Gynecology Clinic Research Articles

Investigation of serum apelin-13 and apelin-36 concentrations in pregnancies complicated by preeclampsia; a prospective case-control study

Objective We aimed to investigate the relationship between preeclampsia and maternal serum apelin-13 and apelin-36 concentrations. Methods This cross-sectional study was carried out in the Gynecology and Obstetrics Clinic of Umraniye Training and Research Hospital. The preeclampsia group consisted of 40 pregnant women diagnosed with preeclampsia, and the control group consisted of 40 healthy pregnant women matched with the preeclampsia group in terms of age and body mass index. The two groups were compared in terms of maternal serum apelin-13 and apelin-36 concentrations. Results Both groups were similar in terms of demographic characteristics and the gestational week at blood sampling. Maternal serum apelin-13 and apelin-36 concentrations were significantly lower in the preeclampsia group than in the control group (p = 0.005, p = 0.001, respectively). The optimal cutoff value for the prediction of preeclampsia in receiver operator curve analysis for apelin-13 was determined as 1781.67 pg/ml with 60% sensitivity and 60% specificity, and 885.5 pg/ml for apelin-36 with 67% sensitivity and 65% specificity. We divided the preeclampsia group into two groups mild and severe and compared the three groups in terms of maternal serum apelin-13 and apelin-36 concentrations. The lowest apelin-13 concentration was detected in the severe preeclampsia group, while the lowest apelin-36 concentration was detected in the mild preeclampsia group (p = 0.020, p = 0.003, respectively). Considering the onset of the disease, we divided the preeclampsia group into two groups early and late-onset, then compared the three groups in terms of maternal serum apelin-13 and apelin-36 concentrations. The lowest maternal serum apelin-13 and apelin-36 concentrations were detected in the early-onset preeclampsia group (p = 0.016, p = 0.001, respectively). Conclusion It was determined that serum apelin-13 and apelin-36 concentrations were significantly lower in preeclamptic pregnant women, this decrease was more significant in early-onset preeclampsia, and low maternal serum apelin-13 concentration was more associated with the severity of preeclampsia.

Impact of COVID-19 pandemic on changing the ratio of abdominal, vaginal, and laparoscopic hysterectomies

Introduction/Objective. Coronavirus pandemic caused most hospitals in the world to suspend regular activities. The aim of this study was to analyze pandemic influence on patients who underwent hysterectomy with classical (abdominal) and minimally invasive surgery (laparoscopic and vaginal approach) at the Clinic for Gynecology and Obstetrics of the University Medical Centre of Serbia. Methods. There were 2446 hysterectomies for five-year period. The study analyzed number and types of hysterectomies before and during COVID-19 pandemic. Results. The total number of operated patients was most decreased in the first year of the pandemic. During pandemic, the number of vaginal and laparoscopic hysterectomies did not change, whereas there was an increase in the number of abdominal hysterectomies. Statistical significance (p < 0.01) was found between abdominal and vaginal as well as between abdominal and endoscopic hysterectomies. Conclusion. The global pandemic impact on care of symptomatic patients with COVID-19 has led to the redeployment of staff and resources, which has significantly reduced the total number of operations in many hospitals around the world.

Assessment of Metabolic, Cardiovascular, and Anthropometric Parameters in PCOS Women Attending Gynecology Clinic at Nnewi, Anambra state, Nigeria.

