Effectiveness of Structured Counseling and Preventive Strategies in Promoting Awareness and Expressed Habitual Practices Toward Prevention of Urinary Tract Infection Among Women of Reproductive Age Group: A Pilot Study

Objectives Urinary tract infection (UTI) is the most common infection that affects half of all women in their lifetime and one-fourth have recurrent infections. Health behaviors could prevent the recurrence of UTIs and therefore motivation and increasing awareness are necessary for healthy behavior change. This study was done to evaluate the effectiveness of structured counseling and preventive strategies (SCAPS) in promoting awareness and expressed habitual practices among the women of the reproductive age group to prevent UTI. Materials and Methods Block randomization with multiple interventions and follow-up were conducted among 60 women (30 in each group, randomly assigned using the SNOSE technique) attending the OBG and urology OPDs of a selected medical college hospital. Purposive sampling was used to select the subjects. Women who were positive for urine culture and experiencing typical symptoms of UTI, as assessed using the symptom score checklist, were recruited for the study. Pre-test awareness was assessed using a structured awareness questionnaire and a rating scale for expressed habitual practice. After the pre-test, on the same day, the experimental group received SCAPS intervention followed by a second session during the third month. At the third (before the second session) and the sixth-month post-tests were conducted by delivering the same tool to determine the post-test level of awareness and expressed habitual practice after the administration of SCAPS. Results The study shows there is a significant difference in the awareness and expressed habitual practice values in the experimental group (p < 0.005). The effectiveness of SCAPS showed that the mean ± standard deviation (SD) pre-test score of women (awareness - x̄1 ± SD = 9.47 ± 2.57, hygienic habitual practice - x̄1 ± SD = 20.93 ± 1.91, fluid and dietary practice - x̄1 ± SD = 7.73 ± 2.18 and sexual habits - x̄1 ± SD= 8.00 ± 3.33) was significantly lower than the mean ± SD post-test scores (awareness - x̄2 ± SD =11.37 ± 1.65, awareness - x̄3 ± SD = 12.00 ± 1.05), (hygienic habitual practice - x̄2 ± SD = 22.57 ± 2.16, x̄3 ± SD = 23.90 ± 1.99), (fluid and dietary practice - x̄2 ± SD = 10.07 ± 2.21, x̄3 ± SD =11.97 ± 1.79) and (sexual habits - x̄2 ± SD = 8.81 ± 2.51, x̄3 ± SD =9.81 ± 2.26). Conclusion SCAPS was found to be effective on awareness and preventive habitual practices with regard to UTI. SCAPS can be recommended for vulnerable groups such as females so that UTI could be prevented. Trial Registration CTRI/2018/10/016064 (Registration on 17/10/2018).

Intra-Abdominal Hemorrhagic Catastrophe due to Large Subserous Myomatous Capsular Venous Rupture

Uterine leiomyoma is a common benign uterine tumor of women in the reproductive age group. Although the common symptoms of leiomyoma are menorrhagia and dysmenorrhoea, this patient presenting as a near collapse is a rare finding. The patient presented with abdominal pain and worsening anemia within a span of hours and hypotension, tachycardia, and tachypnoea needing urgent surgical intervention and blood transfusion and intensive care support is relatively rare. Though every effort to know the exact cause of intraperitoneal hemorrhage in this patient was taken, the rarer diagnosis of capsular venous rupture was not identified prior to surgical intervention. Initially, laparoscopy was introduced first to identify the cause of massive hemorrhage; the approach was changed to open myomectomy keeping in mind the general condition of the patient. Hence, for any patient with a prior diagnosis of myoma with hemodynamic instability, the rarer diagnosis of leiomyomatous capsular venous erosion should be a differential diagnosis to aid in the appropriate management of the women. The team of interdisciplinary expertise will definitely improve the outcomes in such cases.

