Gynae OPD Research Articles

Prevalence of Thyroid Disorder in First Trimester of Pregnancy, Study from Lumbini Province Nepal

INTRODUCTION Thyroid disorder is the second most common endocrine disorder of pregnancy. The most common thyroid disorder is hypothyroidism which often goes undiagnosed during pregnancy without screening. It has influence in maternal and fetal outcome of pregnancy. The objective of this study is to determine the prevalence of thyroid disorder in the first trimester of pregnancy. MATERIAL AND METHODSThis was cross-sectional observational study conducted for a period of 6 months (Jan - June 2022) at Universal College of Medical Sciences, Bhairahawa, Nepal. All the pregnant women in their first trimester who came for antenatal check-up in gynae OPD was included after taking consent. RESULTSTotal 393 cases were evaluated. 58% were primigravida and 42% were multigravida. Mean age was 26 years with minimum 17 years and maximum 41 years. Majority of cases were of the age group 20 to 30 years 76.6%. Thyroid disorder noted in 21.3%. Hypothyroidism found in 18.6% with overt hypothyroidism in 12.8% and subclinical hypothyroidism in 5.8%. Hyperthyroidism noted in 2.7% with overt hyperthyroidism in 1.5% and subclinical hyperthyroidism in 1.2%. CONCLUSIONThyroid disorder in pregnancy in common health problem in first trimester in pregnancy. Early diagnosis and treatment is needed to reduce complications associated with this endocrine disorder of pregnancy.

Urethral Large Hemangioma in a Prepubertal Female Patient – A Case Report

Background: Hemangiomas rarely occur in the urethra, and most reported cases have involved in men and elderly women1-4. The clinical manifestations of urethral hemangiomas include lower urinary tract symptoms, dysuria, hematuria, perineal discomfort, and urethral discharge. There are only a few cases reported in the literature and exact incidence is still not known.1-5 A few case reports and occasional series have described posterior urethral hemangioma presenting as hematuria. We are reporting a rare case of a cavernous hemangioma of the anterior urethra in a prepubertal female who presented in the gynae OPD with bleeding per vagina. J Com Med Col Teachers Asso Jan 2023; 27(1): 42-43

THREE CASES OF FEMALE INFERTILITY WITH DIFFERENT CAUSES - IS UTTAR BASTI REALLY EFFECTIVE?

Introduction- Number of cases of female infertility are increasing day by day in gynae OPD and to treat infertility with 100% efficacy without any side effects has become very challenging for every gynaecologist. Many causes are responsible for female infertility in which 25-35% cases are related with tubal factor and 30-40% cases are related with ovulatory dysfunction and so on … Aim/Objective- To evaluate the efficacy of Uttar Basti and Pratimarsh Nasya in female infertility. To assess the conceiving rate during trial and follow up. Methodology- Conceptual Study and Clinical Study. Result- We present 3 cases of female infertility (one related to tubal factor second related to tubal factor and ovulatory dysfunction and third one related to tubal factor including uterine fibroid with anovulation) with treatment outcomes. Discussion- And the discussion arises here, Is Uttar Basti as effective as we think and how does it work. Procedure explained in Ayurveda like Uttar Basti and Pratimarsh Nasya are found to be highly efficient in curing local and systemic factor responsible for female infertility as per research done. These therapies collaboratively have capability to change the scenario and can be proved as boom in the field of Ayurveda in curing female infertility. With these prospectives in mind, we designed a combined treatment plan to cure female infertility.

The effects of structured teaching programme regarding preventive aspects of cervical cancer among women in reproductive age

Background: Cervical malignancy is second most normal disease on the planet and driving reason for death from malignant growth among ladies in non-industrial nations. Objectives: To evaluate the knowledge among women in regards to cervical cancerand to discover the relationship between the demographic variables in regards to the cervical malignancy. Design: Univariant research configuration plans were embraced for this investigation. Setting: The study was conducted in Gynae OPD in Sewa Hospital and research Centre, Lucknow. Participants: 200 ladies who fulfill the inclusion criteria were selected as sample. Methods: The examination configuration Univariant research configuration was utilized for this investigation. The non-probability convenient sampling method was utilized to choose the 200samples. The information was gathered by managing the organized structured teaching plan on prevention of cervical malignant growth to survey the degree of information among women. Results: The investigation discovering uncovered that in a posttest with the mean of the level of knowledge was 16.28 and the standard deviation of 2.11. The result explained that a structure teaching programme to the females about cancer cervix was much effective and brought the outstanding changes in their level of knowledge.

