1 Population Control and Women Health , Yunis Khushi
Asian, African, South American and other poor regions of the globe are being extremely overcrowded due to high population growth rate and the material resources of these regions are being choked, which ultimately affects the quality of life for the masses of these regions and is also affecting the health and life span of women of these regions. More than 50 per cent population of these regions does not have basic facilities like potable water, basic edu-cation, proper health facilities, proper, decent and suitable housing, decent clothing and nutritional food. The living standards of the people of these regions are very poor and majority of them lives below the poverty line.
2 The Role of Radiologist in Conservative Management of Breast Cancer , Tarek Aref1 and Walid Mohamed Ahmed
Breast conserving therapy (BCT) means breast conserving surgery (BCS), followed by a suitable-dose of radiotherapy to eliminate any microscopic residual neoplastic breast disease. BCS is currently considered the most suitable protocol for management of early stage of invasive cancer, that combines both adequate surgical margins and an acceptable cosmetic result. The role of mammography and breast ultrasonography for many years was concerning the diagnosis of breast tumors and local recurrence after treatment. The advent of the Breast Imaging Reporting and Data System (BIRADS) by the American College of Radiology, helps to maximize Radiolo-gist’s role through any factors: standardized the description and recommended management of breast lesions. BIRADS has increased the radiopathological correlation of radiologists’ reports, improving the reports’ reliability and has also established a common lan-guage for all of the physicians involved in multidisciplinary breast disease management team, favoring agreement on decisions, and Furthermore, advances in breast magnetic resonance imaging; functional MRI and image-guided interventional procedures have increased our responsibility in the therapeutic decision-making process. The role of Radiologist in BCT: I- Accurate and early diag-nosis of breast cancer and staging. II- Interventional role of Radiologist in BCT including imaging-guided biopsy of breast masses, stereotactic biopsy of nonpalpable lesions and or microcalcifications guided by mammography or MRI. Post-biopsy-clips insertion, and pre-neoadjuvant chemotherapy localization of malignant lesion by US-guided insertion of a hydromark (clips). Pre-operative localization of non-palpable breast mass or microcalcifications by US-guided insertion of wire. III- Evaluation of response to neoad-juvant therapy using RECIST (Response Evaluation Criteria in Solid Tumors).
3 Assessment on Frequency of ABO Blood Group and RH (D) Negative Mothers among Pregnant Women Attending at Antenatal Care Clinic of Sodo Health Center, SNNPR, Ethiopia , Kebreab Paulos
It's important for women to find out their blood type at the start of their pregnancy. Blood will be taken to find out and there are four different types: A, B, AB and O.In addition to blood type, women can have Rh factor (specifically Rhesus D antigen), which is when proteins appear on the surface of the blood. Women who do have Rh factor are classified as Rh positive (A+, B+, AB+ and O+) and women who don't are Rh negative (A-, B-, AB- and O).
4 Effect of Endosulfan Toxicity on 1st Stage of Spermiogenesis Leading to Infertility , Asiya Nisa, Yashowardhan Suman, Mehjabeen1 and Suhail Jeelani Shah
Toxicities of organochlorine pesticides like Endosulfan show adverse effects on many organs and organ systems like liver, kid-ney, testes, muscles, immune system and hematological system. Most of the previous studies focused on effects of organochlorine on activity of spermatogenic cells. However, there is very little research reporting effects of endosulfan on spermiogenesis till date. Therefore, the current study was aimed to assess the effect of Endosulfan on spermiogenesis in the testes of mice model. A 5 mg/gm body wt. Endosulfan was administered to mice by oral gavage method. Normally in the beginning of spermiogenesis, the sperm head gets embedded in the sertoli cell and finally released from the seminiferous tubules. It is very significant to note that the testes in endosulfan treated mice. They were found to get affected at an early stage (from spermatids to 1st stage of spermiogenesis), as com-pared to any other organochlorine pesticide. The present study also confirms that only oral administration (5 mg/gm body wt.) for 20 days shows effect on spermiogenesis in 30% of mice. Furthermore, in 20 days treated mice, notable changes were seen during the 1st stage of spermiogenesis. Significant decrease in testosterone level (P ≤ 0.0001) and sperm count (P ≤ 0.001) was observed after endosulfan exposure. Abnormal spermatozoa in the lumen of seminiferous tubules were found to be very few in number and with a non-motile tail. Approximately 30% of the heads of spermatozoa were found with rounded acrosome, which will lead to infertility.
5 Currently Used Drugs for Prevention and Treatment of Acute Organ Rejection , Vera Maravić-Stojković and Branislav Stojković
It is clear from the knowledge gained from the ancient times that healing is not as simple process as it seems. During long periods of time, major advancements in technology, pharmacology, and medicine have enabled the extraction of countless remedial prod-ucts from the plants. And not only from plants. Natural products have also been extracted from animal organs and later, synthetic equivalents with identical properties have been developed. The fascinating progress of humankind was achieved when the animal organs have become available as a drug. Nevertheless, revolutionary progress in solid organ transplantation was marked by the in-troduction of the cyclosporine A. Transplant immunology has become a leading science in modern medicine. Since then, solid organ transplantation has become a routine procedure accomplished with the help of protocols of immunosuppressive therapy. This article is designed as an overview of currently used immunosuppression in solid organ transplantation. Currently available groups: steroids, antimetabolites, polyclonal and monoclonal antibodies, calcineurin inhibitors, proliferation signal inhibitors, are described closely below. Each transplant center creates their own protocols. Protocols for immunosuppressive therapy offer three major strategies: in-duction, maintenance and therapy for treating acute rejection. The backbone of immunosuppression in organ transplantation recipi-ent: cyclosporine A and tacrolimus, have been widely used as maintenance therapy combined with adjunctive immunosuppressant. These drugs are in use either as a prophylaxis or as the part of the maintenance immunosuppressive treatment. Induction therapy provides immunologic ablation with upstream antibody therapy as prelude to induce graft tolerance. Protocols are briefly described in the text
6 Extramarital Affairs (EMA) for Indian Women: An Overview of its Health Impacts , Sanjeev Davey
Extramarital affairs (EMA) of men and women is becoming a rising Phenomenon in our modern society globally. Both men and women may get sexual and/or emotional motivations for EMA if their marriage is not satisfying in any aspect. EMA can put serious Impact on women if it is not secret. So, Couples should openly communicate regarding their sexual desires and expectations in their Married relationship to their partners
7 Effect of Data Selection on Reimbursement Decisions. Breast Cancer Case , Abdalla Abotaleb
One of the daily challenges for health care policy makers is selecting the right patient for the right treatment with affordable price. If we taking breast cancer treatments at law middle income country, as Egypt's experience with breast cancer, an incidence (15.4) per 100,000 beside the prevalence of HER2-positive breast cancer is approximately 15% to 20% of primary breast cancers. this will lead to economic burden as well as consequences on decision makers. When they decides to treat with monoclonal antibodies like Trastuzumab what is the appropriate time to treat the patient to achieve the efficient management of resources 6 months versus 12 months of adjuvant Trastuzumab in early breast cancer. What will be the best option for the resources and patients outcomes?To answer the previous question an economic study was conducted trying to support decisions makers. The result of economic model showed that selecting one clinical study for deciding shorter time regimen versus standard regimen is might not be strong evidence for taking the decisions because the economic model was so sensitive to the following parameters. Selecting data for health care decision making in oncology should take in consideration.Strength of evidence sensitivity analysis of that data should be conducted to ensure effective health care decisions and losing the previous criteria might lead to negative impact on patients’ outcomes and treatment resources.
8 Knowledge Attitude and Practice of Health Care Workers towards COVID-19 in Nowshera Pakistan , Hamzullah Khan
Corona Virus disease termed as COVID-19, is an emerging highly contagious respiratory disease that is caused by novel corona virus. It was first reported from Wuhan China in December 2019.
9 An Observational Study of Women’s Experience and Health Needs Related to Menopause at the Clinic of complementary medicine in Lucca, Tuscany Region,Italy , Alessia Melacca
Introduction During their life women go through very different phases such as puberty, fertile age, pregnancy, puerperium and menopause. Each phase is defined by important changes and different women’s needs. In particular, menopause determining the end of the fertile age, represents a delicate period which although can be experienced in very subjective way, is generally characterised by a higher psycho-physical vulnerability.
10 DIY Making an Herbal Extract and High-Tannic Wine Treated Nose-Filter against Coronavirus   , Johnson K Gao
This article is based on the current situation that the sudden explosion of coronavirus epidemic causes a shortage of facemask. It is known that Dryopteris root, Radix isatidis have antiviral effect. Tannic acid can fix the cell membrane in electron microscopy sample preparation. Tannic acid could also cause certain degree of fixation or alteration of coronavirus membrane. The Domaine de Moulie red wine is famous in its source of Tannat grapes, which contains higher concentration of tannic acid. This is a suggestion to use Domaine de Moulie red wine to extract antiviral chemicals from herbs to treat gauze, and then use that kind of gauze to make a nose filter in order to decrease the possibility of transmission of coronavirus. However, the effectiveness has not yet been validated
11 Effect of Soy Beans on Women Health   , Sheeba Chellappan
Soybean contains all amino acid essential to human beings and has a positive effect on health. It is widely available in India and many studies reported the positive effects of soybeans. Ingestion of soybeans may help to prevent and control chronic diseases such as diabetes mellitus, cancer and improve  the quality of life in postmenupausal women.
12 Novel Coronavirus Disease (COVID-19): Pregnancy Issues , Goce Kalcev;Ivan Barbov ; Jovan Bozinovski and Elizabeta Zisovska
Immune and physiological changes that occur during a woman's pregnancy place her in a high-risk group for the physical and mental health consequences of various factors [1]. Previous studies showed high rates of maternal mortality, abortion, and preterm labor after pneumonia caused by the H1N1, MERS, influenza A, and SARS viruses [2]. However, information on the impact of COVID-19 infection on mothers and newborns outcomes is veru limited.
13 Endometriosis in Umbilical Hernia , Saud Al Omani and Nouf Yassin
Endometriosis is the presence of functional endometrium tissue outside the uterus. It affects approximately 11% of the population [1]. Here we present a patient with atypicalhistory who was found to have Extra-pelvic endometerosisin the sac of a recurrent  para-umbelical hernia
14 Feto-Maternal Outcome of HIV Positive Pregnant Women on HAART at the Gambia - Case - Control Study , Matthew Anyanwu1,2*, Samuel Anya2, Richard Offiong3 and Bissallah Ekele3
Human Immunodeficiency virus (HIV) infection in pregnant women remains a huge public health concern globally. There were conflicting reports regarding pregnancy outcome among HIV positive mothers. The aim was to compare pregnancy outcome among HIV-infected and uninfected women at Edward Francis Small Teaching Hospital, Banjul the Gambia. Pregnant women attending antenatal clinic at the hospital were prospectively recruited and followed up. HIV positive and negative mothers were matched for age and parity. Recruitment occurred irrespective of gestation age. At the time of delivery, obstetric and neonatal characteristics were entered into computer database. Mothers and their children were followed until 6 weeks postpartum. The data was analyzed with Epi-info version 7.1.5. Chi square at significant level of 0.05 and confidence level of 95% was used to determine significance. A total of 166 mothers, 55 HIV positive and 111 HIV negative controls were in the study. The age range was between 18 to 45 years and parity was 0 to 8. The measured adverse outcome includes; Low Birth Weight; 20% Vs 5.2% odds ratio (OR) 4.6; 95% confidence interval (CI) 1.46-14.2; P- 0.01220 and maternal anaemia (40% Vs 11% OR 5.4 95% CI 2.3 - 12.6; P-0.0001). Both showed statistical significant difference. Preterm delivery; 29.2% and 26.6%; OR 1.14; 95% CI 0.52 - 2.46; P-0.9 and stillbirth, low Apgar score at 5 minutes and NICU admission of 5.45%vs 0-0.9% showed no statistical difference; (OR = 6.3; CI; 0.6 - 6.25; P -0.21). HIV infection was associated with low birth weight and maternal anaemia.
15 Use of Immunomodulators (Etanercept) in a Miniseries with Covid-19 Patients, to Decrease the Progress of Complications and Risks of Entry into Critical Care. Bibliography Review , Adán Oliveros-Ceballos1*, Janeth Gutiérrez-Segura2, Adrian Israel Ramirez-Mendoza3 and Bryan Adan Oliveros-Galeana4
Objective: This study aims to describe the clinical results of a miniseries of 6 patients who presented characteristic COVID-19 symptoms and PCR positive, who were administered Etanercept, to avoid Cytokine release syndrome with the purpose of decreasing admission to the critical care unit. Design: This is a prospective, descriptive observational study. Patients and Methods: 6 patients with (SARS-CoV-2) COVID-19 symptoms were evaluated for the administration of the immunomodulator Etanercept 50 mg. Two groups were aligned: A) Mild: with fever, cough, images compatible with pneumonia, and gastrointestinal symptoms; B) Moderate: with fever, cough, images compatible with pneumonia, gastrointestinal symptoms and respiratory distress considered as L phenotype. Results: A total of 13 patients were identified with suspected infection of the virus (SARS-CoV-2) COVID-19, from which 6 patients accepted the administration of the immunomodulator Etanercept 50 mg (subcutaneous) in a single dose and protocol follow-up. From these 6 patients: 4 patients had fever, cough, headache and risk factors such as pregnancy and obesity; and 2 patients also presented respiratory distress considered as L phenotype. All 6 evolved to improvement. No patient was admitted to the critical intensive care unit and did not require invasive ventilatory support. Conclusion: In this miniseries, the administration of the Etanercept immunomodulator in patients with (SARS-CoV-2) from mild to moderate stage, improved the clinical evolution and reduced the risk of admission to the intensive care unit. However, more patients and more controlled and randomized studies are necessary to recommend immunomodulators.
16 Fetal Sacrococcygeal Teratoma Requiring Emergency Hysterotomy in Second Trimester , Amrit Pokharel1* and Geeta Gurung2
Sacrococcygeal teratoma (SCT) is the commonest fetal tumor. We report a case of fetal SCT requiring emergency hysterotomy at 21+4 weeks of gestation. A 22 years primigravida, with prior uneventful antenatal care, presented at 21+4 weeks of gestation with on and off pain abdomen and back for 3 days associated with passage of show for 1 day. Vital signs were stable and her abdomen was tense and tender with fundal height of 30 weeks. She was in early labor. Urgent USG revealed a live intrauterine fetus with features suggestive of huge fetal SCT for which she underwent emergency hysterotomy
17 Assessment of Surgical Treatment Outcome of Women Patients with Stress Urinary Incontinence Managed in Jimma University Medical Center, Southwest Ethopia , Chuchu Arega*
Background: Stress Urinary incontinence (SUI) is a common problem in women and with appropriate diagnosis stress urinary incontinence can most often be treated. Jimma University Medical Centre (JUMC) has been performing surgical treatment since the past four years and it was crucial to determine the clinical characteristics and outcomes of surgical treatment done for women with stress urinary incontinence JUMC. Objectives: To determine outcomes of surgical treatment of women with stress urinary incontinence, and associated factors in Jimma University Medical Centre (JUMC). Methods: Hospital based cross sectional study was conducted among 44 female patients with stress urinary incontinence admitted to gynecology ward and underwent surgical treatment in Jimma University Medical Centre (JUMC) over a period of 1 year and 7 months from 1 January/2018 to 30 July/2019 G.C. The collected data was entered into Epidata version 4.1, and then it was exported to SPSS (Version 20.0) for statistical analysis. Result: The study showed that the age of the patients ranged from 14 to 65 years with mean of 35 (± 13) years, 24 (54.5%) patients were house wife, 19 (43.2%) divorced, 33 (75%) were not sexually active, 30 (68.2%) multiparous and 30 (68.2%) patients gave birth by vaginal route. Forty two (95.5%) patients were from rural areas and 27 (61.4%) patients were having stress urinary incontinence for less than 36 months, 17 (38.6%) patients were having stress urinary incontinence for 36 months and above. Thirty nine (88.6%) patents were treated with pubovaginal sling and 36 (81.8%) patients on discharge were continent to urine and were cured of SUI after surgical treatment. Conclusion and Recommendations: In this study the majority of patients had lived with stress urinary incontinence and were treated with Pubovaginal Sling and high success rate was achieved with vulvovaginal Sling procedure.
18 Non Communicable Diseases and Women's Health , Oliseneku Damien Uyagu
While there are many gender-specific challenges about women’s health, Non Communicable diseases (NCDs) constitute the most significant threat to women’s health worldwide. The impact of this problem drew the attention of the World Health Organization 10 years ago at the 2010 UN global strategy for women and child health [1]. The summit considered NCDs as a critical element of improving the lives of girls and women worldwide. Ten years after that summit, NCDs remains the highest cause of death among women and girls. Several papers published about women and girls allude to this fact. Global efforts to improve women’s health primarily focused on Sexual and reproductive health while neglecting the number one cause of mortality and morbidity to women and girls. In a recent article titled ‘Women’s health, A new global agenda’ published in the BMJ 4 years ago, attention was drawn to the actual burden borne by women and girls due to the direct effects of NCDs
19 Evaluation of Black Transition to Disharmony Episodes of Private Burnside Pharmacy Institutions in Pune, India , Rahul Hajare
Consuming smelly food at the office desk can affect working conditions. Represents a substantial void in the literature both on corporate governance and international business. The new theoretical proposition of culturally determined agency has suggested. It builds on the recently put forward behavioral theory of corporate governance. This novel theoretical lens in corporate governance merges the under-socialized agency theory, as the dominant institutional logic in corporate governance of domestic firms, and the behavioral theory of the firm, which has probably the only theory of the firm that explicitly treats firms as complex social systems. Finally, three exemplifications of application of this new theoretical construct of culturally determined agency to the analysis of contemporaneous business issues in pharmaceuticals
20 Women Health amongst COVID , Rupinder Kaur
COVID has affected diverse population throughout the world. The female domain exhibit amplified effects of this pandemic. Lockdown implications has exponential impact for women in every sphere of their lives. The multilayered effects have worsened the pre-existing conditions of inequality, informal economy, unsecure jobs, limited social protection, domestic violence and so on. Heightened care demands of family members staying back at home has burdened this very group of community to bear top up household responsibilities. Mismatch in competing both home and job demands has lead her exhausted. Instead of ventilating her feelings she has been subjected to certain neglectful strategiesPsychological abuse, physical and sexual violence in relationship, family abuse and greater reports of intimate partner violence. This has left her all shattered with feeling of worthlessness, anger, humiliation and helplessness. All these have somatic presentation in the form of changes in memory, attention, appetite and sleep with fatigue, body aches and adverse thoughts of self -harm and suicide. Of course there is unpaid care and unequal share in domestic responsibilities but there is likely more chance of women getting infected with virus by comprising 70% in the frontline health care workforce. Amongst this all women has proved to be backbone of recovery in community. The need of the hour is to ensure women safety, foster her health and combat inequalities. Increase awareness and advocacy campaigns. Prioritize legal aid in domestic violence and reproductive health services. All the frontline health workers to be equipped adequately. We should find out ways to include women in response and recovery decision making whether at home or outside.
21 Woman and Breast Cancer - Early Detection Saves Life , Tabassum Kotagasti
Breast Cancer is the most common cancer in Indian women and accounts for 27% of all cancers in women. About 1 in 28 women are likely to develop breast cancer during their lifetime. In the urban areas the incidence is 1 in 22 as compared to the rural areas where 1 in 60 women develop breast cancer. Breast cancer patients experience physical symptoms and psychosocial distress that adversely affect their quality of life (QOL).
