bluuebunny/crossref_metadata_2025_split huggingface dataset:
The influence of menopause on urinary incontinence in the women of the community: a cross-sectional study from North India
Authors: Khan Samreen , Ansari M. Athar , Vasenwala Shaista M. , Mohsin Zehra 
Published: February 2017

Background: Urinary incontinence is defined as the complaint of any involuntary loss of urine that is a social or hygienic problem. Worldwide, over 200 million people are living with urinary incontinence and as the life expectancy of women is increasing, more number of women are bound to suffer from it. The aim of the present study is to find out the effect of menopause on the occurrence of Urinary Incontinence in women and to find out risk factors in post-menopausal women associated with Urinary Incontinence.Methods: It was a community based cross-sectional study involving post-menopausal women living in the urban and rural areas registered under Community Medicine, J.N. Medical College, Aligarh, India. A total of 530 women were taken for this study. Descriptive statistics as well as simple proportion were calculated with SPSS 20.0. Tests of significance and Binary Logistic regression analysis were used for analysis.Results: Significant differences were found in the association of Urinary Incontinence with increasing age groups and consequent years spent in menopause, rural area of residence, illiteracy, lower socio-economic class, inadequate housing standards, obesity, smoking, parity, history of hysterectomy, and co-morbidities such as Urinary Tract Infection and Pelvic organ prolapse.Conclusions: From a public health perspective, there is considerable opportunity to improve women's quality of life by increasing health education about urinary incontinence and its treatment by taking steps for life style modifications.
Menstrual hygiene: knowledge and practice among adolescent school girls in rural settings
Authors: Kapoor Gitanjali , Kumar Dinesh 
Published: February 2017

Background: Menstrual hygiene is an issue that every girl and women must deal within her life, but there is lack of awareness on the process of menstruation and proper requirements for managing menstruation among adolescent girls. The objectives of present study are to assess the knowledge and the practices of menstrual hygiene among the rural school going adolescent girls and to assess the restrictions practiced by adolescent school going girls during menstruation.Methods: It was a community based cross-sectional study. The present study was undertaken among the adolescent school going girls in the Govt. Higher Secondary School in Marh block of Jammu district. 132 girls of the 8th, 9th, 10th, 11th and 12th standard of the school was selected for the study. A predesigned, pretested and structured questionnaire was used in the study. The data collection technique was a personnel interview of the study subjects.Results: The mean age of menarche in the study subjects was 13.43 years. It was evident that only 65 (49.24%) of the participants were aware about menstruation before menarche and the most important source of the information about menstruation for them was found to be their mothers. 59.09% girls used sanitary pads only, 27.27% used new cloth and 13.64% used old washed cloth. 98.48% of the respondents followed some restriction or taboo during menstruation. 93.18% had daily bath. Regular hand washing was present in 90.91% subjects of which 86.36% subjects used soap and water for hand washing. Regular cleaning of the external genitalia was present in 65.91% subjects only, of which 66.67% used soap and water and 33.33% used only water.Conclusions: There is a need to educate the girls about menstruation, its importance and hygiene maintenance; to enable them to lead a healthy reproductive life in future.
Prediction of caesarean section for arrest of descent during the second stage of labour
Authors: Samal Sunil Kumar , Rathod Setu 
Published: February 2017