Polycystic ovarian syndrome (PCOS) is a common hormonal disorder in reproductive-age women, characterized by irregular periods, excess androgen levels, and ovarian cysts, often leading to infertility. While incurable, symptoms can be managed through lifestyle changes and treatments. Its exact cause is unknown, but genetic and metabolic factors are implicated. A comprehensive evaluation assessed various health markers including insulin resistance, glycemic index, lipid profile, blood pressure, BMI, and waist-to-hip ratio in PCOS women at Nnewi Anambra State Nigeria’s gynecology clinic, likely aiming to understand metabolic health, cardiovascular risks, and overall well-being. In this cross-sectional study conducted at a hospital, 45 participants diagnosed with PCOS were compared to 45 participants without PCOS, all aged between 18 and 50. Biochemical parameters were assessed using the enzyme-linked immunoassay technique. Data was expressed as Mean ± standard deviation. The differences in parameters studied between the PCOS group (test) and the control group were evaluated using an independent t-test. Statistical significance was set at a p-value of <0.05. Results showed that significantly lower differences exist in the mean serum levels of LDL-C (1.23±0.73) and Insulin resistance (15.13±8.13), in women with PCOS compared with the control (1.96±0.43) and (18.46±10.20)(p<0.05) respectively. A higher significant difference exists in the BMI (32.42±8.72) and WHR (0.71±0.14) of the test group (women with PCOS) compared with the control group (26.79±6.35) and (0.60±.178) respectively. The study found that women with PCOS attending the gynecology clinic at Nnamdi Azikiwe University Teaching Hospital in Nnewi, Anambra state exhibited obesity, without dyslipidemia as indicated by notably elevated mean values of the body mass index.

A Retrospective Observational Study on Telemedicine in Prescribing Low-Dose Pills for Patients with Dysmenorrhea.

In Japan, telemedicine has gradually expanded due to deregulation in response to the COVID-19 pandemic. However, its current status remains unclear, as it is primarily provided by general practitioners. Meanwhile, telemedicine has begun to be utilized for low-dose estrogen-progestin (LEP) prescriptions for dysmenorrhea. We conducted a retrospective analysis of medical record data from two gynecology clinics and performed an exploratory evaluation between a group that combined telemedicine and in-person visits during the initial 6 months of LEP treatment, and another group with only in-person visits. After propensity score matching, 89 and 83 patients were eligible for the telemedicine and in-person groups, respectively, with 53 patients in both. The characteristics of both groups were similar after matching. There were no significant differences in the probability of abnormal uterine bleeding during the first 6 months of treatment (25% and 43% in each group; p = 0.064), side effects, or treatment efficacy between the two groups. The withdrawal rate at 6 months was significantly higher in the telemedicine group than in the in-person group (13% and 0%, p = 0.013). The average copayment for patients who covered 30% of the total cost was also significantly higher in the telemedicine group after 1 and 3 months of LEP prescription. The appropriate combination of telemedicine and in-person visits is currently employed in hospital visits, which does not differ significantly from in-person visits. Given the retrospective nature of this study and the limited number of cases, further investigation is necessary in the future.

Application of Global Trigger Tools in University Hospital and Comparison to Volunteer Adverse Events Reporting System.

A voluntary reporting system (VRS) is still used to detect adverse events (AEs) in health-care services in many countries. We attempted to apply the Global Trigger Tool (GTT) for the first time in our country and searched for an answer to the question of whether there could be new triggers. Two hundred and forty inpatient records were selected from total of 1,807 inpatient files in the university obstetrics and gynecology clinic between 2018 and 2020. Twenty files per month were reviewed retrospectively using GTT, an approach developed by the American Institute for Health Development. VRS records of the same period were examined. The data were evaluated according to the National Coordinating Council for Medication Error Reporting and Prevention scale and those in the E, F, G, H, I categories were included. The number of AEs per 1,000 patient days was 47.81, AEs per 1,000 patient hospitalizations was 95.83, and hospitalizations with AEs was 9.58%. In the VRS data, 10 of 85 reporting cases were listed in the E category (Damage is temporary and requires intervention), 6 of them were related to fall of the patient, and 4 of them were related to medical device and material safety. By applying GTT, 45 cases in category E and 35 cases in category F (Damage is temporary and requires hospitalization or prolonged hospitalization) AEs were detected in 23 patients (9.58%). The number of AEs reported was 8.3 times higher in the GTT than with VRS. Healthcare related infection, development of complications from any procedure, APTT>100 Seconds, INR>6, Organ Injury - Repair or Removal, All Kinds of Operative Complications were found to be the most sensitive triggers (PPV = 100). There was no difference between the patients with and without AEs in terms of age and number of hospitalization days (p: 0.707, p: 0.618). The sensitivity rate of vaginal dinoprostone use and CRP elevation (30% and 22%, respectively) was higher than the mean sensitivity rate of GTT triggers (15.6%). The GTT is more effective than VRS in detecting AEs. Using vaginal dinoprostone (propess) and high CRP levels could be used as a trigger. The GTT is a credible and fruitful instrument for determining AEs when adapted to the departmental practices.

