Gynecology Outpatient Clinic Research Articles

Grading Sonographic Severity of Adenomyosis

ObjectivesThe reported prevalence of adenomyosis ranges widely due to different study populations, diagnostic tests and criteria. Categorizing the severity of disease may prove important. This study aims to develop a semi‐quantifiable sonographic method to grade the severity of adenomyosis and assess the feasibility and interobserver reliability of this method.MethodsCross‐sectional pilot study performed at a gynecology outpatient clinic, included 35 premenopausal women with adenomyosis, not taking hormonal medication. Diagnosis required ≥1 direct sonographic feature of adenomyosis. Two‐dimensional (2D) grayscale video clips and 3‐dimensional (3D) volumes of the uterus of the first 5 patients were evaluated using 6 offline methods to assess feasibility. Feasible methods were analyzed for interobserver (n = 3) reliability (Fleiss kappa or intraclass correlation) and compared with current ultrasound methods (Cohen's weighted kappa and Spearman's rank correlation). Current methods include real‐time estimation (mild/moderate/severe) and counting the individual sonographic features.Results“eXtended Imaging virtual organ computer‐aided analysis (XI VOCAL) counting” (counting affected slices of 20 parallel slices in the 3D volume), “Multiplanar and 3D rendering (MPR) estimation” (grading volume by eyeballing in multiplanar render mode), and “2D‐clip estimation” (grading volume in 2D‐clips) emerged as feasible methods. “XI VOCAL counting” and “2D‐clip estimation” demonstrated good interobserver reliability, whereas “MPR estimation” had poor reliability. Comparison with real‐time estimation showed moderate reliability with all methods. “XI VOCAL counting” and “MPR estimation” correlated positively with the number of sonographic features.Conclusion“XI VOCAL counting” demonstrated to be feasible with good interobserver reliability to assess the severity of adenomyosis in an objective, systematic, and semi‐quantifiable fashion and should be validated with large‐scale studies for future use. Future studies should also explore the association between sonographic severity and symptoms of adenomyosis.

Prevalence and Risk Factors Associated With Carpal Tunnel Syndrome Among Sudanese Females: A Cross-Sectional Study.

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy resulting from compression of the median nerve. This condition is more common in females than in males. The earlier the diagnosis, the better the prognosis and treatment outcomes. This is a cross-sectional hospital-based study conducted at Soba Teaching Hospital in obstetrics and gynecology outpatient clinic in Khartoum in the period from February 2022 to March 2022. A simple random sampling was applied, and an interview was conducted using a four-partquestionnaire. The first part was based on socio-demographic data, the second was lifestyle, and the third and fourth were based on the Boston Carpal Tunnel Questionnaire (BCTQ). The data were analyzed using the statistical package for social sciences (SPSS) software, version 23 (IBM Corp., Armonk, NY) to find the correlation between the various variables. A total of 113 women participated in the study (response rate=100%). The prevalence of CTS was found to be 5%. No significant association was found between lifestyle and medical history, e.g., obesity and oral contraceptives and CTS were p=0.167, 0.841 respectively. Conversely, there was a significant association between age and residency, with p=0.005 and 0.049, respectively. The prevalence of CTS is increasing in Sudan. Therefore, it is essential to thoroughly assess patients for any symptoms related to hand pain by asking detailed questions during consultations. In addition, further studies covering more states are neededto better understand the regional variation in CTS prevalence.

Interactions between pregnant women's nutrition habits, psychological well-beings, sleep quality and biochemical parameters.

