Reproductive Group Research Articles

Prevalence and predictors of Intimate Partner Violence among Women of Reproductive Age in Plateau state, North-Central Nigeria

Introduction: Intimate Partner Violence (IPV) is an important public health problem that affects both men and women, especially women globally. This study brings to bear, the prevalence and predictors of IPV among women of reproductive age in Plateau state, Nigeria.
 Materials and methods: An analysis of secondary data from the 2018 NDHS dataset was done. The survey collected data on a sample of women within the reproductive age group 15-49 years in Plateau State. The data set was analyzed using the Statistical Package for the Social Sciences (SPSS) version 23.
 Results: A total of 139 responded to the questions on IPV in Plateau state, more of whom are within the age range of 25-39 years (67.6%) and resided in rural areas (77%). The overall prevalence of IPV was 62.6%, that of more severe physical violence was 7.9%, 15.8% for less severe physical violence, emotional violence was 58.3% and 12.2% for sexual violence. Living in rural a rural area (OR=4.28; 95% CI=1.72-10.93), belonging to the middle/rich/richer wealth quintile (OR=0.25; 95% CI=0.11-0.59), and having a partner who has control issues (OR=2.67; 95% CI=1.32-5.38) were significant predictors of IPV. Having a non-professional job also showed higher odds of IPV but it was not statistically significant (OR=1.67; 95% CI=0.56-4.97).
 Conclusion: The prevalence of IPV among women in Plateau state was found to be high, with socio-economic status significantly predicting its occurrence. Opportunities for improving the socioeconomic status of women in the state, especially those in rural areas should be encouraged by providing better jobs and creating public awareness that would discourage IPV.

Bleeding for life: a perspective of menstruation among slum dwellers of a temple town in coastal Karnataka, India

IntroductionChallenges in the achievement of good menstrual hygiene management in resource poor settings have been well documented and are linked to deleterious effect on women's health. This study was an attempt to assess the vulnerability with regards to menstrual health among the migrant population residing in urban slums in Udupi taluk. MethodsA community-based cross-sectional study was conducted among 392 migrant women in reproductive age group using a predesigned 31- item questionnaire.The domains of knowledge, attitude and practice about menstrual hygiene were categorized into poor and adequate knowledge, positive and negative attitude, and poor and good practice by using median as a cut off. ResultsOut of the 392 study subjects who participated in the study 31%,27% and 41% of them had good knowledge, positive attitude and good practice regarding menstrual hygiene respectively. Good knowledge was significantly associated with better standard of living (p < 0.001, OR = 3.612, CI = 2.159–6.042). Attitude was significantly almost five times better in women with more than ten years of schooling as compared to illiterates and school drop outs (p < 0.001, OR = 4.655, CI = 2.360–9.179). With regards to standard of living, adherence to good menstrual hygiene practice was better in women belonging to middle as compared to those of low class. (p = 0.001, OR = 2.730, CI = 1.502–4.962). ConclusionThe findings show an overall poor knowledge, attitude and practice towards menstrual health. This displays an urgent need of conducting health promotional activities to impart appropriate knowledge regarding hygienic practices during menstrual periods and simultaneously address to the misconceptions linked with it.

Congenital Mullerian anomalies may lead to acute life threatening emergency in reproductive age group- An experience in a tertiary care centre in Eastern India

Congenital Mullerian anomalies are associated with higher incidence of reproductive failure and adverse obstetrical outcomes. The new ESHRE classification is a precise way to describe a genital anomaly in simple way. Many genital tract anomalies lead to devastating life-threatening conditions but under-reported and poorly explained. This study aims at finding out those anomalies which more frequently lead to specific diseases needing emergency intervention to save life of the patient. This longitudinal observational study evaluates the diagnosis and treatment of 12 patients with congenital Mullerian abnormalities which led to life threatening emergency with case discussion and pictorial documentation. Among 12 women with uterine anomalies 4 abortions, 7 delivered preterm, 1 term delivery occurred. Majority of complications associated with U3 types (58.3%). Other types with complications are U4 (25%) and U2 (16.7%). Presenting features at emergency varied like mimicking ectopic, labour complications, ruptured corpus, placenta previa and accreta as well as iatrogenic perforation. Presence of congenital uterine anomalies have adverse effect on obstetrical outcome. Majority of complications are associated with U2, U3 &amp; U4. Probably U1 doesn’t interfere with ongoing pregnancy and U5 fails to continue pregnancy. This knowledge warrants the need for a larger case control study to extrapolate these findings to the general population and also to recommend the need for universal Prenatal Screening for uterine anomalies so as to improve the obstetrical outcome in patients with uterine anomalies.

