Women In Age Group Research Articles

Hysteropathological Correlation in Abnormal Uterine Bleeding in a Tertiary Care Hospital in South India.

Abnormal uterine bleeding is a common problem mainly encountered in reproductive age group and post-menopausal women. Hysteroscopy is a safe, simple, well tolerated and reliable procedure for the diagnosis of AUB across all age groups. The aim of the study is to determine the association of hysteroscopy and histopathologic examination (HPE) findings in abnormal uterine bleeding. The secondary objective of the study are to enumerate the hysteroscopy findings in patients with AUB and to evaluate the pattern of AUB. Observational cross-sectional study among 60 women in reproductive and post-menopausal age group presenting with features/symptoms suggestive of abnormal uterine bleeding were studied. All patients reporting in the outpatient department (OPD) and who are eligible to participate were included in the study, after obtaining written informed consent. Detailed history, Clinical examination, Ultrasound pelvis and endometrial thickness assessment is done. Hysteroscopic findings were compared against histopathological findings. The various patterns of bleeding documented in our study population were menorrhagia, metrorrhagia, menometrorrhagia, polymenorrhea, and post-menopausal bleeding. Out of these patterns, the commonest was menorrhagia at 50.0% and post-menopausal bleeding at 26.67%. In our study population, the various hysteroscopy findings were strawberry, tongue-shaped projections, pebble stones, polypoidal patterns, and cerebroid patterns. Out of these, the most common was a polypoidal pattern, strawberry pattern, and tongue-shaped projections with 45%, 31.67%, and 26.7%, respectively. The most common histopathology finding was secretory and proliferative constituting 35% and 26.67%, respectively. Carcinoma endometrium constitutes about 6.67% of the study population. The sensitivity, specificity, PPV, and NPV of strawberry appearance in hysteroscopy in comparison with secretory changes in histopathology were 52.38%, 79.49%, 57.89%, and 75.61%, respectively. The sensitivity, specificity, PPV, and NPV of tongue-shaped projections appearance in hysteroscopy in comparison with HPE findings was 60%, 76.36%, 18.75%, and 95.45%, respectively. The sensitivity, specificity, PPV, and NPV of polypoidal pattern in hysteroscopy in comparison with Endometrial hyperplasia in histopathology was 66.67%, 56.14%, 7.41%, and 96.97%, respectively. The sensitivity, specificity, PPV, and NPV of cerebroid appearance in hysteroscopy in comparison with carcinoma endometrium in histopathology were 75.0%, 100%, 100%, and 98.25%, respectively. This correlation of cerebroid pattern with carcinoma endometrium was highly significant. Among all correlations, the highly reliable was in Carcinoma endometrium followed by endometrial polyps. Hysteroscopy has high sensitivity and specificity in diagnosing intrauterine pathology especially endometrial cancer followed by endometrial polyps. Among the various patterns of abnormal uterine bleeding, menorrhagia was the most common. A combination of hysteroscopy and endometrial sampling was found to increase diagnostic accuracy in patients with abnormal uterine bleeding and will effectively guide us in planning the appropriate management for these patients.

Percutaneous laser coagulation of dilated intradermal veins: from theory to practice

Review authors consider the current possibilities of percutaneous laser coagulation for telangiectasias and reticular veins, which are the most common cosmetic defects of vascular genesis, occurring in more than 80% of women of different age groups. This vascular pathology constituting an aesthetic defect and causing local physical discomfort is one of the most common indications for phlebosclerosing therapy and percutaneous laser coagulation. The authors present the most effective and safe guidelines for percutaneous laser coagulation based on analyses of a large volume of specialized literature. Due to the use of state-of-the-art Nd:YAG lasers, percutaneous laser coagulation is increasingly used in patients with various types of intradermal vein lesions and, owing to high efficiency and safety, has advantages over compression sclerotherapy by several criteria. Nd:YAG lasers can be divided into long- and short-pulse ones according to their technical characteristics. Long-pulse lasers provide coagulation of the target vessel due to a single pulse with a high energy density (fluence), while short-pulse lasers, on the contrary, generate a series of pulses to the target vein with a running time of fractions of a millisecond, which ensures the conversion of hemoglobin into methemoglobin with a ten-fold increased ability to absorb laser energy and convert it to heat. As the duration of the pulses generated by the device is a priori shorter than the thermal relaxation time, the risk of burns to the skin and paravasal structures almost completely disappears. The authors provide clinical examples of the application of Aerolase Neo device that utilizes MicroPulse technology to confirm the effectiveness and safety of shortpulse Nd:YAG lasers.

