Gynecology Outpatient Department Research Articles

Effects of a therapeutic lifestyle modification intervention on cardiometabolic health, sexual functioning and health-related quality of life in perimenopausal Chinese women: protocol for a randomised controlled trial

IntroductionPerimenopause is a critical transitional period in reproductive ageing. A set of physiological and psychological changes can affect perimenopausal women’s quality of life and further threaten their older adult health...

Exploring the Concordance Between High-Risk Human Papillomavirus Infections in Cervical and Oral Sites Among Females: A Cross-Sectional Study in Punjab, Pakistan.

Human papillomavirus (HPV) is widely recognized as a key contributing factor in cervical and oropharyngeal cancers. However, there has been limited research on the prevalence of concurrent HPV infections in various anatomic regions. This study aimed to investigate the prevalence and specific types of high-risk HPV (HR-HPV) infections in the cervical and oral regions of females in Punjab, Pakistan. We conducted a cross-sectional study involving women seeking care for general gynecologic issues at the gynecologic Outpatient Department of Lady Wallington Hospital in Lahore. After interviews and clinical examinations, we collected whole-saliva samples and high vaginal swabs from each participant. HR-HPV detection and genotyping were performed using real-time polymerase chain reaction at both the anatomic sites. In this study, 170 females, averaging 35.36 ± 8.305 years, participated. HR-HPV infection was more prevalent in the cervix (83/170 [48.8%]) than in the oral cavity (19/170 [11.2%]). Concordant HPV infections occurred in 10/170 participants (5.9%). HPV 16 was the most common genotype in cervical and oral locations, at rates of 21.8% and 5.3%, respectively, among concordant HR-HPV types. Socioeconomic status (P = .013), age at first sexual intercourse (P = .015), and history of oral sex (P = .01) were significantly associated with concurrent HR-HPV infection in both regions. This study suggests that HR-HPV cervical infections may increase the risk of oral transmission, especially during orogenital sexual practices. Thus, it is important to recognize that HPV infections may be linked in both areas. We emphasize the importance of comprehensive cervical and oral examinations and HPV vaccination in young women irrespective of their sexual practices.

A Comprehensive Approach: Correlating Ultrasound Imaging with Endometrial Histopathological Analysis in Perimenopausal Women with Heavy MenstrualBleeding.

Abnormal uterine bleeding (AUB) is a common troublesome symptom in the perimenopausal age group. The most common type of AUB in this age group is heavy menstrual bleeding. There is a risk of endometrial carcinoma and atypical endometrial hyperplasia in women with AUB in the age group of 40-50 years. Hence early evaluation is of paramount importance in managing women with perimenopausal heavy menstrual bleeding. The current study was undertaken to study the correlation between ultrasound findings and various benign and malignant endometrial histologies in perimenopausal women with heavy menstrual bleeding. Women aged 40-55 years presenting with heavy menstrual bleeding at the gynaecology outpatient department at Sree Balaji Medical College and Hospital, Chennai, India, were included in the study. Patients on anti-platelet and anti-coagulation therapy and patients already on hormonal treatment for heavy menstrual bleeding were excluded from the study. The demographic factors, symptom profiles, ultrasound findings, and histopathological reports were tabulated and analysed. Of the 147 women included in the study, 75 (51%) were aged 45-50 years and 107 (73%) had two or more pregnancies. Fibroid was the common non-endometrial cause of heavy menstrual bleeding in 52 (35%) cases. The proliferative pattern was the most common non-pathological histology identified in 46 (31%) cases. Endometrial hyperplasia without atypia was the most common pathological histology observed in the study population. Endometrial thickness of more than 8 mm was strongly associated with premalignant or malignant endometrial lesions. Our study has attempted to identify the correlation between ultrasound evaluation of perimenopausal women with heavy menstrual bleeding and endometrial pathology. Ultrasound, being cost-effective and widely available, is proven to be a tool for first-line investigation of perimenopausal women with heavy menstrual bleeding that guides further evaluation and management.

Saudi women's perspectives on postpartum depression.

