Oral Contraceptive Pill Users Research Articles

Exploring technology-based interventions to improve oral contraceptive pill adherence: a cross-sectional survey

Purpose To assess the resources that oral contraceptive pill (OCP) users currently use and wish to use after missing pills. Materials and Methods People 18–44 years old with a OCP prescription were emailed a cross-sectional survey to assess how they obtain information about managing missed pills, what information they would prefer to access, and whether they would use additional information if it were available. We performed a logistic regression and a dominance analysis to compare independent predictors of desire for a technological resource at the time of missed pills. Results We received 166 completed surveys. Nearly half of participants (47%, n = 76, 95% CI 39.0–54.4%) did not seek information about managing their missed pills. When missing a pill, more patients preferred non-technology-based information (57.1%, n = 93, 95% CI 49.3–64.5%) over technology-based information (43%, n = 70, 95% CI 35.5–50.7%). Most reported they would appreciate more information at the time of missed pills (76%, n = 124, 95% CI 68.9–82.0%). The strongest predictors for desire for technology-based information were: current use of technology, lower parity, white race, and higher educational attainment. Conclusions This study indicates that most OCP users would utilise additional information at the time of a missed pill if they had access to it and that they desire information in varying formats.

Examination of Blood Urea, State of Reactive Oxygen Species and Antioxidants Associated with Oral Contraceptive Pills Among Female Athletes

Blood urea, reactive oxygen species, and antioxidants are interconnected biochemical parameters. In case of any adverse effects of any agents, it directly affects the body's physiological activities. Objective: To examine blood urea, the state of reactive oxygen species and antioxidants associated with oral contraceptive pills (OCP) among female athletes. Methods: Participants of the study were randomly selected as participants of the study. The users of OCP were placed in the Experimental Group (EG), and the nonuser of OCP was put in (CG). Each group was comprised of twenty-five subjects. 5 ml blood was collected from all the subjects. Each subject was marked with a different identification code. The blood urea level was measured through the blood urea nitrogen (BUN) test. The balancing state of reactive oxygen species and antioxidants was measured through FRAP Assay. Results collected through both BUN and FRAP were calculated through the statistical package for social sciences (SPSS, version 26). Results: The mean and standard deviation of EG in term of blood urea was 29.23 ±7.89; df was 82, t-score was -.822, P- value was .413. A significant difference in term of FRAP between CG and EG was found, such as the mean and SD of CG were 137.95±.20.87, means and SD of EG was 110.54±.39.22, the t score was 3.23, and the P value was .002. Conclusions: Results show that OCP significantly impacts blood urea and causes an imbalance in both reactive oxygen species and antioxidants among users.

P078Use of direct-to-consumer telemedicine companies for contraception among young adults

<h3>Objectives</h3> A growing number of direct-to-consumer telemedicine companies, such as Nurx and Pandia Health, offer contraception without a traditional office visit, but little data exist describing their use among a general population. This study examines the prevalence and determinants of using telemedicine companies for contraception in a sample of sexually active young adults. <h3>Methods</h3> We collected survey data from May 2020 to May 2022 from individuals at risk of pregnancy aged 18–28 recruited at 29 community colleges in California and Texas (n=1,620 participants; 6,270 person-periods). We used multivariable mixed-effects logistic regression models with random effects for site and individual to assess whether participants used telemedicine companies for contraception by sociodemographic characteristics, state of residence, and oral contraceptive pill (OCP) use. <h3>Results</h3> Participants reported using a telemedicine company for contraception in 412 of 6,270 observations (6.6%). Participants were more likely to report using a telemedicine company if they were Asian/Pacific Islander (adjusted OR (aOR), 4.15; CI, 1.90–9.06) compared to Hispanic respondents; were Texas residents (aOR, 3.20; CI, 1.79–5.73) vs. California residents; and if they were OCP users (aOR, 6.35; CI, 4.25–9.48). We found no differences by health insurance status. Among telemedicine company users, almost all (91%) were very satisfied or satisfied with their experience and almost all (96%) reported that ordering contraception online was very convenient or convenient. <h3>Conclusions</h3> While relatively few young people used telemedicine companies for contraception, use varied by race/ethnicity and state of residence. Those who chose this alternative to traditional clinic visits reported high satisfaction levels.