Indicators of free radical oxidation in neutrophils of patients with primary and recurrent soft tissue sarcomas

Purpose of the study. To carry out a comparative analysis of lipid peroxidation intensity and antioxidant system indices in blood neutrophils of patients with primary and relapsed soft tissue sarcomas (STS) depending on sex and age.Patients and methods. Of the 81 patients included in the study, 48 had primary STS, 5 patients with continued growth, and 28 patients with recurrent STS. The patients were divided by sex and age; the level of lipid peroxidation products, superoxide dismutase (SOD) activity, total peroxidase activity (TPA), glutathione peroxidase (GPx) activity and reduced glutathione (RG) content in blood neutrophils were investigated by conventional spectrophotometric methods. The comparison groups (donors) consisted of 12 men and 17 women divided into the same age subgroups: ≤ 45 years and > 45 years.Results. In donors, there was a multiple decrease in the SOD/TPA ratio with age, especially in women, and in men this was accompanied by an age-related decrease in GPx activity. In primary sarcomas in older women and in men with continued growth and recurrence, there was an increase in diene conjugates (DC). In men over 45 years of age, there was an increase in SOD, TPA, and GPx. Women of the older age group were characterized by activation of SOD and GPx, expressed in the relapsed process to a significantly greater extent than in men, and an increase in RG was observed in women. The increase in both components of the glutathione system and SOD activity was especially significant in the development of relapses in women for periods exceeding three years, which was accompanied by a decrease in DC content. Conclusions. Neutrophils are characterized by an increase in DC content in patients of both sexes in the older age group with primary and recurrent STS, with its highest content in men with continued growth and relapses. GPx activity, increased in both men and women in the older age group in all variants of STS development, may play an important role in the antioxidant protection of blood cells in STS. Thus, the most pronounced activation of GPx, accompanied by a maximum increase in reduced glutathione and activation of SOD, contributes to a decrease in the level of DC and the absence of MDA increase in women with slow development of recurrences.

A Study to assess the Knowledge and Attitude of women regarding MCH services in selected Urban and Rural areas, Rajahmundry

Maternal and Child health services deliver health care to a special population vulnerable to disease, disability, and death. These groups are women in the reproductive age group (15-45years) and children under the age of five years. These groupscover 31.6% of the total Indian population. The study aims to describe and compare the knowledge and attitude of women in selected urban and rural areas regarding MCH services. A community-based comparative descriptive cross-sectional survey was conducted among 60 women, each of 30 from urban and rural areas. Participants were selected for the study by non-probability convenient sampling technique. The data was collected by using a structured questionnaire consisting the items related to knowledge of MCH services and a Likert scale was used to assess the attitude of women towards MCH services. The collected data were analyzed by using descriptive and inferential statistics. The result showed that the majority (60%) of rural women had moderately adequate knowledge and 66.7% of women in urban areas had adequate knowledge. With regard to the attitude of the women in rural areas, the majority 90% had positive attitudes and 10% had negative attitudes. In urban areas, the majority 96.7% hada positive attitude and 3.3% hada negative attitude. The knowledge mean score was 17.76 in rural women and 19.1 in urban women. The mean attitude score was 47.2 and 50.2 respectively in rural and urban women regarding MCH services, which elicited that there was no significant difference in knowledge and attitudes of urban and rural women regarding MCH services.

Nationwide analysis of neuromyelitis optica in systemic lupus erythematosus and Sjogren's syndrome.