Postpartum depression (PPD) is a serious disorder that affects women worldwide, making it a crucial public health concern and one of the most prevalent childbirth complications. Assessing the perspectives of Saudi women towards PPD is essential for addressing the issue and developing effective solutions. This study aimed to assess the knowledge and attitude of Saudi women about PPD in King Abdulaziz Medical City, Western Region. This study employed a descriptive cross-sectional research design and included 226 women recruited through convenience sampling at the Obstetrics and Gynaecology Outpatient Department in King Abdul-Aziz Medical City, Jeddah. Data were collected using a structured questionnaire with 3 main sections: socio-demographic characteristics, knowledge regarding risk factors and symptoms of PPD, and attitude about PPD. The mean score (SD) of the knowledge scale was 31.8 (6.2) with 53.5% of participants having a good level of knowledge about PPD. The mean score (SD) of the attitude scale was 27.1 (2.8) with 47.3% of participants having a positive attitude towards PPD. Significant differences were identified in the knowledge scale, where women who were postgraduates, working in the health sector and unpregnant scored higher in the knowledge scale compared to others (P = .008, P = .02, & P = .008, respectively). The findings of this study indicate that women's knowledge about PPD was generally good; however, many of them held negative attitudes towards PPD. These findings underscore the importance of proper education to improve mental health literacy and address prejudices and negative stereotypes related to PPD among Saudi women.

Infective Vaginal Discharge among Women of the Reproductive Age in the Outpatient Department of a Primary Care Centre.

Infective vaginal discharge is the most common complaint of the women of reproductive age group attending gynaecology outpatient department. Vaginal discharge may be normal or abnormal. Infective vaginal discharge is usually related to one of the three conditions, like bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis. This study aimed to find out the prevalence of infective vaginal discharge among women of the reproductive age in the outpatient department of a primary care centre. A descriptive cross-sectional study was carried out among women of the reproductive age group visiting the outpatient Department of the primary care hospital from 1 March 2022 to 1 August 2022 after obtaining ethical approval from the Institutional Review Committee. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Among 138 patients, infective vaginal discharge was found in 42 (30.43%) (21.32-39.54, 95% Confidence Interval). Bacterial vaginosis was seen in 22 (52.38%), Candida was seen in 13 (30.95%), and Trichomonas was seen in 7 (16.66%) cases. The prevalence of infective vaginal discharge was lower as compared to other studies done in similar settings. bacterial; candidiasis; prevalence; vaginitis.

Uncommon Metachronicity: Breast and Endometrial Carcinomas in a Young Woman with No Familial Cancer History - A Case Report

Background: Worldwide, breast and endometrial carcinomas are the two most common cancers of women, but their coexistence in a woman <40 years of age is a rare event. The risk of developing a new second primary cancer is higher in cancer survivors compared to those without a history of cancer. The exact pathogenesis of two different primary malignancies is not clear. Still, the coexistence of breast and endometrial carcinoma may be due to germline mutations of p53, BRCA 1, and BRCA 2 genes, environmental, hereditary, and immune-mediated factors. Case Presentation: The present case report briefs the finding of a 37-year-old woman who presented to the Gynecological outpatient department with complaints of abnormal uterine bleeding and a solid irregular lump in the upper outer quadrant of the right breast and the right axilla. She had a history of modified radical mastectomy for left breast ductal carcinoma five years back. She was diagnosed as a case of metachronous endometrial carcinoma (stage IA) with a recurrence of invasive ductal carcinoma in the right breast with metastasis to the right axillary lymph node. Conclusion: The metachronous development of breast and endometrial carcinoma in young women is relatively rare. In young patients <40 years of age with gynecological or breast carcinoma, a thorough work-up, including genetic testing and follow-up, should be done for early diagnosis of metachronous or synchronous primary malignancies of other organs.

The relationship of maternal age, BMI, serum Tenascin-C, and HOMA-IR values with gestational diabetes mellitus.

To explore the relationship, if any, of gestational diabetes mellitus with maternal age, body mass index, serum tenascin-C and homeostatic model assessment for insulin resistance, and to see if these could act as predictive markers for gestational diabetes mellitus. The case-control study was conducted from February to August 2022 at the outpatient department of gynaecology and obstetrics at the Civil Hospital, Karachi, and comprised pregnant females aged 18-40 years having gestational age 20-34 weeks. After noting down baseline characteristics and anthropometric measurements, the participants were subjected to oral glucose tolerance test on the basis of which they were divided into three groups; pregnant healthy controls in group 1, those with gestational diabetes mellitus on diet control in group 2, and those with gestational diabetes mellitus taking medicines for the condition in group 3. Fasting serum samples were used for further analysis using enzyme-linked immunosorbent assay kits. Data was analysed using SPSS 21. Of the 90 subjects, 30(33.3%) were in group 1 with mean age 26.0±4.9 years, 30(33.3%) were in group 2 with mean age 30.7±5.6 years, and 30(33.3%) were in group 3 with mean age 29.1±5.5 years. Age, gestational age, body mass index and homeostatic model assessment for insulin resistance values were significantly higher in groups 2 and 3 compared to group 1 (p<0.05), while serum Tenascin-C values were not significantly different (p>0.05). HOMA-IR values and BMI were more reliable in diagnosing GDM before its onset, and should be included in the screening test for GDM in early pregnancy.