22 Role of Healthy Food Daily Consumption on the Forming of the Breasts, Thighs, Buttocks for Getting Healthy, Sexy and Interesting Body , Rosa Lelyana
A person’s body shape is influenced by various factors. Many women who want a healthy body shape, sexy and attractive. One of the parameters of a woman’s attractiveness is the shape and size of her breasts, thighs and buttocks. Unclear understanding the ways to get a healthy, beautiful and attractive body shape because of many factors that influence it. One of many factors is the food factor, but it is still unknown how food affects the formation of breasts, thighs and buttocks. Therefore, this paper aims to discuss the role of food in the formation of breasts, thighs and buttocks in women so that they look healthy, sexy and attractive.
23 Impact of Oocytes Insemination Timing on Fertilisation and Embryo Development Rate , Chandan N*, Raghunandan K, Reeta Janet Jessy I, Saleem M and Shwetha C
Background: Pre-incubation period between oocyte retrieval and injection in Intracytoplasmic sperm injection (ICSI) cycles improved the percentage of mature oocytes, the preincubation of oocytes prior to in vitro fertilization (IVF) improves the fertilization rate and the quality of embryo formation. Objective: The study was to analyze whether the preincubation of oocytes and microinjection timings on the outcome of ICSI increases rates of fertilization and the quality of embryo formation and also to evaluate the relationship between different pre-incubation periods of oocytes. Design: Retrospective randomized controlled trial. Methods: A total of 129 patients undergoing their Intracytoplasmic sperm injection cycles, retrieved oocytes were preincubated for 2 - 6h prior to injection, the injected oocytes were cultured in Culture NX media, fertilization and Embryo development assessment was performed on day 1 and day 3, Patients were randomly divided into different groups. Results: Neither 2 - 3 hour and 3 - 4 hour insemination time of post oocyte retrieval had no significant influence on the fertilisation rate (FR) and showed no significant improvement in Embryo development, fertilization rate showed a significant improvement after inseminating at 2 - 3 hour gives 86% fertilization rate and 95% embryo development rate while FR significantly decreased with the increase of insemination time. Also, inseminating oocytes at 3 - 4 hour post oocyte retrieval gives 81% fertilization rate and 97% embryo development rate.
24 Low Value of Apnea-test on Fetal Survival in Intrauterine Hypoxia is Universal Indicator for Planned Caesarean Section , NA Urakova1 and AL Urakov2
The review is devoted to the justification of apnea-test on fetal survival for hypoxia in a pregnant woman as a criterion for choosing the type of planned delivery through the natural birth canal or by Cesarean section. It is shown that during physiological childbirth in women, the uterus repeatedly worsens the blood supply to the placenta, which causes intrauterine hypoxia of the fetus at each contraction. This is because during contractions, the uterus squeezes not only the fetal bladder with amniotic fluid and the fetus, but also the placenta, as well as blood vessels that are located inside the uterine wall and through which arterial blood flows to the placenta. Therefore, when giving birth through the natural birth canal, the fetus is forced to repeatedly experience periods of hypoxia. However, the ability of fetuses to survive periods of intrauterine hypoxia in future births today is not taken into account when choosing the type of delivery. It has been shown that apnea-test on fetal survival at hypoxia can increase the accuracy of choosing the planned type of birth resolution. It has been established that if the period of immobility of the fetus during respiratory retention by its mother is less than 10 seconds, then childbirth through the natural birth canal is contraindicated, since this can cause drowning of the fetus in amniotic fluid, asphyxia, encephalopathy and pneumonia of the newborn. Planned Caesarean section can improve the prognosis of childbirth.
25 Osteoporosis - Relationship of Bone Mass Density with Body Mass Index and Selected Variables: A Descriptive Survey , Athar Javeth
Osteoporosis is a silent thief of bone which is characterized by decreased bone mass density and gradual decline in bone tissue which increases the susceptibility to bone fracture. The objective of the study is to assess the bone mass density and body mass index and to find out the relationship between them.
26 Holistic Quality of Life in Women during Natural Perimenopause and Postmenopause , Cárdaba-García Rosa María1* and Aparicio-García Marta Evelia
Objective: The goal of the present study was to assess the health status of women during the natural climacteric with respect to physical, mental, and social variables. Design: It is a descriptive correlational study. Setting 419 perimenopausal women are involved on a voluntary basis. 273 women were premenopausal and 146 were postmenopausal. The tools used were the GHQ-12 General Health Questionnaire, and DukeUNC-11 Questionnaire of Functional Social Support. Results: It was found that the youngest women tended to suffer from anaemia more often, and that the oldest women suffered from osteoporosis, osteoarthritis and arthritis. It was also found that postmenopausal women had better mental health. Regarding social support, there were no statistically significant differences between the two groups of women. With respect to holistic quality of life, it was found that the youngest women enjoyed better living conditions. Conclusion: This study provides insight into the health of women during the natural climacteric, and a gender perspective with respect to health research with the aim of removing the possibility of health discrimination by gender.
27 Risk Assessment of Airborne PM2.5 Exposure of Forest and Land Fire Haze to Petrol-Pump Officers in Pekanbaru , Elisa Moetiara.
The forest and land fire situation in Sumatra have led to a haze disaster that contain harmful particulate matter exposing Pekan-baru population. Number of studies concerned with associations between respiratory and cardiovascular health effects and exposure to fine fractions of particulate matter (PM2.5) on polluted air have been reviewed by Kim [1]. Although studies have proven signifi-cance difference of health effect due to haze, currently there is no study to estimate the potential health risk to population exposed to haze in Pekanbaru. This study aims to estimate the risk of PM2.5 in ambient air during haze period that exposed Petrol-pump officers. The risk magnitude is represented by Risk Quotient (RQ) that determined by comparing the PM2.5 exposure intake with exposure dose-response of the workers using the Environmental Health Risk method from The International Programme on Chemical Safety (IPCS). Intake value is generated based on the concentration of PM in the environment, individual activity patterns and anthropo-metric values. Concentration of PM2.5 was using secondary data generated by real-time PM measurement for Pekanbaru. The activity patterns and anthropometric values were collected using questionnaire to 20 Petrol-Pump Officers from 5 different gas stations in Pekanbaru. The calculation of lifetime risk showed that Petrol-Pump Officers who were exposed longer since 2015 haze period, has four times greater health risk compared to those who are just exposed in 2019. Petrol-Pump Officers who just got exposed to PM2.5 in 2019 has RQ ≤ 1, hazard was not a threat - however risk still need to be maintained under 1. While RQ for PM2.5 exposure to Petrol-Pump Officers who has worked since 2015 is > 1, means PM2.5 in haze that exposes Petrol-Pump Officers cause the adverse health effects and the risk needs to be managed.
28 Follicular Fluid Aspiration and Oocyte Retrieval Techniques, Several Flushing, Difficulty Situations Damage Risk to the Cumulus Complex and Complications , Mohamed Zarqaoui1, Mustafa Zakaria2*, Noureddine Louanjli3, Nisrine En-Naciri4, Mohamed Ennaji5, Malak Jamil6, Amal Kabit5, Saadani Brahim7 and Boutiche Romaissa8
In Assisted Reproductive Technology (ART), oocyte retrieval is a vital step. It was initially performed through laparoscopy, which was complex and difficult and of low efficiency. Ultrasound-guided transvaginal oocyte retrieval was safer and more effective; it is presently the standard operation for in vitro fertilization (IVF) treatment. Theoretically, oocyte retention is achievable after the initial aspirate due to abnormal development of the follicle or oocyte and human technical factors, and such retention could be overcome by recurrent follicular flushing. Follicular flushing is considered to maximize the number of oocytes retrieved and thereafter to improve the rate of IVF pregnancy. There are a number of factors that can affect egg collection and/or egg damage. These involve variables like pump vacuum flow, velocity, needle bore size and length, follicle pressure and size and collection techniques. Cook Medical Technology, Brisbane, has developed appropriate equipment to study the factors influencing the success of egg collection and the cause of egg trauma
29 A Prognostic Tool to Predict the Development of Postpartum Endometritis and Haematometra , Bulavenko O1, Ostapiuk Lesia1,2*, Rud V1 and Rud O3
Introduction: Obstetric sepsis remains one of the top 5 causes of maternal death in Ukraine, according to the data collected between 2009 - 2015. Postpartum purulent-inflammatory diseases are the reason of sepsis occurrence. Currently, there is a lack of methods of early diagnostics of postpartum endometritis (PPE). Objectives: The main aim is to evaluate the risks of postpartum endometritis (PPE) among postpartum women and development of means of its early diagnosis using fluorescent spectroscopy. In addition, the reliability of such approach is tested via creation of a prognostic model. Methods: Fluorescent spectroscopy was used, along with the standard diagnostic tools in order to diagnose 170 postpartum patients of the participants cohort and 40 postpartum patients of the control group with uncomplicated course of postpartum period. Results: By statistical analysis using logistic regression, the data was evaluated according to more than 40 indicators and as a result, a prognostic model was derived. This prognostic model enables to assess the probability of development of postpartum endometritis among postpartum patients. ROC-analysis was implied in order to evaluate the quality of the proposed model. Conclusion: Proposed multi-structured model for prognosis of the development of PPE among postpartum women, which enables determination of the patient groups susceptible to develop PPE. The major risk factors in the finalised multi-structured model of the development of PPE are: extragenital pathology, risk of miscarriage, TORCH-infections, colpitis, labour duration > 12 hrs, abnormal labour, lambda (λ) max, fluorescence intensity ≤ 0,845, a number of bed days and the presence of foetal distress. It was confirmed, that the results obtained by using fluorescent spectroscopy have the highest significance among the prognostic tools used in the investigation. Therefore, application of this prognostic tool in clinical practice is a highly feasible way to improve diagnosis and prognosis of the development of postpartum endometritis. .
30 Complete Supracervical Uterine Transection - A Rare Complication of Abdominal Myomectomy , Kunal Rathod1*, Sheela Swamy2, Adam Jakes3, Holland Tom4 and Kumar Kunde4
Iatrogenic disconnection between the uterus and cervix remains an unreported complication post myomectomy. We report a case following abdominal myomectomy and the surgical repair. A 41-year-old presented with secondary amenorrhea and primary subfertility. Ultrasound pelvis and Magnetic resonance imaging showed that the uterine body was entirely separated from the cervix. Successful reanastomosis of uterus and cervix followed by a Hysteroscopy and adhesiolysis which was performed after 6 months led to regular establishment of periodic menstruation
31 An Interaction of Human Health and Soil Fertility: A Lost Opportunity for Producers and Consumers , Sanjay Rode*
The people, plants, animals, and insects are depending on fertile soil for survival and growth. Fertile soil produces quality food and nurture all species. Plants prepare food from soil and provide it to animals and human being. The domestic animals eat fodder and few provide milk. Their reproduction is depending on clean environment, soil, water and fodder. There is large-scale interdependence on each other of human beings, animals and plants. Soil nourishment is very important for high production and growth of all plants.
32 Effect of Pelvic Floor Descent on Posterior Pelvic Floor Disorders in Women with Obstructed Defecation Syndrome , Akira Tsunoda*, Tomoko Takahashi and Hiroshi Kusanagi
Background: The relation between age, parity, and posterior pelvic floor disorders involving obstructed defecation syndrome (ODS) is a matter of controversy. This study aimed to determine the effect of pelvic floor descent (PFD) on the prevalence of posterior pelvic floor disorders in women with ODS. Methods: Data for women with ODS, collected in a prospective pelvic floor database, and were assessed retrospectively. Data on demographic variables and defecography were analyzed. PFD during defecation was estimated by the degree of the anorectal junction in relation to the inferior margin of the ischial tuberosity. Results: Of 334 women with ODS, the most frequently detected defecographic abnormalities were rectal intussusception (58%) and rectocele (45%). Regression analysis showed that the presence of rectocele and enterocele was more common in women with increased PFD. A higher incidence of rectocele and enterocele was found in women with excessive PFD (≧ 30 mm) than those without excessive PFD [58% (68/118) vs. 37% (77/209), P < 0.0001; 23% (27/118) vs. 14% (29/209), P = 0.038, respectively]. Increasing size of rectocele was significantly associated with increasing PFD. There were no significant differences in the prevalence of various posterior pelvic floor disorders between nulliparous and parous women. Conclusions: The prevalence of both rectocele and enterocele increased significantly with increasing PFD in women with ODS, but the incidence of rectal intussusception showed no such relationship.
33 Embryology and Uterine Abnormalities, Shapes and Miscarriage Risks , Mohamed Zarqaoui1, Mustafa Zakaria2* and Noureddine Louanjli3
An abnormal uterus can sometimes be a risk factor for miscarriage and, in some cases, a cause of recurrent miscarriages. however, only some types of uterine malformations increase the risk of miscarriage and require treatment. others may not cause any problems with pregnancy at all. about 18% of women who have recurrent miscarriages have some type of uterine abnormality. Some uterine malformations are present from birth, while others develop during adulthood. most often, women with uterine abnormalities do not have any symptoms and are not aware of these malformations before they become pregnant. Diagnosis of congenital uterine malformations usually comes after a hysterosalpingogram (HSG), but this test can miss some conditions, such as uterine septum. Any abnormal HSG should be followed by a hysteroscopy. A uterine septum (septate uterus) is the most common congenital uterine anomaly, comprising roughly 55% of Mullerian duct anomalies. Congenital means that it is present at birth. A uterine septum is a band of fibrous tissue that partially or completely divides the uterus, usually without a good blood supply. If a fertilized egg implants on the septum, the placenta is unable to grow properly and miscarriage is likely, for women who have a septate uterus, the risk of miscarriage is significant. In fact, in one study nearly 67% of the women in the study with a septate uterus experienced pregnancy loss, for women who do not miscarry, a septate uterus may increase the risk of preterm birth. In fact, the same study found that the likelihood of having a full-term, normal-sized baby was only on 25%. treatment is usually minor surgery, performed during a hysteroscopy, to remove the abnormal tissue. this usually works extremely well to resolve the problem and allow women to successfully carry a full-term pregnancy
34 Women for the Women Leaving Behind in Marginalized Teagarden Community Addressing the Unmet Need for Family Planning , Abu Sayeed Md Abdullah
National maternal and perinatal death surveillance and re-sponses (MPDSR) data of Bangladesh represents that 120 mater-nal deaths occurred in Moulvibazar district during 2014, 39.1% (47 maternal deaths) of which occurred in Tea Gardens catchment areas. Verbal autopsies conducted in those deaths also identi-fied poor care seeking behaviour, access to services; availability and utilization of appropriate MNH services and family planning services including referral.
35 Knowledge, Attitude, and Practice of Cervical Cancer Screening and Associated Factors Among Reproductive Aged Women in Ethiopia: A Meta-Analysis and Systematic Review , Yoseph Merkeb Alamneh1*, Alehegn Aderaw Alamneh2 and Abtie Abebaw Shiferaw3
Cervical cancer is the leading cause of cancer deaths, accounting for 9% of female cancer deaths. In addition, more than 85% of cervical cancer related deaths are found in low and middle-income countries. Women’s knowledge and attitude are barriers for the uptake of cervical cancer screening service in Ethiopia. Studies conducted on knowledge, attitude, and practice of cervical cancer screening and associated factors among reproductive age women are inconsistent. Therefore, this systematic review and meta-analysis aimed to estimate the national level of knowledge, attitude, and practice of cervical cancer screening and associated factors among women aged 15 - 49 years in Ethiopia
36 Improving Handwashing Promotion and Practice in Emergency Contexts: Evaluating Two Novel Approaches in Nduta Camp, Tanzania , Foyeke Tolani1*, Betty Ojeny1, Michelle Ping-Lee D’Amico2, Loveness Raphael1, Liz Barker3 and Jamae Fontain Morris2
Handwashing with soap can disrupt the transmission of diarrhea-causing pathogens, a major cause of morbidity in emergency settings. However, evidence that traditional hygiene promotion activities drive sustained increases in handwashing is weak. We aimed to test: 1) an improved handwashing station and whether it increased handwashing and 2) if pairing improved sta-tions with a behavioral intervention based on emotional drivers further increased handwashing.
37 Impact of Herbal Medicine on Restoration of Post Menopausal Women's Health , Anjum AA1, Tabassum K2* and Banu S
Menopause is a natural biological process occur after 40 years in every women's life. But the physical symptoms, such as hot flashes, and emotional symptoms of menopause may disrupt their sleep, lower energy or affect emotional health. The mean age of menopause is 49.4 years and 130 million Indian women are expected to live beyond menopause into old age by 2015. In India, 19% of women age 40 - 41 have already reached menopause, and the incidence of menopause increases rapidly after 41. By the age of 48 - 49 years two third of women are in menopause. So, the number of women in menopause is increasing with their life expectancy and also with reported problems. Therefore, quality of this population becomes a major issue and understanding of menopause is very important issue. Long term use of HRT (Hormone Replacement Therapy) has been associated with increased risks for venous thromboembolism, coronary heart diseases, stroke and breast cancer. In classical unani text, though menopausal transition is not mentioned as such, but its clinical features can be correlated with complications occurring due to Ehtebase haiz (Amenorrhoea). There are many effective treatments available, from lifestyle adjustments to hormone therapy. In unani system of medicine, many herbal medicines are documented to alleviate these symptoms. Herbal medicines include Asgandh, Soya, Alsi, Todari, Aslasoos, etc. This review paper focuses on herbal medicines which are useful in menopausal syndrome
38 Duration of the Effect of Fertility and Insulin Resistance on IVF or ICSI Results in Women with Polycystic Ovarian Syndrome , Mustafa Zakaria1*, Mohamed Zarqaoui2, Noureddine Louanjli3, Nisrine En-naciri4, Mohamed Ennaji5, Amal Kabit6, Naima El-yousfi7and Romaissa Boutiche
The main effects of insulin resistance in the pathogenesis of PCOS, strategies to reduce insulin and improve reproductive param-eters in PCOS patients and should be recommended for all overweight and obese patients, and the effects of insulin resistance on the results of IVF or sperm injection were examined. Intracytoplasmic (ICSI) in women with PCOS. Insulin sensitivity was measured by continuous glucose infusion with a form evaluation test (CIGMA). Insulin-resistant (n = 26) and non-insulin-resistant (n = 30) women with PCOS underwent a total of 100 cycles of long-term down-regulation with poserilin acetate, stimulation with recombinant human FSH, and IVF or ICSI. And the ovarian stimulation period for hormone tests. The insulin-resistant and non-insulin-resistant women had similar concentrations of FSH, LH, testosterone, and androstenedione during stimulation, but the insulin-resistant women had hyperinsulinemia and low concentrations of globulin associated with sex hormones. The insulin-resistant women also had low con-centrations of estradiol during stimulation and required higher FSH doses, but these differences disappeared after controlling for higher body weight in the insulin-resistant group of women. Insulin resistance was neither associated with hormone levels nor with IVF outcomes. Obesity, regardless of insulin resistance, is associated with relative gonadal resistance, necessary to confirm these findings. In conclusion, it has been shown that reducing insulin resistance improves the ovulation rate in PCOS patients, but there is strong evidence to maintain the usefulness of insulin-causing drugs as a treatment option.
39 Non Surgical Management of Stress Urinary Incontinence , Non Surgical Management of Stress Urinary Incontinence
Urinary incontinence is defined as the involuntary leakage of urine. This condition occurs in both men and women, but is much more frequent in women. It is typically related to dysfunction of urinary bladder or pelvic floor muscles which occur after child-birth or due to ageing related to menopause. In women, there are two main types of urinary incontinence - stress incontinence and urge incontinence.