A comparative prospective observational study on the use of ulipristal acetate versus mifepristone in reduction of the size of uterine leiomyoma

Background: Fibroid or uterine leiomyoma is the most common benign tumor of the uterus in the reproductive age group and found in one out of every four women. They are symptomatic in 50% of women, with the peak incidence occurring among women in their 30s or 40s. Fibroid can cause a variety of symptoms which include menstrual disturbances commonly menorrhagia and dysmenorrhea. It is a common indication of hysterectomy in Indians. An effective medical treatment option may reduce hysterectomy-associated morbidity and mortality. This study is undertaken to evaluate the efficacy and safety of medical management of myoma and contribution in the reduction of myoma size comparing the two drugs ulipristal and mifepristone. Aims and Objectives: The study was conducted to compare reduction of menorrhagia (By pictorial blood loss assessment chart score), reduction of fibroid size (using transvaginal ultrasonography), and improvement of hemoglobin (Hb) level. We are also evaluating safety or side effects using these drugs. Materials and Methods: The study includes 210 patients who are divided into two groups. Group A includes 105 patients who are treated with tablet Ulipristal Acetate 5 mg daily for 3 months and Group B includes 105 patients who are treated with tablet mifepristone 25 mg daily for 3 months. Results: Ulipristal and mifepristone both are effective in reduction of menorrhagia and improvement of Hb levels, but Ulipristal is more effective in reduction of size of uterine myoma than mifepristone after 3 months of treatment. Conclusion: Multicentric study over a larger population is required to reach a valid conclusion.

NEGATIVE APPENDECTOMIES ARE MORE COMMON IN FEMALES OF REPRODUCTIVE AGE GROUP

Objective: To compare the negative appendectomy in the females of reproductive and non-reproductive age groups. Study Design: Cross-sectional study. Place and Duration of Study: Department of Pathology, Diagnostic and Research Laboratory, Liaquat University of Medical and Health Sciences, Hyderabad, Pakistan, from January 2018 to December 2019. Methodology: A total of 1126 appendectomy specimens were enrolled irrespective of age and gender. The biodata of patients was retrieved from the database. Statistical analysis was done using SPSS version 22. Results: Out of total 1126 reported cases, 787 (69.9%) were males and 339 (30.1%) were females. The mean age was calculated to be 24.43 ± 12.42 years ranging from 2-94 years. Histopathological examination revealed cases of acute appendicitis 374 (33.2%), acute appendicitis with peri-appendicitis 478 (42.5%), fibrous obliteration 28 (2.5%) and parasitic infestation 7 (0.6%). Overall negative appendectomies were 219 (19.4%) and were prominent in females 100 (29.5%) than males 119 (15.1%). Also it was higher in females of reproductive age group 77 (30.4%) than in non-reproductive age group 23 (27.9%). Conclusion: In our study negative appendectomy in females of reproductive age groups was found to be higher than expected. Clinical scoring systems, biochemical markers, imaging modalities, and second opinion from other specialties like internal medicine, gynae and obstetric have been introduced to substantiate the diagnosis of acute appendicitis and thereby decreases the negative appendectomy.

Rare case series: iniencephaly, conjoined twins and anencephaly

A discovery is said to be an accident meeting a prepared mind. This quote is true when we happen to see certain rare cases which we could not diagnose unless we are aware. The aim of this presentation is to bring attention of cases like Iniencephaly, conjoined twins, Anencephaly to our medical fraternity and the need to focus still more on health need of the women in reproductive age group in particular. This is also to highlight the benefits of periconceptional Folic acid supplementation and need for intense antenatal surveillance programmes and proper genetic counselling to affected parents.