Neuromyelitis optica (NMO), also known as Devic's disease, is a rare inflammatory demyelinating disorder causing myelitis and optic neuritis. While there have been reports of systemic lupus erythematosus (SLE) and primary Sjogren's syndrome (SS) occurring with NMO, a formal association is not established. We aimed to investigate the occurrence of NMO in SLE and SS patients and study the clinical characteristics and outcomes of NMO and SLE/SS hospitalizations utilizing the national inpatient sample (NIS) database. The NIS database from 2016 to 2019 was used to extract data. Adult hospitalizations with the principal or secondary diagnosis of NMO were included. We classified NMO patients with and without concomitant diagnosis of SLE or Sjogren's syndrome. We evaluated and compared the clinical characteristics and outcomes of NMO hospitalizations with and without SLE or Sjogren's syndrome. STATA17 was used for data analysis. We also calculated the odds ratio of NMO in SLE and Sjogren's syndrome. There were a total of 16,360 adult hospitalizations with the principal or secondary discharge diagnosis of NMO. Among all NMO hospitalizations, 1425 (8.71%) had the primary or secondary diagnosis of SLE or SS. The odds of NMO in SLE and Sjogren's syndrome were noted to be 12.29 and 5.56, respectively. NMO with SLE/SS group had higher proportion of females (89.82% vs 79%, P value < 0.001), African Americans (56.63% vs 38.28, P value < 0.001), and Asians (5.73% vs 3.25, P value 0.04). The Charlson comorbidity index was higher for NMO-SLE/SS overlap (2.44 vs 1.28, P value < 0.001). There was no significant difference in overall mortality rates of both groups (2.11% vs 1.2%, P value 0.197). There were significantly higher reported seizures (14.73% vs 6.05, P value < 0.001) and paraplegia (21.75% vs 13.93%, P value < 0.001) in NMO-SLE/SS patients. These patients also had a longer length of stay in comparison to the reference group (7 vs 5 days, P value < 0.001) as well as higher total charges. NMO patients had a 12-fold higher risk of SLE and 5-fold higher risk of Sjogren's disease when compared to general population. Patients with overlap of NMO and SLE or Sjogren's were predominantly women and were more likely to be African-American. Co-existence of these autoimmune disorders was associated with poor prognosis in terms of higher morbidity for patients and increased health care burden. Key Points • NMO is a rare autoimmune disease seen predominantly in women in the middle age group with low overall mortality. • SLE and Sjogren's have increased odds of NMO in comparison to general population. • NMO patients have high rates of several complications such as paraplegia, quadriplegia, seizures, blindness, sepsis, and respiratory failure with even higher rates of seizures and paraplegia in those with concomitant SLE or Sjogren's.

The state of the cytokine system in women of different ages

The article presents the results of a study of the cytokine profile of venous blood serum of 100 practically healthy women of different age groups (IL-1, TNF-, IFN-, IL-4 and IL-10), conducted by the sandwich variant of solid-phase enzyme immunoassay. The relative prevalence of Th 1 type of response in practically healthy women in old age is shown, which reflects the intensity of immune reactions against intracellular pathogens and indicates an increase in delayed hypersensitivity processes. The identified features require further study, including taking into account hormonal regulation.

Comprehensive Knowledge about HIV/AIDS among Women of Reproductive Age in India.

HIV/AIDS has been a major threat to global public health, with India ranking third when it comes to the global burden of people living with HIV, especially women. It is imperative to assess the level of knowledge women have about transmission and prevention of this infection. This study sought to delineate the determinants of the comprehensive knowledge of HIV/AIDS among women in the reproductive age groups in India. Data from the fifth round of the National Family Health Survey conducted in India were analyzed. The sample included 95,541 women aged 15-49 years. Multilevel logistic regression was fitted with individual characteristics, household characteristics, and community characteristics to identify determinants of comprehensive knowledge on HIV/AIDS. Nearly a fourth (24.8%) of the women aged 15-49 in India who had ever heard of HIV had comprehensive knowledge of HIV/AIDS. Multilevel logistic regression showed that the likelihood of comprehensive knowledge of HIV/AIDS was higher among women aged 40-44 (AOR = 1.57) and 30-34 (AOR = 1.56). The likelihood of having comprehensive knowledge increased with the increase in the level of education. Women with secondary and higher levels of education were 1.9 times and 3.38 times more likely to have comprehensive knowledge, respectively, than those with no education. Household wealth, access to mass media, and having ever tested for HIV were also significant determinants of comprehensive knowledge of HIV/AIDS among women. The odds of having comprehensive knowledge about HIV/AIDS were higher for women with higher community wealth (AOR = 1.31), higher community education (AOR = 1.09), and higher community employment (AOR = 1.12). Factors at both the individual and community levels were shown to be indicators of comprehensive knowledge of HIV/AIDS. Policymakers and public health practitioners in India should come up with plans to close the information gaps about HIV/AIDS that exist among women and their demographic subgroups.

Role of Vitamin D in the treatment of polycystic ovarian syndrome: A systematic review

8–13% of women in the reproductive age group are affected by Polycystic ovary syndrome (PCOS) and around 70% of cases stay undiagnosed worldwide. It is one of the most common causes of infertility nowadays. Polycystic ovarian morphology, hyperandrogenism, and ovulatory dysfunction are traits of PCOS. Insulin resistance is the primary finding in the pathophysiology of PCOS.Vitamin D is a fat-soluble vitamin that can be found as a dietary supplement. Hypovitaminosis is a risk for glucose intolerance so it has been found that supplementing vitamin D in females with PCOS lowers insulin resistance, total testosterone, and androstenedione levels and improves pressure profiles. Obese PCOS patients have been found to have lower vitamin D levels than PCOS patients who are not obese. This review aims at the pathophysiology of PCOS and the role of Vitamin D supplementation in PCOS patients.A literature search was performed to identify all relevant studies on PubMed, Google Scholar, Crossref, Medline, and Cochrane. The keyword used were; “Vitamin-D”, “Polycystic ovary syndrome (PCOS)”, “fertility”, “insulin resistance”, and “androgen hormones”. All relevant articles including review articles, original articles, case series, and case reports were reviewed.It was found that Vitamin D supplementation has beneficial effects on reproductive outcome, metabolic abnormalities and regulating menstrual cycle in PCOS patients. Understanding importance of Vitamin D level in treating PCOS patient is of great clinical significance in preventing disease progression.