Acceptance and hesitancy of COVID-19 vaccination among Saudi pregnant women.

Since the COVID-19 pandemic started, it has significantly impacted health systems and societies worldwide. Pregnancy increases the risk of severe illness when associated with COVID-19. Pregnant women are likely to experience COVID-19-related pregnancy complications however many of them were hesitant to receive the vaccine. This study aimed to assess the acceptance and hesitancy of COVID-19 vaccination among pregnant women in Jeddah. The present study utilized a descriptive cross-sectional research design to include pregnant women through convenience sampling at the obstetrics and gynecology outpatient department and antenatal ward at King Abdul-Aziz Medical City, Jeddah. Data was collected from August to October 2022 using a structured questionnaire. Approximately one-third of the 264 participants (36.4%) strongly disagreed that they had developed immunity against COVID-19. More than half of them (61% and 66.3% respectively) had heard that the vaccine was unsafe for them and their babies during pregnancy, and it would contain the COVID-19 virus. However, half of them 50% agreed that vaccination would ease precautionary measures. A high acceptance score toward COVID-19 vaccination was observed among pregnant women working in the health sector. The most frequently reported reason for vaccination refusal was the belief that it was unsafe for the mother and her baby during pregnancy. Most of the participants perceived their susceptibility to COVID-19 infection as low and were hesitant to take the vaccine because of their worry about its effectiveness. However, they indicated a willingness to take the vaccine if it was mandatory and if they received adequate information about it. These findings correspond with previous studies conducted in Saudi Arabia that explore the reluctance of pregnant and breastfeeding women to receive COVID-19 vaccination.

Unveiling the Burden of Osteoporosis: Exploring the Prevalence and Risk Factors among Postmenopausal Women in North Central Bangladesh.

Background: Osteoporosis affects 30% of women globally between the ages of 40 and 50. This disease is among the top causes of death and disability among the elderly. This study aimed to examine the prevalence of primary osteoporosis and poor bone density in postmenopausal women, as well as their socio demographic, obstetric, and lifestyle risk factors. Aim: The purpose of this study is to investigate at the prevalence of osteoporosis and the risk factors linked with it in postmenopausal women. Methods: The present prospective cross-sectional study was conducted on postmenopausal women who visited orthopedics, gynecology, and medicine outpatient departments between August 2022 and March 2023; 539 women aged 45 to 80 years with verified menopause were recruited. The final recommendation was for 539 women to have bone mineral density testing utilizing dual energy X-ray absorptiometry. Socio-individual, obstetric-medical, short-form physical activity, and anthropometric questionnaires were administered. Chi-square and Student's t-tests were applied to categorical and continuous data, respectively, to assess the differences between the groups. In SPSS 26, P&lt;0.05 was regarded to indicate significant connections. Results: In our study, 38.0% of participants were between56 and 60 years of age. The majority of the individuals (51.9%) were illiterate. 37.7% of respondents reported having six or more children. 3.6% of the sample smoked or chewed tobacco. 61.0 percent of individuals had menopause after the age of 45, and 48.8% of subjects had experienced menopause for more than ten years at the time of enrollment in the research. 83.5% of postmenopausal women were affected by osteoporotic fractures (osteoporosis: 40.0% and osteopenia: 43.5%). The incidence of osteoporosis rose as parity and abortion rates increased. The prevalence of osteoporosis was greater (P&lt; 0.05) among those with a familial history of osteoporosis-related symptoms and fragility fracture, as well as a personal history of fragility fracture. Conclusion: Given the significant prevalence of primary osteoporosis and poor bone density in postmenopausal women, health education is essential for minimizing modifiable risk factors and mitigating the disease's consequences. Central Medical College Journal Vol 7 No 1 January 2023 Page: 32-40

What Patients Think About Robot-Assisted Surgery: Lessons to Learn from the Awareness and Perception Study in Mumbai.

