarriages may lead to tomboys, but with...

  4. The safety and acceptance of the PrePex device for non-surgical adult male circumcision in Rakai, Uganda. A non-randomized observational study.

    Directory of Open Access Journals (Sweden)

    Godfrey Kigozi

    Full Text Available OBJECTIVES: To assess the safety and acceptance of the PrePex device for medical male circumcision (MMC in rural Uganda. METHODS: In an observational study, HIV-uninfected, uncircumcised men aged 18 and older who requested elective MMC were informed about the PrePex and dorsal slit methods and offered a free choice of their preferred procedure. 100 men received PrePex to assess preliminary safety (aim 1. An additional 329 men, 250 chose PrePex and 79 chose Dorsal slit, were enrolled following approval by the Safety Monitoring Committee (aim 2. Men were followed up at 7 days to assess adverse events (AEs and to remove the PrePex device. Wound healing was assessed at 4 weeks, with subsequent weekly follow up until completed healing. RESULTS: The PrePex device was contraindicated in 5.7% of men due to a tight prepuce or phimosis/adhesions. Among 429 enrolled men 350 (82.0% got the PrePex device and 79 (18.0% the dorsal slit procedure. 250 of 329 men (76.0% who were invited to choose between the 2 procedures chose Prepex. There were 9 AEs (2.6% with the PrePex, of which 5 (1.4% were severe complications, 4 due to patient self-removal of the device leading to edema and urinary obstruction requiring emergency surgical circumcision, and one due to wound dehiscence following device removal. 71.8% of men reported an unpleasant odor prior to PrePex removal. Cumulative rates of completed wound healing with the PrePex were 56.7% at week 4, 84.8% week 5, 97.6% week 6 and 98.6% week 7, compared to 98.7% at week 4 with dorsal slit (p<0.0001. CONCLUSION: The PrePex device was well accepted, but healing was slower than with dorsal slit surgery. Severe complications, primarily following PrePex self-removal, required rapid access to emergency surgical facilities. The need to return for removal and delayed healing may increase Program cost and client burden.

  5. Evaluation of progress with using community conversation as a strategy to encourage district level abandonment of female genital mutilation and/or cutting in 10 districts in Ethiopia

    Directory of Open Access Journals (Sweden)

    Ellen Alem

    2013-09-01

    Full Text Available Background: Female genital mutilation and/or cutting (FGM/C, whilst widespread, is declining in Ethiopia; 81% of 45–49-year-old women were circumcised in a 2005 survey, and 62%of 15–19-year-olds.Objectives: This evaluation examined progress in abandoning FGM/C in ten woredas(districts where strategy based on the social convention theory had led to official declarations of abandonment and assessed if the strategy could accelerate the declining trend of the FGM/C practice in Ethiopia.Method: Quantitative and qualitative instruments collected data from a document review, a household survey (1275 households, in-depth and key informant interviews and focus group discussions.Results: Overall, there were encouraging results in terms of awareness creation and behavioural change to some extent. Sixty-nine percent of women and 41% of girls interviewed perceived a decline in the practice (range 40% – 90% after the declaration. Seventy-six percent of women said they would not circumcise girls in the future. The involvement of influential people such as religious leaders, elders, health extension workers, and law enforcement officials in the teaching contributed immensely to the awareness creation. However, some districts reports indicated the practice had gone underground. The costs of facilitating the strategy varied from USD 3 to 7 per person, with better results where costs were higher. The abandonment events tended to costaround 25% of total costs, an area where cost efficiency can be improved.Conclusion: The evaluation has informed the dialogue around the development of the country’s first national budgeted strategy that aims to accelerate the abandonment of all harmful traditionalpractices.

  6. Female Athletes Facing Discrimination: Curriculum Regarding Female Athletes.

    Science.gov (United States)

    Palis, Regina

    There continues to be oppression among female athletes, even after the enactment of Title IX in 1972. Female athletes in secondary schools deal with low self-esteem, eating disorders such as anorexia and bulimia, and depression. Female athletes struggle with societal pressures to maintain a model-like figure, while trying to train and perform for…

  7. Female-pattern baldness (image)

    Science.gov (United States)

    Female-pattern baldness is a pattern of hair loss (alopecia) caused by hormones, aging and genetics. Unlike male-pattern baldness, female-pattern baldness is an over-all thinning which maintains the ...

  8. [Facial femalization in transgenders].

    Science.gov (United States)

    Yahalom, R; Blinder, D; Nadel, S

    2015-07-01

    Transsexualism is a gender identity disorder in which there is a strong desire to live and be accepted as a member of the opposite sex. In male-to-female transsexuals with strong masculine facial features, facial feminization surgery is performed as part of the gender reassignment. A strong association between femininity and attractiveness has been attributed to the upper third of the face and the interplay of the glabellar prominence of the forehead. Studies have shown that a certain lower jaw shape is characteristic of males with special attention to the strong square mandibular angle and chin and also suggest that the attractive female jaw is smaller with a more round shape mandibular angles and a pointy chin. Other studies have shown that feminization of the forehead through cranioplasty have the most significant impact in determining the gender of a patient. Facial feminization surgeries are procedures aimed to change the features of the male face to that of a female face. These include contouring of the forehead, brow lift, mandible angle reduction, genioplasty, rhinoplasty and a variety of soft tissue adjustments. In our maxillofacial surgery department at the Sheba Medical Center we perform forehead reshaping combining with brow lift and at the same surgery, mandibular and chin reshaping to match the remodeled upper third of the face. The forehead reshaping is done by cranioplasty with additional reduction of the glabella area by burring of the frontal bone. After reducing the frontal bossing around the superior orbital rims we manage the soft tissue to achieve the brow lift. The mandibular reshaping, is performed by intraoral approach and include contouring of the angles by osteotomy for a more round shape (rather than the manly square shape angles), as well as reshaping of the bone in the chin area in order to make it more pointy, by removing the lateral parts of the chin and in some cases performing also genioplasty reduction by AP osteotomy. PMID

  9. Scientific Advice, Traditional Practices and the Politics of Health-Care : The Australian Debate over Public Funding of Non-Therapeutic Circumcision, 1985

    Directory of Open Access Journals (Sweden)

    Robert Darby

    2011-12-01

    Full Text Available In 1985 the Australian Government sought to delete circumcision of infants from the benefits payable under its newly established universal health scheme, Medicare. Although the decision had been recommended by the government's health advisers and was welcomed by medical authorities, it was soon reversed after protests from Jewish community leaders. I present a detailed narrative of this affair and explain why a decision based on sound medical knowledge advice was rescinded after quite mild objections. The answer is found to lie partly in contingent factors, such as the details of the policy change, the personalities of the government figures involved, and problems with implementation and communication; and partly in the sensibilities of the ethnic/religious communities most directly affected. I dispel the misconception that the original decision aroused widespread opposition and show, on the contrary, that it was based on good advice, represented sound public policy, and was widely supported. I conclude that the episode may have useful lessons for other governments seeking to implement or resist policy changes that affect the sensitivities of cultural minorities.

  10. Circumcision Complications Associated with the Plastibell Device and Conventional Dissection Surgery: A Trial of 586 Infants of Ages up to 12 Months

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    Seyed Abdollah Mousavi

    2008-01-01

    Full Text Available Conventional dissection surgery (CDS or using the Plastibell device (PD is the method most frequently employed for circumcision. The aim of this study was to evaluate two methods in terms of the incidence of complications in infants of ages up to 12 months. In a prospective study, 586 infants equal to or less than 12 months were studied from 2002 to 2008, and complications between the two groups were assessed. The overall rates of complications in CDS and PD groups were 1.95% and 7.08%, respectively. In each group, the rate of complications was not different among children who had a normal weight, compared to those of a lower or upper (10% weight. There was a significant positive correlation between the age and weight of subjects within the time of ring separation (<.001. The results of this study suggest the PD method for neonates and low-weight infants with thin prepuce and the CDS for other infants.

  11. Prevalence and associated factors of behavioral intention for risk compensation following voluntary medical male circumcision among male sexually transmitted diseases patients in China.

    Science.gov (United States)

    Wang, Zixin; Feng, Tiejian; Lau, Joseph T F

    2016-10-01

    Risk compensation was an important concern of voluntary medical male circumcision (VMMC) promotion campaigns. No study investigated risk compensation following VMMC among male sexually transmitted diseases patients (MSTDP). A cross-sectional survey interviewed 308 uncircumcised MSTDP in Shenzhen, China. 26.9% of them intended to perform at least one of the five types of risk compensation behaviors following VMMC. In the summary stepwise model, provision of incorrect response to HIV/sexually transmitted diseases knowledge items (multivariate odds ratios (ORm) = 2.30), genital herpes infection (ORm = 3.19), Risk Reduction Score for Unprotected Sex, and Negative Condom Attitudes Scale (ORm = 1.13) were significantly associated with behavioral intention to perform at least one type of risk compensation behavior following VMMC. The results provided a framework for developing related interventions. Prevention of risk compensation should be an essential component of VMMC promotion for all MSTDP, irrespective of their intention for VMMC. PMID:27120407

  12. Voluntary medical male circumcision: matching demand and supply with quality and efficiency in a high-volume campaign in Iringa Region, Tanzania.

    Directory of Open Access Journals (Sweden)

    Hally R Mahler

    2011-11-01

    Full Text Available The government of Tanzania has adopted voluntary medical male circumcision (VMMC as an important component of its national HIV prevention strategy and is scaling up VMMC in eight regions nationwide, with the goal of reaching 2.8 million uncircumcised men by 2015. In a 2010 campaign lasting six weeks, five health facilities in Tanzania's Iringa Region performed 10,352 VMMCs, which exceeded the campaign's target by 72%, with an adverse event (AE rate of 1%. HIV testing was almost universal during the campaign. Through the adoption of approaches designed to improve clinical efficiency-including the use of the forceps-guided surgical method, the use of multiple beds in an assembly line by surgical teams, and task shifting and task sharing-the campaign matched the supply of VMMC services with demand. Community mobilization and bringing client preparation tasks (such as counseling, testing, and client scheduling out of the facility and into the community helped to generate demand. This case study suggests that a campaign approach can be used to provide high-volume quality VMMC services without compromising client safety, and provides a model for matching supply and demand for VMMC services in other settings.

  13. The Applicability of Behaviour Change in Intervention Programmes Targeted at Ending Female Genital Mutilation in the EU: Integrating Social Cognitive and Community Level Approaches.

    Science.gov (United States)

    Brown, Katherine; Beecham, David; Barrett, Hazel

    2013-01-01

    With increased migration, female genital mutilation (FGM) also referred to as female circumcision or female genital cutting is no longer restricted to Africa, the Middle East, and Asia. The European Parliament estimates that up to half a million women living in the EU have been subjected to FGM, with a further 180,000 at risk. Aware of the limited success of campaigns addressing FGM, the World Health Organization recommended a behavioural change approach be implemented in order to end FGM. To date, however, little progress has been made in adopting a behaviour change approach in strategies aimed at ending FGM. Based on research undertaken as part of the EU's Daphne III programme, which researched FGM intervention programmes linked to African communities in the EU (REPLACE), this paper argues that behaviour change has not been implemented due to a lack of understanding relating to the application of the two broad categories of behaviour change approach: individualistic decision-theoretic and community-change game-theoretic approaches, and how they may be integrated to aid our understanding and the development of future intervention strategies. We therefore discuss how these can be integrated and implemented using community-based participatory action research methods with affected communities. PMID:23983698

  14. The Applicability of Behaviour Change in Intervention Programmes Targeted at Ending Female Genital Mutilation in the EU: Integrating Social Cognitive and Community Level Approaches

    Directory of Open Access Journals (Sweden)

    Katherine Brown

    2013-01-01

    Full Text Available With increased migration, female genital mutilation (FGM also referred to as female circumcision or female genital cutting is no longer restricted to Africa, the Middle East, and Asia. The European Parliament estimates that up to half a million women living in the EU have been subjected to FGM, with a further 180,000 at risk. Aware of the limited success of campaigns addressing FGM, the World Health Organization recommended a behavioural change approach be implemented in order to end FGM. To date, however, little progress has been made in adopting a behaviour change approach in strategies aimed at ending FGM. Based on research undertaken as part of the EU’s Daphne III programme, which researched FGM intervention programmes linked to African communities in the EU (REPLACE, this paper argues that behaviour change has not been implemented due to a lack of understanding relating to the application of the two broad categories of behaviour change approach: individualistic decision-theoretic and community-change game-theoretic approaches, and how they may be integrated to aid our understanding and the development of future intervention strategies. We therefore discuss how these can be integrated and implemented using community-based participatory action research methods with affected communities.

  15. The young female athlete.

    Science.gov (United States)

    Hurvitz, Michal; Weiss, Ram

    2009-12-01

    Participation of adolescents and young women in strenuous sports activity may lead to various metabolic and psychological derangements of clinical relevance to the endocrinologist. The most common manifestations encountered in practice are primary and secondary amenorrhea, reduced bone mineral density and eating disorders. The occurrence of all three together has been named "the athletic triad". The underlying hormonal drivers that lead to some of these manifestations are the reduced leptin level as well as the persistent low grade stress response commonly observed in such females. "Exercise-related female reproductive dysfunction" (ERFRD), can possibly include short-term (infertility) and long-term (osteoporosis) consequences. Functional hypothalamic amenorrhea, a manifestation of ERFRD in adolescence, is an integrated response to the combination of excessive physical and emotional stress, exercise, and/or reduced food intake characterized by decreased endogenous GNRH secretion. The primary aim of treating these athletes should be the prevention of the development of any component of the triad as well as the whole complex by educating athletes, trainers, parents and health care professionals about proper nutrition and safe training. The long term prognosis is good. However, significant long term morbidity may affect these young women later in life. PMID:20118893

  16. Sunat for girls in southern Thailand : its relation to traditional midwifery, male circumcision and other obstetrical practices.

    OpenAIRE

    Merli, C.

    2008-01-01

    Among the Thai- and Malay-speaking Muslims living in southern Thailand, the traditional midwife (alternatively called mootamjae in Thai or bidan in Malay) performs a mild form of female genital cutting (FGC) on baby girls. This article is based on material collected in the Satun province, located on the Andaman coast, bordering on the Malaysian state of Perlis (once part of Kedah). People have different views of the practice: men question the cutting, considering it both un-Islamic and un-mod...

  17. Female Bladder Outlet Obstruction.

    Science.gov (United States)

    Hoffman, Daniel S; Nitti, Victor W

    2016-04-01

    The non-specific symptoms the patients express upon the presentation of female bladder outlet obstruction make it a challenge to diagnose. There are subtle differences between the obstructed patient and those whose bladders are underactive and/or fail to mount a detrusor contraction. These disparities can be extracted through a thorough history and examination. At times, the clinician may utilize nomograms, non-invasive uroflow, and urodynamics with the addition of fluoroscopy to establish the diagnosis of obstruction. Management of the obstruction depends on the nature of the condition, whether functional or anatomical. The increase in the number of sling procedures performed to treat stress urinary incontinence has resulted in a rise in the number of iatrogenic obstructions. The temporal relationship between surgery and obstruction is the key to identifying the problem. PMID:26902625

  18. Female Sexual Arousal Disorders

    DEFF Research Database (Denmark)

    Giraldi, Annamaria; Rellini, Alessandra H; Pfaus, James;

    2012-01-01

    Introduction.  Definitions and terminology for female sexual arousal disorder (FSAD) are currently being debated. While some authors have suggested that FSAD is more a subjective response rather than a genital response, others have suggested that desire and arousal disorders should be combined in...... psychological disorders, as well as to discuss different medical and psychological assessment and treatment modalities. Methods.  The experts of the International Society for Sexual Medicine's Standard Committee convened to provide a survey using relevant databases, journal articles, and own clinical experience...... comorbid with other sexual problems and are of biopsychosocial etiology. In the assessment, a thorough sexological history as well as medical and gynecological history and examination are recommended. Treatment should be based on of the symptoms, clinical findings and, if possibly, on underlying etiology...

  19. Hormones and female sexuality

    Directory of Open Access Journals (Sweden)

    Bjelica Artur L.

    2003-01-01

    Full Text Available Introduction In contrast to animal species in which linear relationships exist between hormonal status and sexual behaviour sexuality in human population is not determined so simply by the level of sexual steroids. The article analyses female sexuality in the light of hormonal status. Administration of sexual steroids during pregnancy and sexual differentiation High doses of gestagens, especially those with high androgen activity, widely used against miscarriages may lead to tomboys, but without differences in sexual orientation. However, it has been observed that the frequency of bisexual and lesbian women is higher in women with congenital adrenogenital syndrome. Hormones sexual desire and sexuality during menstrual cycle It has been established that sexual desire, autoeroticism and sexual fantasies in women depend on androgen levels. There are a lot of reports claiming that sexual desire varies during the menstrual cycle. Hormonal contraception and sexuality Most patients using birth control pills present with decreased libido. But, there are reports that progestagens with antiandrogenic effect in contraceptive pills do not affect sexual desire. Hormonal changes in peri- and postmenopausal period and sexuality Decreased levels of estrogen and testosterone in older women are associated with decreased libido, sensitivity and erotic stimuli. Sexuality and hormone replacement therapy Hormonal therapy with estrogen is efficient in reference to genital atrophy, but not to sexual desire. Really increased libido is achieved using androgens. Also, therapy with dehydroepiandrosterone (DHEA and tibolone have positive effects on female libido. Conclusion Effect of sexual steroids on sexual sphere of women is very complex. The association between hormones and sexuality is multidimensional, as several hormones are important in regulation of sexual behaviour. Still, it should be pointed out that sexuality is in the domain of hormonal, emotional

  20. The socio-cultural-symbolic nexus in the perpetuation of female genital cutting: a critical review of existing discourses

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    Esho, Tammary

    2011-12-01

    Full Text Available Female Genital Cutting (FGC, also known as Female Genital Mutilation (FGM and Female Circumcision (FC, continues to be a prevalent practice in many parts of the world and especially in Africa. This is somewhat perplexing given the concerted efforts aimed at eradicating this practice. This article argues that the perpetuation of FGC is due to the unintended effects of marginalization experienced by individuals and groups of women as a result of the approach of some of the anti-FGC global discourses and policies put forward to eradicate the practice. This, we argue, happens when the social structure that provides such groups and individuals with a sense of identity and belonging breaks down. Therefore, the attack on what practicing communities consider to be of crucial cultural value causes a re-focus on the practice resulting in a re-formulation and re-invention of these practices in a bid to counter the feelings of alienation. FGC is thus reframed and reconstructed as a reaction against these campaigns. This article intends to investigate the socio-cultural-symbolic nexus surrounding the practice of FGC, its meaning and implications with respect to its continued existence. It draws examples mainly from communities in Kenya that practice FGM as a rite of passage into adulthood. Herein, perhaps, lies the driving force behind the practice in this contemporary age: it carries a lot of significance with respect to transformational processes, and it is seen as crucial in the representation of the body, identity and belonging. The aim of this article is not to defend FGC’s continuation, but rather to explore the interplay between its changing socio-cultural dimensions as a counter-reaction to the eradication discourse and policies. In this way we will try to explore some of the factors that lay behind its perpetuation.