THE RELATIONSHIP BETWEEN GESTATIONAL DIABETES MELLITUS (GDM) AND VITAMIN D DEFICIENCY IN PREGNANT WOMEN WITH A BMI BELOW 30 KG/M²

In this study, we aimed to investigate the relationship between vitamin D deficiency and Gestational Diabetes Mellitus (GDM) in women with no significant risk factors for developing GDM. After obtaining approval from the Dubai Scientific Research Ethics Committee, a retrospective cross-sectional study was conducted at the Primary Health Center of the Dubai Health Authority. The electronic medical records system collected data from 200 pregnant women with a BMI of less than 30 kg/m2 who had completed the oral glucose tolerance test (OGTT) and had their vitamin D levels measured between weeks 24 and 28 of gestation. The women were divided into two groups using a random sample procedure. Group A consisted of women with normal serum 25(OH) D concentration (&gt;30.0 ng/mL), while Group B consisted of women with low serum 25(OH) D concentration (&lt;30.0 ng/mL for insufficiency and &lt;10.0 ng/mL for deficiency). The data collected were analyzed using SPSS version 28. Out of the 200 women who met the inclusion criteria, 58 were primigravida (29%), 122 were multigravida 1-3 (61%), 15 were multigravida 4-6 (7.5%), and 5 were multigravida &gt;6 (2.5%). The average age of women in Group A was 24.5±2.4 years, while in Group B, it was 25.0±2.2 years. The average BMI of women in Group A was 26.6±1.5, while in Group B, it was 26.8±2.5. The study's results revealed that 12% of the women in Group A and 20% in Group B developed GDM (p= &lt;0.01). Our data analysis showed a positive correlation between low vitamin D levels and the development of GDM. However, further large-scale randomized controlled studies are required to establish a causal association between low vitamin D levels and GDM.

Sex differences in the age-related decrease of spontaneous baroreflex function in healthy individuals.

The baroreflex is a powerful physiological mechanism for rapidly adjusting heart rate in response to changes in blood pressure. Spontaneous baroreflex sensitivity (BRS) has been shown to decrease with age. However, studies of sex differences in these age-related changes are rare. Here we investigated several markers of spontaneous baroreflex function in a large sample of healthy individuals. Cardiovascular signals were recorded in the supine position under carefully controlled resting conditions. After quality control, n = 980 subjects were divided into five age groups [age < 30 yr (n = 612), 30-39 yr (n = 140), 40-49 yr (n = 95), 50-59 yr (n = 61), and >60 yr (n = 72)]. Spontaneous baroreflex function was assessed in the time domain (bradycardic and tachycardic slope) and in the frequency domain in the low- and high-frequency band (LF-α, HF-α) applying the transfer function. General linear models showed a significant effect of factor age (P < 0.001) and an age × sex interaction effect (P < 0.05) on each indicator of the baroreflex function. Simple main effects showed a significantly higher BRS as indicated by tachycardic slope, LF-α and HF-α in middle-aged women compared with men (30-39 yr) and higher LF-α, bradycardic and tachycardic slope in men compared with women of the oldest age group (>60 yr). Changes in BRS over the lifespan suggest that baroreflex function declines more slowly but earlier in life in men than in women. Our findings could be linked to age-related changes in major sex hormone levels, suggesting significant implications for diverse cardiovascular outcomes and the implementation of targeted preventive strategies.NEW & NOTEWORTHY In this study, we demonstrate that the age-related decrease of spontaneous baroreflex sensitivity is different in men and women by analyzing resting state cardiovascular data of a large sample of healthy individuals.