STUDY OF ENDOMETRIAL PATHOLOGY IN ABNORMAL UTERINE BLEEDING

Objective: Endometrial pathology is becoming the most common issue that affects women of reproductive age group worldwide. AUB encompasses a wide variety of presentations, for example, frequent menstrual cycles, frequent and heavy cyclical bleeding, irregular bleeding, and postcoital bleeding. This study was done to evaluate the endometrial causes of AUB and to determine the specific pathology in different age groups.&#x0D; Methods: This study was a prospective cross-sectional study conducted on 200 patients from January 2023 to October 2023 in the department of pathology in a reputed teaching hospital and research centre. All the endometrial biopsies/curretages and hysterectomy specimens sent for Histopathological examination with history of AUB were included in the study.&#x0D; Results: Age of the patients with AUB ranged from 17 to 71 y in our study. Out of 200 cases, 90 cases (45%) were seen in Perimenopausal group followed by 68 cases (34 %) in Reproductive age group and 42 cases (21%) in Postmenopausal age group. Menorrhagia was the most common bleeding pattern seen in 54% pf patient with AUB. In 28% in reproductive age group, hormonal imbalance was observed in 13% of reproductive age group and 6% in perimenopausal age group. Atrophic endometrium was observed in 7.5% of women in post-menopausal age group. Chronic endometritis was seen 3% of reproductive age group.&#x0D; Conclusion: Abnormal uterine bleeding in women belonging to different age group show variable endometrial pattern on histopathological examination. They are valuable in early detection of pre-cancerous endometrial lesions as well as malignancy.

Clinical and pathological study of patients with fibrocystic disease of breast in tertiary care hospital of Gurugram, Haryana

A fibrocystic breast disease group of benign breast diseases that consists of fibrocystic breast disease, breast cyst, breast abscess, duct ectasia, cyclic and non-cyclic mastalgia, Gynaecomastia and Mondor's disease. Abnormal hormonal balance and cellular interactions mediated growth factors leading to ductal and cellular hyperplasia is the main pathophysiological cause of the disease. This prospective observational study was conducted on 100 SGT medical college and hospital patients from January 2021 to august 2022 to assess the detailed clinicopathological study of patients with fibrocystic disease breast diagnosed clinically with relevant investigations. In our study, we found that fibroadenoma is the maximum among all Fibrocystic breast diseases, i.e. 34%, with the majority between 11-30 years. It rises in the 2 decade of life and peaks in the 4 decade. Non-cyclic mastalgia constituted 29% of the total cases, with most patients lying in the age group of 31-50 years, where mastalgia was the presenting complaint in most cases. Inflammatory breast diseases formed 4% of the total, with the main presenting symptoms being mastalgia, fever and nipple discharge. Again, it mainly included patients from the age group of 31-50 years. Gynaecomastia and breast abscess were diagnosed in 3 cases, with all lumping on the right side of the breast.Our study attempted to derivate the spectrum of breast diseases in different age groups among patients reporting to SGT medical college and hospital, SGT University, Gurugram, Haryana. Apart from the incidence of various fibrocystic diseases, various other facts were recorded. Benign breast lesions were recorded to comprise the bulk of the patients presenting with breast disorders and were maximum in the reproductive age group. Breast sclerosing adenosis should be identified by excluding the malignancy. Most Fibrocystic breast diseases have been managed conservatively.