Hormonal changes during pregnancy may cause various changes in biological, physiologic and psychosocial areas. The main objective of this study was to analyze the relationship between dietary habits, psychological well-being, sleep quality and biochemical parameters of pregnant women. The study was conducted on a total of 93 patients who applied to Ankara Koru Sincan Hospital Gynecology and Obstetrics Outpatient Clinic for routine pregnancy control between November-December 2023, were between the ages of 18-45, had a live singleton fetus, had no diagnosed psychiatric disease or chronic disease, and agreed to participate in the study. Anthropometric measurements and biochemical findings of the individuals were recorded with a questionnaire including the psychological well-being scale (PWBS) and Pittsburgh sleep quality index (PSQI). According to the study, PSQI scores during the second and third trimesters are significantly higher than the first trimester. It was observed that while individuals have bad sleep quality during the second and third trimesters, they have good sleep quality during the first trimester (χ2 = 14.736; P < 0.001). In the biochemical results, the thyroid-stimulating hormone (TSH) value in the second trimester was higher (P > 0.05). Weight gain during pregnancy, age and trimester have a negative effect on sleep quality. When the effects of lifestyles and eating habits of pregnant women on the process are considered, there is a relationship between smoking/alcohol consumption, less physical activity, poor eating habits, sleep quality and depressive symptoms. Factors such as age, educational background, trimester period and other basic sociodemographic variables are also involved.

The application value of low-risk human papillomavirus testing in cervical cancer prevention and treatment in low- and middle-resource areas

ObjectivesTo assess the application value of low-risk human papillomavirus (lrHPV) detection in the prevention and treatment of cervical cancer in low- and middle-resource areas (LMRAs). Study designA retrospective cross-sectional study. MethodsCervical HPV typing results were collected from 2019 to 2023, utilizing fluorescence PCR technology. An adjusted logistic regression model was used to assess the relative risk (OR) and 95 % confidence interval (CI) for co-infection with lrHPV and high-risk HPV (hrHPV). ResultsOut of 113,883 women included in the study, the overall lrHPV positivity rate was 1.9 %. In total, 47.7 % (1033/2167) of lrHPV positive women also had hrHPV co-infections. Multivariate analysis identified 12 hrHPV subtypes (T-hrHPV) significantly associated with co-infection risk, including HPV16, 31, 33, 39, 51, 52, 53, 56, 59, 66, 68, and 73. The risk of T-hrHPV infection was 3.77 times higher (95 % CI: 3.44-4.12) for women with a single lrHPV infection and 9.71 times higher (95 % CI: 4.72-19.99) for those with two lrHPV infections. Women screened in the gynecological outpatient clinic faced a T-hrHPV infection risk 2.64 times higher (95 % CI: 2.54-2.74) than those in the general health check department. ConclusionslrHPV positivity significantly increases the risk of T-hrHPV co-infection, particularly under multiple infections, highlighting the importance of comprehensive HPV screening in LMRAs. The notable differences in T-hrHPV infection risks across various screening settings highlight their critical role in cervical cancer prevention and offer new insights into optimizing vaccination strategies to enhance effective prevention and treatment in LMRAs.

Analysis of factors affecting the accuracy of colposcopic diagnosis of cervical lesions: a retrospective cohort study.

Cervical cancer is a leading cause of cancer-related deaths among women. However, in developing countries, the primary focus for cervical cancer prevention and control remains on the timely detection and treatment of precancerous lesions. This study aims to evaluate the accuracy of colposcopic diagnosis of cervical intraepithelial lesions and analyze the factors influencing its accuracy. This study collected data from 512 eligible patients who visited the gynecology outpatient clinic of the Second Hospital of Jilin University from January 2022 to August 2023. The final diagnosis was based on the highest grade observed in both biopsy pathology and postoperative pathology. A self-controlled, retrospective analysis was conducted to evaluate the accuracy of colposcopic diagnosis. Univariate analysis was used to assess the impact of factors such as menopausal status, duration of menopause, high-risk human papillomavirus (HR-HPV) genotypes, and transformation zone (TZ) types on the accuracy of colposcopic diagnosis of cervical lesions. The overall colposcopy diagnostic concordance rate was 78.71%. The concordance rates between the premenopausal and postmenopausal groups differed significantly (χ 2 = 75.450, p < 0.05). The HPV16/18 positive group and the non 16/18 HR-HPV positive group also showed a significant difference in concordance rates (χ 2 = 5.890, p < 0.05). There were significant differences in concordance rates between TZ2 and TZ3 (χ 2 = 10.585, p < 0.05), as well as between TZ1 and TZ3 (χ 2 = 14.607, p < 0.05). Factors such as menopausal status, duration of menopause, HR-HPV genotypes, and TZ types influence the accuracy of colposcopic diagnosis. Therefore, a comprehensive evaluation incorporating these factors should be performed in clinical practice to enhance diagnostic accuracy.