P064Depression after 12-month use of oral or intrauterine contraception

<h3>Objectives</h3> To evaluate whether levonorgestrel intrauterine devices (LNG-IUD) or oral contraceptive pills (OCPs) users are more likely to have a positive depression screen after 12 months of use compared to copper IUD users. <h3>Methods</h3> We conducted a secondary analysis of the Contraceptive CHOICE Project of LNG-IUD, OCP, and copper IUD users. Participants completed the Center for Epidemiologic Studies Depression Scale (CESD-10) at baseline and at 12 months. We examined differences in participant characteristics, depression/anxiety history, and CESD-10 scores between method groups using chi-square test, and used Poisson regression to assess factors associated with a positive depression screen (CESD-10 score ≥10) at 12 months. <h3>Results</h3> At enrollment, 5,217 initiated an IUD or OCPs. At 12 months, 3,882 participants were still using their method and were included in this analysis. LNG-IUD users were more likely to have a positive depression screen at baseline, followed by copper IUD and OCP users (22.1% vs. 20.1% vs. 17.1%, p=0.04). After adjusting for positive depression screen at baseline, history of depression or anxiety, and parity, LNG-IUD and OCP users were no more likely to have a positive depression screen at 12 months compared with copper IUD users (Rradj 1.02; 95% CI, 0.87–1.18; Rradj 0.93, 0.72–1.19, respectively). The proportion of patients discontinuing their method prior to 12 months due to worsening mood did not differ between method groups (range, 2.2–4.9%; p=0.31). <h3>Conclusions</h3> Among individuals using contraception for 12 months, those initiating a LNG-IUD or OCPs were no more likely to screen positive for depression at 12 months compared to copper IUD users.

Contraceptives and cancer risks in BRCA1/2 pathogenic variant carriers: a systematic review and meta-analysis.

Increasing numbers of BReast CAncer (BRCA) 1 or 2 pathogenic variant (PV) carriers, who have an inherited predisposition to breast and ovarian cancer, are being identified. Among these women, data regarding the effects of contraception on cancer risks are unclear and various guidelines provide various recommendations. We aim to optimize counselling regarding contraception for BRCA1/2-PV carriers. Therefore, we performed a systematic review and meta-analysis. We investigated the risk ratio for developing breast cancer or ovarian cancer in BRCA1/2-PV carriers who have used any form of contraception versus non-users. Second, we analysed breast and ovarian cancer risk among BRCA1/2-PV carriers as influenced by the duration of contraceptive use and by the time since last use. In addition, we provide an overview of all relevant international guidelines regarding contraceptive use for BRCA1/2-PV carriers. A systematic search in the Medline database and Cochrane library identified studies describing breast and/or ovarian cancer risk in BRCA1/2-PV carriers as modified by contraception until June 2021. The search included medical subject headings, keywords and synonyms related to BRCA and contraceptives (any kind). PRISMA guidance was followed. Risk Of Bias In Non-randomized Studies of Interventions and Grading of Recommendations, Assessment, Development and Evaluations assessments were performed. Random-effects meta-analyses were used to estimate pooled effects for breast and ovarian cancer risk separately. Subgroup analyses were conducted for BRCA1 versus BRCA2 and for the various contraceptive methods. Results of the breast cancer risk with oral contraceptive pill (OCP) analysis depended on the outcome measure. Meta-analyses of seven studies with 7525 women revealed a hazard ratio (HR) of 1.55 (95% CI: 1.36-1.76) and of four studies including 9106 women resulted in an odds ratio (OR) of 1.06 (95% CI: 0.90-1.25), heterogeneity (I2) 0% and 52%, respectively. Breast cancer risk was still increased in ever-users compared with never-users >10 years after last OCP use. In contrast, ovarian cancer risk was decreased among OCP users: HR 0.62 (95% CI: 0.52-0.74) based on two studies including 10981 women (I2: 0%), and OR 0.49 (95% CI: 0.38-0.63) based on eight studies including 10390 women (I2: 64%). The protective effect vanished after cessation of use. Tubal ligation also protects against ovarian cancer: one study including 3319 women (I2: 0%): HR: 0.44 (95% CI: 0.26-0.74) and three studies with 7691 women (I2: 44%): OR: 0.74 (95% CI: 0.53-1.03). Data regarding other contraceptives were unavailable. No differences were observed between BRCA1 and BRCA2-PV carriers. The quality of evidence was either low or very low. The OCP potentially increases breast cancer risk, while ovarian cancer risk decreases with either the OCP and tubal ligation in BRCA1/2-PV carriers. Counselling of BRCA1/2-PV carriers should be personalized; the genetic and non-genetic factors (like prior risk-reducing surgeries, prior breast cancer and age) and patients' preferences (reversibility, ease of use, reliability and effect on menstrual cycle) should be balanced. To further optimize counselling for high-risk women, future research should focus on other (commonly used) contraceptive methods and cancer risks in this specific population, and on the potential impact of changing formulations over time.