VULVOVAGINAL CANDIDIASIS- PREVALENCE AND ANALYSIS OF ASSOCIATED RISK FACTORS AMONG WOMEN OF REPRODUCTIVE AGE GROUP IN VINDHYA REGION

Background: Although it can affect all groups, vaginitis remains one of the most common ambulatory problems to occur in women of reproductive age group. It accounts for 5-10 million office visits per year throughout world. In India prevalence of vaginitis is approximately 30%. Vaginitis has substantial impact on various aspects of female reproductive health, mental health, work ability and routine physical activity. It is also associated with various obstetrical and gynecological complications. Vulvovaginal candidiasis is common form of vaginitis. So, we aim to find out prevalence and analyze risk factors associated with vulvovaginal candidiasis at tertiary care hospital in Rewa, Madhya Pradesh India. Method: An observational cross-sectional study was conducted at Department of Obstetrics and Gynecology, Shyam Shah Medical College Rewa for 18 months from January 2021 to June 2022 on 1000 women of reproductive age group, visiting routine Gynae OPD of department of Obstetrics & Gynecology. Results: Prevalence of vulvovaginal candidiasis in present study was found to be 12%. Various associated risk factors were OCP use, use of cloth during menses, douching/cleanliness habit, rural area of residence, middle and lower socioeconomic class and various occupations like factory workers and farmers. Conclusion: As it is evident that vaginitis will never be completely prevented, but incidence can be reduced. Much of the morbidity and complications can be reduced by identification and prevention of modifiable risk factors and interventional strategies directed mainly on high-risk behaviors in day-to-day life.

Comparative Study of Static and Dynamic Hand Grip Endurance with Correlation of Deep Breathing among Pregnant Women; A Cross-sectional Study

Background: Physiology of the mother, changes constantly during pregnancy including reduced HGS that is require for carrying the child after delivery. Activities of daily living require manual gripping tasks that require dynamic and static contractions. Predictor of upper extremity function is Hand Grip Strength and handgrip endurance. Screening of hand grip strength during antenatal care is still uncommon. Objectives: To compare static and dynamic hand grip endurance in pregnant females and to find its correlation with deep breathing. Material and Methods: The study recruited 40 participants of primi-gravida of 1st and 2nd trimester, between ages 20 and 35 years from SHALAMAR GYNAE OPD. The participants assigned to the groups (Group 1: with DB, Group 2: without DB) based on their trimester and gravidity. Static and dynamic endurance assessed using hand held dynamometer. Results: Mean Age ± Standard deviation for deep and non-deep breathing groups was 22.85 ± 2.30 and 24.05 ± 0.514. Age had negative little or low correlation with all variables of deep and non-deep breathing groups. Peak hand grip strength was moderately correlated with hand grip endurance with deep and non-deep breathing group (r = -0.628, r = -0.566 respectively). Static hand grip endurance was weakly correlated with peak hand grip strength in deep breathing group (r = -0.239) whereas static hand grip endurance had little, if any correlation with peak hand grip strength in deep breathing group (r = -0.165). Clinical implication: Management of hand grip strength and endurance improves general well being of pregnancy. By employing deep breathing exercises hand grip strength can be improved. Conclusion: Peak hand grip strength and endurance improved markedly in 2nd trimester with deep breathing. Deep breathing can improve peak hand grip endurance and peak hand grip strength in pregnancy with increasing trimester. Whereas static and dynamic hand grip endurance has insignificant effect in different trimester. Keywords: Pregnancy, deep breathing, trimester, endurance, peak grip endurance

