Special Journal of the Medical Academy and other Life Sciences.

REVEALING OVERLOOKED GYNECOLOGICAL PAIN: A CLINICAL INVESTIGATION INTO DYSMENORRHEA, MITTELSCHMERZ SYNDROME, AND THEIR COMMON MISDIAGNOSIS

2026-03-03T18:30:13+00:00

Background: Dysmenorrhea and mittelschmerz are highly prevalent cyclical gynecological pain syndromes affecting women of reproductive age. Although generally physiological, these conditions are frequently misdiagnosed due to symptomatic overlap with gastrointestinal, urinary, inflammatory, and surgical pathologies such as appendicitis, pelvic inflammatory disease, ectopic pregnancy, and urinary tract infections. Misdiagnosis may lead to unnecessary investigations, inappropriate interventions, delayed appropriate care, and psychological distress. Additionally, systemic factors—including limited menstrual health education and gender bias in clinical settings—further complicate accurate diagnosis.

Materials and Methods: This study employed a multi-modal investigative approach. A comprehensive literature review of over 30 peer-reviewed sources published since 2020 was conducted to evaluate epidemiology, diagnostic challenges, and systemic contributors to misdiagnosis. Semi-structured interviews were performed with four healthcare professionals (gynecologist, emergency physician, family medicine physician, and clinical nurse specialist) to identify real-world diagnostic barriers. Based on identified gaps, educational interventions were developed, including a diagnostic algorithm, symptom timeline chart, clinical checklist, and patient-centered educational materials. A social media awareness campaign targeting women aged 16–35 was implemented to assess baseline knowledge and community engagement.

Results: Findings revealed that diagnostic inaccuracies primarily stem from three factors: (1) significant symptom overlap with acute abdominal and pelvic conditions; (2) insufficient menstrual history-taking and limited provider education on cyclical pain disorders; and (3) implicit gender bias leading to symptom minimization. Expert consultations confirmed that incomplete cycle assessment frequently contributes to unnecessary imaging and hospital admissions. Implementation of structured diagnostic tools improved clinician confidence and clarity in differential diagnosis. The awareness campaign demonstrated high engagement, with over 70% of participants reporting unfamiliarity with mittelschmerz prior to intervention.

Conclusion: Dysmenorrhea and mittelschmerz remain under-recognized contributors to pelvic pain misdiagnosis in reproductive-age women. Improving diagnostic accuracy requires integration of standardized menstrual assessment protocols, curriculum reform in medical education, bias-awareness training, and patient-centered communication strategies. Incorporating structured clinical algorithms and cycle-tracking tools may reduce unnecessary interventions, enhance quality of life, and promote more equitable gynecological care.

MULTITASKING: ALZHEIMER'S DISEASE IS ALSO CAUSED BY A DISRUPTION OF MITOCHONDRIAL PROTEOSTASIS

2026-03-31T00:54:46+00:00

Introduction: Alzheimer disease (AD) and mechanisms underlying its etiology and progression are complex and multifactorial. The higher AD risk in women may serve as a clue to better understand these complicated processes [1]. Lifestyle behaviors such as poor diet and reduced physical activity, as well as environmental and metabolic risk factors. Described negatively tau protein impacts mitochondria, with provocation of AD and tauopathies [2,3]. Beta amyloid is present on the outside of cells in the form of plaques. Tau protein, inside cells in the form of glomeruli.

Material and methods: Were analyses articles from Google Scholar database, from the last 5 years 2020-2025, mentioned such words as ”Alzheimer's disease”, ”multitasking”, ”tau protein”, ”amyloid”, ”mitochondria”, ”mitochondrial proteostasis”, ”ubiquitin”, ”autophagy (mitophagy)”.

Results: Three types of task were administered to patients and 30 healthy controls: 1) informant –based scales and questionnaires, 2) a neuropsychological assessment exploring executive functions, episodic and semantic memory, and 3) a new original tests featuring multi-step naturalistic actions and multitasking: The Sequential Daily Life multitasking (SDLM). We predicted that patients with AD would mainly exhibit task perplexity. The accumulation of soluble and insoluble aggregated amyloid-beta may potentiate pathologic processes in AD [4,5].

