Females Of Reproductive Age Group Research Articles

A CASE REPORT ON ANGIOMYXOMA OF VULVA - A RARE MESENCHYMAL TUMOR IN REPRODUCTIVE AGE GROUP WOMEN

Aggressive angiomyxoma (AAM) is a mesenchymal tumor that arises from perineal or lower pelvic connective tissue. This tumor is locally aggressive. It has mostly been found in reproductive age group females. The correct diagnosis and follow-up of this tumor are very important, as it has similar presentation to many other vulvar masses and it tends to recur due to its locally aggressive nature. We report here a case of 40-year-old female P2L2, who presented with a soft, non-tender swelling on the left labia majora.

IJCM_95A: To Assess the knowledge and practice regarding reproductive tract infection among female of reproductive age group in Raipur city Chhattisgarh

Background: Reproductive tract infection (RTI) is a global health problem among women, especially in South East Asia Region (SEAR) countries. They may progress to serious complications and cause a high degree of morbidity during the sexually active period of life. More than a million women and infants die of the complications of RTI every year. RTI has become a silent epidemic that devastates women’s lives. Globally, three different types of RTI cause significant amounts of morbidity and mortality among women – sexually transmitted infections (STIs) (including gonorrhea, chlamydia, syphilis, trichomonas, and HIV infections); endogenous infections resulting from the overgrowth of organisms normally present in the reproductive tract (such as candidiasis and bacterial vaginosis); and iatrogenic infections related to medical procedures (such as menstrual regulation, abortion or IUD insertion). The presence of STI increases the risk of acquiring and transmitting HIV infection by three to five times. Objectives: 1- To Assess the knowledge of female what is reproductive tract infection how it occur and spread among residents of Raipur City, Chhattisgarh. 2- To Assess the Factors associated with Knowledge among residents of Raipur City, Chhattisgarh. Methodology: This is an observational cross-sectional study conducted in Raipur City of Chhattisgarh state during the month October 23-January 2024. A pre-designed, self-administered, semi-structured questionnaire was used for data collection. Systematic Random sampling technique was adopted to select the 350 Study participants. Results: The majority of subjects were between the age of 15-34 year. Most of the subject were of lower middle class socioeconomic status. Additionally, 37.8% of participants were graduates, 59.4% were married and 70% were unemployed. 30.3% subjects had not heard about Reproductive tract infection. 50.6% subjects don’t know about symptoms of RTI, almost half 49.4% subject don’t have knowledge about effect of RTI on health and only 84% female believed that good personal hygiene prevent RTI. 45.1% subjects did not wash their private part after urination, 10.5% female did not wash their used cloth daily after each use. 63.9% female used feminine hygiene products to maintain personal hygiene, 10% female did not change their cloth daily, 33.1% women did not change their pad/ cloth within every 4–6-hour interval during menstruation. Conclusion: Educate women through camps about genital hygiene practices to reduce the risk of RTI. For increased usage of Sanitary pads, more number of sanitary vending machine should be installed in schools, colleges, and health facilities. Implement awareness programs, promoting regular check- ups and safe sex practices to mitigate the risk of RTI.

A cross talk study on sitagliptin mediated reclamation on TGF β signalling, DPP 4, miR-29a and miR-24 expression in PCOS rats fed with high fat-high fructose diet

Polycystic Ovary Syndrome (PCOS) is a multifactorial reproductive, endocrine and metabolic disturbance which is very commonly observed in females of reproductive age group. The disease is still incurable however the use of synthetic drugs in combination with lifestyle is recommended. Accordingly, the present study was conducted to investigate the possible beneficial effects of sitagliptin on PCOS induced rats on control diet (CD)/ high fat- high fructose diet (HFFD). PCOS was induced by giving testosterone propionate (TP) for 28 days to both the CD/ HFFD rats and treated with STG i.p. for last 15 days. At the end of the experiment lipid profile, inflammatory markers, expression of NF-κB-p65, miR-24 and miR-29a, fibrotic and apoptotic proteins from ovary tissue were examined. Moreover, lipid accumulation and fibrosis of ovary tissue was further confirmed using Sudan III and Masson’s trichrome stain. STG treated rats exerted a significant decrease in levels of cholesterol, TG, LDL-C, VLDL-C, IL-6 and TNF-α and increased HDL-C level, miR-24 and miR-29a expression. STG treated groups expressed significantly decreased expression of NF-κB-p65, TGF-β1, p-Smad 2 and p-Smad 3 followed by no significant changes in the expression of BAX, caspase-9, caspase-3 and Bcl-2 in all the PCOS induced groups. Among all the CD/ HFFD fed groups, rats on HFFD showed more devastating effect which suggests that diet plays a major role in genesis of PCOS. In conclusion, current results reflect the potential impact of STG against dyslipidaemia, inflammation and fibrosis in PCOS rats via regulating dyslipidaemia and fibrosis via DPP 4 mediated miR-29a expression.

