GAMBARAN HEALTH BELIEF MODEL WUS DALAM DETEKSI DINI KANKER LEHER RAHIM MENGGUNAKAN PEMERIKSAAN IVA DIPUSKESMAS BAREGBEG 2021

Kanker leher rahim merupakan keganasan yang terjalin pada leher rahim merupakan bagian terendah dari rahim yang menonjol ke puncak liang vagina, kanker leher rahim dapat dideteksi dini dengan menggunakan metode pemeriksaan IVA. Masalah yang utama yaitu rendahnya peminat pemeriksaan IVA. Health Belief menjadi penyebab yang mengakibatkan peminat rendah, karena health belief yang kurang. Penelitian ini bertujuan untuk menggambarkan health belief WUS di wilayah kerja PUSKESMAS Baregbeg dalam deteksi dini kanker leher rahim menggunakan metode pemeriksaan IVA. Metode penelitian ini deskriptif. Teknik sampling menggunakan non probality sampling (consecutive sampling) dengan jumlah responden 126 WUS. Hasil penelitian 46 (36,5%) WUS dengan health belief baik, dan 80 (63,5%) dengan health belief kurang. Diharapkan bagi penyelenggara program IVA untuk meningkatkan penyuluhan dan penyebaran informasi terkait adanya program gratis pemeriksaan IVA untuk meningkatkan kesadaran WUS dan meningkatkan kunjungan program skrining deteksi dini kanker leher rahim menggunakan metode pemeriksaan IVA.Cervical cancer is a malignancy that is entwined in the cervix, which is the lowest part of the uterus that protrudes to the top of the vaginal canal. Moreover, cervical cancer can be early detected by using the IVA examination method. Furthermore, the main problem is the low interest in conducting the IVA examination. In addition, Health Belief is recognized as the cause of low interest. In the meantime, this study aims to describe the health beliefs of WUS in the working area of Baregbeg Public health center in early detection of cervical cancer using the IVA examination method. On the other hand, the study carried out a descriptive method. The sampling technique used non-probability sampling (consecutive sampling) with 126 WUS respondents. The results of the study 46 (36.5%) WUS indicated the good awareness of healt beliefs and 80 (63.5%) indicated the unawareness of health beliefs. Regarding the result, it is hoped that the organizers of the IVA program will conduct counseling and inform more information related to the free IVA examination program to increase awareness of WUS and increase visits to the screening program for early detection of cervical cancer using the IVA examination method.

Safety and Efficacy of an Atraumatic Uterine Cervical Traction Device: A Pilot Study

Introduction: Alignment of the uterine cervix with the vaginal canal is often required during insertion of an intrauterine contraceptive device (IUD). Currently available instruments are traumatic tenacula, which can cause pain and bleeding and represent an obstacle for certain patients to pursue their medical follow-up. A novel investigational cervical vacuum tenaculum, enables atraumatic traction of the cervix using a semi-circular suction pad, designed to conform to the anatomical shape of the external cervical os. Suction is generated by manually pulling out a sliding tube in a vacuum chamber.Methods: We performed a single arm non-comparative pilot study to assess the safety and efficacy of the cervical vacuum tenaculum in 13 women receiving an IUD. Data on procedural efficacy, safety, patient-reported pain scores at specific time points during IUD insertion procedure and patient satisfaction were collected prospectively.Results: Insertion of IUD was successful with use of the study device in 7 of the 13 enrolled patients (54%). No bleeding or only limited ecchymosis were caused by the device. No adverse events were reported. Participants reported very little pain (mean Visual Analog Scale <10) when applying the device. Participants who achieved IUD insertion with the device reported strong overall satisfaction with the procedure.Conclusions: The suction-based atraumatic tenaculum can be used to manipulate the cervix during IUD insertion with satisfactory efficacy and safety. The results of this pilot study support further studies of this device in larger populations comparing with standard single-tooth tenaculum.Clinical Trial Registration:ClinicalTrials.gov, identifier: NCT 04441333.