40 Prevalence of TORCH Infections during Pregnancy: A Prospective Cohort Study in Tribal Region of Gujarat, India , Kranti Suresh Vora1,2*, Paridhi Gupta1, Shahin Saiyed1, Bhumika Prajapati1 and Senthilkumar Natesan
Maternal infections are important causes of poor birth outcomes, child morbidity, and mortality. The most common infections during pregnancy causing adverse birth outcomes are TORCH. Few studies have been done in India to know prevalence of TORCH in general population. The objective of this study is to determine the Prevalence of TORCH infections in a tribal area of the Aravalli district in Gujarat, India.
41 The Role of Sporting Activates in Reducing Plastic Surgeries among Women Students at Al-Balqa Applied University , Lubna M Obeidat
Introduction:Beauty is one of God’s blessings conferred on us, especially on women. Our true religion instilled in us love for adorn-ment and being beautified.Objectives: This study aimed to identify the role of sports activities in reducing plastic surgeries as to women students at Al-Balqa Applied University.Methods:The researcher used the descriptive correlation method. The sample consisted of (200) females chosen randomly from the university by implementing the study tool on a sample consisting of (60) items including six domains. Suitable methods were used to ensure validity and reliability, to answer the research used the two-way analysis of variance, the multi-variant analysis of Viviane and Scheffe’s test.Results: The means (3.86 - 3.00) with the highest mean (3.86) for the personal motivations, which ranked first, whereas the academ-ic motivations came last with the mean of (3.00). The means of the tool as a whole reached (3.33). The results of the study showed statistical differences (0.05 = a) attributed to the case effect. They also showed significant statistical differences (0.05 = a) attributed to the impact of the academic year on the aesthetic and health field, with the differences on behalf of the 3rd and 4th women students.Conclusion: The research came out with a set of recommendations among the most prominent of which is the necessity of enhanc-ing the culture and concepts of sports as related sports do the role of sporting activities for women, for such activities have a positive impact on the different walks of life: aesthetic, personal, psychological, social, academic and health issues. It was also recommended that positive motives have to be boasted through exercising sports activities to minimize plastic surgeries
42 Clinical Significance of Pathological Nipple Discharge as a Single Breast Symptom: A Single-institute Experience , Mostafa Ramadan and Rabie Ramadan
Background: Nipple discharge is a common symptom which can cause anxiety although usually caused by benign etiologies and only reported as the presenting symptom in 15% of breast cancer cases. The evaluation and management of nipple discharge is diverse and confusing between breast clinics. The aim of this study was to identify clinical characteristics and preoperative examinations which can be used to identify malignancy as the underlying cause of nipple discharge, thereby facilitating patient tailored treatment.Patients and Methods: We retrospectively reviewed all patients with nipple discharge as a single symptom who attended our insti-tution breast clinic from March 2018 till February 2020. Patients clinical, radiological, lab, pathological, surgical and follow up data were registered. Results:A total of148 patients with nipple discharge were reviewed. Discharge was unilateral in 70.3%, Multiductal in 58.1%, bloody in 23% and induced on squeezing in 62.2% of the included patients. the causes of discharge were ductectasia in 47 patients (51.6%), benign papilloma in 28 patients (30.8%) and carcinoma in 12 patients (13.2%){DCIS in 7 patients (7.7%) and IDC in 5 patients (5.5%)}. Regarding discharge characteristics in cancer patients; it was unilateral (58.3%), uniductal (66.7%), bloody (75%) and induced (75%).Conclusion:Pathological nipple discharge is a common breast complain and may indicate serious condition. Although unilateral, uniductal, bloody and induced discharge in patients above 50 years old with abnormal imaging and suspicious pathology are alarm-ing signs of malignancy; non-bloody, bilateral, multiducatl and spontaneous discharge with normal imaging and non-suspicious pa-thology may still carry the risk of underlying malignancy.
43 The Possible Association of Female Pattern Hair Loss and Alteration in Serum Cholecalciferol Level , Mohammed S Al-Abadie1, Hussain Tukmatchy2, Ari Ahmad3, Anandadeep Mandal4, Patrick A Ball5 and Hana Morrissey6
Background:Vitamin D has a central role in neuronal, reproductive, autoimmune, infectious, and heart diseases. Female Pattern Hair Loss (FPHL) is described as a non-scarring, progressive thinning of the hair resulting from a decreasing ratio of terminal hairs to thinner vellus hairs. Aim:To explore the possibility of vitamin D deficiency contribution to hair loss in women in the local population in West Midlands England. Method:Records of women from different age groups who were treated in the dermatology outpatient clinic for any skin conditions and had their vitamin D status assessed as part of their usual care. In this study we also examine the impact of vitamin D levels and age on hair loss.Results:The studies reviewed medical records of 48 patients diagnosed with dermatological conditions. Low levels of vitamin D significantly affects the loss of hair (p = 0.046). The odds ratio estimated is 3.545. Our results show that the impact of low vitamin D level is significantly prevalent for the age groups 35 - 45 and moderately impacted age group 55 - 65 years. Conclusion:Vitamin D has a significant role in hair-loss process, and possibly early correction may have a role in prevention and treatment in women aged 35 - 45 year of age
44 A Comparative Cross-sectional Study on Anthropometry and Body Composition of Selected Female Type 2 Diabetics and Non-diabetics , Bhavani S and Jemima Beryl Mohankumar
A study was designed to compare the body composition of female diabetics and non-diabetics in the age group of 35 - 45 years. A validated questionnaire was used to collect background information. The tools used to measure anthropometric measurements were properly calibrated and used according to the NHANES protocol. The Waist-to-Height Ratio (WHtR) and Body Adiposity Index (BAI) are focused in this article. Other anthropometric measurements are also presented. We found BMI to be significantly different (p ≤ 0.05) between the diabetics and non-diabetics. The diabetic women had greater subcutaneous fat in the trunk and legs. The skeletal muscle percentage was also lower. We recommend that body composition may be studied using the hand-held BIA device to make a better assessment of the metabolic condition to suggest suitable management.
45 Women's Health Problems in the 21st Century and Ways to Solve them , Ostapiuk L
The problem of preserving women's reproductive health is a guarantee of the well-being of future generations. At the same time, the problem of maternal mortality is relevant even in the 21st century with its significant progress, including in medicine. Postpartum purulent-inflammatory diseases are on the second place in the world in the structure of maternal mortality and com-plicate significantly the course of the postpartum period.
46 What Information is Available to Women Regarding Coronavirus and Childbirth in Italy? A Mixed-methods Exploration of the Web During the COVID-19 Lockdown , Simona Fumagalli1*, Laura Iannuzzi2, Virna Franca Zobbi1, Romina Sada1, Dominique Mylod2 and Antonella Nespoli
Problem: The world is fighting against the COVID-19 pandemic and an infodemic; Italy is one of the most severely affected countries. Background: The internet represents a popular source of health information. In Italy, its use amongst pregnant women and new mothers has increased during the lockdown. No research has examined the nationally accessible information related to childbirth in these unprecedented circumstances. Aim: To explore online information accessible to Italian users concerning childbirth and coronavirus-related issues. Methods: A mixed methods exploration of the web was conducted involving searches on Google, peer discussion forums and mid-wifery association webpages. Data were analysed both quantitatively and qualitatively. A cross-consultation analysis of themes was performed to identify macro categories of information. Findings: A total of 720 results from free searches, 635 interventions from 97 forums and 68 posts from four midwifery associa-tion webpages were analysed. Informative/divulging sources were the most prevalent in Google; pregnancy-related topics appeared more in discussion forums and midwifery association webpages. ‘Prevention’; ‘risks and outcomes’; ‘users’ experiences’ and ‘reor-ganisation of maternity services’ represent the cross-consultation categories of information Discussion: Google emerges as the main contributor to the infodemic; national systems of alert and ranking of web sources are needed. Women’s pragmatic needs are more likely to be addressed by peer-discussion forums and midwifery association webpages during and after COVID-19. Conclusion: This is the first study to investigate childbirth-related web information during COVID-19 in Italy; findings may impact on education, research and practice
47 Uptake of Family Planning Services Among Refugees in South-South Nigeria: The Impact of Medical Outreaches , Abayomi Joseph Afe*, Idowu Araoyinbo, Yakubu Aliyu, Olanrewaju Alabi, Jacque Karungi, Polycap Takou and Theresa Adah
Refugees especially the female adolescents and youths have highly vulnerable due to high risk of sexual violence, exploitation and abuse, and early or forced marriage. Adolescent pregnancies are reported to be higher among refugees or displaced persons than the non-displaced persons at 30 and 19% respectively. They also have low contraceptive prevalence rate and have accessibility and availability challenges in procuring family planning services. To mitigate these challenges, routine family planning outreaches were conducted to two refugee camps in south-south region of Nigeria over a period of 12months.A total of 308 men and women received modern contraceptives during the outreaches. This is about 4% of the total population of men and women within the reproductive age group. Also, only 179 women and girls within the reproductive age group received modern contraceptives during the outreaches, which also account for 4% of all women within reproductive age group residing in the camps. About 46% received condoms only, 54% received implants and condoms, 2% received both injectables and condoms and another 2% received oral pills and condoms.The low uptake of contraceptives in this study is similar to the results in other studies in similar settings. Factors responsible could include inadequate knowledge on contraceptives, fear of side effects, partner prohibitions, poor access to modern contraceptives.The pattern of contraceptive types distributed could reflect availability of contraceptives and fulfilling the eligibility criteria by the clients.
48 PAS Rising Threat to Safe Motherhood , Preeti Sharma
Placenta accreta spectrum is a potentially life-threatening pregnancy complication that occurs in approximately 3 in 1000 pregnancies. The incidence of this iatrogenic disorder is ever in-creasing with the alarming rates of caesarean deliveries and fer-tility enhancing surgeries in the last decade. It occurs when the placenta grows too deeply into the wall of the uterus and is unable to detach at childbirth. The etiology is a defect of the endometrial -myometrial interface (absence of fibrinoid Nitabuchs layer) that leads to a failure of normal decidualization in the area of a uter-ine scar, which allows abnormally deep placental anchoring villi and trophoblast invasion. FIGO has given a classification of PAS in 2019 according to the clinical symptoms and degree of adherence (Luke’s classification) into creta accreta and percreta. WHO has used the wider term Morbidly adherent placenta and used code ICD 10 O42 for international coding
49 Frequency of Complications of Vaginal Delivery in Patients with a History of Cesarean Section , Edgar Allan Villagómez Mendoza1*, Rubén Razo Solano2, Saúl Palapa Ramirez2 and Alan Moisés Santana Ramirez
Objective: To determine the frequency of complications of vaginal delivery in patients with a history of cesarean section. Methods: Prospective, observational, and descriptive study carried out from June 2019 to June 2020, with a total of 45 cases in the study period, 45 patients attended for resolution of gestation were analyzed, all with a history of cesarean section, they were con-centrated in a database in the Excel program and quantitative and qualitative analysis of the study variables was carried out (gesta-tions, maternal age, interpregnancy interval, indication for previous cesarean section, type of complication, obstetric outcome and, if necessary, reasons for a repeat cesarean section measures of central tendency were specified. Statistical significance was made as p < 0.05 and was performed using the Chi-square test and Fisher's exact statistic for nominal variables. Inclusion criteria: patients with full-term pregnancies, history of a transverse segmental cesarean section without contraindication for vaginal delivery, the reason for the previous cesarean section, and interpregnancy interval greater than 18 months. Results: 45 patients were studied, complications were analyzed in 40%, by type of obstetric outcome, complications appeared in 36% of women with childbirth, and in 45% of women with a cesarean section, In patients with a vaginal outcome, the most frequent complication was third-degree B perineal tear in 12% of cases, however, in patients with repeat cesarean section, the most frequent complication in 20% of cases was the obstetric hemorrhage. The complications obtained in the study were not statistically major. Conclusions: Cesarean section is a major surgical procedure that implies higher morbidity and mortality than childbirth, admitting delivery after cesarean section is a safe method in patients with a history of cesarean section with transverse segmental incision without contraindication for vaginal delivery, however, strategies should be developed to improve delivery care, decrease obstetric bleeding, and improve the obstetrician's ability to assess the risk of uterine rupture
50 Male Infertility in Cryptozoospermia or Severe Oligozoospermia is sperm Useful Cryopreservation , Aya AL-ibraheemi1, Mustafa Zakaria2*, Mohamed Zarqaoui3, Mohamed Ennaji4, Wassym R Senhaji5, Ritu S Santwani6, Nisrine En-naciri7, Hafida Tarik7, Romaissa Boutiche8 and Noureddine Louanjli9
Male infertility count for almost 30% of the total cases of infertility. Male infertility can be caused by several and various factors such as environmental, genetics and hormonal factors. Male infertility can be diagnosed through semen sample analysis; a fresh semen sample can indicate different semen abnormalities. A semen sample can indicate Azoospermia, Cryptozoospermia (Co) or Severe Oligozoospermia (ESO), who can cause infertility in male. It is challenging for an andrologist to distinguish between ESO and CO in clinic diagnose since both of them show no sperm in the sample in the initial sample test. In Cryptozoospermia or Severe Oligo-zoospermia, cryopreservation plays a significant part in preserving male fertility by freezing the individual sperm
51 Women's Health Problems in the 21st Century and Ways to Solve them , Ostapiuk L
The problem of preserving women's reproductive health is a guarantee of the well-being of future generations. At the same time, the problem of maternal mortality is relevant even in the 21st century with its significant progress, including in medicine. Postpartum purulent-inflammatory diseases are on the second place in the world in the structure of maternal mortality and com-plicate significantly the course of the postpartum period.
52 Factors Associated with the Utilization of Focused Antenatal Care Among Women in Chiro Town of Oromia Region; Eastern Ethiopia , Abera Worku Foli1*, Fekadu Assefa Jiru2, Ayingida Adamu Walle3 and Zalalem Kaba Babure
Focused antenatal care (FANC) is one of the important factors in dropping maternal morbidity and mortality; mean-while, it is a prevailing challenge in Ethiopia as many women do not access such care. However, little is known about the determinants factor of FANC service utilization in Ethiopia and particularly in Chiro town. Hence, this study was conducted to determine focused antenatal care status and associated factors among mothers who gave birth within 6 months preceding the study in Chiro town
53 Prevalence of Metabolic Syndrome and Associated Risk Factors Among Indigenous Indian Women , Partha Sarathi Datta
Metabolic Syndrome (MetS) is a bunch of conditions that increases the risk of heart disease, stroke, diabetes etc. MetS includes hypertension, diabetes, excess centripetal body fat, abnormal cholesterol levels etc. and it increases a person’s risk of heart attack and stroke. MetS is one of the major causes of death and disability globally. In India, several studies have revealed that various modifiable risk factors are responsible for a huge number of disabilities and deaths due to MetS among indigenous peoples especially among women. Hypertension, dyslipidemia and diabetes are significantly prevalent among indigenous women, which may indicate the high rate of heart attack and diabetes among them. The MetS are becoming a burden to indigenous women in India because of their proper knowledge and ignorance about their personal health. In remote rural areas, indigenous women have their own ethnic healing meth-ods and rare reluctant to receive modern health care. They still believe that diseases are caused by super natural forces and can only be controlled by supernatural means. In India, the high commonness of MetS risk factors among indigenous women’s societies needs the immediate attention of the policy makers and healthcare providers. Society and at-risk individuals must be prevented by proper strategies to improve their health conditions. The Government of India is responsible for providing quality and modern healthcare to them. In addition to government activities, a number of NGOs are working in healthcare sector among indigenous peoples in India. So, Health and Hygiene awareness camps need to be organized regularly to maintain their regular health.
54 Urinary Tract Obstruction and Stercoral Colitis Complicating Constipation in Geriatric Patient , O Osman1*, Susmitha Dande2, Isaac Trelles3 and Odalys Frontela
Constipation is common among geriatric patients. A prevalence of 40% has been reported which is increasing over the years [1,2]. Geriatric population suffer from constipation due to various reasons such as polypharmacy, endocrine disorders, electrolyte imbalance, insufficient fiber and water intake, neurological conditions and pelvic floor dysfunction in women. In this case report we present a geriatric patient with chronic untreated constipation which leads to urinary tract obstruction and a rare condition called stercoral colitis
55 Etiology, Management, and Treatment of Polycystic Ovary Syndrome: A Systematic Review , Marwa B Bakir1, Samir M Abdel-Mageed2 and Ehab I Mohamed
Polycystic ovary syndrome (PCOS), which affects 5-20% of women in their reproductive age, is the most common endocrinopa-thy affecting women worldwide. It is a condition characterized by hyperandrogenism, ovulatory dysfunction and polycystic ovarian morphology, with excessive ovarian androgen production being a key feature of PCOS. Metabolic dysfunction characterized by insu-lin resistance and compensatory hyperinsulinaemia is evident in the vast majority of affected women. PCOS increases the risk for cardiovalscular diseases, type-2 diabetes mellitus, gestational diabetes and other pregnancy-related complications, venous throm-boembolism, cerebrovascular and cardiovascular diseases and endometrial cancer. PCOS is a diagnosis of exclusion, based primarily on the presence of hyperandrogenism, ovulatory dysfunction and polycystic ovary morphology. Treatment should be tailored to the complaints and needs of the patient and involves targeting metabolic abnormalities through lifestyle changes, medication and po-tentially surgery for the prevention and management of excess weight, androgen suppression and/or blockade, endometrial protec-tion, reproductive therapy and the detection and treatment of psychological features. This review summarizes the current state of knowledge regarding the etiology, mechanisms and pathophysiology, diagnosis, screening and prevention, management and future investigational directions of PCOS.
56 Octonians and the EM-Compass , Gudrun Kalmbach HE*
In the first section, the EM compass is described and an application to leptons. Since the octonians are used, a Hilbert subspace lattice structure is described: why the extension from spacetime coordinates to octonians necessary.
57 Screening for Carcinoma Cervix , Shashi Joshi1* and Jose Manuel Perez2
Cervical cancer is the second most common cancer in women. It is largely preventable by different screening, diagnostic and ther-apeutic procedures. It is the only gynaecological cancer that can be prevented through routine screening. The precursor lesions de-tected take a long time to progress to cancer and can be treated. Hence screening reduces both the incidence and mortality of cervical cancer. Till now cytology-based screening has been the main stay for screening of cervical cancer. Pap smear screening has reduced the incidence of cervical cancer by 80% and deaths by 70%. In many low resource settings, it is difficult to maintain high quality and high coverage of cytology-based screening programmes. This limitation can be removed by use of FRD as a screening device.
58 Urinary Incontinence in Elderly Women: Impact of Surgical Correction in Quality of Life and Occurrence of Bacteriuria , Nino José Wilson Moterani Júnior1*, André Aranda Selverio2, Milena Fernandes Castro2, Eduardo Federighi3 Baisi Chagas3 and Zamir Calamita
An almost experimental study in which 19 elderly patients with stress urinary incontinence were submitted to surgical treatment by transobturator sling, with the main objective of evaluating the impact on the quality of life, through questionnaires validated and translated into Portuguese: International Consultation on Incontinence Questionnaire - Short Form and King's Health Questionnaire. The secondary objectives were to evaluate the occurrence of infectious and bacterial complications, by uroculture, before and after the surgical intervention. The sample consisted mainly of white women (78.9%), above the normal body mass index, multiparous. The levels of asymptomatic bacteriuria before and after surgery were 15% and 5.3% respectively. There was improvement of all qual-ity of life parameters in the questionnaires used. It was concluded that the surgical intervention had a positive impact on the quality of life of incontinent elderly women. Although there was a drop in the levels of asymptomatic bacteriuria in absolute numbers, there was no statistical significance.