MODALITIES OF TREATMENT OF PELVIC ORGAN PROLAPSE IN A TERTIARY CARE HOSPITAL (GMCH) AND ITS SHORT TERM FOLLOW UP

Pelvic organ prolapse is an increasingly common condition seen in women with advancing age. The objective of this study is to observe the different modalities of treatment of pelvic organ prolapse and evaluate its outcome. In this study, all patients with pelvic organ prolapse, attending Gynae OPD or admitted in GMCH were included. In this study, 45(22.5%) patients were advised to use vaginal tamp Results: on, 9(4.5%) patients were advised Kegel's exercise, 125(62.50%) patients were treated with VH + PFR, , 15 (7.5%) patients underwent vaginal hysterectomy (VH), 4(2%) patients underwent VH + PFR + Sacrospinous xation and 2 (1%) patients were treated with Fothergills' surgery. The feedback received revealed that 118(59%) were satised and responded well to the treatment, 26 (13%) patients were not satised and from the remaining 56(28%) patients, no feedback had been received. It was observed that satisfaction was higher in patients who had surgical intervention.

Outcomes of oligohydramnios in term pregnancy ending in normal vaginal delivery or C section irrespective of induction

Objective: To determine the outcome of oligohydramnios in term pregnancy ending in normal vaginal delivery or C Section irrespective of induction. Study Design: Descriptive Study. Place and Duration of Study: Department of Obs & Gynae, HMC, Peshawar from 23rd January 2022 to 22 July, 2022. Methodology: A total of 289 pregnant female patients at term (37-42 weeks) presented to the Gynae OPD of our hospital with oligohydramnios (diagnosed clinically having AFI < 5%) were enrolled through nonprobability consecutive sampling technique. Sample size was calculated taking 75%10 proportion of meconium-stained liquor cases as an outcome of oligohydramnios, 95% confidence interval and 5% margin of error on WHO sample size calculator. Patients with singleton pregnancy, nulliparity, Bishop score <5, gestational age of 37-42 weeks were included. Results: Statistically insignificant differences were observed for various outcomes variables in oligohydramnios at term as meconium-stained liquor, Apgar Score < 7 at 1 min, NICU admissions, apgar score < 7 at 5 min with respect to age of patients as p-values of 0.702, 0.489, 0.244, 0.489 and 0.900 were recorded respectively. Conclusion: This study demonstrated that oligohydramnios at term did not influence the outcomes in nulliparous women with unfavorable cervix.

A STUDY OF SOCIODEMOGRAPHIC CHARACTERSTICS, ANXIETY & DEPRESSION IN WOMEN WITH POLYCYSTIC OVARIAN SYNDROME

Background: Polycystic ovarian syndrome (PCOS) is the most common and distressing disorder of reproductive age group female which include symptoms like amenorrhea, hirsutism, obesity, acne, infertility etc. Because of these distressing symptoms PCOS has been associated with signicant psychiatric morbidity. Aims & objectives: 1.To study the sociodemographic characterstics of females with PCOS. 2.To nd out the frequency of different symptoms in females suffering from PCOS. 3.To study the prevalence of anxiety and depression among females suffering from PCOS. Materials & methods: 30 consecutive female patients attending gynae OPD from 1/3/2022 to 1/4/2022 suffering from PCOS as per Rotterdam criteria diagnosed by a consulatant gynaecologist were taken for the study. They were thoroughly evaluated on a specially designed semistructred proforma,GHQ-12,Hamilton anxiety rating scale, Beck's depression inventory and PCOS questionnaire. Results were analysed using suitable statistics. Result and conclusion: Majority (60%) of the patients were from the age group 25-30 years. Most common symptom of PCOS in the patient was menstrual irregularity(90%) followed by obesity(80%), hirsutism(50%), acne(40%), alopecia(20%) and acanthosis nigricans(10%), 33%of the patients showed clinically signicant anxiety symptoms, 10% shown clinically signicant depression and 10% showed mixed anxiety depression disorders.