The effect of digital storytelling on women's human papilloma virus awareness: Randomized controlled experimental study.

This study aims to determine the effectiveness of the digital storytelling (DS) method in increasing human papilloma virus (HPV) awareness. The study was conducted in the gynecology and obstetrics outpatient clinic of a state hospital between April and December 2023. The universe of the study consisted of women who applied to the outpatient clinic between these dates and volunteered. A total of 80 women who met the inclusion criteria were included in the study (n = 40 for each group). Data for the study were gathered using Personal Introduction Form and Human Papilloma Virus Knowledge Scale. Repeated measures ANOVA method was used to determine the difference between the pre-training, post-first training and post-second training measurement scores according to the intervention and control groups. For significant ANOVA results, measurements with differences were compared pairwise using Bonferroni correction. All statistical analyses were examined at the p < 0.05 significance level. Socio-demographic characteristics and HPV awareness levels of women in the intervention and control groups were similar before training (p > 0.05). After the activity conducted with the digital story method in the intervention group, the HPV awareness levels of women in this group increased significantly (p < 0.05). Considering the development in each group, an increase in posttest scores is observed in both groups. However, when the increase amounts in each group in the intervention and control groups were examined, it was determined that all awareness levels increased more in the intervention group. In the intergroup comparison, it was determined that the mean measurements of general HPV knowledge, general HPV vaccine knowledge, and knowledge of the current HPV vaccination program of women in the intervention group at the first and second follow-ups after the training were higher than those in the control group. The DS method was effective in raising HPV awareness given to the intervention group. Health professionals and researchers can benefit from DS in providing health education and consultancy services such as HPV awareness.

Implementation of Genetic Carrier Screening at Gynecologic-Related Visits

ObjectiveTo increase patients’ knowledge and access to genetic carrier screening (GCS) in a gynecologic setting by implementing a protocol to universally offer GCS education and screening to reproductive-age women during the preconception period at gynecologic-related visits. DesignThe model for improvement quality improvement process model was used to guide this initiative. Local Problem/SettingScreening for genetic disease has been a part of preconception and genetic care for the past 50 years. Despite its longstanding presence and better accessibility and affordability of testing, there are no established protocols to universally offer screening to reproductive-age women during preconception care in the United States. The project was implemented at an outpatient gynecology clinic in Phoenix, Arizona. ParticipantsFifty-one women ages 18 to 51 years. Intervention/MeasurementsA protocol was implemented to universally offer expanded GCS and health education to reproductive-age women during the preconception period at gynecologic-related visits. Women’s responses to being offered GCS and the rationale for their response was documented on a spreadsheet. ResultsAll 51 participants were offered GCS during their visit. None of those 51 participants had any previous knowledge of GCS. All 51 participants declined GCS; reasons included the following: would consider it once closer to childbearing (53%), did not have any childbearing plans (31.3%), did not have any further childbearing plans (9.8%), or were not worried about the possibility of genetic disease (5.8%). None cited cost as a reason for declining GCS. After project completion, 3 of the 51 participants returned to the clinic to undergo GCS, and the clinic has adopted the intervention described here as its standard of care for patients who meet criteria for GCS. ConclusionIt is imperative to provide health education about GCS to women during preconception care so that they can make informed choices about family planning.