Background: Friedman described the normal progress of labor in different curves for nulliparous and multiparous women in 1954. Any deviation from these curves during the second stage of labor is considered as failure to progress in the second stage of labor. The aim of the study is to define obstetrical risk factors for arrest of descent during the second stage of labour.Methods: All singleton, vertex, term deliveries with an unscarred uterus, between December 2013 to November 2016 (3 years) were included. Univariable and multivariable analysis were performed to investigate independent risk factors associated with arrest of descent during the second stage of labor.Results: The study included 7260 deliveries, of these 163 (3.3%) were complicated with arrest of descent during the second stage of labor. Using a multivariable analysis, the following obstetric risk factors were found to be significantly associated with arrest of descent: primigravida (RR=7.8, 95% CI=6.9-8.7, p<0.001), obesity (RR=1.8, 95% CI=1.6-2.0, p<0.001), short stature (RR=2.3, 95% CI=1.9-2.8, p<0.001), hypertensive disorders(RR=1.5, 95% CI=1.3-1.8,p<0.001), gestational diabetes(RR=1.5, 95% CI=1.2-1.8, p<0.001), free floating head before labour(RR=3.4, 95%CI=2.5-4.1, p<0.001), Occipito-posterior position(RR=3.3, 95% CI=2.1-4.5, p<0.002), Prelabour rupture of membrane (PROM) (RR=1.3, 95% CI=1.0-1.6, p<0.02), induction of labour (RR=2.2, 95% CI=1.0-3.4, p<0.03) and birth weight>3.5 kg (RR=2.2, 95% CI=2.0-2.4, p<0.001). Deliveries complicated by arrest of descent resulted in cesarean section in 67% and 34% vaginal delivery.Conclusions: In this era of increased public awareness and medicolegal events it is very crucial to assess and evaluate every woman in labor and to identify in advance the possibility of arrest in advanced labor so that a timely obstetric intervention possibly Cesarean section can prevent unnecessary maternal- fetal complications.
Risk factors for still birth: a hospital based case control study
Authors: Lakshmi Sujatha Thankappan , Thankam Uma , Jagadhamma Preetha , Ushakumari Anuja , Chellamma Nirmala , Hariharan Sankar Vaikam 
Published: February 2017

Background: The study of the risk factors contributing to still birth is imperative in our attempts to bring about a decline in the still birth rate. By identifying the risk factors, we can understand the areas where specific interventions may be applied to bring about a reduction in the still birth rate. The aim of the present study was to identify the risk factors for stillbirth among the mothers attending Sri Avittom Thirunal Hospital, TrivandrumMethods: This was a prospective hospital based case control study conducted from March 2014- September 2015. Sample size was calculated as 100 cases and 200 controls. Odds ratios with 95% confidence interval were calculated using multi variate logistic regression.Results: The major risk factors associated with still births were maternal age, socio economic status, and obesity, sleep position during pregnancy, primi parity, hypertension and febrile illness during pregnancy. The risk of still birth was 3 times higher among mothers with hypertension compared to the control group. Although the prevalence of diabetes slightly more in the case group it was not statistically significant. By analyzing all the risk factors in preparing a model 42% of the risk for still birth was contributed by these factors.Conclusions: The modifiable risk factors seen in this study to prevent still births are maternal sleep position during pregnancy, diabetes, hypertension and febrile illness especially urinary tract infection. By better antenatal care we can detect complications like diabetes, hypertension and manage appropriately thereby preventing complications. By screening for urinary tract infections in every trimester morbidity can be reduced.
Comparative analysis of continuous and interrupted suturing techniques for repair of episiotomy or second degree perineal tear
Authors: Samal Sunil Kumar , Rathod Setu 
Published: February 2017

Background: Perineal trauma is a serious and frequent problem after childbirth which is experienced by millions of women worldwide and the type of perineal repair may have an impact on pain and healing. The objective of this study was to assess the effects of continuous subcuticular versus interrupted transcutaneous sutures on women following episiotomy or second degree perineal repair following childbirth.Methods: A prospective comparative study comprising 141 women who had undergone vaginal deliveries with episiotomies or second-degree tearing of the perineum between August 2015 and July 2016Two groups were made among which one group was repaired with continuous, nonlocking sutures involving the vagina, perineum, and subcutaneous tissues and the other group had continuous, locking sutures of the vagina, interrupted sutures in the perineal muscles, and interrupted transcutaneous sutures. The threads used for stitching were identical in both groups i.e. rapidly absorbed polyglactin 910 suture material.Results: On the 2nd day after delivery, the perineal pain scores during lying, sitting and walking in the continuous technique(CT) group was less compared to the interrupted technique(IT) group(p value 0.009). On 10th day after delivery the perineal pain score during sitting and walking were statistically less (p value 0.027) in the CT group. On 42th day there was no difference in pain score between both the groups. The amount of suture materials consumed in CT group was statistically less than IT group(p<0.001). There was no difference in incidence of wound dehiscence (p value 0.301) but superficial dyspareunia is more in IT group which is statistically significant.Conclusions: The episiotomy and perineal tear repairs with continuous suturing associated with lesser incidence of short or long term pain, lesser requirement of suture material without an increase in complication than interrupted suturing.
Comparison of oral and vaginal misoprostol after oral mifepristone in early medical abortion
Authors: J. Nithya , P. Reddi Rani 
Published: February 2017