KNOWLEDGE REGARDING CONTRACEPTIVE METHODS AMONG MARRIED WOMEN OF REPRODUCTIVE AGE GROUP

Uncontrolled population growth is recognised as the single most important impediment to national development and birth control is the first important step woman must be taken to keep a check over uncontrolled population. Often family planning is used as synonym for birth control. The main objective of family planning programme is to assist individuals and couples to space and/or limit their children prevent unwanted pregnancy, improve their overall reproductive and child health. Contraception is one of the major components of Reproductive health programme. The use of contraceptive measures constituted the backbone of the programme. Therefore, assessing the current level of the knowledge regarding contraceptive devices among general population is very important so that the further planning can be done for educational teaching programmers to enhance their knowledge. Aim: This study was conducted to assess knowledge regarding selected contraceptive methods among married women attending gynae opd, Govt. Multi speciality hospital-16, Chandigarh. Setting and Design: Govt. Multi speciality hospital-16, Chandigarh was the setting for the study. Quantitative research approach and a descriptive research design was used for the study. Material and Methods: The study was conducted on a sample of 100 married women between the age group of 15-49 yrs of age attending gynae opd, Govt. Multi speciality hospital-16, Chandigarh using simple random sampling. Data was collected using self structured multiple choice questionnaire on contraceptive method usage. The collected data was organized, tabulated, analyzed and interpreted using descriptive and inferential statistics. Results: The findings of the study revealed that out of 100 married women majority i.e. 54% of the respondents had good level of knowledge and near about 40% had average knowledge. It has been concluded from the present study that respondents have basic knowledge of contraception but detailed knowledge about contraceptive methods was not known to the women. Therefore, the health talk was given to enhance the knowledge of the subjects regarding the topic.

The psychological impact and perception of COVID -19 pandemic on pregnant women presenting to a tertiary care hospital, KPK, Pakistan.

Purpose: To determine the psychological impact and perception of covid -19 pandemic on pregnant women presenting to a tertiary care hospital, KPK, Pakistan.
 Methodology: An observational cross-sectional study was conducted on pregnant women in the outpatient department of Lady Reading Hospital, Peshawar from 1st February 2020 to 31st March 2021. All pregnant women (n=424) visiting gynae OPD who fulfilled the inclusion/exclusion criteria were included. The questionnaire was filled out by physicians for patients and the Kessel-10 scale was used to classify the anxiety.
 Findings: Fifty one 51% females fall in the 19-25 years age group. 54.5% were illiterate with most of the women (94.6%) being housewives. The majority of the 424 women in the study were multiparous (59%) and 59.1% presented in their third trimester. The highest number of patient women in the age group 19-25 years suffered mild distress. Moderate stress was found in 54 women. In all age groups, a total of 11 patients suffered severe psychological distress. 144 women reported having no stress. Nulliparous women were 109 in total and most of them had either mild disorder (n=54) or no stress at all (n=48). the majority of ladies who were housewives stated that they have been mildly stressed (n=208) or not stressed at all (n=139). A total of 11 women had faced severe stress. 247 women had third-trimester pregnancies and most of them (n=129) had mild stress. Severe distress affected 8 of the third-trimester women and 3 of the 2nd-trimester women. Most women (71.9%) believed that elective Cesarian surgery is not better than vaginal delivery during the covid -19 pandemic. COVID-19 pandemic has created anxiety in more than half (53%) of pregnant women visiting OPDs. The literacy rate and occupational status of women had little effect on the occurrence of psychological distress.
 Recommendations: Strict SOPs must be observed in hospitals and pregnant women should receive counseling regarding their fears and anxiety from medical care-takers. More studies are needed to measure mental health challenges in pregnant and postpartum women, as well as the resilience and risk factors associated with beneficial outcomes, to attenuate the pandemics' long-term mental health impacts.

Conception in a case of primary infertility with intra mural fibroid–A case report

Infertility is a state of inability to conceive after unprotected intercourse for 1 year. Incidence of infertility is 10%–15%. In the Unani system of medicine, many herbal drugs are used empirically for enhancing fertility. This case report was an effort to understand the role of Unani formulations in conception. This patient had unilateral tubal blockage with Bilateral PCOS and twice IVI and IUI was failed. This study was performed in the Gynae OPD of A&U Tibbia College, Karol Bagh, New and Delhi. A 23-year-old female patient with primary infertility for 3 years was diagnosed with intra mural fibroid. She was given Unani treatment with Majoon Supari Pak, 5gm BD, Qurs -e-Kafoor 2BD and Itrifal Shatrta 5gm B.D and Majoon Ard Khorma 5 g b.i.d. for 1 month for husband in first cycles. Medicines were added and changed and she conceived in third month. The main outcome measure was to observe the conception in the patient. The patient conceived within 3 months of the treatment. These formulations might have assisted in conception as they are considered to have uterine tonic, vitalizer, and aphrodisiac properties in Unani medicine.