We attempt to understand our patients' awareness and perception about robot-assisted surgery (RAS), to be able to educate them better and help them make informed decisions. Patients who visited the Obstetrics & Gynaecology out-patient department were given questionnaires. Two hundred and sixty-two completed questionnaires were analysed. Comfort with technology was significantly associated with the patients' knowledge of the robot's appearance. Correct identification of the meaning of RAS, the surgeon's role, and appearance of the robot were also individually associated with preference towards RAS. Those who had undergone RAS before favoured it significantly more than those who did not have a history of RAS. Counselling is important to help patients get over misinformation. Patients need to be explained that the robot does not have autonomy. The three main concepts to be focused on are-meaning of robotic surgery, surgeon's position/role during the surgery, and appearance of the robot. Limitations also need to be discussed. The online version contains supplementary material available at 10.1007/s13224-023-01927-9.

Clinical Audit of Gynecological Cancers at National Institute of Cancer Research and Hospital, Dhaka, Bangladesh

The aim of this audit was to assess the trend of the gynecological cancers for the year of 2022. This is an observational study on retrospectively collected data of gynecological cancer patients at National Institute of Cancer Research and Hospital (NICRH), Dhaka. All cases of cancer seen at the gynecology outpatient department and cases admitted in the gynecological oncology ward at NICRH, between the months of January to December 2022 were audited. The results shown that about 5.8% of all the new cases were young women aged below 25 years. The majority of gynecological cancers were among women aged between 35 and 64 years (73.17%) and only 2.6% patients were aged above 75 years. Cervical cancer (59%) was the leading gynecological cancer among all female cancers attended at NICRH. In ovarian malignancy, most of the patients(61%) had stage lll disease and no patient in stage IV diseases. Due to improper evaluation of abnormal uterine bleeding, majority of the endometrial carcinoma patients (64%) presented with histopathology reports after hysterectomy. This study might help to get a in depth understanding of the trend of major gynecological cancers. J Bangladesh Coll Phys Surg 2024; 42: 43-48

Evaluation of prescribing pattern of fixed-dose combinations in obstetrics and gynecology department of a tertiary care hospital of central India

Background: Improved patient compliance and cost effectiveness are two benefits of fixed-dose combination drugs. Irrational fixed-dose combinations (FDCs) raise the most urgent issue since they put patients at needless risk for negative medication responses. Aims and Objectives: The present study was done with objective of analyzing prescribing pattern of FDCs in department of fixed-dose combination in department of obstetrics and gynecology in a tertiary care hospital of central India. Materials and Methods: This study, which was both prospective and observational, was conducted at the tertiary care hospital of central India. This study comprised the prescriptions of all patients who visited the obstetrics and gynecology Outpatient Department during the study period. Results: In the present study, 1605 prescriptions were analyzed, comprising total 3016 drugs. Out of these 1262 were prescribed as FDCs and 1754 were prescribed as single drugs. On analyzing system-wise prescriptions, it was found that majority drugs were prescribed pertaining to gastrointestinal tract, that is, 1720 prescriptions, of which 722 (38.8%) were prescribed as FDCs. Four hundred and sixty-three drugs were prescribed related to hematological system, of which 97 (14.9%) were FDCs. Four hundred and thirty-three drugs were prescribed related to anti-infective class, comprising 196 (36.6%) FDCs. Among FDCs prescribed in gastrointestinal system, Vitamin D3 + Calcium carbonate was most commonly prescribed, accounting for 644 (51%) prescriptions. Clotrimazole + Clindamycin was most commonly prescribed FDC in anti-infective system comprising 118 (9.3%) patients. Ferrous ascorbate + folic acid was most commonly prescribed hematological FDC, accounting for 49 (3.8%) patients. Dextromethorphan + phenylephrine + Chlorpheniramine was most commonly prescribed FDC in respiratory segment accounting for 39 (2.9%) patients. Conclusion: The present study highlights a considerable number of drugs prescribed as FDCs. FDCs reduce pill burden and also help to improve patient compliance. However, rationality of FDCs should be thought before prescribing it to patients.