Background: Abortions are still a major problem in developing countries contributing to significant maternal morbidity and mortality. WHO has reported that 53 million unplanned pregnancies result in termination each year. One third of these are performed under unsafe conditions. Deaths related to these accounts for up to about 20% of the maternal deaths that occur each year throughout the world. the main objective of the present study is to compare the efficacy, side effects and acceptability of oral and vaginal misoprostol after single oral dose of mifepristone in induction of abortion in pregnancy up to 63 days.Methods: It was a prospective randomized trial of 100 healthy women opting for termination of pregnancy with ultrasound confirmed intrauterine gestation of less than or equal to 9 weeks who were randomized in to two groups. Mifepristone 200mg was administered on day one followed by 800µg of misoprostol orally or vaginally 48 hours later. They were reviewed on day 7 and day 14 by ultrasound for completeness of abortion. If abortion was incomplete or bleeding was excessive, surgical evacuation was performed.Results: The two groups were comparable with respect to age, parity and gestational age. The mean induction abortion interval was 51.2 hours.98% of the women in both the groups had complete abortion. Nausea (68%) and vomiting (58%) were more common in oral group. Diarrhoea (60%) was common in vaginal group. None of them had fever. Mean duration of bleeding was 9 days. 92% of the women found the procedure to be highly acceptable and would recommend it to others.Conclusions: Medical abortion with 200mg mifepristone in combination with 800µg of misoprostol either orally or vaginally 48 hours later was found to be safe, simple, effective, inexpensive, noninvasive and acceptable method.
Maternal and foetal outcome of eclampsia in a referral hospital
Authors: Ghosh Mousumi Das , Singh Vinita , Ray Alokananda 
Published: February 2017

Background: Eclampsia is a life-threatening condition, common in developing countries with high fatality rate. It is a cause of maternal and foetal mortality and morbidity. The aim of the study is to determine the maternal and foetal outcome in Tata Main Hospital, Jamshedpur, Jharkhand, India.Methods: All cases of eclampsia were analysed from January 2012 to December 2014 from admission to discharge or death of the patient. Age, parity, antenatal care, interval between attack and admission, blood pressure on admission, gestational age and mode of delivery were taken into account. There were 135 cases of eclampsia out of 14572 deliveries. Only singleton pregnancies were analysed.Results: The incidence of antepartum eclampsia was 84.4%, intrapartum 3% and postpartum 12.5 %. 83% patients were primigravida, 33% less than 20 yrs,42% had no antenatal checkup and 45% had < 4 visits. Only 15% patients received magnesium sulphate before referral to the hospital. There were four maternal deaths and twenty-one perinatal deaths. Eleven patients needed ventilatory support, four developed pulmonary oedema, two patients had respiratory depression and three patients had renal failure.Conclusions: Hypertensive disease in pregnancy requires proper antenatal care, early recognition and referral, adequate treatment and timely delivery.
Maternal and perinatal outcomes in cases of antepartum haemorrhage: a 3-year observational study in a tertiary care hospital
Authors: Samal Sunil Kumar , Rathod Setu , Rani Reddi , Ghose Seetesh 
Published: February 2017