Randomized, Single Blind, Standard Controlled, Equivalence Clinical Trial to Evaluate the Comparative Efficacy of Eladi Kasaya Versus Tranexamic Acid Tablet in the Management of Asrigdara (Heavy Menstrual Bleeding): A Clinical Trial Protocol

Introduction: Excessive menstrual bleeding is a common problem in reproductive age group females, and it is reported that 1 in 20 lifetime chances, a female needs consulting the physician for excessive and prolonged menstrual bleeding. Ayurvedic literature describes excessive menstrual bleeding as Asrigdara (HMB). Eladi kasaya is one of the treatment modalities for heavy menstrual bleeding given in classics and hence chosen for the current clinical trial.
 Methods: We planned a prospective, randomized, controlled, and equivalence trial on the patients with Heavy menstrual bleeding (blood loss > 80 ml) for the last two cycles or more. Eladi Kasaya 50 ml with honey and sharkara(sugar) thrice a day will be given from day 1 to day 7 for 3 consecutive menstrual cycles to Group A and Tablet Tranexamic acid 500mg thrice a day to Group B. Primary outcome measures are menstrual blood loss improvement, reduction in pain assessed by visual analog scale, and change in Haemoglobin concentration. The secondary outcome measure is improvement in quality of life. All adverse drug reactions will be monitored and reported to Ayush Suraksha, pharmacovigilance center, Maharashtra.  Following sample size calculation 46 patients will be recruited in each group to demonstrate equivalence with 80% power. The duration of study will be 2 years. The study is approved through Institutional Ethics Committee dated 07/10/2022, MGACHRC/IEC/Oct-2022/585. Participant recruitment shall be started after getting registered with the Clinical Trial Registry of India.
 Results: Current manuscript is a clinical protocol, hence results are yet to derive from the study. Results will be presented in conferences and shall be attempted to publish in indexed/peer-reviewed medical journals.
 Conclusion: Conclusion shall be drawn after completion of the clinical study.

Knowledge Regarding Reproductive Tract Infection Among Ever Married Females of Reproductive Age Group in Rural Tamil Nadu.

Background Reproductive tract infection (RTI) is an overgrowth of the normal flora of the reproductive tract. It is an iatrogenic infection caused by unhygienic practices like unsafe abortion. Lack of knowledge plays a major role among the factors associated. The District Level Health Survey (DLHS)-4 reported that the knowledge about RTI among the rural population of Tamil Nadu is 8 percent. It is thus necessary to know about their knowledge regarding RTI. Aim To assess the knowledge regarding reproductive tract infection among the ever-married rural women in the reproductive age group in Kancheepuram district, Tamil Nadu. Settings and design A cross-sectional study was conducted in the rural Kancheepuram district of Tamil Nadu. Materials and methods The sample size calculated was 330. Using multi-stage random sampling, a population proportion to the calculated sample size was used. A standardized questionnaire was used for data collection. Ethical approval was obtained. Statistical analysis used SPSS -21.0 was used for statistical purposes. A chi-square test was applied for significance. P-value <0.05 is considered significant. Results Among 330 females, 166 (50.3%) presented with any symptom of RTIs in the past three months, and 300 (90.9%) have heard about RTIs, with the main source of information being health education by the health care workers (155, 46.9%); 9.1% (31) females had no or poor knowledge regarding the RTIs. Conclusions Because of a lack of knowledge, RTI was prevalent among women in the rural community who were of reproductive age. Regular health education should be given to women who are fertile in order to increase their understanding.

Evaluating Adenomyosis with Transvaginal Sonography: Diagnostic Precision and Clinical Relevance