  1. UNITED NATION'S RESOLUTION ON ELIMINATION OF FEMALE GENITAL RITUAL: A LEGITIMATE RESPONSE TO A HUMAN RIGHTS PROBLEM OR WHAT?

    Science.gov (United States)

    Nnamuchi, Obiajulu

    2014-12-01

    A recent United Nations' (U.N.) Resolution, "Intensifying Global Efforts for the Elimination of Female Genital Mutilations," urging all countries to enact legislation outlawing female circumcision or female genital ritual (FGR) signals a disturbingly new frontier in the polemic surrounding the ancient cultural practice. Never before has the apex global institution lent its imprimatur to a project whose foundation is profoundly muddled in uncertainties and murkiness. That the Resolution received an instantaneous and near-universal acclaim as a necessary protective weapon against supposed assault on the human rights of women is not news. After all, aside from essentially validating extant legislative frameworks in several countries, the proclamation fits seamlessly with decades-long agitations of activists, scholars and media pundits of one stripe or the other. What is absurd--indeed, the real news--is continued neglect of calls for a rethinking of the criminalization fervor currently gripping the world, for a reassessment of the evidence trumpeted by abolitionists as justificatory of their unbridled interference in what practicing communities revere as a sacred cultural rite. Relying on the premise that claims regarding harmful impact of FGR, the fulcrum upon which eradication forces depend for their activism, cannot be substantiated, this paper argues that prohibitory regimes based thereon, whether at the U.N. or country level, is per se a violation of the human rights of the women purportedly sought to be protected. Human rights (including, in this case, its self-appointed "apostles"), cannot, as a popular Igbo maxim admonishes, become "outsiders who wept louder than the bereaved." This is the prism from which this paper analyzes the on-going supranational crusade to suppress FGR. It is a critique of extant FGR legal and policy regimes, an instance of which is the U.N. Resolution, as unrepresentative of legitimate advancement of human rights. PMID:27351048

  2. Comparison of three intervention models for promoting circumcision among migrant workers in western China to reduce local sexual transmission of HIV.

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    Chuanyi Ning

    Full Text Available OBJECTIVE: Three models for promoting male circumcision (MC as a preventative intervention against HIV infection were compared among migrant worker populations in western China. METHODS: A cohort study was performed after an initial cross-sectional survey among migrant workers in three provincial level districts with high HIV prevalence in western China. A total of 1,670 HIV seronegative male migrants were cluster-randomized into three intervention models, in which the dissemination of promotional materials and expert- and volunteer-led discussions are conducted in one, two, and three stage interventions. Changes in knowledge of MC, acceptability of MC, MC surgery uptake, and the costs of implementation were analyzed at 6-month and 9-month follow-up visits. RESULTS: All three models significantly increased the participants' knowledge about MC. The three-stage model significantly increased the acceptability of MC among participants and led to greatest increase in MC uptake. At the end of follow-up, 9.2% (153/1,670 of participants underwent MC surgery; uptake among the one-, two-, and three-stage models were 4.9%, 9.3%, and 14.6%, respectively. Multivariable Cox regression analysis showed that three-stage model was the most effective method to scale up MC, with RR = 2.0 (95% CI, 1.3-3.1, P=0.002 compared to the on-site session model. The two-stage intervention model showed no significant difference with either the on-site session model (RR=1.5, 95% CI, 0.92-2.4, P=0.12 or three-stage model (P=0.10. CONCLUSIONS: A three-stage intervention with gradual introduction of knowledge led to the significantly increase in MC uptake among migrant workers in western China, and was also the most cost-effective method among the three models.

  3. Surgical efficiencies and quality in the performance of voluntary medical male circumcision (VMMC procedures in Kenya, South Africa, Tanzania, and Zimbabwe.

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    Dino Rech

    Full Text Available INTRODUCTION: This analysis explores the association between elements of surgical efficiency in voluntary medical male circumcision (VMMC, quality of surgical technique, and the amount of time required to conduct VMMC procedures in actual field settings. Efficiency outcomes are defined in terms of the primary provider's time with the client (PPTC and total elapsed operating time (TEOT. METHODS: Two serial cross-sectional surveys of VMMC sites were conducted in Kenya, Republic of South Africa, Tanzania and Zimbabwe in 2011 and 2012. Trained clinicians observed quality of surgical technique and timed 9 steps in the VMMC procedure. Four elements of efficiency (task-shifting, task-sharing [of suturing], rotation among multiple surgical beds, and use of electrocautery and quality of surgical technique were assessed as explanatory variables. Mann Whitney and Kruskal Wallis tests were used in the bivariate analysis and linear regression models for the multivariate analyses to test the relationship between these five explanatory variables and two outcomes: PPTC and TEOT. The VMMC procedure TEOT and PPTC averaged 23-25 minutes and 6-15 minutes, respectively, across the four countries and two years. The data showed time savings from task-sharing in suturing and use of electrocautery in South Africa and Zimbabwe (where task-shifting is not authorized. After adjusting for confounders, results demonstrated that having a secondary provider complete suturing and use of electrocautery reduced PPTC. Factors related to TEOT varied by country and year, but task-sharing of suturing and/or electrocautery were significant in two countries. Quality of surgical technique was not significantly related to PPTC or TEOT, except for South Africa in 2012 where higher quality was associated with lower TEOT. CONCLUSIONS: SYMMACS data confirm the efficiency benefits of task-sharing of suturing and use of electrocautery for decreasing TEOT. Reduced TEOT and PPTC in high volume

  4. Assessing Odor Level when Using PrePex for HIV Prevention: A Prospective, Randomized, Open Label, Blinded Assessor Trial to Improve Uptake of Male Circumcision.

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    Vincent Mutabazi

    Full Text Available The PrePex is a WHO--prequalified medical device for adult male circumcision for HIV prevention. The Government of Rwanda was the first country to implement the PrePex device and acts as the leading center of excellence providing training and formal guidelines. As part of the Government's efforts to improve PrePex implementation, it made efforts to improve the psychological acceptability of device by men, thus increasing uptake with VMMC in sub-Saharan Africa. Some men who underwent the PrePex procedure complained of foreskin odor while wearing the PrePex 3-7 days after it was placed. This complaint was identified as potential risk for uptake of the device. Researchers from Rwanda assumed there is a possible relation between the level of foreskin odor and patient foreskin hygiene technique. The Government of Rwanda decided to investigate those assumptions in a scientific way and conduct a trial to test different hygiene-cleaning methods in order to increase the acceptability of PrePex and mitigate the odor concern. The main objective of the trial was to compare odor levels between three arms, having identical personal hygiene but different foreskin hygiene techniques using either clear water with soap during a daily shower, soapy water using a syringe, or chlorhexidine using a syringe. One hundred and one subjects were enrolled to the trial and randomly allocated into three trial arms. Using chlorhexidine solution daily almost completely eliminated odor, and was statistically significant more effective that the other two arms. The trial results suggest that odor from the foreskin, while wearing the PrePex device, could be related to the growth of anaerobic bacteria, which can be prevented by a chlorhexidine cleaning method. This finding can be used to increase acceptability by men when considering PrePex as one of the leading methods for HIV prevention in VMMC programs.

  5. The Female Athlete Triad.

    Science.gov (United States)

    Weiss Kelly, Amanda K; Hecht, Suzanne

    2016-08-01

    The number of girls participating in sports has increased significantly since the introduction of Title XI in 1972. As a result, more girls have been able to experience the social, educational, and health-related benefits of sports participation. However, there are risks associated with sports participation, including the female athlete triad. The triad was originally recognized as the interrelationship of amenorrhea, osteoporosis, and disordered eating, but our understanding has evolved to recognize that each of the components of the triad exists on a spectrum from optimal health to disease. The triad occurs when energy intake does not adequately compensate for exercise-related energy expenditure, leading to adverse effects on reproductive, bone, and cardiovascular health. Athletes can present with a single component or any combination of the components. The triad can have a more significant effect on the health of adolescent athletes than on adults because adolescence is a critical time for bone mass accumulation. This report outlines the current state of knowledge on the epidemiology, diagnosis, and treatment of the triad conditions. PMID:27432852

  6. CERN's first female firefighter

    CERN Multimedia

    Alizée Dauvergne

    2010-01-01

    Until recently, the women's changing room in the Fire Station, built in 2005, has always been empty. With the arrival of Séverine Peverelly, CERN's first female firefighter, it now has a purpose. Séverine Peverelly took up her post as a firefighter in April. Séverine, who comes from Gap in France, took up her post as a firefighter in the CERN fire brigade at the beginning of April. "We were looking for a new member," explains David Peyron, Head of the Fire and Rescue Service. It didn't matter if it was a man or a woman; we needed a firefighter with the right skills, and Séverine just happened to have them." With ten years experience working in French fire services, Séverine was looking for a new challenge. "What attracted me to CERN was the international dimension, because that creates additional challenges," she explains. And these can be considerable! For one thing, every country has its own way of worki...

  7. The limited effectiveness of legislation against female genital mutilation and the role of community beliefs in Upper East Region, Ghana.

    Science.gov (United States)

    Ako, Matilda Aberese; Akweongo, Patricia

    2009-11-01

    Female genital mutilation (FGM) has long been practised in many communities in the Upper East Region of Ghana. Although the Ghanaian state has a long tradition of supporting women's rights, it has not been successful in eradicating FGM, despite a law against the practice in an amendment to the Criminal Code in 1994 and the Domestic Violence Act 2003. This qualitative study in the Upper East Region examined the role of the state in stopping the practice of FGM through legal means, and why FGM continues to be practised in the community. In-depth interviews were conducted with six state officials, a circumciser, the president of a women's advocacy organisation, and semi-structured interviews with 32 community members. Although FGM has been criminalised, political support to ensure that the law is effectively implemented has been lacking. FGM education and eradication must be given more priority and significant funding by the Ghanaian state. For interventions to be effective, legal measures need to be combined with social measures. Communities practising FGM must be involved in the planning and implementation of anti-FGM interventions. Successful eradication of the practice is possible if education and dialogue between state institutions, gender and human rights groups and practising communities is strengthened. PMID:19962637

  8. Progress in the clinical studies of male circumcision using the Shang Ring%中国商环(Shang Ring)男性包皮环切技术临床应用研究进展

    Institute of Scientific and Technical Information of China (English)

    吕年青; 李石华; David Sokal; 程跃; 彭弋峰; Mark Barone; 黄翼然; Marc Goldstein

    2011-01-01

    男性包皮环切能显著降低男性阴茎一阴道性交获得性HIV感染风险大约60%,被WHO和联合国艾滋病规划署(UNAIDS)推荐作为HIV预防策略中的一个重要干预措施.寻求一种更加安全、有效和可接受的男性包皮环切器械和手术方法,以便能够满足加快执行扩大包皮环切预防HIV感染项目的需求,已经成为相关国际组织,特别是非洲国家政府公共卫生事业的当务之急.2008年中国商环(Shang Ring)包皮环切标准化手术方案的建立,以及应用这个标准化手术方案和手术培训在中国以及2009年和2010年在肯尼亚实施中国商环成人包皮环切手术获得有用的和有意义的临床数据,证明了中国商环包皮环切术的诸多优势.手术培训手册和教学视频的多次修订为培训医护人员提供了更加准确的教学指南.经过多家相关国际机构专家的考察和评估,中国商环包皮环切技术已经成为支持在非洲HIV高发地区扩大包皮环切服务预防HIV感染项目最具潜力的候选包皮环切器械之一.可以预计,中国商环包皮环切技术的成功应用将会在改变数百万非洲人的生活方式的同时,也为中国男科学与泌尿外科学医生在包皮环切与HIV预防和生殖健康相关的临床研究领域提供了丰富的机会.本文报告了2008年2月至2010年底期间中国商环包皮环切技术临床应用的国际和国内研究进展.%Male circumcision can reduce men's risk of HIV infection from heterosexual intercourse by 60% and is therefore recommended as an important strategy for HIV prevention in Africa by WHO and UNAIDS. However, rapid expansion of male circumcision efforts could be greatly facilitated by a safer, more effective and acceptable male circumcision surgical technique or device. Shang Ring is a simple technique developed in China. It allows a circumcision to be completed with minimal bleeding, without suturing, and in only 3 -5 min and

  9. Mental health problems associated with female genital mutilation

    Science.gov (United States)

    Knipscheer, Jeroen; Vloeberghs, Erick; van der Kwaak, Anke; van den Muijsenbergh, Maria

    2015-01-01

    Aims and method To study the mental health status of 66 genitally mutilated immigrant women originating from Africa (i.e. Somalia, Sudan, Eritrea and Sierra Leone). Scores on standardised questionnaires (Harvard Trauma Questionnaire-30, Hopkins Symptom Checklist-25, COPE-Easy, Lowlands Acculturation Scale) and demographic and psychosocial correlates were analysed. Results A third of the respondents reported scores above the cut-off for affective or anxiety disorders; scores indicative for post-traumatic stress disorder were presented by 17.5% of women. Type of circumcision (infibulation), recollection of the event (a vivid memory), coping style (avoidance, in particular substance misuse) and employment status (lack of income) were significantly associated with psychopathology. Clinical implications A considerable minority group, characterised by infibulated women who have a vivid memory of the circumcision and cope with their symptoms in an avoidant way, reports to experience severe consequences of genital circumcision. In terms of public healthcare, interventions should target these groups as a priority. PMID:26755984

  10. Female pattern hair loss

    Directory of Open Access Journals (Sweden)

    Archana Singal

    2013-01-01

    Full Text Available Female pattern hair loss (FPHL is a common cause of hair loss in women characterized by diffuse reduction in hair density over the crown and frontal scalp with retention of the frontal hairline. Its prevalence increases with advancing age and is associated with significant psychological morbidity. The pathophysiology of FPHL is still not completely understood and seems to be multifactorial. Although androgens have been implicated, the involvement of androgen-independent mechanisms is evident from frequent lack of clinical or biochemical markers of hyperandrogenism in affected women. The role of genetic polymorphisms involving the androgen and estrogen receptors is being increasingly recognized in its causation and predicting treatment response to anti-androgens. There are different clinical patterns and classifications of FPHL, knowledge of which facilitates patient management and research. Chronic telogen effluvium remains as the most important differential diagnosis. Thorough history, clinical examination, and evaluation are essential to confirm diagnosis. Patients with clinical signs of androgen excess require assessment of biochemical parameters and imaging studies. It is prudent to screen the patients for metabolic syndrome and cardiovascular risk factors. The treatment comprises medical and/or surgical modalities. Medical treatment should be initiated early as it effectively arrests hair loss progression rather than stimulating regrowth. Minoxidil continues to be the first line therapy whereas anti-androgens form the second line of treatment. The progressive nature of FPHL mandates long-term treatment for sustained effect. Medical therapy may be supplemented with cosmetic concealment in those desirous of greater hair density. Surgery may be worthwhile in some carefully selected patients.

  11. Diagnostic Testing for Female Infertility

    Science.gov (United States)

    ... American Society for Reproductive Medicine Diagnostic Testing for Female Infertility An evaluation of a woman for infertility is ... or suspected male infertility problems Any evaluation for infertility should be ... as well as female partners. The least invasive methods that can detect ...

  12. Dispelling Myths about Female Potential.

    Science.gov (United States)

    Sloane, Ethel

    1980-01-01

    Discussed are several myths and stereotypes about female physiology. Also included are new technical advances concerning the female reproduction physiology, new techniques in hormone measurement, hypotholomic-pituitary-ovarian axis, hormones and the monthly cycles, dysmenorrhea, menopause, infertility, and future areas for investigation about the…

  13. Female Superintendent Longevity in California

    Science.gov (United States)

    Rohlfing, Tracy

    2011-01-01

    The purpose of this study was to investigate, through narrative inquiry (Clandinin & Connelly, 2000), the leadership evolution of five female superintendents in California with longevity of 5 or more years in their current school district positions. The research question addressed was, "How do California female superintendents evolve to…

  14. Female Consciousness in Jane Eyre

    Institute of Scientific and Technical Information of China (English)

    鲁存

    2014-01-01

    Charlotte Bront is a remarkable women writer in the 19th-century English literature. Jane Eyre received comprehensive attention. This thesis analyzes main characters from three aspects, Jane Eyre’s female consciousness, pursuit of equality, freedom and presents the limitation in Jane Eyre. It also examines the nature of Charlotte Bront?’s pioneering female consciousness and demonstrates its positive development.