Do E2 and P4 contribute to the explained variance in core temperature response for trained women during exertional heat stress when metabolic rates are very high?

PurposeWomen remain underrepresented in the exercise thermoregulation literature despite their participation in leisure-time and occupational physical activity in heat-stressful environments continuing to increase. Here, we determined the relative contribution of the primary ovarian hormones (estrogen [E2] and progesterone [P4]) alongside other morphological (e.g., body mass), physiological (e.g., sweat rates), functional (e.g., aerobic fitness) and environmental (e.g., vapor pressure) factors in explaining the individual variation in core temperature responses for trained women working at very high metabolic rates, specifically peak core temperature (Tpeak) and work output (mean power output).MethodsThirty-six trained women (32 ± 9 year, 53 ± 9 ml·kg−1·min−1), distinguished by intra-participant (early follicular and mid-luteal phases) or inter-participant (ovulatory vs. anovulatory vs. oral contraceptive pill user) differences in their endogenous E2 and P4 concentrations, completed a self-paced 30-min cycling work trial in warm–dry (2.2 ± 0.2 kPa, 34.1 ± 0.2 °C, 41.4 ± 3.4% RH) and/or warm–humid (3.4 ± 0.1 kPa, 30.2 ± 1.2 °C, 79.8 ± 3.7% RH) conditions that yielded 115 separate trials. Stepwise linear regression was used to explain the variance of the dependent variables.ResultsModels were able to account for 60% of the variance in Tpeak (overline{R }2: 41% core temperature at the start of work trial, overline{R }2: 15% power output, overline{R }2: 4% [E2]) and 44% of the variance in mean power output (overline{R }2: 35% peak aerobic power, overline{R }2: 9% perceived exertion).ConclusionE2 contributes a small amount toward the core temperature response in trained women, whereby starting core temperature and peak aerobic power explain the greatest variance in Tpeak and work output, respectively.