Background: Adenomyosis is an important benign gynecological condition among females with variable signs and symptoms. Prompt detection of suspicious cases is important for the effective management of the disease. The objective of the current study was to determine the frequency of adenomyosis on transvaginal ultrasound (TVS), its diagnostic accuracy, and the identification of associated factors in women with symptoms of adenomyosis. Methods: This cross-sectional study was carried out at the radiology department of Dow University Hospital, Karachi, Pakistan from January 2022 to March 2023. All married females of reproductive age group presented with symptoms of adenomyosis for more than 7 days were included. Adenomyosis on TVS and histopathology were noted. Moreover, associated factors of adenomyosis were also studied. Results: Of 280 patients, adenomyosis on TVS was observed in 180 (64.3%) patients whereas on histopathology in 176 (62.9%) patients. Diagnostic accuracy of adenomyosis on TVS showed that sensitivity was 89.20%, specificity 77.88%, positive predicted value 87.22%, negative predicted value 81.00%, and accuracy was found to be 85.00%. A significantly higher proportion of adenomyosis was observed among women who had infertility (p&lt;0.001), symptoms of dysmenorrhea (p &lt;0.001), dyspareunia (p&lt;0.002), urinary symptoms (p &lt;0.001), and GI symptoms (p&lt;0.001). Conclusion: TVS is a valuable imaging modality for identifying adenomyosis, especially in patients with clinical symptoms. Furthermore, there is a significant association between adenomyosis and various clinical symptoms, including infertility, dysmenorrhea, dyspareunia, urinary symptoms, and gastrointestinal symptoms.

Morbidity Pattern Amongst Women of Reproductive Age Group (15-44 Years) Residing in Rural and Urban Field Practice Areas of Government Medical College, Amritsar: A Cross-Sectional Study

Background: Health of a woman in the family is far more important because whole family revolves around her.Any deviation from the state of normal physical, mental and social well being is morbidity and the morbidity inwomen at any stage of the life cycle , more so during reproductive age group, adversely affects the quality of life ofher own as well as that of whole family. It creates hinderances in the overall development at the individual leveland that of the nation as well.Objectives: To assess the morbidity pattern of women in reproductive age group (15-44 years).Material and methods: A cross- sectional study was conducted on the females of reproductive age group (15-44years) in rural and urban field practice areas of Government Medical College, Amritsar from 1st March 2021 to28th Feb. 2022. Sample size was calculated using formula N ≥ Z 2 × P × (1-P) / d2 . A pre-tested, semi structuredquestionnaire was used for collection of the required data.Participants: All females in the age group of 15-44 years who gave a consent to participate in the study wereselected. Any female with any congenital disease / malformation / intellectual disability, pregnant female andfemales who failed to give written informed consent / not willing for participation in the study were excluded.Results: Out of 330 study participants, 146 (44.2%) had one or more types of morbidities at the time ofstudy. The majority (95%) of these morbidities were chronic in nature while a small proportion i.e. 5% were acute.The system involved in multiple morbidities was reproductive and gynaecological system in majority (43.8%) ofstudy participants which was followed by cardiovascular system (9.6%), musculoskeletal system (9.3%), centralnervous system (4.2%), metabolic, ENT and urinary system (3.9% each), gastrointestinal system (3.3%), skin (2.4%)and respiratory system (2.1%).Conclusions: The pattern of morbidity in females of reproductive age group turned out to be Reproductive andGynecological inclusive of menstrual disturbances, PID, fibroid, RTIs, STIs, vaginal discharge etc. followed bycardiovascular system (9.6%), musculoskeletal system (9.3%), central nervous system (4.2%), metabolic, ENT andurinary system (3.9% each), gastrointestinal system (3.3%), skin (2.4%) and respiratory system (2.1%).

Twisted Paraovarian Cyst with Secondary Torsion of the Fallopian Tube: A Rare Cause of Abdominal Pain with Diagnostic Dilemma

Acute abdominal pain is one of the common reasons for patients to seek medical attention. There are multiple medical and surgical causes of abdominal pain. One uncommon cause is a twisted paraovarian cyst, which requires prompt intervention to decrease the patient’s morbidity. A paraovarian cyst is a fluid-filled sac that develops in the broad ligament and is often asymptomatic. A 38-year-old woman presented with dull aching pain in her right lower abdomen for four days. Abdominal ultrasonography revealed thickening of the segmental bowel in the right lower abdomen with adjacent oedema. The uterus and both ovaries appeared normal. Contrast-enhanced Computed Tomography (CT) showed a cystic density lesion measuring 4.0×3.3 cm, adjacent to the uterus, and the right ovary could not be visualised separately. Inflammatory changes were observed in the small bowel, extending into the right iliac region, and the appendix could not be visualised separately. An emergency laparotomy was performed, which, however, revealed a twisted paraovarian cyst along with a right fallopian tube showing signs of complete necrosis. The paraovarian cyst and the right fallopian tube were removed, and the patient had an uneventful recovery. Torsion of the paraovarian cyst with secondary torsion of the fallopian tube is a rare phenomenon and should be considered as a cause of abdominal pain in females of reproductive age group.

