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BACKGROUND: Adnexal masses is a significant condition commonly seen in women’sreproductive age. Most common masses arise from ovaries due to their complexembryologic & histologic origin. For diagnosis, ultrasonography is the gold standard.Laproscopy is the gold standard surgical intervention.METHODS: This study was a prospective study that was conducted at a tertiary carehospital in the obstetrics and gynecology department from October 2021 to December2021.RESULTS: In this study, No. 31% of the patients were between the ages of 26 and 35.Of the patients, 12.90% came from the upper socioeconomic class, 72.58% from themiddle, and 14.51% from the lower socioeconomic class. The most common complaintwas abdominal pain (41.93%) followed by menstrual irregularities (25.80%). 46.77% ofpatients were managed medically. In 32.25% of patients, laparoscopy was performed andin 20.96% of patients, laparotomy was performed.CONCLUSION: Adnexal masses are a very common gynecological problem, Presentwith abdominal pain / other symptoms /an incidental finding on ultrasonography done forother purposes. So, the basic approach should be early diagnosis and appropriate medicalor surgical treatment, to minimize morbidity and avoid mortality.
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Objectives: Orexins are hypothalamic neuropeptides, which are involved in feeding behaviour, sleep-wakefulness, and neuroendocrine homeostasis in the body. The study was conducted with the aim to estimate the serum orexin levels in reproductive age group (RAG) women and to determine the association of serum orexin levels with body mass index (BMI) in females of RAG. Materials and Methods: One hundred and forty apparently healthy women of RAG (20–40 years) were randomly selected. Fasting serum orexin levels were measured using ELISA and BMI was calculated in women based on their height and weight. Results: Serum orexin levels were significantly higher in women with BMI ? 25 kg/m2 (P = 0.035) as compared to women with BMI < 25 kg/m2 . Conclusion: In the present study, BMI correlated significantly with mean serum orexin levels. However, serum orexin levels did not correlate with the age of women.
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Background: Abnormal uterine bleeding (AUB) is debilitating condition affecting 14-25% of women of reproductive age. It has significant impact on women’s personal, social, physical and quality of life. Present study is planned to study causes, investigation along with management of structural causes of abnormal uterine bleeding in reproductive age group.Methods: Consecutive type of non-probability sampling was used for selection of study subjects. A total of 100 gynaecology OPD women diagnosed with menorrhagia of 15-45 years age group were enrolled in study.Results: Mean age of the study subjects was between 26-35 years (47%). 67% were from low socio-economic class while 33% were from middle class. Maximum number of women (66%) had symptoms for less than 6 months. 47% presented with Menorrhagia. 89% were Multiparous, and 11% were Nulliparous. Most common structural causes of AUB was leiomyoma (41%) followed by polyps (23%), adenomyosis (17%), endometrial hyperplasia (15%) and endometrial carcinoma (4%). Prevalence of anemia was 73% in present study. Maximum leiomyoma were treated medically while higher percentage of polyps and hyperplasia was treated surgically. Most commonly performed surgery was polypectomy (20%) followed by dilatation and curettage (17%) and myomectomy (15%). Total abdominal hysterectomy was done in 8% cases while radical hysterectomy was done in 2% cases.Conclusions: Benign lesions of endometrium account for majority of cases presenting with AUB in reproductive age group. Other premalignant and malignant causes should also be considered. High prevalence of anemia was observed in these cases. A comparative clinicopathological study will help in arriving at the cause and correct diagnosis. Histopathological examination is one of the major tools in evaluation of abnormal uterine bleeding and helps us in proper management and treatment of cases.
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Background: Reproductive tract infection (RTI) is a public health problem, especially in developing country like India. The associated odium with this reproductive morbidity is often a stumbling block in seeking health care. The aim was to study the prevalence of RTI symptoms and its socio-demographic corelates.Methods: A cross-sectional study was undertaken in the rural field practice area of department of community medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India, from July 2018 to September 2018. Total sample size calculated was 410. Random sampling was used to select eligible couple to whom a predesigned, pretested, semi-structured and anonymous interview schedule was administered after taking consent.Results: The prevalence of self-reported reproductive tract infections was found to be 41.2%. The prevalence was more in lower socio-economic classes, and it was statistically significant. Other socio-demographic corelates (age, education, occupation) did not showed any significant association.Conclusions: The reproductive tract infections prevalence is found to be considerably high in the women of reproductive age group. The frequency was higher among multigravida women and those using cloth during menstrual periods. RTIs are usually spurned by women and even the health care providers, so there is a need to give due consideration to this aspect of reproductive health.