Unmasking Dermoscopic Evaluation of Melasma

Background: There exists a wide range of variations in skin tone around the world, with Asian and Indian subjects showing a greater susceptibility toward pigmentation disorder. Objective: This study was carried out with the objective to assess the clinical and dermoscopic findings among different types of melasma in a single center of Central India. Materials and Methods: A cross-sectional study was carried out among patients with clinical features of melasma attending the outpatient department at multispecialty hospital with a sample size of 100. A prestructured pro forma was used to collect the baseline data. Clinical and dermatological examination was done after taking a detailed history. Clinical pattern of melasma such as centrofacial, malar, and mandibular was noted. The areas of melasma were examined using a contact polarized Dermlite DL4 3rd Gen Dermoscope attached to an iPhone. Results: The mean age of study participants was 38.15 years with a standard deviation of 6.93. Seventeen percentage were of male gender. Thirty-one percentage of the female patients had a history of oral contraceptive pill (OCP) usage, and 22% of the female patients had a history of menstrual abnormalities. Fitzpatrick skin Type IV was the most commonly affected skin type. Centrofacial type of melasma is the most common clinical type and reticuloglobular pattern is the commonly seen pattern on dermoscopy. The color of dermoscopy was predominantly brown in malar (52.2%) and mandibular (57.1%) and mixed in Centrofacial (45.7%), which was followed by 26.1%–28.6% mixed color in malar and andibular types and 41.4% brown color in centrofacial type. The difference in the color of dermoscopy (P = 0.48), presence of telangiectasia on dermoscopy (P = 0.23), pattern of dermoscopy (P = 0.15), and mean Melasma Severity Index scores with different clinical types was not statistically significant. Similarly, the association between different clinical types of melasma with duration of sun exposure (P = 0.33) and topical photo protection (P = 0.34) was also not statistically significant. Conclusion: Our study findings concluded that melasma is common in women in the age group of 27–56 years range. Exposure to sunlight and the hormonal changes (due to OCP usage) were those among the various factors influencing the development of melasma. Centrofacial melasma was the most common pattern seen in our study group. Epidermal melasma features on dermoscopy were reticuloglobular patterns with a brownish hue, while the features of dermal melasma were irregular patterns with a bluish hue and mixed melasma had irregular patchy brown pigmentation. Perifollicular globules and telangiectasia were also seen.

Contraceptive awareness and practices in reproductive age couples: A study from urban slums of Punjab.

Developing countries are characterised by high birth rates and explosive population growth. With a lower contraceptive usage rate among eligible couples and resistance towards family planning methods, the goal of population stabilisation looks distant. The present study was conceived to assess knowledge, attitude and practices regarding contraceptive usage and to identify the barriers in reproductive-age couples in an urban slum area. The present study was cross-sectional in nature and was conducted in an urban slum. Three hundred married subjects were enrolled through a convenient sampling technique. One member of the married couple was interviewed for the present study. Data were collected through a semi-structured proforma. 67% of the participants were using one or another contraceptive. Higher contraceptive usage was seen in more educated participants. Awareness was higher in males regarding contraception. Condom was the most known method for contraception. Three fourth of the participants agreed with two-child norm. Preference for a male child was less than 50% in both genders. Current users of condoms and oral contraceptive pills were 71.8% and 7.1%, respectively. Wanting children, fear of side effects and lack of knowledge were cited as reasons for not choosing family planning methods. With a suboptimal level of awareness and attitude among respondents regarding contraceptive methods, there exists a gap between awareness and practice. Misconceptions regarding contraceptive methods can be allayed through health education, involvement of the community and religious leaders and peer counselling.

Risk of Venous Thromboembolism: The Prothrombin-G20210A Mutation and Combined Oral Contraceptives

The risk of venous thromboembolism in oral contraceptive pill users becomes dramatically increased in patients with inherited thrombophilias. The often undiscovered prothrombotic genetic conditions pose a potentially deadly threat to its generally young demographic. When thrombosis is discovered in oral contraceptive pill users with a strong family history of related events, it becomes essential to screen for prothrombotic genetic conditions and further mitigate any associated modifiable risk factors. Here we present a case of pulmonary embolism requiring cardiopulmonary resuscitation in 30-year-old female found to have a Prothrombin G20210A on oral contraceptive pills. The emergent management of the critical case, as well as the subsequent evaluation for prothrombotic conditions and the role of potential screening is discussed.

Association of Use of the Oral Contraceptive Pill (OCP) with the Expression Pattern of Different Molecular Subtypes of Breast Cancer