Conclusion: According to burgess (200a), multitasking is a common characteristic of most daily life activities and relates to situations involving several tasks of carrying difficulty or priority. Performances on these tasks need to be dovetailed. A large amount of evidence supports the amyloid cascade hypothesis, which stated that amyloid-beta accumulation triggers tau hyperphosporylation and aggregation [6]. In the context of which, eu-ergic mitochondria with the normalization of mitochondrial uniporter-Ca++ and mitochondrial permeability pore transition, productively inactivating the active oxygen species and reactive nitrogen species, rejects the necrosis / apoptosis, cellular hypo- (an) ergic and proves the mitochondrial eu-energetic metabolic remodeling with the elimination of the hypo (an) ergic mitochondria performed by clearance lysosomal (mitophagy) [7-9]. Thus improving the functional activity of mitochondria, which is very important for AD. Accumulation of damaged mitochondria is a hallmark of aging and age-related neurodegeneration, including AD. Mitochondrial dysfunction (MD) is being considered as a potential therapeutic target in the treatment of AD and other neurodegenerative diseases. MD contributes to the development of many chronic, fatal diseases, such as Leigh syndrome and mitochondrial myopathy. These include the most severe forms of diabetes mellitus with deafness. MD also contribute to the development of neurodegenerative diseases, including Parkinson's and AD. Scientific research, supports the relevance of enhancing mitochondrial proteostasis to delay amyloid-β proteotoxic diseases, such as AD. Mitochondrial proteostasis is a localized form of mitochondrial homeostasis within general systemic homeostasis. It is a quality control system for intramitochondrial proteins. 1. Ensuring the proper formation of the unique three-dimensional structure of the protein molecule from a linear amino acid chain (proper folding), in which the protein assumes the most energetically favorable shape necessary for its cellular function, which is critical for protein activity. 2. The functioning. 3. Accumulation of toxic endogenous substances (degradation of damaged proteins), in the event of disruption of the ubiquitin-proteasome system (for short-lived proteins) and autophagy (for long-lived, aggregated proteins)[10-14].

It is important to note that life-saving successes in critically ill patients were discussed in our published studies with targeting therapies Lysosomal Mitochondrial Clearance of Autophagy (Mitophagy) and Abnormal/Extreme Myelopoiesis of the non-functional and incapable mitochondria to generate the energy needed by the body [15-48] and in the case of AD mental energy.

Scientific coverage of the relationship between gender and refractive error of the eye: problems and prospects, was considered as a localized disorder of mitochondrial dysfunction of mitochondrial proteostasis, a localized form of ocular mitochondrial homeostasis within general systemic homeostasis. With a description of sex-specific differences in the expression of mitochondrial genes and mitochondrial target proteins (MTPs) involved in oxidative phosphorylation (OXPHOS), in contrast to women, who showed increased expression of non-OXPHOS MTPs, indicating a pronounced sexual dimorphism of energy metabolism at the whole-body level. In energy homeostasis, the role of glucose as an energy substrate in the regulation of the menstrual cycle deserves special attention [49,50].

ENDOTHELIAL DYSFUNCTION IN PATIENTS WITH GOUT AND ASYMPTOMATIC HYPERURICEMIA: AN INTEGRATIVE LITERATURE REVIEW

2026-03-05T02:02:09+00:00

Introduction: Endothelial dysfunction is a key pathophysiological mechanism underlying cardiovascular disease and is characterized by reduced nitric oxide bioavailability, increased oxidative stress, and enhanced inflammatory activity. Growing scientific evidence suggests a relationship between endothelial dysfunction, gout, and asymptomatic hyperuricemia. While hyperuricemia has traditionally been viewed primarily as a precursor to gout, recent research indicates that elevated uric acid levels may independently contribute to vascular impairment. This integrative review aims to analyze the existing evidence regarding the relationship between endothelial dysfunction, gout, and asymptomatic hyperuricemia and to explore the potential mechanisms linking these conditions.

Methods: An integrative literature review was conducted using PubMed, CAPES Periodicals Portal, and IntraMed databases. The search included the descriptors “endothelial dysfunction,” “endothelial function,” “hyperuricemia,” and “gout,” combined using Boolean operators. Inclusion criteria comprised full-text studies published within the last 20 years in English, Portuguese, or Spanish that directly addressed the relationship between endothelial dysfunction and hyperuricemia or gout. After screening 369 identified articles by title, abstract, and full-text review, 18 studies were selected for analysis.

Results: The reviewed literature demonstrates a consistent association between elevated uric acid levels and endothelial dysfunction. Mechanisms identified include reduced nitric oxide bioavailability due to increased reactive oxygen species production, endothelial nitric oxide synthase (eNOS) uncoupling, activation of inflammatory pathways such as HMGB1/RAGE and NF-κB, disruption of the ADMA/DDAH pathway, mitochondrial calcium overload, and increased expression of pro-inflammatory cytokines and genes. Clinical and experimental studies also suggest that xanthine oxidase activity plays a central role in oxidative stress-mediated endothelial injury. While some uric acid-lowering therapies, such as allopurinol, show improvement in endothelial function, results remain inconsistent across pharmacological interventions.

