Gynecology Outpatient Department Research Articles

Prevalence of cervical cancer and associated factors among women attending gynecological clinic outpatient department at tumbi regional referral hospital, Tanzania

Prevalence of cervical cancer and associated factors among women attending gynecological clinic outpatient department at tumbi regional referral hospital, Tanzania

HPV DNA status and clinical history of patients are supplements for accurate reporting of the cytological Pap smear

The present study was aimed at showing the importance of HPV DNA status and the clinical history of the patients required by the cytologist for accurate reporting. A total of 1250 symptomatic women who attended the gynaecology outpatient department of the Mahavir Cancer Sansthan and Nalanda Medical College, Patna, for pap smear examinations were screened and recruited for the study. Due to highly clinical symptoms out of the negative with inflammatory smears reported, one hundred and ten patients were randomly advised for biopsy and HPV 16/18 DNA analysis by a gynaecologist to correlate negative smears included in the study. Pap smear reports revealed that 1178 (94.24%) were negative for intraepithelial lesions (NILM) with inflammatory smears, 23 (1.84%) smears showed low-grade squamous intraepithelial lesions (LSIL), 12 (0.96%) smears showed high-grade squamous intraepithelial lesions, and 37 (2.96%) smears showed an atypical squamous cell of undetermined significance (ASC-US). A biopsy of 110 out of 1178 (NILM) patients revealed that 15 (13.63%) women had cervical cancer, 29 women had CIN I, 17 women had CIN II + CIN III, 35 women had benign cervical changes, and 14 women had haemorrhages. On the other hand, HPV 16/18 DNA was detected as positive in 87 out of 110. The high positivity of HPV in biopsied cases where frank cervical cancer and at-risk cancer were also observed in the negative smear-screened patients reveals that the HPV status and clinical history of the patients will be quite helpful to the cytologist for accurate reporting, and suggests that a negative HPV DNA result may be a stronger predictor of cervical cancer risk than a negative Pap test.

Awareness and Attitude of Pregnant Couple Toward Umbilical Cord Blood Banking in Telangana: A Cross-sectional Study

Banking of umbilical cord blood (UCB) is performed to collect and store umbilical cord stem cells. Both public and private cord blood banks have been established around the world. The study aimed to determine the level of awareness of UCB banking among pregnant couples and to assess the attitude of the couples toward UCB banking. We also tried to explore the factors influencing the UCB banking donation and the couple’s expectations of UCB banking in the future. A prevalidated questionnaire on UCB banking was administered, and the interview was conducted among the same pregnant couples (both husband and wife) attending the obstetrics and gynecology (OBG) outpatient department (OPD). Only 28% (N = 121) of the participants had heard of UCB banking, and only 12% had correct knowledge of UCB banking. Only 4.9% of participants had heard of public or private UCB banks. Only one couple of 121 has stored UCB in their previous pregnancy, and about 36% of couples were willing to store their newborn’s UCB in the present pregnancy. Poor understanding continues to be a significant barrier to reaping the benefits of UCB and preservation. Obstetricians and pediatricians should take a more active role in educating patients about the benefits and drawbacks of UCB banking.

Vitamin D deficiency, insulin resistance, and antimüllerian hormone level: a tale of trio in the expression of polycystic ovary syndrome

To study the association between altered vitamin D profiles and different indices as well as clinical features of polycystic ovary syndrome (PCOS), including antimüllerian hormone (AMH) levels, phenotypes (A [hyperandrogenism {HA} + ovulatory dysfunction {OD} + polycystic ovarian morphology {PCOM}], B [HA + OD], C [HA + PCOM], and D [OD + PCOM]), insulin resistance, oligomenorrhea, hyperandrogenism, obesity indices, and stress biomarkers in the ethnic population of West Bengal. Case-control observational study. Outpatient department of gynecology and obstetrics and environing. Sample size: case group (PCOS, n = 160), age: 16-38 years, and their gender, age, as well as ethnicity-matched healthy control (n = 160). In this observational study, a structured questionnaire for menstrual status and to determine the scores of cutaneous manifestations, a bioelectrical impedance analyzer for measurement of anthropometric indices, relevant biochemical assessments (vitamin D, AMH, insulin, glucose, and other associated hormonal profiles), statistical software for the social sciences, and Microsoft Office Excel were used to evaluate as well as analyze different indices. Study of the association of vitamin D deficiency with differential manifestations of PCOS such as phenotypes of the syndrome, altered AMH levels, and risk of insulin resistance. An attempt has been made to determine the cutoff value of AMH of the patients with PCOS belonging to the ethnic population of West Bengal using receiver operating characteristic (ROC). Vitamin D deficiency was found to be directly correlated with AMH level in PCOS phenotype A (67%), oligomenorrhea, and PCOM, along with a substantial agonistic relationship with insulin resistance in the PCOS population under study. In the PCOS phenotype B, the AMH level was highest, with a cutoff value of 5.27 ng/mL (asymptotic sig. = 0.000, 95% confidence interval: 8.37-9.95, derived by ROC analysis, with area under the ROC curve- area under the curve value = 0.949, sensitivity=0.882, and specificity = 0.880). Oligomenorrhic women with PCOS possess significantly higher values of AMH levels (8.70 ± 3.66 > 3.09 ± 1.86 ng/mL) level than the regular menstrual rhythm within the same group. Patients with PCOS had significantly less skeletal muscle mass and greater subcutaneous fat content than the control group. 25-hydroxy-vitamin D might be intermeshed with the underlying pathophysiology and severity of PCOS, as well as associated metabolic disorders like insulin resistance. The AMH level is finely tuned by most of the plausible effectors of PCOS and contends to be a promising biomarker for the diagnosis as well as prognosis of PCOS.