Delivery Mode Shapes the Composition of the Lower Airways Microbiota in Newborns

Radical alterations in the human microbiota composition are well-known to be associated with many pathological conditions. If these aberrations are established at the time of birth, the risk of developing correlated pathologies throughout life is significantly increased. For this reason, all newborns should begin their lives with a proper microbiota in each body district. The present study aimed at demonstrating a correlation between the mode of delivery and the development of a well-balanced microbiota in the lower airways of newborns. 44 pregnant women were enrolled in this study. Microbiological comparative analysis was carried out on tracheobronchial secretions of babies born through vaginal delivery (VD) or caesarean section (CS). All samples showed the presence of bacterial DNA, regardless of the mode of delivery. No viable cultivable bacteria were isolated from the CS samples. On the contrary, VD allowed colonization of the lower airways by alive cultivable bacteria. The identification of bacterial species revealed that Lactobacillus spp. and Bacteroides vulgatus were the most common microorganisms in the lower airways of vaginally-delivered newborns. Data obtained from quantitative PCRs showed a significantly higher total bacterial load, as well as Firmicutes and Lactobacillus spp. amount, in VD samples than CS ones, while no statistically significant difference was found in Torque Teno Virus (TTV) load between samples. Taken together, our findings confirm the hypothesis that passage through the maternal vaginal canal determines more beneficial colonization of the lower airways in newborns.

Pre-Clinical Applications of High-Definition Manometry System to Investigate Pelvic Floor Muscle Contribution to Continence Mechanisms in a Rabbit Model

External anal sphincter (EAS), external urethral sphincters and puborectalis muscle (PRM) have important roles in the genesis of anal and urethral closure pressures. In the present study, we defined the contribution of these muscles alone and in combination to the sphincter closure function using a rabbit model and a high-definition manometry (HDM) system. A total of 12 female rabbits were anesthetized and prepared to measure anal, urethral, and vaginal canal pressures using a HDM system. Pressure was recorded at rest, and during electrical stimulation of the EAS and PRM. A few rabbits (n=6) were subjected to EAS injury and the impact of EAS injury on the closure pressure profile was also evaluated. Anal, urethral, and vaginal canal pressures recorded at rest and during electrical stimulation of EAS and PRM demonstrated distinct pressure profiles. EAS stimulation induced anal canal pressure increase whereas PRM stimulation increased the pressures in all the three orifices. Electrical stimulation of EAS after injury resulted in about 19% decrease in anal canal pressure. Simultaneous electrical stimulation of EAS and PRM resulted in an insignificant increase of individual anal canal pressures when compared to pressures recorded after EAS or PRM stimulations alone. Our data confirm that HDM is a viable system to measure dynamic pressure changes within the three orifices and to define the role of each muscle in the development of closure pressures within these orifices in preclinical studies.

Grade IV Utero Vaginal Prolapse (Procidentia): A Case Report

Introduction: The uterus is normally held in place inside the pelvis with various muscles, tissue, and ligaments. But because of pregnancy, childbirth or difficult labor and delivery, in some women the muscles become weaken. And also, as the woman ages and also with a natural loss of the hormone oestrogen, the uterus can drop into the vaginal canal, this cause the condition which is known as prolapsed uterus. There are different degrees, in which the fourth degree the entire uterus is outside the vagina and this condition is also called procidentia, which is caused by weakness in all of the supporting muscles [1]. Case Presentation: A female patient of 70 years was admitted to Gynae Ward, AVBRH on 2nd June 2021 with a known case of Grade IV Utero Vaginal Prolapse (procidentia) for further management and known case of hypertension and type II diabetes melitus for 22 years. Patient came with a complain of something coming out of vagina for 5 years, increased frequency of micturition for 5 years and also complain of white discharge for 1.5 months.