A Cross Sectional Study on Knowledge and Attitude Regarding Exclusive Breast Feeding among Women of Reproductive Age Group in Chennai, Tamil Nadu

Aim & Objectives: To assess the knowledge and attitude on exclusive breast feeding among reproductive age group women in Chennai. Materials and Methodology This is a cross sectional quantitative descriptive study. The data was collected by handing out physical questionnaire forms to volunteers or by sending a link of the google form format of the same questionnaire. The data was collected from February 2021 to September 2021. The both physical and online forms data collected were compiled with help of Microsoft Excel. These compiled data were then analyzed using SPSS 16.0 software. All the frequencies and percentages were also obtained from this. Results: In this study a total of 342 volunteers participated, all belonging to the reproductive age group i.e., 15 years to 45 years. Majority of the participants were among the age group 20 to 30 years belonging to both married and unmarried category. Out of the 342 volunteers, 74.2% (254) of the participants planned to breast feed their infants for several months. 60% of participants had scored more than 75% overall. The lowest score seen was 26/40 points. So no one in my study had low knowledge (less than 20). The knowledge percentage and attitude percentage here are 68.6% 65.4% respectively. My interpretation of the knowledge and attitude is that we need to increase the knowledge about the term “Exclusive Breast Feeding” and also encourage the mothers to breast feed their infants. Conclusion: Although most have scored more than 75%, some important questions were chosen incorrectly. This might be mostly due to the fact that there is lack of knowledge with respect to the term “exclusive” breastfeeding. This suggests that there has to be more awareness created amongst the youth population, who are tomorrow’s mothers. The need for them to know the importance of these matters lies in hands being doctors. It should be taught from school level itself.

Spectrum of Lesions in the Fallopian Tubes – A Histopathogical Study

Introduction: The Fallopian tubes are a pair of narrow tubular structures connecting the ovary and the uterus. It is usually the site of fertilization and plays a very important role in the fusion of the sperm and ovary and helps in movement of the fertilized zygote to the uterus. Even though being an organ of very small size the importance of the variety of lesions occurring in the fallopian tubes is often not considered. Biopsies of the fallopian tubes are taken to show the different lesions found in the tubes. Aim: The main aim of the study is to study the spectrum of lesions occurring in the fallopian tubes and correlation of these findings with its clinical parameters. Study Design: This is a retrospective descriptive study Place and Duration of Study: Department of Pathology, Saveetha Medical College, Saveetha Institute of Medical and Technical Sciences, Thandalam, Chennai between June 2019- December 2019. Methodology: A retrospective study of all the fallopian tube specimens sent for routine histopathological analysis over a period of 6 months was carried out. The different pathological lesions were observed from the relevant clinical data and the correlation with its clinical parameters was done. Results: A sample size of 77 specimens was collected among which the commonest age group which was found to have the highest number of lesions was between 26-30 years. This was found to be in correlation to the reproductive age group of women. The most common form of pathological lesion observed was ectopic pregnancy (about 46% of total pathological lesions), followed by Paratubal cysts (23%), Hydrosalpinx (15%) and Hematosalpinx (8%). Cystadenoma was the only benign tumor observed in this study and constituted 8% of the total pathological lesions. Conclusion: This study shows the importance of histopathological examination of all fallopian tube specimens with or without abnormal findings.

Clinicopathological Study of Uterine Leiomyomas – A Retrospective Study

Leiomyomas are benign tumors of the uterus affecting women of the reproductive age group. They are the most common gynaecologic neoplasms in women. The aim of our study was to analyse and correlate the histopathological findings of leiomyomas in 203 hysterectomy specimens received in the department of Pathology at Saveetha Medical College and to further delineate the associated changes and variants that were observed in the leiomyoma specimens. In this study we found that the dominant age group was 31-50 years of age with multiple leiomyomas being more common than solitary ones. The most commonly observed location was intramural. Majority of the hysterectomy specimens showed a proliferative pattern of endometrium. Degenerative changes were observed in 26 cases with hyaline degeneration being the most common secondary change. There were multiple uterine pathologies associated with the uterine leiomyomas of which ovarian cortical cysts were the most frequently noted. The histopathological study of leiomyomas is important as it helps to further ascertain the diagnosis and ensure optimal patient management.