Determination of the Internet Decision-Making Status of Risky and Non-Risky Pregnant Women

Objective: This study was conducted to evaluate the Internet decision-making status of risky and non-risky pregnant women. Method: The research employed an analytical and case-control design. The sample of the study consisted of 214 pregnant women, including 107 in the risky group and 107 in the non-risky group, who applied to the Obstetrics and Gynecology Outpatient Clinic. In the study, the data were collected using The Introductory Information Form and The Internet Decision-Making Scale in Pregnancy (IDMSP) through face-to-face interviews. In the evaluation of the data, Chi-square test, Independent Samples t-Test and Mann Whitney U test were used in addition to descriptive statistics. Results: The mean age of the pregnant women participating in the study was 28.08 ± 6.37 years. It was determined that 56.1% of the pregnant women who participated in the study met their need for information on the Internet, 46.7% checked the blog pages of the doctors while searching on the Internet to receive information about pregnancy, and 49.1% mostly used the Internet for searching about the prenatal development and health of the baby. The overall mean score of the pregnant women at risk obtained from the IDMSP was significantly higher compared to those in the non-risky group (p=0.002). Conclusion: The Internet decision-making status of risky pregnant women has been found to be higher compared to non-risky pregnant women. Accordingly, midwives and nurses should inform pregnant women that information on the Internet is not always safe, and it is important to consult healthcare professionals when making a decision regarding pregnancy.

Seroprevalence of human papilloma virus 6, 11, 16 and 18 among pregnant women in Mwanza-Tanzania

IntroductionHigh-risk human-papilloma viruses 16 and 18 (HR-HPV 16 and HR-HPV-18) are well known to be associated with carcinoma of the cervix, head and neck, penis, and anus. Low-risk human papillomaviruses 6 and 11 (LR-HPV 6 and LR 11) infection has been associated with anogenital warts, oral papilloma, and laryngeal papillomatosis in children. HPV infection during pregnancy (HR-HPV and LR-HPV) increases the risk of vertical transmission from infected pregnant women to unborn children. The burden of HR-HPV type 16 and 18 and LR-HPV 6 and 11 is not well documented among pregnant women attending antenatal clinics (ANC). This study determined the seroprevalence and distributions of HR-HPV 16, 18, and LR –HPV 6, 11 antibodies among pregnant women attending ANC at Bugando Medical Centre (BMC) in Mwanza, Tanzania.MethodologyA cross-sectional study involving 255 pregnant women enrolled in obstetrics and gynecology outpatient clinics was conducted between November 2020 and March 2021 at Bugando Medical Centre (BMC) in Mwanza. A structured pre-tested questionnaire was used to obtain patients’ information. Sandwich Enzyme-Linked Immunosorbent Assay (ELISA) was used to detect HPV 6, 11, 16 and 18 specific immunoglobulin G (IgG) from sera. Stata version 15v1 was used for the descriptive data analysis.ResultsThe median age was 27(IQR: 22–31) years. The overall HPV seropositivity for any of the four serotypes was 63.9% (165/255), 95% CI: 58.0-69.7, whereby 37.6%(97/255), 32.2%( 83/255), 15.5% (40/255) and 27.1% (70) were positive for HPV 6, 11, 16 and 18 respectively. Eight participants (3.1%) were positive for all 4 genotypes.ConclusionAbout two-thirds of pregnant women had antibodies against HPV 6, 11 16, and 18 indicating previous HPV exposure. Vaccination programs should be emphasized to reduce the HPV-related manifestations in this population.

Psychometric properties of the Turkish version of the perceived barriers of mammography scale.