Factors associated with modern contraceptive utilization among reproductive age women in Kenya; evidenced by the 2022 Kenyan demographic and health survey

BackgroundGlobally, sexual and reproductive health is a significant public health issue for women of the reproductive age group. A modern contraceptive method enables individuals and families to manage fertility by reducing unintended pregnancies, abortions, pregnancy-related morbidity, and death. A modern contraceptive method is a drug or medical treatment that prevents sexual activity from leading to pregnancy. However, there is limited reliable and updated data on factors associated with modern contraceptive utilization among reproductive-age women at the national level in Kenya. So, the major goal of this study was to evaluate factors associated with modern contraceptive utilization among women of reproductive age in Kenya at the national level, as evidenced by the 2022 Kenyan demographic and health survey.MethodsThe most recent datasets from the Kenyan Demographic and Health Survey were used for secondary data analysis. In all, 14,987 women of reproductive age participated in the investigation. Data for multivariable analysis on the factors influencing modern contraceptive utilization among Kenyan women of reproductive age can be obtained from the Kenyan Demographic and Health Survey. Finally, the odd ratio and percentages were presented along with their 95% confidence intervals.ResultThis study includes a total weighted sample of 14,987 reproductive-age women from the Kenyan demographic and health survey. Of the total contraceptive use, 90.1% of the study participants used modern contraceptives. Being married [AOR: 1.593, 95% CI (1.302, 1.948)], living in an urban area [AOR: 1.230, 95% CI (1.060, 1.428)], reading a magazine [1.002, 95% CI (0.921, 1.091)], listening to radio [AOR: 1.265, 95% CI (1.101, 1.454)], not breastfeeding [AOR: 1.296, 95% CI (1.114, 1.507), and having more than two children [AOR: 2.350, 95% CI (1.603, 3.445)] were the factors that promote modern contraceptive utilization. Conversely, having a history of terminated pregnancy [AOR: 0.767, 95% CI (0.657, 0.897), being Muslim [AOR: 0.566, 95% CI (0.418, 0.766)], and being in the 35–39 age range [AOR: 0.766, 95% CI (0.605, 0.971)] were all associated with a lower use of modern contraceptives.ConclusionCertain factors such as marriage, living in urban areas, having more than two children, having a female-led household, belonging to the middle class, reading magazines, listening to the radio, and not breastfeeding have a positive correlation with the use of modern contraceptives. Conversely, being a Muslim, aged between 35 and 39, and having a history of miscarriages are negatively correlated with the use of modern contraceptives. This indicates that addressing socioeconomic, geographic, and cultural barriers could improve the effectiveness of modern contraceptive.

Prevalence and Factors Associated with Sexually Transmitted Diseases Among Women of Reproductive Age Group at Fort Portal Regional Referral Hospital, Uganda

Sexually transmitted diseases are a significant public health concern in Uganda, particularly among women of reproductive age. This study aimed to determine the prevalence and factors associated with STDs among women of reproductive age at Fort Portal Regional Referral Hospital, Uganda. A cross-sectional study was conducted among 302 women of reproductive age attending the hospital’s outpatient department between August 2023 and November 2023. Data were collected using interviewer-administered questionnaires. Descriptive and logistic regression analyses were conducted to determine the prevalence and factors associated with STDs. The prevalence of STDs among women of reproductive age attending Fort Portal Regional Referral Hospital was found to be 27.2%. Factors significantly associated with STDs included being residence outside the city (adjusted odds ratio [aOR] 2.30, 95% confidence interval [CI] 1.21-4.38), age group 20-29 (aOR 2.42, 95% CI 1.05-5.57), having more than 3 sexual partners (aOR 2.13, 95% CI 1.19-3.80) and not using a condom during sexual intercourse (aOR 0.55, 95% CI 0.31-0.98). Additionally, women who reported an increased frequency of sexual activity were more likely to have current STDs (aOR 1.88, 95% CI 1.10-3.21). The prevalence of STDs among women of reproductive age at Fort Portal Regional Referral Hospital was high, and several factors were identified as significant predictors of STDs. These findings highlight the need for targeted STD prevention and control interventions, including increased STD screening, counselling on condom use, and promoting safe sexual practices among women of reproductive age in the region. Keyword: STDs, Productive age, Women, Condom, Sexual activities, Sexual partners.