  15. The female runner: gender specifics.

    Science.gov (United States)

    Lynch, Stacy L; Hoch, Anne Z

    2010-07-01

    There has been a tremendous increase in the number of female runners of all ages and abilities in the past 35 years. Women who participate in running and sports are generally healthier and have higher self-esteem. However, unique medical and orthopedic issues exist for the female runner. This article reviews the history of women in sports, physiologic and biomechanic differences between genders, the pregnant runner, knee osteoarthritis, an update on the female athlete triad and the relationship between amenorrhea and endothelial dysfunction associated with athletics. PMID:20610034

  16. Female genital mutilation in Djibouti.

    Science.gov (United States)

    Martinelli, M; Ollé-Goig, J E

    2012-12-01

    The practice of female genital mutilation (we will use the latest definition adopted by WHO/UNFP: female genital mutilation/cutting or FGM/C) is still widespread in 28 African countries. The World Health Organisation (WHO) estimates that more than two million females undergo some form of genital mutilation every year. Its negative health impact and its ethical and human rights aspects have been discussed and attempts to eliminate it have been the objectives of several meetings promoted by national and international organisations thanks to an increased awareness related to FGM/C in those countries practicing it and also, maybe due to the number of Africans migrating to industrialized countries. We review the present situation in Djibouti, a small country in the Horn of Africa, where 98 % of the female population has suffered different forms of FGM/C. PMID:23515242

  17. TC in female pelvic cancer

    International Nuclear Information System (INIS)

    This presentation is about the role of imaging in the female pelvis. The CT is an important key in the diagnosis of gynecological malignant pathologies such as Ovarian, endometrial cervical, bladder, vaginal and vulvar cancer

  18. QUALITATIVE STUDY ON WILLINGNESS FOR ACCEPTING MALE CIRCUMCISION IN DRUG ADDICTS ON METHADONE MAINTENANCE TREATMENT IN CHONGQING%重庆美沙酮门诊男性服药者包皮环切术接受意愿定性研究

    Institute of Scientific and Technical Information of China (English)

    李凌竹; 窦贵旺; 秦波; 王婷; 李革

    2012-01-01

    目的:了解重庆市美沙酮门诊男性服药者包皮环切术接受意愿.方法:在2009年10月至2009年12月期间选取50名美沙酮门诊男性服药者,采用个人深入访谈的方式对每位服药者进行个人访谈,归纳总结美沙酮门诊男性服药者包皮环切术接受意愿.结果:50名访谈对象中,9名访谈对象自觉包皮过长,其中7位愿意进行包皮环切术.在自觉无包皮过长情况的41名访谈对象中,22名在进行包皮环切术能预防艾滋病的前提下愿意(或考虑)进行包皮环切手术.在医疗机构和医疗费用的访问中,24名愿意进行手术的访谈对象选择三甲医院进行手术,并且有23名的访谈对象认为费用不应超过一千元.结论:包皮过长和行包皮环切术后,预防艾滋病能提高包皮环切术的接受意愿.医疗花费能部分影响包皮环切术接受意愿.在包皮环切术的推广中着重提高包皮过长检出率;强调该手术对艾滋病的预防作用和降低医疗花费,能够提高该人群包皮环切术接受意愿.%Objective: To understand the situation on willingness of accepting male circumcision in drug addicts on methadone maintenance treatment ( MMT) in Chongqing, and provide information for the establishment of a good extension model of male circumcision. Methods: Individual in - depth interviews were conducted among 50 drug addicts from October to December in 2009, the willingness for accepting male circumcision in drug addicts on methadone maintenance treatment( MMT) were summaried. Results: Nine drug addicts believed that they had redundant prepuce, and 7 of them accepted male circumcision. However, 22 of 41 drug addicts who had not redundant prepuce accepted male circumcision if this surgery was a way to prevent AIDS. Most of the drug addicts who accepted male circumcision chose Three -A hospitals for their surgeries, and more than half thought that the cost should be less than 1000 RMB. Conclusion: Redundant prepuce

  19. Female terrorism:a review

    OpenAIRE

    Jacques, Karen; Taylor, Paul J

    2009-01-01

    The sharp growth in the number of publications examining female involvement in terrorism has produced a valuable but un-integrated body of knowledge spread across many disciplines. In this paper, we bring together 54 publications on female terrorism and use qualitative and quantitative analyses to examine the range of theoretical and methodological approaches in these papers. Using a content analysis, we identify six primary research foci: Portrayal in media, Feminism, Interviews with terrori...

  20. Immune Aspects of Female Infertility

    OpenAIRE

    Andrea Brazdova; Helene Senechal; Gabriel Peltre

    2016-01-01

    Immune infertility, in terms of reproductive failure, has become a serious health issue involving approximately 1 out of 5 couples at reproductive age. Semen that is defined as a complex fluid containing sperm, cellular vesicles and other cells and components, could sensitize the female genital tract. The immune rejection of male semen in the female reproductive tract is explained as the failure of natural tolerance leading to local and/or systemic immune response. Present acti...

  1. Impact of circumcision on the sexual function of adult patients with phimosis%包皮环切术对成年包茎患者性功能的影响

    Institute of Scientific and Technical Information of China (English)

    韩精超; 白焱; 张继伟; 夏溟; 蔡建良; 何群

    2015-01-01

    Objectives:To investigate the adult patients’sexual life after phimosis circumcision.Meth-ods:216 patients were investigated on erectile function changes,masturbation frequency,frequency of sexual inter-course,sexual intercourse,pain during intercourse,and other aspects by questionnaire before and after circumcision respectively.Results:There was no obvious difference in the postoperative International Index of Erectile Function-5 (IIEF -5)and the frequency of sexual intercourse,but the difference in sexual intercourse,pain during inter-course and masturbation frequency were statistically significant.Conclusion:Circumcision can improve the erectile function in patients with phimosis,prolong sexual intercourse,reduce the frequency of painful intercourse and mas-turbation,thereby enhancing their sexual satisfaction.%目的:评价包皮环切术对成年包茎患者性功能的影响。方法:采用问卷调查的方法对216例施行包皮环切术的成年包茎患者手术前后勃起功能、手淫频率、性交频率、性交时间、性交疼痛等方面的变化进行随访。结果:手术前后患者国际勃起功能指数-5(IIEF -5)、性交频率之间的差异均无统计学意义,而性交时间、性交疼痛和手淫频率之间的差异均有统计学意义。结论:包皮环切术对改善包茎患者性功能有一定帮助,可延长性交时间,减少性交疼痛和手淫频率,提高性生活的质量。

  2. Female genital mutilation in Britain.

    Science.gov (United States)

    Black, J A; Debelle, G D

    1995-06-17

    The practice of female genital mutilation predates the founding of both Christianity and Islam. Though largely confined among Muslims, the operation is also practiced in some Christian communities in Africa such that female genital mutilation takes place in various forms in more than twenty African countries, Oman, Yemen, the United Arab Emirates, and by some Muslims in Malaysia and Indonesia. In recent decades, ethnic groups which practice female genital mutilation have immigrated to Britain. The main groups are from Eritrea, Ethiopia, Somalia, and Yemen. In their own countries, an estimated 80% of women have had the operation. Female genital mutilation has been illegal in Britain since 1985, but it is practiced illegally or children are sent abroad to undergo the operation typically at age 7-9 years. It is a form of child abuse which poses special problems. The authors review the history of female genital mutilation and describe its medical complications. Assuming that the size of the population in Britain of ethnic groups which practice or favor female genital mutilation remains more or less unchanged, adaptation and acculturation will probably cause the practice to die out within a few generations. Meanwhile, there is much to be done. A conspiracy of silence exists in medical circles as well as widespread ignorance. Moreover, none of a number of well-known obstetric and pediatric textbooks mentions female genital mutilation, while the National Society for the Prevention of Cruelty to Children has neither information nor instructional material. It is high time that the problem was more widely and openly discussed. PMID:7787654

  3. Female Genital Mutilation in Egypt

    OpenAIRE

    Nissrin Hoffmann

    2013-01-01

    Female Genital Mutilation is widely practiced in Egypt as well as in big sections of the African continent. The tradition of mutilation of the female genital areas has been practiced over the course of many years in the country and has been attributed to being promoted by the Islamic religion in Egypt. The Islamic religion is the most widely practiced religion within Egypt and therefore is linked to being the main reason why the country possesses one of the highest prevalence rates of the pra...

  4. A structural comparison of female-male and female-female mounting in Japanese macaques (Macaca fuscata).

    Science.gov (United States)

    Ottenheimer Carrier, Lydia; Leca, Jean-Baptiste; Pellis, Sergio; Vasey, Paul L

    2015-10-01

    In certain populations, female Japanese macaques (Macaca fuscata) mount both males and females. Vasey (2007) proposed that female-female sexual mounting in Japanese macaques may be a neutral evolutionary by-product of a purported adaptation, namely, female-male mounting. In this study, we aim to further examine the proposed link between female-male and female-female mounting in Japanese macaques by comparing the structural characteristics that define both forms of mounting. We do so using Eshkol-Wachman Movement Notation (EWMN), a globographic reference system that can be used to describe the position of body segments. No significant differences were observed in the female mounters' positioning of eight different body segments (i.e., lower torso, mid-torso, upper torso, upper arm, lower arm, upper leg, lower leg, and foot) during female-male and female-female mounting. This finding lends support to the conclusion that female-female and female-male mounting are structurally, and thus, evolutionarily, related. PMID:26232264

  5. Archetypes of Outstanding Female Superintendents.

    Science.gov (United States)

    Funk, Carole; Pankake, Anita; Schroth, Gwen

    This report documents a study of women superintendents. Specifically, the study identified professional and personal characteristics and styles of leadership to develop archetypes of six outstanding female superintendents in Texas. The intent of the research was also to reveal similarities between and among these superintendents that could provide…

  6. Adolescent Leadership: The Female Voice

    Science.gov (United States)

    Archard, Nicole

    2013-01-01

    This research investigated the female adolescent view of leadership by giving voice to student leaders through focus group discussions. The questions: What is leadership? Where/how was leadership taught?, and How was leadership practised? were explored within the context of girls' schools located in Australia, with one school located in South…

  7. Chapter 22: Female Reproductive Toxicology

    Science.gov (United States)

    The female reproductive system provides multiple targets for environmental toxicants with the hypothalamic-pituitary-ovarian axis. Moreover, the functional impact of a chemical can differ, depending on the species involved and the parameters of exposure. While cross-species compa...

  8. Female Studies: The Elective Approach

    Science.gov (United States)

    Biemer, Linda

    1975-01-01

    Ten elective courses are outlined with objectives, implementation suggestions, and evaluation devices to raise the consciousness of both males and females in secondary schools. Courses include sex education, women in American history, child studies, women in other societies, economics, law, marriage and alternative life styles, and child rearing.…

  9. Female Entrepreneurship in Finland and Bangladesh

    OpenAIRE

    Islam, Sohana

    2016-01-01

    Female entrepreneurship plays a vital role in economic growth. In this study two countries with different social norms and economic situations are compared to describe the opportunities and challenges dealt with by female entrepreneurs. The major purposes of the study are to find out the obstacles of female entrepreneurs, opportunities provided to them and recommendations provided by female entrepreneurs to other female entrepreneurs as well as authorities. The implementation of the th...

  10. The Dutch Female Board Index 2010

    OpenAIRE

    Lückerath – Rovers, M.

    2010-01-01

    The Dutch Female Board Index 2010 shows for the fourth year a survey of female representation on the Executive Boards and Supervisory Boards of 99 Dutch NVs listed on Euronext Amsterdam. The companies were classified by the percentage of women in their joint Executive Board and Supervisory Board. The Dutch ‘Female Board Index 'also gives an analysis of the differences between male and female directors and between companies with or without female representation on the Eexcutive Board and/or Su...

  11. Female Genital Mutilation in Egypt

    Directory of Open Access Journals (Sweden)

    Nissrin Hoffmann

    2013-07-01

    Full Text Available Female Genital Mutilation is widely practiced in Egypt as well as in big sections of the African continent. The tradition of mutilation of the female genital areas has been practiced over the course of many years in the country and has been attributed to being promoted by the Islamic religion in Egypt. The Islamic religion is the most widely practiced religion within Egypt and therefore is linked to being the main reason why the country possesses one of the highest prevalence rates of the practice within Africa, according to many surveys performed by many leading agencies and nongovernmental organizations that advocate for the abolition of the practice within the country. FGM as a social health concern has been realized as not possessing any health benefits for the women and young girls who are taken through the practice.

  12. Prepuceplasty: an alternative to circumcision.

    OpenAIRE

    Castella, H.

    1994-01-01

    The operation of prepuceplasty overcomes phimosis in children while conserving the foreskin. The narrowed preputial outlet is incised longitudinally and repaired transversely. When appropriate, this minor procedure produces lasting relief of the deformity, as shown in 55 patients followed for up to 20 years.

  13. Rembrandt and the Female Nude

    OpenAIRE

    Sluijter, Eric Jan

    2006-01-01

    Rembrandt's extraordinary paintings of female nudes - Andromeda, Susanna, Diana and Her Nymphs, Danaë, Bathsheba - as well as his etchings of nude women, have fascinated many generations of art lovers and art historians, but they have also elicited vehement criticism. They were considered against-the-grain, anti-classical, even ugly and unpleasant. However, Rembrandt chose conventional subjects, keeping close to time-honored pictorial schemes, and was well aware of the high prestige accorded ...

  14. Melanoma of the female urethra

    OpenAIRE

    Ramos, Juan A.; Ramos, Wilmer E.; Ramos, Claudia V.

    2011-01-01

    Melanoma is a malignant tumor that can affect any area of the anatomical economy. Its appearance in the female urethra is extremely rare, with approximately 121 cases in indexed literature since 1966. The subject to be described is an 86-year-old woman who seeks assessment for intermittent macroscopic hematuria with blood clots of 3 months progression. On physical examination, there are no suspicious lesions detected on the surface of the skin. On external genital examination, it is observed ...

  15. Myiasis in female external genitalia

    Directory of Open Access Journals (Sweden)

    Usha Kataria

    2013-01-01

    Full Text Available Myiasis is derived from the Greek word-"Myia", meaning "fly". The term was first introduced by Hope in 1840 and refers to the infestation of human beings with dipterous larvae (maggots. Presence of maggots on exposed parts is already known, but on covered parts like external genitalia it is very rare. We hereby describe a case of young unmarried female who presented with multiple sinuses over external genitalia along with maggots coming out of it.

  16. Myiasis in female external genitalia

    OpenAIRE

    Usha Kataria; Sunita Siwach; Sanjeev Gupta

    2013-01-01

    Myiasis is derived from the Greek word-"Myia", meaning "fly". The term was first introduced by Hope in 1840 and refers to the infestation of human beings with dipterous larvae (maggots). Presence of maggots on exposed parts is already known, but on covered parts like external genitalia it is very rare. We hereby describe a case of young unmarried female who presented with multiple sinuses over external genitalia along with maggots coming out of it.

  17. Female pattern alopecia: current perspectives

    OpenAIRE

    Levy LL; Emer JJ

    2013-01-01

    Lauren L Levy, Jason J Emer Department of Dermatology, Mount Sinai School of Medicine, New York, NY, USA Abstract: Hair loss is a commonly encountered problem in clinical practice, with men presenting with a distinctive pattern involving hairline recession and vertex balding (Norwood-Hamilton classification) and women exhibiting diffuse hair thinning over the crown (increased part width) and sparing of the frontal hairline (Ludwig classification). Female pattern hair loss has a strikingly ov...

  18. Background Factors and Female Dominance

    OpenAIRE

    Asghar Mirardi; Ali Edalati; Ma’rof Redzuan

    2010-01-01

    The aim of this study is examine the relationship between duration of marriage, number of children, years of education and family income with female dominance. The study employed survey design. It was carried out among a sample of 337 married women in Shiraz City, Iran. Hamby Dominance Scale (HDS) was used to measure romantic dominance. The study employed correlations test to determine the relationships between duration of marriage, number of children, years of education and family income wit...

  19. Ethnic Female Journalists Group Founded

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    ACROSS such a multi-national country as China with 56 ethnic groups, up to one third of those in the press circle are women journalists, among whom 56.2 percent are in the broadcasting and television arenas, 42.5 percent in newspapers and magazines and 1.3 percent in news agencies. Statistics from National Unity shows that 42 of China's minority groups have produced female

  20. Power and Gender: Female Perspective

    OpenAIRE

    Khamseh, Zahra

    2009-01-01

    In this research through pilot study, I seek and explore the cultural differences of Iranian and Malay females by illustrating their stories. I believe that in organizational studies, stories are valuable constructs; therefore, I adopt storytelling approach to capture the lovely moments, through living among individuals. In addition, by adopting narrative approach in this research, along with my ethnography position, I am able to write about my Iranian friends and Malay classmates’ stories ve...

  1. Female pattern alopecia: current perspectives

    Directory of Open Access Journals (Sweden)

    Levy LL

    2013-08-01

    Full Text Available Lauren L Levy, Jason J Emer Department of Dermatology, Mount Sinai School of Medicine, New York, NY, USA Abstract: Hair loss is a commonly encountered problem in clinical practice, with men presenting with a distinctive pattern involving hairline recession and vertex balding (Norwood-Hamilton classification and women exhibiting diffuse hair thinning over the crown (increased part width and sparing of the frontal hairline (Ludwig classification. Female pattern hair loss has a strikingly overwhelming psychological effect; thus, successful treatments are necessary. Difficulty lies in successful treatment interventions, as only two medications – minoxidil and finasteride – are approved for the treatment of androgenetic alopecia, and these medications offer mediocre results, lack of a permanent cure, and potential complications. Hair transplantation is the only current successful permanent option, and it requires surgical procedures. Several other medical options, such as antiandrogens (eg, spironolactone, oral contraceptives, cyproterone, flutamide, dutasteride, prostaglandin analogs (eg, bimatoprost, latanoprost, and ketoconazole are reported to be beneficial. Laser and light therapies have also become popular despite the lack of a profound benefit. Management of expectations is crucial, and the aim of therapy, given the current therapeutic options, is to slow or stop disease progression with contentment despite patient expectations of permanent hair regrowth. This article reviews current perspectives on therapeutic options for female pattern hair loss. Keywords: androgenetic alopecia, female pattern hair loss, minoxidil, finasteride, antiandrogens, spironolactone

  2. Aging changes in the female reproductive system

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/004016.htm Aging changes in the female reproductive system To use ... sharing features on this page, please enable JavaScript. Aging changes in the female reproductive system result mainly ...

  3. Female directors, key committees, and firm performance

    OpenAIRE

    Green, Colin; Homroy, Swarnodeep

    2015-01-01

    There is pressure to increase female representation on corporate boards. A number of studies have found no, or in some cases a negative, effect of female representation on boards and firm performance. We demonstrate robust positive and economically meaningful effects on firm performance of female representation on European boards. Moreover, while previous work has considered female representation broadly, we focus on membership of committees involved explicitly in firm governance. We demonstr...

  4. Predictably Philandering Females Prompt Poor Paternal Provisioning

    OpenAIRE

    J. Schroeder; Hsu, Y-H.; Winney, I.; Simons, M.; Nakagawa, S; Burke, T.

    2016-01-01

    One predicted cost of female infidelity in socially monogamous species is that cuckolded males should provide less parental care. This relationship is robust across species, but evidence is ambiguous within species. We do not know whether individual males reduce their care when paired with cheating females compared with when paired with faithful females (within-male adjustment) or, alternatively, if the males that pair with cheating females are the same males that provide...