Visual Inspection of Cervix wiih Acetic Acid as A Method of Cervical Cancer Screening in Tertiary Hospital

Background: Cervical cancer belongs to a glorious natural history which favors well implemented secondary prevention. Considering the various constraints in our country, our study aimed to evaluate Visual Inspection of Cervix with Acetic Acid (VIA) as an alternative or adjunct to cervical cytology (Pap smear) in early detection of cervical cancer and also to assess its effectiveness as a screening method in a tertiary center outside of low resource settings.
 Materials and methods: This cross-sectional descriptive study was carried out at Gynae OPD of Chittagong Medical College Hospital (CMCH) from January to December 2012. A total of 1600 sexually active women with 21 to 60 years old were enrolled in this study by purposive sampling technique. The women underwent a complete clinical evaluation, including Pap smear and VIA. Any positive test was referred to colposcopy and directed biopsy. Finally, data were analyzed with the help of SPSS 16 software.
 Results: Out of 1600, VIA was positive in 135(8.4%) and cytology was positive in 74(4.6%) cases of the true positive 48 cases. The sensitivity of VIA (75%) was much higher than that of Pap smear (48%). The sensitivity ratio 1.54 (p<0.001). The positive predictive value for detection of CIN2 and above was 17% for VIA and 16% for pap (p=0.5). Moreover, patients of lost to follow-up before colposcopy and biopsy were only 4.44% with VIA positive cases while 28.38% with positive Pap smear (p<0.0001).
 Conclusions: The high sensitivity of VIA indicates that it may be a feasible alternative test for detection of precancerous lesions of the cervix not only in limited-resource settings but also in a well-equipped tertiary hospital.
 IAHS Medical Journal Vol 4(2), June 2021; 22-26

Knowledge and Practice of Breast Self-examination among Women in Yavataml, India, A Cross- Sectional Study

Objectives: Worldwide breast cancer is the most common cancer among women. By 2030 the global burden of breast cancer is expected to exceed 2 million, with increasing proportions from developing countries. The aim of this study was to assess awareness about breast cancer among women attending in a gynecological clinic in rural area India. Materials & Methods: It was a cross sectional study done for period of 3months among women attending & Gynae OPD of rural medical college. A total of 460 study participants were enrolled during the study period. Results: About 85% were aware about the disease. Among participants who were aware 41% said its due to obesity, 24.74% said because of genetic,16.32% said due to advancing age and 17.60% said due to inadequate breast feeding. It was observed that 52.80% were aware that biopsy is the first modality of diagnosing breast cancer. And 59.43% were aware about Breast Self-Examination. Conclusion: Awareness about breast cancer among the study participants was good in the present study. Intense health education campaign should be conducted at regular intervals regarding BSE importance. Women should be taught how to do BSE as BSE is the main screening modality which will detect early stage of cancer.

Pharmacological & Non-Pharmacologic Strategies Used by Working Ladies of Reproductive age for the Management of Pre Menstrual Syndrome

Introduction: Premenstrual syndrome (PMS), a common cyclic disorder of young and middle-aged women, is characterized by emotional and physical symptoms that consistently occur during the luteal phase of the menstrual cycle, and remit after onset of menstruation .It’s bad impact will influence the professional activities specially in working ladies. Although PMS is undiagnosed disease but Different treatment strategies are being adopted by females to eliminate the symptoms of PMS. This study is design to find out which strategy is most commonly practiced especially in working ladies. Objectives: To determine the frequency of pharmacological & non-pharmacologic strategies used by working ladies of reproductive age for the management of pre menstrual syndrome. Setting: Dow University Hospital, Dow International Medical Centre (DIMC). Duration: 12 months from 15.6.2016 to 15.6.2017 Designee: Cross sectional study Subject and Methods: A total of 221 female having PMS problem reported in Gynae OPD were including in this study. All the working women were assessed the management strategies used during PMS to overcome its symptom all the assessment was done. All the information was entered in proforma. Results: The average age of the patients was 26.68±5.31 years. There were 19(8.6%) females used non-pharmacologic strategies, 82(37.1%) was used pharmacological strategies while 120(54.3%) female used both pharmacological & non-pharmacologic strategies to relive PMS. In pharmacological strategies, ponstan and paracetamol were commonly used to relive PMS while in non-pharmacologic strategies exercise and psychological therapy was 35.7% and 38.9% respectively. Conclusion: - In is concluded that complete social and personal counseling and awareness along with medical treatments will improve the life style of the working ladies facing this problems. As it adversely affects the educational, social and emotional well-being, means should be adopted to reduce the incidence of this disorder. Keywords: Premenstrual syndrome, pharmacological, non-pharmacologic strategies