Factors Influencing Utilisation of Family Planning Services at Fort Portal Regional Referral Hospital, Kabarole District in Western Uganda

Family Planning was defined by the World Health Organization as a voluntary and informed decision by an individual or couple on the number of children to have and when to have them. According to the 2013 WHO facts sheet on Family Planning, “it was achieved mainly through the use of various contraceptive methods and treatment of involuntary infertility. The intervention for family planning reveals a contraceptive prevalence of 43. 1% which was way below the national target of 50% by 2020. This leaves 4 in 10 sexually active Ugandan women not using any form of contraception, including 3 in 10 who express a desire to delay childbearing. This study intended to assess factors influencing the utilization of family planning services at Fort Portal Regional Referral Hospital, Western Uganda. A cross-sectional, descriptive and analytical hospital-based study design was used to get 174 men and women of the reproductive age group at Fort Portal Regional Referral Hospital based on the Fischer et al., (1990) formula and the targeted 100% response rate was obtained however due to knowledge gaps, not all questions were answered 100% but a valid percentage was considered for the questions answered. Self-administered questionnaires were used, data was entered and reviewed for faults using Microsoft Excel, and after transferred to STATA version 20 for analysis, presented in frequency and percentage charts and tables with P-values and Odds ratios and their respective Confidence intervals where necessary. According to the findings, the proportion of people who use contraceptives was 44.91%of the participants at Fort Portal Regional Referral Hospital in Western Uganda. In multivariate analysis, socio-demographic factors like the education level of respondents that was to say tertiary had a P-value of 0.004[COR(CI; 95%);1.00 (65-3.09)], place of residence that was to say urban had a P-value of 0.003[COR(CI; 95%); 1.94 (1.35-4.92)], obstetric factors like history of abortion had a P-value of 0.001[COR(CI; 95%); 2.15 (1.04-4.51)], and medical factors like HIV had a P-value of 0.028[COR(CI; 95%); 1.94 (1.35-4.92)], and were significant and considered for the discussion because they had a P-value of less than or equal to 0.05. The utilization of family planning services at Fort Portal Regional Referral Hospital remains low at 44.91% in comparison to the national target which is 50% as per Uganda. Similarly, socio-demographic factors like level of education and place of residency, obstetric factors like history of abortion and medical factors like HIV significantly influence the utilizationof family planning services at Fort Portal Regional Referral Hospital in Western Uganda. Keywords: Family Planning services, Contraceptive methods, Childbearing, Women, HIV.

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.&#x0D; Methods: We planned a prospective, randomized, controlled, and equivalence trial on the patients with Heavy menstrual bleeding (blood loss &gt; 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.&#x0D; 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.&#x0D; Conclusion: Conclusion shall be drawn after completion of the clinical study.

Colposcopic findings to study cervical changes in reproductive age group women using various contraceptives.