  5. Paradox lost:disappearing female job satisfaction

    OpenAIRE

    Green, Colin Peter; Heywood, John Spencer; Kler, Parvinder; Leeves, Gareth

    2016-01-01

    The greater job satisfaction reported by female workers represents a puzzle given, on average, their worse labour market outcomes. Using the original data source of Clark (1997), we show that over the last two decades the female satisfaction gap has largely vanished. This reflects a strong secular decline in female job satisfaction. This decline happened for younger women in the 1990s as they aged and because of new female workers in more recent years that have lower job satisfaction than the...

  6. Female genital cutting: nursing implications.

    Science.gov (United States)

    Goldenstein, Rachel A

    2014-01-01

    Female genital cutting (FGC) is a practice that affects millions of girls and women worldwide. This deeply rooted practice has cultural, religious, and psychosexual meaning to its practitioners, but it also carries long-term physical and mental complications. Decried as a human rights violation, nonetheless this practice is still carried out today. Nurses are in a unique position to contact and educate women who have been cut or are at risk for mutilation. To advocate for these women, a thorough understanding of the practice of FGC, its cultural overtones, religious implications, and psychosexual effects is needed. PMID:23835896

  7. Charismatic female leadership and gender

    DEFF Research Database (Denmark)

    Meret, Susi

    2015-01-01

    Research on the leadership and electorates of populist right-wing parties emphasizes that most of these parties are charismatic and male-dominated, both as regards their leadership and voters. However, while studies about the gender gap focus mainly on demand-side factors, such as electoral support......, socio-economic characteristics and the voters' attitudes towards issues such as immigration, those that analyse the role and position of gender issues are still rare. Similarly, or even more, overlooked is an analysis of the rhetoric, style, charisma and discourse of populist female leaders, such as...

  8. Exertion injuries in female athletes.

    OpenAIRE

    Orava, S.; Hulkko, A; Jormakka, E.

    1981-01-01

    Because sports injuries in men form most of the available statistics, the reportage of injuries in female athletes is sparse. We describe exertion injuries and disorders in 281 women athletes, all of which hampered athletic training or performances. Sixty per cent of the injuries occurred to girls ages between 12-19 years, and about forty-eight per cent were track and field athletes. The most common sites of injury were the ankle, foot, heel and leg. Osteochondritic disorders were the most ty...

  9. Reconceptualizing the HIV epidemiology and prevention needs of Female Sex Workers (FSW in Swaziland.

    Directory of Open Access Journals (Sweden)

    Stefan Baral

    Full Text Available HIV is hyperendemic in Swaziland with a prevalence of over 25% among those between the ages of 15 and 49 years old. The HIV response in Swaziland has traditionally focused on decreasing HIV acquisition and transmission risks in the general population through interventions such as male circumcision, increasing treatment uptake and adherence, and risk-reduction counseling. There is emerging data from Southern Africa that key populations such as female sex workers (FSW carry a disproportionate burden of HIV even in generalized epidemics such as Swaziland. The burden of HIV and prevention needs among FSW remains unstudied in Swaziland.A respondent-driven-sampling survey was completed between August-October, 2011 of 328 FSW in Swaziland. Each participant completed a structured survey instrument and biological HIV and syphilis testing according to Swazi Guidelines.Unadjusted HIV prevalence was 70.3% (n = 223/317 among a sample of women predominantly from Swaziland (95.2%, n = 300/316 with a mean age of 21(median 25 which was significantly higher than the general population of women. Approximately one-half of the FSW(53.4%, n = 167/313 had received HIV prevention information related to sex work in the previous year, and about one-in-ten had been part of a previous research project(n = 38/313. Rape was common with nearly 40% (n = 123/314 reporting at least one rape; 17.4% (n = 23/314reported being raped 6 or more times. Reporting blackmail (34.8%, n = 113/314 and torture(53.2%, n = 173/314 was prevalent.While Swaziland has a highly generalized HIV epidemic, reconceptualizing the needs of key populations such as FSW suggests that these women represent a distinct population with specific vulnerabilities and a high burden of HIV compared to other women. These women are understudied and underserved resulting in a limited characterization of their HIV prevention, treatment, and care needs and only sparse specific and competent

  10. Characteristics of Female College Student Drug Use.

    Science.gov (United States)

    Traub, Stuart H.

    1983-01-01

    Examined female college students' (N=466) drug use, marihuana use in particular. Results indicated that the gap in marihuana usage patterns between females and males has substantially narrowed. Female marihuana users used other drugs quite extensively and had friends who use marihuana. Peer influence was a major factor in drug use. (JAC)

  11. Political Conditions and Female Labour Force Participation

    OpenAIRE

    Nooreen Mujahid

    2013-01-01

    This paper examines the impact of political conditions on female labour force participation in case of Pakistan. The study covers the period of 1980-2010. We found the existence of cointegration between the variables. Democracy and government spending lowers labour female labour participation. Development spending increases female labour participation. This study opens up new insights for policy makers in Pakistan.

  12. Female pattern alopecia: current perspectives.

    Science.gov (United States)

    Levy, Lauren L; Emer, Jason J

    2013-01-01

    Hair loss is a commonly encountered problem in clinical practice, with men presenting with a distinctive pattern involving hairline recession and vertex balding (Norwood-Hamilton classification) and women exhibiting diffuse hair thinning over the crown (increased part width) and sparing of the frontal hairline (Ludwig classification). Female pattern hair loss has a strikingly overwhelming psychological effect; thus, successful treatments are necessary. Difficulty lies in successful treatment interventions, as only two medications - minoxidil and finasteride - are approved for the treatment of androgenetic alopecia, and these medications offer mediocre results, lack of a permanent cure, and potential complications. Hair transplantation is the only current successful permanent option, and it requires surgical procedures. Several other medical options, such as antiandrogens (eg, spironolactone, oral contraceptives, cyproterone, flutamide, dutasteride), prostaglandin analogs (eg, bimatoprost, latanoprost), and ketoconazole are reported to be beneficial. Laser and light therapies have also become popular despite the lack of a profound benefit. Management of expectations is crucial, and the aim of therapy, given the current therapeutic options, is to slow or stop disease progression with contentment despite patient expectations of permanent hair regrowth. This article reviews current perspectives on therapeutic options for female pattern hair loss. PMID:24039457

  13. FEMALE ENTREPRENEURSHIP IN LOCAL DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    Iuliana, CIOCHINA

    2014-11-01

    Full Text Available Under the pressure of globalization, local communities around the world are looking for new strategies to facilitate local economic development, to reduce poverty and for social inclusion, through harnessing local resources, the creation of workplaces and of better life quality for men and women. In this context, programs to encourage and promote the entrepreneurial spirit in women considering that, on a global level, one third of new businesses are their creation, a significant part of SMEs, the primary source of new workplaces and of economic growth in a local community. In a competition where women continue to be confronted with more obstacles than men, measures must be taken to ensure the best possible context to support female entrepreneurship in such a way that local communities to fully benefit from their potential in creating workplaces, economic and social development on a local, national and European scale. The lack of confidence in creating their own businesses, difficulty in balancing professional and family life, inability to obtain the capital necessary for developing their business, difficulty in preparation and limited access to information are all problems that hinder initiative and the development of women's entrepreneurship. Female entrepreneurs are in need of recognition, from financers and business partners, logistical support and help in increasing managerial and leading capacity.

  14. Hormesis and Female Sex Hormones

    Directory of Open Access Journals (Sweden)

    Elvar Theodorsson

    2011-05-01

    Full Text Available Hormone replacement after menopause has in recent years been the subject of intense scientific debate and public interest and has sparked intense research efforts into the biological effects of estrogens and progestagens. However, there are reasons to believe that the doses used and plasma concentrations produced in a large number of studies casts doubt on important aspects of their validity. The concept of hormesis states that a substance can have diametrically different effects depending on the concentration. Even though estrogens and progestagens have proven prone to this kind of dose-response relation in a multitude of studies, the phenomenon remains clearly underappreciated as exemplified by the fact that it is common practice to only use one hormone dose in animal experiments. If care is not taken to adjust the concentrations of estrogens and progestagens to relevant biological conditions, the significance of the results may be questionable. Our aim is to review examples of female sexual steroids demonstrating bidirectional dose-response relations and to discuss this in the perspective of hormesis. Some examples are highlighted in detail, including the effects on cerebral ischemia, inflammation, cardiovascular diseases and anxiety. Hopefully, better understanding of the hormesis phenomenon may result in improved future designs of studies of female sexual steroids.

  15. An incident of female-female aggression in the house wren

    NARCIS (Netherlands)

    Alworth, T; Scheiber, IBR

    1999-01-01

    In this paper we describe one example of female-female aggression in the House Wren (Troglodytes aedon). An intruding female usurped the resident female and paired with the resident male. House Wrens are known for committing infanticide as well as puncturing and removing eggs of conspecifics and oth

  16. FEMALE FETICIDE: CAUSES, EFFECTS AND SOLUTIONS

    Directory of Open Access Journals (Sweden)

    Bhavna Jagdishbhai Desai

    2015-01-01

    Full Text Available Women are murdered all over the world. But in India a most brutal form of killing females takes place regularly, even before they have the opportunity to be born. Female feticide- -the selective abortion of female fetuses--is killing upwards of one million females in India annually with far-ranging and tragic consequences. In some areas, the sex ratio of females to males has dropped to less than 8000:1000. Females not only face inequality in this culture, they are even denied the right to be born. Why do so many families selectively abort baby daughters? In a word: economics. Aborting female fetuses is both practical and socially acceptable in India.

  17. [Psoriasis in a female chimpanzee].

    Science.gov (United States)

    Biella, U; Haustein, U F; Seifert, S; Adler, J; Schüppel, K F; Eulenberger, K

    1991-05-01

    Psoriasis, a widespread genodermatosis in Homo sapiens, also appears in primates. We report on a female chimpanzee in Leipzig Zoo. After years of captivity the animal developed erythematosquamous, highly hyperkeratotic, lesions, some confluent, on the knees, elbows, back of the hands and feet and on the forearms and the seat, which showed histologically characteristic features of psoriasis. It may be that both previous infections and psychic stress resulting from social isolation had caused eruption of the disease. In the literature single cases of psoriasiform dermatoses have also been described in other species of monkeys and even in a springer spaniel. Nonetheless, the search for an animal model of psoriasis vulgaris is still going on. PMID:1874622

  18. Flibanserin and Female Sexual Desire.

    Science.gov (United States)

    Fantasia, Heidi Collins

    2016-01-01

    Female hypoactive sexual desire disorder (HSDD) is one type of sexual problem that can affect women. It is characterized by low or absent sexual desire that cannot be attributed to another cause and results in difficulty in interpersonal relationships. HSDD is not well understood, and women may not report symptoms of difficulties to their health care providers. In August 2015, the U.S. Food and Drug Administration approved flibanserin, a nonhormonal oral medication for the treatment of HSDD in premenopausal women. Flibanserin is the only currently available pharmacologic treatment for HSDD. This article will provide an overview of flibanserin, including potential adverse reactions, special considerations for use, and implications for nursing practice. PMID:27287358

  19. Exertion injuries in female athletes.

    Science.gov (United States)

    Orava, S; Hulkko, A; Jormakka, E

    1981-12-01

    Because sports injuries in men form most of the available statistics, the reportage of injuries in female athletes is sparse. We describe exertion injuries and disorders in 281 women athletes, all of which hampered athletic training or performances. Sixty per cent of the injuries occurred to girls ages between 12-19 years, and about forty-eight per cent were track and field athletes. The most common sites of injury were the ankle, foot, heel and leg. Osteochondritic disorders were the most typical injuries in the series, and the chronic medical tibial syndrome was the injury that needed surgical treatment most frequently. Overuse injuries seem to differ very little from each other in the events included in this survey. PMID:6797496

  20. Load Carriage and the Female Soldier

    Directory of Open Access Journals (Sweden)

    Venerina Johnson

    2011-07-01

    Full Text Available This paper reviews the physiological, biomechanical and health impacts of load carriage on the female soldier and extends to include issues acknowledged as impacting on the female athlete and hence the female soldier. Physiological factors such as fat mass, strength, aerobic endurance and biomechanical factors such as stride length and forward lean have the potential to increase the energy cost of load carriage and cause injury. The female athlete triad, iron deficiency, pelvic floor muscle dysfunction and military equipment issues can likewise reduce female soldier performance and increase injury risk. Research evidence is presented to inform the development and implementation of performance optimisation and injury prevention strategies. Discussed strategies include structured physical conditioning, improving nutrition and hydration practices and modification of load carriage equipment to meet female soldier requirements.

  1. 阴囊纵隔翼型皮瓣修复包皮环切术后隐匿型阴茎皮肤短缺%THE WING-LIKED SKIN FLAP WITH SCROTAL SEPTAL VASCULAR PEDICLE IN THE TREATMENT OF CONCEALED PENIS AFTER CIRCUMCISION

    Institute of Scientific and Technical Information of China (English)

    陈辉; 刘凡

    2001-01-01

    目的:用阴囊纵隔翼型皮瓣修复包皮环切术后患者的隐匿型阴茎皮肤短缺。方法:对3例包皮环切术后隐匿型阴茎皮肤不足的病人,用阴囊纵隔翼型皮瓣修复。结果:3例均荻成功,术后即获得立竿见影的良好效果。随访6个月~12个月,阴茎外形满意,发育良好。结论:用该皮瓣修复包皮环切术后隐匿型阴茎皮肤短缺具有血供良好,取材方便、结构相似,外形良好的优点。%Objective: To develop a method for repairing of skin defect of concealed penis after circumcision. Methods:The wing-liked skin flap with scrotal septal vascular pedicle was designed and applied to 3 patients with skin defect of concealed penis after circumcision. Results: All operations were successful. During a follow-up period of 6~12 months, both the shape and development of phalluses were satisfactory. Conclusion: The repair of skin defect of concealed penis after circumcision by this way is one of the best choices. This method had some merits such as the tissue flap has good blood supply,it is easy to elevate, and penis has good appearance following correction.

  2. Female alternative reproductive behaviors: the effect of female group size on mate assessment and copying.

    Science.gov (United States)

    Brennan, Bernard J; Flaxman, Samuel M; Alonzo, Suzanne H

    2008-08-01

    Extensive theoretical and empirical research has focused on male alternative reproductive tactics. In comparison, female alternative tactics have attracted little attention, and further theoretical and empirical research are needed. Using a game theoretical model, we examine female choice alternatives (1) by considering assessment errors in a novel and more realistic manner than done previously, and (2) for the first time, by highlighting the formation of groups of females as an important consequence of copying behavior. We consider two alternatives: direct assessment of male quality by females and female copying of the choice of other females. Assessment and copying are predicted to coexist under a wide variety of circumstances and copying is favored when females make assessment errors, when high-quality males are either common or very rare, and when female fitness declines with the number of other females choosing the same male. We also find that the frequency of copying at equilibrium is predicted to decrease when the presence of other females mating with the same male has a positive effect on female fitness (e.g. through increased male parental effort, decreased predation risk or cooperation among females). Female alternative choice tactics also influence the potential for sexual selection. In our model, when the frequency of copying females is low, the potential for sexual selection can be higher than in the absence of female copying. However, contrary to previous theory, we find that as copying females become more common than assessing females, the potential for sexual selection will be low as more females copy the mate choice of other copiers without assessment. PMID:18511084

  3. PROMOTION OF THE ENTREPRENEURSHIP IN THE CONTEXT OF FEMALE EMPLOYEES AND FEMALE ENTREPRENEURS

    Directory of Open Access Journals (Sweden)

    Gintarė Gulevičiūtė

    2015-07-01

    Full Text Available Purpose – to examine the characteristics of female employees and female entrepreneurs in the context of women entrepreneurship, analyze, what factors encourage and promote women entrepreneurship and give recommendations on the improvement of public policy for the promotion of women entrepreneurship. Design/methodology/approach – there had been used scientific literature deduction (drawing conclusions from the available information, analysis (obtained data analyzed separately, analogy (comparison of data with each other, generalization (the main features complex generalization, induction (from individual elements went to a general conclusion, comparison methods. Quantitative research method had been applied by questioning female employees and female entrepreneurs in various cities of Lithuania. Research was carried out using questionnaire, which was filled by 258 female employees and female entrepreneurs. Findings – after analyzing the theoretical aspects of female employees and female entrepreneurs in the context of women entrepreneurship, there were introduced the factors, that encourage and promote women entrepreneurship. As the results of qualitative research showed, those factors differ between female employees and female entrepreneurs. Research limitations/implications – the research is limited to questioning female employees and female entrepreneurs in Lithuania, nevertheless it is sufficient for satisfying the purpose of the research and producing the recommendations on the improvement of public policy for the promotion of women entrepreneurship. Practical implications – women entrepreneurship is a new area for scientific research. The differences between female employees and female entrepreneurs in the context of the factors, that encourage and promote women entrepreneurship are not analyzed. Quantitative research of Lithuanian female employees and female entrepreneurs and recommendations on the improvement of public policy for

  4. Understanding the Burden of Adult Female Acne

    OpenAIRE

    Tanghetti, Emil A.; Kawata, Ariane K.; Daniels, Selena R.; Yeomans, Karen; Burk, Caroline T; Callender, Valerie D.

    2014-01-01

    Objective: Typically regarded as an adolescent condition, acne among adult females is also prevalent. Limited data are available on the clinical characteristics and burden of adult female acne. The study objective was to describe clinical characteristics and psychosocial impact of acne in adult women. Design: Cross-sectional, web-based survey. Setting: Data were collected from a diverse sample of United States females. Participants: Women ages 25 to 45 years with facial acne (≥25 visible lesi...

  5. FEMALE URETHRA – ANATOMO-CLINICAL IMPLICATIONS

    OpenAIRE

    C. Zanoschi; R. Moldovanu

    2006-01-01

    Urethra represents the last segment of the urinary tract. We present a comprehensive account of the female urethral anatomy, including its component structures, neurovascular supply, relationship to adjacent structures (the vagina, bladder and vestibular glands, and connective tissue supports) and histology. These data are important because the distal segment of the female urethra is implicated in the mechanism of urinary continence (female stress urinary incontinence is thought to result f...

