Females Of Reproductive Age Group Research Articles

Domestic violence against women in rural areas of Saharanpur: A population-based study on prevalence and risk factors

ABSTRACT Background: Domestic violence (DV) against women is a global problem and is present in every country. It is a matter of serious concern in most communities and cultures and has consequences on women’s mental, physical, reproductive, and sexual health. The study aimed to determine the prevalence and pattern of DV among married women. Materials and Methods: A community-based, cross-sectional study was conducted among 400 reproductive age group females in the rural area of district Saharanpur for a period of six months using multistage random sampling. Results: The prevalence of DV was found to be 21%. The most common type of DV was physical violence (18%) followed by psychological violence (12.8%), financial violence (5.5%), and sexual violence (2.3%). The major perpetrators of DV were the husbands in 79% of the cases. Regression analysis depicted a significant association between age, education of husband, husband’s addiction, and depression of study participants with events of DV. Multivariate analysis shows only the addictions of husbands and the depression status of study participants to be significantly associated with DV. Conclusion: The prevalence of DV was 21% which is still high and appropriate measures should be taken to strengthen the laws for women and to empower them.

A CROSS-SECTIONAL STUDY ON KNOWLEDGE AND PRACTICE REGARDING MENSTRUAL HYGIENE AMONG FEMALE NURSING STUDENTS IN A TERTIARY CARE HOSPITAL

Objectives: Menstruation, though a normal physiological process in the females of reproductive age group, is surrounded by various misconceptions and social taboos. Inadequate knowledge and unhygienic menstrual practices can adversely affect female health. Poor menstrual hygiene practice has been negatively associated with infection of the reproductive and genitor-urinary tract, cervical cancer, absenteeism from school, or drop-out, poor academic performance, lower self-esteem, and poor quality of life. We conducted this study to evaluate the knowledge and practices regarding menstruation in female nursing students in a tertiary care hospital. Methods: An observational, cross-sectional, questionnaire-based study was conducted over for three months on female B.Sc nursing students in the first year to the fourth year through face-to-face interview at the department of Pharmacology in a tertiary care hospital. Data regarding socio-demographic profile, knowledge of obstetric and gynaecological factors, perception of menstruation, and hygienic practice of the participants during their menstruation were collected. Results: Responses from 165 participants were analyzed. The mean (± SD) age of the students was 19.64 (± 1.09) years. Most of their parents had education up to a diploma and above (47.27% among mothers and 70.9% among fathers). The majority of the participants used to experience dysmenorrhea (52.72%) and had pre-menarcheal ideas about menstruation (78.18%). Mother was the most common source of information (54.54%) followed by teachers (16.96%) and media (13.33%). The majority knew the source (89.09%) and cause (100%) of menstrual bleeding. A considerable portion (45.45%) thought menstruation as the sign of conception. The majority (96.36%) used commercially made sanitary pads, and used to dispose of the used sanitary pads in the dustbin (98.19%) by wrapping them with paper (98.19%). Conclusion: Present study found an encouraging picture regarding knowledge and hygienic practices during menstruation among the participants. Education about menstrual hygiene needs to be imparted at the grass root level. In this regard Anganwadi and health care workers, teachers and media can play a major role. All mothers need to be taught about the importance of hygienic practices during menstruation, convey correct information to their daughters, and should be encouraged to break the age-old myths and taboos associated with menstruation.

Evaluation of Leiomyoma: A Clinicopathological Study in a Tertiary Care Center in Kathmandu