Background: The leading cause of maternal mortality in world is obstetric haemorrhage. Antepartum haemorrhage (APH) is defined as bleeding from or into the genital tract after 28weeks of pregnancy and before delivery of the baby. The aim of the present study is to study the demographic profile, type of antepartum haemorrhage (APH), maternal and perinatal complications in cases of APH and to formulate preventive guidelines so as to reduce maternal and perinatal complications in cases of APH.Methods: The study was a retrospective observational study conducted in Mahatma Gandhi Medical College & Research Institute, Pondicherry from November 2013- October 2016 [3 years]. Cases of pregnancy complicated with APH were taken. Cases with bleeding before 28 weeks and after delivery of the baby were excluded. Data collected from the records present in Labour ward complex and Medical record section. Statistical analysis done by using SPSS software version 21.Results: Total 218 cases were presented with APH and the incidence was 2.9%. Among these 49.5% were Placenta Praevia, 42.2% were abruption placentae, 6.8% cases were indeterminate (3 cases of vasa praevia and 12 cases of excessive show) and 1.5% cases were of extraplacental cause(Local causes). Most cases were multipara with most common age group was 26-30 years (42.2%). Pregnancy in most of the cases was terminated during 34-36+6 weeks of gestation (73.0%). Most common associated risk factors found were previous caesarean section, preeclampsia, previous history of curettage, malpresentation and anaemia. Postpartum haemorrhage was found in 42.2% cases while in 4 cases peripartum hysterectomy done. Most common perinatal complications were due to low birth weight (66.5%).Conclusions: The morbidity and mortality in pregnancies complicated with APH can be achieved by early diagnosis, proper antenatal planning and terminating the pregnancy in a well-equipped tertiary health care centre.
Classification of stillbirths by relevant condition at death (ReCoDe): a cross sectional study at a rural tertiary care centre in Kerala, India
Authors: K. K. Ajini , K. R. Radha , R. P. Reena 
Published: February 2017

Background: Stillbirths account for a major proportion of perinatal deaths. The cause for a large number of stillbirths, remain unexplained. The ReCoDe system (classification of stillbirths by relevant condition at death) has helped to improve our understanding of the causes of stillbirths. We evaluated stillbirths and classified them by the ReCoDe system. The objective was to identify factors associated with stillbirths and to classify the causes of stillbirths using the ReCoDe system.Methods: We recruited all women admitted to a tertiary care centre with a diagnosis of intrauterine fetal death after 22 weeks of gestation. Maternal sociodemographic characteristics and relevant antenatal and intrapartum investigations were studied. We examined the stillborn babies, placenta and umbilical cord and classified them according to the ReCoDe system.Results: There were177 women with intrauterine fetal death admitted during the 2 year study period. The stillbirth rate was 38.56 per 1000 live births. We could explain the cause of stillbirth in 87.58% of cases by using the ReCoDe system. Intra uterine growth restriction (41.8%) was the commonest cause followed by hypertensive disorders (27.68%), congenital anomalies (15.81%) and diabetes (14.68%) in present study.Conclusions: We found the ReCoDe system useful in classifying the cause of stillbirths in resource limited settings.
Two different timing of intra uterine insemination in patients of unexplained infertility: a randomized clinical trial
Authors: Elsersy Mervat A. 
Published: February 2017

Background: Unexplained infertility is diagnosed when the basic infertility workup is found to be normal. The objective was to compare between the results of IUI performance at 24 hours or 36 hours after hCG injection in couples with unexplained infertility.Methods: A prospective comparative study was conducted on 250 patients diagnosed with unexplained infertility who were randomly allocated in two equal groups. Each patient received ovulation induction. Follicular growth scanning was performed, patients received 10.000 hCG injection when there was mature follicle equaled to or more than 18mm. Then they randomly allocated to either group 1 who underwent IUI 24 hours after hCG injection or group 2 who underwent IUI 36 hours after hCG injection.Results: The positive qualitative serum β -hCG test was higher in group 1 who received IUI 24 hours after hGC injection, 24%, while in group 2 who received IUI 36 hours after hGC injection, it was 16.8% but no statistical differences between the two studied groups could be observed. The most important finding in this study is that the clinical pregnancy rate in group 1 was significantly higher than in group 2.Conclusions: Earlier IUI procedures increased the clinical pregnancy rate in patients with unexplained infertility during ovulation induction with gonadotropins. Correct timing of insemination is essential.
Assessment of labor and delivery in pregnant women on sulfadoxine-pyrimethamine regimen in Yaoundé gynaeco-obstetric and paediatric hospital: a comparative study of 313 cases
Authors: Foumane Pascal , Essiben Felix , Dohbit Julius Sama , Tongn Carine Yondjeu , Meka Esther Juliette Ngo Um , Ojong Samuel , Mboudou Emile Telesphore 
Published: February 2017