Retrospective Study of the Use of Heparins in Pregnant Women and in vitro Testing on the HCT 116 Colorectal Carcinoma Cell Line.

Pregnant women manifest an increased risk of developing coagulation disorders. Unfractionated heparin (HEP) and low-molecular-weight heparin (LMWHep) are considered as selective medication in the case of pregnancy which needs anticoagulant treatment. In addition to anticoagulant properties, HEP and its derivatives manifest other properties including anti-cancer potential. According to Globocan's latest data, colorectal cancer (CRC) is the second most encountered form of malignancy in the case of women, manifesting some special particularities, as confusion of symptoms from cancer with symptoms encountered normally in pregnant women (such as constipation or rectal bleeding), delayed diagnosis because of limitations imposed both for the fetus and for the mother, and the need for special treatment. The aim of the present work is to follow the incidence and safety of consumption of HEP and LMWHep in the case of pregnant women and to analyze their potential on the HCT 116 colorectal carcinoma cells. Analyzing the consumption of heparins in case of pregnant women hospitalized from 01.01.2022 to 31.12.2022 at the Pius Brînzeu" Emergency Clinical Hospital from Timisoara, Obstetrics and Gynecology Clinic I, it was observed that 44,6% of the patients were administered the following medication and no administration risks were observed. When tested on HCT 116 cells, heparins manifested a significant anti-migratory effect (with wound healing rates of 2,6%, when tested with HEP 100 UI concentration and 14.52% wound healing rates in case of fraxiparine 100 UI). In addition, different signs of apoptosis were observed, suggesting the pro-apoptotic potential of the tested substances. Heparins remain the preferred medication to be administered to pregnant women with the potential for coagulation disorders, showing a high safety profile. Testing on the cancerous line of colorectal carcinoma highlights important properties that stimulate future studies, to establish the anti-tumor potential and the exact mechanism of action.

Estimates of the incidence, prevalence, and factors associated with common sexually transmitted infections among Lebanese women.

We analyzed the prevalence of active infection with common curable sexually transmitted infections (STIs) including N. gonorrhea, C. trachomatis, T. vaginalis, and T. pallidum, as well as active infection with HPV, herpes simplex virus types I (HSV-1) and II (HSV-2), M. hominis, M. genitalium, C. albicans, and Ureaplasma in 351 Lebanese women. A cross-sectional study, involving 351 sexually active women, 40 years or younger, who were recruited from outpatient Obstetrics and Gynecology clinic attendees between September 2016 and November 2017. The prevalence of active infection was low at 0.3% for N. gonorrhea, 0.6% for HSV-2, 2.8% for C. trachomatis, and 2.9% for any curable STIs. Prevalence of active HPV infection was high assessed at 15.7% for high-risk and 12.2% for low-risk genotypes. Furthermore, the prevalence was 2.0% for M. genitalium, 6.8% for ureaplasma, 13.7% for Candida albicans, and 20.5% for M. hominis. No active infections with T. vaginalis, T. pallidum, or HSV-1 were observed. Significant age differences were noted in the prevalence of high-risk and low-risk HPV genotypes, but no such differences were noted in the prevalence of other infections. No appreciable variations were identified in the prevalence of key STIs based on smoking, marital status, or the number of sexual partners. The study documented active infection with substantial prevalence for multiple STIs among women attending outpatient gynecology and obstetrics clinics in Lebanon. These findings underscore the importance of strengthening STI surveillance, linkage to care, and prevention interventions in reducing STI incidence among women.