Evaluation of association between periodontitis in pregnant women and preeclampsia

Abstract Background and Objective: Preeclampsia is a maternal disease encountered during the second half of pregnancy. Many risk factors have been implicated in its pathogenesis. Periodontitis may burden pregnant patients systemically with cytokines and endotoxin at the maternal fetal interface leading to endothelium dysfunction. Hence, our objective was to check the association between periodontitis and preeclampsia. Materials and Methods: This observational study was conducted in the outpatient department (OPD) of community health center from March 15, 2022, to December 14, 2022, on 100 patients. Inclusion Criteria: Pregnant women of age group &gt;18 years with informed consent with gestational age between 26 and 36 weeks with Singleton pregnancy. Women with a history of smoking, alcohol and periodontal treatment, multiple pregnancy, and consumption of antibiotics (3 months before study inclusion) were excluded. All eligible candidates in the antenatal clinic in OPD of obstetrics and gynecology were screened by history, obstetrical examination, routine antenatal tests, including urine routine and blood pressure measurement. Subjects were evaluated as per the designed protocol. Fifty preeclamptics were taken as case and 50 non preeclamptic were taken as control. Oral examination was conducted on the patients at the inclusion in the study and followed till delivery. Blood pressure and urine albumin were checked at each visit. Details noted on delivery and outcomes were observed. Results: The risk of preeclampsia in women having periodontitis showed an odds ratio of 3.436 (95% confidence interval: 1.460–8.065; P = 0.006). Conclusion: As the etiology of both events is multifactorial preeclampsia and periodontitis relationship needs wise attention.

Comparison of clinical tests versus electrodiagnostic testing in the diagnosis of pregnancy-related carpel tunnel syndrome

Background: Pregnancy-related carpal tunnel syndrome (PRCTS) is a persistent mononeuropathy in pregnancy. The incidence of PRCTS has a wide fluctuation range of 0.8% to 70%. Their incidence depends on the diagnostic technique. The nerve conduction study (NCS) is a very specific test for the diagnosis of PRCTS. There have been very few studies to compare the results of diagnosing PRCTS via NCS with clinical tests. Aims and Objectives: To assess the most reliable technique in the diagnosis of PRCTS by comparing clinical tests with the nerve conduction studies in electrodiagnostic (EDX) testing. Materials and Methods: As per inclusion and exclusion criteria, 100 subjects were included in the study. Out of 75 pregnant females, 25 were agematched non-pregnant females as controls. All were enrolled in the ANC clinic and gynecology outpatient department of Jawahar Lal Nehru Medical College and Hospital, AMU, Aligarh. All the females were assessed for CTS by the clinical tests as well as the EDX test performed in the department of physiology at JNMCH and AMU. The testing was done at the wrist joint in order to assess the normal functioning of the median nerve. Results: There was a highly significant difference between the two methods for the diagnosis of PRCTS. Out of the total 75 pregnant females enrolled, only 2 were found to be positive for PRCTS via clinical testing, whereas in the EDX techniques, 48% of the pregnant females were diagnosed as having PRCTS. Conclusion: Clinical tests are not emerging as a good method for PRCTS diagnosis, while EDX testing is the gold standard and a prudent method to diagnose PRCTS.

Comparison of Foetal Kidney Length with foetal Biometric Parameters (Biparietal Diameter, Abdominal Circumference, Head Circumference and Femur Length) in the Third Trimester of Pregnancy

Introduction: The basis for an obstetrician's capacity to successfully organise an intervention, administer prenatal care, and conduct prenatal testing. exact awareness of the gestational age. This study conducted to find out correlation of foetal kidney length with foetal biometric parameters like BPD, AC, HC and FL in the third trimester of pregnancy&#x0D; Methodology: A cross-sectional observational research was carried out on third-trimester pregnant patients who were seen in the obstetrics and gynaecology outpatient department at a tertiary care hospital in India. The study included all women who were singleton pregnant in the third trimester (28 to 40 weeks), had date scans that were documented, were certain of their last menstrual cycle, had a normal prenatal period, and had no risk factors connected with them.&#x0D; Results: A reasonably excellent positive correlation between MKL and GA. With a decent fit and a R squared (R2) value of 0.599. There is a reasonably strong positive correlation (r) between MKL and GA by HC. With a decent fit and a R squared (R2) value of 0.545, this regression model explains 54.5 percent of changes in GA by HC with MKL. According to the Pearson Association Coefficient (r), there is a relatively strong positive correlation (r) between MKL and GA via AC. A high positive correlation (very good) between MKL and GA via FL. With a decent fit and a R squared (R2) value of 0.668, this regression model explains 66.8% of changes in GA by FL with MKL.&#x0D; Conclusion: That there is a high correlation between the mean kidney length of the foetus and established biometric markers of gestational age, including femur length, head size, belly circumference, and biparietal diameter.