59 Being a Healthy Woman , Maithili A Athavale
A woman undergoes various physiological changes during her lifetime. A regular menstrual cycle is an important indicator of a healthy reproductive system. Menstrual cycle is regulated by two hormones, Luteinizing Hormone and Follicle-Stimulating Hor-mone. These are produced by the pituitary gland; they promote ovulation and stimulate the ovaries to produce estrogen and pro-gesterone. The levels of these hormones decide the regularity of cycle
60 Assessment of Neurodevelopment of Infants of Diabetic Mothers 6 Year Follow-up , Jiménez-Quiroz Rosalía1*, López-Vasquez Ethel2, Alvarez-Ramírez Elizabeth3, Conde-Reyes María de la Paz1, Romero-Palencia Angélica4, Fernández-Carrocera Luis Alberto5, Guido-Campuzano Martina Angélica6, Castro-Soto Laura7 and Martínez-Cruz Carlos Fabián
The infant of a mother with gestational diabetes (IDM) is a newborn with high neurological risk and can not ensure an evolution-ary pattern in his neurodevelopment; therefore, he must be monitored during the first years of life. The objective of this research is to describe the neurodevelopment of infants of mothers with gestational diabetes at 1 - 6 years of age born in the National Institute of Perinatology, through a retrospective longitudinal study. The sample consisted of 46 participants; 17 boys and 29 girls, children of mothers with gestational diabetes born between 2000 and 2010, who were assessed with the Bayley II Development Scale at the first and second years of life and the Stanford-Binet Intelligence Scale 4th ed. at the 3rd, 4.5 and 6 years. The results show that IDM have a slight delay in the Psychomotor Developmental Index in the first two years that does not affect scores in the Intellectual Quotient at 3-6 years, obtaining scores within the normal range
61 Domestic Violence against Women in Hard to Reach Districts: A Cross-sectional Study , Abu Sayeed Md Abdullah*
Globally one in every three women experiences violence in life-time. According to UNODC 2018 report 6 out of 10 women (64%) were killed by their partner or family. Only 36% men were killed worldwide in such circumstances. In Bangladesh, violence stands at sixth position at grade C among ten selected countries. About 55% of married women faced physical or sexual harassment in their lifetime in Bangladesh
62 Psychological Impact of Acne on Women , Ruksana Hamid1, Rayees ul Hamid Wani2, Suhail Hamid Wani3, Ghulam Mustafa Malik4 and Mohammad Sarwar Mir
Background: It is well-known that acne vulgaris is a common malady of adolescence. Objective: To evaluate the level of impact among acne female adolescent students on their quality of life.Methods: A total of 200 patients studied. Acne severity was graded using Global Acne Grading System (GAGS) after the clinical diag-nosis. All the patients went through self administered questionnaire of Cardiff Acne Disability Index (CADI) to fill out, to assess the reflection of patients’ experiences and perceptions.Results:The maximum number of patients was in the age group of 16 - 20 years (142/200, 71%). The impact on quality of life was more in the age-group of 21 - 30 years even though in this age group clinical severity of acne was mild to moderate only. Conclusion: Study found that women with acne had profound emotional, as well as, social impact on their quality of life
63 Comparison of the Effects of Maternal and Postnatal Application of Protein Malnutrition, Testes Morphology and Spermatological Parameters in Adult Rats , Dildan Kavak1, Ömer Satici2 and Vatan Kavak
Our Goal: To investigate the development of male baby rats born from mother rats fed with different diet groups starting from em-bryonal period to adulthood.Objective: To determine the percentage of morphologically abnormal spermatozoa in the caudal epididymis, the slides stained with eosin-nigrosin were prepared.Methodology: Low protein diet (LPD) 4%; Control protein diet (CPD) 24%, Middle protein diet (MPD) 12% and yogurt diet groups fed with different diets were followed by the same method in rats. The female rats whose uterine arteries were ligated on day 17 of gestation bilaterally intrauterine growth restriction began to be fed with Control protein diet (CPD9 24%.The epididymis was finely minced with anatomical scissors in 10 ml of physiologic saline, placed in a rocker for 10 minutes, and allowed to sit at room temperature for two minutes.The fluid obtained from the caudal epididymis with a pipette was diluted to 2 ml with Tris buffer solution.Right testes from the rats were placed in 10% Bouin solution for 24 hours for fixation and further pathologic examination.Statistics: Mann Whitney U test and Kruskal Wallis tests were used.Results: The average weight of the experimental groups was different in testis location. Epididymis and vesicula seminalis locations; the mean weight of the experimental groups was different.Conclusion: The spermium development in the locations is examined; the development of testis, epididymis, vesicula seminalis, prostate and motility were found to be different according to the groups. Density did not differ between groups
64 The Role of Educational Institutions in Raising Awareness of the Concept of Empowering Arab Women , Mehany Ghanaiem*
The concept of empowering women is considered relatively re-cent, as it appeared in the mid-eighties of the twentieth century and became one of the common concepts, especially in the field of development and in writings about women and their rights. This concept replaced well-being, combating poverty and community participation, and the concept of empowerment emerged as a re-sult of injustice and marginalization that women suffer. However, the concept remained ambiguous due to the fear of some of it and the misunderstanding of others
65 Scenario of Sexual Assault on Patients at Faridpur Medical College Hospital in Bangladesh , Jasmine Sharifa1 and Rabiul Islam
Violence against women is one of the general offences in Bangladesh. It is increasing day by day although dynamic law against prevention. Rape is one of the silent barbarous sexual offences in our country. Despite potential laws against it, the evil of rape con-tinues to increment. Increasing trend of the voiceless cruel sexual offence (rape) represents a major psychopath sexual illness and public health problem and growth of the country. The goal of the study was to determine the pattern of alleged outrage victim such as physical, sexual and burn victims in a village region of southern part in our country basically faridpur, madaripur, rajbari, shariotpur, gopalgonj district of Bangladesh with the ultimate object to create public awareness about the brutal crime. This retrospective study was carried out from 2012 to 2019 total eight years admitted victim where admitted at One stop Crisis Center (OCC) and Divisional DNA Screening Laboratory (DDSL), Faridpur Medical College Hospital. Among the study subjects highest number of alleged outrage cases were below the age of 20 years. More than two-thirds of the adversary was known to the victims; greatest of the incidents oc-curred in the victims’ houses and neighbor places. The study also revealed that number of physical victims 535, sexual victim 352 and burn victim10, total 897 victims admitted at OCC and received free service of medical, law, police and mental support and service. According to DDSL, total 274 number of sexual assault victim collected DNA sample and stored laboratory freeze finally through the order of judicial magistrate to serve free test service for DNA profiling. Common awareness about rape would be efficient to report in due time with preserving the evidence of crime and new techniques like DNA diagnosis may be of aid to find out the assailant.
66 COVID-19, the Masked Villain in Plain Sight , Emmanuel Unwaha1* and Obehioye Enabor2
The celebration of International Women’s day is often a time to highlight the significance of a systematic, directed, effective ap-proach to the diverse conditions that impinge on women’s health. The world is in a desperate situation due to the ravaging effect of the COVID-19 pandemic; many countries have struggled to cope with the virus leading to a desperate race for vaccine development and the start of aggressive vaccination campaigns. Unfortunately, the burden of diseases and conditions affecting women-pregnancy related complications, gynaecological cancers, reproductive health care and mental health continue to inflict pain in our women’s lives. This has only been made worse by the pan-demic as health workers find themselves and our women engulfed in a mental health crisis, confronted with difficult decisions in cancer care and distracted by the arrival of a new villain in the sphere of women’s healthcare with grave implications for developing countries.
67 ‘Women Empowerment’ Effects on Global Economics: A Quantum Economic Study , Arijit Bag*
Background: Women’s empowerment is a global concern today. But, the effect of women’s empowerment on global economics is not studied explicitly. As several governments are focusing on this matter, it is necessary to know the effect of it. To fulfill this need, present research work is conducted.Objective: In the recent past quantum economics is found very successful to explain the economical problems more accurately. Thus, to solve the problem of women’s empowerment related issue mention earlier, we focus to use quantum economic methodology.Methods: Though quantum economics is as old as 43 years, it is not systematized properly to use for our problem directly. We have transformed various related laws and equations to increase the applicability and accuracy of the method. We have transformed the Maxwell-Boltzmann velocity distribution law to population - income distribution law. We have also constructed the wealth consump-tion function taking the knowledge of Gaussian type orbital function. These two are used to solve our problem.Results: We observed that women’s empowerment is not always related to the positive growth of society. All three possibilities, posi-tive growth, negative growth and no growth are there. We have mentioned the conditions for which what kind of outcome would be expected.Conclusion: From the present study, we conclude that women’s empowerment would produce positive effect on the global economy if the additional job opportunity is created rather substituting of a male employee by a female employee
68 COVID-19: Defeating the Pandemic , Preeti Sharma
As we usher in the new year, we reflect upon the catastrophe of the COVID-19 pandemic and how our modern society, with all its scientific advances designed to help mankind, feels inadequate in the face of such global disasters.This pandemic is a truly global event, affecting the health and well-being of millions of people and sparing no nation in its wake.
69 The Effects of Drawings on Permanent Anatomy Education , Kavak V
The aim of this study was to determine the method for students to learn permanent anatomy from the studies of anatomists who have worked before in anatomy education.This study was conducted on 1202 students studying anatomy in five faculties and high schools. In order to determine the impacts of permanent anatomy education, 2 questions were asked to the students included in the study. a) Should the anatomy lesson be given as a slide presentation in the classroom?b) Under the supervision of an anatomist; To make the anatomical drawing of the opened area of the student after cadaver dissection in the laboratory.Based on the answers how anatomy education should be, 95.5%, 72.4%, 82.4%, 47.7, and 44.4% of students repectively in facul-ties of medical, pharmacy, Dentistery, Vacational and Physical and Sports students stated cadaver dissection and drawing under an antomist direction. Also 4.5%, 27.6%, 17.6%, 53.3%, and 55.6% respectively in faculties of medical, pharmacy, Dentistery, Vacational, andPhysical and Sports prefered slide presentation in anatomical education in order to permanent impact.As a result, to achieve success in permanent anatomy education; It is essential to establish cadaver halls, Cadaver theater halls, Anatomy museums and equipped drawing halls
70 Pre-cancer Lesions in the Cervix and Cervical Cancer Explained by Fooling of Homeostasis Hypothesis , Pushpam Kumar Sinha
The three common disease states of the cervix upon having undergone Human Papillomavirus infection are Low-grade Squamous Intraepithelial Lesion, High-grade Squamous Intraepithelial Lesion, and Cervical Cancer. The genesis of all the three have been ex-plained using the Fooling of Homeostasis Hypothesis. According to this hypothesis, for cancers that have stem cell basis, the would-be cancer cells just before turning cancerous undergo aggressive proliferation and aggressive apoptosis (at equal rate) thereby leading to fooling of the homeostasis maintained by the surrounding healthy cells and immune cells. This hypothesis predicts that the pos-sible cure for Cervical Cancer could be the use of chemicals ethanol-alcohol dehydrogenase and sodium metabisulphite
71 Multiple Re-treatments with Atosiban, an Oxytocin Receptor Antagonist Helps to Delay the Preterm Labor Successfully , Kedar N Ganla, Priyanka H Vora*, Rana A Choudhary, Manjusha K Ganla, Prajkta Joshi and Kavita Desai
Assisted reproduction technology (ART) for infertile couples is strongly associated with twinning and twins remain a high-risk group for preterm labor as compared with singletons. Atosiban is used for the management of preterm labor and threatened abor-tion cases. Re-treatment with atosiban is possible (≤ 3 cycles), but there is only limited clinical experience available with multiple re-treatment cycles. Herein, we report the case where 4 full course re-treatment cycles with atosiban (tocolytic) were used successfully to delay the preterm labor in the same gestation. A 33-year-old female patient with twin pregnancy conceived via Intracytoplasmic Sperm Injection (ICSI) presented with preterm labor with vigorous uterine contractions. She was administered with continuous 48-hour intravenous atosiban infusion (full course) on 4 different occasions at 28, 28.5, 30.4 and 31.4 weeks of gestation. The gestation of women who reported preterm labor at 28th week, was extended to 34th week by repeated use of Atosiban treatment cycles. At 34 weeks, due to leaking per vaginum an emergency caesarean section was performed to deliver two live, premature babies weighing 2.1 kg and 1.5 kg, respectively. In our experience, comparing to other tocolytic agents, atosiban multiple re-treatment cycles success-fully help to delay the preterm labor and presents no safety concerns for either mother or fetus in twin pregnancy.
72 Prevalence and Risk Factors of Pregnancy Induced Hypertension Including Preeclampsia/Eclampsia in Women of Odisha, an Eastern Indian State , Madhusmita Bal1, Sujata Dixit1, Subrata K Rath2, Tahziba Hussain1, Nihar Ranjan Nayak3, Sanghamitra Pati1 and Manoranjan Ranjit
Aim: Despite several measures the maternal mortality rate (MMR) and infant mortality rate (IMR) in the state of Odisha is signifi-cantly high. Since pregnancy induced hypertension (PIH) including pre-eclampsia or eclampsia (PE or E) is one of the leading causes of maternal and fetal mortality/morbidity, we attempted to analyze the burden and risk factors of PIH including PE/E for the first time among pregnant women in Odisha. Methods: The medical records of 2393 mothers and their infants were retrospectively audited from January 2015 to December 2016 in KIMS Hospital, Bhubaneswar, the capital city of the state. Results:Out of total 150 (6.2%) cases presenting pregnancy induced hypertension disorder (PIHD), 105 (70%) had PIH, 32 (30.47%) had developed PE and 13 (12.38%) eclampsia. Of the babies born to mothers with PIH, 56% had low birth weight (< 2.5kg) and 6.6% (10 out of 150 live births) had died during their infancy. Oedema, pallor, pain in lower abdomen, headache and vaginal leaking were the most common clinical features, while chronic hypertension, gestational diabetes, PIH in previous pregnancy and family history of hypertension were the highest risk factors of PE/E. Conclusions:The present study highlights the magnitude/associated risk factors of the PIHD and underscores the need for a large scale community survey to find out the exact burden of the disease for development of strategy for proper management of pregnant women during the time of antenatal checkups in the state that contributes high MMR and IMR in the country.
73 Impact of COVID-19 Pandemic on Integrated Management of Diabetes in India in 2020 , Suresh Kishanrao
Covid-19 Pandemic continues to cause huge disruption in health care services worldwide. Among the immediate health service consequences of the pandemic on diabetes, were disruption of proactive screening, diagnosis, and treatment and monitoring of blood sugars for appropriate change in treatment plans. Available evidence hint that the presence of diabetes was associated with a poor outcome in Covid 19 patients and the Covid 19 infections and disrupted services increased the diabetes complications. National data indicates that diabetes prevalence was 40% among Covid 19 hospitalized cases and deaths. Though exact statistics is not available on the impact of Covid 19 pandemic on diabetes care, it is feared that the screening of diabetes has dropped at least 50% in NCD clinics around 70% in outreach and population-based screening since April 2020. This is attributable to: 1. Periodical lockdowns led to disruption of services both in Public and private sectors 2. Conversion of large number of urban hospitals (Public and Private) into Covid care centres (CCC) 3. Most services under the NPCDCS were either suspended or sparingly provided as the human resource was redeployed for Covid 19 duties. 4. Diabetics avoided consultation and monitoring of Blood sugar fearing the risk of Covid 19 infection.A study in two diabetes hospitals in India indicates that the glycaemic parameters were significantly higher among patients with onset of diabetes during COVID-19 pandemic when compared to those who had onset diabetes before the pandemic. A systematic review of 32 studies estimated a median direct cost of diabetes treatment to be in the range of ₹8822/- to ₹45,792/- p.a. and the median indirect cost of diabetes was ₹1198/- p.a to ₹18,707/- p.a. This variance in the treatment cost is yet another determinant of utilization of services. India aims to offer a collaborative, integrated and personalised approach for optimal therapy to people with diabetes or those at risk of developing the disorder. This includes screening at community level, early diagnosis and putting patients on standard treatment protocols and follow-up of each case for complications and their timely management. Clinical data indicates an increased proportion of complications among the known diabetes cases in the recent months. In, this article I look at the impact of Covid 19 Pandemic on detection and treatment of Diabetes Mellitus in India in the FY 2020-21
74 Citiscreen Cancer Screening: An Update , B Petrikovsky
CitiScreen puts together fragmented screening system by cre-ating screening algorithms for the following cancers: lung, ovary, breast, prostate, cervix, thyroid colorectal, pancreas, and skin. Individual screening algorithms combine ultrasound, MRI, CT im-aging, genetic and tumor markers, as well as other technologies. From the practical point view, screening starts with obtaining fam-ily, personal, and social history as well as demographics for identi-fication of risk factors
75 A Review Article of Successful Feto-Maternal Outcome in Bombay Blood Group with Pregnancy and Severe Anemia: A Rarest Clinical Scenario , Rajshree Katke1*, Shreya Chinchoriya2, Shubhangi Nawarange3 and Aliya Farogh
Bombay blood type is the rarest blood group known all over the world. The worldwide incidence of Bombay Blood group is one in every 250000 worldwide [1]. On red blood cells of these people there was absence of A, B and H antigens and also the anti-H antibodies were present in plasma. There is a probability that he anti-H antibodies in the maternal blood may lead to hemolytic disease in newborn and may trigger severe transfusion reaction specially hemolysis when exposed to any blood type other than Bombay blood group. Bombay blood group in pregnant is a rare entity. We report a case of Bombay blood group with anemia with preeclampsia with previous caesarean section managed intensively to give a healthy mother and baby. The biggest task is arranging blood for transfusion because the Bombay blood group is not available easily.
76 A Review Article of Successful Feto-Maternal Outcome in Bombay Blood Group with Pregnancy and Severe Anemia: A Rarest Clinical Scenario , Rajshree Katke1*, Shreya Chinchoriya2, Shubhangi Nawarange3 and Aliya Farogh
Bombay blood type is the rarest blood group known all over the world. The worldwide incidence of Bombay Blood group is one in every 250000 worldwide [1]. On red blood cells of these people there was absence of A, B and H antigens and also the anti-H antibodies were present in plasma. There is a probability that he anti-H antibodies in the maternal blood may lead to hemolytic disease in newborn and may trigger severe transfusion reaction specially hemolysis when exposed to any blood type other than Bombay blood group. Bombay blood group in pregnant is a rare entity. We report a case of Bombay blood group with anemia with preeclampsia with previous caesarean section managed intensively to give a healthy mother and baby. The biggest task is arranging blood for transfusion because the Bombay blood group is not available easily.