Uterine leiomyoma with bizarre nuclei – A series of four cases

Uterine leiomyoma is the most common benign mesenchymal tumor of the uterus occurring in females of reproductive age group and are derived from smooth muscle. Degenerative changes are usual in leiomyoma. There is a wide spectrum of morphological patterns in leiomyomas, among them 90% of leiomyomas are the conventional type or usual type. Leiomyoma with bizarre nuclei is an unusual variant of uterine leiomyoma with presence of marked nuclear atypia and pleomorphism. However, there is low mitotic activity (&amp;#60; 5 mitoses/10 high power fields), absence of tumor cell necrosis and intermixed normal spindled smooth muscle cells. The present study describes histopathological analysis of 4 cases of leiomyoma with bizarre nuclei. All these cases underwent abdominal hysterectomy for leiomyomas in the uterus. The age range was 47 to 52 years. On gross examination the cases had well-defined masses with grey white, whorled areas and microscopic impression was leiomyoma with bizarre nuclei. These cases had low mitotic activity ranging from 1 to 3/ 10 high power fields and absence of tumor necrosis. Ki 67 index was 0.5 -1.0%. Leiomyoma with bizarre nuclei can create a diagnostic dilemma due to marked nuclear atypia, multinucleated tumor cells and karyorrhectic cells resembling mitotic figures. Hence it is important to rule out more aggressive and malignant mesenchymal tumors.

Phenotypic characterization and antifungal susceptibility profile of Candida isolates from women with vulvovaginal candidiasis at a community health center linked to a teaching institution in the Sub-Himalayan region of North India.

Vulvovaginal candidiasis (VVC) is considered a common gynecological problem among females of reproductive age group. 70-75% of women report having had candidal vulvovaginitis at some point in their lifetimes and 40-50% suffer recurrent candidal vulvovaginitis. This study aims to identify the Candida species involved in VVC and to determine their antifungal susceptibility pattern. The present study was a cross-sectional study conducted on 257 females (18-55 yr) with complaints of abnormal vaginal discharge. For detection of Candida, the swab samples were subjected to Gram stain, 10% KOH mount, and culture on Sabouraud dextrose agar (SDA). Candida species identification was done by subculturing Candida isolates onto CHROMagar, corn meal agar (Himedia), and further confirmation was done by MALDI-TOF MS. Antifungal testing was done using the disk diffusion method. A total of 257 females with complaints of abnormal discharge were enrolled in this study. Out of 257, C. albicans 37 (58.7%) and 26 (41.3%) isolates were identified as non-albicans Candida. Out of 63 positive cases, a maximum number of study subject belongs to the age group 26-35 years (50.8%). Along with vaginal discharge, itching (65.37%) is the most common complaint. VVC was found to be most predominant in patients with prolonged antibiotic therapy (38.1%), and in pregnant females (15.9%). Understanding the emerging fungal pathogens and their drug susceptibility patterns is essential for the effective management of infections. Drug resistance can lead to treatment failure and highlights the need for alternative treatment options or strategies.

Antibiogram of uropathogens and associated risk factors among asymptomatic female college students in Dessie town, Northeast Ethiopia.

Asymptomatic urinary tract infection (asymptomatic bacteriuria and asymptomatic candiduria) may not be routinely detected in sexually active non-pregnant female population at the initial and reversible stages. This is mainly due to the fact that most women may not feel compelled to seek medical attention. The aim of this study was to determine the prevalence, and factors associated with urinary tract infection (UTI), and antibiogram of the uropathogen isolates among asymptomatic female college students. An institutional-based cross-sectional study was conducted at selected colleges in Dessie from January 2021-March 2021. A total of 422 reproductive age (15 to 49 years) non-pregnant female students were included. Socio-demographic and clinical characteristics data were collected using structured questionnaires. Ten mLs of freshly voided mid-stream urine specimen was collected, transported and processed according to the standard operating procedures. Data were coded and entered for statistical analysis using SPSS version 22.0. Descriptive statistics, bivariate and multivariate logistic regression analysis were performed and p-values <0.05 with the corresponding 95% confidence interval (CI) were considered statistically significant. The overall prevalence of UTI was 24.6%. The prevalence of asymptomatic UTI bacteriuria and candiduria was 57 (13.5%) and 47 (11.1%), respectively. The predominant uropathogens were Staphylococcus saprophyticus 24 (23.1%), followed by Candida tropicalis 23 (22.1%), Candida albican 10 (9.6%), Candida krusei 9 (8.7%) and Escherichia coli 8 (7.7%). Gram negative bacterial isolates showed a higher level of resistance to amoxicillin-clavulanic acid 24 (92.3%). Gram positive bacterial uropathogens showed high level of resistance to penicillin 28 (96.6%) and trimethoprim-sulfamethoxazole 23 (79.3%). Gram positive bacterial isolates were sensitive to norfloxacin, clindamycin, and ciprofloxacin, accounting for 24 (82.7%), 20 (69.0%), and 19 (65.5%), respectively. Multidrug resistance was seen in 50 (87.7%) of bacterial uropathogens. Factors identified for acquisition of UTI were frequency of sexual intercourse (≥3 per week) (AOR = 7.91, 95% CI: (2.92, 21.42), and genital area washing habit (during defecation (AOR = 5.91, 95%CI: (1.86, 18.81) and every morning (AOR = 6.13, 95%CI: (1.60, 23.45)). A significant prevalence of uropathogens, and high resistance of bacterial isolates to the commonly prescribed drugs were detected. Therefore, routine UTI screening, regular health education on the risk of asymptomatic infectious diseases for reproductive age group females, and antimicrobial susceptibility testing should be practiced to avoid the progression of an asymptomatic infection into a symptomatic UTI.