Consumption of chewing tobacco alters the serum metal contents in pregnant women at Tandojam and adjoining areas.

Chewing tobacco may play a contributing role in complications during pregnancy as it contains various kinds of toxic metals such as lead (Pb), cadmium (Cd), cobalt (Co), manganese (Mn), chromium (Cr), and can cause alteration in serum metal concentration. Hence, the present study aimed to explore the effects of chewing tobacco consumption on serum metal contents in pregnant women. A total number of 200 chewing tobacco consumer pregnant women and 200 age-matched non-consumer pregnant women were selected for the study from the outpatient department of gynaecology at Rural Health Centre Tandojam, Pakistan. After obtaining the sociodemographic characteristics of all participants, 10ml of venous blood was also drawn for serum metal analysis by atomic absorption spectroscopy. Different chewing tobacco samples consumed by consumer pregnant women were collected from local shops of Tandojam, Pakistan. Drinking water samples from the residential areas of consumer and non-consumer pregnant women were prepared and analysed for the same metal contents. In present study, serum Pb, Cd, K and Co were found significantly increased in CPW as compared to NCPW. Serum Pb was found significantly increased in gutkha consumers in comparison to mainpuri consumers. Serum Pb, Cd, and Co were present with significantly increased concentration in serum of CPW who were taking canal and well water for drinking purpose when compared with NCPW. Significant negative strong correlation of serum Pb with K and Cr of drinking water and Na of chewing tobacco samples were observed. Strong positive correlation of serum Cd and Cr with Co of drinking water had been observed. Whereas, serum maternal Co was strongly negatively correlated with Mn of chewing tobacco samples, and serum Cu of CPW had a strong positive correlation with K and Cr of drinking water and Na of chewing tobacco samples.In conclusion, consumption of chewing tobacco alters the serum metal contents in pregnant women at Tandojam and adjoining areas, Pakistan.

A Cross Sectional Study on Prevalence of Bacterial Vaginosis in Preterm and Term Labor

Background: The aim is to examine bacterial vaginosis (BV) in women with preterm and term labor, explore the link between bacterial vaginosis and preterm labor (PTL), and analyze complications for both mother and baby related to bacterial vaginosis. Design: Hospital based cross sectional study. Materials and Method: We had conducted an observational study at Basaveshwara Medical College and Hospital, involving 100 pregnant patients with preterm and term labor (50 patients in each group). Eligible patients attending the Obstetrics and Gynecology Outpatient Department (OBG OPD) and inpatient department will be included. Bacterial vaginosis will be determined using Amsel's criteria, which include evaluating discharge characteristics, vaginal pH, amine odor with KOH test, and presence of clue cells under microscopic examination. Additionally, vaginal swabs will undergo Gram staining. Results: The percentage of patients meeting Amsel's criteria for diagnosing bacterial vaginosis was significantly higher in the preterm labor group compared to the term labor group, with a statistically significant difference. According to Amsel's criteria, the prevalence of bacterial vaginosis was 30% in the preterm labor group and 2% in the term labor group. Conclusion: Bacterial vaginosis is a significant risk factor for preterm labor. Hence, conducting tests for bacterial vaginosis and promptly treating it can help reduce the risk of preterm labor.

Correlation of cervical cancers with long-term use of hormonal oral contraceptive pills - A retrospective observational multicentric study in suburban-based medical colleges in West Bengal

Background: Hormonal oral contraceptive pills (OCP) may increase the risk of carcinoma cervix by changing the susceptibility of cervical cells to persistent infection with high-risk human papilloma virus. There is a causal and promoting association with long-term use of these pills for more than 5 years of use, and the association is diminished 10 years after last use. Aims and Objectives: In this study, retrospective data were collected to analyze the risk of association of carcinoma cervix with hormonal contraceptive pill use. Materials and Methods: Interview-based retrospective observational study to enquire about the history of hormonal OCP use and duration of intake in all diagnosed cases of cervical carcinoma attending gynecology and oncology outpatient departments over the period of 2 years in two medical colleges in suburban West Bengal. Results: Of the total 401 subjects, 119 have a history of intake of hormonal OCPs, and 198 have a history of other methods of contraception. Among the subjects, 67.58% had squamous cell carcinoma (SCC), 31.67% had adenocarcinoma of the cervix, and 0.75% had other varieties. There is no correlation between the duration of hormonal OCP use and SCC cervix (P=0.269), whereas there is a significant correlation between adenocarcinoma of the cervix and duration of intake of hormonal OCP (P=0.002). Conclusion: Studies have shown that women who have used OCPs for 5 or more years have a higher risk of cervical cancer than women who have never used oral contraceptives. This study reported a statistically significant increase in the relative risk of adenoca of the cervix but not of the SCC of the cervix, even after long-term use of hormonal OCPs.