Childbirth in adolescents - features and outcomes

Introduction. Adolescent pregnancies significantly impact the welfare of young mothers, their infants, and the general population. These pregnancies represent a public healthcare concern associated with numerous consequences. Aim: To investigate the prevalence of adolescent pregnancies and their outcomes. Material and Methods. This retrospective descriptive study included adolescents who gave birth at the Gynecology and Obstetrics Clinic between January 1, 2020 and December 31, 2020. Data on anthropometric measurements, number and mode of deliveries, newborn birth weights, and complications were collected from medical records and statistically analyzed. Results. A total of 174 adolescents (aged 13-19) were included in the study. Most were first-time mothers living in common-law unions. Four spontaneous twin pregnancies were documented. No significant differences were found in the anthropometric measures between younger (<15 years old) and older (16-19 years old) adolescents. Pelvic measurements did not affect the mode of delivery. Younger adolescents and those with smaller pelvic measurements experienced longer hospitalizations. Vaginal delivery was the prominent mode of birth. Newborns delivered by caesarian section had significantly lower birth weights and lengths. While no significant complications during labor and delivery were observed, there was notable postpartum blood loss and higher rates of anemia in the puerperium. Conclusion. Although the number of adolescent pregnancies and births is declining, it still remains a significant concern. Welldeveloped perinatal care and the promotion of reproductive health within educational and health systems could not only further reduce pregnancy rates but also ensure optimal conditions for normal pregnancies and deliveries in adolescents.

Effect of Practicing Deep Breathing and Kegel Exercises on Menopausal Urinary Incontinence at Beni-Suef

Background: Urinary incontinence (UI) is one of the most common problems in menopausal women; it is defined by the International Continence Society (ICS) as the complaint of any involuntary loss of urine and its classification according to the presence of symptoms and pathophysiological mechanisms of occurrence. The Kegel Breathing technique combines breathing and pelvic floor contraction patterns to increase pelvic floor muscular strength while performing daily activities regularly. Normal breathing occurs when the pelvic floor muscles and the breathing muscle (diaphragm) move up and down in harmony manner. Aim of the study: The study aimed to evaluate menopausal women's urinary incontinence before and after practice of deep breathing and Kegel exercise. Design: A quasi-experimental study design was utilized in this study (one group pre and post-test). Sample: A purposive sample of 100 Menopausal women diagnosed with stress urinary incontinence. Setting: gynecological and urological outpatient clinics Beni-Suef university hospital. Tools: 1) a structure interviewing questionnaire schedule, 2) The International Consultation on Incontinence Modular Questionnaire 3) Pelvic floor muscles exercises checklist. Results: about 45% of the studied women reported that their frequency of urination is several times per day preprogram but it became only 19% post program implementation. Only 32% of the studied women can accurately detect the right muscle group at the 1st week of the 1st month. However, at the end of the 1st month; 82% of them can do. Moreover, at the end of the 2nd month; 90% can do. Additionally, at the end of the 3rd month; 93% of the studied women can accurately detect the right muscle group. Conclusion: Deep breathing and kegel exercise had positive effect on women's urinary incontinence. Recommendations: disseminate brochures and booklet about kegal and breathing exercise to enhance awareness program regarding stress urinary incontinence reliving measures for elderly women.

'Age specific variations in ovarian reserves in healthy fertile and infertile women: A cross sectional study.

Ovarian reserve tests are valuable for evaluation of female fertility, and to formulate appropriate treatment strategies for infertile women. Antral follicle count (AFC) and Anti-Mullerian hormone (AMH) are most reliable markers of ovarian reserve which are related inversely to age. There are many factors that affect ovarian reserve like race, ethnicity, fertility status, BMI or any chronic illness. We conducted this study to find outage specific nomograms for AMH and AFC among fertile and Infertile Indian women, to find out any variations between fertile and Infertile ovarian reserves at various centiles, to define the age cut-off of decline in AMH and AFC among fertile and Infertile Indian women and to find correlation between AMH and AFC. It was a prospective cross sectional single centre study conducted at a tertiary hospital of northern India from March 2017 to February 2022. Fertile healthy women were recruited from family planning clinic, oocyte donors and subfertile women from Gynaecology and ART clinic. AMH was done using ELISA, Beckmann Coulter Gen II assay and AFC was done using TVS with high frequency probe (9.0 MHZ, Voluson,S-6, GE Healthcare, USA) by trained personnel. R Statistical Programming Language was used for statistical modelling and visualization. Age-specific AFC centile chart and AMH centile chart were generated using GAMLSS (Generalized Additive Models for Location Scale and Shape) package available in R Statistical Computing Language. A Non-linear decline in ovarian reserves among fertile, while linear among infertile women was seen. Centiles defined for both groups with a faster decline in infertile women. Age cut off for decline in AMH and AFC in fertile women approximately 31 years using ROC analysis and Age cut off for decline in AMH and AFC in infertile women is approximately 34 years. There seems to be a good correlation between AFC and AMH. We need to counsel women to consider child bearing well before ovarian reserves decline (31-34 years).