Incidence of cardiovascular diseases over the past 20 years - a population-based study in 22 million individuals

Abstract Background The incidence of atherosclerotic diseases has declined considerably since the early 2000s but the extent to which these reductions have occurred in different subgroups of patients is unknown. Whether there have been similar changes in the incidence of other cardiovascular diseases is also uncertain. Methods We used linked primary and secondary electronic health records of 22 million individuals from the Clinical Practice Research Datalink (CPRD), a cohort that is representative of the UK population in terms of age and sex. We calculated the incidence of 10 cardiovascular diseases from 2000 to 2019 and used Poisson regression models to investigate temporal trends and variation by age, sex, and socioeconomic status. Findings: Among the 22 009 375 individuals included in the study, we identified a total of 2 015 280 patients with a new diagnosis of at least one cardiovascular disease between 2000 and 2019 (mean (SD) age: 68.7 (16.8) years, 49% women). Collectively, the incidence of all 10 cardiovascular disorders (standardised by age and sex) decreased by 8% over the study period (incidence rate ratio (IRR) comparing 2017-2019 vs 2000-2002: 0.92 [0.92, 0.93]). The incidence of ischaemic heart disease and stroke decreased by about 30% over the study period (IRR comparing 2017-2019 vs 2000-2002: 0.72 [0.72, 0.73] and 0.73 [0.72, 0.74] for ischaemic heart disease and stroke, respectively), yet these improvements were largely restricted to older age groups and no improvements were observed in the incidence of atherosclerotic disease before the age of 60 years. The reductions in atherosclerotic diseases were also paralleled by a rising number of diagnoses of cardiac arrhythmias, valve disease, and thromboembolic diseases, which increased considerably over the 20 years studied (Figure 1). Most cardiovascular disorders were more common in men than in women of the same age. However, the overall crude incidence of cardiovascular diseases was similar in men and women, due to the higher number of women in older age groups. A socioeconomic gradient was evident across all cardiovascular diseases, did not decrease over time, and was most important for peripheral arterial disease (IRR most deprived compared to least deprived: 1.56 [1.55, 1.58]), heart failure (1.50 [1.49, 1.51]) and ischaemic heart disease (1.48 [1.48, 1.49]) (Figure 2). Interpretation: Despite important improvements in the prevention of atherosclerotic diseases, the overall burden of cardiovascular diseases remains very high. Further improvements in cardiovascular disease prevention may need to consider the broader spectrum of cardiovascular diseases, such as arrhythmia, valve diseases, and thromboembolic diseases, and examine the specific needs of younger age groups and socioeconomically deprived populations.Figure 1Figure 2

Asthma care during pregnancy in South Asia

Bronchial asthma is among the commonest chronic inflammatory respiratory diseases affecting women of reproductive age group. Adequate attention has not been given to the diagnosis and the management of asthma in countries of South Asia. Management of asthma in pregnant women is more or less same as that of in non-pregnant women and stepwise approach is recommended. To confirm the diagnosis of asthma during pregnancy, spirometry can be used. Patients suffering from very severe asthma or difficult-to control asthma are more prone to develop exacerbations during pregnancy needs hospitalization for care. Well-controlled asthma during pregnancy prevents complications of pregnancy and results in better pregnancy outcomes. It better to follow the guidelines for management of asthma during pregnancy. The pregnant women must be educated regarding the care of asthma during pregnancy, delivery, in postpartum period and thereafter.

Risk and Protective Factors for COVID-19 Infection Among Pregnant Women with Sickle Cell Trait