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Background: Tobacco imposes a colossal burden of disease and death leading to catastrophic health, social, economic, and environmental effects. “Tobacco” kills both men and women but sex-specific differences exist. Traditional forms of tobacco like dentifrice or tobacco tooth powder and betel quid, tobacco and lime mixture are commonly used and also, the new products use is increasing not only among men but even among children, teenagers, women of reproductive age. This study was done to know the patterns and other correlates of tobacco use among the rural women in the reproductive age group.Methods: A community based cross sectional study, conducted from January 2011 to December 2011 among 1200 rural women aged between 15 years to 49 years residing in primary health centre, Vantmuri area, Belgaum, Karnataka, India. Statistical analysis was done using rates, ratios and chi-square tests.Results: Tobacco consumption was seen in 9.7% of the study participants. A very high percentage of 79 (67.5%) had more than 10 years of exposure to tobacco amongst the users. Dentifrice was the most common form of tobacco used (85.5%) followed by 32 (27.4%) plain tobacco consumption. However, 49 (4.1%) consumed multiple forms of tobacco, most common being dentifrice along with plain tobacco or paan with beetelquid or used snuff.Conclusions: The distribution of tobacco consumption is likely to maintain, and perhaps increase, the current considerable socioeconomic differentials in health in India. Dual users are at much higher health risks than those who consume the individual tobacco product. It also emphasizes the variations in patterns of using tobacco among rural women. There is a need for periodical surveys using more consistent definitions of tobacco use and eliciting information on different types of tobacco consumed.
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Background: Abnormal uterine bleeding (AUB) is a common reason for women of all ages to consult their gynecologist and is one of the most common debilitating menstrual problems ending up in hysterectomy in developing countries. This study was done with the aim to observe the clinical and demographic profile of the patients and the pattern of AUB.Methods: It is an observational study, conducted in department of obstetrics and gynaecology, DR Rammanohar Lohia institute of medical sciences, Lucknow, Uttar Pradesh from August 2018 to July 2019. All patients in the reproductive age group with symptoms of abnormal uterine bleeding were included in the study.Results: Majority (37.50%) of the women were in the age group of 30-40 years. 71.66% were multiparous and maximum women (60%) were in normal BMI. 69.17% were belonging to middle class. Commonest presentation was menorrhagia (48.3%) followed by oligomenorrhoea (18.1%) followed by polymenorrhoea (17.27%).Conclusions: Excessive menstrual blood loss is a common reason for women to seek medical help and leads to large demands in health resources According to our study majority of the women with AUB were in the age group of 30-40 years, were multiparous with normal BMI belonging to middle class. Commonest presentation was menorrhagia. Following study highlights the clinical and epidemiological pattern of abnormal uterine bleeding of reproductive age group, which is crucial factor in management for these patients. In order to predict causal association, further more studies with larger sample size of higher level of evidence should be conduct to draw causal evidence.
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Background: Reproductive health plays a significant role in a woman’s life. Women of child bearing age group in developing countries suffer ill health due to lack of knowledge on reproductive health issues. The objective of the present study was to assess the knowledge regarding reproductive health among women and the associated socio-demographic factors.Methods: A total of 345 women of age group 15-44 years were recruited using cluster sampling in 15 clusters from among 28 villages under a Primary Health Center from May to July 2017. Data on sociodemographic details and knowledge of reproductive health under the following domains: menstruation, contraception, reproductive tract infections and marriage and pregnancy were collected using a modified interview schedule.Results: The mean age of the study population was 28.59±9.08 years. Majority of them belonged to age group 15-30 years (60%), attained school level education (55.7%), 45% were gainfully employed, married (65.5%) and from middle class (40.6%). It was found that out of 345 study population; only 19% had adequate knowledge on reproductive health. The proportion of women who had adequate knowledge in each domain was marriage and pregnancy (47.5%), menstruation (29.9%), contraception (17.4%) and least being reproductive tract infections (15%). Knowledge on reproductive health was significantly inadequate among women in the age group 31-44 years, illiterate women, who belongs to lower class and students. Only, socio-economic status and occupation were the significant predictors of knowledge.Conclusions: Knowledge regarding reproductive health was inadequate among women in reproductive age group in rural areas.
