ImportanceAdequate management of menstrual hygiene is taken for granted in affluent countries; however, inadequate menstrual hygiene is a major problem for girls and women in resource-poor countries, which adversely affects the health and development of adolescent girls.ObjectiveThe aim of this article is to review the current evidence concerning menstrual hygiene management in these settings.Evidence AcquisitionA PubMed search using MeSH terms was conducted in English, supplemented by hand searching for additional references. Retrieved articles were reviewed, synthesized, and summarized.ResultsMost research to date has described menstrual hygiene knowledge, attitudes, and practices, mainly in sub-Saharan Africa and South Asia. Many school-based studies indicate poorer menstrual hygiene among girls in rural areas and those attending public schools. The few studies that have tried to improve or change menstrual hygiene practices provide moderate to strong evidence that targeted interventions do improve menstrual hygiene knowledge and awareness.Conclusion and RelevanceChallenges to improving menstrual hygiene management include lack of support from teachers (who are frequently male); teasing by peers when accidental menstrual soiling of clothes occurs; poor familial support; lack of cultural acceptance of alternative menstrual products; limited economic resources to purchase supplies; inadequate water and sanitation facilities at school; menstrual cramps, pain, and discomfort; and lengthy travel to and from school, which increases the likelihood of leaks/stains. Areas for future research include the relationship between menarche and school dropout, the relationship between menstrual hygiene management and other health outcomes, and how to increase awareness of menstrual hygiene management among household decision makers including husbands/fathers and in-laws.Target AudienceObstetricians and gynecologists, family physicians.Learning ObjectivesAfter completion of this educational activity, the obstetrician/gynecologist should be able to define what is meant by “adequate menstrual hygiene management,” identify the challenges to adequate menstrual hygiene management that exist in resource-poor countries, and describe some of the intervention strategies that have been proposed to improve menstrual hygiene management for girls and women in those countries.

Despite advances in neurologic diagnosis and therapy, there has been little change in practice characteristics of US neurologists.

This report describes the adoption and integration of Western medicine in Cherán K’eri after the social changes in the 1940s which led to the transition from healer to pharmacist. There are various health models that rely heavily on community pharmacies. The place used as the basis for this report was a clinic managed by a Purépecha-speaking physician and pharmacist that served primarily monolingual indigenous Purépecha patients, whose population was around 9550 according to the 2010 census. Twelve major differences were observed between community pharmacies in the United States and the community pharmacies of Cherán. It was also observed that the modern approach to the health of the indigenous population used a combination of Western medicine together with traditional methods and only resorted to short-term therapies with Western medicines lasting five days or less. A formulary from the clinic’s community pharmacy compiled in 2022 listed the 38 most common medications. Medications used included anti-infectives (n = 3), central nervous system (n = 2), endocrine/hormonal (n = 3), gastrointestinal (n = 3), musculoskeletal (n = 17), respiratory or allergy (n = 6), and genitourinary (n = 2).