BACKGROUND: Pregnant women and individuals with sickle cell trait (SCT) and underlying comorbidities are more vulnerable to severe illness from the coronavirus disease of 2019 (COVID-19) compared to nonpregnant women and those without SCT (PMID: 35916859, 34129519). However, the impact of the pandemic and factors affecting susceptibility to COVID-19 among pregnant women with SCT is unknown. This study aims to examine various factors that can alter the likelihood of COVID-19 among pregnant women with SCT, including vaccination against COVID-19 and influenza and the presence of underlying comorbidities such as cardiac disease, diabetes, obesity, renal disease, and stroke. In addition, the study aims to provide insights into the fetal outcomes among pregnant women with SCT who have contracted COVID-19. METHODS: A total of 295 individuals with the diagnosis of SCT who had encounters at three large hospitals in Michigan from January 1, 2022, to December 31, 2022, were screened in this retrospective study. 151 women with SCT met the inclusion criteria and are within the reproductive age group between 15-49 years old. Demographics, underlying comorbidities, fetal outcomes, and other clinical information were collected by electronic medical records review. COVID-19 and influenza vaccination were verified from the immunization records registry in Michigan. Multivariable regression analysis was used to analyze the protective or risk factors associated with COVID-19 infection. Statistical analyses were performed using the SPSS version 29 statistical software, and a p-value of &amp;lt;0.05 was considered statistically significant. RESULTS: Data was collected from 151 women with SCT, with 34% being pregnant and 66% being non-pregnant. Approximately 85% of the participants were Black, and their mean age was 32 years. 35% contracted COVID-19 among pregnant women, while 31% among non-pregnant women (p&amp;gt;0.05). In a multivariable regression analysis, the study found that pregnant women with SCT who received COVID-19 vaccine were 90% less likely to have a COVID-19 infection (OR=0.102 with 95%CI: 0.011-0.950) and 9 times more likely to have a COVID-19 infection if they had a history of pulmonary conditions such as asthma, chronic obstructive pulmonary disease, or obstructive sleep apnea (OR=9.375 with 95% CI: 1.090-80.627). There were no other protective or risk factors that showed a significant statistical association with COVID-19 infection among pregnant women, including influenza vaccination, obesity, underlying cardiac history, diabetes mellitus, renal disorder, stroke, or transient ischemic attack (p&amp;gt;0.05). Most pregnant women with SCT who contracted COVID-19 in the study had mild-moderate disease, except for one patient who developed severe disease in the third trimester, warranting premature delivery of an infant via emergency cesarean section. 72% did not have fetal complications, except for 3 newborns who were delivered preterm (&amp;lt;37 weeks) and 2 with low birth weight (&amp;lt;2500 grams). While 2 newborns initially had a low Apgar score (APGAR&amp;lt;7) at 1 minute, their condition eventually improved after 5 minutes. Overall, all newborns delivered to COVID-19-infected women with SCT had a good 5-minute Apgar score. CONCLUSION: The study further emphasizes the importance of encouraging COVID-19 vaccination among individuals with SCT, particularly pregnant, reproductive age group women and those with underlying comorbidities. Pregnant women with SCT and underlying comorbidities should be carefully monitored to prevent severe disease, as they may be more vulnerable to COVID-19 infection. Further studies with larger sample sizes are recommended to investigate factors associated with severe COVID-19 infection among these populations.

Epidemiology of female infertility in Sonepat district of Haryana: a community based cross-sectional study

Background: Infertility is a global reproductive health problem and the prevalence rate increased by 0.37% per year for females. There are many such risk factors which are avoidable. Thus the purpose of the study is to identify and quantify the burden of infertility and associated risk factors for infertility. Methods: This observational community based cross-sectional study was conducted among 444 reproductive age group (18-49 years) women residing in district Sonepat, from August 2021 to May 2022. Simple random sampling technique was used to select the study subjects. The categorical data were analyzed statistically using Chi-Square test and Odds ratio with 95% confidence interval. Continuous variables were analyzed using independent t-test. Results: Out of 444 study population majority of women were fertile (88.7%), while 6.3% of women were secondary infertile and 5% women were primary infertile. Most women were aged between 30-39 years. The difference of occurrence of infertility in relation to time since marriage, male age at marriage, number of family members, thyroid, PCOD, tuberculosis and height were statistically significant. Conclusions: Almost all the factors came out to be responsible for infertility were modifiable. Awareness generation and provision of infertility care services at primary health care facilities will be of use in addressing infertility in Haryana.

Structure-Activity Relationship and Biological Investigation of a REV-ERBα-Selective Agonist SR-29065 (34) for Autoimmune Disorders.

Autoimmune diseases affect 50 million Americans, predominantly women, and are thought to be one of the top 10 leading causes of death among women in age groups up to 65 years. A central role for TH17 cells has been highlighted by genome-wide association studies (GWAS) linking genes preferentially expressed in TH17 cells to several human autoimmune diseases. We and others have reported that the nuclear receptors REV-ERBα and β are cell-intrinsic repressors of TH17 cell development and pathogenicity and might therefore be therapeutic targets for intervention. Herein, we describe detailed SAR studies of a novel REV-ERBα-selective scaffold. Metabolic stability of the ligands was optimized allowing for in vivo interrogation of the receptor in a mouse model of multiple sclerosis (EAE) with a ligand (34). Reduction in frequency and number of T-cells in the CNS as well as key REV-ERB target genes is a measure of target engagement in vivo.