Colposcopy has a key role to play in see-and-treat programs for premalignant cervical lesions. The aim of the study/was to observe cervical changes with a colposcope using the Swede scoring system in fertile age group women using various contraceptives: conventional methods (barrier methods, coitus interruptus), oral contraceptives (OCPs), copper-T and bilateral tubectomy. The aim of the study was to observe and evaluate the colposcopic findings using the Swede scoring system for the diagnosis of premalignant/malignant lesions in reproductive age group women using various contraceptives. This was a prospective observational study, conducted among 200 women of reproductive age group using various contraceptives in a tertiary care institute in North India. PAP smear, direct visual examination, VIA (Visual Inspection with Acetic Acid) examination, colposcopic examination, and (biopsy if indicated) were done. The data were collected, and analysis was done using Microsoft Excel Office Software 2019 version 19.11 and epi info (CDC Atlanta) 7.23.1. Statistical analysis was done using percentages, mean, mode, median, standard deviation, Chi-square, Fisher's Test, and Anova Test. We found positive PAP (Papanicolaou test) smears in 61.50%, positive VIA examination in 9%, and positive findings in colposcopic examination in 28.50%, Swede score of 0-3 in 100% (0-91%, 1-2%, 2-6%, and 3-1%) and positive biopsy in 9% subjects. Malignant findings were observed in 1.00% of PAP smears. Colposcopic findings were CIN 1 (cervical intraepithelial neoplasia 1) in 8.5% and CIN 2 in 0.5% subjects. Swede score was zero in 91%, 1 in 2%, 2 in 6%, and 3 in 1% of subjects. HPE (histopathological examination) was chronic cervicitis in 8.50% and mild dysplasia/CIN 1 in 0.5%. No significant statistical associations between contraceptive choice and false-positive test results or disease prevalence was found in any group except Cu-T users p = 0.0184 (especially for CIN 2; p = 0.0109 and CIN 1 more in all groups than Cu-T users). Colposcopy had sensitivity 100%, specificity 91.46% (0/0 = 0%) PPV = 5.56%, NPV = 100%, Accuracy = 91.5% for detecting mild dysplasia/CIN-non-significant (p = 0.055). Our study had mainly low-grade lesions with 100% NPV. With increase in Swede Score, sensitivity increases but at the expense of specificity but it was statistically non-significant (p = 0.055). Our study may guide the rational use of colposcopy with Swede scoring for see-and-treat lesions, which is easy and with a low learning curve, as a tool for diagnosis but only in cases where indicated like unhealthy cervix because of the high rate of false-positive results. In low-grade lesions, it is highly useful to rule out the disease.

Ovarian torsion: A retrospective case series at a tertiary care center emergency department.

Ovarian torsion (OT) is a gynecological emergency that can have diverse clinical presentations makings its diagnosis especially challenging. Few studies exist in the literature describing the clinical presentation as well as the management of OT in the emergency department (ED). This study aims to describe the clinical presentation, physical examination, emergency management, radiographic and intraoperative findings, histopathology reports and the time-to-intervention metrics of OT cases presenting to the emergency room of our tertiary care center. Data was collected by a retrospective chart review of all OT cases that presented to our ED over a period of 1 year. A total of 20 cases were included in the final analysis. The incidence of OT in the ED was 157.4 per 100 000 visits of women in the reproductive age group. All patients were women of reproductive age, with a mean age of 27.3 years. A total of 15 patients (78.9%) presented within 24 hours of symptom onset. The most common presenting symptom was abdominal pain (95%, 19/20) with most localizing to the right lower quadrant (60%, 12/20), followed by nausea and vomiting (90%, 18/20). Almost all patients (95%, 19/20) required opioids for pain management. The majority (80%, 16/20) were diagnosed by ultrasound prior to surgery, whereas (20%, 4/20) went straight to surgery based on a high index of clinical suspicion. Among those who underwent ultrasound, ovarian cyst was present in (75%, 12/16) while (68.9%, 11/16) showed ovarian enlargement and (50%, 8/16) showed abnormal ovarian blood flow. All patients except one patient underwent operative management. Out of the 19 patients who underwent surgery, the majority of patients (94.7%, 18/19) had viable ovaries with the exception of 1 patient (5.3%) who required a salpingo-oophorectomy post ovarian detorsion. A total of 13 cases included histopathologic review of specimens out of which 6 (46.2%) had a mature cystic teratoma. The mean time from door to ultrasonography was 1.4 hours and from door to surgery was 11.4 hours. Our study provides valuable insights into the incidence, clinical presentation, physical examination, emergency management, ultrasonographic and intraoperative findings, histopathology reports as well as the time-to-intervention metrics of OT patients presenting to the ED.