An epidemiological study of period poverty among females of reproductive age group in Lucknow (U.P.).

Females in developing countries face brunt of lack of access to affordable menstrual supplies and inequitable distribution of menstrual health education and are victims of period poverty. The objective of the present study was to estimate prevalence of period poverty and to determine association of period poverty with socio-demographic determinants, menstrual knowledge, menstrual hygiene management practices, and reproductive health. This was an analytical cross-sectional study, conducted at an urban primary health care centre. Reproductive age group (20-49 years) females attending the primary health care centre from December 2022 to May 2023 were selected for study. Data were collected on semi-structured, pre-tested questionnaires. The collected data were entered in M.S Excel and analysed in STATA version 17.0. Chi-square test was used for comparison of qualitative data, and for quantitative data, unpaired t-test was used. The prevalence of period poverty in the present study was 92 (29.7%). The mean age of females with period poverty was 29.72 ± 7.13 years, and it was 26.45 ± 6.62 years with no period poverty (P 0.001). Period poverty was significantly associated with socio-demographic variables. Period poverty had significant association with menstrual knowledge, menstrual hygiene management practices, and reproductive health. Many females cannot afford menstrual health products to meet their monthly needs, and this may affect their education and socio-economic status. Improved access to affordable sanitary products is requisite of females.

Assessment of Symptoms and Risk Factors as a Screening Tool of Bacterial Vaginosis Among Reproductive Age-Group Females in West Bengal, India.

Background Bacterial vaginosis (BV) is a ubiquitous vaginal discomfort and has overlapping symptoms with other reproductive tract infections. The World Health Organization suggested a symptomatic approach for diagnosing BV with insufficient laboratory setup. However, due to symptom overlap, BV is often misled and ends up with injudicious drug application. Objective The study aims to identify the most relevant symptoms and behavioral risk factors associated with BV in tertiary healthcare settings in West Bengal, India. It also seeks to develop a scoring system based on clinical symptoms to screen for BV, especially when laboratory facilities are limited. Methodology The study is a retrospective case-control study involving 95 women of reproductive age. It employs both univariate and multivariate binary logistic regression models to identify risk factors and symptoms associated with BV. The study also compares these clinical symptoms with laboratory tests (Amsel's test) and attempts to create a scoring system for BV diagnosis. Key Findings Good menstrual hygiene and condom use were identified as key behavioral practices reducing the risk of BV. Four clinical symptoms, like malodor (P = 0.007), lower abdominal pain (P = 0.015), abnormal vaginal discharge (P = 0.071), and painful intercourse (P = 0.08), were identified as notable predictors. Based on these four symptoms, the scoring system showed a sensitivity of 88.2%, a specificity of 67.25%, and an overall accuracy of 74.7%. An additional diagnosis of vulvovaginal candidiasis (VVC) revealed that the odds of malodor (P= 0.006) and burning sensation (P= 0.011) increased significantly during co-infection.

PET/CT imaging in invasive endometriosis: a way to minimize missed diagnosis and reduce invasive interventions.