RECONSTRUCTION OF THE FEMALE UROGENITAL COMPLEX IN THE PRENATAL PERIOD OF ONTOGENESIS

In 9-weeks prefetuses, urogenital complexes are located lower than in prefetuses of previous age groups. In the vertical sections of the urogenital cords, the paramesonephric ducts diff erentiate into the uterine tubes. Above the entrance to the pelvis, the urogenital cords pass obliquely in the vertical direction, at the level of which the paramesonephric ducts are connected, on both sides of which the mesonephric ducts are located. The primary kidneys are completely reduced in their upper two-thirds, the reduction of mesonephric cells in the lateral areas of the lower third of the kidneys begins. The caudal divisions of the paramesonephric ducts touch dorsally to the wall of the urogenital sinus, while the lower ends of the mesonephric ducts are in the thickness of the wall. The urogenital cords (mesonephric and paramesonephric ducts) protrude above the upper ends of the primary kidneys and below the permanent kidneys. The mesonephric and paramesonephric ducts are clearly demarcated by a layer of loosely spaced mesenchymal cells.In 10-weeks prefetuses, due to the connection of the lower vertical parts of the paramesonephric ducts, a common uterine- vaginal canal is formed, lined with pseudolayered epithelium. Mesonephric ducts retain their lumen in fragments.In 11-weeks prefetuses, the upper vertical sections of the urogenital cords, in connection with the reduction of the mesonephric ducts, contain mainly paramesonephric ducts, which are separated from each other by a loose layer of the mesenchyme. From these sections of paramesonephric ducts uterine tubes are formed. Oblique (middle) sections of the paramesonephric ducts with further development are transformed into intrauterine parts of the uterine tubes. The lower caudal sections of the paramesonephric ducts are transformed into the uterus and the upper two-thirds of the vagina.In 12-weeks prefetuses, the primary kidneys are almost completely reduced. Only single mesonephric tubules within their caudal area are determined. In parallel, there are intense processes of formation of internal female reproductive organs. The cranial ends of the uterine tubes expand, acquiring a funnel- shaped shape. The outer border of the infundibulum of the tube reminds a zigzag line, which is evidence of the beginning of the formation of the fi mbria of the uterine tube. The lumens of the mesonephric ducts are reduced to 6±0.1 μm, and in some parts of their walls are in contact with each other. Transformation of paramesonephric ducts into their derivatives (uterine tubes, uterus, upper part of the vagina) is accompanied by corresponding histological changes of their walls.

Urinary Retention Secondary to Colpocleisis: A Case Report

Introduction: Pelvic Organ Prolapse (POP) is common in older women, and depending on its extent, it is conservative or surgically treated. Colpocleisis is a technique for POP treatment, in which the vaginal canal is closed, entirely or partially, in order to avoid the protrusion of the pelvic structures, with preservation of the urethral meatus in order to preserve normal micturition. Clinical Case: We present a case of a 61-year old woman, who 8 years after a colpocleisis, progressed to urinary retention associated with the progressive scarring of the labia, causing the obstruction of the urethral meatus. The patient underwent a labiaplasty with anterior colpoperineoplasty, with complete normalization of her micturition and sexual activity. Conclusion: Long term urinary retention complication has not been previously reported in the literature and should be included as a possible adverse event after colpocleisis.

Morphology of the genital organs of male and female giant anteaters (Myrmecophaga tridactyla)

Background The giant anteater belongs to the supraorder Xenarthra which occupies a systematically isolated position among placental mammals. The species is categorized as Vulnerable by the International Union for Conservation of Nature, and understanding its reproductive characteristics is critical for future conservation efforts. Methods Gross and microscopic anatomy of the genital organs of 23 male and 21 female adult and young roadkill giant anteaters in Brazil were studied. Results Male giant anteaters presented a short conical penis, intraabdominal testes, and prostate, vesicular and bulbourethral glands. A tubular remnant of the partially fused Müllerian ducts extended from the seminal colliculus through the prostate gland, continued cranially in the genital fold, bifurcated, and attached with one elongation each to the left and right epididymal corpus. The structure presented a total length of up to 10 cm and contained a yellowish liquid in its lumen. Histologically, the caudal section of this structure resembled the female vagina, the middle portion corresponded to the uterus, and the extensions showed characteristics of uterine tubes. In adult female giant anteaters, ovoid ovaries with occasional seminiferous cord-like structures were observed. The animals possessed a simple uterus, which was directly continuous with the vaginal canal. The caudal portion of the vagina had two lumina, separated by a longitudinal septum and opening into two apertures into the vaginal vestibule, cranial to the urethral opening. In the urethral and the lateral vestibular wall, glandular structures with characteristics of male prostate and bulbourethral glands, respectively, were found. The vestibule opened through a vertical vulvar cleft to the exterior. A pair of well-differentiated Wolffian ducts with a central lumen originated ventrally at the vaginal opening into the vestibule and passed in a cranial direction through the ventral vaginal and uterine wall. Each duct extended highly coiled along the ipsilateral uterine tube until the lateral pole of the ovaries where it merged with the rete ovarii. Discussion The reproductive morphology of giant anteaters reveals characteristics shared with other Xenarthrans: intraabdominal testes, a simple uterus, and a double caudal vagina. The persistence of well-differentiated genital ducts of the opposite sex in both males and females, however, singles them out among other species. These structures are the results of an aberration during fetal sexual differentiation and possess secretory functions. The possibility of a pathological degeneration of these organs should be considered in reproductive medicine of the species. Conclusion Knowledge of the unique reproductive characteristics of the giant anteater is essential for future reproductive management of the species. Additionally, further research on the peculiarities of the persisting genital duct structures might help to understand sexual differentiation in placental mammals in general.