Assessing the modifiable and non-modifiable risk factors associated with multimorbidity in reproductive aged women in India

BackgroundReproductive span is the foundation of every woman’s health in later life. India is currently facing a growing burden of multiple morbidities among the women in their reproductive age group which may further increase over the coming decades. The purpose of the present study aimed to identify different modifiable and non-modifiable risk factors affecting multimorbidity among the women in reproductive age group in Indian context.MethodsSecondary data were obtained from the Demography and Health Survey (DHS), conducted in India during 2019–2021. A total of 671,967 women aged 15–49 years were selected for this present study. Descriptive, association studies and multinominal logistic regression analyses were performed to accomplish the objectives.ResultsCurrently, 6.3% of total study participant’s reproductive age group women suffered from multimorbidity in India. Never consuming protein, fruits, vegetables and milk increase the chances of developing multimorbidity. Consumption of fried foods, aerated drinks and addiction towards tobacco and alcohol also has a greater influence on the prevalence of multimorbidity. The prevalence of multimorbidity is sharply increased with increasing age and Body Mass Index (BMI). Regionally, the prevalence of multimorbidity was found more among the women hailed from eastern and north-eastern India.ConclusionTo reduce the risk of developing multimorbidity, targeted interventions are needed in the form of educating every woman concerning the importance of having minimum health-related knowledge, maintaining healthy lifestyle, weight management and having proper and balanced diet.

Clinical spectrum study of female patients with benign breast diseases in surgery department of tertiary care centre

Background: Benign breast disorders are classified as congenital disorders, injury related inflammatory conditions infective conditions, aberration of normal differentiation and involution, duct ecstasies and congenital breast conditions such as inverted nipple etc. Aberration of normal differentiation and involution of breast consist of cystic nodularity, mastalgia, cysts and fibroadenoma. Methods: Aim of the study is to study the co-relation of clinical, pathological and radiological parameters in benign breast diseases and study detail the different modes of presentations of benign breast disease respect to age, marital status, religion, clinical features, menstruation, presentation of lump, diagnostic modalities used. Results: The 200 patients diagnosed with benign breast disease. Most of the cases belong to the age group of 20-29 years, fibroadenoma is the most common benign disorder in that age group followed by fibroadenosis. The presentation is breast lump without pain in most of the time. Conclusions: Benign breast disease occupy majority of the total breast diseases. Majority of the benign breast diseases occur in the reproductive age group with fibroadenoma as the most common lesion. Lump is the most common presentation of all of the benign breast diseases.

Facilitators of Skilled Birth Attendants’ Utilization in Government and Christian Health Association of Malawi Hospitals: A Cross-Section Study of Lilongwe Rural

Background: Every woman must have access to a Skilled Birth Attendant (SBA) for routine care and management of complications during labour, childbirth, and early postnatal period. SBA utilization has been identified as an essential approach of reducing maternal morbidity and mortality among reproductive age group of 15-49. Malawi as a developing country is also utilizing skilled birth attendants in an effort to reduce maternal death by 70 per 100,000 births. Report of 2020 from Demographic and Health Survey (DHS) on skilled birth attendants (SBA) revealed that Malawi was 89.8% by 2018, while Lilongwe District, the study area, was 67% of SBA utilization against a target of skilled birth attendant utilization of 95% by the year 2022. Purpose: To evaluate the facilitators of skilled birth attendants’ utilization in government and CHAM hospitals and their relationship to hospital delivery. Methods: This research used logistic regression test and quantitative cross-sectional approach. Questionnaires were used to collect data from December 2021 to February 2022 in 390 participants. The sampling techniques used were cluster and random sampling. Results: Based on logistic regression marital status (p=0.001, OR 14.56), pregnancy complication (p=0.000, OR 12.21), and ANC three times (p=0.010, OR 2.11) and four times (p=0.000 OR 0.76) were found to be significantly associated with hospital delivery. On the other hand ANC once (p=0.005, OR -2.33) and twice (P=0.008, OR -1.94) did not significantly influence utilization skilled birth attendants by pregnant mothers Conclusion: Based on the results, it is concluded that age from 15 to 30 and employment, marital status, education, complication, antenatal clinic, are the facilitators for pregnant mothers to utilize skilled birth attendant. These facilitators might be of importance for policy makers to consider when coming up with programs to increase skilled birth attendants utilization at rural area of Lilongwe District.