Silent struggles: Unveiling the unspoken epidemic of domestic violence against infertile women in Egypt

BackgroundGlobally, the issue of domestic violence (DV) against women remains a paramount concern in public health. However, a distinct facet of this challenge revolves around DV targeting women grappling with infertility, presenting a unique nexus with their overall well-being. This study endeavors to unravel the prevalence, associated determinants, and diverse manifestations of domestic violence against infertile women. MethodsThe investigation unfolded within the Center for the Diagnosis and Treatment of Delayed Reproduction and the Gynecological Outpatient Clinic at Beni-Suef University spanning from the first of March to the end of July 2022. Employing a cross-sectional descriptive approach, the study engaged 200 infertile women actively seeking infertility treatment. Data acquisition transpired through an interview questionnaire tailored for the purpose. ResultsAmong surveyed women, 69.0 % reported experiencing physical violence due to infertility, while 65.5 % reported verbal violence. Additionally, 36.5 % reported incidents of sexual violence, and 47.0 % reported being subjected to financial violence. Statistical analyses revealed noteworthy correlations between physical and verbal violence and various factors, including age (p = 0.013), types of infertility (p = 0.001), gender of children (p = 0.006, p < 0.0001), and frequency of coitus (p = 0.019, p = 0.012), respectively. Conclusion and recommendationsDomestic violence exerts a profound impact on the general well-being of women, particularly affecting their emotional and social dimensions. This study underscores a heightened prevalence of violence among infertile women, with verbal abuse emerging as the predominant form. Recognizing the pivotal role of domestic violence in women's health, it becomes imperative for healthcare professionals to proactively identify at-risk individuals. Tailored interventions, such as comprehensive training programs encompassing communication skills and problem-solving approaches, should be devised and implemented. Moreover, counseling sessions should involve both spouses, elucidating the detrimental effects and challenges associated with all forms of violence.

Evaluation of cervical cytological abnormalities in correlation with clinical findings in Iraqi patients

Abstract Objective: Many articles study the efficiency of pap smears in detecting cervical disease and precancerous lesions; however, in Iraq, only few researches study the clinic-pathological correlation in pap smear results. In this study, we will highlight the correlation of pap smears with the most important and frequent clinical data and findings on cervical examination. Materials and Methods: One hundred and twenty cases are collected from private clinics of gynecology in Al-Kut province during the interval (June 1, 2020, to February 28, 2021). Clinical history was obtained and pap smear test was examined by two pathologists. Data were analyzed using SPSS software program version 26. Results: There were significant statistical association between cytological abnormalities on pap smear test and age of the patient (P-value of 0.01), with low grade squamous intraepithelial lesion (LSIL) result showed the highest mean age of 46.91 as well as significant association with a number of live birth and a number of pregnancies with significant P value (&lt;0.001 and &lt;0.001) in the same order. Atypical squamous cells of undetermined significance were the most common cytological abnormality. Conclusion: Women should not delay their first screening pap test for more than 30 years of age since the mean age for LSIL (the most significant abnormality present in this study) was the age of 46. 91 ± 10.75. awareness about screening for cervical precancerous lesions should be increased especially among multiparous women and those more than 40 years of age.