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Background: Vaginitis is one of common medical problem in women that often results in frequent medical consultations. Aim was to study the clinico-epidemiological profile and etiopathogenesis of various causes of vaginal discharge among females in age group 18-45 years residing in rural area of Bhojipura district.Methods: This Hospital based cross sectional study was conducted over a period of one year (March 2011 to February 2012) among 150 females aged 18-45 years presenting with the complaint of vaginal discharge. Information on sociodemographic data was obtained with the aid of questionnaires. Samples were obtained with two dry cotton-wool tipped swabs from vaginal fornices and were sending to department of microbiology.Results: The prevalence rate of vaginal discharge was found to be 24.6% among females in reproductive age group attending the outpatient department from rural background. Out of 150 patients who were enrolled for study 86 (57.30%) were diagnosed with non-infective discharge while 64 (42.60%) patients with infective discharge. Bacterial vaginosis was detected in 25 (39.1%), Candida albicans was detected in 23 (35.9%), T. vaginalis in 4 (6.3%) and mixed infections were found in 12 (18.7%). According to vagina flora morphology 85 (56.6%) had normal morphology, 30 (20%) had shift from normal flora and 35 (23.3%) had definitive bacterial vaginosis. About 20.5% females with Candida based etiology were diabetic.Conclusions: Some common reproductive tract infections can be diagnosed and managed at primary level health facilities. This promotes community awareness through behavior change communication which includes safer sex practices, awareness of HIV and appropriate and timely health care seeking behavior.
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Background: Genital infections, a major cause of illness among women in reproductive age group, affect their quality of life and social living. Early diagnosis and treatment of STI/RTI is also an important aspect in prevention of HIV transmission. As there are only a handful of studies in Kerala and none in Kannur assessing the prevalence, associated factors of genital infections and health seeking behaviour among women in reproductive age group, this study stands important.Methods: A community based descriptive study was conducted in Kulappuram area of Cheruthazham Panchayat which is the field practice area of Department of Community Medicine, Government Medical College, Kannur, Pariyaram from June, 2017 – July, 2018. A total of 404 women in reproductive a group were studied. A semi-structured, pre-tested questionnaire was used to collect relevant information. Data was analyzed using SPSS-version 19 software.Results: The mean age of the study population was 32.20±10.741years. 52.7% of the study population had genital infection, with 40.6% having symptoms of Reproductive Tract Infections (RTI) and 12.1%, symptoms of Urinary tract Infections (UTI). The presence of these was significantly associated with menstrual disorders, cloth as menstrual pad users, marriage, sexual activity and absence of infertility. Only 39.0% of the women with infections had sought treatment.Conclusions: Although there was high prevalence of genital infections among the study population, treatment seeking behaviour was very low. There is a need for sustained motivation and support to promote women to seek timely medical care than to suffer silently.
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Background: The concept of unmet need for family planning points to the gap between some women’s reproductive intentions and their contraceptive behaviour. The National Population policy (NPP) 2000 states that the immediate objective is to address the unmet need for contraceptive services. Unintended pregnancy related to unmet need is a worldwide problem that affects women and their families and societies at large.Methods: A community based cross-sectional study was conducted from November 2016 to October 2017 in Maralur and Maralur Dinne, urban localities under urban health Training Centre of Sri Siddhartha Medical College. 260 Married women (15–49 years) were interviewed by house to house survey. The questionnaire was used to collect data to assess their reproductive intentions and contraceptive behaviour.Results: Out of 260 participants, 144 (55.4%) of them belonged to the group where their contraceptive needs were met for spacing and limiting births, 59 (22.69%) of them of did not have any need for contraceptives, 16 (6.15%) had unmet need for spacing births and 41 (15.77%) of the participants had unmet need for limiting births.Conclusions: The unmet need for contraceptives was 21.92% in the study which is much higher compared to NFHS-4 data for urban India (12.1%). The reasons and the factors associated with the unmet need should be addressed.