Background: Malaria is still a major public health problem in sub-Saharan Africa. The aim was to determine the prevalence of malaria infection at the onset of labor and the resulting complications.Methods: We carried out a five-month cross-sectional study at the Yaoundé Gyneco-Obstetric and Pediatric Hospital. We used results from the rapid diagnostic test (RDT) to compare two groups of pregnant women admitted into the labor room. Women who tested positive were assigned to the exposed group versus negative to the non-exposed group. Independent factors associated with malaria infection were investigated by the logistic regression method.Results: Up to 79.6% (249/313) of women had received the sulfadoxin-pyrimethamine regimen with 32.9% (82/249) receiving at least 3 doses. Malaria infection was detected in 32.2% (101/313) of women. Only 14.9% (15/101) of the exposed group had received 3 doses of SP versus 31.6% (67/212) of the non-exposed group. After univariate analysis, malaria infection at the onset of labor was associated to premature rupture of membranes (OR=1.39; CI=1.01-1.94), fever during labor (OR=73.37; CI=64.80-681.95), non-reassuring fetal status (OR=2.08; CI=1.36-3.20), low birth weight (OR=1.65; CI=1.23-4.13), prematurity (OR=2.79; CI=2.12-367), a poor Apgar score at the 1st minute and postpartum fever (OR=3.19; CI=2.56-4.00). Linear logistic regression indicated that the occurrence of fever during labor (aOR=63.09), and low Apgar score at the first minute (aOR=6.27) remained significant and malaria infection was significantly associated to the single marital status (aOR=2.56) and a history of malaria during the current pregnancy (aOR=2.56).Conclusions: Systematic RDTs is thus recommended at the last antenatal consultation to avoid identified complications.
Intrauterine levobupivacaine for pain control during intrauterine device insertion
Authors: Akgun Nilufer , Keskin Esra , Kalem Muberra Namlı , Bakirarar Batuhan 
Published: February 2017

Background: Safe, effective, long term and a reversible contraception method is offered by intrauterine devices (IUDs). The objective was to determine the potency of intrauterine administration of 5 cc levobupivacain for pain relief with IUD insertion, when compared with saline placebo.Methods: This was a prospective randomized, double blind placebo-controlled trial undergoing İUD insertion. The trial medication was intrauterine anesthesia, either 5 mL 0.9% saline (control group), or 5 mL 0.5% levobupivacaine. Our primary outcome was self-reported pain scores on a 10 cm visual analogue scale (VAS) immediately following IUD insertion.Results: 95 women were enrolled, and data for 88 women were analyzed. In IUD insertion procedure, no difference was observed between groups during teneculum placement and solution administration, in the course of VAS scores (p=0.349, p=0.396). There was a significant difference in the VAS scores measuring pain suffering during and after IUD procedure (p=0.001).Conclusions: Intrauterine instillation of 5 cc of levobupivacaine along with saline solution reduces pain with IUD insertion when compared to intrauterine saline placebo. Broad deviation in pain scores and persistent pain after IUD insertion recommends that patient would benefit from more functioning method of pain control than before at IUD insertion and during the post interval.
Combined transurethral and laparoscopic partial cystectomy for the treatment of bladder endometriosis
Authors: Algreisi Fahad , Badr Hattan , Alturkistani Daniya , Vilos George 
Published: February 2017

We present a case of a 22-year-old nulliparous woman, initially investigated by a urologist after she presented with a history of urinary tract symptoms including catamenial hematuria and suprapubic pain. Ultrasonographic and cystoscopic findings suggested a bladder mass suspicious for endometriosis. Further MRI revealed a 3 X 4 cm mass in the bladder, and the diagnosis of endometriosis was confirmed by the biopsy. Consequently, the patient was offered treatment options including combined laparoscopic and transurethral resection of the bladder lesion for definitive diagnosis and treatment. Using a combination of hydrodissection and CO2 laser energy laparoscopically and monopolar electro-surgery cystoscopically, the lesion was resected uneventfully and the bladder defect was repaired laparoscopically. The patient was discharged on the same day with a Foley catheter, which was removed 10 days later. After 8 weeks follow up period, she remained free of symptoms. Histopathology confirmed endometriosis. We conclude that this combined approach is feasible, safe and effective therapy for intramural bladder endometriosis.