Prevalence of Vaginal Inflammation Due to Candida sp., Trichomonas vaginalis and Associated Factors Among Patients Visiting the Gynecology Clinic at Hoang Anh Gia Lai University Medical Hospital

Candida spp., T.vaginalis infections can cause genital inflammation in women, leading to many adverse effects such as increased risk of infertility and severely impacting the patient's health and quality of life. Objective: To determine the prevalence of vaginal inflammation due to Candida spp., T. vaginalis infections and identify associated factors. Subjects and methods: Cross-sectional research. The research subjects were women of reproductive age (18-49 years old) who visited the gynecology clinic at Hoang Anh Gia Lai University Medical Hospital, Gia Lai province. Results: The prevalence of vaginal inflammation due to Candida spp., T.vaginalis infection was 26.7% (of which Candida sp. was 99.1% and T.vaginalis was 0.9%). The group using unsanitary water sources had a 1.6 times higher risk of infection (95% CI: 1.1-2.6), and the group that did not regularly undergo gynecological examinations had a 1.8 times higher risk of infection (95% CI: 1.1-2.9). Conclusion: The prevalence of Candida spp., T.vaginalis infection was 26.7%, and was associated with the use of unsafe water sources and irregular gynecological checkups.

Uzrok prevremenog porođaja kao prognostički faktor neonatalnog ishoda i načina završavanja porođaja

Introduction: Premature birth, occurring before the 37th gestational week, is commonly attributed to uterine contractions, premature rupture of the amniotic sac, or placental abruption. In 20% - 30% cases involving maternal or fetal complications, premature birth may be induced, often due to conditions such as preeclampsia, fetal growth retardation, or severe maternal heart disease. Aim: The study aims to determine whether the cause and time of preterm birth affect the neonatal outcome. Material and methods: This retrospective study analyzes patients prematurely born at the Obstetrics and Gynecology Clinic Narodni Front in 2020, the cause of their premature birth, as well as the status of the fetus after birth. In the study, we compared the neonatal outcome in spontaneously induced preterm birth. Results: Among all the births (n = 4,211), in the period between July and December 2020, there were 498 preterm births, i.e., 11.83%. Based on the data on the status of the premature infants' vital signs, the percentage of stillborn preterm infants was 8.9% while the percentage of live births was 91.1%. The Apgar score was the highest in neonates born by vaginal birth after the 34th week of gestation, with intact fetal membranes and spontaneous contractions. According to the study, 54.1% of preterm births ended in cesarean section due to gestational age younger than 28 weeks and with a predominantly pelvic presentation of the fetus. Conclusion: The high rate of premature births highlights a serious problem and suggests a continued rising trend, despite preventive efforts. Improved outcomes are seen in pregnancies reaching later gestational weeks, particularly after the 34th week of gestation, with intact fetal membranes and no signs of infection. Spontaneously born premature infants tend to have higher Apgar scores and better neonatal outcomes, as compared to induced births.

Clinical value of optical coherence tomography in the early diagnosis of cervical cancer and precancerous lesions: a cross-sectional study.

This study aimed to measure the accuracy of optical coherence tomography (OCT) in the early diagnosis of high-grade cervical lesions and assess its diagnostic value in the triage of high-risk HPV infection. From Jan 2019 to Jan 2021, women who visited the gynecology clinics of 2 hospitals for colposcopy were invited to participate in this study. Women aged 35 to 64 years old who were sexually active and had an intact cervix with a diameter of more than or equal to 2cm were included in this study. Additionally, individuals with abnormal cytology, positive HPV test results, or other clinically suspicious symptoms or signs were referred. All participants were examined before colposcopy using OCT. Biopsy and/or ECC were conducted under colposcopy. We used the results of histopathology as the gold standard and assessed the accuracy of OCT. Overall, 883 women were included in the analysis. Approximately 13.25% of women were ASCUS+ in cytological assessments, and 22.31% were positive for high-risk HPV. Nearly 15.18% of women were positive in OCT. Of them, 27 women were diagnosed with CIN2, and 33 were diagnosed with CIN3+ lesions. Among HPV-positive women, the detection rates for CIN2+ and CIN3+ were much lower for those who were negative in OCT, compared with NILM cytology (CIN2+: 20.0% vs. 30.0%, P=0.002, and CIN3+: 18.2% vs. 27.3%, P=0.013). Among women who were positive for HPV16/18, the detection rate for CIN2+ was much lower for negative OCT, compared with NILM cytology (8.3% vs.15.0%, P=0.005). Compared to HPV and cytological tests, HPV combined with OCT had higher specificity for detecting CIN2+ and CIN3+ (96.1% vs. 93.2%, P=0.002; 93.8% vs. 91.3%, P=0.013). OCT triage after HPV genotyping had the highest AUC for detecting CIN2+ and CIN3+ cases among patients with high-risk HPV infection (0.921, 0.920). OCT is an accurate test for the early diagnosis of high-grade cervical lesions and has great diagnostic value in the triage of patients with high-risk HPV infection.