77 General Teaching Hospital "Octavio of the Concept and the Pedraja" Baracoa , Gabriela Arce Garcia1, Reudis Durán Rodríguez2*, Irayma Cazull Imbert3, Belsaida Galbán Rodríguez4 and William Jiménez Reyes
Introduction: Deep vein thrombosis is a common disease that can be subclynic or present with a sharper picture of edema and other phlogistic signs, while pulmonary thromboembolism is one of the most important problems in cardiopulmonary pathology and generally in medicine. Objectives: To characterize pregnant and postpartum with venous thrombotic diseases and pulmonary thromboembolism, entered in the Adult Intensive Care Unit of the General Teaching Hospital “Octavio de la Concepción y la Pedraja” in Baracoa, Guantanamo, Cuba. Methods: Descriptive, prospective and longitudinal study, which included 47 patients who were performed full physical examina-tion, complementary studies useful for diagnosis and the APACHE II index was applied. Results: Pregnant women with venous thromboembolic disease predominated and ages between 31 and 40 years. Despite all the uncoagulated patients, the doses used were those considered as the average dose. The stay oscillated between 4 and 5 days in both groups, despite the death of two posterperas from pulmonary thromboembolism and taking into account the predictive rate of sever-ity obtained in each case, achieving that 95.7% would graduate alive. Conclusions: With an early follow-up strategy in pregnant and at-risk post-pérperas, the diagnosis of serious and incipient forms of venous thrombotic disease and pulmonary thromboembolism can be diagnosed and thus improve survival in these severe cases with prevention measures that exist at the national and protocolized level at the same time
78 Fresh Air and Sufficient Oxygen Content in it Contribute to the Birth of a Healthy and Intelligent Child , Aleksandr L Urakov1* and Natalya A Urakova
Every woman since childhood dreams of successfully getting married and becoming a happy mother. Every woman with trepi-dation and with great responsibility prepares for the upcoming pregnancy, because she realizes that a healthy lifestyle largely determines the normal development of her fetus. It is no secret that after the onset of pregnancy, it is the pregnant woman who is responsible for the birth of a healthy, intelligent and capable child. Of course, a lot of things are determined by the appropriate “nec-essary” heredity and the “necessary” genes received by the fetus from the parents. However, it is not only this that determines the birth of a healthy, intelligent and capable child. Very much depends on the conditions under which the embryo originated, formed and developed, as well as on the conditions in which the fetus grew inside the mother’s womb and in what conditions it was born
79 Mitral Valve Prolapse - A Case Study , Pallavi1* and K Suresh
A 25-year nursing graduate Lady with H/o of chest discomfort, palpitations, fatigue, dizziness, shortness of breath consults a cardiologist. The cardiologist on physical examination records finds tachycardia (Pulse rate - 125/minute) but no other signs. Her 2 D Echocardiogram showed Ejection Fraction (EF) of 66% and she was diagnosed as having Mitral Valve prolapse (MVP) in the first week of February 2021. She was put on oral medication Metoprolol succinate 12.5 mg for one month and advised for regular check - up for every year or whenever required any symptoms recurred. Follow-up for 3 days indicated her to be normal and continues to be doing well. She is advised an annual health check-up, regular sleep, stress free living and maintaining healthy lifestyle through yoga, physical exercises, and meditation
80 Diarrhoea Management Flouting National Guidelines - A Case Study , Rashid1* and Suresh Kishanrao
As per WHO every year around 525000 children die due to Diarrhoea, making it second most cause of death among under five children and which is both preventable and treatable.Dehydration and electrolyte imbalance are the main complications of diarrhoea. Timely replacement of fluids and electrolytes are the simple interventions to prevent dehydration and resultant consequences. I report here such a case in a two and half year-old female that was not treated as per national or WHO guidelines. The girl reported with sudden onset of fever of two days followed by Diarrhoea. Initially home available fluids were given, but as the child started vomiting the baby was taken to a Paediatrician. Apart from legitimate Oral Rehydration solution (ORS) the child was given antibacterial, Furazolidone and Metronidazole (since banned in India) for three days that was unwarranted but not Zinc supplemented as mandated. Indian Academy of Paediatrics guidelines do not recommend Antibiotic therapy unless there is blood in the stool. In Indian chil-dren most diarrheal episodes are caused by viruses, and therefore no antibiotics are recommended by WHO or UNICEF or Govern-ment of India, Ministry of Health and Family Welfare and IAP. WHO and GOI guidelines for acute Diarrhoea management aims at preventing dehydration, if there are no signs of dehydration treat dehydration, when it is present; prevent nutritional damage, and reduce the duration and severity of diarrhoea, and the occurrence of future episodes, by giving supplemental zinc as most of diar-rhoea cases are self-limiting, regardless of causative factor.Such practices are a challenge to the National and Provincial governments for empowering families and practitioners for the ap-propriate management.
81 Markers of Female Reproductive Ageing and for Assessing Ovarian Function and Ovarian Stimulation Outcome , Juliano Brum Scheffer
Woman’s fertility begins to decline at age 30 and worsens at age 35 due to a decrease in the quantity of eggs as well as in the qual-ity of the eggs. This drop in the quality and quantity of eggs occurs thanks to the programmed cell apoptosis process known as apop-tosis and also the genetic changes in that egg. Although this fall in the ovarian reserve is known with age, it is difficult to predict how the decline in fertility of each woman will be
82 COVID-19: Thick Pus, Mucus and Sputum with Streaks of Blood as a Cause of Airway Obturation in SARS and Oxygen-Foaming Pus Solvent as a Medicine for their Recanalization , Aleksandr L Urakov1*, Ilnur I Yagudin2, Daria O Suntsova2, Milena D Svetova2 and Anastasia P Stolyarenko
A few years ago, “pus solvents drugs” were discovered in Rus-sia [1]. These drugs are antiseptics and are alkaline solutions of hydrogen peroxide [2]. As solvents of thick purulent masses, it was proposed to use aqueous solutions of 0.3-3% hydrogen peroxide and 1-10% sodium bicarbonate. They were originally proposed for the treatment of purulent diseases. The peculiarity of their use in medicine is that they are intended exclusively for topical use. And there is one more feature: before using them, they are heated to a temperature of +42 - +45°C. The mechanism of action of these drugs is that when they interact locally with pus, these drugs cause an alkaline saponification of the protein-lipid complexes in it. At the same time, the enzyme catalase (which is always present in pus) decomposes hydrogen peroxide into oxygen gas and water, which provides the formation of oxygen gas bubbles. This is how the cold boiling process begins. Pus solvents have been shown to provide and dissolve not only thick pus, but also blood clots, plaque, sulfur plugs, and tear stones
83 Current Covid Summarized Treatment Plan , Deeksha Singh
Covid is spreading so rapidly and this time pandemic is killing so many people! In India we lack medical facilities, especially we lacks hospital and specialised staff ! So, government asked people for home isolation in case of viral infections! I have made this covid treatment plan with the help of many data from my patients and study! Hi I’m Dr Deeksha and today am going to give you summarize treatment to help you recover with covid! Thanks to Dr Ramakrishna Chaitanya, anaesthesiologist, Medical College, Hyderabad for helping me with this! Covid summarized treatment plan include:• Medicine• Role of meditation• Role of social media• Diet • Physiotherapy role! So in the whole study I have explained in detail about role of all these in rehab of Pre and Post covid treatment ! I have also in-cluded the lab tests needed to know about covid!
84 Body-Composition Analysis for Women’s Health , Ehab I Mohamed
Our everyday conversations on diet and fitness usually tend to focus on the amount of weight that we want to gain or most im-portantly to lose. What we overlook is that our body-composition is completely different, even if we are of the same sex and body weight. A sedentary lifestyle, welfare, and the culture of bad eat-ing habits due to easy access to unhealthy fast foods are respon-sible for excessive weight gain and widespread obesity, especially among women worldwide
85 Neurodevelopment of Infants with a Birth Weight ≤1500g at Two and Four Years of Age , Jiménez-Quiroz Rosalía1*, Hernández-Guerrero Diana1, Fernández-Carrocera Luis Alberto2, Alvarez-Ramírez3, Elizabeth Higareda Sánchez Jesús Javier4, Conde-Reyes María de la Paz1, Guido Campuzano Martina Angélica5, Castro-Soto, Laura6, Romero-Palencia Angélica7, García Alonso-Themann Patricia8 and Ibarra-Reyes María del Pilar9
Background: Extremely low weight has been associated with a high risk of sequelae or Neurodevelopmental disorders, including personality disorders and emotional distress. Objective: to learn the differences in neurodevelopment at 2 and 4 years of infants with a weight ≤1500g. Material and Methods: observational, analytical retrospective, comparative study of a cohort of children with a birth weight ≤1500g compared with children >1500g who attended the Pediatric Follow-up at the National Institute of Perinatology. BSID II and the Stanford-Binet Intelligence Scale by Terman-Merril 4th ed were used. Results:128 patients were included in the comparative analysis; significant differences were found in MDI and PDI of BSID II. For the group ≤1500 g presented a higher incidence in behavior (Orientation, Commitment and/or Emotional Regulation).In the Intelligence Scale, the group of children <1500g at birth presented a statistically significant difference in all cognitive abili-ties and IQ. Conclusions: At two and four years of age, children weighing <1500 grams have lower scores in neurodevelopment when compared to the group >1500 grams. Behavioral problems are a factor that influences MDI and PDI at two years of age.Keywords: Neurodevelopment; Neuropsychology; Prematurity; Extremely Low Birth Weight
86 Meta-analysis of Impact of Pelvic Floor Exercises on Physiology of Defecation, Urination, and Sexual Life among Women , Vatan Kavak1*, Ömer Satici2 and Dildan Kavak3
Aim: The aim of this study is; With the knowledge of pelvic floor anatomy, the aim is to “metanalize the researches on pelvic floor muscle exercises on urination, defecation, sexual life and birth physiology”. In addition, it will contribute to the correction of muscle damage, changes occurring during pregnancy and childbirth, and sexual life with accurate anatomical information in women.Materials and Methods: After the introduction about the pelvic floor muscle anatomy; from 24 scientific publications in total; We benefited from two doctoral theses and one master’s thesis. Meta analysis has been studied in 17 works. It has benefited from the re-sults of the related publications as a summary. Areas of interest were as follows; Nursing services, obstetrics clinic patients, physical therapy clinic findings were examined. General meta-analysis working conditions were examined in these publications. The results of studies in many different fields were presented in the discussion section.Results:It is a meta-analysis evaluation of the results of studies screened on pelvic floor muscle training.Conclusion: In the light of all the researches about pelvic floor muscle training, which were meta-analyzed; It is important that the pelvic floor muscle training given to the subjects be given under the direction of an experienced anatomist. It is possible for people to live a comfortable and happy life by mastering their bodies. Living in comfort and happiness is possible by learning the right ana-tomical information at the right time. Learning the correct anatomical information at the right time provides comfortable defecation, comfortable urination and happy sexual life. Researchers state that choosing and accepting appropriate sexual behavior and sexual function is difficult due to low sexual self-efficacy in the postpartum period. For this situation, researchers report that an 8-week pelvic floor muscle exercise program has positive effects on the loss of sexual self-efficacy in women after childbirth [24].Keyword: Pelvic Floor Muscles; Human Body; Defecation; Urination; Sexual Life; Meta Analysis; In Women
87 Development and Validation of a Survey Instrument to Build Capacity for Examining Constraints to Sport Participation , Irmina Klicnik, Samah Mohammed* and Caroline Barakat
It is well documented that sport participation is relatively low among adolescent girls due to various constraints. Though much knowledge exists on these constraints, there is a need to examine if and whether constraints interact to influence sport participation. The purpose of this study was to develop a survey instrument to facilitate the examination of interactions of constraints to sport par-ticipation among adolescent girls, and to verify the survey’s validity. Two theoretical frameworks were combined to guide the survey development. Newell’s model of constraints was used to categorize constraints, into environmental, individual and task constraints. The 40 Developmental Assets Profile was used to index the constraints into broader categories within each constraint type. In total, 51 constraints were sorted into the combined frameworks which developed an 81-question survey. An expert panel was consulted to review for construct and content validity. This study has contributed a new survey instrument to the literature on constraints to sport participation. When used in different locations globally, the survey has the potential to reveal the most salient constraints, as well as build capacity for research to better inform future interventions and promote further discussions regarding sport.
88 Endometriosis and Oral Health: An Unsolved Mystery , Swati Jain1* and Kirti Jain
Endometriosis is a pathological entity characterized by abnormal growth of endometrial tissue in ectopic sites which induces a chronic inflammatory reaction, scar tissue and adhesions that may distort a woman’s pelvic anatomy. The signs and symptoms of the disease may be contributed to the generalized inflammatory response of the disease. In women with endometriosis, the peritoneal fluid is becomes dynamic with the increased number of activated macrophages and important differences in the cytokine/chemokine profile. Keeping in mind the inflammatory milieu which endometriosis creates; it would be interesting to analyze its effect on similar health conditions affecting the other parts of the body as well including mouth. Oral health is a key indicator of overall health, well-being and quality of life. Periodontal disease is a chronic inflammatory disease of periodontium and is characterized by periodontal ligament loss and destruction of surrounding alveolar bone. It is the main cause of tooth loss. The present article reviews the possible mechanism of association between Endometriosis and Oral Health. The literature search reveals three possible mechanisms include Oxidative Stress and Increased Reactive Oxygen Species (Ros) Production, Global Immune Dysregulation and Hormonal dysregula-tion. Endometriosis still remains a mystery to most of the gynaecologists throughout the world. It would be interesting to under-stand in detail whether an etio-pathogenic link exists between endometriosis and oral health. Further, population based longitudinal studies are required to assess the possible link to ensure comprehensive treatment for the patients suffering from endometriosis. Multidisciplinary approach is the key.
89 A Randomized Clinical Trial: The Effectiveness of Educating Based on Rational Emotive Behavior Therapy (REBT) on Marital Quality Components of Couples Who are Coping with Breast Cancer , Bahman Pirmardvand Chegini*, Bagher Sani Zaker and Kidnoosh Zahrakar
The purpose of this study was to determine the effects of an education program based on rational emotive behavior therapy (REBT) on marital quality components of couples coping with breast cancer. According to the purpose of this study, it was semi-experimental and its design was pretest and posttest with a control group. The statistical population of the present study included all the couples with breast cancer who visited Velayat Hospital in Qazvin province in October 2018 for follow-up cancer treatment. Sixty women were selected via available sampling and tested. Of them, 18 women, along with their husbands (18 couples), who had a score lower average on the marital quality of relationship scale were selected and randomly assigned to two groups. The experimental group re-ceived 8 2-hour sessions of education based on REBT. The research instrument was the perceived Relationship Quality Components (PRQC). The data of this study were analyzed using SPSS-24 software and multivariate analysis of covariance (MANCOVA). The results of the present study showed that the experimental and control groups were significantly different in terms of quality components of marital relationship, so that the amount of quality components of marital relationship in couples in the experimental group was significantly higher than the control group. (P <0.001). Based on the findings of this study, it can be concluded that education based on rational-emotional-behavioral therapy improves the quality components of marital relationship in couples with breast cancer
90 Socio-economic Predictors of Annual and Bi-annual Clinical Breast Examination among Women in Northeast Brazil , Adriana Raquel Araújo Pereira Soares, Raissa de Oliveira Ramos and Mathias Weller
Introduction: There exist only few Brazilian studies about women’s adherence on the clinical breast examination (CBE).Objectives:This study of women in northeast Brazil addressed socio-economic variables besides physical activity and ancestry and their impact on performance of CBE.Methods:Data were obtained by interviewing 307 women aged ≥ 40 years old. All interviews were performed in a public health center of Campina Grande, state of Paraíba, Northeast Brazil. Multinomial logistic regression analysis was applied to determine odds ratios (ORs) and confidence intervals (CI) of variables.Results:Of the 307 women 140 performed CBE never or irregular, whereas 137 and 30 performed it each year, respectively each second year. Women who used exclusively public health service centers had a 2.0- fold (OR = 0.495; 95%CI: 0.28 - 0.74) decreased chance of annual CBE performance, compared to those ones who used public and private services (p = 0.006). In a model of logistic regression analysis, low- income women had a 3.1-fold (OR = 0.321; 95%CI: 0.11 - 0.92) decreased chance to undergo CBE every year (p = 0.009). Unemployed women had a 2.8- fold (OR = 0.360; 95%CI: 0.15 - 0.88) decreased chance of bi- annual CBE performance. Women who informed European ancestry had a 2.8 (95%CI: 1.45 - 5.26) increased chance to perform CBE each year, compared to those ones who informed African or mixed ancestry (p = 0.005). Regular physical activity increased chance of annual CBE perfor-mance 1.9 (95%CI: 1.10 - 3.29) times (p = 0.013). Conclusion:Low income and unemployment decreased chance of regular CBE performance. Compared to African and mixed ances-try, informed European ancestry increased chance of regular CBE performance. Physical activity was also positively associated with regular CBE performance. Present data indicated that even among women sampled in the same public health service center regular CBE performance depended strongly on the socio- economic and ethnic background of women
91 Ecological Problems of Central Asia , BA Mukhamedgaliev1*, DA Palvuaniyazova2, ZA Nuruzova3 and OV Savenok
Sustainable development of any country is based on three compo-nents - they are economic growth, social protection and ecologi-cal safety.At the same time, in the system for achieving country's national safety the main role-plays the ecological sustainability. In the context of global climate change, the past decades have been marked by worsening of environmental problems, the emergence of new threats and challenges of environmental sustainability. They concern the increase in water scarcity, salinization of signifi-cant art of irrigating lands and degradation of pastures, increase of industrial and municipal wastes, decrease of bio diversity, produc-tion emission of industrial enterprises that pollute atmosphere, soil and water.
92 Immediate Breast Reconstruction with Latissimus Dorsi Musculo-cutaneous V-D Flap in Breast Conserving Surgery. A New Modified Technique , Chaparro Aranguren EA1*, Rolf Smit2, Casas3, Jose Geles4 and Julio Ochoa Pena
The objective of this study is to present a new modified technique for immediate breast reconstruction, in breast conserving sur-gery. We present a descriptive study of four patients with breast cancer treated with a modified radical mastectomy, with skin and nipple-areolar complex preservation and immediate breast reconstruction with latissimus dorsi musculo-cutaneos V-D flap. Only one of the four patients presented in this descriptive study required adjuvant radiotherapy. One patient required partial de-epithelialization of the flap and in another patient the flap was not de-epithelialized at all. In three of the four patients, the mas-tectomy was performed through the same approach as the flap harvest. Only in one patient was necessary to use two different ap-proaches for the mastectomy and breast reconstruction
93 Alzheimer's Patients Need End-of-Life Care: A Necessity Neglected , Fatemeh Hajibabaee1 and Hadis Ashrafizadeh2
Due to the rapid growth of the elderly population, one of the most important challenges in this field is the higher prevalence of age-related degenerative diseases. Alzheimer's disease (AD) is a common disorder with severe and progressive disability in these people, which is eventually referred to as a deadly disease. End-of-life care is care in a situation where the disease leads to death. The purpose of this care is to achieve a good and calm death for the patient, and consolation for the family, therefore, due to the increasing growth of the phenomenon of aging, the high prevalence of this incurable disease, the limitation of special beds, human resources, financial and equipment in medical centers, the provision of end-of-life care is of particular importance. This method of care is con-sidered as one of the important priorities of the health system so that patients and their families can adapt to the disease process and increase their quality of life in the last days of their lives, reduce pain, and experience a quiet death. Therefore, the present study will have a brief overview of the importance of end-of-life care in patients with AD
94 Immune Thrombocytopenic Purpura - A Recurrent Case in a Young Lady , Shilpa Kalal1* and K Suresh
Immune thrombocytopenic purpura (ITP) is an isolated condition with low platelet count and normal bone marrow with no other causes of low platelets. ITP can lead to easy or excessive bruising and bleeding because of unusually low levels of platelets, the cells that help blood clot. It can cause purple bruises, as well as tiny reddish-purple dots that look like a rash. We present a case in an adult 24-year-old lady, who presented with acute symptoms of unusually heavy menstrual flow, gum bleeding and Purpura, that was managed by Platelet’s transfusion for the second time in 2 years in Jan 2021. Her first episode was identified in her first pregnancy, due to low levels of Haemoglobin and the pregnancy was continued despite contradictory opinions. In the Current episode, her main symptom was per-vaginal bleeding, that worsened, and she had gum bleeding and purpuric rashes on the lower and upper limbs. She was managed with 2 platelet transfusions and Corticosteroid therapy. She recovered after 4 weeks of struggle and is currently normal since 8 February 2021.