  6. Female consciousness in The Thorn Birds

    Institute of Scientific and Technical Information of China (English)

    Yang Miao

    2015-01-01

    Colleen McCullough’s significant novels The Thorn Birds causes a tremendous sensation after its publication. This thesis tries to explore the female protagonist Meggie Cleary: a painful and significant process from suspecting and losing transfers into identification of the female consciousness.Colleen McCullough would like to mold female characters to highlight the heroine’s self-respect, the pursuit of equality and freedom.

  7. Queering gender in contemporary female Bildung narrative

    Directory of Open Access Journals (Sweden)

    Šnircová Soňa

    2015-09-01

    Full Text Available The paper explores, in the context of feminist discussions about the Bildungsroman, a contemporary British novel that offers shocking images of female coming of age at the turn of the millennium. Queering gender and introducing male elements into the heroine’s process of maturation, the analysed novel appears to raise questions about the continuous relevance of the feminist distinction between male and female version of the genre. The paper however argues that although significantly rewriting both female Bildung and pornographic narratives, Helen Walsh’s Brass can still be read as a variation of the female Bildungsroman and an example of its contemporary developments.

  8. Body composition analysis in female ballet dancers

    OpenAIRE

    Mihajlović Bojan; Mijatov Saša; Srdić Biljana; Stokić Edita J.

    2003-01-01

    Introduction The aim of this study was to evaluate and compare the nutritional status and body composition in female ballet dancers and a group of non-athletic female controls. Materials and methods The study group consisted of 30 female ballet dancers, aged 17.4±2.01, whereas the control group included 30 non-athletic female examinees, aged 18.00 years on average. Height and weight were measured and body mass index (BMI) was calculated in all subjects. Body composition was estimated using th...

  9. The evolution of female sex pheromones

    Directory of Open Access Journals (Sweden)

    Ally R. HARARI, Hadass STEINITZ

    2013-08-01

    Full Text Available The role of female sex pheromones in natural selection, particularly as a means for species recognition to avoid the generation of hybrid offspring with low fitness, has been widely explored and is generally accepted by scholars. However, the significance of sex pheromones in shaping mate choice (sexual selection and in competition over breeding resources (social selection has been largely ignored. The effect of sexual selection on sex pheromones as a sexually dimorphic signaling trait has been discounted because the amount of pheromone released by females is typically minute, while the role of sex pheromones in competition over breeding resources (other than mates has not yet been considered. As a result of natural selection, variation in sex pheromones among females is expected to be low, and males are not expected to choose their mates among pheromone-releasing conspecific females. Sexual selection, on the other hand, should drive the increase in pheromone variance among females, and males are expected to choose females based on this variation. Moreover, social selection resulting from more general social interactions, for example competition among females for breeding sites and food, should also promote variance among female sex pheromones. Here, we review the current evidence for each of the three selection processes acting on sex pheromones of female moths as an advertising trait. We suggest that the three selection types are not mutually exclusive but rather act together to promote different fitness components in diverse ecological situations [Current Zoology 59 (4: 569–578, 2013].

  10. Eating disorders throughout female adolescence.

    Science.gov (United States)

    Dominé, F; Dadoumont, C; Bourguignon, J-P

    2012-01-01

    Eating disorders (EDs) are conditions which are becoming more and more widespread among adolescents and they often lead them to seek the opinion of a professional health caregiver, including gynecologists and pediatricians. EDs, and particularly anorexia nervosa (AN), are usually classified as psychological or psychiatric disorders, but they may have major somatic implications and complications as osteoporosis, nutritional deficiencies, cerebral atrophy, cardiac and metabolic disorders. A key issue in the management is prevention or reduction of both the serious somatic consequences and the important mental health consequences (e.g. depression, psychosocial withdrawal, phobia and suicide), integrating different perspectives (psychological or psychiatric - individual and familial -, genetic, nutritional, pediatric, gynecological). Adolescence is a critical period for the onset of EDs though they may also involve younger children. In this case, the consequences on the development (height, weight, puberty) can also be significant. In this review, we will focus on eating disorders in adolescent girls with an emphasis on AN. We describe variations in ED characteristics and their management depending on age at occurrence. A possible ED should be considered by pediatricians consulted about delayed female growth and puberty as well as gynecologists in patients with primary or secondary amenorrhea or infertility. PMID:22846535

  11. Promoting the female condom to refugees

    Directory of Open Access Journals (Sweden)

    Jacqueline Papo

    2006-05-01

    Full Text Available UNHCR and its partners have been providing male condoms since the late 1990s. However, uptake remains alarmingly low. Will the agency be more successful in promoting the female condom, a female-initiated barrier method of contraception and disease prevention?

  12. The Dutch Female Board Index 2010

    NARCIS (Netherlands)

    Lückerath – Rovers, M.

    2010-01-01

    The Dutch Female Board Index 2010 shows for the fourth year a survey of female representation on the Executive Boards and Supervisory Boards of 99 Dutch NVs listed on Euronext Amsterdam. The companies were classified by the percentage of women in their joint Executive Board and Supervisory Board. Th

  13. Are Female Top Managers Really Paid Less?

    NARCIS (Netherlands)

    Geiler, P.H.M.; Renneboog, L.D.R.

    2014-01-01

    Abstract: Are female top managers paid less than their male counterparts? Is the gender gap higher in male-dominated industries? What effect on pay do female non-executive directors and remuneration consultants exert? While we find no pay gap for the figure-head (CEO), there is strong pay discrimina

  14. Female alcoholism: Gender differences as victimogenic predispositions

    Directory of Open Access Journals (Sweden)

    Konstantinović-Vilić Slobodanka

    2014-01-01

    Full Text Available The subject matter of this paper is an analysis of stereotypical social reactions to women’s alcoholism in the micro and macro social and cultural environment. The social stigma and blame that female alcohol abusers are exposed to have become part of deeply rooted gender-related labels. In a broader social context, they lead to discrimination and social exclusion. In the contemporary society, female alcoholism is turning into a growing social and health problem and because of that it is essential to make the social environment more sensitive to the issue of female alcoholism in order to eliminate the causes of female alcoholism and fully support women’s medical treatment,. It would have a preventive effect in suppressing female alcoholism and it would significantly reduce victimization of women who are, in such circumstances, much more vulnerable and exposed to physical and sexual violence. The aim of this paper is to point out to the basic phenomenological and etiological feature of female alcoholism, prejudices and stereotypical attitudes they are exposed to, social and cultural implications of female alcoholism, which is perceived as a predisposition for women’s victimization and exposure to violence, so as to promote a different social approach to female alcoholism and advocate for instituting social and educational policy based on the concept of gender equality and support of social control measures.

  15. Characteristics Related to Female & Male Leaders

    Science.gov (United States)

    Richardson, Agnes M.

    2004-01-01

    The following research investigated gender and the leadership role and determined if there are differences in leadership styles, behaviors, traits, and characteristics between female leaders and male leaders. Literature suggests there are specific gender leadership differences between males and females in leadership styles, behaviors, traits, and…

  16. Aggression and coexistence in female caribou

    Science.gov (United States)

    Weckerly, Floyd W.; Ricca, Mark A.

    2014-01-01

    Female caribou (Rangifer tarandus) are highly gregarious, yet there has been little study of the behavioral mechanisms that foster coexistence. Quantifying patterns of aggression between male and female, particularly in the only cervid taxa where both sexes grow antlers, should provide insight into these mechanisms. We asked if patterns of aggression by male and female caribou followed the pattern typically noted in other polygynous cervids, in which males display higher frequencies and intensity of aggression. From June to August in 2011 and 2012, we measured the frequency and intensity of aggression across a range of group sizes through focal animal sampling of 170 caribou (64 males and 106 females) on Adak Island in the Aleutian Archipelago, Alaska. Males in same-sex and mixed-sex groups and females in mixed-sex groups had higher frequencies of aggression than females in same-sex groups. Group size did not influence frequency of aggression. Males displayed more intense aggression than females. Frequent aggression in mixed-sex groups probably reflects lower tolerance of males for animals in close proximity. Female caribou were less aggressive and more gregarious than males, as in other polygynous cervid species.

  17. Male versus Female Attitudes toward Stuttering

    Science.gov (United States)

    St. Louis, Kenneth O.

    2012-01-01

    Purpose: The study investigated the extent to which differences existed between public attitudes of males versus females. Method: One hundred adults, 50 males and 50 females, were chosen at random from each of 50 study samples comprising a total of 3371 respondents in a database archive who had completed the "Public Opinion Survey of Human…

  18. Troubling Success: Interviews with Black Female Faculty

    Science.gov (United States)

    Edwards, Nivischi N.; Beverly, Monifa Green; Alexander-Snow, Mia

    2011-01-01

    This study explores the complexity of success for Black female faculty members based on six Black women at a public research oriented university in the Southeast. All women shared the challenges they experience as Black female faculty members. Findings indicate that while these women seemingly have attained professional success, they are leery of…

  19. Advertising discourse analysis : a case study of female identities in a Hong Kong local female magazine

    OpenAIRE

    Lee, Ka-yan, Maggie; 李嘉欣

    2014-01-01

    Although Hong Kong ranked 15th globally in the United Nations Gender–related Development Index 2013 (UNDP, 2014), a discrepancy was identified between female images portrayed in print media and the actual gender equality progresses achieved (Equal Opportunities Commission, 2009). Media portrayals of female, particularly body beauty advertisements, disseminate female stereotypes and unequal gender ideologies. According to Wolf (1992, p.12), evaluating females with reference to a “culturally im...

  20. Female Athlete Triad: Past, Present, and Future.

    Science.gov (United States)

    Matzkin, Elizabeth; Curry, Emily J; Whitlock, Kaitlyn

    2015-07-01

    After the passage of Title IX in 1972, female sports participation skyrocketed. In 1992, the female athlete triad was first defined; diagnosis required the presence of an eating disorder, amenorrhea, and osteoporosis. However, many athletes remained undiagnosed because they did not meet all three of these criteria. In 2007, the definition was modified to a spectrum disorder involving low energy availability (with or without disordered eating), menstrual dysfunction, and low bone mineral density. With the new definition, all three components need not be present for a diagnosis of female athlete triad. Studies using the 1992 definition of the disorder demonstrated a prevalence of 1% to 4% in athletes. However, in certain sports, many female athletes may meet at least one of these criteria. The actual prevalence of athletes who fall under the "umbrella" diagnosis of the female athlete triad remains unknown. PMID:26111876

  1. Perspective for Female Medical Physicists (abstract)

    Science.gov (United States)

    Naqvi, Syed Mansoor; Hasnain, Aziz Fatima

    2009-04-01

    Due to cultural and religious reasons, Pakistani women can be reluctant to seek medical attention for disorders affecting their genitals or breasts. As a result, in the case of cervical and breast cancers, oncological treatment is often not received until the diseases are in the late stages. Once a cancer is classified and the tumor marked, the role of the medical physicist begins. Medical physicists' responsibilities include treatment planning, supervising treatment through radiation, dosimetry, contouring, training, equipment selection, education, research, and supervising radiotherapy facilities. In brachytherapy, isotopes are placed at the tumor site in the form of wires or seeds. There are very few female medical physicists in Pakistan. This leads to further hesitation on the part of many women to seek treatment. To help female patients obtain needed medical care, female physics students should be encouraged to pursue the emerging field of medical physics. This would provide a new professional opportunity for female physics students and give comfort to female patients.

  2. Motivations of female Black Hills deer hunters

    Science.gov (United States)

    Gigliotti, Larry M.; Covelli Metcalf, Elizabeth

    2016-01-01

    State fish and wildlife agencies are particularly interested in attracting female participation because of the potential to offset declining participation in hunting. Understanding female hunters’ motivations will be critical for designing effective recruitment and retention programs for women hunters. Although female participation in hunting is increasing, males still outnumber females by about tenfold. Gender differences in deer hunters were explored by comparing ratings of eight motivations (social, nature, excitement, meat, challenge, trophy, extra hunting opportunity, and solitude). Hunter types were defined by hunters’ selection of the most important motivation for why they like Black Hills deer hunting. Overall, females and males were relatively similar in their ratings of the eight motivations, and we found 85% gender similarity in the selection of the most important motivation. Women were slightly more motivated by the food aspect of the hunt while men placed slightly more value on the hunt as a sporting activity.

  3. A CLINICAL STUDY OF CLONIDINE 0.5 µg/Kg AND 1µg/Kg AS AN ADJUVANT TO 0.25% BUPIVACAINE IN PAEDIATRIC CAUDAL BLOCK FOR CIRCUMCISION

    Directory of Open Access Journals (Sweden)

    Madahava

    2014-01-01

    Full Text Available : Regional techniques are now increasingly being used in pediatric patients to provide post - operative analgesia. Caudal epidural block is one of the most common regional techniques used in pediatric anesthesia . AIMS AND OBJECTIVES : 1. To assess the safety and efficacy of 0.25% Bupivacaine with Clonidine in pediatric caudal block. 2. To compare the duration of analgesia with different dosages of Clonidine as an adjuvant. METHODS : This study was conducted in the department o f Anesthesiology with co - operation from the department of Pediatric Surgery at KIMS hospital and research centre , Bengaluru from December 2008 to September 2010. Study design: Comparative Randomized study . Sampling method: Purposive sampling . Statistical analysis: Using Student’s t test and chi - square test . In this study caudal block was givenin 60 children aged between 1 - 6years , posted for circumcision who were divided into two groups. Group I consisting of 30 children who received0.25% Bupiva caine 0.5ml/kg with Clonidine 0.5μg/kg as adjuvant and group II consisting of 30 children who received 0.25% Bupivacaine 0.5ml/kg with Clonidine 1μg/kg. All the children were premedicated with Inj. Atropine 0.01mg/kg and Inj. Midazolam 0.1mg/kg. Caudal blo ck was performed in all children after induction with Propofol and maintained on spontaneous ventilation with Oxygen , Nitrous oxide and Halothane. Intraoperatively the hemodynamic changes were monitored by recording the heart rate , blood pressure and SPO 2 and the onset of action was noted. Postoperatively the duration of sedation was assessed using the sedation score , duration of analgesia using the observational pain scale , motor block using the modified Bromage scale and any complications that occurred we re noted. RESULTS : Intraoperatively there was a minimal fall in the heart rate and no significant variation in the mean arterial pressure in both the groups. Postoperatively all the vital parameters were

  4. Female sexuality, regulation and resistance.

    Science.gov (United States)

    Khanna, R; Price, J

    1994-06-01

    India was the context for this discussion of female sexuality, rigid social norms, women's strategies for resistance, the evolution of norms from colonial India, prostitution, myths, and self-help women's activities. Sexuality is a changing set of ideas, and women have contributed to the redefinition. The biological view without consideration of the sociocultural and historical influences proscribes what is deviant and may be used to reinforce patriarchy and colonialism. Management and control of sexuality has been influenced by class, religion, caste, and ethnicity. During the colonial period, women's sexuality and treatment was challenged by the missionaries. The abolishment of "sati" as a traditional practice was used by the British to expand their rule and control over a wider regional area. Attempts were also made to regulate prostitution as means of protecting the health of the British army. The law requiring registration, examination, and commitment for treatment of prostitutes was not adhered to by the women involved. The notion of mothers as irresponsible came into being about 1900, and encouraged abandonment of traditional child- rearing ways for the Western standard of health and hygiene, and lifestyle. In Bengal, motherhood and mother qoddesses became the symbol of the liberation movement. The maternal role could be strengthened through education. The notion of mother and nationhood was supported by the women's movement in Great Britain and the US through positive eugenics ideas of quality race, which supported the ruling elite of British and Indians. Thus, the high class women were to be protected from early marriage, and encouraged to produce children fit to govern; the poor were to be protected from prostitution and overpopulation. Post colonial ideas about sexuality reflected a number of influences both from within and outside India. Health was a focus, and program targets were those who were outside the norm: women with too many children

  5. Laparoscopic evaluation of female infertility

    International Nuclear Information System (INIS)

    Background: Sub-fertility is inability to ensure child bearing when it is wanted. Prevalence of sub-fertility in industrialised countries has been quoted as 20%, and seems to be on the rise. Traditional way to assess the uterine cavity, tubal structure and tubal patency was hysterosalpingography but it has now been largely superseded by laparoscopy and hysteroscopy. The objective of this study was to highlight the role of laparoscopy in establishing diagnosis of female infertility. Methods: This descriptive study was conducted in Gynaecology Unit of Liaquat University of Medical Health Sciences, Hyderabad, Pakistan from August 28, 2000 to July 1, 2001. Total 200 sub-fertile patients attended the gynaecology OPD. Out of these 30 patients were selected for laparoscopy and dye test who were suspected cases of endometriosis, abnormal HSG and unexplained infertility. Those patients who had medical disorders and contraindication for laparoscopy were excluded from study. Detailed history of every patient was recorded on a proforma and physical examination was performed. Laparoscopy was scheduled in proliferative phase of menstrual cycle. Data were analysed using SPSS 11. Frequency and percentages were calculated to describe the results. Results: Out of 200 sub-fertile patients total 30 patients were selected for laparoscopy. Twenty (66%) patients were in primary infertility group while 10 (33%) patients were in secondary infertility group. Eleven (55%) patients of primary infertility belong to age group of 18-25 years while 6(60%) patients of secondary infertility belong to age group of 26- 33 years. Mean duration of sub fertility at time of presentation in primary infertility group was 1.95 years while in secondary infertility was 2.70 years. In primary infertility group main associated symptoms were dysmenorrhoeal in 8 (40%), irregular cycles 5 (25%), and dyspareunia in 4 (20%). In secondary infertility group 3 (30%) patients had dysmenorrhoeal and dyspareunia while 2

  6. 七氟醚复合小剂量芬太尼在小儿包皮环切术麻醉的应用%Application of sevoflurane combined with small dose of fentanyl in pediatric circumcision anesthesia

    Institute of Scientific and Technical Information of China (English)