Conclusion: The current body of evidence supports a significant association between endothelial dysfunction, gout, and asymptomatic hyperuricemia, although the precise causal nature of this relationship remains unclear. Hyperuricemia appears to contribute to vascular injury through oxidative stress, inflammation, and nitric oxide pathway disruption. Given the rising global prevalence of hyperuricemia and gout, further clinical and mechanistic studies are necessary to clarify causality and guide preventive and therapeutic strategies aimed at reducing cardiovascular risk.

THE EFFECTIVENESS OF PUBLIC HEALTH INTERVENTIONS IN REDUCING DENGUE CASES IN MALAYSIA

2026-03-05T21:48:25+00:00

Background: Dengue fever remains a major public health concern in Malaysia, with frequent outbreaks and increasing incidence, particularly in densely populated urban areas. Despite the implementation of various public health interventions such as vector control programs, public awareness campaigns, and environmental management strategies, dengue transmission continues to pose a significant burden on healthcare systems and communities. Evaluating the effectiveness of these interventions is essential to understand their impact and identify strategies for improving dengue control in Malaysia.

Methods: This study employed a mixed-methods research design combining quantitative and qualitative approaches to assess the effectiveness of public health interventions in reducing dengue cases in Malaysia. Quantitative data were collected from Ministry of Health reports, surveillance records, and community surveys to analyze dengue incidence rates before and after intervention implementation. Qualitative data were obtained through semi-structured interviews and focus group discussions with public health officials, healthcare providers, and community members. Statistical analyses including descriptive statistics and comparative analysis were used to evaluate trends in dengue cases and the impact of interventions.

Results: The findings indicate that integrated vector control strategies, including fogging, source reduction, and environmental management, contributed to reductions in mosquito populations and dengue incidence in several regions. Community participation and public awareness programs were identified as important factors influencing intervention effectiveness. However, challenges such as rapid urbanization, inconsistent community engagement, and insecticide resistance limited the long-term impact of some control measures. Innovative approaches such as Wolbachia-infected mosquito releases showed promising results in reducing dengue transmission in pilot areas.

Conclusion: Public health interventions in Malaysia have demonstrated potential in reducing dengue cases, but their effectiveness depends on sustained implementation, strong community participation, and integrated control strategies. Strengthening surveillance systems, expanding innovative mosquito control technologies, and improving community engagement are essential to enhance dengue prevention efforts. A comprehensive and coordinated public health approach

COMPREHENSIVE ASSESSMENT OF BREAST HEALTH AND CANCER AWARENESS UNDERSTANDING SYMPTOM RECOGNITION AND BREAST SELF-EXAMINATION AMONG WOMEN IN INDIA, MALAYSIA, AND AFRICA

2026-03-08T19:48:02+00:00

Background: Breast cancer remains one of the leading causes of morbidity and mortality among women worldwide, with approximately 2.3 million new cases and 670,000 deaths reported in 2022. Early detection through breast self-examination (BSE), awareness of symptoms, and timely screening significantly improve outcomes. However, disparities in knowledge, cultural perceptions, and access to screening services affect breast health practices across different regions. This study aimed to assess breast health awareness, symptom recognition, and BSE practices among women from India, Malaysia, and Africa.

Methods and Materials: A cross-sectional online survey was conducted among 69 non-pregnant women aged 18–45 years (mean age 24), primarily female students from Kursk State Medical University. Participants originated from India, Malaysia, and African countries. The structured questionnaire collected demographic data, menstrual history, family history of breast cancer, awareness of breast cancer risk factors, familiarity with BSE techniques, screening behaviors, and reported breast symptoms. Data were analyzed to compare awareness levels and preventive practices among the three regional groups.

Results: Indian women represented the largest proportion of participants (49.3%), followed by Malaysian (30%) and African women (21.7%). Familiarity with BSE was highest among Indian women (76.47%), followed by African (73.33%) and Malaysian women (65%). However, regular monthly BSE practice remained relatively low across all groups (23–26%). African participants showed higher utilization of imaging investigations (60%) and a greater prevalence of family history of breast cancer (13.33%). Malaysian women reported higher detection of breast lumps during BSE (15%), while African women reported higher rates of breast pain and nipple sensation changes. Most participants indicated willingness to seek medical consultation after detecting abnormalities.

Conclusion: Although awareness of breast self-examination exists among women in India, Malaysia, and Africa, the regular practice of BSE remains limited. Regional differences in screening utilization, symptom recognition, and health-seeking behavior highlight the need for targeted educational programs and culturally appropriate breast health interventions. Strengthening awareness campaigns, improving access to screening services, and promoting regular BSE practice may enhance early detection and reduce breast cancer burden globally.