Three new species of Urocleidoides (Monogenoidea: Dactylogyridae) parasitizing characiforms (Actinopterygii: Characiformes) in Tocantins River, states of Tocantins and Maranhão, and new record for U. triangulus in Guandu River, state of Rio de Janeiro, Brazil

Three new species of Urocleidoides Mizelle & Price, 1964 are described from the gills of characiform fishes in the Tocantins River and its tributaries. Urocleidoides boulengerellae sp. nov. is described from Boulengerella cuvieri (Spix & Agassiz, 1829) and differs from all its congeners by the dorsal bar with a long posteromedial projection; male copulatory organ with 2–3 counterclockwise rings and a base with a flange; an accessory piece comprising a robust Y-shaped unit and a sheath-like unit; and a highly sclerotized vaginal canal. Urocleidoides paratriangulus sp. nov., described from Psectrogaster amazonica Eigenmann & Eigenmann, 1889, Cyphocharax gouldingi Vari, 1992, Caenotropus labyrinthicus (Kner, 1858) and Mylesinus paucisquamatus Jégu & Santos, 1988, is most similar to Urocleidoides triangulus (Suriano, 1981) Rossin & Timi, 2016 based on the shape of the anchors and bars but differs from U. triangulus in the morphology of the projection of the dorsal bar, the number of rings of male copulatory organ, and by the smaller size of members of hook pairs 1 and 5 compared with those of the remaining pairs. Urocleidoides tocantinensis sp. nov. is easily distinguished from all other species of the genus by the morphology of the vagina, which present a vaginal vestibule with a membranous cap. Urocleidoides triangulus is reported from its type host in the Guandu River, state of Rio de Janeiro. The present study increases the number of Urocleidoides species to 37 recognized species that fit all the generic characters.

Ayurvedic Treatment Protocol in Prasramsini Yoni Vyapat (Second Degree Uterine Prolapse)

At present stage due to modern lifestyle, nuclear family and working motherhood, the rest needed for the women during menses time and during and after delivery have been reduced. Protrusion of the pelvic organs into or out of the vaginal canal is termed as Pelvic organ prolapse. It is also called pelvic relaxation. It results from weakening or damage to pelvic supporting structures, which can occur generally throughout the vagina or at specific sites. This problem may develop after child birth, progression of age, and injury to the muscles and organs situated there. Anything that causes increased pressure in the abdomen can lead to pelvic organ prolapse. Some common causes include: pregnancy, labour, and childbirth (the most common cause) etc. Acarya Susrutha mentions that in Prasramsini, any irritation causes excessive vaginal discharge/displacement and labour is difficult/abnormal. Dalhana explains the reason for difficult labour is abnormality in passage. Clinical features of Pitta vitiation i.e., burning sensation and heat etc. are present. According to WHO estimation, the global prevalence of uterine prolapse is 2- 20%. As Prasramsini is a Pittaja yoni vyapat and Vata is the main Dosa involved in all the Yoni vyapat, the drug selected for the study is mainly Vata pitta hara and Balya. Hence an attempt was made by giving tablet Neo (Charak pharmaceuticals) orally, and Mahamasha tailam for Abyangam and Yoni pichu dharana.