Association of Socio-demographic factors with Polycystic Ovarian Syndrome; A Comparative Study

Objective: To compare the association of Socio-demographic factors in Polycystic Ovarian Syndrome (PCOS) patients with healthy controls. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Biochemistry and Molecular Biology, Army Medical College, Rawalpindi, Pakistan, in collaboration with Department of Gynecology and Obstetrics PEMH, Rawalpindi, Pakistan from Apr to Aug 2023. Methodology: The study comprised 300 females within reproductive age groups. Participants were separated into two groups. Group-I included 150 diagnosed PCOS patients, and Group-II had 150 healthy females selected by non-probability purposive sampling. Results: The PCOS patients exhibit a higher mean weight than the control Group (p-value; 0.017). The comparison of PCOS patients and controls showed significant association with physical activity (p-value: 0.038), hirsutism (p-value: 0.010) and Ferriman-Gallwey score (p-value: 0.001) and consanguineous marriages (p-value: 0.076). Conclusion: This study underscores the significance of socio-demographic factors in the manifestation of PCOS in Pakistan, emphasizing the need for early diagnosis, intervention, and tailored healthcare strategies, particularly among young women.

Association between domestic violence and unintended, terminated pregnancy and complications during pregnancy among Indian women: Findings from nationally representative survey

BackgroundWomen experiencing domestic violence might have restrictions in the pregnancy-related decision-making and care-seeking process leading to adverse pregnancy outcomes. We explored the association between domestic violence and undesirable pregnancy events. Methods63,796 women aged 18–49 years covered under the domestic violence module of National Family Health Survey-5, 2019-21. Stratification and clustering in the complex sampling design of the survey were accounted in analysis. Using Poisson regression, prevalence ratio (PR) was reported to provide association of domestic violence with undesirable pregnancy events. ResultsPrevalence of undesirable pregnancy events was 25.0% (95%CI: 24.4%–25.7%) amongst women aged 18–49 years. Prevalence of unintended, terminated pregnancy and complications during pregnancy was 3.2%, 5.1% and 20.9%, respectively. Women aged ≥35 years, educated, unemployed, primi or multi parity, intimate partner/husband being uneducated, facing problem with access to healthcare, belonging to large number of household members (≥4) and poorest or poorer quintile had significantly higher chance of having undesirable pregnancy events. Sexual violence (aPR: 1.11, p = 0.02) had higher chance of having undesirable pregnancy events. ConclusionOne-fourth of reproductive-age group women had undesirable pregnancy events. Sexual violence was significantly associated with these events. Effective policy should protect women from domestic violence to promote maternal well-being.

Fertility with Ayurveda - A Single Case Study on Treatment of Primary Infertility due to Tubal Blockage with Polycystic Ovarian Syndrome

Infertility associated with Polycystic Ovarian Syndrome (PCOS) is a major cause of concern in the present generation among the reproductive age groups due to unhealthy lifestyles in the modern era. This is a case report of an infertile couple who had not been able to conceive for 4 yrs. The female was diagnosed with PCOS with left tubal blockage. The objective of the present treatment included Ayurvedic management of PCOS, ensuring regular ovulation and thereby helping to develop healthy pregnancy and successful childbirth. Based on Ayurvedic science this case was diagnosed as Vandhyatva (Infertility) due to Nashtartava (that can be related with Polycystic ovarian disease) And Tubal blockage that can be related with Artava Vaha Strotosangha. This research paper presents a case study of the effectiveness of a comprehensive Ayurvedic treatment approach involving Uttarbasti with Kasisadi Tail along with oral medicines i.e., Pushpadhanva Ras and Kanchnar Guggulu as major medications in the successful treatment of a primary infertility patient having history of Polycystic Ovarian Syndrome (PCOS) And Tubal blockage. In Ayurveda primary infertility can be correlated with Anapatya type of Vandhyatava and its causative factor PCOD can be correlated with Nashtaartava as per Sushrut and Pushpaghnijataharni as per Kashyap and tubal blockage as Sanga variant of Artavavaha Strotodushti. Treatment plan included both Shodhana (Purification) and Shamana (mitigation) therapies. The outcome of the Ayurvedic intervention was the conception of the patient within 1 year of treatment.