Early diagnosis and screening of breast cancer are of vital importance in the fight against the disease. It is crucial to identify the underlying barriers that prevent women from undergoing mammography and to develop necessary strategies to overcome these obstacles. The purpose of this study was to adapt "The Perceived Barriers of Mammography Scale (PBMS-23)" into Turkish and to conduct a validity and reliability study. This study used a methodological approach. The study was conducted with 233 women admitted to the Gynecology Outpatient Clinic of a university hospital. Data were collected by using the Introductory Information Form, PBMS-23, Champion's Health Belief Model Scale for Mammography Screening (CHBMS-MS). Psychometric properties of the scale were tested with content validity, confirmatory factor analysis, convergent validity, and test-retest reliability coefficient. Content validity confirmatory factor analysis resulted in 𝜒2/SD = 1.67; CFI = 0.97, NFI = 0.92, GFI = 0.86, RMSEA = 0.054. The scale had a Cronbach's alpha of 0.87, while the subscales had Cronbach's alpha values of 0.34 to 0.80. The intraclass correlation coefficient values calculated for the test-retest reliability were between 0.83 and 0.96 for the subscales and 0.96 for the overall scale. There is a positive and statistically significant relationship (p < 0.01) between the CHBMS-MS barriers dimension and prejudices dimension scores and all subdimensions and the total of the PBMS-23. The PBMS-23 was accepted as a valid and reliable tool with 23 items and eight-factor structure that can be useful in measuring Turkish women's barriers to mammography.

Vulvovaginal candidiasis clinical signs, and distribution of Candida species

Background: Vulvovaginal candidiasis is a global issue of concern due to its association with economic costs, sexually transmitted infections, and ascending genital tract infection. The aim of this study was to determine clinical signs and species distribution of Candida species causing vulvovaginal candidiasis. Methods: A cross-sectional study was conducted from December to June 2021-2024 among 400 women attending Obstetrics and Gynecology outpatient clinics in Sana'a City. The study involved collecting vaginal swabs from each participant and analyzing them in a microbiology laboratory. The swabs were used to identify yeast cells, fungal culturing, and germ tube formation tests. The study also used the VITEK II system to confirm species identification, with the VITEK® 2 YST ID identification card being used to identify Candida species. Results: A study of 400 women found that 91.8% were infected with Candida albicans, while 8.2% were infected with other non-Candida albicans. The majority were aged 26-35, with secondary education being the most common. Most were married, with 1-3 pregnancies. The most common sign distribution was vaginal discharge with a 99.5% prevalence. Dysuria was the lowest, with a 65.0% prevalence. Candida species were most frequently isolated, with Candida albicans being the most common. Candida tropicalis was found in 1 out of 6 women, while Candida dubliniensis, Candida famata, Candida glabrata, and Candida lusitaniae were found in 1 out of 6 women. Conclusions: The high prevalence rate of vulvovaginal candidiasis and observation of a low prevalence rate of nonalbicans Candida species in the present study substantiate the importance of conducting continuous epidemiological surveys to measure changes in species distribution from C. albicans to non-albicans Candida species in Yemen.

Effect of Comprehensive Educational Program on Preeclamptic Women's Risk Perception of Cardiovascular Disease, Self-Efficacy, and Adherence to Healthy Lifestyle Behaviors.

To evaluate the effect of a comprehensive educational program on preeclamptic women's knowledge, risk perception of cardiovascular disease, self-efficacy, and adherence to healthy lifestyle behaviors. This study employed a pretest-posttest design. One hundred and two women who previously had preeclampsia were enrolled from July 2022 to December 2022 from outpatient obstetrics, gynecology, and family planning clinics. The primary and secondary outcomes were measured at baseline, after eight weeks, and after three months of the educational intervention. The data were analyzed using SPSS version 23, descriptive and inferential statistics, specifically the Chi-square test, independent t-tests, and repeated measures ANOVA. A statistically significant difference was found between the two groups immediately post-intervention and the three-month follow-up, with a significant improvement among the intervention group than control group regarding cardiovascular disease knowledge (p < 0.001), risk perception (p < 0.001), self-efficacy (p < 0.001), and healthy lifestyle behaviors (p < 0.001). There was a statistically significant interaction between group and time regarding total cardiovascular disease risk perception (F = 203.67, p < 0.001, η2 = 0.673), self-efficacy (F = 70.06, p < 0.001, η2 = 0.405), and adherence to healthy lifestyle behaviors (F = 145.08, p < 0.001, η2 = 0.597). This study concluded that the comprehensive educational program had a positive effect on improving preeclamptic women's knowledge and risk perception of CVD, self-efficacy, and adherence to healthy lifestyle behaviors following preeclampsia.