Heterogeneous and nonspecific symptoms make invasive endometriosis a difficult entity to diagnose. Small lesions with absent associated changes can be easily missed in cross-sectional imaging. Even when the lesions satisfy the thresholds for various investigations, their appearance changes with cyclical fluctuations in the hormonal levels. Therefore, newer approaches are needed to achieve correct diagnosis. Six females in reproductive age group (mean age = 32.5 ± 4.3 years) were retrospectively selected, wherein the diagnosis of invasive endometriosis was confirmed after 18F-FDG-PET/CT. Indications for PET/CT were staging in 4 patients, suspected progression in 1 and suspected inflammatory bowel disease in one patient. The study was repeated in proliferative phase in two patients and in the menstrual phase in another patient. FNAC was available in two patients and a drop in CA125 was documented in the last patient. In five patients metabolically active lesions were seen in PET/CT and in the last, activity was absent despite symptoms. Repeat menstrual phase imaging in the last patient confirmed the diagnosis. In two patients with metabolically active lesions at baseline, resolution was seen in proliferative phase PET/CT. In the other two patients, repeat study was not indicated as FNAC revealed normal endometrial tissue and in the last patient, significant drop in CA125 was documented after just 2 weeks. In all of these patients, the final diagnosis was of invasive endometriosis. In reproductive-age women, PET/CT acquisition should be optimized in the context of menstrual cycle. This approach can be used to non-invasively rule in/rule out endometriosis, especially with repeat imaging in proper menstrual phase.

Assessment of knowledge and attitude towards menstrual cup usage among adolescent girls

A woman is the essence of whole universe. If there would be no women, the human race is surely going to end. Women deserves more care and attention especially during the reproductive phase. Menstruation is a unique phenomenon of females of reproductive age group. Cultural, religious and traditional beliefs can lead to different restrictions that women face during their menstrual period. Menstrual cup is a device for menstrual flow management and is claimed to be a healthy and environmentally friendly alternative to the conventional menstrual sanitary protections.Even though menstrual cup is highly efficient it requires fair amount of self-confidence and assurance to insert into one’s own body. And the prevailing myths on breakage of hymen make the confusion of adolescents even worse. This study was aimed at assessing knowledge and attitude towards menstrual cup usage among adolescent girls. Descriptive survey design was used. A total of 100 adolescent girls were selected using convenient quota sampling methods. Data was collected using structured knowledge questionnaire to assess knowledge and an attitude rating scale to assess attitude towards menstrual cup usage. The study results revealed that 50 % students had good knowledge, 35 % students had satisfactory knowledge, 8 % students had excellent knowledge, 6 % students had poor knowledge and one percent students had very poor knowledge about menstrual cup usage. Majority (81%) had a positive attitude towards menstrual cup usage, 19% had neutral attitude and none had negative attitude. Hence majority of the subjects had a good attitude towards menstrual cup usage. There was no relation between knowledge and attitude of adolescent girls towards menstrual cup usage. Women have lots of concerns about managing menstrual flow. Fear of spotting, stains, squishy, messy, smelling and annoying nature of sanitary pads is still a major dilemma. Other alternative measure to sanitary napkins is menstrual cup. Adolescent girls achieve their knowledge on menstrual cup through the social media.In a developing world, menstrual management is not only difficult but also may have serious adverse impact on the lives of women. Even when taboos are not a major problem, convenient or inexpensive menstrual collection materials are not available. Efforts to produce inexpensive materials are solely lacking. Women use clothes, absorbent pads or tampons to manage menstrual flow. Washing the clothes or disposing the pads hygienically is a challenge for most of the females. By interacting with other teens, investigators understood that women have lots of concerns about using sanitary pads. Other alternative measure to sanitary napkins is menstrual cup but females require self-confidence and assurance to insert it to one’s own body.

Nutritional status of reproductive age group women: A community-based study.

Anemia continues to be a major public health problem worldwide, particularly among females of reproductive age in developing country settings. The prevalence of anemia in South Asia is among the highest in the world, mirroring overall high rates of malnutrition. 1) To estimate the prevalence of anemia and undernutrition among reproductive age group females. 2) To study factors associated with anemia and undernutrition among reproductive age group females. This was cross-sectional study, which was carried out from June 2011 to December 2012 at Nanded City in Maharashtra state among nonpregnant ever-married women of 15-49 years age with a sample size of 750 selected using probability proportional to size sampling technique. Percentage, Chi-square test, analysis of variance (ANOVA) test, and Student's t test were used for analyzing the data. The prevalence of anemia among reproductive age group women was 554 (73.9%). 20.8% of women were undernourished and 4.1% were obese. There was a significant difference in the hemoglobin percentage of study subjects in relation to their age at marriage, weight, and body mass index (BMI). Mean BMI increases significantly as the age of women and duration of marriage increases. Nutritional status has a significant effect on the grade of anemia. Women of reproductive age groups are affected by anemia irrespective of age and parity.

Effects of Different Types of COVID-19 Vaccines on Menstrual Cycles of Females of Reproductive Age Group (15-49): A Multinational Cross-Sectional Study.