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The aim of the pap smear to prevent progression to cervical cancer. The Pap test, when combined with a regular program of screening and appropriate follow-up, can reduce cervical cancer deaths by up to 80%. In general, screening starts about the age of 20 or 25 and continues until about the age of 50 or 60, typically recommended every three to five years, if results are normal. Aim: The aim of the present study is a study of cervical pap smears was undertaken to identify the inflammatory, precancerous and cancerous lesions among women catering to the rural and urban population. Methods: Present study was conducted on 530 female patients above 20 years attending the Gynecology OPD in Madha Medical College, Chennai, during September 2016 to August 2018. Pap smear was collected according to guidelines. The modified Papanicolaou stain was used in this study which is still the method of choice. Results: Majority of the cervical pap smears were revealed nonspecific inflammation (86.9%) followed by trihomonas vaginalis (7.7%), ASCUS (5%) and carcinoma (0.1%). In inflammation, leucorrhea (89%)is the most common clinical presentation followed by inter menstrual bleeding and bleeding per vaginum (1%) being the least. In Trichomonas Vaginalis, high incidence of leucorrhea and post coital bleeding (22%) are seen and dysmenorrhea (2.5%) is the least common clinical presentation. In ASCUS and carcinoma, bleeding per vaginum is the most common clinical presentation. Conclusion: Community education regarding cervical carcinoma and regular screening with pap smear among reproductive age group women helps to decrease the incidence of carcinoma of cervix.
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Granular cell tumour (GCT) is tumours showing neuroectodermal differentiation. It occurs mostly in the dermis and subcutaneous tissue and occurrence in the muscle layer is rare. The most common site is the head and neck region. It has been known to occur in the vulva, with clitoris being a very rare site. Granular cell tumours are slow growing tumours, which are mostly asymptomatic. We report a case of lump in the clitoris in a 42-year-old woman which was managed with surgical excision. Histopathology confirmed the diagnosis of granular cell tumour. Very few cases of granular cell tumour of clitoris have been reported in literature till date. Although mostly benign, the differential diagnosis of granular cell tumour should be borne in mind by the clinicians in cases of clitoral lump.
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Background: Anemia is an important public health problem all over the world, both in rich and poor countries. The present study is a cross-sectional multicentric study where data from 10 different stations by 16 different medical establishments were collected. Objective: The present study was conducted to determine the prevalence of anemia in female spouses of army personnel in an Army’s Corps zone. Materials and Methods: The total size of the sample was 14,273 which covered female spouses of army personnel of five different formations under an Army’s Corps zone. All the non-pregnant female spouses of army personnel were screened for anemia using hemoglobin level estimation. Uniform instructions for screening were given from the medical branch of Army’s Corps Headquarters to medical units. Results: The prevalence of anemia found in this study was 21.54% which is much below the national prevalence of 55% as per National Family Health Survey-3 data. Conclusions: Our study with a large sample size demonstrates that the prevalence of anemia in female spouses of army personnel is almost half of national prevalence. This is indeed a landmark achievement of the Army Medical Corps where success was achieved in reducing the burden of anemia.
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Background: Menstruation, a phenomenon unique to the females, is the cyclical shedding of the inner lining of uterus. It is associated with myths and misconceptions and poor knowledge of the normal physiology. Above all, poor menstrual hygiene is a precursor of various morbidities related to the reproductive tract. This study was conducted among women of reproductive age (WRA) group with the aim to assess their socio demographic characteristics, to elicit the knowledge, attitude and practices regarding menstruation and to find the factors associated with the menstrual hygiene practice.Methods: This community based cross-sectional study was conducted among 152 women aged (15-49 years) during December 2017 to January 2018 in Lockgate area of Chetla, Kolkata, West Bengal, India. Data on socio-demographic characteristics, knowledge, attitude and practices towards menstruation were obtained from structured questionnaire. Outcome variable was menstrual hygiene practice. Descriptive statistics and logistic regression were performed to analyze the data by using SPSS 16.0 version.Results: The mean ages of the participants were 27±8 years. Inadequate knowledge, negative attitude and unsatisfactory practice towards menstruation were 73.7%, 65.1% and 62.5% respectively. Significant correlates were Lower level of education [AOR=1.6 (1.3, 2.1)] and less per capita income [AOR=4.7(1.4, 15.5)] for inadequate knowledge. Less per capita income [AOR=4.7(1.9, 11.1)] for negative attitude. Increasing age [AOR=1.1 (1, 1.2)] and lower level of education [AOR=1.3 (1.2, 1.6)] for unsatisfactory menstrual hygiene practice when adjusted with other variables in the multivariate analysis.Conclusions: Women need to be educated about the significance of menstruation, importance of high quality menstrual hygiene management, use of satisfactory absorbent material, proper and hygienic disposal of menstrual absorbent so as to enable them to lead a healthy reproductive life.