Analysis of Public Health Care Management in Women Suffering from PCOS in India

The concept of "health" is multifaceted and goes beyond simply being free from sickness or illness. Because the concept of health is so nebulous, it is difficult to define. Not only have the most common types of health problems changed over time, but so has our comprehension of health. In the modern world, behaviour often affects one's health because it is influenced by biological, psychological, and social factors. Reproductive processes and events mix with psychological and physiological aspects. In a similar vein, psychological disorders influence reproductive physiology and control reproductive processes. The empirical data points to several aspects that require attention for a deeper comprehension of psychological suffering and ultimately its avoidance. It is quite difficult to learn about the evolution of distress, which means that it is hard to distinguish between acute and persistent manifestations of this condition. According to the few studies that have looked into the problem of psychological discomfort in gynaecology out-patient clinics, women who frequent these clinics are thought to be more distressed than typical—about 50% of them, on average. Additionally, this study will identify the psychosocial variables and aetiology of PCOS in women.

The effects of motivational interviewing on sexual quality of life and sexual self-efficacy in postmenopausal women with sexual dysfunction.

This study was conducted to determine the effects of motivational interviewing on sexual quality of life and sexual self-efficacy in postmenopausal women with sexual dysfunction. This randomized controlled study was conducted with 164 postmenopausal women with sexual dysfunction who presented to the gynecology outpatient clinic of a university hospital in Kahramanmaras, Türkiye (82 experimental, 82 control). The data were collected using a personal information form, the Arizona Sexual Experiences Scale-Female Version Questionnaire, the Sexual Quality of Life-Female Questionnaire, and the Sexual Self-Efficacy Scale. Four motivational interview sessions were conducted with the postmenopausal women in the experimental group at 1-week intervals, and those in the control group did not receive any intervention. The data were analyzed using descriptive statistics, Pearson's chi-squared test, and independent samples and paired samples t tests. Both the sexual quality of life and sexual self-efficacy levels of the participants in the experimental and control groups were similar in the pretest stage (P > 0.05). After the motivational interviews with those in the experimental group, the rate of sexual dysfunction was determined as 82.9% in the experimental group and 98.8% in the control group. Additionally, after the motivational interviews, the sexual dysfunction scores of the participants in the experimental group decreased significantly, and their sexual quality of life and sexual self-efficacy levels increased significantly compared to those in the control group (P < 0.001). The results of this study revealed that motivational interviewing decreased sexual dysfunction and increased sexual quality of life and sexual self-efficacy in postmenopausal women with sexual dysfunction.

High-risk human papillomavirus infection and cervical cytopathology: relationship with cervical nitric oxide levels

BackgroundNitric oxide (NO) may contribute to the persistence of high-risk human papillomavirus (hrHPV) infection, which has been linked to the development of premalignant lesions and cervical cancer. Our study aimed to examine the relationship between cervical NO metabolite (NOx) levels, hrHPV infection, and cytopathological findings. Additionally, we assessed cervical NOx levels as a biomarker for predicting hrHPV infection and epithelial atypia.MethodsThe study involved 74 women who attended the Gynecology and Obstetrics outpatient clinics at Cairo University Hospitals between November 2021 and August 2022. Cervical samples were subjected to Pap testing, assessment of NOx levels by the Griess method, and detection of hrHPV DNA by real-time polymerase chain reaction.ResultsHigh-risk HPV was detected in 37.8% of women. EA was found in 17.1% of cases, with a higher percentage among hrHPV-positive than negative cases (35.7% vs. 4.3%, p = 0.001). The most prevalent hrHPV genotype was HPV 16 (89.3%). The cervical NOx level in hrHPV-positive cases was significantly higher (37.4 µmol/mL, IQR: 34.5–45.8) compared to negative cases (2.3 µmol/mL, IQR: 1.2–9.8) (p = < 0.001). Patients with high-grade atypia showed significantly higher NOx levels (38.0 µmol/mL, IQR: 24.6–94.7) in comparison to NILM and low-grade atypia cases (5.0 µmol/mL, IQR: 1.6–33.3 and 34.5 µmol/mL, IQR: 11.7–61.7, respectively) (p = 0.006). Although the NOx levels among hrHPV-positive cases with low-grade atypia (40.4 µmol/mL, IQR: 33.3‒61.8) were higher than those with NILM (36.2 µmol/mL, IQR: 35.7‒44.0) and high-grade atypia (38.0 µmol/mL, IQR: 24.6‒94.7), the difference was not significant (p = 0.771). ROC curve analysis indicated that the cervical NOx cut-off values of > 23.61 µmol/mL and > 11.35 µmol/mL exhibited good diagnostic accuracy for the prediction of hrHPV infection and EA, respectively.ConclusionsThe high prevalence of hrHPV infection, particularly HPV 16, in our hospital warrants targeted treatment and comprehensive screening. Elevated cervical NOx levels are associated with hrHPV infection and high-grade atypia, suggesting their potential use as biomarkers for predicting the presence of hrHPV and abnormal cytological changes.