    王新强; 王荣江

    2014-01-01

    Objectives:To explore the safety and efficacy of applying sevoflurane combined with small dose of fentanyl in the pediatric circumcision anesthesia.Method:80 patients to undergo pediatric circumcision were randomly divided into observation group and control group,40 cases in each.The observation group was given sevoflurane inhalation combined with small dose of fentanyl for intravenous anesthesia,while the control group was given only inhalational sevoflurane for anesthesia.The eyelash reflex time,recovery time,postoperative recovery pe-riod,sedation,and the pain of both groups immediately and 1h after recovery were recorded,as well as the adverse reactions of both groups.Result:Children in both groups were of stable vital signs.The eyelash reflex absent time of observation group was significantly shorter than the control group (P 0.05);the pain scale im-mediately after recovery of the observation group was significantly better than the control group (P 0.05);the agitation score and sedation score of the observation group were significantly better than the control group (P <0.01);no respiratory depression,laryn-geal spasm and airway obstruction were observed in both groups.Conclusion:Sevoflurane combined with small dose of fentanyl is of fast effect,stable vital signs,and postoperative pain and less restless in the application in pediatric circumcision anesthesia,making it a safe and effective anesthesia method.%目的:探讨七氟醚复合小剂量芬太尼在小儿包皮环切术麻醉的安全性和有效性。方法:80例择期行包皮环切术的患儿随机分为观察组和对照组,各40例。观察组采用七氟醚吸入复合小剂量芬太尼静注复合全麻,对照组全凭吸入七氟醚全麻。记录两组患儿睫毛反射消失时间、清醒时间、术后苏醒期、镇静、苏醒后即刻及术后1h 的的疼痛情况,记录两组患儿的不良反应。结果:两组患儿生命征均平稳。观察组患儿睫毛反射消失时

  7. Sexual signalling by females: do unmated females increase their signalling effort?

    Science.gov (United States)

    Simmons, Leigh W

    2015-06-01

    Theory predicts that females should invest least in mate searching when young, but increase their effort with age if they remain unmated. Few studies have examined variation in female sexual signalling. Female Dawson's burrowing bees (Amegilla dawsoni) search for males by signalling their receptivity on emergence, but many leave the emergence site unmated and must attract males at feeding sites. Female bees prevented from mating on emergence had more extreme versions of cuticular hydrocarbon profiles that make them attractive to males, lending empirical evidence of adaptive shifts in female mating effort. PMID:26109613

  8. Complex chemosensory control of female reproductive behaviors.

    Science.gov (United States)

    Fraser, Eleanor J; Shah, Nirao M

    2014-01-01

    Olfaction exerts a profound influence on reproductive physiology and behavior in many animals, including rodents. Odors are recognized by sensory neurons residing in the main olfactory epithelium (MOE) and the vomeronasal organ (VNO) in mice and many other vertebrates. The relative contributions of the MOE and VNO in the display of female behaviors are not well understood. Mice null for Cnga2 or Trpc2 essentially lack odor-evoked activity in the MOE and VNO, respectively. Using females mutant for one or both of Cnga2 and Trpc2, we find that maternal care is differentially regulated by the MOE and VNO: retrieval of wandering pups requires the MOE and is regulated redundantly by the VNO whereas maternal aggression requires both sensory epithelia to be functional. Female sexual receptivity appears to be regulated by both the MOE and VNO. Trpc2 null females have previously been shown to display male-type mounting towards other males. Remarkably, we find that females double mutant for Cnga2 and Trpc2 continue to mount other males, indicating that the disinhibition of male-type sexual displays observed in Trpc2 null females does not require chemosensory input from a functional MOE. Taken together, our findings reveal a previously unappreciated complexity in the chemosensory control of reproductive behaviors in the female mouse. PMID:24587340

  9. Complex chemosensory control of female reproductive behaviors.

    Directory of Open Access Journals (Sweden)

    Eleanor J Fraser

    Full Text Available Olfaction exerts a profound influence on reproductive physiology and behavior in many animals, including rodents. Odors are recognized by sensory neurons residing in the main olfactory epithelium (MOE and the vomeronasal organ (VNO in mice and many other vertebrates. The relative contributions of the MOE and VNO in the display of female behaviors are not well understood. Mice null for Cnga2 or Trpc2 essentially lack odor-evoked activity in the MOE and VNO, respectively. Using females mutant for one or both of Cnga2 and Trpc2, we find that maternal care is differentially regulated by the MOE and VNO: retrieval of wandering pups requires the MOE and is regulated redundantly by the VNO whereas maternal aggression requires both sensory epithelia to be functional. Female sexual receptivity appears to be regulated by both the MOE and VNO. Trpc2 null females have previously been shown to display male-type mounting towards other males. Remarkably, we find that females double mutant for Cnga2 and Trpc2 continue to mount other males, indicating that the disinhibition of male-type sexual displays observed in Trpc2 null females does not require chemosensory input from a functional MOE. Taken together, our findings reveal a previously unappreciated complexity in the chemosensory control of reproductive behaviors in the female mouse.

  10. Female Clergy as Agents of Religious Change?

    Directory of Open Access Journals (Sweden)

    Kati Niemelä

    2011-08-01

    Full Text Available This article focuses on female clergy as potential agents of change in the Church. I argue that the adoption of female clergy is one of the main factors that cause the Church to change its practices, policies and theological orientation. The first female ministers were ordained in the Evangelical Lutheran Church of Finland in 1988. This is fairly late compared to other Nordic countries. However, the number of female ministers and female students has been growing fast and nowadays about 70 percent of theology students are female.The paper is based on quantitative surveys conducted among the members of the Clergy Union in 2002, 2006 and 2010 (N = about 1,000 each and among the applicants for university studies in theology in 2010. The research shows that clergywomen are changing the Church in a clearly more liberal direction. They do it in various areas of church life: they change the perception of faith and dogma, the policies of the Church as well as daily practices in parishes. Clergymen are notably more traditional in their orientation, even young clergymen. Therefore it is especially the female clergy who serve as agents of religious change in the Church.

  11. The evolution of female sex pheromones

    Institute of Scientific and Technical Information of China (English)

    Ally R.HARARI; Hadass STEINITZ

    2013-01-01

    The role of female sex pheromones in natural selection,particularly as a means for species recognition to avoid the generation of hybrid offspring with low fitness,has been widely explored and is generally accepted by scholars.However,the significance of sex pheromones in shaping mate choice (sexual selection) and in competition over breeding resources (social selection) has been largely ignored.The effect of sexual selection on sex pheromones as a sexually dimorphic signaling trait has been discounted because the amount of pheromone released by females is typically minute,while the role of sex pheromones in competition over breeding resources (other than mates) has not yet been considered.As a result of natural selection,variation in sex pheromones among females is expected to be low,and males are not expected to choose their mates among pheromone-releasing conspecific females.Sexual selection,on the other hand,should drive the increase in pheromone variance among females,and males are expected to choose females based on this variation.Moreover,social selection resulting from more general social interactions,for example competition among females for breeding sites and food,should also promote variance among female sex pheromones.Here,we review the current evidence for each of the three selection processes acting on sex pheromones of female moths as an advertising trait.We suggest that the three selection types are not mutually exclusive but rather act together to promote different fitness components in diverse ecological situations.

  12. The female athlete triad and endothelial dysfunction.

    Science.gov (United States)

    Lanser, Erica M; Zach, Karie N; Hoch, Anne Z

    2011-05-01

    A tremendous increase in the number of female athletes of all ages and abilities has occurred in the past 35 years. In general, sports and athletic competition produce healthier and happier women. However, explosion in participation has revealed clear gender-specific injuries and medical conditions unique to the female athlete. This article focuses on the latest advances in our knowledge of the female athlete triad and the relationship between athletic-associated amenorrhea and endothelial dysfunction. Treatment of vascular dysfunction with folic acid is also discussed. PMID:21570034

  13. Are Female Top Managers Really Paid Less?

    OpenAIRE

    Geiler, P.H.M.; Renneboog, L.D.R.

    2014-01-01

    Abstract: Are female top managers paid less than their male counterparts? Is the gender gap higher in male-dominated industries? What effect on pay do female non-executive directors and remuneration consultants exert? While we find no pay gap for the figure-head (CEO), there is strong pay discrimination at the level of the other top managers. These female executive directors earn over a five-year tenure period £1.3 million less than male directors, and this pay gap is visible for all componen...

  14. [Female sexual dysfunction: Drug treatment options].

    Science.gov (United States)

    Alcántara Montero, A; Sánchez Carnerero, C I

    2016-01-01

    Many women will likely experience a sexual problem in their lifetime. Female sexual dysfunction is a broad term used to describe 3 categories of disorders of a multifactorial nature. Effective, but limited pharmacotherapeutic options exist to address female sexual dysfunction. The FDA recently approved the first agent for treatment of hypoactive sexual desire disorder in pre-menopausal women. Off-label use of hormonal therapies, particularly oestrogen and testosterone, are the most widely employed for female sexual dysfunction, particularly in post-menopausal women. Other drugs currently under investigation include phosphodiesterase inhibitors and agents that modulate dopamine or melanocortin receptors. PMID:27041639

  15. Predictors of Depression in Female Adolescents.

    Science.gov (United States)

    Milne, Lisa A.; Lancaster, Sandra

    2001-01-01

    Study examined factors associated with symptoms of depression in female adolescents. Specifically, the relationship between theoretically related measures-separation-individuation; interpersonal concerns; attachment style; parental representations-and symptoms of depression was investigated. The model developed explained interrelationships of…

  16. Female self-employment and children

    NARCIS (Netherlands)

    Noseleit, Florian

    2014-01-01

    Several analyses report a positive correlation between fertility and female self-employment; however, scholars disagree about the direction of this relationship. Knowing about the causal relationship is important because the relevant mechanisms and possible implications differ tremendously. This pap

  17. Selected Resources for Encouraging Females in Mathematics.

    Science.gov (United States)

    Wiest, Lynda R.

    2001-01-01

    Offers selected resources that educators can use to increase their knowledge of ways to help girls and young women succeed in mathematics, integrate information into classroom instruction, and bring self-help opportunities to their female students' awareness. (KHR)

  18. Questionnaires for assessment of female sexual dysfunction

    DEFF Research Database (Denmark)

    Giraldi, Annamaria; Rellini, Alessandra; Pfaus, James G;

    2011-01-01

    There are many methods to evaluate female sexual function and dysfunction (FSD) in clinical and research settings, including questionnaires, structured interviews, and detailed case histories. Of these, questionnaires have become an easy first choice to screen individuals into different categories...

  19. Frequency of undiagnosed hypothyroidism in obese females

    International Nuclear Information System (INIS)

    To determine the frequency of undiagnosed hypothyroidism in obese females. Study Design: Cross sectional. Place and Duration of Study: Department of General Medicine, Combined Military Hospital, Multan (a tertiary care hospital). Six months. Subjects and Methods: All individuals fulfilling the inclusion criteria were enrolled in the study after their consent. Based upon their height and weight, the body mass index was calculated and their blood drawn for thyroid profile. Results: Total 133 participants were included in the study and all were females, and their mean age (± SD) was 47.68 ± 11.382 years. The overall frequency of undiagnosed hypothyroidism was 4.5% (6 out of the 133 subjects) Conclusion: The determined frequency of undiagnosed hypothyroidism in obese females is not high enough to recommend mass screening in all obese females. (author)

  20. Molecular aspects of Schistosoma mansoni female maturation

    Directory of Open Access Journals (Sweden)

    Ana Lúcia Moraes Giannini

    1995-04-01

    Full Text Available Incubation of total protein extracts of Schistosoma mansoni with 3H 17-beta-estradiol and 20-hydroxyecdysone, revealed steroid binding proteins in both, male and female worms. The interaction of nuclear proteins with restriction fragments of the gender and stage-specific gene F-10 was investigated using the "Band-Shift" technique. Distinct male and female nuclear proteins bound to the fragments of this gene. Among the nuclear proteins, only those rich in cysteine residues bound to DNA. In vitro incubation of live worms with the estrogen antagonist Tamoxifen, altered the pattern of the DNA binding proteins, producing in females, a band profile similar to that obtained with male worm protein extracts. When Tamoxifen was injected into schistosome infected mice, the eggs produced by females presented an abnormal morphology, compatible with non-viable eggs. These results suggest that the regulation of transcription of the F-10 gene might involve steroid receptors.

  1. Mates of Competitive Females: The Relationships between Female Aggression, Mate Quality, and Parental Care

    Directory of Open Access Journals (Sweden)

    Kristal E. Cain

    2014-01-01

    Full Text Available Though rarely mate-limited, females in a wide variety of species express traits commonly associated with mate competition in males. Recent research has shown that these competitive traits (ornaments, armaments, and intense aggression often function in the context of female-female competition for nonsexual reproductive resources and are often positively related to reproductive success. Increased success could occur because competitive females acquire limited ecological resources (nest sites, territories, etc. or because they pair with high quality males, that is, older, more ornamented, or more parental males. Further, males paired with aggressive/low care females may compensate by increasing their paternal efforts. Here, I examined patterns of social pairing and parental care in free-living dark-eyed juncos (Junco hyemalis, a biparental songbird. I found no detectable relationship between female competitive behavior (aggression and male quality (age, size, or ornamentation or male provisioning. Thus, neither of the mate choice hypotheses (females compete for males or males prefer aggressive females was supported. Instead, these results suggest that females compete for nonsexual resources and mate quality is a secondary consideration. I also found a negative relationship between male and female provisioning rates, suggesting that partners adjust their level of parental effort in response to their partner’s efforts.

  2. Female labour supply in india: proximate determinants

    OpenAIRE

    Majumder, Rajarshi

    2011-01-01

    Traditional official definition of ‘work’ in developing countries excludes large number of activities that are predominantly performed by women. Naturally official Female Labour Force Participation Rate is quite low in such countries. Women who are officially in the labourforce must therefore have compelling reasons for doing so. This paper fills the research gap arising due to dearth of econometric analysis of female labour supply in Indian context by identifying proximate determinants. Apar...

  3. Biocontrol: Fungal Parasites of Female Cyst Nematodes

    OpenAIRE

    Kerry, Brian

    1980-01-01

    Three species of fungi, Catenaria auxiliarls (Kühn) Tribe, Nematophthora gynophila Kerry and Crump, and a Lagenidiaceous fungus have been found attacking female cyst nematodes. All are zoosporic fungi which parasitize females on the root surface, cause the breakdown of the nematode cuticle, and prevent cyst formation. Their identification and some aspects of their biology are reviewed. N. gynophila is widespread in Britain and reduces populations of the cereal cyst nematode, Heterodera avenae...

  4. EATING BEHAVIOR DISORDERS OF FEMALE ADOLESCENTS

    OpenAIRE

    Burgić-Radmanović, Marija; Gavrić, Živana; Štrkić, Dijana

    2009-01-01

    Background: Adolescence is a period of significant physical, emotional and intellectual changes, as well as changes in social roles, relations and expectations. Objective: Our objective was to inquire into eating attitudes among female adolescents. Subjects and method: The sample consisted of female adolescents, age of 16-17, attending first grade Economic and Medical Secondary School pupils in Banja Luka, 2007. Survey questionnaire (16 questions) is a scale for self-rating of eating di...

  5. Financial Behaviors of Female Teachers in Malaysia

    OpenAIRE

    Zaimah R.; Sarmila M. S.; N. Lyndon; Azima A. M.; S. Selvadurai; Suhana Saad; A. C. Er

    2013-01-01

    This paper aims to identify the pattern of financial behavior among female teachers in Bandar Baru Bangi, Selangor. A total of 325 female teachers was involved in the study. Questionnaires were used in the survey to collect data. Data on questions relating to socioeconomic background, financial knowledge and financial behavior were gathered. The financial behavior pattern was formulated using the 5-Likert scale and financial knowledge with the choice of either ‘right’ or ‘wrong’ answer. The a...

  6. Aging, life trajectories and female homosexuality

    OpenAIRE

    Andrea Moraes Alves

    2010-01-01

    The social science's literature about female homosexuality has recently grown in Brazil, showing the awakened interest in this issue. Since the 1990's, academic works have discussed female homosexuality: its meanings and its impact on gender issues, its relationships with social movements, specially the ones concerned with sexual rights in Brazil. Great part of these works focus on a young age rate, and some of them are dedicated to middle age women. However, there aren't works concerned with...

  7. Women's Responses towards Female Nudity in Advertising

    OpenAIRE

    Surendranath, Anupama

    2012-01-01

    Female nudity has been explicitly used in advertisements. They have been around for a while and continue to be a significant part of the promotion technique. Consumers have different opinions about these advertisements. This study focuses on women’s responses towards female nudity in advertising. A comprehensive review on previous literature emphasis the different roles portrayed by women, memorization, brand recall, arousal and attraction, positive impacts, negative impacts, purchase intenti...

  8. ETHOLOGICAL STUDIES ON CALIFORNIAN RABBIT FEMALES

    OpenAIRE

    M. Botha; I. BUD; ŞTEFAN REKA

    2013-01-01

    The aim of this paper was to underline different ethological aspects on Californianrabbit females, aspects which have important technological involves and definespecific approach of this breed, his temperament being net different from other breeds.Studies shows, that the Californian rabbit females demonstrate almost withoutexceptions that, they gets extremely lively and nervous temperament with its kind andhumans alike. This behavior determinates difficult approaches in breeding andreproducti...

  9. Female song occurs in songbirds with more elaborate female coloration and reduced sexual dichromatism

    Directory of Open Access Journals (Sweden)

    Wesley Howard Webb

    2016-03-01

    Full Text Available Elaborate plumages and songs in male birds provide classic evidence for Darwinian sexual selection. However, trait elaboration in birds is not gender-restricted: female song has recently been revealed as a taxonomically-widespread trait within the songbirds (oscine Passerines, prompting increased research into likely functions and social/ecological correlates. Here we use phylogenetically-informed comparative analysis to test for an evolutionary association between female song and plumage color elaboration in songbirds. If there is an evolutionary trade-off between signaling modes, we predict a negative correlation between acoustic and visual elaboration. This trade-off hypothesis has been commonly proposed in males but has mixed empirical support. Alternatively, if song and plumage have similar or overlapping functions and evolve under similar selection pressures, we predict a positive correlation between female song and female plumage elaboration. We use published data on female song for 1,023 species of songbirds and a novel approach that allows for the reliable and objective comparison of color elaboration between species and genders. Our results reveal a significant positive correlation between female colorfulness and female song presence. In species where females sing, females (but not males are on average more colorful – with concomitantly reduced average sexual dichromatism. These results suggest that female plumage and female song likely evolved together under similar selection pressures and that their respective functions are reinforcing. We discuss the potential roles of sexual versus social selection in driving this relationship, and the implications for future research on female signals.