95 Using the CS Fractional CO2 with PRP Approach™ in the Treatment of Bartholin Cyst and Abscess , David Ghozland* and Ericka Herrera
Objective:To describe the results of treatment with the CS Fractional CO2 Approach™ and Platelet Rich Plasma (PRP) for Bartholin gland cysts. Methods: Bartholin gland cysts were treated with Fractional CO2 and PRP as an outpatient’s setting in our medical clinic. Skin incisions were performed with a fractional CO2 laser. The capsule of the cyst was opened to drain mucoid content, followed by internal vaporization of the impaired capsule. This was followed by injection of PRP into the base of the cyst as well as the edges of the skin incision.Results: There were no complications. Five patients had recurrence of the cyst and were submitted to a second and successful treatment session. Conclusion: CS Fractional CO2 Approach therapy was effective in treating Bartholin gland cysts/abscess with minimal or no complications and can be easily and safely performed in an outpatient setting.
96 The Magic of Human Immune System , Maithili A Athavale*
We are surrounded by millions of microorganisms, but we do not fall sick very often: Thanks to our incredible “immune system”.Now let us understand how our immune system works.Our immune system is broadly divided into two types:• Innate immunity• Adaptive immunity- which is subdivided into Humoral im-munity (also called antibody-mediated immunity and cel-lular immunity).
97 Late Onset Asthma in an Elderly Health Personnel , Jyothi Kiran Kumar S1* and Suresh Kishanrao2
Asthma is generally considered as a disease of childhood, but it may be first diagnosed in the adults and even senior citizens, then it is called as Late-onset asthma, that may begin even in the eighth and ninth decades of life. When late onset occurs, symptoms are more likely to be moderate to severe. Some studies of older persons who have asthma have shown that as a group, as many as 40% have their first attack after the age of 40 years. We present one such case of A -60year-old woman, nurse by profession. She was diagnosed with asthma at the age of 57 years and was given an inhaler for her mild shortness of breath and a non-productive cough that used to be worse at night. In the last one year her symptoms worsened slightly and persisted over several months. She has wheezing sound while breathing and her family members have noticed that her sleep gets disturbed due to breathlessness. The current asthma episode was considered as moderate persistence asthma and treated with Aerocart (Beclomethasone Dipropionate and Levalbuterol) inhaler and Salbutamol syrup 10ml and steam inhalation (by adding Eucalyptus oil). For co-morbidity of diabetes was given Glykind M 500mg (a combination of Gliclazide 80 mg and Metformin Hydrochloride 500 mg -1/2 tablet morning and evening) taking for 2 years. Has been advised to continue the regimen regularly and periodic reviews.
98 New Aspects of Diagnosis and Treatment of Sepsis , Ostapiuk L
Since 1991, for the last 30 years, the world medical community has paid considerable attention to the problem of sepsis, one of the most serious diseases in the world with the high mortality rate. Significant work was done in order to understand the essence of this disease in order to develop effective methods of its treatment. The main attention was paid to the formulation of the definition of sepsis and its main diagnostic criteria. Three conciliatory world conferences (1991, 2001 and 2016) were dedicated to this prob-lem. They offered important definitions and interesting views on the problem of sepsis. But, despite such big efforts of the world community, the problem of sepsis was not finally resolved. In this regard, in May 2017, the 70th session of the World Health Assembly adopted a new resolution on sepsis on the basis of the report of the WHO Secretariat. According to it, the primary attention should be focused on improving early diagnosis, finding new markers and improving treatment tactics and monitoring of patients.
99 ‘Anemia in Men’ too Needs National Attention - A Case Study , Tejaswini BS1* and K Suresh2
Anemia among men in India is an important public health problem, with adverse effect on health, wellbeing, and economic pro-ductivity. However, Population-based studies on anemia in India have mostly focused on women and children, but men with anemia have received much less attention.We, present here a case of a 53-year-old male from a village with the compliant of loss of appetite, fatigue, shortness of breath for 6-7 months that exaggerated after a bout of fever lasting for 3days about 2 weeks ago. His personal history revealed that his dietary practices were far from balanced, because poverty and other family problems. He was a chain smok-er, beginning with smoking of 5 to 6 Bidis per day and reaching 15 to 20 beedis and 1 to 2 cigarette per day for 2-3 years. He was also addicted to tea, consuming 5 to 7 cups per day. Simple Hb% estimation helped to diagnose severe Anemia, as his hemoglobin level was exceptionally low, at 8G /dl. He was put on Tab. Livogen Z twice daily morning and evening with Syrup. Hemo care(10ml) once at night, He was advised to avoid smoking and tea, and increase the consumption of fruits, green leafy vegetables, and other vegetables. hemoglobin increased gradually reaching 11 gm/dl, over a period of 3 months.
100 Parenting of Children with a High Risk Birth in Mexico: Psychometric Validation of a Parental Emotional Scale , Conde-Reyes María de la Paz1*, Jiménez-Quiroz Rosalía1, Padilla Gámez Nélida2, Romero-Palencia Angélica3, López Becerra Claudia4, Guido Campuzano Martina Angélica1 and Castro Soto Reyes Laura Mercedes5
A high risk birth implies more responsibilities for parents, who suffer negative effects in their global quality of life in a direct and indirect form, presenting disorders of the emotional sphere, amongst others. Perceiving their child as vulnerable, weak and sickly generates emotional sequelae in the parents that affect the child’s development.Emotions are fundamental aspects of human relationships and are invariably involved in parenting as the first emotional links between parents and children are established. Parenting involves emotions related to the difficult task adults face since the beginning of their child’s life due to birth conditions. This may result in short and long-term altered emotional states that influence attitudes towards parenting and impact the high risk newborn’s development.In Mexico, little has been inquired about parent emotions concerning parenting in this population.Objective: This study has the objective of validating an emotional scale in parents concerning parenting of high risk newborns.Materials and Methods: Non-experimental, exploratory, cross-sectional study with intentional non-probabilistic sampling of an only sample. 710 parents of children with a high risk birth who attended the pediatric follow-up at the National Institute of Perinatol-ogy (INper) participated. 73.2% (520) were women and 26.8% (190) men, with μ= 35.5 years (S.D.= 8.15) of age.Results: An exploratory factor analysis (EFA) was conducted using the method of main components with orthogonal rotation. The analysis yielded a Kaiser-Meyer-Olkin index that revealed a factorizable matrix (KMO = 0.829), as well as a significant Bartlett’s test of sphericity (p < .000), which allowed for an adequate factor analysis. The instrument included 14 items distributed in three factors: Guilt and fear, Joy and Happiness and States associated with negative emotions towards parenting that account for 54.16% of total variance, with a global Cronbach alpha of 0.81.Conclusion: The present work emphasizes the relevance of having a scale that enables learning about emotions that parents experi-ence when parenting a high risk child. It is concluded that the instrument is valid and reliable for the Mexican population. It is sug-gested to use it in clinical practice and in future studies side by side with other scales that contain variables or constructs related to parental emotions in their factorial structure.
101 Approach to the Management of Pregnancy in Rh Negative Woman , Seema Thakur*
The prevalence of Rhesus antigens varies among populations•Basques - 30 to 35 percent•Caucasians in North America and Europe - 15 percent•African Americans - 8 percent•Africa - 4 to 6 percent•India - 5 percent•Native Americans and Inuit Eskimos - 1 to 2 percent•Japan - 0.5 percent•Thailand - 0.3 percent•China - 0.3 percent.Red cell antigens causing isoimmunization:•Rh D•Other antigens- Kell, Lewis, Duffy, Kidd, MNS.The risk of fetal anaemia is greatest with anti-D, anti-c and anti-K antibodies. Other antibodies that potentially cause significant fetal anaemia include anti-E, -Fya, -Jka, -C and -Ce. Rh antigen ac-counts for 40% cases of alloimmunization
102 Hemoglobin Electrophoresis - A Stitch in Time Saved Beta thalassemia Mother and Newborn , Preeta Kurvattigoudar1* and Kishanrao Suresh
Hemoglobinopathies are inherited disorders of red blood cells,an important cause of morbidity and mortality, as they impose a heavy burden on families in the absence of a antional program. People with Beta thalassemia minor exibit mild anemia needing no medical treatment but if the client be a lady may fall short of Hb% during pregnancies. We report one such case of Beta-thalassemia. An young female of 30 yrs, married for 4 years a housewife reported happily with amenorrhea for 2.5 months and a positive preg-nancy test using a rapid test kit at home for routine check-up, follow-up, expecting normal outcome. She revealed normal menstrual history but the exact LMP was not known. Her past history indicated delayed developmental milestones following her mother’s death an obstructed delivery by outlet forceps.Physical examination revealed a uterus of 16 weeks size, urinary pregnancy test reconfirmed the pregnancy and all other findings were normal. Gestational diabetes was ruled out by a GTT. Investigation reports showed that Hb was 8.2 gm% with MCV count 69fL, WBC count was 7400 cells/ cumm and Platelet count was 301000 cells/cumm, Red blood cells count was 3.7 million. HIV and HbsAg were also negative and the patient blood group was “O” positive. Cardiotocography showed FHS (Fetal Heart Sound) ranging from 150 - 160 beets/min. An anomaly scan reported that a single live intrauterine fetus of gestational age 17wks 2 days +- 8 days with no obvious anomalies. And EDD (Expected Date of Delivery) was given on 28 September 2020. T. Iron and a multivitamin -Bd for 30 days. And T. calcium carbonate 600 mg + T. Vitamin D3 400 Iu - od for 30 days was given. Same follow-up was repeated, but Hb% did not improve after 3 more months. An USG was normal. Hemoglobin electrophoresis confirmed that she had Beta thalassemia trait in the 7th month of the pregnancy. She was given Inj. OROFER FCM 500 mg IV that improved the Hb% level to 10 gm%. As a result she underwent a full term lower segment Cessarian Section (LSCS) on 21st September 2020, No complications durng the entire process of LSCS. Both mother and baby with birth weight of about 2900 gms were healthy. No further peurperal complications were observed. Now the baby turned to 8th month with no such issues and Hb% of the mother mentained same as 10 gm% and the growth and de-velopment of the newborn are normal
103 Fulminating Fungal Infections Complicating Covid19 Recovery in India , Suresh Kishanrao*
The cases of mucor mycotic infections are on the rise in the wake of rise in Covid 19 cases and recovery since a month or so in India. As of end May 2021, India has recorded over 19000 cases across the country. Among all the opportunistic fungus worldwide Aspergil-losis is the most common variety. Globally outbreaks of mucor mycosis have occurred due to contaminated products such as hospital linens, medications, and packaged foods. Three types of fungi colloquially called as Black, White, and yellow fungus have identified. While the black fungus infection is the most prevalent both as single and combined infections, the other 2 are reported along with the black fungus recently. Misuse of steroids in managing Covid 19 cases especially among diabetics is attributed playing a major role behind this infection. Other contributory factors being blamed are long stay in ICU, unclean water used is dehumidifiers of the Oxygen cylinders and ventilators, unclean masks and going in the dusty construction sites after recovery from the Covid 19 infection. The symptoms appeared on an average of 2-3 weeks after patients were discharged from hospital, shortest interval being as early as 5-6 days after testing positive for Covid 19. One eye care hospital in Mumbai that used to see about 5-6 cases in the entire year before the pandemic has reported more than 10 MM patients first two weeks of May 2021.
104 Evolution of Intracavitary Brachytherapy in the Treatment of Cervical Cancer , Chrishanthi Rajasooriyar1,2* and Peter Hoskin
Purpose: The evolution of intracavitary brachytherapy in the treatment of cervical cancer spans over 120 years. The purpose of this review is to understand how the discovery of radium paved the way to the current standard of care; the image-guided adaptive brachytherapy. Materials and Methods: A literature search was done to identify the important milestones in the evolution. The terminologies used for the search were “history”, “brachytherapy”, “radium”, “dosimetric systems” and “image-guided adaptive brachytherapy” (IGABT). The information gathered was organized in chronological order and the key milestones were identified. Results: The origin of brachytherapy can be tracked down to the discovery of radioactivity by Sir Henry Becquerel, followed by the invention of radium by the Curies’ in the late 19th century. In the early 20th century, various dosimetric systems evolved. Among these systems, the Manchester system prescribing to point A became popular and was widely in practice for many decades. The deficien-cies of the point A prescription model were brought to light with the advances in soft tissue imaging in the late 20th century. Imaging helped in prescribing to the actual tumor volume and to generate dose-volume histograms to achieve better target coverage while reducing the dose to the organs at risk. The IGABT started with computed tomography and was further enhanced by magnetic reso-nance imaging (MRI) due to better anatomical delineation of the pelvis anatomy. Hence MRI based adaptive brachytherapy became the gold standard and has been proven to be safe and effective while significantly reduced toxicity. As cervix cancer is most prevalent in low resource regions, ultrasound scanning has been identified as a reasonable substitute for MRI. Conclusion: Intracavitary brachytherapy in the treatment of cervical cancer has developed over the last 120 years and has made tremendous advances in the last 20 years.
105 Determınation of Hepatıtıs E Vırus Infection Frequency and Risk Factors in Viral Hepatites in Diyarbakır Regıon , Songül Beskisiz1, Omer Satici2, Vatan Kavak3* and Kendal Yalcin
Aim: Our aim in this study; Liver in the domain of hepatitis E virus infection; It is the largest organ in the body located in the upper right of the abdominal cavity. The liver organ is the organ in the domain of the hepatitis E virus.It is to retrospectively investigate the HEV seropositivity in patients with viral hepatitis who are 18 years of age and older who applied to Dicle University Faculty of Medicine, Department of Gastroenterology, and to determine the risk factors associated with HEV infection by evaluating the cases according to epidemiological, clinical and laboratory characteristics.Material and Methods: Within the scope of this study, 1025 patients aged 18 and over who applied to Dicle University Faculty of Medicine Gastroenterology Department between May 2011 and March 2015 were included. Age, gender, biochemistry (ALT, AST, GGT, Total bilirubin, albumin), whole blood (hemoglobin, thrombocyte), coagulation (INR), demographic criteria (origin (urban/rural), educational status (primary school and below-low, middle school and above-high), marital status (married/single), pregnancy (yes/no), known family history of viral hepatitis (yes/no), contact with animals, substance abuse (yes/no), alcohol use (yes/no no), cirrhosis status (yes/no), time of infection in patients with viral hepatitis, and antiviral drug use were retrospectively investigated.Statistical Analysis: The data were transferred from the Excel package program to the SPSS (Statistical Package for Social Sciences) 25 package program. Variables were defined as categorical, ordered, and continuous measurement variables, and appropriate tests were used for these variables.Results: The mean age of the patients was 49.29 ± 15.39 years and Anti-HEV IgG seropositivity was determined 56,4% of all patients (578/1025). HEV seropositivity was 76,3% in patients with HCV (29/38), 50% in patients with HBV (142/284), 70,7% in patients with HDV (58/82) and 56.2% in control group (349/621). Highest mean age in the groups was detected in HCV patients as 51.84± 15.77 years ( P = 0.001). Rate of Anti-HEV IgG seropositivity according to age groups was highest in patients older than 61 years old ( 141/578, 24.4%) and lowest in patients between 18-30 years old (68/578, 11.8%) (P < 0.001). Advanced age, rural origin, low education level, being married, history of contact with animals, high ALT levels, high GGT levels, low platelet levels, anti-delta sero
106 Biodegradable Polymeric Nanoparticles for Photodynamic Laser Cancer Therapy , Mohammadreza Saboktakin*
Photodynamic cancer therapy is well known and recognized in many countries best therapy for cancer therapy. However, previ-ous findings on PDT are limited to Tumors on the body surface, since the available photosensitizers largely from Porphyrin exist and can only be stimulated with red laser light. The penetration depth of the red laser with effective stimulation of the photosensitizer is about 1 - 2 cm and also limited to a tumor size of about 1 cm. The penetration into the liver or through bone is almost impossible, so that there is no possibility. To successfully treat liver metastases or brain tumors. Infrared laser beams penetrate a lot deeper into the body and can even penetrate liver and bone. A perfect one Photosensitizer should therefore have an absorption spectrum in the infrared range, in the market however, nothing is available. The new polymeric systems have reviewed in this review.
107 Biodegradable Polymeric Nanoparticles for Photodynamic Laser Cancer Therapy , Mohammadreza Saboktakin*
Photodynamic cancer therapy is well known and recognized in many countries best therapy for cancer therapy. However, previ-ous findings on PDT are limited to Tumors on the body surface, since the available photosensitizers largely from Porphyrin exist and can only be stimulated with red laser light. The penetration depth of the red laser with effective stimulation of the photosensitizer is about 1 - 2 cm and also limited to a tumor size of about 1 cm. The penetration into the liver or through bone is almost impossible, so that there is no possibility. To successfully treat liver metastases or brain tumors. Infrared laser beams penetrate a lot deeper into the body and can even penetrate liver and bone. A perfect one Photosensitizer should therefore have an absorption spectrum in the infrared range, in the market however, nothing is available. The new polymeric systems have reviewed in this review.
108 Oncological and Reproductive Outcome in Epithelial Ovarian Cancer in Women Less than 30 Years of Age , Binamra Sigdel1*, Chitrathara Keshav2, Sanam Puzhakkal3, VP Gangadharan4, Suresh Kayastha1, Remi Abdul Shukur1, Anupana S1and Tony Augustine
The objective of this study is to evaluate oncological and reproductive outcome of epithelial ovarian cancers and its clini-copathological patternsin patients less than 30 years of age. Methods: This is a retrospective, single center study and all the patients diagnosed with EOCs from 2014 to 2019 AD who underwent either primary surgery or completion surgery in this center were included in the study. Thirty-six patients with EOCs were identified and their clinicopathological characteristics, overall survival, progression free survival and reproductive outcomes were determined. Mean was used to describe continuous variables whereas frequency and percentages were used to describe categorical variables. Results: The number of Epithelial Ovarian Cancers in women less than 30 years was 36 (8.07%). The mean age of the patients was 24. The most common mode of presentation was abdominal pain in cases followed by abdominal distension. The most common tumor subtypes were mucinous carcinoma followed by eight cases each of borderline serous and serous carcinoma. Most of the patients presented in early stage of disease. Twenty-two patients (61.12%) underwent fertility sparing surgery. Five patients had recurrence and there was one mortality. The median follow up period was 44 (14 - 90) months. Progression free survival was 37.41 months and overall survival was 44 months. The overall survival rate was 94.45%. Conclusion: EOCs are rare in young patient and diagnosed at early stage. They have excellent prognosis with fertility sparing surgery and adjuvant chemotherapy and successful pregnancy can be achieved in most of the cases
109 The Role of Sporting Activates in Reducing Plastic Surgeries among Women Students at Al-Balqa Applied University , Lubna M Obeidat*
Introduction:Beauty is one of God’s blessings conferred on us, especially on women. Our true religion instilled in us love for adorn-ment and being beautified.Objectives: This study aimed to identify the role of sports activities in reducing plastic surgeries as to women students at Al-Balqa Applied University.Methods:The researcher used the descriptive correlation method. The sample consisted of (200) females chosen randomly from the university by implementing the study tool on a sample consisting of (60) items including six domains. Suitable methods were used to ensure validity and reliability, to answer the research used the two-way analysis of variance, the multi-variant analysis of Viviane and Scheffe’s test.Results: The means (3.86 - 3.00) with the highest mean (3.86) for the personal motivations, which ranked first, whereas the academ-ic motivations came last with the mean of (3.00). The means of the tool as a whole reached (3.33). The results of the study showed statistical differences (0.05 = a) attributed to the case effect. They also showed significant statistical differences (0.05 = a) attributed to the impact of the academic year on the aesthetic and health field, with the differences on behalf of the 3rd and 4th women students.Conclusion: The research came out with a set of recommendations among the most prominent of which is the necessity of enhanc-ing the culture and concepts of sports as related sports do the role of sporting activities for women, for such activities have a positive impact on the different walks of life: aesthetic, personal, psychological, social, academic and health issues. It was also recommended that positive motives have to be boasted through exercising sports activities to minimize plastic surgeries.