Tobacco use and outcomes of pregnancy: A community-based cross-sectional study among the women in the reproductive age group in the rural area of Belgaum District, Karnataka, South India

Exposure to tobacco smoke affects all stages of human reproduction. Smoking is not rare among Indian women, but research over the past decade has shown that Indian women’s use of smokeless tobacco products is substantial and increasing, with negative consequences for both oral morbidity and perinatal health, including premature delivery, low birth weight, and birth length. This study was done to know the prevalence of tobacco consumption among rural women in the reproductive age group and its association with the outcomes of pregnancy A community-based cross-sectional study, was conducted from January 2011 to December 2011 among 1200 rural women aged between 15 years to 49 years residing in Primary Health Centre (PHC) Vantmuri area, Belgaum, Karnataka, India. Statistical analysis was done using rates, ratios, and chi-square tests. The prevalence of tobacco consumption was 9.7%. In this study, we found that except for the first pregnancy outcomes, and all the subsequent outcomes of the pregnancies, the differences are statistically significant indicating an association between tobacco consumption and the outcome of pregnancy. Also, a significant association was found between tobacco consumption and low birth weight. Women under the reproductive age group constitute an important cohort of the population. A significant association was found between tobacco consumption and the outcomes of pregnancy. It has become the need of the hour to provide enough evidence on the correlates of tobacco use in the community and to put increasing effort against the expansion of tobacco companies in developing countries, which are often aimed at women.

Impact of Risk Minimisation Measures on Valproate Use among Women of Reproductive Age in Latvia Between 2013 and 2020: A 7-Year Nationwide Prescription Database Study.

A relevant safety concern for the use of valproate (VPA) in women of reproductive age is its teratogenicity. In 2014 European Medicines Agency (EMA) introduced risk minimisation measures (RMMs) to reduce the VPA use by women of reproductive age, where the impact on VPA use was not as large as expected. In 2018, the EMA introduced additional RMMs, and it is essential to assess impact of these interventions. The objective of this study was to evaluate the impact of the EMA-published RMMs in 2014 and 2018 on the prevalence of VPA use and to describe trends in the prevalence rate and incidence proportion of VPA use in epilepsy, bipolar disorder and off-label indications in Latvia. This was a nationwide population-based study using a primary care prescription database. The study included women in age groups <15, 15-49 and >49years and men in age group 15-49years who have received VPA. This study assessed the prevalence rate and the incidence proportion of VPA use. The impact of RMMs on the two study intervention periods [fourth quarter (Q4) 2014 and Q4 2018] in men and women was evaluated using causal impact analysis. In the study cohort, VPA use in women in the age group 15-49years decreased after the first and second intervention periods, where after the first intervention period the relative reduction in prevalence of VPA consumption was -7.7 [95% confidence interval (CI) -10%, -5.1%] and after both study periods -6.4% (95% CI -11%, -1.5%). In girls <15years of age, valproate use decreased after both intervention periods, while in women >49 years old VPA use increased. In men aged 15-49years, an increase after the first period and a non-significant decrease after both intervention periods was observed. The prevalence of valproate use in girls <15years and women 15-49 years of age with bipolar disorder, epilepsy and off-label indications decreased per 1000 people during the study period. The incidence proportion of VPA use in women aged 15-49years decreased each year since the beginning of the study period. A statistically significant decrease in the prevalence of VPA use was identified among girls <15 years and women 15-49years of age. In Latvia, an overall good reaction to the EMA RMMs was observed. The effects go beyond the target population and affect the use of VPA in young girls as well.

Arterial hypertension and stiffness in women of different age groups and reproductive status

Objective: study of the relationship between arterial hypertension and arterial stiffness in women to identify potential markers of target organ damage and therapeutic targets of antihypertensive therapy.Materials and methods: the study involved 161 women who were divided into three groups depending on age and reproductive function. Group 1 consisted of 52 women aged 18 to 30; group 2 – 54 women aged 31 years before menopause; 3rd group – 55 women in the postmenopausal period. All women were questioned, clinical examination, determination of anthropometric data, measurement of carotid-femoral pulse wave velocity, determination of arterial stiffness by volumetric sphygmography, 24-hour blood pressure monitoring with assessment of aortic stiffness and characteristics of the central pulse wave.Results: 24-hour blood pressure monitoring revealed arterial hypertension in 38 (34,8%) women: 15 (27,8%) women in the 2nd group and 23 (41,8%) women in the 3rd group. Correlation analysis revealed the most significant correlations between the presence of arterial hypertension (R=0,45-0,71; p&lt;&lt;0,01) with central aortic pressure, double product index and average daily aortic pulse wave velocity in the aorta (PWVao), regardless of the state reproductive function. For women of reproductive age with arterial hypertension, the ambulatory vascular stiffness index (AASI: R=0,36; p=0,01) is more significant, while in the menopausal period, the arterial stiffness index (ASI: R=0,33; p=0,01). Correlation analysis did not reveal significant relationships between carotid-femoral pulse wave velocity and cardio-ankle vascular index (CAVI) with arterial hypertension in women of the 2nd and 3rd groups. The relationship between carotid-femoral pulse wave velocity and arterial hypertension in women was confirmed by analysis of variance (p=0,007).Conclusion: Central aortic pressure, carotid-femoral pulse wave velocity, AASI, ASI, PWVao – direct and indirect indicators of arterial stiffness – are interconnected with the presence of arterial hypertension in women of reproductive and menopausal age. In this regard, these indicators are potential markers of target organ damage in arterial hypertension.