Prevalence of Pelvic Floor Disorders in Parous Women from the Tibet Autonomous Region: A Cross-Sectional Study.

Pelvic floor disorder (PFD) seriously affects the everyday life of women. This cross-sectional study aimed to evaluate the prevalence and risk factors for postpartum PFD in women living in the Tibet Autonomous Region (TAR). Parous women who attended the outpatient gynaecology clinic at our hospital between June 2022 and August 2022 were screened in this study. The demographic and clinical data of these women were collected. Their pelvic floor functions were evaluated via a pelvic organ prolapse (POP) quantification examination, the Pelvic Floor Distress Inventory Questionnaire-20 (PFDI-20) and the Overactive Bladder Symptom Score (OABSS). A total of 201 women were included in this study, of whom 81.09% (163/201) were Tibetan. Twenty-seven women (13.43%) were diagnosed with POP stage ≥2 and 27 women (13.43%) with an OABSS score ≥3. The median PFDI-20 total score was 4.17 (range 0-43.75). Han women (n = 38) in the TAR had much lower PFDI-20 total scores, compared with Tibetan women (n = 163) (p < 0.05). The results of the multiple linear regression models showed that the PFDI-20 scores obtained from women living in the TAR were closely related to parity, history of heavy weight lifting, age, history of instrumental deliveries, ethnicity and number of caesarean sections. Pelvic floor disorder is common among parous women living in the TAR. Ethnicity, parity, history of heavy weight lifting, age, history of instrumental deliveries and number of caesarean sections are the factors closely related to the PFDI-20 scores.

Is postpartum depression related to total weight gain during pregnancy and maternal anemia?

This study aimed to investigate the effects of weight gain and maternal anemia on postpartum depression. This is a prospective, single-center, case-control study. We recorded the demographic characteristics, blood ferritin level, and weight gain during the pregnancy. This study was planned between April 2023 and June 2023 in the Obstetrics and Gynecology Clinic of Ankara Etlik City Hospital. A total of 109 patients were enrolled in the study. Patients were assessed with the Edinburgh Postpartum Depression Scale. Weight gain, nutritional education, educational level, mode of delivery, and pregnancy history were asked in person. Ferritin levels at the onset of labor were determined to detect anemia. Twin births, births due to fetal anomalies or intrauterine stillbirths, patients with systemic infections, and patients diagnosed with a psychiatric disorder in the past 6 months whose records were not accessible were excluded from the study. Pregnancy weight gain and percentage of pregnancy weight gain were higher. Serum ferritin levels and nutritional education during pregnancy were lower in the postpartum depression group (p<0.001). These parameters with statistical significance were identified as risk factors in the regression analysis for postpartum depression (p<0.05). In receiver operating characteristics analysis, >15 kg for weight gain, >28.8 for percentage of weight gain in pregnancy, and <19 ng/dL for serum ferritin level were identified as cutoff values (p<0.001). Nutritional education and vitamin supplementation should be recommended to pregnant women during routine examinations.