Isolation and Susceptibility of Microorganisms Responsible for Asymptomatic Antenatal Bacteriuria

Aim &amp; Objective: Determination of prevalence, bacterial profile and antibiotic sensitivity of microorganisms responsible for asymptomatic UTI during pregnancy.&#x0D; Methodology: The type of study is cross-sectional, Prospective type, was conducted at the PUMHS for Women Nawabshah (SBA) after approval from the Ethical Review Committee and the duration was 2 years from 1st Jan 2021-31st Dec 2022. Samples were collected by non-probability- convenient method from all pregnant women without any clinical complaints attending the Outpatient Department of Gynecology and Obstetrics PUMHS Hospital Nawabshah. The midstream urine collected by clean catch method in sterile containers was processed for DR of urine including physical, chemical, and microscopic examination. After the urine detailed report, the samples were sent for, culture by using the following media, blood, Macconkey’s, and CLED agar. Growth-positive samples were proceeding for gram staining, biochemical tests, and antibiotic sensitivity reports according to world standard methods for confirmation.&#x0D; Results: Out of 477 patients 96 (20%) were positive for ASB, with the mean age of the patient being 29.32±5.74 The most common microorganisms found in the study were E.coli 67 (69.7.%), followed by Klebisella in 4(4%), proteus 9(9%), pseudomonas 8(8.3%), staphylococcus aureus 2(2%), staphylococcus saprophyticus in 4(4%), streptococcus pyogen 2(2%).&#x0D; There was 100% sensitivity found for all isolated microorganisms following culture examination to following antibiotics: Ciprofloxacin, Cefuroxime, Imepenem, Ceftriaxone Amikacin, Meropenem, and Piperacillin-tazobactam; however, 52% and 45% sensitivity of E.coli and 100% sensitivity of streptococci were present for amoxicillin-clavulanic acid and ampicillin respectively.&#x0D; Conclusion: A rising number of silent antenatal bacteriuria was observed in younger age women with severe maternal and fetal complications in advanced stages of pregnancy and thereafter. It is therefore suggested to routinely perform urine cultures for every suspected pregnant lady during advanced antenatal visits to diagnose and properly treat the asymptomatic bacteriuria in terms of avoiding antibiotic resistance and materno-fetal complications in the near future.

PREVALENCE OF CERVICAL CANCER AMONG THE WOMEN’S ATTENDING THE TERTIARY CARE CENTER OF EASTERN PART OF BIHAR

Objectives: The objective of this study was to study the prevalence of cervical cancer and its grade in the patients presenting to the gynecology outpatient department (OPD) of a tertiary care center. Methods: This is a record based cross-section study which shows the percentage of women having pathological cervical lesions from the total number presenting to gynecology OPD of our tertiary hospital with specific symptoms with in a period of more than past 2 year. Results: As the catchment area is of lower status general health which was low and routine regular check-up was not considered important by the patients. Poor knowledge about cancer cervix and lack of regular screening at primary center’s was the main constraint. The mean age of patient was 37±5.4 years and shows that maximum incidence that is reported is of negative for intraepithelial lesion for malignancy followed atypical squamous cells of undetermined significance and high-grade squamous intraepithelial lesion. Discussion: The major limitation found in this study was lack of proper knowledge among patients, poor health-care facilities, and shortage of trained staffs. It is essential to upgrade the basic facilities of primary health-care centers and mass education to vulnerable age group and enhanced awareness on this issue will lead to early diagnosis and greater chance of screening leading to timely diagnosis and treatment. Conclusion: Lack of awareness has led to underreporting and faulty health seeking behaviour has led to delayed diagnosis. Comprehensive approach and affordable extended package of health care under Ayushmann Bharat can be helpful in reducing the disease burden.