Predictors of intimate partner violence among women of reproductive age group from Rwanda

Background Intimate partner violence (IPV) against women is an important global health and human rights concern, with significant prevalence in Rwanda. This study aimed to identify predictors of IPV among women of reproductive age in Rwanda, providing essential insights for targeted interventions. Methods Data from the Rwanda Demographic Health and Survey 2019-20, a nationally representative survey, were analyzed. The study included 14,634 women aged 15-49. Descriptive statistics, chi-square analysis to check the experiences of IPV by background characteristics of the women and logistic regression were used to explore associations between background characteristics and IPV. Results The study revealed that women's educational status, wealth index, witnessing parental violence, husband or partner's drinking habit, and fear of husbands or partners were significantly associated with IPV. Women with higher education and those from wealthier households were less likely to experience IPV. In contrast, women whose partners consumed alcohol and those who feared their partners faced higher risks of IPV. Conclusion This study highlights the importance of addressing social determinants such as education, economic status, and alcohol consumption patterns in efforts to reduce IPV in Rwanda. The findings show up the urgency of comprehensive interventions and policies aimed at promoting gender equality and preventing intimate partner violence.

THU473 Acute Hypercalcemia In The Setting Of Acute Fatty Liver Of Pregnancy, A Case Report

Abstract Disclosure: M. Ahmad: None. M. Mack: None. A. Arif: None. L.A. Tejada: None. U. Siddiqui: None. Introduction: Hypercalcemia in pregnancy is rare and often goes unrecognized due to the overlapping symptoms of hypercalcemia and pregnancy. The most common cause of hypercalcemia in pregnant patients is primary hyperparathyroidism, with malignancy, milk alkali syndrome and familial hypocalciuric hypercalcemia being less common. Additionally, endogenous PTHrP production by breast and placental tissue have also been described as rare causes of hypercalcemia in pregnancy. We describe an interesting case of severe hypercalcemia in a pregnant woman presenting with acute fatty liver of pregnancy (AFLP) which rapidly corrected after delivery. Case description: The patient was a 32-year-old female with a past medical history of hypothyroidism and type 2 diabetes mellitus who presented to the emergency department at 32 weeks gestation due to four days of nausea, vomiting and epigastric pain. The patient’s vital signs were as follows: blood pressure: elevated to 133/79 mmHg, heart rate: 75 beats per minute, temperature: 36.7 C, and respiratory rate: 12 breaths per minute. On physical exam, the patient had diffuse abdominal tenderness with no vaginal bleeding. The patient’s blood work was significant for: bicarbonate: 17 mmol/L, creatinine: 1.26 mg/dL (baseline 0.7 mg/dL), corrected calcium of 15.1 mg/dL, ALP: 438 IU/L, AST: 653 IU/L, ALT: 666IU/L, total bilirubin: 2.3 mg/dL, INR 1.3, and ammonia: 43 mcmol/L. She was taken to the operating room for emergent cesarian delivery for concerns of AFLP. Further workup of the patient’s hypercalcemia, revealed a low normal PTH level of 11 pg/dL (normal 11-65 mg/dL), PTHrP level of &amp;lt;5 mg/dL, TSH of 1.37 uIU/ml, 25-OH vitamin D 55 ng/ml, and 1,25-OH vitamin D: 20 pg/ml. After delivery, the patient had alleviation of her symptoms and was kept on dextrose 5% with lactated ringers at 100 cc/h for a total of two days and had complete resolution of her hypercalcemia (corrected calcium of 10.2 mg/dL on discharge). The patient follows with endocrinology as an outpatient and since has had normal calcium levels. Discussion: Hypercalcemia in pregnancy is rare, only affecting 0.03% of women in the reproductive age group, with primary hyperparathyroidism being the most common cause. Hypercalcemia in pregnancy can often be missed due to the hemodilution of serum calcium in pregnancy and also the nonspecific symptoms present in pregnant patients. Our case describes a patient presentation of severe hypercalcemia with AFLP, who had rapid correction of her calcium levels after delivery. The exact mechanism of her severe hypercalcemia developed remains unclear, however, given its rapid resolution with delivery of the placenta potential etiologies include the AFLP itself or possibly the placenta contributing to hypercalcemia. Through this case report, we hope to highlight a possible association between AFLP and hypercalcemia. Presentation: Thursday, June 15, 2023