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Background: Common mental disorders are commonly encountered in community settings, especially in women. The somatic symptoms often lead to repeated visits to health care practitioners without resolution of the problem. The knowledge of magnitude of common mental disorders and their associated factors has proved useful in psychiatric epidemiological research.Methods: A community based cross-sectional study was carried out among 480 randomly selected women in the reproductive age group using self-reporting questionnaire (SRQ-20), a validated tool developed by World Health Organisation. A standard cut-off score of 7 was used to identify women with common mental disorder. Data was analysed using descriptive statistics and suitable tests of significance in statistical package for social sciences (SPSS) v. 21.0.Results: The prevalence of common mental disorder was found to be 33.5% in the present study. Analysis showed that various socio-demographic characteristics of women like lower educational levels of women, widowed women, and women belonging to lower socio-economic class, belonging to joint family, lower body mass index had statistically significant association with common mental disorders.Conclusions: This study revealed that the prevalence of common mental disorders was high (33.5%) among the women of reproductive age group and there existed statistically significant association between common mental disorders and various socio demographic determinants.
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Background: Uterine fibroid is the most common pelvic tumor in women of reproductive age and are asymptomatic in at least 50% of affected women. Various risk factors are associated with development of uterine fibroids during this reproductive age. The present study established various associated risk factors increases the prevalence of uterine fibroid among reproductive age group and clinical symptoms burden of diagnosed case.Methods: A cross sectional study design was used to collect samples for a period of six months in an OPD basis. Purposive sampling technique was used to select the 362 sample of reproductive age group (15-45 years) women in a tertiary care hospital, Southeastern India. Women diagnosed with uterine fibroid by ultrasonography were included as cases. Symptomatic features and associated risk factors of UF were collected through structure interview schedule.Results: Point prevalence of uterine fibroid among women in reproductive age group during the period of six months was 20%. Majority of them were in the age group of 30-39 years. Demographic factor such as overweight and obesity and consume dairy products daily has increased the prevalence of UF, whereas use of oral contraceptive pills and normal BMI had inverse relationship with UF risk. Most of the cases reported of having menstrual disturbances like heavy bleeding, passes blood clots during menstruation, prolonged period, urinary symptoms and pressure symptoms were considered independent predicting factors for the occurrence of uterine fibroid.Conclusions: Uterine fibroid is more prevalent among women of reproductive age causing various bleeding and renal symptoms that can have negative impact on quality of women’s life.
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Background: Today, female feticide and gender preference are a big problem in India. Although there is so much emphasis against it, the problem has become aggravated. In this context, various studies showed that the male child preference leads to skewed sex ratio. The present paper is an attempt to determine the view of the people for giving their preference to the male child. Objectives: The objectives were to study the preference of women for gender of child, as well as reasons for preference for it, and association between socioeconomic factors and demographic factors with gender preference. Materials and Methods: It is a community-based cross–sectional study, in which 500 married women of 15–49 years of reproductive age group, 150 randomly selected women from one urban municipal ward, and 350 randomly selected women from seven villages of rural area were constituted the study population. Widow and separated women were excluded from the study. A pre-tested, semi‑structured questionnaire was administered to each individual to collect information. Microsoft Excel 2007 software and the Chi‑square test were used. Results: Almost half of the women (51.4%) have preference for male child. Women from lower age group (65.25%), currently married (66.42%), Muslim religion (72.22%), lower education (59.01%), and low socioeconomic status (66.67%) and those who are laborer (71.83%) have male child preference. Conclusions: This study concludes that more number of females have preference for male child in women of younger age group. Muslim religion and its customs, thoughts, and rearing practices make difference. Lower socio-economic status and poor education are also major contributory factor. Male child will support in old age and will take social responsibilities are the main basic reasons found to be associated with male child preference.