Women’s knowledge and practices of modern contraceptives in rural Jammu

Background: India was the first country in the world to adapt a national population control program in 1952. So, it is important for couples and society as a whole to understand and adopt the methods of family planning. Use of contraceptives can prevent at least 25% of all maternal deaths by preventing unintended pregnancies and unsafe abortions and also protect against sexually transmitted infections.Methods: A cross-sectional study was conducted in the women of the reproductive age group (15-49 years) in gynae OPD of community health centre of block Bishnah in district Jammu.Results: The study was conducted in 408 women of the reproductive age group. Almost all the women had knowledge of various spacing methods, maximum being for being for oral contraceptive pills (OCPs) (96%), followed by intrauterine contraceptive devices (IUCD) (93.8%) and 90.9% for condoms. However, they had less knowledge about injectable contraceptives (13.9%).Conclusions: Family planning related knowledge was found to be very encouraging with two-third having a positive attitude as well. Main identified reasons for contraceptive defaults were unsustain availability, side-effects, need of a child and family opposition. It is hence, important to improve education of women to overcome barriers to modern contraceptive methods.

Impact of Midwife-led Supportive Educational Intervention on Perinatal Outcome among Fearful Primipara Mothers

The aim of the study was to develop and assess the effect of supportive-educational intervention on perinatal outcome among primipara mothers with a fear of childbirth. This randomized controlled trial was conducted on 205 primipara mothers with a fear of childbirth attending a Gynae OPD. At 24-28 weeks of pregnancy primipara mothers were screened for fear of childbirth WDEQ-A and then randomly allocated to experimental and control group. Within one week of delivery perinatal outcome was assessed with help of self-made checklist. After the interventions, there were signi cant differences between groups on post-intervention scores for term of delivery and newborn birth weight at p<0.001. Based on the results of the study it can be concluded that supportive educational intervention was effective in primipara mothers for positive birth outcome.

Frequency of Cervical Cancer in Women Attending Gynae OPD with Complaint of Abnormal Vaginal Bleeding

Aim: Frequency of cervical cancer in women of reproductive age presenting with abnormal vaginal bleeding. Methodology: Descriptive cross sectional study, done at Department of Obs &Gynae, JPMC, Karachi Duration of study: Six months from 01-11-2014 to 30-04-2015 Total 73 patients of age 18-45 years, having history of abnormal vaginal bleeding > 3 menstrual cycles were selected. Pregnant woman, abortion within last 6 months, age >45 years, fibroid/ tumors/ polyps, PID, gonorrhea, or Chlamydia patients were excluded. Chi-square was used as test of significance with a P value <0.05 taken as significant. Results: Mean ± SD age was 38.12 ± 4.33 years. Mean ± SD parity was 2.21 ± 1.67 children (Range: 0-5). Mean ± SD duration of presenting symptoms was 7.45 ± 2.81 months (Range 3-11). About one fifth of patients (i.e. 19.2%) were of age between 18-25 years. a vast majority (i-e; 43.8%) were in 26-35 years age category while remaining (36.99%) patients were of age between 36-45 years. 12.3% women had no children, 35.6% had 1-2 children, 28.8% had 3-4 children while remaining 23.3% women had 5 children. 12 out of 73 (16.4%) women had cervical cancer confirmed through biopsy and histopathology of cervical tissue. Age was significant (P value = 0.003) while parity & duration of presenting symptoms were non-significant (P values = 0.110 & 0.405 respectively). Conclusion: The study found that almost every 6th women with abnormal vaginal bleeding is suffering from cervical cancer. Younger age women and those having lesser parity are less prone to this condition. Keywords: Abnormal vaginal bleeding, Cervical cancer, Postcoital bleeding