110 What can Indicate the Presence of an Additional Lobe of the Breast , Aleksandr L Urakov1*, Natalya A Urakova2 and Anastasia P Stolya- renko
The presence of an undiagnosed additional breast lobe in a woman can significantly worsen her health on the day of the birth of her first child and postpone the start of breastfeeding for several days. Unfortunately, today, the additional lobes of the mammary glands are detected only after the beginning of lactation, when they swell and become painful. At the same time, in nulliparous women, such lobes can also worsen their health, as they can be- come the site of the development of mastitis, cancer and some other pathological processes.
111 Knowledge of the General Population about Chronic Kidney Disease , Maryem Labrassi*, Fadili Wafaa, Lamiae El Abbady, Meriem Chettati and Inass Laouad
Chronic kidney disease (CKD) is a major public health problem in Morocco and around the world. Public awareness is a determi- nant factor in the adoption of early programs of this disease. The objectives of our work were to determine the general population’s knowledge of the CKD using a questionnaire, and to deter- mine the impact of the participants’ epidemiological characteristics on their level of knowledge. We have managed a descriptive cross-sectional study using a survey carried out among consultants and their companions at pri- mary health care centers in Marrakech. Our study included 200 volunteers aged over 18 years old, not working in the medical field, and having no personal history of nephropathy. The predominant age group in our survey was between 18 and 29 years (43.5% of cases), with a female predominance 81.5% of the participants were from urban origin and 54.5% of the participants were married. Most of the subjects were schooled (85%), of which 34.5% had completed higher education. High blood pressure and diabetes were found in respectively 12.5% and 18.5% of participants in our study. In univariate statistical analysis, the factors significantly related to the knowledge of the participants in our study about CKD were: the presence of a family history of CKD, and the personal history of medical intake, diabetes and hypertension. The consequences of CKD amplify its socio-economic impact and deplete public health resources, hence the crucial need for the participation of the different actors of the health system for the implementation of public awareness programs on CKD. They should be more targeted to people with risk factors of CKD
112 Is there a Greater Risk in the Use of Hormones Nowadays? , Huang Wei Ling*
The implantation of the Flexner report in almost all the conti- nents in 1913, brought the modernization of medicine in all areas related to the diagnosis and treatment of the most diverse patholo- gies, but at the same time, many of its negative effects we can see in our today’s patient. Also, the modernization of the devices used in the communication with the implementation of 5G technol- ogy brought changes that few studies have shown, because these changes are subtle and not noticeable to the naked eye
113 Effects of Intravenous Administration of Tranexamic Acid in Reducing Blood Loss during and After Caesarean Section , Anita Kant1*, Usha Priyambada Gupta2, Amrita Razdan Kaul3 and Shephali4
Objective: To study the safety and efficacy of Tranexamic acid (TXA) in reducing blood loss during and after the caesarean section. Methodology: This is a randomized, case controlled, prospective open label trial conducted on ninety term pregnant females un- dergoing caesarean in our hospital for evaluating the blood loss with or without the use of TXA. Patients were randomly assigned to either cases (Receiving injection TXA) or controls (Not receiving TXA). Results: Mean of total blood loss among cases was 267.27 ± 115.77 ml, while it was 428.13 ± 98.24 ml in controls (p value < 0.001). Its use was not associated with any side effect or complications like Thrombosis. Overall, the study supports the evidence of benefi- cial effects of TXA in significantly reducing blood loss during and after CS and hence reducing the need for blood transfusion. Conclusion: TXA is effective in reducing blood loss during and after caesarean section. Keywords: Bleeding; Caesarean Section; Postpartum; Tranexamic Acid
114 Mental Health Counselors’ Experiences with Intrafamilial Childhood Sexual Abuse (ICSA)Victims: An Application of Transcendental Phenomenology Reduction Model , Bridget Holyfield-Moss and Komanduri S Murty*
The complexity of prevalent Intrafamilial Childhood Sexual Abuse (ICSA) in society often induces its victims to seek counseling to manage the abreactions that may have rooted in their earlier abuse. Professional counselors listen to stories of abuse to assist those victims in reasoning their personal violence. The study participants included 12 Licensed Professional Counselors (LPC’s) in the State of Georgia ranging in ages from 25 to 55 years. Utilizing the data triangulation method: (1) face-to-face interviews were conducted with all participants via a semi-structured questionnaire; (2) a focus group interview was held; and (3) the collection of artifacts was employed. Once the interview data were transcribed and coded, five emerging themes and twelve subthemes were de- rived—(1) Professional Reflections with subthemes of challenges, successes, emotions, and self- care; (2) Professional Development with subthemes of training and supervision; (3) Trauma with subthemes of multiple definitions, intergenerational abuse, and re- victimization; (4) Presenting Problems with a subtheme of cooccurring disorder; and, (5) Counseling Interventions with subthemes of theoretical orientation, creative arts therapy, mindfulness, EMDR (Eye, Movement, Desensitization and Reprocessing), group ther- apy—as mental health counselors’ lived experiences within the context of working with victims of ICSA. Suggestions for counseling practice; counselor education and supervision; and recommendations for future research in the area of ICSA for the benefit of those working with this population are provided
115 Women and Urinary Tract Infection , R Nambu Mahalakshmi* and R Thillai Raj Kumar
Women face health problems in day to day life. One of the serious issues is urinary tract infection. Urinary infection is very com- mon, but women get more infection than men. UTI caused by the organisms cause serious urinary inflammation. The major causative organisms are E. coli, Pseudomonas aeruginosa, Staphylococcus aureus, Enterococcus faecalis etc. Today, all age group of women have urinary infection. Women can get easily infection than men through improper hygiene, sexual activity, maternal time, menstrual cycle, and menopause. In this study, frequently we found that those having above 40 age group women have got more infection with E. coli and Pseudomonas aeruginosa. Few peoples were infected by mold. In this primary investigation, we isolated clinical pathogens from normal urine samples by plate count method. In macroscopic observation we found cloudiness or turbidity, also we performed basic tests like glucose, ketone bodies, nitrite, bile deposits etc. In microscopic studies, like WBCs, RBCs, Epithelial cells, Hyaline cast, Waxy cast. Next, the studies focus on antimicrobial susceptibility test.
116 Unborn Child as a Person - To the New Paradigm , Grigori Brekhman*
The prenatal and perinatal psychology is a interdisciplinary scientific field, which studies the emotional perception of un- born child, and the influence the impressions, which stayed in his memory on his subsequent thinking and behavior in lifetime. Last 50 years the scientific researchers have shown that all organs of a child at 6-7 weeks after conception morphologically had formed. These organs, including sense organs, simultaneously begin to function, gradually spread their diapason that is far before the birth.
117 Echocardiographic and Electrocardiographic Manifestations of Newly Diagnosed Adult Patients Suffering with Overt Hyperthyroidism , Rashmi Aggarwal1*, Hemant Aggarwal2, Pradeep Chugh1 and Vipin VS1
Background: Thyroid hormones directly affect the heart and cardiovascular system. Cardiovascular symptoms like hypertension, palpitations, dyspnoea, chest pain, pedal edema and exercise intolerance are common presenting symptoms of hyperthyroidism. These symptoms usually revert back to normal when a euthyroid state is restored and maintained with help of antithyroid drugs ini- tially and a definitive treatment later. Hyperthyroid patients can be easily evaluated using two non invasive modalities namely elec- trocardiography and echocardiography. This study aims at understanding the various electrocardiographic and echocardiographic manifestations of newly diagnosed patients with overt hyperthyroidism. Aim: To evaluate electrocardiographic and echocardiographic manifestations of newly diagnosed adult patients suffering with overt hyperthyroidism. Methods: 77 patients with overt hyperthyroidism who visited the thyroid clinic of Institute of nuclear medicine and allied science (INMAS), Timarpur, Delhi were enrolled for the present study. All the patients were asked about the symptoms including cardiac symptoms with the help of a structured questionnaire. Detailed clinical, biochemical evaluation and nuclear imaging was done for all the patients and it included estimation of freeT3, free T4, TSH, Technetium 99 scan and Radio-active iodine uptake. Cardiovascular evaluation included a 12 lead resting electrocardiogram (ECG) and a two dimensional transthoracic echocardiogram. Conclusion: Symptoms pertaining to cardiovascular system are the common presenting feature in patients with hyperthyroidism. Apart from clinical examination of the cardiovascular system electrocardiography and echocardiography are two non-invasive mo- dalities that can evaluate the cardiac abnormalities in such patients.
118 Scale Validation: The Couple in Light of the Birth and Upbringing of a Child with High Risk in Mexico , Rosalía Jiménez-Quiroz1, Ma de la Paz Conde-Reyes1, Angélica Romero-Palencia2, Elizabeth Alvarez Ramírez3, Martina Angélica Guido-Campuzano1* and Castro-Soto, Laura
Introduction: The birth of a high risk child leads to a disruption of psychic processes in the couple due to the morbidity of the neo- nate, the hospital environment, and an initial long separation from a child with a risk of death, anomalies or sequels. This acquires a traumatic nature, and has persistent emotional effects and symptoms on the couple. After hospital discharge, stress in relation to the child’s health slightly decreases and stress related to parenting and daily chores increases. In a couple’s relationship, it is common to find insecurity caused by experiences during the perinatal period, as well as all the challenges that must be faced. This activates psychological resources allowing for couple negotiations, understood as communication processes that take place in different set- tings: the division of domestic chores, parenting, sexuality, control of money and materials, time, personal space and the equilibrium of the couple with other social and affectionate relationships, as well as opportunities for dialogue, mechanisms to establish rules, relationship conditions and difficulties generated by these processes. The above highlights the importance of creating instruments to understand the experience of the couple under these circumstances. Objective: To create and validate an instrument to measure the couple facing a high risk birth and upbringing in Mexico. Materials and Methods: The sample consisted of 372 participants living as a couple, with children with a high risk birth, who at- tended the Pediatric Follow-up at the National Institute of Perinatology (INPer), with an age μ= 34.46 (SD = 7.87). In an exploratory study using focus groups, the most frequent indicators found were expressed as Likert 5-point statements. Ethical concerns for the investigation with human subjects were considered. The method used for psychometric analysis was the one suggested by Reyes- Lagunes and Garcia-Barragan (2008). For validation, the exploratory factor analysis with orthogonal rotation (Varimax) was used. Results: The scale presents Bartlett’s test of sphericity of 4924.824 and a Kaiser-Meyer-Olkin (KMO) sample fitness index with a value of 0.941, indicating a satisfactory factor analysis. As a result of the 7 interactions of the factor analysis, 3 groups of factors were assembled: Positive affection towards the partner, asynchrony and negative communication towards agreements and synchrony and positive communication towards agreements; these explain 51.15% of the total variance and a global Cronbach’s alfa of 0.808. Cor- relations between factors were low to moderate and significant, proving the adequate construct validity of the scale. Conclusion: The design and validation of this instrument allows the observation of the phenomenon, understanding the experience of couples with children with a high risk birth and their upbringing from a familiar and social perspective according to the character- istics of the instrument. This scale will be useful for future investigations
119 Relationship Between Vitamin D and Autoimmune Condition and Thyroid Function with Newly Onset Grave’s Disease , Victor Kravchenko*, Oleg Rakov, Olena Kovzun, Andriy Kovalenko and Viktoria Rakova
Vitamin due to the presence of the receptor (VDR), which is found in almost all nuclear cells is an important regulator in the pathogenesis of many diseases. The question of the causal relationship between vitamin D deficiency and Graves 'disease and the importance of this vitamin for thyroid function in the treatment of Graves' disease deserves special attention. The aim of the study was to investigate the level of 25- (OH) D in the body in Graves' disease and its relationship with thyroid function. We examined 143 patients who were first diagnosed with moderate Graves' disease (GD). All patients studied by us, residents of Ukraine, 67% of them live in Kyiv, 19% in Kyiv region, 14% in other regions of Ukraine. The average age of the subjects was 43.8 ± 0.95, among whom were men 22.4%, women - 77.6%. The analysis of immune parameters and thyroid function depending on the age of patients, the content of vitamin D in the serum, and its quartile distribution before treatment. Subsequently, all patients were divided into two groups depending on the therapy. The first group included 73 subjects, whose average age was 44.69 ± 1.39, patients in this group received tyrosol at a dose of 5 - 10 mg per day. The second group consisted of 70 patients. whose average age was 42.93 ± 1.29, they took tyrosol at a dose of 5-10 mg per day and vitamin D preparations - 2000 MO/day. In patients with Graves' disease. the highest content of 25- (OH) D in serum was observed in the age group of 19-30 years -59.1 nmol/l and a low level of antibodies to the TSH receptor - 9.0 mUi/l. A significant decrease in the immune index was observed only in the 3rd and 4th quartiles, when the content of 25- (OH) D in the serum reached 47.5 nmol/l and above, i.e. approached a moderate deficit. At a slight increase to 34 nmol/l, such changes were insignificant. After 3 months of treatment, the level of AbrTSH in the serum during treatment with vitamin D was twice lower than when treated with tyrosol alone. After 6 months, compared with the treatment with tyrosol, the effect of treatment was 2 times better. In contrast to TPOAbs in Graves' disease without treatment with vitamin D, where it did not differ depending on the level of 25 (OH) D, in the second group after 6 months of treatment there was a significant decrease in this indicator (p = 0.009). Compared to tyrosol treatment alone, there was a significant increase in TSH levels and a decrease in thyroid volume after 6 months. Data on the dependence of thyroid function on the level of 25 (OH) D were indicative. In each of the quartiles, the level of TSH after treatment with vitamin D was 4-5 times higher than in the group of patients treated only with tyrosol. Convincing data on the positive effect of vitamin D on autoimmune parameters, thyroid function and the need for its inclusion in the treatment of Graves' disease. Keywords: Thyroid, Graves' Disease, Tyrosol, Vitamin D, TSH, TSH Receptor, Antibodies to Thyroxine Peroxidase, Free Thyroxine, Free Triiodothyronine, Thyroid Volume, Risk Factors
120 Cardiovascular Manifestations of Hyperthyroidism , Rashmi Aggarwal1* and Pradeep Chugh2
Hyperthyroidism is associated with increased morbidity and mortality from cardiovascular disease [1]. Thyroid hormones signifi- cantly affect the cardiovascular systems. Both Heart and blood vessels are affected through genomic and non-genomic mechanisms. Tri iodothyronine (T3) the active thyroid hormone directly initiates the transcription of specific and non-specific genes acting on THR in the nucleus [2]. Non genomic effects of T3 are exerted on the plasma membrane, mitochondria and sarcoplasmic reticulum of cardiac myocytes. Hyperthyroidism causes a spectrum of hemodynamic changes in the cardiovascular system like increase in heart rate, cardiac output, stroke volume, myocardial contractility and Left Ventricular mass [3]. Atrial fibrillation is a common cardiac manifestation of hyperthyroidism. Even subclinical hyperthyroidism has been also associated with an increased risk of atrial fibrillation [4]. In patients with pre - existing heart disease, the hyperdynamic circulation accompanying hyperthyroidism will further impair cardiac function leading on to congestive cardiac failure, worsening angina, atrial fibrillation and thromboembolism [5].
121 The Bitter Truth of a Cold Drink , Maithili A Athavale*
In this modern era, when technology is moving at a great pace, fast food has become an integral part of life at the workplace, col- leges and at many celebrations. Many teenagers get addicted to junk food and the cold drink/Soft drink is a part of it. Frequent consumption of Cold drink can have an adverse impact on the ado- lescent health
122 Bone Marrow Mesenchymal Stem Cells (BMSC)-upregulated miR-139 Inhibited the Migration and Invasion of Breast Cancer Cells In Vitro by Inhibiting PXN Expression and EMT , Liandi Shen1, Mengdi Niu2, Yangyong Lu2, Weihong Cao3 and Xueqiang Gao3
Short non-coding RNAs (microRNAs) is reported to exerted a crucial impact in tumor biology. While, the biological effect of miR- 139 in breast cancer cells remain unclear yet. Here we intend to clarify the effect and mechanism of miR-139 derived from Bone mar- row mesenchymal stem cells (BMSCs) on the biological behavior of gastric cancer cells. Breast cancer cells were divided into BMSC group (mixed culture of BMSC and breast cancer cells 1:1). Cells in the miR-139 mimics group, si-PXN group and control group were not treated. miR-139 abundance is evalued through Real time PCR, cell activity is analysed by MTT assay.Finally, the targeted binding of miR-139 to PXN was verified by double luciferase reporter genes. In relative to control, miR-139 abundance was notably declined in gastric cancer cells, while PXN abundance was higher, and the higher expression of PXN was linked to the prognosis of patients. miR-139 can be up-regulated by BMSCs or miR-139 mimics, thereby regulating EMT process through targeted inhibition of PCN, and ultimately inhibiting in vitro activity of breast cancer cells. BMSC co-culture can inhibit PCN by up-regulating miR-139, thus regulat- ing EMT process and inhibiting the progression of gastric cancer. The results of this study revealed the mechanism of breast cancer progression to a certain extent, and suggested that miR-139 and PXN could be used as therapeutic targets for metastatic breast can- cer, and BMSC could be of great value as a novel biologic therapy.