Background Globally, there are more than 474 million cases and around 6 million deaths due to COVID-19. The case fatality rate was 0.5-2.8% while for 80-89 years old, it was 3.7-14.8%. Given the seriousness of this infection, prevention becomes critical. Hence, the introduction of vaccines led to a significant reduction (> 75% protection) in COVID-19 cases. On the other hand, patients seeking help for serious pulmonary, cardiovascular, neurological, and gynecological complaints have also been recorded. Clinical studies on the effects of vaccination focused mostly on life-or-death results rather than reproductive outcomes such as menstruation, fertility, or even pregnancy outcomes. This survey was conducted to get more evidence on the association between menstrual cycle irregularities and some globally most prevalent COVID-19 vaccines. Methods An online cross-sectional survey was conducted by a team from Taif University, Kingdom of Saudi Arabia, from January to June 2022 on females within the reproductive age group (15-49 years) using a semi-structured questionnaire. Data were analyzed using SPSS Statistics version 22.0 and presented as frequency and percentage. The chi-square test was applied for the association and a p-value of <0.05 was considered significant. Results A total of 2381 responses were included. The mean age of respondents was 25±7.7 years. Around 1604 (67%) participants observed post-vaccination menstrual changes, and the findings were significant (p< 0.001). A strong association (p=.008) was found between the type of vaccine and changes in the menstrual cycle in participants (AstraZeneca 11 (36%)) after one dose. A strong association (p=.004) was also seen between the type of vaccine (Pfizer 543 (83%)) and menstrual changes after the booster dose. Cycles became irregular 180 (36%) or prolonged 144 (29%) in females inoculated with Pfizer after two doses of vaccination (p=0.012). Conclusion Post-vaccination menstrual irregularities were reported by females of reproductive age, especially the new vaccines. Prospective studies for similar insights are needed. Finding the co-occurring impacts of vaccination and COVID-19 infections in the wake of the emerging new long-haul COVID-19 phenomena is crucial for reproductive health.

An Exploratory Study on the Perspectives And Practices of Contraceptive Use Among Married Females of Reproductive Age Group (15-49 Years) of Selected Urban Areas Of Dist. Shimla (Himachal Pradesh)

“AN EXPLORATORY STUDY ON THE PERSPECTIVES AND PRACTICES OF CONTRACEPTIVE USE AMONG MARRIED FEMALES OF REPRODUCTIVE AGE GROUP (15-49 YEARS) OF SELECTED URBAN AREAS OF DIST. SHIMLA (HIMACHAL PRADESH)” 1Heena Verma, 2Gunjali Singh, 3Ankit Sharma 1Community Health Nursing Department, 2Mental Health Nursing Department, 3Mental Health Nursing Department ABSTRACT Contraception is a process or technique for preventing pregnancy by means of medication, device or method that blocks or alters one or more of the processes of reproduction in such a way that sexual union can occur without impregnation. Objectives: To assess the perspectives of contraceptive use among married females of selected urban areas of Dist. Shimla (H.P), To identify the contraceptive practices among married females of selected urban areas of Dist. Shimla (H.P), To associate the perspectives and practices of contraceptive use with the selected socio demographic variables of married females. Method: The study has adopted quantitative research approach and exploratory research design. Total 238 samples were selected based on inclusion and exclusion criteria through multistage cluster sampling technique. Data was collected in terms of socio demographic profile of the married females, semi structured questionnaire and Likert scale was used to assess the perspectives of contraceptives use, semi structured checklist was used to assess the practices of contraceptives among married females. Results: Major findings of the study revealed that most of the married females i.e. 47% were between the age group of 20-29 years, 72% belonged to Hindu religion, 47% were graduate or above, 32% were self-employed, 58% were having duration of marriage between 1-10 years, 85% were living with spouse and children, 64% were having 1 child, 39% had monthly family income Rs. between 20001-30000, 66% married females were living in nuclear family, 91% married females had television as the source of information and contraceptive method used was condom in 71% married females. In the present study, the perspectives of married females in terms of awareness showed that 35% of females were having good awareness, 50% were having average awareness and 15% were having poor awareness. In terms of opinion, 30% of married females were having positive opinion, 70% were having neutral opinion and none of them was having negative opinion regarding contraceptive use. Majority 65% of married females having average practices of contraceptives, only 31% of females were having poor practices and the rest 4% were having good practices. Mean and standard deviation for perspectives of contraceptive use in relation to awareness and opinion was 14.66 ± 3.98, 72.16 ± 8.24. Mean and standard deviation for practices of contraceptives were 7.71 ± 2.42. There was significant association of age, education, occupation, duration of marriage, living status, monthly family income, type of family, source of information and contraceptive method used with perspectives of contraceptive use at p&lt;0.05 level of significance.