Symptomatology of Postmenopausal Women Presenting at Punjab Rangers Hospital, Lahore

Objective: To describe the immediate symptoms of the post menopausal women attending Punjab Rangers Hospital Lahore. To see the effects of these symptoms on quality of life (QOL). Study Design: This was a descriptive type of study that was carried out at the Department of Gynecology and Obstetrics at Punjab Rangers Hospital. Setting: O&G OPD at Punjab Rangers Teaching Hospital Sample Size: 100 patients with menopause were studied for symptomatology and these symptoms affect the quality of life. Sample Collection: Sample collection was done by a non-probability convenient method. Inclusion Criteria: All patients who attended gynae opd at Punjab rangers hospital with:  Natural menopause  Above 45 years  Below 55 years  With no other Gynecological problems Exclusion Criteria: All those patients were excluded from the study that had  Surgical menopause  Perimenopause  History of depressive illness  Women on antidepressant  Women on HRT  Below 45 YEARS Data Collection: The questionnaires based on menopausal rating scale for symptomatology and quality of life were generated to see the impacts of these symptoms on life. The educated patients filled questionnaires. I filled out questionnaires of illiterate patients outdoors myself. Data Analysis: An analysis of data was done by using computer software SPSS. Data master sheet was developed. Frequency tables and graphs were generated The data was analyzed by using computer software SPSS.. Confidence interval was calculated for important frequency tables. Cross tabulation was done for marital status,parity,literacy,smoking and chi-square was applied as a test of significance. 65% patients described that their quality of life decreased after menopause especially due to vasomotor and psychological symptoms. 35% of patients were happy and satisfied after their menopause.Besides menopause there were other stresses of middle life, which made life worse. Subject: The study was performed during the period November2020 to May 2021.Sample was collected by a non probability convenient method and 100 patients were selected. Data was collected by questionnaire provided to patients attending the outpatient department. Data was analyzed with a computer software system by using SPSS. Results: The mean age observed was 49 years and frequency distribution of symptoms were:Hot flushes 60%, Night sweats 55% ,Insomnia 50% ,Mood changes 60% ,Anxiety 50% ,Irritability 50% ,Memory loss 30% ,Vaginal dryness 10%, Dyspareunia 10% ,Loss of libido 15% ,Urethral symptoms 25% ,Lethargy and general body aches 75% .65% patients described that their QOL had decreased after menopause. 35% patients described no effect. Conclusion: To promote the awareness in women about menopause, HRT and other alternatives which can improve their QOL

Screening and Risk Factor Associated with Vulvovaginal Candidiasis among Pregnant Women

Background: Vulvovaginal candidiasis is also known as vaginal yeast infection and candida vulvovaginitis there is excessive growth of yeast in vagina which leads to vaginal thrush. The sign and symptoms of vulvovaginal candidiasis includes severe vaginal discharge and itching. The symptoms get more before menstruation. The other symptoms show pain during sex, burning urination and redness over vagina. This infection mostly occurs due to excessive amount of growth of candida. According to research in all around 75% of total women suffer from vaginal candidiasis once in their lifetime and around 5% of the women suffer from twice or thrice. The preventive measures include wearing cotton undergarment rather than wearing synthetic and wearing loose cotton cloths.
 Objective: This study is planned to assess screening and risk factors associated with vulvovaginal candidiasis among pregnant women.
 Methodology: The Descriptive Evaluatory Research Design used for data collection procedure will be required 1 week per plan. 7-8 High vaginal swab are taken from gynae Opd in a day accordingly data will be collected. The number of pregnant women will be taken from Gynae Opd who come for check-up on the regular basis. Soon after their check-up written consent form will be given and sample will be collected. Then interview will be taken with the following questionnaires prepared according to the risk factors assessment scale. The pregnant women will be selected non-Probability convenient sampling technique.
 Conclusion: Reproductive age group women have more risk of developing vulvovaginal candidiasis, because of High oestrogen levels cause an increased glycogen load in epithelium, which is a nutritional source for growth of candida & germination. Vulvovaginal candidiasis the most common gynaecologic diagnosis in the primary care setting. So, the available statistics say that there is a need for the study regarding the assessment and screening of vulvovaginal candidiasis among pregnant women.