Special Journal of the Medical Academy and other Life Sciences.

Etiology of cancer: increased formation of blood vessels among cells

Vasilieva Irina, Ilie Vasiliev — Sun, 02 Nov 2025 00:00:00 +0000

Introduction: During malignant transformation, dysregulation of angiogenesis leads to the formation of a vascular network of tumor-associated capillaries promoting survival and proliferation of the tumor cells. Starting with the hypothesis formulated by Judah Folkman [1] that tumor growth is angiogenesis-dependent, this area of research has a solid scientific foundation and inhibition of angiogenesis is a major area of therapeutic development for the treatment of cancer.

Material and methods: There were analyzed articles from Google scholar database, from the last 5 years 2020-2025, mentioned such words as “vascularization of tumor cells”.

Results: Tumors rely on blood vessels to grow and metastasize. The tumor microenvironment is rich in pro-angiogenic factors [2]. Pro-angiogenic conditions in the tumor microenvironment, such as hypoxia, are double-edged swords, promoting both the repair of normal tissues and the development of an abnormal blood vessel network. Vascular normalization entails modifying the tumor vascular system to improve tumor oxygenation and substance transport, thereby contributing to improving the efficacy of radiotherapy, chemotherapy, and immunotherapy.

Conclusion: Over this period numerous authors published data of vascularization of tumors, which attributed the cause of neo-vascularization to various factors including inflammation, release of angiogenic cytokines, vasodilatation, the role of the endothelial system [3-12] and increased tumor metabolism. According to legend, Paul of Aegina reported in the 7th century AD that cancer was so called because this disease “has the veins stretched on all sides as the animal the crab has its feet, whence it derives its name”. However, the first historical description of blood vessels related to cancer is commonly accredited to Galen of Pergamon (AD 129-c. 200/c. 216).

Comparative analysis of femoflor and microscopic examination in vaginal flora assessment

Nurin Syafiqah Binti Syazali Ong , Dr. Ghassan Salibi, Prof Nikolaos Tzenios — Sun, 02 Nov 2025 00:00:00 +0000

Background: Vaginal health is intricately tied to the composition and balance of the vaginal microbiome, which is predominantly dominated by Lactobacillus species. Disruptions in this balance can lead to bacterial vaginosis (BV), aerobic vaginitis, and other complications. Traditional diagnostic methods such as Nugent scoring and Amsel’s criteria have been widely used to assess vaginal flora but are limited by subjectivity, low sensitivity, and inability to detect polymicrobial infections. Molecular techniques, such as Femoflor multiplex real-time PCR, offer a more sensitive, rapid, and comprehensive approach to diagnosing vaginal dysbiosis and identifying co-infections.

Methods and Materials: This cross-sectional retrospective study included symptomatic women aged 18 to 45 undergoing both microscopic and Femoflor-16 testing. Vaginal swabs were analyzed by Gram-stained microscopy using Nugent and Amsel criteria, and by Femoflor-16 PCR, which quantifies 16 microbial groups and assesses total bacterial biomass. Diagnostic outcomes were compared based on sensitivity, specificity, and Cohen’s kappa to determine concordance. Turnaround time, microbial load, and species-level detection rates were also analyzed to evaluate diagnostic efficiency and clinical applicability.

Results: Femoflor-16 demonstrated significantly higher diagnostic accuracy, with 99% sensitivity and 93% specificity for BV, compared to 75% and 82% respectively for microscopy. Femoflor detected polymicrobial infections, including Gardnerella vaginalis, Atopobium vaginae, and Mycoplasma spp., which microscopy often missed. It also identified intermediate dysbiosis and quantified microbial loads, aiding in stratifying the severity of infection. Additionally, Femoflor provided results within 2 hours, compared to the 48-hour average for microscopy. In samples with normocenosis, Femoflor detected asymptomatic low-abundance pathogens, highlighting its diagnostic precision.

Conclusion: Femoflor multiplex PCR offers superior sensitivity, specificity, and turnaround time compared to traditional microscopy in vaginal flora assessment. Its ability to quantify bacterial loads, detect polymicrobial infections, and differentiate Lactobacillus species provides enhanced clinical insights for personalized treatment strategies. These findings support the integration of molecular diagnostics into routine gynecological practice to improve early detection, reduce misdiagnosis, and optimize patient outcomes.

Maternal Factors and their impact on Gestational Diabetes Mellitus in the Maldives

Khadeeja Shana Ahmed , Dr. Ghassan Salibi, Prof Nikolaos Tzenios — Sun, 02 Nov 2025 00:00:00 +0000

Background: Gestational diabetes mellitus (GDM) is a significant public health concern globally, with a growing burden in South Asian countries, including the Maldives. South Asian women are genetically predisposed to insulin resistance and often experience GDM even at lower levels of adiposity. This study investigates maternal factors influencing the development of GDM among Maldivian women, aiming to inform risk stratification and preventive strategies.