Background: Triple-negative breast carcinoma (TNBC) is a breast cancer subtype associated with high mortality and inadequate therapeutic options when compared to non-TNBC. Clinical data indirectly suggests where Oral Contraceptive Pill (OCP) usage is high, the prevalence of Estrogen Receptor+ (ER+) breast cancer is high, and the prevalence of TNBC is low. This has lead to our hypothesis that OCP use may increase the risk of ER+ breast cancer, and OCP use may reduce the risk of TNBC. We aimed to compare the prevalence and association of subtypes of breast cancer in OCP users with that of non-users among women 30 to 60 years of age. Methods: This hospital-based observational study of three-year duration included 155 subjects of primary invasive breast cancer who got admitted to our institution. The data was obtained for ER, PR, HER2 status, clinical classification, and data in relation to demographic factors, reproductive history, and history of OCP use. 155 subjects were divided into two groups. Group-1 included 48 patients with a history of OCP use, and group-2 included 107 patients who have not used OCP. Data was analysed using SPSS-20. Results: A significant increase in the prevalence of molecular subtypes ER+, Progesterone Receptor+ (PR+) and Luminal B breast cancer in OCP users was observed compared to non-users. There was a significant decrease in the age at the time of admission in ER+ cancer in OCP users (45.3 years) compared to non-users (52.2years). While age at the time of admission of Basal (TNBC) cancer patients in OCP users (53.1 years) was higher when compared to non-users (45.4years). Upon logistic regression, the likelihood of ER+, PR+ and Luminal B in OCP users was 11%,10% and 13% less, respectively, with 1 year of higher age and the likelihood of TNBC in OCP users was 18% more and 8% less in non-users. Conclusion: OCP use may be associated with increased prevalence of ER+, PR+ and Luminal B breast cancer. On the contrary, OCP use may be associated with a delay in the progression of the TNBC.

Knowledge, Attitude and Practices regarding Contraceptive Pill and Its Side Effects among Women in Jazan Region, Saudi Arabia.

Contraception is one of the common methods of family planning. The oral contraceptive pill (OCP) is among the most effective methods of contraception. This study aimed to assess the knowledge, attitude, and practice of oral contraception use and its side effects among women in the Jazan region, Saudi Arabia. A cross-sectional study was carried out among adult women 18 years and older in the Jazan region. A pre-tested questionnaire was used to assess their demographic characteristics, knowledge, attitudes, previous experience, and pattern of OCP usage. Descriptive analysis and a logistic regression model were used to analyse data. About 570 questionnaires were distributed and achieved a 98.3% response rate. The majority of women participants were between 18 and 25 years old, and 51.4% of the respondents reported that they had previously used or were using OCP. We found that women had good knowledge and a positive attitude towards OCP, with more than half of the users preferring them over other contraceptive methods. This study indicates that attitude, knowledge, and prior experience of OCP have no significant effect on the usage pattern of OCP among women with relatively high socioeconomic status in the Jazan region, Saudi Arabia.

Did COVID-19 Impact Contraceptive Uptake? Evidence from Senegal.

This study assessed the impact of the COVID‐19 pandemic on the number of new contraceptive acceptors in Senegal overall and by method. Monthly service data from March 2019 to December 2020 were extracted for the number of new contraceptive users of IUDs, implants, injectables, and oral contraceptive pills (OCPs). Data were analyzed using descriptive statistics and interrupted time series analysis for trend analyses overall and by the contraceptive method. Following the announcement of the first COVID‐19 case in Senegal in March 2020, there was an immediate significant decrease in the number of new acceptors overall, and for new users of implants and injectables. From March–December 2020, the trend in monthly new family planning acceptors increased overall, mainly driven by significant increases in new IUD and implant acceptors. Compared to the period before the onset of COVID‐19, there was a statistically significant shift from shorter‐acting methods (OCPs, injectables) to long‐acting reversible methods (IUDs, implants). Despite the immediate adverse impact of COVID‐19‐related restrictions, the number of new acceptors rebounded, trends in the number of new monthly acceptors significantly increased, and there was a significant shift to longer‐acting methods.