  10. Female Zebra Finches Smell Their Eggs.

    Directory of Open Access Journals (Sweden)

    Sarah Golüke

    Full Text Available Parental investment in unrelated offspring seems maladaptive from an evolutionary perspective, due to the costs of energy and resources that cannot be invested in related offspring at the same time. Therefore selection should favour mechanisms to discriminate between own and foreign offspring. In birds, much emphasis has been placed on understanding the visual mechanisms underlying egg recognition. However, olfactory egg recognition has almost been completely ignored. Here, we investigated whether female zebra finches (Taeniopygia guttata are able to discriminate between their own and a conspecific egg based on olfactory cues alone. Zebra finches are colonial-breeding songbirds. Eggs are monomorphic, i.e. without any spotting pattern, and intraspecific brood parasitism frequently occurs. In a binary choice experiment, female zebra finches were given the choice between the scent of their own and a conspecific egg. After the onset of incubation, females chose randomly and showed no sign of discrimination. However, shortly before hatching, females preferred significantly the odour of their own egg. The finding that females are capable to smell their own egg may inspire more research on the potential of olfaction involved in egg recognition, especially in cases where visual cues might be limited.

  11. Female Zebra Finches Smell Their Eggs.

    Science.gov (United States)

    Golüke, Sarah; Dörrenberg, Sebastian; Krause, E Tobias; Caspers, Barbara A

    2016-01-01

    Parental investment in unrelated offspring seems maladaptive from an evolutionary perspective, due to the costs of energy and resources that cannot be invested in related offspring at the same time. Therefore selection should favour mechanisms to discriminate between own and foreign offspring. In birds, much emphasis has been placed on understanding the visual mechanisms underlying egg recognition. However, olfactory egg recognition has almost been completely ignored. Here, we investigated whether female zebra finches (Taeniopygia guttata) are able to discriminate between their own and a conspecific egg based on olfactory cues alone. Zebra finches are colonial-breeding songbirds. Eggs are monomorphic, i.e. without any spotting pattern, and intraspecific brood parasitism frequently occurs. In a binary choice experiment, female zebra finches were given the choice between the scent of their own and a conspecific egg. After the onset of incubation, females chose randomly and showed no sign of discrimination. However, shortly before hatching, females preferred significantly the odour of their own egg. The finding that females are capable to smell their own egg may inspire more research on the potential of olfaction involved in egg recognition, especially in cases where visual cues might be limited. PMID:27192061

  12. Do Female Executives Make a Difference? The Impact of Female Leadership on Gender Gaps and Firm Performance

    OpenAIRE

    FLABBI, Luca; Macis, Mario; Moro, Andrea; SCHIVARDI, Fabiano

    2014-01-01

    We analyze a matched employer-employee panel data set and find that female leadership has a positive effect on female wages at the top of the distribution, and a negative one at the bottom. Moreover, performance in firms with female leadership increases with the share of female workers. This evidence is consistent with a model where female executives are better equipped at interpreting signals of productivity from female workers. This suggests substantial costs of under-representation of wome...

  13. Psychotherapeutic interventions for treating female sexual dysfunction.

    Science.gov (United States)

    Leiblum, Sandra R; Wiegel, Markus

    2002-06-01

    A review of the current approach to the assessment and treatment of female sexual disorders from a sex therapy perspective is described. The importance of a comprehensive evaluation of both the woman and her partner, prior to formalizing a treatment plan, is stressed. Certain interventions are common in the treatment of all female sexual difficulties, for example, education and information about female sexuality generally, communication training, non-demand pleasuring, and permission to engage in self-pleasuring. Specific interventions are also described for such issues as past sexual or physical trauma. The overall goal of treatment is increased pleasure and satisfaction, rather than perfect genital response. Finally, the factors associated with treatment success are noted along with the observation that these factors are the same factors that contribute to a successful outcome in any psychotherapeutic endeavor. PMID:12107544

  14. High Injury Incidence in Adolescent Female Soccer

    DEFF Research Database (Denmark)

    Clausen, Mikkel Bek; Zebis, Mette Kreutzfeldt; Møller, Merete;

    2014-01-01

    BACKGROUND: Previous studies report varying rates of time-loss injuries in adolescent female soccer, ranging from 2.4 to 5.3 per 1000 athlete-exposures or 2.5 to 3.7 per 1000 hours of exposure. However, these studies collected data using traditional injury reports from coaches or medical staff......, with methods that significantly underestimate injury rates compared with players' self-reports. PURPOSE: The primary aim was to investigate the injury incidence in adolescent female soccer using self-reports via mobile telephone text messaging. The secondary aim was to explore the association between soccer...... exposure, playing level, and injury risk. STUDY DESIGN: Descriptive epidemiology study and cohort study; Level of evidence, 2 and 3. METHODS: During a full adolescent female soccer season in Denmark (February-June 2012), a population-based sample of 498 girls aged 15 to 18 years was included...

  15. Male and Female Differences in Nonconscious Mimicry

    DEFF Research Database (Denmark)

    Lehane, Christine Marie

    2015-01-01

    Previous research on nonconscious mimicry suggests that females mimic their communication partners more often than males. Many studies have investigated the association between mimicry, emotion recognition, and empathy. However, there is a trend in this research area to recruit same-sex samples......, thus neglecting a discussion regarding the role of sex or gender as a moderator of nonconscious mimicry. This article reviews the research on nonconscious mimicry – facial, behavioural, and verbal, in order to identify whether or not there are male and female differences. The results indicate that...... mimicry may be moderated by participant sex or gender depending upon, among others, choice of mimicry measurement, stimulus exposure length, and social context. However, few studies address male and female differences in mimicry and many have methodological limitations. The review concludes with a...

  16. Resistance Training for Pediatric Female Dancers.

    Science.gov (United States)

    Stracciolini, Andrea; Hanson, Emily; Kiefer, Adam W; Myer, Gregory D; Faigenbaum, Avery D

    2016-01-01

    Resistance training often is not an inherent component of current dance training for pediatric female dancers. Reasons for this include concerns surrounding injury to the immature skeleton and diminishing dancer aesthetic appearance, as well as questions related to the effectiveness of such training for increasing dancer strength and muscle endurance. Many forms of dance demand sufficient muscle strength and endurance for prolonged periods of high intensity dance, power generation during leaps and jumps, as well as stabilization of the lower extremity to prevent injury. The benefits of resistance training for the pediatric female dancer are multiple, including improved muscle strength and bone health and decreased risk for stress related injuries to the actively growing skeleton. Understanding the biomechanical changes that occur during growth that may predispose the female dancer to injury is important, as well as initiating individualized resistance training protocols early in training that may serve to improve performance and prevent future injury. PMID:27245945

  17. Piecing together female extra-pair mate choice: females really do prefer more ornamented males.

    Science.gov (United States)

    Wells, Sarah J; Safran, Rebecca J; Dale, James

    2016-08-01

    Evolutionary biologists have long been fascinated by extravagant male traits that abound across the animal kingdom and yet convey no apparent benefits to survival. From isopods to elephants, from armaments to ornaments, researchers have spent decades studying male-male competition and female mate choice in an effort to understand the significance of these secondary sexual characteristics. Among socially monogamous species, a frequently proposed explanation for the existence of male ornaments is that they are indicators of male genetic quality subject to female extra-pair mate choice. However, despite over two decades of extensive research into extra-pair paternity (EPP), the evidence that females actually choose more ornamented extra-pair sires is surprisingly scant. Consequently, whether EPP and female choice have contributed to the evolution of male ornaments in socially monogamous species, and what fitness benefits (if any) they signal to females, remains unclear. Progress in this field has been hampered by the challenge of dissociating clear female choice for ornamentation from confounding factors. In this issue of Molecular Ecology, Whittingham & Dunn (2016) use an experimental approach in a bird species with very high rates of EPP to tease apart these correlative effects. In doing so, they demonstrate clearly that male ornamentation is subject to female extra-pair mate choice. Their findings further suggest that EPP can be adaptive for females, and represent an important step forward in validating the role of EPP as an evolutionary driver of ornamental elaboration in socially monogamous species. PMID:27463236

  18. Understanding and management of female pattern alopecia.

    Science.gov (United States)

    Leavitt, Matt

    2008-11-01

    Female pattern hair loss is devastating to many of the 21 million U.S. women who suffer from it. It is essential to differentiate female pattern hair loss from other types of hair loss to ensure appropriate treatment. Through use of follicular units, follicular families, and follicular pairing between existing hair follicles, natural-looking results can be achieved in women. Hair transplants create the benefit of increasing density and providing options for hair styling and can be combined with medications, devices, and styling aids such as minoxidil, low-level laser therapy, and topical powder makeup, respectively. PMID:19034818

  19. Female Versus Male Entrepreneurship within Europe

    Directory of Open Access Journals (Sweden)

    Ardelean Dorina

    2015-08-01

    Full Text Available Entrepreneurship is a topic much debated and analyzed by many research institutions and organizations. In recent years, the total number of entrepreneurs has been increasing significantly, female entrepreneurship being the one that has increased a lot. In this study, we are going to present and analyze the results of studies conducted at European level regarding the comparative evolution of male versus female entrepreneurship. The main conclusion that emerges from the analysis of the results obtained is that the number of women entrepreneurs is almost equal to that of men entrepreneurs in many European countries.

  20. Ultrasonographic Doppler Use for Female Reproduction Management.

    Science.gov (United States)

    Bollwein, Heinrich; Heppelmann, Maike; Lüttgenau, Johannes

    2016-03-01

    Transrectal color Doppler ultrasonography is a useful technique to get new information about physiologic and pathophysiologic alterations of the uterus and ovaries in female cattle. During all reproductive stages characteristic changes in uterine blood flow are observed. Cows with puerperal disturbances show delayed decrease in uterine blood flow in the first few weeks postparturition compared with healthy cows. Measurement of follicular blood flow is used to identify normally developing follicles and predict superovulatory response. Determination of luteal blood is more reliable than B-mode sonography to distinguish between functional and nonfunctional corpora lutea. Color Doppler ultrasonography is a promising tool to improve reproductive management in female cattle. PMID:26922117

  1. In search of female IT-students

    DEFF Research Database (Denmark)

    Nicolajsen, Hanne Westh; Sørensen, Lene Tolstrup; Schultz, Nette

    This article looks at the problem of retaining female students in IT educations. It is argued that there are changes to be made at the university were the male domination is resulting in a limited approach to teaching IT both with regard to content and methods. Emphasis on more modern teaching me...... methods and application of technology is needed as well as elimination of female hostile attitudes. The findings are based on a literature review supplemented with results from a work shop with students from a technical university....

  2. FEMALE SEXUALITY, NATIONALISM AND LARGE GROUP IDENTITY.

    Science.gov (United States)

    Gonzalez-Torres, Miguel Angel; Fernández-Rivas, Aranzazu

    2015-12-01

    Nationalist movements are emerging today everywhere in the world. Many of them display a high level of aggression and a negative attitude toward sexuality and especially female sexuality. Along with this, erotic fiction with a sadomasochistic orientation has achieved great success and has hundreds of millions of readers in the world. This collective fantasy allows some integration of aggression in sexual life while questioning liberal morality and its equality in gender roles and conservative morality and its idea of control over passion. Both phenomena may represent different responses to the appearance of a new female sexuality threatening the social structure we know. PMID:26611132

  3. Fertility in female childhood cancer survivors

    DEFF Research Database (Denmark)

    De Bruin, Marie L; Van Dulmen-den Broeder, Eline; Van den Berg, Marleen H;

    2009-01-01

    chemotherapy and radiotherapy may have an adverse effect on ovarian function, ovarian reserve and uterine function, clinically leading to sub-fertility, infertility, premature menopause and/or adverse pregnancy outcomes. Here we will first address normal female fertility and methods to detect decreased...... fertility. Hence we will focus on direct effects as well as late fertility-related adverse effects caused by chemotherapy and radiotherapy, and we will conclude with a summary of current options for fertility preservation in female childhood cancer survivors....

  4. Female Juvenile Offending: A Review of Characteristics and Contexts

    Science.gov (United States)

    Mullis, Ronald L.; Cornille, Thomas A.; Mullis, Ann K.; Huber, Jessica

    2004-01-01

    We reviewed current literature on female juvenile offending including the scope and nature of offending by female adolescents and the risk and protective factors across ecological contexts. We suggested that female juvenile offending is best viewed within a multidimensional framework in which female adolescent developmental characteristics as well…

  5. The evolution of female social relationships in nonhuman primates

    NARCIS (Netherlands)

    Sterck, E.H.M.; Watts, David P.; Schaik, C.P. van

    2002-01-01

    Considerable interspecifc variation in female social relationships occurs in gregarious primates, par- ticularly with regard to agonism and cooperation be- tween females and to the quality of female relationships with males. This variation exists alongside variation in female philopatry and dispersa

  6. Hearing Female Voices in Life Science Classrooms.

    Science.gov (United States)

    Dunlap, Julie

    1990-01-01

    The author makes a case for keeping sensitivity and intuitive approaches in the science classroom. The importance of emotional connections with other organisms, considered a critical part of enriched, effective scientific thinking, is emphasized. Female and male learning styles are described. (KR)

  7. Male-Female Wage Differences in Korea

    OpenAIRE

    Kil Man Shin; Young Sook Chung

    1991-01-01

    Three basic methods of measuring wage discrimination are discussed in this paper: the single equation method, the two-equation decomposition method, and the reverse regression method. The three methods are applied to measure wage discrimination between male and female workers in the Korean labor market.

  8. Female Sexuality as Capacity and Power?

    DEFF Research Database (Denmark)

    Arnfred, Signe

    2015-01-01

    article investigates preparations of the erotic female body such as body tattoos, hip belts of glass beads, and elongated labia. It also discusses how “traditional” sexual capacity-building has been transferred from rural contexts into urban settings, empowering young women in love relationships with...

  9. Sport Injuries for Females: Incidence and Prevention.

    Science.gov (United States)

    Kindig, Louise E.

    Comparisons between sport-related injuries for male and female athletes are discussed in relation to statistics gathered by the National Athletic Injury/Illness Reporting System (NAIRS) and other sources. Tables display data on: (1) athletic injuries and fatalities in colleges and universities by sport, l975-76; (2) average annual frequency of…

  10. CLINICAL TRIAL OF PHALAGHRITA ON FEMALE INFERTILITY

    OpenAIRE

    Otta, S.P.; Tripaty, R.N.

    2002-01-01

    The present study was carried out in a sample of 30 numbers of female infertility cases with the use of phalagritam in the from of intra uterine insuffulation. After the treatment of three consecutive cycles an overall encouraging result was observed which will be represented in the full paper.

  11. Large inclusion cyst complicating female genital mutilation

    Directory of Open Access Journals (Sweden)

    Abdel Aziem AbdAllah Ali

    2011-12-01

    Full Text Available We report a case of an inclusion cyst, resulting from female genital mutilation (FGM, which enlarged to such a degree that it restricted the patient’s movement. This report aims to raise the awareness of the medical community to the dangers that arise from a common remote complication of FGM.

  12. Irma Optimisti "Female mathematics" / Raivo Kelomees

    Index Scriptorium Estoniae

    Kelomees, Raivo, 1960-

    2007-01-01

    Irma Optimisti näitusest "Female mathematics" Helsingis Muu-galeriis, mis on osa projektist "Mõistelisus ja käsitöölikkus (Käsitteellisyys ja käsityöläisyys) ehk naine ja tehnoloogia". Ilmunud ka ajalehes "Eesti Päevaleht", 1996, 27. veebruar

  13. The Family Functioning of Female Pathological Gamblers

    Science.gov (United States)

    Dowling, Nicki; Smith, David; Thomas, Trang

    2009-01-01

    The available evidence suggests that pathological gambling significantly disrupts family relationships and has a substantial impact on family members. However, these conclusions are based almost exclusively on male pathological gamblers and their female spouses or partners. The current study, which was a secondary study derived from a treatment…

  14. Chants of the Tikuna Female Initiation Ritual

    OpenAIRE

    Emilio Angarita; Roberto Vento; Javier José; Marcelino Manduca; Ramos, Hugo A.

    2010-01-01

    Seven ritual chants of the Tikuna female initiation ritual, recorded in the Amazon Trapezium in 2008. The chants are transcribed in Tikuna with a Spanish translation.TO LISTEN THE MP3 FILES WITH THE CHANTS, SELECT "Supplementary Files" IN THE MENU ON THE RIGHT

  15. Supporting the emergence of female student entrepreneurs

    DEFF Research Database (Denmark)

    Geert Jensen, Birgitte; Kruse, Merethe

    2011-01-01

    years (60%), while it drops to 35% on the 5th and last year. Among graduates from AAA, the gender distribution remains skewed, since more than twice as many men as women start their own architect or design firm.1 Q: Ark is a project which promotes entrepreneurship among female students at AAA. Q: Ark...

  16. Intimate Relationships of Female International Students

    Science.gov (United States)

    Popadiuk, Natalee E.

    2008-01-01

    Five female international students studying at a western Canadian university were interviewed about their experiences of being in a difficult intimate heterosexual relationship. An in-depth interpretive analysis revealed that, according to the participants, these relational struggles influenced their adjustment to the host culture. Implications…

  17. Physical Activity and Adolescent Female Psychological Development.

    Science.gov (United States)

    Covey, Linda A.; Feltz, Deborah L.

    1991-01-01

    Relationships between self-reported past and present physical activity levels and self-image, sense of mastery, gender role identity, self-perceived physical ability, and self-perceived attractiveness were studied for 149 female high school sophomores, juniors, and seniors. Results are discussed in terms of adolescent emotional health. (SLD)

  18. Menarche: Responses of Early Adolescent Females.

    Science.gov (United States)

    McGrory, Arlene

    1990-01-01

    Investigated responses of menarcheal age females to menarche. Results from 95 girls indicated that premenarcheal girls thought menses was more debilitating than did postmenarcheal girls. Subjects who had been menstruating longer considered menses natural event but denied its effects. Found no significant difference in overall self-esteem and…

  19. Gamma ray induced female mutation in castor

    International Nuclear Information System (INIS)

    Three female mutants in castor (Ricinus communis L.) were obtained from 100 to 125 kR gamma-rays treated M2 population. The racemes of these mutants bore only pistillate flowers. This character is monogenic, recessive and these mutants can be used for large scale hybrid seed production

  20. Marathon Group Therapy with Female Narcotic Addicts.

    Science.gov (United States)

    Kilmann, Peter R.