Methods and Materials: A cross-sectional study was conducted among 137 postpartum Maldivian women within two years of delivery. Participants self-reported demographic, obstetric, and lifestyle information via an online survey. Key variables included maternal age, pre-pregnancy body mass index (BMI), gestational weight gain (GWG), parity, maternal birth weight, family history of diabetes, prior GDM history, nutrition, physical activity, and smoking. Statistical analysis, including logistic regression, was used to identify significant predictors of GDM.

Results: The prevalence of GDM in the sample was 34.3%. Statistically significant risk factors included maternal age ≥30 years (p = 0.0026), high pre-pregnancy BMI (p < 0.001), low maternal birth weight (p = 0.0014), family history of diabetes (p = 0.0334), and prior diagnosis of GDM (p < 0.001). Unhealthy eating patterns and lack of physical activity were also more common in the GDM group. Multivariate analysis confirmed previous GDM, family history, and low birth weight as the strongest predictors of GDM.

Conclusion: This study highlights the considerable influence of both modifiable (diet, BMI, physical activity) and non-modifiable (maternal age, birth weight, genetics) maternal factors on the development of GDM in the Maldivian population. These findings underscore the need for targeted public health interventions, preconception counselling, and culturally adapted prenatal education to reduce GDM incidence and its intergenerational consequences.

The impact of maternal age on pregnancy outcomes & mode of delivery: a focus on cesarean section & vaginal delivery rates.

Richard Tetteh Foli — Sun, 02 Nov 2025 00:00:00 +0000

Background: The global trend toward delayed childbearing has raised concerns about its impact on pregnancy outcomes, particularly regarding the mode of delivery. Advanced maternal age is associated with an increased risk of obstetric complications, influencing a significant rise in cesarean section (CS) rates. This study investigates the relationship between maternal age and delivery outcomes, with a focus on CS and vaginal delivery rates across 16 countries with diverse healthcare systems.

Methods and Materials:A retrospective analysis of public health data from 2.7 million women in 16 countries was conducted. Participants were stratified into three maternal age groups: <20 years, 20–34 years, and ≥34 years. Variables analyzed included parity, smoking status, previous cesarean delivery, use of assisted reproductive technology (ART), and mode of delivery. Country-specific healthcare policies and cultural factors were also considered to contextualize differences in delivery practices.

Results: The study revealed a clear increase in cesarean section rates with maternal age, particularly among women aged ≥34. Vaginal delivery remained the most common method overall but declined significantly in older age groups. Nordic countries maintained high vaginal delivery rates (80–90%) and low CS rates (<25%) across all age groups. In contrast, countries like Ghana and China showed marked increases in CS rates among older mothers. Factors such as ART use, obstetric complications, and healthcare policy differences contributed to variations.

Conclusion: Maternal age is a significant predictor of delivery mode, with advanced age correlating with higher CS rates due to physiological risks and systemic healthcare factors. However, variations across countries highlight the influence of healthcare models and cultural attitudes. Encouraging evidence-based practices, enhancing preconception care, and supporting patient-centered decision-making may help balance safety with reduced medicalization of childbirth for older mothers.

Factors influencing premenstrual syndrome and premenstrual dysphoric disorder in different countries

Muhammad Daniel Bin Mohd Hisham — Sun, 02 Nov 2025 00:00:00 +0000

Background: Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) are cyclical conditions affecting a substantial proportion of women of reproductive age, marked by a range of emotional, behavioral, and physical symptoms. While the global prevalence of PMS ranges from 30% to 90%, PMDD affects a smaller yet clinically significant proportion of women. Variations in prevalence and severity across countries suggest that biological, psychological, and sociocultural factors play influential roles. This study explores the multifactorial determinants of PMS and PMDD in different national contexts, focusing on both physiological mechanisms and environmental influences.

Methods and Materials: A narrative review approach was used to synthesize findings from peer-reviewed literature published between 2009 and 2025. Studies included were cross-sectional, systematic reviews, meta-analyses, and public health reports that assessed prevalence, risk factors, and management strategies for PMS and PMDD across countries. Emphasis was placed on hormonal imbalances, neurotransmitter dysregulation, genetic predispositions, stress, lifestyle, and cultural stigma. Comparative data from countries such as Ethiopia, India, Malaysia, Jordan, and the United States were included.

Results: Hormonal fluctuations, particularly in estrogen and progesterone, as well as serotonergic sensitivity, were identified as core biological factors contributing to PMS and PMDD. Lifestyle factors including high stress levels, poor diet, lack of physical activity, and sleep disturbances were found to exacerbate symptoms. Sociocultural influences—such as menstrual stigma, limited mental health literacy, and healthcare access—significantly shaped symptom reporting and treatment-seeking behavior. Countries with stronger public health infrastructure showed better awareness, diagnosis, and support mechanisms.

Conclusion: PMS and PMDD are complex, multifactorial disorders influenced by an interplay of physiological, environmental, and cultural factors. Cross-national differences highlight the need for culturally sensitive diagnostic tools and integrative care models. Future interventions should focus on improving awareness, reducing stigma, and promoting early screening, particularly in low-resource settings.