Early menopause is associated with increased risk of retinal vascular occlusions: a nationwide cohort study

This nationwide population-based cohort study evaluated the association between female reproductive factors and the incidence of retinal vein occlusion (RVO) and retinal artery occlusion (RAO) using data provided by the Korea National Health Insurance Service. A total of 2,289,347 postmenopausal women over 50 years of age who participated in both national health screening and cancer screening in 2013 or 2014 were included. Data on female reproductive factors, including age at menarche, age at menopause, parity, history of hormone replacement therapy, and oral contraceptive pill usage, were collected. Patients were followed up until December 2018, and incident cases of RVO and RAO were identified using registered diagnostic codes from claim data. During an average follow-up period of 4.90 years, 7461 and 1603 patients were newly diagnosed with RVO and RAO, respectively. In the multivariable-adjusted Cox proportional hazard model, patients who experienced menopause after 55 years of age had a lower risk of RVO and RAO development compared to those who had menopause before 45 years of age, with a hazard ratio (95% confidence interval) of 0.83 (0.76–0.95) for RVO and 0.80 (0.66‒0.98) for RAO. In conclusion, early menopause was an independent risk factor for future development of RVO and RAO.

Exploring Oral Contraceptive Use and Perceived Weight Among Women Aged 20 to 49 in the United States

Objective There is a myth that oral contraceptive pill (OCP) use increases body weight. The objectives of this exploratory study were to examine the relationship between OCP use and perceived weight and to test whether OCP ever use moderates the relationship between measured body mass index (BMI) and perceived weight. Setting and participants The sample included 6,897 females aged 20 to 49 from the 2007 to 2018 National Health and Nutrition Examination Surveys (NHANES). Perceived weight was the dependent variable; OCP ever use and measured BMI were independent variables. Covariates included socioeconomic variables and perceived health. Results In a crude model, the odds of participants perceiving themselves as overweight relative to perceiving themselves as “just about the right weight” were 40.4% higher for each 1-unit increase in measured BMI. In an adjusted model, participants had 40.6% greater odds of having overweight self-perception compared to “right weight” with every 1-unit increase in BMI and OCP ever users had 35.9% higher odds of overweight self-perception compared to “right weight” than never users. OCP moderates the association between measured BMI and perceived weight. In stratified models, OCP users had 44.6% higher odds of overweight self-perception, while never users had 33.6% higher odds of overweight self-perception compared to “right weight” self-perception for every 1-unit BMI increase. Conclusions OCP use moderates the relationship between measured BMI and perceived weight. For two women with different OCP use history and the same measured BMI, the ever OCP user has 11% higher odds of perceiving herself as overweight compared to the never user.

Arterial stiffness and blood pressure are similar in naturally menstruating and oral contraceptive pill-using women during the higher hormone phases.

What is the central question of this study? Are there differences in blood pressure, arterial stiffness and indices of pressure waveforms between young oral contraceptive pill-using and naturally menstruating women during lower and higher hormone phases of their cycles? What is the main finding and its importance? Blood pressure, arterial stiffness and indices of pressure waveforms are influenced similarly by exogenous and endogenous hormones. However, lower levels of exogenous hormones moderately increase blood pressure among oral contraceptive pill-using women. Elevations in blood pressure (BP) are understood as having a bidirectional relationship with stiffening of central and peripheral arteries. Arterial stiffness is mitigated by oestrogen, which aides in arterial vasorelaxation. To evaluate whether BP, stiffness, and pressure waveforms were different between young healthy naturally menstruating (non-OCP) and oral contraceptive pill (OCP)-using women, we measured brachial and aortic BPs, carotid-to-femoral pulse wave velocity, carotid β-stiffness, elastic modulus, central augmentation index and augmentation index normalized to a heart rate of 75bpm, and forward and backward pressure waveforms in 22 women (22 (1) years, OCP: n=12). To assess phasic differences, women were studied during the early follicular (≤5days of menstruation onset) and early luteal (4 (2)days post-ovulation) phases of non-OCP and compared to the placebo pill (≤5days of onset) and active pill (≤5days of highest-dose active pill) phases of OCP. During the lower hormone phases, OCP users had significantly higher brachial systolic blood pressure (SBP) (119.3 (8.3) vs. 110.2 (8.3) mmHg, P=0.02) and aortic SBP (104.10 (7.44) vs. 96.80 (6.39) mmHg, P=0.03) as compared to non-OCP users; however, during the higher hormone phases, there were no differences in measures of brachial or aortic BP, arterial stiffness, or indices of BP waveforms between OCP and non-OCP users (P≥0.05). In conclusion, exogenous and endogenous hormones have similar influences on BP and arterial stiffness; however, lower levels of exogenous hormones augment both central and peripheral BPs.