Mothers&amp;apos; perception and practice on newborn care and the use of social media as informational source for newborn care at King Abdul-Aziz Medical City, Riyadh

Objective: This study aimed to measure the level of knowledge and practice of mothers on newborn care and the use of social media as a source of newborn care information by those mothers. Methods: This was an observational, descriptive cross- sectional study that was conducted at three primary health care (PHC) centers including Health Care Specialty Center (HCSC), King Abdulaziz City Housing (Iskan), National Guard Comprehensive Specialized Clinic (NGCSC) and Obstetric and Gynecologic clinics 101 (KAMC) in Riyadh, Saudi Arabia. A self-administered questionnaire was distributed amongst 400 Saudi mothers to collect the data. Results: This study included 346 participants with a mean age of 32.01±6.388 years. More than half (n=208, 60.1%) participants got an average knowledge score. Additionally, 57.6% (n=196) women breast fed their children after birth, while 61.7% (n=208) gave colostrum milk. Further, 95% (n=323) women considered that the information from social media was not sufficient. It was found that mothers with educational level up to high school level, had higher average scores of knowledge (66.9%) as compared to the women with university level who had (57.4%) a less average score of knowledge, and this was a significant difference. It was also found that mothers who took information from their doctors had high average knowledge scores (69.8%) and this was again a considerable difference. Conclusion: The study revealed significant gaps in mothers&amp;apos; knowledge of certain child health matters. Health education in hospitals before delivery and upon discharge needs to be more regularized and supervised.

A LITERATURE REVIEW ON THE MOST COMMON WOMEN PROBLEM (SAILAN-UR-RAHEM) AND ITS MANAGEMENT IN UNANI SYSTEM OF MEDICINE

Sailan-ur-Rahem, a common problem in women's health, in the context of the Unani medical system. Sailan-ur-Rahem is a term used to describe a range of illnesses affecting the female reproductive system that pose serious health and quality of life difficulties to countless women worldwide.Approximately 20% of patients who visit gynecological clinics report having vaginal discharge, which could be an infection. 90% of the time, the inflammation is only mild, with the remaining 10% including more serious conditions. Due to their increased exposure to sexual activity and frequent childbearing, married women are more likely to experience vaginal infections such as cervical erosion, cervicitis, and pelvic inflammatory diseases, which can result in leucorrhoea.The Unani approach to Sailan-ur-Rahem stresses a holistic view of health, emphasizing the use of specialized therapeutic procedures to correct underlying imbalances and bring physiological humors back into balance. In order to reduce symptoms and enhance general wellbeing, these interventions frequently involve dietary changes, lifestyle adjustments, herbal remedies, and specialist medical care. The management methods and understanding of Sailan-ur-Rahem within the Unani medical system by fusing traditional knowledge with contemporary scientific ideas. This would improve healthcare services and improve women's health outcomes globally.

Incidence of Violence and Sexual Dysfunction among Infertile Women Attending Women's Health Hospital, Assiut University

In the present day, people view infertility as a social issue that can result in psychological instability, relationship problems, and divorce. Consequences of infertility, such as low self-esteem, anxiety, and sexual relationship disturbances associated with failure in reproduction, have a major impact on sexual satisfaction. Aim:This study aims to assess the incidence of violence and sexual dysfunction among infertile women. Methods:Apurposive sample of 60 infertile women was enrolled; a cohort design was used. The outpatient gynecological clinic and ARTunit at Women's Health Hospital, Assiut University served as the study's sites. Data collection tools include a structured interview questionnaire, the Arabic version of the female sexual dysfunction index, and the WHO women domestic violence scale. Results:The study findings illustrate that the majority (85%) of infertile women experience violence, and a vast majority (93.3%) of them have sexual dysfunction. a highly statistically significant relationship between exposure to violence and occupation (p= 0.004) as well as type of family (p=0.001). Another highly statistically significant relationship exists between sexual dysfunction and occupation (p=0.004), in addition to educational level (p=0.009). Conclusion:Various forms of intimate partner violence and sexual dysfunction afflict infertile women. So, nurses should consider routine screening for domestic violence victims in infertility clinics. Recommendation:Providing marital counseling as a general course in higher institutions of learning to prepare couples to have positive sexual behaviour.