    This study evaluated the impact of structured and unstructured marathon therapy on institutionalized female narcotic addicts. Subjects were randomly assigned to one of five groups: two structured therapy groups, two unstructured therapy groups, and a no-treatment control group. The Personal Orientation Inventory, the Adjective Check List, and a…

  1. Patellofemoral Pain Syndrome in Iranian Female Athletes

    Directory of Open Access Journals (Sweden)

    Hamid Reza Baradaran

    2011-03-01

    Full Text Available Patellofemoral pain syndrome (PFPS is the most common overuse syndrome in athletes. It is one of the causes of anterior knee pain in athletic population who come to the sports medicine clinic. Patellofemoral pain is more common among female athletes especially adolescents and young adults. Symptoms include: persistent pain behind the patella or peripatella. Pain increases on ascending and descending stairs and squatting and prolonged sitting. The aim of this study was to evaluate the prevalence of PFPS in Iranian female athletes. 418 female athletes aged 15-35 years were examined in five sports: Soccer (190, volleyball (103, running (42, fencing (45 and rock climbing (38. The athletes who had non- traumatic onset anterior knee pain of at least 3 months that increased in descending and ascending stairs and squatting, had no other causes of anterior knee pain such as ligament instability, bursitis, meniscal injury, tendonitis and arthritis and no history of knee surgery during the one past year were diagnosed as PFPS. 26/190 (13.68 % soccer players, 21/103(20.38 % volleyball players, 7/42 (16.66 % runners, 6/45(13.33 % fencers and 10/38 (26.31% rock climbers had patellofemoral pain. Among the 418 female athletes who were evaluated 70 had PFPS. Rock climbers were the most common athletes with PFPS followed by volleyball players and runners.

  2. Female Special Education Directors: Doubly Marginalized.

    Science.gov (United States)

    Keefe, Charlotte Hendrick; Parmley, Pamela

    2003-01-01

    A qualitative study of five Texas female special education directors found that although participants achieved an administrative position, they were marginalized due to their leadership style, gender discrimination, and socialization. Participants also indicated a negative connection between being in special education administration and top-level…

  3. New plan to prevent female infanticide mooted.

    Science.gov (United States)

    1999-06-01

    The Campaign Against Female Infanticide in Tamil Nadu (CAFIT), sponsored by the Union Ministry of Human Resource Development, has brought to light a quadrangular model for the prevention of the social evil of female infanticide. The existence of female infanticide, according to the CAFIT, exposed the deplorable condition of women in society and reflected the perpetuation of customary and traditional practices in the sociocultural life of the people. The practice was associated with militant communities and other weaker segments living in less developed regions and with backward pockets marked by illiteracy, superstition, poverty, indebtedness, fear of liability, and emotional attachments to the soil and to cults. This paper also indicates the following preventive measures against female infanticide that are aimed at empowering women: establishing self-help groups and the sanction of micro credit for women in order to facilitate economic development, establishing rural and agriculture-based small-scale industries in order to generate local self-employment, and synchronization of crop insurance and marketing facilities in order to facilitate the provision of appropriate compensation in the event of crop failure caused by natural disasters. PMID:12179545

  4. Recurrent suicide attempt and female hormones

    Directory of Open Access Journals (Sweden)

    Seyed Ghafur Mousavi

    2014-01-01

    Full Text Available Background: Because of more frequency of suicidal attempts in females, we need to study about its relationship with the female hormones. The aim of this study was to evaluate the serum estrogen and progesterone concentration and their relationship with suicidal attempt ranking in the attempted females. Materials and Methods: The studied cases chose from patients who had referred to clinical toxicology emergency of Noor Hospital (Isfahan, Iran, during 2012, because of suicidal attempt. The estrogen and progesterone serum level of the 111 females were measured during 24 hours after suicidal attempt. The rank of their suicide, the demographic properties, and the menstrual cycle phase of them were also registered, as the patient′s statement. The results were analyzed by ANCOVA and Kruscal-Wallis under SPSS16. Results: Mean serum concentration of the estrogen was 76.8 pg/mL, and the mean serum concentration of progesterone was 2.99 ng/mL. Of them, 62.2% were in the luteal phase, and 37.8% were in the follicular phase, as they said. The serum progesterone concentration of the patients with more than two times suicidal attempts was significantly higher than the others. Conclusion: The suicidal attempt ranks significantly related to the serum progesterone concentration and the luteal phase.

  5. Nutrition Education for Elite Female Runners.

    Science.gov (United States)

    Clark, Nancy; And Others

    1988-01-01

    A survey of the dietary habits of 115 elite female runners revealed that some did not eat wisely, pointing out nutrition education needs for these subjects in the areas of sweets, vitamin and mineral supplementation, intake of red meat, body weight and body image, eating disorders, calorie intake, and amenorrhea and stress fractures. (Author/CB)

  6. The Female Experience of Sibling Incest.

    Science.gov (United States)

    Canavan, Margaret M.; And Others

    1992-01-01

    Calls occurrence of sibling incest underrecognized. Presents four cases of females who experienced sibling incest to illustrate problem areas, including issues of enforced secrecy, interpersonal power differentials, influences on sexual development, individual after effects, disturbances in family dynamics, and gender-based differences in…

  7. Why are there so few female physicists?

    CERN Multimedia

    Marianne Johansen

    Physics has always had a relatively low proportion of female students and researchers. In the EU there are on average 33% female PhD-graduates in the physical sciences, while the percentage of female professors amounts to 9% [1]. At CERN the proportion is even less with only 6.6 % of the research staff being women [2]. The fact that there is no proportional relationship between the number of PhD-graduates and professors also suggests women are less likely to succeed in an academic career than men [1]. A typical ATLAS plenary meeting. More laptops than women... Is the low representation of women in physics a problem, do we actually need more female physicists? In my view this question has to be answered from three perspectives, the perspective of society, the perspective of science and the perspective of women. The perspective of society Starting from the viewpoint of society, several issues can be raised. Firstly, physics is a field of innovation. Many technological advancements having a huge imp...

  8. Do females behave differently in COPD exacerbation?

    Directory of Open Access Journals (Sweden)

    Kilic H

    2015-04-01

    Full Text Available Hatice Kilic,1 Nurdan Kokturk,2 Gulcin Sari,3 Mustafa Cakir41Department of Pulmonary Medicine, Ankara Atatürk Training and Research Hospital, 2Department of Pulmonary Medicine, School of Medicine, Gazi University School of Medicine, 3Department of Pulmonary Medicine, Dr. Nafiz Körez Sincan Devlet Hastanesi, 4Department of Public Health, School of Medicine, Gazi University, Ankara, TurkeyIntroduction: Little is known about whether there is any sex effect on chronic obstructive lung disease (COPD exacerbations. This study is intended to describe the possible sex-associated differences in exacerbation profile in COPD patients.Methods: A total of 384 COPD patients who were hospitalized due to exacerbation were evaluated retrospectively for their demographics and previous and current exacerbation characteristics.Results: The study was conducted on 109 (28% female patients and 275 (72% male patients. The mean age was 68.30±10.46 years. Although females had better forced expiratory volume in 1 second and near-normal forced vital capacity, they had much impaired arterial blood gas levels (partial oxygen pressure [PO2] was 36.28 mmHg vs 57.93 mmHg; partial carbon dioxide pressure [PCO2] was 45.97 mmHg vs 42.49 mmHg; P=0.001, indicating severe exacerbation with respiratory failure. More females had two exacerbations and two hospitalizations, while more men had one exacerbation and one hospitalization. Low adherence to treatment and pulmonary embolism were more frequent in females. Females had longer time from the onset of symptoms till the admission and longer hospitalization duration than males. Comorbidities were less in number and different in women (P<0.05. Women were undertreated and using more oral corticosteroids.Conclusion: Current data showed that female COPD patients might be more prone to have severe exacerbations, a higher number of hospitalizations, and prolonged length of stay for hospitalization. They have a different comorbidity

  9. Sexual function in female patients with obstructive sleep apnea

    DEFF Research Database (Denmark)

    Giraldi, Annamaria G.E.; Petersen, Marian; Kristensen, Ellids;

    2011-01-01

    . Female Sexual Function Index, Female Sexual Distress Scale and four questions from Life Satisfaction-11 (Lisat-11). Results. Female Sexual Function Index indicated that obstructive sleep apnea patients were at a higher risk for having sexual difficulties. Female Sexual Distress Scale showed significantly...... more sexual distress in the obstructive sleep apnea group. Manifest Female Sexual Dysfunction (combined data from Female Sexual Function Index and Female Sexual Distress Scale) showed that female patients with obstructive sleep apnea also had more sexual dysfunction. Severity of sleep apnea was...... function and distress are sparse. Aim. To investigate sexual dysfunction and sexual distress in female patients with obstructive sleep apnea and to determine which factors are of importance for their sexual function. Methods. We investigated 80 female patients (ages 28–64) admitted to a sleep laboratory...

  10. Lifetime number of mates interacts with female age to determine reproductive success in female guppies.

    Directory of Open Access Journals (Sweden)

    Jonathan P Evans

    Full Text Available In many species, mating with multiple males confers benefits to females, but these benefits may be offset by the direct and indirect costs associated with elevated mating frequency. Although mating frequency (number of mating events is often positively associated with the degree of multiple mating (actual number of males mated, most studies have experimentally separated these effects when exploring their implications for female fitness. In this paper I describe an alternative approach using the guppy Poecilia reticulata, a livebearing freshwater fish in which females benefit directly and indirectly from mating with multiple males via consensual matings but incur direct and indirect costs of mating as a consequence of male sexual harassment. In the present study, females were experimentally assigned different numbers of mates throughout their lives in order to explore how elevated mating frequency and multiple mating combine to influence lifetime reproductive success (LRS and survival (i.e. direct components of female fitness. Under this mating design, survival and LRS were not significantly affected by mating treatment, but there was a significant interaction between brood size and reproductive cycle (a correlate of female age because females assigned to the high mating treatment produced significantly fewer offspring later in life compared to their low-mating counterparts. This negative effect of mating treatment later in life may be important in these relatively long-lived fishes, and this effect may be further exacerbated by the known cross-generational fitness costs of sexual harassment in guppies.

  11. Left Ventricular Function and Physiological Performance in Female Ironman Athletes and Female Police Officers.

    Science.gov (United States)

    Leischik, Roman; Foshag, Peter; Strauss, Markus; Spelsberg, Norman

    2016-06-01

    Data about physiological performance of female ironman triathletes are rare. However, some studies have reported this endurance sport may cause damage to the right or left ventricles, even in females. The goal of this study was to assess prospectively the right/left ventricular function and physiological performance in female athletes (middle- and long ironman distance) and to compare the findings to female federal police officers. A total of 33 female triathletes and 37 female police officers were examined using spiro-ergometry and echocardiography. Female triathletes achieved VO2max 52.8 ± 5.7 ml/kg(-1)·min(-1), and police officers 35.3 ± 6.5 ml/kg(-1)·min(-1) In athletes, left ventricular end-diastolic diameter was 4.4 ± 0.3 cm and in police officers 4.5 ± 0.4 cm, and the left ventricular muscle mass index was 85.8 g/m(2 )± 18.7 in athletes and in police officers 72.0 g/m(2 )± 9.1. Right ventricular area change among athletes was 49.4 ± 8.5%, and in police officers 46.0 ± 6.9%. The performance date of female triathletes can be used as training prescription for leisure female triathletes, when middle or long distances in triathlon competitions are planned. No right or left ventricular dysfunction was found despite long training and finishing of long distance competitions: non-elite athletes, 5.4 ± 2.8 years of triathlon competitions; elite athletes, 7.6 ± 5.8 years. PMID:27207600

  12. Estudo retrospectivo de fimose traumática em equinos e tratamento utilizando a técnica de circuncisão com encurtamento de pênis (1982-2007 Retrospective study of traumatic phimosis in horses and treatment with penis shortening surgery circumcision (1982-2007

    Directory of Open Access Journals (Sweden)

    Luiz Antonio Franco da Silva

    2010-02-01

    Full Text Available Traumatismos no pênis e prepúcio de garanhões são causas comuns de infertilidade nos equinos e entre elas destaca-se a fimose, que, neste estudo retrospectivo, realizado em 367 propriedades rurais, foram encontrados 49 casos da enfermidade, sendo 43 casos de origem traumática e com 12 óbitos. A técnica de circuncisão com encurtamento do pênis foi utilizada para a correção da enfermidade em 20 animais, distribuídos em dois grupos de acordo com o protocolo anestésico utilizado. Todos os equinos apresentaram como complicação pós-operatória edema em vários graus, porém diminuindo significativamente em 95% dos animais após o sétimo dia. Assim, concluiu-se que a técnica de circuncisão com encurtamento peniano constitui-se em alternativa viável e eficiente no tratamento de fimose traumática em equinos.Penis and prepuce injuries of stallions are common causes of infertility in horses and among them, paraphimosis is featured. This retrospective study was conducted in 367 rural properties and 49 cases were found; 43 of them were traumatic with 12 deaths. The technique of circumcision with shortening of the penis was used for the correction of the disease in 20 animals. They were divided into two groups according to the anesthetic protocol used. All horses had post-operative complications such as edema in various degrees, which decreased significantly in 95% of animals after the seventh day. Thus, it was concluded that the technique of circumcision with penis shortening is an effective alternative in the treatment of traumatic paraphimosis in horses.

  13. Understanding Female Aggression In Situationally Violent Relationships: A Qualitative Study

    OpenAIRE

    Adi, Samar G

    2007-01-01

    The purpose of this multiple case study was to gather information about female aggression in situationally violent relationship. The interviews and surveys of four African-American couples were coded and analyzed to gather information about the impact of female aggression on the relationship, the contextual factors surrounding female aggression, and the motivations for female aggression. The results indicated that female aggression impacts the couple relationship in several ways. First,...

  14. Female empowerment and education of children in Nepal

    OpenAIRE

    Magnus Hatlebakk; Yogendra B. Gurung

    2014-01-01

    A family survey was conducted in Nepal to investigate whether female empowerment leads to more education, in particular for girls. The relative economic power of the male and female side of the extended family was used as an instrument for female empowerment. The findings indicate, however, that both female empowerment and relative economic power affect education. There is a positive association between female empowerment and children’s education for both gender, while boys are prioritized if...

  15. The progressing female: The development of the female through vampire fiction

    OpenAIRE

    Gunnhildur Schram Magnúsdóttir 1985

    2014-01-01

    Throughout time, women’s progressing fight for equality can be seen to coincide with the development of female characters in vampire fiction. In the ancient, world the demonic vampire is often of feminine gender and it seems that most cultures, at one time or another, have some version of a female vampire or blood-sucking fiend. Some might say that in old-fashioned vampire fiction, for instance Polidori’s “The Vampyre”, the female characters were most often secondary to the males. However, th...

  16. The view of male and female leadership : From a male and female perspective

    OpenAIRE

    Hilding, Daniella

    2013-01-01

    The study is quantitative and is about working men and women’s view of male and female leadership. The intention of the study is to see if the men and women have a different perception of male and female leadership and also if they have different personality types. The method used was a survey where the sample is 80 participants, 31 men and 49 women from four different companies. Previous research shows that the perception of male and female leadership can be different, and that the reason ca...

  17. Female Chauvinism: An Ideal or Not-On the Impossibility of the Realization of Female Chauvinism

    Institute of Scientific and Technical Information of China (English)

    席坤

    2011-01-01

    This essay analyzes the concept of female chauvinism, as a radical idea evolved from feminism, is considered to be excessive expansion of feminism in modem society. Some people even think that it may cause excessive expansion of gender discrimination towa

  18. Colonizing Bodies: a Feminist Science Studies Critique of Anti-Fgm Discourse

    OpenAIRE

    Njambi, Wairimu Ngaruiya

    2000-01-01

    The contentious topic of female circumcision brings together medical science, womenâ s health activism, and national and international policy-making in pursuit of the common goal of protecting female bodies from harm. To date, most criticisms of female circumcision, practiced mainly in parts of Africa and Southwest Asia, have revolved around the dual issues of control of female bodies by a male-dominated social order and the health impacts surrounding the psychology of female sexuality and t...

  19. Behavioural processes in social context: female abductions, male herding and female grooming in hamadryas baboons.

    Science.gov (United States)

    Polo, Pablo; Colmenares, Fernando

    2012-06-01

    The formation of bonds between strangers is an event that occurs routinely in many social animals, including humans, and, as social bonds in general, they affect the individuals' welfare and biological fitness. The present study was motivated by an interest in the behavioural processes that drive bond formation in a social context of hostility, in which the incumbent partners vary greatly in physical power and reproductive interests, a situation in which individuals of many group-living species find themselves often throughout their lives. We focused on the quantitative analysis of female abductions via male aggressive herding in a nonhuman primate, the hamadryas baboon, in which intersexual bonds are known to be strong. We tested three hypotheses informed by sexual conflict/sexual coercion theory (male herding-as-conditioning and female grooming-as-appeasement) and by socioecological theory (unit size and female competition). The results supported the predictions: males resorted to coercive tactics (aggressive herding) with abducted females, and abducted females elevated the amount of grooming directed at their new unit males; in fact, they escaped from the otherwise negative effect of unit size on female-to-male grooming. These findings reveal that conflicts of interest are natural ingredients underpinning social bonds and that resorting to coercive aggression may be an option especially when partners differ greatly in their physical power. PMID:22391051

  20. Career situation of female astronomers in Germany

    CERN Document Server

    Fohlmeister, J; 10.1002/asna.201211656

    2012-01-01

    We survey the job situation of women in astronomy in Germany and of German women abroad and review indicators for their career development. Our sample includes women astronomers from all academic levels from doctoral students to professors, as well as female astronomers who have left the field. We find that networking and human support are among the most important factors for success. Experience shows that students should carefully choose their supervisor and collect practical knowledge abroad. We reflect the private situation of female German astronomers and find that prejudices are abundant, and are perceived as discriminating.We identify reasons why women are more likely than men to quit astronomy after they obtain their PhD degree. We give recommendations to young students on what to pay attention to in order to be on the successful path in astronomy.