Assessment of risk factors for deep vein thrombosis associated with natural anticoagulants and fibrinolytic regulatory proteins.

Deep vein thrombosis (DVT) is a critical condition and a potential cause of mortality and morbidity in Africa and worldwide with a high recurrence rate. The study was designed to assess the roles of natural anticoagulants and fibrinolytic regulatory factors in the development of DVT in Sudanese patients. A case-control study was conducted in Omdurman Teaching Hospital, Khartoum State over a period of 1 year. The study enrolled 200 patients diagnosed with DVT and 200 age-matched and gender-matched controls. Demographic data and data on acquired risk factors were collected using a semi-structured questionnaire. Protein C (PC), protein S (PS), antithrombin III (AT-III), thrombin-activable fibrinolysis inhibitor (TAFI), and plasminogen activator inhibitor-1 (PAI-1) were measured in patients and controls. Among the patients with DVT, 5.5% had PC deficiency, 8.5% had PS deficiency, and 3% had AT-III deficiency. Elevated TAFI and PAI-1 levels were demonstrated in 1.5 and 0.5% of patients, respectively. Risk factors for DVT (overweight, surgical history, and family history of DVT) were remarkably higher in patients than in controls. Among the female participants, pregnancy and usage of oral contraceptive pills were the highest associated risk factors for DVT. The findings concluded that the early assessment of risk factors, including the measurements of natural inhibitors, can predict the occurrence of DVT before it is actually detected in patients.

Altered color of plasma component - Unnecessary wastage of a precious resource.

The present study was conducted to evaluate the etiology of altered color of plasma component of blood in transfusion practice. The study was conducted at the blood center of a tertiary care teaching hospital in western India for a period of 6 months. After component separation, all the plasma units with altered color were segregated and samples were taken for further evaluation. Altered colored plasma units were divided into three - green discoloration, yellow discoloration, and lipemic plasma. Donors were called, their detailed history was taken, and necessary investigations were done accordingly. Forty plasma units out of 20,658 (0.19%) donations showed discoloration. Out of which, 3 plasma units showed green discoloration, 9 plasma units showed yellow discoloration, and the remaining 28 plasma units were lipemic. Among three donors whose plasma showed green discoloration, one female donor had a history of oral contraceptive pill usage and had higher values of copper and ceruloplasmin. All donors with yellow plasma had a higher value of unconjugated bilirubin. All the donors with lipemic plasma gave a history of intake of fatty meal prior to donating blood and showed higher values of triglyceride, cholesterol, and very-low-density lipoprotein. Plasma component with altered color restricts its issue to the patient and also for use in fractionation. In our study, many of the altered color plasma units were safe to transfuse, but the decision regarding transfusion was debatable on consultation with the treating doctor. Further studies with a large sample size are recommended for the use of these plasma components.

Risk Factors and Symptoms of Ovarian Cancer in Patients Attending Hiwa Oncology/Hematology Hospital in Sulaimaniyah City