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.

Non-Communicable Diseases among Women of Reproductive Age Visiting the Department of Obstetrics and Gynecology of a Tertiary Care Hospital.

Non-communicable diseases are a significant cause of mortality worldwide, posing a substantial risk to women's health, as stated by the World Health Organization. In Nepal, a survey revealed that 10.5% of the population suffers from hypertension. The primary objective of this study was to determine the prevalence of non-communicable diseases among women of reproductive age visiting the Department of Obstetrics and Gynecology of a tertiary care hospital. A descriptive cross-sectional study was conducted at the Department of Obstetrics and Gynecology among women of reproductive age presented from 6 November 2023 to 6 January 2024. The data was retrieved from the medical record during 1 November 2023 to 1 December 2023. Ethical approval was taken from the Institutional Review Committee. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. The prevalence of non-communicable diseases was 608 (39.02%) (36.60-41.45, Confidence Interval). The mean age was 29.26±3.46 years. The most common non-communicable disease reported was hypertension 204 (33.55%) followed by chronic respiratory diseases 200 (32.89%) and diabetes mellitus 154 (25.34%). The prevalence of non-communicable diseases among women of reproductive age group was higher as compared to other studies done in similar setting. The study underscores the urgency for stakeholders to implement health education, early detection, and preventive strategies, emphasizing the necessity of targeted interventions and broader public health initiatives to address non-communicable diseases. chronic disease; non-communicable disease; prevalence; risk factors.

Patterns and management outcomes of intracranial extra-axial hematomas in low-resource setup: a 6-month prospective observational study at Jimma University Medical Center, Ethiopia

IntroductionIntracranial hematoma is the collection of blood in various intracranial spaces. Knowledge of patterns, origins, causes and outcomes of ICH conditions is important for decision-making for urgent surgical interventions such as craniotomy and hematoma evacuations. No prior study was conducted in our setup. Hence, this study aimed to assess the patterns and management outcomes of intracranial hematomas in low-resource setting and tailored our management approach at Jimma University Medical center.MethodsAn institution-based prospective observational study was conducted at Jimma University Medical Center, Ethiopia, for six consecutive months from June to December 2020. Different data sources and interview methods were used and analyzed using SPSS version 24. A bivariate and multivariate logistic regression was conducted to determine the association between the variables.ResultsA total of 91 eligible patients were recruited during the study period, with a mean age of 34 years. The majority of patients were males [73 (80.2%)] and more common in reproductive age groups (62.6%), from rural areas (50.5%). About 93.4% of patients reported a history of trauma, and road traffic accidents & fighting account for 63.8% of the trauma cases. Sixty-five percent of patients arrive in the hospital within 24 h. Upon presentation, there were loss of consciousness (48.4%), convulsion (11%), aspiration (9.9%) and increased ICP (12%). The majority (49.5%) of the patients had a mild head injury. The focal neurologic deficits were hemiparesis (29.7%) and hemiplegia (5.5%). Acute epidural hematoma (68.1%) was a common finding, followed by sub-acute subdural hematoma. Of the total study participants, 11% had died. All the surviving patients were accessed at 30 days after discharge and re-assessed, 66 patients had good neurologic recovery (62 upper and 4 lower good recovery), 11 patients had moderate disability (7 lower and 4 upper-moderate disabilities), two patients had a severe disability, and two patients (among those with severe disability) had died.ConclusionTrauma was invariably the cause of intracranial hematoma, and patients with low GCS, papillary abnormalities, aspiration and increased ICP had an increased risk of dying from their illness. It is good to formulate policies to enhance injury prevention and bring about health-oriented behavioral change.