Uterine leiomyoma is one of the common gynecological benign tumors. It is usually observed in female of reproductive age group and often presented with symptoms like abdominal pain, dysmenorrhea and fertility disorders. Hysterectomy and myomectomy are the procedure for management of uterine leiomyoma. The prime objective of our study was to evaluate the demographic distribution and clinicopathological changes in hysterectomy and myomectomy specimens with leiomyomas. A descriptive hospital based cross-sectional study was conducted in the Department of Pathology, Nepal Medical College Teaching Hospital (NMCTH), Nepal from May 2023 to October 2023. A total of 57 uterine leiomyoma samples received in the department of Pathology for histopathological examination were included in the study. Ethical approval for the study was obtained from Institutional Review Committee of NMCTH and informed consent was taken from each patient. The tissue biopsies were routinely processed and stained with Hematoxylin and Eosin (H and E). The observed findings were managed in MS Excel sheet and later analyzed using SPSS 17. The most common age group diagnosed with uterine leiomyoma was 41 to 50 years (64.9%). The leiomyomas were highly prevalent in women from Janajati community (47.4%). Pelvic pain, menorrhagia and bleeding disorders were the most frequent clinical manifestations. Intramural was the commonest site (77.2%) and the hyalinization was the most usual secondary changes (19.2%) found. The correlation between age distribution and site of leiomyoma, age distribution and secondary changes and site of leiomyoma and secondary changes were statistically not significant. However, detailed histopathological examination gives many information related to leiomyoma and it is necessary for the effective management.

Study of Serum Creatinine in Female Type 2 Diabetes Mellitus Patients

Diabetes mellitus is a chronic illness that affects millions of individuals worldwide. In the present study serum creatinine was estimated in female type 2 diabetes to observe the frequency of increase serum creatinine level in these patients. A cross-sectional, descriptive study was carried out in the Department of Physiology, Mymensingh Medical College, Bangladesh, between July 2016 and June 2017. A total of 210 subjects were selected and were grouped as: control group (group I) having 70 healthy female of reproductive age (21-45 years) and study group (group II), which was again subdivided to group IIA (70 diabetic female of reproductive age (21-45 years) and group IIB (70 diabetic female of post-menopausal age, 45-70 years). Laboratory analysis of serum creatinine was done by enzymatic colorimetric method. A comparison in serum creatinine concentration was done in between group I and group II and in between Group IIA and Group IIB. The results were calculated and analyzed by using SPSS. For statistical analysis students unpaired ‘t’ test was performed. Our study revealed that serum creatinine was increased among females of the study group and the result was statistically significant. In the control group serum creatinine was within the normal physiological range. CBMJ 2024 July: vol. 13 no. 02 P: 198-202

Can Probiotics Play a Major Role as an Adjunctive Therapy in Treatment of Bacterial Vaginosis?

Background: Bacterial Vaginosis is one of the most common causes of abnormal vaginal discharge in women of reproductive age, which can have a major impact on quality of life. Although the treatment course of oral metronidazole for 7 days results in curative rate of 70%–80% at four weeks of treatment, but is associated with high rates of recurrence occurred within twelve months, reaching up to 40%–50%. Methods: A Randomized Prospective Interventional Study was done on 1000 reproductive age group females (pregnant or non-pregnant) diagnosed with bacterial vaginosis from November 2020 to October 2022 at department of Obstetrics & Gynaecology, Kanpur. The study group were divided into two subgroups - Group 1 were given metronidazole 500 mg for 7 days and probiotics for 14 days and group 2 were given metronidazole 500 mg for 7 days and placebo for 14 days. The patients were followed after 3 months to know the recurrence. Results: Majority of patients belonged to rural background (63.1%) with lower socioeconomic (46.6%) and belong to age group 20-35 years. It was observed that there was significant change in Amsel’s criteria and Nugent’s scoring in Group 1 as compared to Group 2. The rate of recurrence at the end of the treatment for Amsel’s criteria in group 1 were 1.03 as compared to group 2 was 1.68 and for Nugent’s scoring, the rate of recurrence at the end of treatment in group 1 was 3.17 as compared to group 2 was 4.78. Conclusion: Probiotics can be considered as one the adjuvant therapy for treating bacterial vaginosis and re-establishing equilibrium in the vaginal microflora thus, preventing the recurrences.