Background: Ovarian cancer is responsible for higher mortality rate than any other cancer of the woman genital system. &#x0D; Aims of the study: this study aims to find the risk aspects and symptoms of ovarian cancer in patients visiting Hiwa Oncology/Hematology hospital in Sulaimaniyah City. &#x0D; Methodology: This study was a retrospective case-control study conducted in Hiwa Oncology / Hematology Hospital in Sulaimaniyah city, Northern Iraq, the period of the study was 1 / July / 2019 to 1 / march / 2020, based on the recorded database system of Hiwa Oncology / Hematology Hospital from 2013 - 2019, involving 100 diagnosed patients and 200 healthy women as control. Personal information such as age, education, economic status, cigarette smoking, height, weight, diet and eating habits, and used oral contraceptive pills were collected. &#x0D; Results: The incidence of ovarian cancer in 2013 was 13 cases which increased to 83 cases in 2019. The highest percentage (30%) of patients' age range were 40- 49 years (p = 0.004). Most cases 60% had an insufficient economic state and 33 % of cases were illiterate women. Passive smoking appeared to be more prone to ovarian cancer: especially those with a smoking duration of &gt; 5 years. Additionally, 68% of patients used oral contraceptive pills with a duration range of 1-5 years. Also, a highly significant correlation between diet and ovarian cancer was found in patients. The majority of the patients (76%) complained of abdominal pain and abdominal distension as the first presenting symptoms of ovarian cancer. &#x0D; Conclusion: This study concluded that age, economic status, educational level, height, passive smoking, weight, diet, and oral contraceptive pill usage were directly accompanied by the possibility of ovarian cancer. &#x0D; Recommendations: All women especially those after age of 40 years old, should pay attention to education and health awareness including symptoms and causes of ovarian cancer, especially attention to decrease weight and passive smoking and using a healthy diet through decrease consumption the sweets, dairy products, and animal fat and increase consumption of legumes, fish meat, vegetable and fruits. &#x0D;

Opinions, Attitudes, and Prescribing Practices of Oral Contraceptive Pills of General Practitioners and Gynecologists in India

Background To study the prescription behavior of oral contraceptive pills (OCPs) by physicians, gynecologists, and alternative medicine practitioners (AMPs). Materials and Methods Close-ended questionnaire-based cross-section study was performed between 1st September 2012 and 28th February 2014 in three groups of responders, i.e., AMP, general medical practitioners (GMPs), and obstetricians and gynecologists (ObGy). A stratified random cluster sample was used. Data of 400 subjects in all three groups were obtained using both univariate and multi-variate sophisticated statistical analyses for analyzing attitude and practices and were recorded on an ordinal scale using appropriate non-parametric test. Results Of the 1,237 subjects surveyed, 400 completed questionnaires were received from each of the three groups viz; AMPs, GMPs, and ObGy. Remaining 37 incomplete questionnaires were not included in the final analysis. Conclusion There are equal misconceptions regarding OCPs among users and prescribing physicians. Preference for OCPs in married and unmarried women is also equally low. OCP usage and their prescription practices can be improved by removing potential barriers, developing public–private partnership, and training promoters.

Measurement error of self-paced exercise performance in athletic women is not affected by ovulatory status or ambient environment.

Measurement error(s) of exercise tests for women are severely lacking in the literature. The purpose of this investigation was to 1) determine whether ovulatory status or ambient environment were moderating variables when completing a 30-min self-paced work trial and 2) provide test-retest norms specific to athletic women. A retrospective analysis of three heat stress studies was completed using 33 female participants (31 ± 9 yr, 54 ± 10 mL·min-1·kg-1) that yielded 130 separate trials. Participants were classified as ovulatory (n = 19), anovulatory (n = 4), and oral contraceptive pill users (n = 10). Participants completed trials ∼2 wk apart in their (quasi-) early follicular and midluteal phases in two of moderate (1.3 ± 0.1 kPa, 20.5 ± 0.5°C, 18 trials), warm-dry (2.2 ± 0.2 kPa, 34.1 ± 0.2°C, 46 trials), or warm-humid (3.4 ± 0.1 kPa, 30.2 ± 1.1°C, 66 trials) environments. We quantified reliability using limits of agreement, intraclass correlation coefficient (ICC), standard error of measurement (SEM), and coefficient of variation (CV). Test-retest reliability was high, clinically valid (ICC = 0.90, P < 0.01), and acceptable with a mean CV of 4.7%, SEM of 3.8 kJ (2.1 W), and reliable bias of -2.1 kJ (-1.2 W). The various ovulatory status and contrasting ambient conditions had no appreciable effect on reliability. These results indicate that athletic women can perform 30-min self-paced work trials ∼2 wk apart with an acceptable and low variability irrespective of their hormonal status or heat-stressful environments.NEW & NOTEWORTHY This study highlights that aerobically trained women perform 30-min self-paced work trials ∼2 wk apart with acceptably low variability and their hormonal/ovulatory status and the introduction of greater ambient heat and humidity do not moderate this measurement error.