Гинекологические проблемы у подростков: тенденции обращений к гинекологам и жалоб

Adolescence represents a pivotal phase in the transition from childhood to adulthood. Adolescent gynecology is the clinical specialty that focuses on the management of gynecologic problems during this period. This study's primary objective is to emphasize the importance of adolescent gynecology by examining the gynecological causes of adolescent presentations and highlighting the differences that warrant consideration in the clinical approach to adolescent patients. The study was designed as a retrospective cohort study in an academic tertiary hospital and included adolescent individuals presenting to the obstetrics and gynecology emergency department or outpatient clinic. The analysis encompassed a range of factors, including age, presenting symptoms, examination findings, ultrasound results, laboratory data, and the necessity for hospital admission. The study cohort comprised 750 adolescent patients, 71.3% seeking gynecological care. Adolescents most frequently presented for menstrual irregularities (57.6%) and secondly for dysmenorrhea. The results of the gynecological clinical evaluations indicated that 62.9% of the patients had menstrual disorders. Of these, 53.4% had irregular menstrual cycles, 4.5% had prolonged and/or heavy bleeding, and 3% had amenorrhea. Ultrasound imaging revealed the presence of pathological findings in 25.8% of the patients. In conclusion, this study's findings indicate that irregular menstrual cycles are the most common gynecological condition in the adolescent population. The physiological characteristics of adolescents require a distinct approach to diagnosis and treatment compared to adult women, which can significantly impact future fertility and overall reproductive health.

Examining the Relationship Between Spiritual Well-Being and Pregnancy Distress in Pregnant Women

Aim: This study was conducted to determine the relationship between pregnant women's spiritual well-being levels and their pregnancy-related stress. Material and Methods: The sample of the descriptive and correlational study consisted of 250 pregnant women aged 18 years and over with the 12th week of pregnancy and above who were admitted to the Obstetrics and Gynecology outpatient clinic of a Training and Research Hospital between November 2020 and April 2021 and who agreed to participate in the study. The data were obtained by collecting the Personal Information Form, Spiritual Well-Being Scale (SWBS), and Tilburg Pregnancy Distress Scale (TPDS). The SPSS statistical program was used to evaluate the data. Results: The mean age of the pregnant women was 26.5±5.3 years. It was determined that 39.6% of the pregnant women were secondary school graduates, 72% had planned pregnancies, 31.6% were primiparous and 60% were in the third trimester. A statistically significant, negative, and weak relationship was found between the spiritual well-being levels of pregnant women and pregnancy-related stress (r=-0.33, p=0.000). Conclusion: In this study, the spiritual well-being of pregnant women was determined to be high, and pregnancy-related stress was found to be low. However, it was found that as the spiritual well-being of pregnant women increased, their pregnancy-related stress decreased.