Prevalence and Management of Premenstrual Dysphoric Disorder (PMDD): Literature Review

Premenstrual Dysphoric Disorder (PMDD) is a severe form of premenstrual syndrome (PMS) characterized by significant mood disturbances and functional impairment. It affects approximately 3-8% of menstruating women and has been recognized as a distinct clinical entity by the American Psychiatric Association in the DSM-5. Recent studies have emphasized the global prevalence of PMDD and its substantial impact on daily functioning, relationships, and overall mental health. Understanding its prevalence of PMDD helps in recognizing the scale of the problem and the need for targeted interventions. This literature review provides an overview of the current understanding of PMDD, including its pathophysiology, diagnosis, and treatment options. As a result, it was observed that there exist a high prevalence of Premenstrual syndrome and Premenstrual Dysphoric Disorder among Indian females of reproductive age group that consequently affects the quality of life adversely.

Mullerianosis of the urinary bladder: A great mimicker

Mullerianosis is a rare benign lesion consisting of an admixture of two or more of the following tissues: endometriosis, endocervicosis, and endosalpingiosis. It most commonly affects the urinary bladder and females of reproductive age group. Müllerianosis of the bladder is an extremely rare entity with fewer than 30 cases reported. Herein we report one such rare case of mullerianosis of the urinary bladder in a 33-year-old female who had undergone cesarian section 2 years back, presented with painless hematuria associated with menstruation. USG revealed a soft tissue lesion measuring 23×11 mm abutting the wall of the urinary bladder and extending into it. These findings were suspicious for endometriosis. The patient was admitted to the hospital for transurethral resection of a bladder lesion (TURBT). Operative findings revealed a solid 2x2 cm mass in the posterior wall of the urinary bladder. Superficial and deep TURBT chips were sent for histopathological examination. On microscopic examination, there were variable-sized glands lined by endometrial, endocervical, or tubal epithelium embedded in the bladder wall. The case was diagnosed as mullerianosis of the urinary bladder. As this rare entity, since it mimics benign and malignant neoplasms clinically and radiologically, pathologists should be aware of this rare entity to avoid misdiagnosis, which has great therapeutic implications for the patient.

A Prospective Observational Study of Abnormal Uterine Bleeding in Females of Reproductive Age Group at a Tertiary Care Hospital in Mumbai, India

A Prospective Observational Study of Abnormal Uterine Bleeding in Females of Reproductive Age Group at a Tertiary Care Hospital in Mumbai, India

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.

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.

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.

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.

REFERENCE INTERVAL OF PLACENTAL GROWTH FACTOR IN NON-PREGNANT AND PREGNANT FEMALES

Objective: To determine the reference interval of placental growth factor in healthy non-pregnant and pregnant females. Material and Methods: This cross-sectional study was conducted at Chughtai Institute of Pathology Chemical pathology department from January 2023-May 2023. Reference individuals were selected by purposive, non-probability sampling technique from 130 diseased free non-pregnant and 130 disease free pregnant females. Informed consent was obtained from females of reproductive age group who fulfilled the inclusion criteria. Levels for PGF was measured by a fully automated immunoassay analyser Elecsys system Cobas e601. Data was analyzed by using SPSS21. Kolmogorov-Smirnov test was applied. P value &lt;0.05 was considered significant. The 2.5th and 97.5th percentiles were calculated at 90% CI by using the formula 0.025x(n+1) at rank number 1 and 0.975x(n+1) at rank number 7. Results: Reference intervals were calculated by Rank-based method. Data values were arranged and rank numbers were allocated. Reference interval of PGF in non-pregnant and pregnant females were determine on the basis of 2.5th and 97.5th percentiles was 3.8 to 12.7 pg/mL and 46.43 to 1148 pg/mL respectively. Conclusion: Current study findings add on contribution in comparison between reference interval of PGF in healthy non-pregnant and pregnant females. It will subsequently help the gynaecologist, clinicians, pathologist to interpret the results in order to decrease the feto/maternal complications related to pre-eclampsia. PGF levels can be cost effective by reducing unnecessary hospitalization and investigations in females at minimal risk of pre-eclampsia. Keywords: Reference interval, Placental growth factor, Pre-eclampsia.

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.