Integration of cervical cancer screening into healthcare facilities in low- and middle-income countries: A scoping review.

Cervical cancer is a prevalent disease among women, especially in low- and middle-income countries (LMICs), where most deaths occur. Integrating cervical cancer screening services into healthcare facilities is essential in combating the disease. Thus, this review aims to map evidence related to integrating cervical cancer screening into existing primary care services and identify associated barriers and facilitators in LMICs. The scoping review employed a five-step framework as proposed by Arksey and O'Malley. Five databases (MEDLINE, Maternity Infant Care, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science) were systematically searched. Data were extracted, charted, synthesized, and summarised. A total of 28 original articles conducted in LMICs from 2000 to 2023 were included. Thirty-nine percent of the reviewed studies showed that cervical cancer screening (CCS) was integrated into HIV clinics. The rest of the papers revealed that CCS was integrated into existing reproductive and sexual health clinics, maternal and child health, family planning, well-baby clinics, maternal health clinics, gynecology outpatient departments, and sexually transmitted infections clinics. The cost-effectiveness of integrated services, promotion, and international initiatives were identified as facilitators while resource scarcity, lack of skilled staff, high client loads, lack of preventive oncology policy, territorial disputes, and lack of national guidelines were identified as barriers to the services. The evidence suggests that CCS can be integrated into healthcare facilities in LMICs, in various primary care services, including HIV clinics, reproductive and sexual health clinics, well-baby clinics, maternal health clinics, and gynecology OPDs. However, barriers include limited health system capacity, workload, waiting times, and lack of coordination. Addressing these gaps could strengthen the successful integration of CCS into primary care services and improve cervical cancer prevention and treatment outcomes.

Patient-initiated follow-up in gynaecology: Patient and clinician views

ObjectivesFollow-up appointments in the UK National Health Service account for up to two thirds of outpatient activity, but there is a significant resource impact in providing time fixed follow-up appointments. Increasingly patient initiated follow-up is being used, to make follow-up appointments work better for patients both in terms of timing and necessity, and to reduce unnecessary outpatient activity. The objective of this study was to use a modified questionnaire to evaluate patient and clinician views regarding Patient-Initiated Follow-Up (PIFU) in gynaecology services and identify subgroups suited to this pathway of care. Study designParticipants including both patients and clinicians were recruited from a gynaecology outpatient department. Patients who have poorer access healthcare (with disabilities and black and ethnic minority background) were purposively targeted so their experiences could be included. Value and burden scores were evaluated using patient and clinician surveys based on a modified QQ-10 questionnaire which assessed perceived value and burden of patient initiated follow-up in gynaecology. Free text comments regarding PIFU were also collected. Results305 patients and 30 clinicians were surveyed. Overall response to patient initiated follow-up was positive. Patients and clinicians attributed high value (77.4 % and 81.4 %) and low burden scores (37.5 % and 44.7 %) to PIFU. Patient autonomy was cited as a reason for this by 84.6 % of patients and 93.3 % of clinicians. Patients attending benign gynaecological sub-specialties including endometriosis (84.2), general gynaecology (82.5) and vulval clinics (81.4) attributed the highest value scores. Gynaecology oncology patients attributed the lowest value (64.0) and highest burden score (51.3) of all subgroups. Younger adults (<60) were more likely to express a preference for PIFU (52.9 %) than older adults (≥60) (28.6 %). ConclusionsIn this study, both patients and clinicians are in favour of selected use of PIFU in gynaecology services. Both questionnaires found younger patients with benign gynaecological conditions were perceived as best suited PIFU. We recommend offering PIFU to select patients who are confident in self-monitoring, factoring patient choice so patients are not disadvantaged by this system. Further evaluation of PIFU in practice is needed before widespread implementation.

Quantifying the Occurrence of High-Risk Pregnancy: A Comprehensive Survey.

Background High-risk pregnancies are characterized by various factors that pose potential risks to maternal and newborn health outcomes. Early detection of these high-risk pregnancies serves as a crucial initial step in preventing maternal mortality and morbidity, thereby promoting the overall health of both mother and baby. This study sought to assess the occurrence of high-risk pregnancy and investigate the factors associated with it among pregnant women. Methods A descriptive survey was undertaken at the Obstetrics and Gynaecology outpatient department of a District Government Hospital in Tamil Nadu, involving 1889 pregnant women in their second and third trimesters. A structured questionnaire, constructed following the Indian standard criteria outlined by the National Health Portal of India, served as the data collection tool. The survey was conducted in February and March 2022, during which pregnant women were interviewed. Subsequently, the collected data underwent descriptive and inferential statistical analysis. Results Among the 1889 pregnant women surveyed, 29% (n=530) were classified as high-risk pregnancies. Within this group, 34.3% (n=182) were diagnosed with hypothyroidism, while 23.2% (n=123) experienced pregnancy-induced hypertension. Significant associations with high-risk pregnancy were observed for factors such as age, education status, occupation, family income, socioeconomic status, and gravida among the pregnant women. Conclusion Policymakers must urgently implement evidence-based interventions aimed at early detection and treatment of high-risk pregnancies. This proactive approach is essential in preventing maternal mortality and morbidity.

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 &lt;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 &lt;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

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.