A qualitative study of women’s experiences of vaginal douching in Türkiye

Vaginal douching, a practice that has existed for many years, is defined as the process of intravaginal cleansing using a liquid solution. Despite its negative consequences with respect to health, vaginal douching is widely practised in many countries. This study sought to examine the vaginal douching experiences of women in the southeastern region of Türkiye. We used a phenomenological approach with semi-structured, in-depth interviews conducted between January and June 2022. Participants were 20 women who either currently practised vaginal douching or had stopped practising it at some point in their lives. The women were admitted to the obstetrics and gynaecology outpatient clinic of a district state hospital in Eastern Turkey for care and treatment. The data collected from the respondents were categorised into five thematic areas: sources of information about douching; reasons for doing so; as well as frequency, methods, and feelings about douching. The findings provide a rich source of information about each of these areas. These findings may help inform future studies on the prevention of vaginal douching in women.

Investigation of Toxoplasma gondii Seroprevalence in Pregnant Women in Çankırı

Toxoplasma gondii can be transmitted to humans through consumption of raw or undercooked meat containing live tissue cysts, consumption of water or food contaminated with oocysts shed from cat feces, and vertical transmission during pregnancy or through tissue, organ, and blood transfusion. The aim of this study was to investigate the seroprevalence of T. gondii in patients admitted to the Obstetrics and Gynecology Department of Çankırı State Hospital (ÇSH). In this study, anti-T. gondii IgG and IgM antibody levels of 62 pregnant women between the ages of 17 and 47 who applied to ÇSH gynecology and obstetrics outpatient clinic for normal pregnancy follow-up between June 2022 and January 2023 were investigated. According to the results of the studies, anti-T gondii IgG positivity is 12.9% and negative 87.1% and anti-T. gondii IgM positivity is 0% while it was found to be 100% negative. According to these results, it is reported that the majority of pregnant women do not encounter T. gondii and; therefore, they should be more careful in terms of congenital toxoplasmosis. T. gondii can be transmitted to humans through consumption of water or food contaminated with oocysts excreted in cat feces and through vertical transmission or tissue, organ, and blood transfusion during pregnancy. Therefore, pregnant women should be carefully monitored for T. gondii.

Influence of Female Genital Mutilation on Women Sexual Function in Egypt

Abstract Background Although Female genital mutilation (FGM) is internationally recognized as a violation of human rights with Short term and long term complications include death due to shock, painful menstruation, dyspareunia, cysts and keloid formation. Aim of the Work aimed to assess the effect of FGM on Women reproductive and sexual function. Subjects and Method This is a cross sectional hospital based study included 800 married or previously married females, between (18 - 40) year old who are apparently healthy. They were recruited from Outpatient clinic of Gynecology and Obstetrics in Etay Elbaroud general hospital, Behaira Governate, Egypt and classified into case group who were circumcised and control non circumcised group. They were subjected to detailed history including history of sexual function and local genital examination after informed consent was taken. During labor; a partogram was used to assess the progess of labor and occurrence of complicated delivery. Partogram is a graph reporting labor events against time which includes cervical dilatation, fetal heart rate, state of membrane and liquor. Results among case group age of FGM ranged from 9-13 with mean value 10.27±0.98 and majority of cases had type I. There was statistically significant difference between the two studied groups regarding regularity of menses and dysmenorrhea. 66% of cases had short term complication and pain was the most common (52%). Assisted mode delivery was higher in cases group with 220(55%) and normal was higher in control group with 244(61%). There was statistical significant difference between two studied groups regarding sexual desire, arousal, orgasm, satisfaction, and pain while there was no statistical significant difference regarding lubrication. Conclusions and Recommendations FGM still being a community problem in Egypt esecially in rural area which running in certain families. The most common type in Egypt is type I and common complication is pain following FGM. Sexual function is affected in all cases experienced FGM especially with type III. Assisted delivery was more common in cases had passed FGM before. It is recommended to raise community awareness about complications and hazard of FGM on sexual function as well as reproductive life.