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Background: Management of Sexually Transmitted Infections (STIs) is important in controlling STIs and to break the chain of infection and transmission.Syndromic case management is a standardized evidence-based approach which utilizes clinical management algorithms and flowcharts that are handy and can be consistently used across health care providers. The objectives of the study were to identify cases of vaginal discharge in Shaheed Nagar, Bhopal and to provide them treatment following syndromic approach.Methods: Prospective cross-sectional study carried out over a period of three months among reproductive age group females (15-45 years) in Shaheed Nagar, Bhopal. Purposive sampling by conducting door- to- door survey until 150 women fulfilling study criteria was interviewed. A pre-designed questionnaire used for data collection. Educational intervention given to all participants. 37 participants identified with vaginal discharge syndrome and were assisted by study team to gynecological OPD for obtaining treatment based on syndromic approach. Data entered in MS Excel 2007 and statistical analysis carried out using epi-info 7.2. Proportions and percentages were calculated. Chi-square was used to find out association between prevalence of vaginal discharge and qualitative variables. P value <0.05 considered statistically significant.Results: Prevalence of vaginal discharge was 24.67%. The most common presenting complaint was general weakness (52%). The most common diagnosis was cervicitis (8.67%) followed by vaginitis (4.67%). Statistically significant correlation was found between presence of disease (STI) and use of intra- uterine device (IUD), non-use of sanitary pads, marital status, occupation and socio- economic class.Conclusions: Abnormal vaginal discharge can both be the cause as well as the effect of pelvic inflammatory disease.
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For each maternal mortality, there are number of various morbidities, which directly or indirectly affects health of women. For every woman who dies of pregnancy-related causes, an estimated 20 women experience acute or chronic morbidity, often with tragic consequences. Objectives: To assess maternal morbidity pattern, prevalence of maternal morbidity & its associated factors. Material and Methods: A community based cross- sectional study was conducted among 450 women of reproductive age group women of Jamnagar district. Study subjects were selected by multistage sampling. Data collected in proforma consist of sociodemographic profile, past obstetric profile & any antenatal, Intranatal, & postnatal morbidities. Results: Prevalence of maternal morbidity was about 80% with, highest morbidity found during antenatal period in 36% subjects, followed by 26% in postnatal period. There were also associated medical problems during pregnancy. Conclusion: There is 80% prevalence of morbidity related to pregnancy which adds on to ill health of women. It was also observed that statistical significance between few of the important variables like educational status, parity & place of delivery, which could be independent risk factors & occurrence of maternal morbidity.
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Background: Premenstrual syndrome is a multifactorial psychoneurendocrine disorder. Etiology of PMS is still not demarcated & research continues in this area. Role of corelates age, parity, marital, educational & occupational status of PMS is being explored in various regions. Objective: To study sociodemographic correlates of psychological symptoms of premenstrual syndrome in woman of reproductive age group. Material and Methods: Prospective observational study was carried on 247 females in the reproductive age group. The participants were given the list of 18 preliminary symptoms and asked to encircle the symptoms they suffer during later part of the menstrual cycle in any of the last 3 cycles. In participants reporting ≥3 symptoms, the psychological symptoms were analysed and their association was observed with various sociodemographic parameters (age, location- rural/urban, marital status, parity, education, occupation). Results: 155(62.57%) reported 3 or more symptoms during later part of the menstrual cycle in the last 3 cycles. 149(96.1%) females reported at least one psychological symptom. These women showed following demographic correlates. 74.5% of females belonged to 18-26 years age group. 75.8% were unmarried. 81% had no child. 87.2% were from urban area. 71.1% were senior secondary. 96% females had mental work occupation. Conclusion: On retrospective screening there was 62.57% prevalence but on prospective follow up with PMTS & daily diary prevalence was found to be only 4.05%. Most common psychological symptom reported was irritability & there was significant association of irritability with educational status, type of work & parity. Mood swings were significantly more in females doing mental work.