Awareness and Uptake of Tetanus Toxoid Vaccination Among Females of Reproductive Age in Rawalpindi

Objectives: To determine awareness and uptake of tetanus toxoid vaccination among females of reproductive age in Rawalpindi, Pakistan.&#x0D; Study Design: Cross-sectional study.&#x0D; Place and Duration of Study: Fauji Foundation Hospital, Rawalpindi Pakistan, from Feb to Sep 2018.&#x0D; Methodology: A consecutive sample of 400 females completed a structured questionnaire translated into Urdu after giving written informed consent. Females, 15 to 49 years, accompanying patients and seeking healthcare were enrolled, and all those belonging to the category of healthcare providers (doctors, nurses, paramedics, etc.) were excluded.&#x0D; Results: The study showed that 343(85.8%) women were aware of tetanus disease, and 230(57.5%) knew it could be prevented through vaccination. Only 147(36.8%) knew the correct range of reproductive age in females, 178(44.5%) knew the correct schedule, and 46(11.5%) knew the correct number of injections of tetanus vaccination program given by the World Health Organization (WHO) for females of reproductive age group. Around 321(80.3%) were willing to get vaccinated, and 338(84.5%) were willing to recommend it to other females. The number of females who ever received tetanus vaccination for females of reproductive age was 81(20.25%), out of which 7(1.8%) completed uptake of all five doses.&#x0D; Conclusion: Our study population was aware of tetanus disease with a positive attitude towards vaccination. However, awareness and uptake of the tetanus toxoid vaccine according to the tetanus vaccination program for females of reproductive age could have been better.Keywords: Reproductive age, Tetanus, Tetanus toxoid Vaccination.

EDUCATIONAL TRAINING OF LADY HEALTH WORKERS AND PREVENTION OF ABORTION RELATED MORBIDITY AND MORTALITY

One of the major challenges faced by developing world for achieving universal health care includes shortage of Manpower indicated by the fact that an estimated one billion people will never see a health worker during the course of their lives. As a consequence to this shortage millions of people die or are disabled each year1. One solution to this dilemma was increasing health workforce by induction of community health workers (CHWs), members of the community who are trained to provide basic health services. They offer the first and at times only admittance to health services for people in the developing world2. But, research has shown that, CHWs are not effectively trained, remunerated, or retained. In Pakistan Lady Health Worker Program started with the overall goal to contribute to poverty reduction by improving the health of the people. So Lady Health Workers (LHWs) were  recruited and trained  to provide family planning services and primary health care (PHC) in their own communities3. The health services, based on PHC, include among other things: education concerning prevailing health problems and the methods of preventing and controlling them, and provision of essential drugs and supplies. One of the major current problems is Abortion. Worldwide 61% (Six out of 10) of all unintended pregnancies, and 29 % (3 out of 10) of all pregnancies, end in induced abortion. And out of all abortions around 45% are unsafe, of which 97% occurring in developing countries4. An estimated Over two million abortions are performed annually in Pakistan5. Involved health risks depend on whether the procedure is performed safely or unsafely. Unsafe abortion is common in rural areas, where plant species are used to terminate an unwanted pregnancy6 and restricted abortion law countries ,where most  attempt to self-abort or go to untrained person7. fIn Pakistan, mostly abortions are due to unwanted pregnancy, poverty, lack of awareness about Reproductive Health and Family planning methods on part of both husband and wife.  Abortion related care includes emergency treatment of abortion, post-abortion family planning services including counseling and making links between the post-abortion emergency services and the reproductive healthcare system. A Lady Health worker informs and counsels any pregnant adolescent about the possible consequences (medical and psychological) of unsafe abortion.  In case of any of any of such complication’s immediate referral to a higher health facility (often a hospital) is needed where she can get sufficient care. Delay in seeking care specially demands improved reproductive health information about abortion care. Improving current PAC services at lower level facilities will also minimize delays resulting from long referral processes8. Improving knowledge through trainings of the health workers about prevention of abortion and risk factors will bridge the gap between the current and ideally required level of knowledge for delivering preventive abortion related health care services. Theses trained health workers can utilize this knowledge for increasing awareness among reproductive age group females especially of rural community. And eventually abortion related morbidity and mortality can be significantly reduced which will contribute for attainment of the Sustainable MDG related to decreasing maternal morbidity and mortality.