123 Menstrual Hygiene Among Medical Female Students , Mihail Kochubovski1,2, Aleksandra Petrova1,2*, Shaban Memeti1,2 and Djansun Bukovec2
Menstruation, or period, is a monthly occurrence for people of reproductive age. The number of girls, women, transgender men and non-binary persons that experience the period is about 1.8 billion. Even though a big progress is made in raising the awareness for menstruation hygiene and health, however, there are some issues that cause girls and women not to meet the basic menstrua- tion hygiene and health needs. Researchers say that poverty, menstruation taboos, lack of basic hygiene services, gender inequality have negative impact on the lives of the vulnerable categories. Adolescent girls during their period, are often faced with intimidation, stigma, and even social discrimination. The aim of the work is to analyze the habits during the menstrual cycle as well as the absence from classes. The study is a cross sectional observational study conducted between November and December 2019
124 Plant-based Vaccines for SARS-CoV-2 Novel Corona Virus - A Review , Ariyanachi K1, Lakshmi Jyothi Tadi2*, Supriya Garapati3 and Pravin Pissude4
Introduction: The novel SARS CoV2 coronavirus is believed to have emerged from bats in Wuhan in 2019 last yearAs of July 8, 2021, 20 vaccines worldwide have been licensed; 96 vaccines are in human clinical trials, 32 of which have entered the final stage of test- ing. VLP proved to be a promising alternative to soluble antigens. Because they have the conformation and composition of natural viruses, their shape, size, repeated antigen structure and geometry will trigger stronger humoral and cellular immune responses. Plants have a complex mechanism for eukaryotic protein production and also support the amplification of a large number of plant- specific viruses. Method: 35 articles from Medline, Embase, Google Scholar, Scopus. PubMed were reviewed using the key words SARS CoV-2 plant- based vaccines. Review: Virus-like particles (VLPs) are self-assembling structures derived from viral antigens, which mimic the natural structure of viruses but lack the viral genome. VLPs are similar in size and shape to real coronaviruses, but they lack nucleic acid and are there- fore not infectious. The Phase 1 trial of Medicago's plant virus-like particles started in July 2020, involving 180 healthy volunteers aged 1855. All preparations are well tolerated, and adverse events after vaccination are usually mild to moderate. British American Tobacco, through its US biotechnology subsidiary Kentucky Bioprocessing (KBP), is developing a potential COVID19 vaccine and is currently undergoing preclinical testing. Using its plant-based Fast Pharming® system, iBio, a biotechnology innovator and biolog- ics contract manufacturing organization, reported on its progress in the development of the second-generation vaccine candidate subunit IBIO202, which aims to prevent SARSCoV2 infection. Conclusion: Now is the time to explore the true potential of plant-based vaccines, proven technologies that have the potential to play an important role in promoting global health
125 The Origin of Ovarian Cancer - Still Debatable , Pushpam Kumar Sinha*
Despite the discovery of two types of Adult Stem Cells (ASCs) in ovary, the Very Small Embryonic like Stem Cell and the Ovarian Stem Cell, the debate over the origin of Ovarian Cancer (OC) is far from over. Like several other cancers, Cancer Stem Cells (CSCs) in recent years have been held responsible for tumor initiation and progress in OC too. CSCs are known to originate from malignant transformation (by genetic and or epigenetic mutations) of ASCs and or their multi-potent progenitors. In liver there exists cellular plasticity between ASC and mature differentiated cells (MDCs). Hence, in liver, even MDCs can be the origin of CSCs. I hypothesize in this article that, like liver, even the MDCs of ovary can be the origin of Ovarian CSC. MDCs of ovary transform to CSC by replacing the nuclei of oocytes by their own nuclei.
126 Pre-post Case Study of the Psycho Physiological Effects of Ujjayi Breathing on Covid-19 and Hypothyroidism , Rashmi A Bapat* and Tanvi Londhe
63 participants from Maharashtra, Pune, India between 18 to 70 years of age participated in the intervention group, while 49 were in the control group. In the experimental group, there were four participants diagnosed with covid-19 and five more diagnosed with hypothyroid ailments. A 40-day online intervention was conducted for the intervention group as 25-minute daily sessions of AUM chanting and Ujjayi breathing. Questionnaires about psychological health parameters were answered by both groups before and after the intervention. Participants also recorded their pulse rate and respiratory rate before and after the intervention. A highly significant effect of Ujjayi breathing was observed on perceived stress, anxiety, pulse and respiratory score for intervention group, when compared with the control group. Overall quality of life showed less significant impact
127 Immunohistochemistry (I.H.C.) and Histopathology of the Fetoplacental Barrier in the Placentas of the Mothers, Recovered from Covid-19 Infection and its Clinical Significance , Satish Patki1*, Rajendra Patil2 and Surhud Patki1
Introduction: Since the outbreak of coronavirus disease 2019 (Covid-19), there has been a continuous research to find out whether the babies born to the affected mothers are infected with Covid-19. Even though, the transmission of this virus has not yet been established by transplacental route, the babies born to covid-positive mothers often show complications like Intra Uterine Growth Restriction (I.U.G.R.) and related problems. Placenta is the most important organ interposed between the mother and fetus and is vital for the fetal health. There are very few studies in the literature about the microscopic functional assessment of the placenta in mothers recovered from Covid-19 infection. Present study is designed to evaluate the biophysical barrier of the syncytium and vil- lous vascularity in the placentas of in such mothers by using Immuno Histo Chemistry (I.H.C.) and histopathology techniques. The microscopic findings are correlated with the perinatal outcome. Aims and Objective: To study the Immuno Histo Chemistry and histopathology of the syncytium and villous vascularity in the pla- centas of the mothers, recovered from covid-19. To study the correlation of these specific findings with the perinatal outcome. Materials and Methods: Present study was undertaken after getting approval by our Institutional Ethics Committee. The study duration was from Jan 2021 to May 2021. 16 pregnant women who recovered from the proven Covid-19 infection during second trimester by positive RT-PCR test were selected after obtaining informed consent. 15 patients had mild symptoms while one had severe form of Covid-19 infection who required ventilatory support for 5 days. She had intrauterine fetal demise during 30th week of gestation. Age and parity matched 16 patients were selected as controls. The mothers having hypertension, diabetes and antepartum hemorrhage were excluded. Placentas were collected immediately after removal, washed in tap water and were preserved in 10% formal saline. Each placenta was cut into three sections, each of 1 cm thickness, from 3 areas starting form cord attachment to periphery. The tissues were processed and stained by H&E stain as well as using CD 34 antibody. The slides were examined with light microscope under 10X objective. The number of capillaries per villus was counted in 10 villi in 3 random fields of each slide. Integrity of the syncytium around each villus was also recorded. Perinatal outcome in terms of APGAR score and I.U.G.R. was noted in each case. Data was compared using unpaired t-test with the help of SPSS software version 21
128 Pancreatitis During Pregnancy Revealing Solid Pseudopapillary Tumor of the Pancreas: Case Report , Imen Ganzoui1*, Dorsaf Nouri1, Mariem Balti1 and Karim Ayed2*
A 26-year-old primigravid patient, at 11 weeks of gestation, was referred to the digestive surgery department for acute pancre- atitis, the abdominal ultrasound revealed a solid pancreatic mass. The MRI showed a well circumscribed tumor in the body of the pancreas with no local or distant invasion. The diagnosis of solid pseudopapillary tumor of the pancreas (SPTP) was then suspected. After multi-disciplinary reunion including the patient and her husband, the decision was to operate the patient but first medically interrupt the pregnancy. The operation consisted in left pancreatectomy with conservation of the spleen gland. The histopathological examination confirmed the diagnosis of SPTP. There was no complication or recurrence after 10 months of follow up
129 Prevalence of Hepatitis B and Hepatitis C Co-infection with Tuberculosis Patients in Khartoum State Sudan , Mugtaba Ahmed Abdalrahman Ahmed1, Hussein Elsayed1, Razan Abdelmoula Musa Ali2, Sara Elsayed Hussein Elsayed2, Mohammed Altyb Alshykh Aboshanab1*, Mohammed Alfatih1 and Mohamed Abdulkarim
Introduction: Tuberculosis infection is a very serious pulmonary infection, sometimes is co-exist with another infectious disease such as Hepatitis B and C which are very dangerous liver infection and may lead to liver cirrhosis and hepatocellular carcinoma. Methods: This is a descriptive cross- sectional study. It was conducted at Abu Anja hospital which is one of the biggest hospitals in Khartoum state during a period from February-April 2016. Result: A total serum specimen of 160 samples was taken from patients with Tuberculosis infection. Aged between 10-80 years (118 males 42 female) were collected. 11 cases (6.9%) were found to be seropositive for Hepatitis B Virus infection). 4 cases (2.5%) were found to be seropositive for Hepatitis C Virus infection. The highest frequency of Hepatitis B Virus seropositivity among age group was observed in the age group 21-40 years. Hepatitis C Virus was found to be highest in the age group 21-40 years also. Conclusion: Co-infection with viral hepatitis (HBV, HCV) among TB patient increases the risk of hepatotoxicity occurring during the treatment of tuberculosis, therefore, it is important to know the seroprevalence of HBV and HCV among TB patients before starting the treatment. Furthermore, once the patient started the treatment of TB, there must be regular follow up for monitoring the indica- tions of hepatotoxicity and routine evaluation of liver function test must be considered wherever possible.
130 The Efficacy and Safety of Oral Tranexamic Acid (TXA) in the Treatment of Melasma , Mohammed Al Abadie*, Hussain Tukmatchy, Daniel Adam and Lamis Sharaf El Din
Melasma is a disfiguring skin disease that is often challenging to treat. Treatments options including topical remedies, laser thera- pies and systemic medications vary widely in efficacy and tend to display safety concerns. Systemic tranexamic acid has been widely feared in practice as a treatment option, despite growing evidence in literature of its high efficacy and safety in the management of melasma. In this article, we discuss the efficacy and safety of oral tranexamic acid in the treatment of melasma.
131 The Spiritual Concept of Human Birth , Satyapriya Maharana, Bapat Rashmi Atul* and Hongasandra Ramarao Nagendra
A comprehensive literature survey is made on the subject of human birth according to yoga text and spiritual texts. We have re- viewed the ancient text and scriptures for the concept of human birth. The soul returns to the mundane life on the exhaustion of the meritorious deeds with residual karma gains a new body suited to it from a womb. As said in Shrimad bhagawatam under the supervision of the Supreme Lord and according to the result of his work, the living entity, the soul, is made to enter into the womb of a woman through the particle of male semen to assume a particular type of body कर्मणा दैव नेत्रेण जन्तुदेह पपत्तयेे karmaṇā daiva netreṇa jantudeha papattaye SB3.33.1. After being connected with a progenitor the soul with the residual karma enters a womb and gains a body suited to the experience of its karma. The birth is high or low, according to the nature of residual karma. An explanation of Karma theory for human birth is also given with the yoga dimension. After the study of the relevant literatures, it is formed that it is the law of karma which decides an individual’s birth.
132 Cancer and Cancer Stem Cells , Maithili A Athavale
For a long time scientists and the medical professionals around the world were wondering about the cause of cancer relapse in pa- tients who had responded positively to chemotherapy. In recent years increasing evidence suggests that cancer origi - nates from a small fraction. Of tumour initiating cells with the abilities of self-renewal, un- limited propagation, multipotent differentiation and giving rise to phenotypically distinct cells found within the tumour population. Such capabilities share similarity with normal stem cells. Thus these cells are called Cancer Stem Cells (CSC).
133 Factors Associated with Tuberculosis Patient Satisfaction Regarding Health Facilities: A Case Study of Hospitals , Nazirullah1*, Sabeeha Rahman2, Irfan Nawaz3, Muhammad Awais Anjam3, M Waheed Iqbal4, Naqeeb Hussain Shah5, Asif Mahmood6, Muhammad Jamil Anjum7, Maz Ullah8 and Niaz Ullah9
The study investigates health literacy and Tuberculosis patient satisfaction regarding health facilities in hospitals. Some factors af- fect TB patient satisfaction regarding hospital facilities, which was hypothesized that TB knowledge, reaction if found TP, information regarding TB, medical help, and healthcare facility availability affect patient satisfaction. The quantitative method of observation was used. The population of the current study was TB patients in Lahore Hospital of Pakistan. The simple random sampling technique applied with a sample size (N = 325 ), and data was collected through a valid adopted questionnaire in probability sampling. SPSS was used for analysing data with simultaneous and hierarchical regression test for the prediction. The findings suggested that TB patient knowledge and reaction found negative for patient satisfaction regarding hospital facilities. If a TB patient has less knowledge regarding disease, then his reaction to drugs taking is also less. Medical help relating to TB and facilities in hospitals for patients was a significant positive predictor of patient satisfaction. This means if a patient has TB knowledge, medical help, good hospital facili- ties, then his or her satisfaction level is high. In conclusion, this study uncovered that TB patients are satisfied with hospital facilities. The suggestion was that health awareness campaigns should be planned to aware TB patients regarding TB symptoms, treatment methods, and medicine uses.
134 Extended Spectrum Use of Percutaneous Transforaminal Endoscopic Decompression for Managing Patient with Cauda Equina Syndrome Due to Upper Lumbar Disc Herniation: A Case Report , Vaishali Waindeskar1, Anuj Jain2, Sunaina Tejpal2 and Charan Raj3*
Cauda Equina, though a rare syndrome, but needs immediate intervention to get a successful outcome. Open surgical techniques like microdiscectomy and lumbar disc decompression and laminectomy combined with facetectomy for patients with Cauda Equina Syndrome (CES). General anesthesia requires all these surgical procedures with extensive bone and soft-tissue handling, resulting in spine instability. We presented a case of low back and severe leg pain with neurological deficit. We diagnosed as Cauda Equina Syndrome, managed successfully with Percutaneous Transforaminal Endoscopic Discectomy (PTED) under local anesthesia in the awake and aware patient. This approach avoids complications associated with general anesthesia. Managing such cases with the percutaneous transforaminal endoscopic approach at the upper lumbar level has not been de - scribed in the literature
135 Nurse-led Field Hospital: A Novel Nursing Innovation During Covid-19 Pandemic , Waranuch Wongjumnong and Kannika Supachai
The uncontrollable spread of Covid-19 has increased huge new cases of respiratory symptoms, causing a serious shortage of med- ical equipment, hospital beds, and healthcare workforce worldwide. Focusing on the shortage of hospital beds, field hospitals have been developed to lighten the caseloads from conventional hospitals. Nurse practitioners, who are prepared to promote the health of people in community, play a significant role in managing field hospitals. Although, current studies have shown the extensive scope of nurse practitioners managing clinics especially regarding chronic diseases, field hospitals remain scarce. This article identified a set of activities of nurse-led field hospitals concerning the novel notion of nurse-led services during the Covid-19 outbreak in Thailand based on a community health nurse practitioner’s experience.
136 Is Averaging Percentages a Correct Method Statistically? , Afraa Talal Barzanji
There is descriptive and inferential statistic. Mean is a descrip - tive statistic and it is usually referred to as the average. Mean is a central tendency measure along with mode and median. Not the frequency is summed for mean calculation, but it is the value of each of the observations. For example, in a histogram, if the ob- servations are the scores of students, the frequency would be on y axis, and the scores on x axis. When calculating the mean; the values to be used would be the scores and not the frequency or percentage. Percentage is a descriptive statistic also
137 The Effect of Integrated Yoga on Cognitive Functions in Pregnant Women - A Randomised Controlled Trial , Satyapriya Maharana1*, Sanjib Patra2, Raghuram Nagarathna3, Padmalatha Venkataram4 and Hongasandra Ramarao Nagendra5
Background: Heightened stress and anxiety during pregnancy can be potential causes of many complications, including impairment of higher brain cognitive functions. Since, there are no studies that address this complication holistically and yoga is found to be ben- eficial in many lifestyles related diseases. Aim: To investigate the impact of integrated yoga (IY) intervention on cognitive functions and anxiety among pregnant women. Methods: This was a prospective randomized two armed active control design with supervised practices for both groups. Ninety-six pregnant women (20 to 35 years of age, between 18 and 20weeks of gestation), satisfying the selection criteria were randomized to yoga (50) and control groups (46). Yoga group practiced specific set of integrated yoga and control group, standard antenatal exer- cises. Pre and post assessments were done at the time of recruitment and at 36th week. Results: A significant increase in the scores of all variables were observed such as ‘Fluency test’, (phonemic fluency, category fluency and design fluency, indicators of general verbal functioning, p < 0.001), ‘Stroop test’ (Stroop effect, measuring brain’s information processing ability, p < 0.001) and ‘Pregnancy related anxiety questionnaire’ (p < 0.001) in yoga group. Mann Whitney U testsshow that the magnitude of change in yoga group was higher than that observed in control group. Conclusion: This study showed that integrated antenatal yoga starting from second trimester helps in improving cognitive functions and reducing anxiety, suggestive of a positive impact of yoga in promoting better information processing in prefrontal cortex. Keywords: Pregnancy; Cognitive Function; Prefrontal Cortex; Anxiety; Integrated Yoga Module
138 Carcinoma of Vagina in Women with Utero Vaginal Prolapse: A Review After Eight Years of Diagnosis , Kavuriel Eliyas Karunakaran
This paper looks into a review of our experience on the woman surviving to date, over seven years of detection of primary vaginal carcinoma associated with utero vaginal prolapse, despite she had a second lesion. Such cancer although rare, is continuing to get reported and thus warranting a Primary Health-Care approach on post-menopausal women for prevention or early detection. Keywords: Carcinoma of Vagina; Utero Vaginal Prolapse; Survival
139 Palliative Care for Women’s Cancer Care , Vaishali Waindeskar
As per WHO the Palliative care is an approach that improves the quality of life of patients and their families facing the problems as- sociated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable treatment of pain and other problems, physical, social, psychoso - cial, and spiritual.
140 Are Women Ok in this Pandemic?? - An Unsung Tale , Vishnupriya Veeraraghavan
COVID 19 pandemic has created a toil on the mental and physi- cal health of people all over the world. It has put enormous burden on the economic, social and occupational functioning of the people. Media often throws light on the suffering of the frontline warriors like doctors, nurses and the police. But the mental suffering of the actual warriors in every front, the females is quite a forgotten is - sue. This is an attempt to throw light on the mental suffering and coping strategies by women during this crisis
141 Microbiota of the Vagina , José T Núñez-Troconis
The objective was to review and analyze the microbiota of the vagina. It was analyzed the composition, the different changes through the women’s lives and, its defense mechanism. It was reviewed the websites of Pub Med, Google Scholar, Springer, Web of Knowledge, DOAJ, Hinari, Oxford Academic, JAMA Network, Embase, Research Life for English and Scielo, Lantidex, Imbiomed-L, Re- dalycy Google Scholar for Spanish. Publications from January 1970 to February 2021. Molecular biology technologies have allowed us to have a better vision of the bacterial diversity present in the vaginal microenvironment or microbiota, as well as have allowed us to discover or reveal the existence of bacterial categories until then unknown. Keywords: Vagina; Microbiota; Lactobacillus
142 Epithelial to Mesenchymal Transition (EMT): A New Target for Anticancer Drugs , Maithili A Athavale
The process by which epithelial cells are transformed into mes- enchymal cells is called EMT. The epithelial tissue covers the inter- nal and external body surface of an organism. Epithelial cells are polarized and they form the extensive cell-cell adhesions, includ- ing the tight junctions, with each other. These cells form the pro- tective barrier for underlying tissues and organs. However, mes- enchymal cells are not very well organized in three dimensional extracellular matrixes
143 Systematization in the Conservative Surgical Management of Myomas of Large Elements.Uterine Desarterialization DAU. POSADAS Technique. Case Report , Javier Enrique Oviedo Venerio and Cols Dra Maria Teresa Zelaya Velasquez
Myomectomy is an alternative to offer in cases of young women, without children, who wish to preserve their uterus, however, it is essential to map the fibroids, pre-surgical planning, and a detailed informed consent of the risks [1]. The most frequent errors in myomectomy are inappropriate uterine incisions and ineffective hemostasis. The purpose of every surgeon during myomectomy is to use pharmacological actions and surgical techniques from the existing arsenal whose common denominator is to decrease the flow in the uterine and ovarian arteries. We use the Posadas technique for uterine dearterialization as it is considered easier and faster to perform combined with phar- macological actions and mechanical effects such as the use of tourniquets, we describe each of the actions carried out to reduce blood losses during the myomectomy of large elements in selected cases
144 The Agony of Being on the Waiting List for an Organ Transplant , Reginald Green
Waiting for an organ transplant is one of the most unsettling experiences in the whole of medicine. Why? Well, for one thing, anyone on the waiting list has an advanced terminal illness. If they don’t receive a new heart or kidney, liver or lungs or some other vital organ they will die, and probably soon. For another, they have no idea if a new organ will be offered to them at all -- there is a shortage in almost every country in the world -- and, if one is of - fered, whether it will arrive in time or fit their individual needs
145 Pandemic and Gender: A Review of the Differential Impact of Covid-19 on Girls and Women , K Jafar
While disasters like epidemics affect almost all areas of human life, their differential impact on the vulnerable groups often ex- poses the structural inequalities in society. The evidence reported from different countries indicates that girls and women bear a disproportionate burden of the pandemic. At one level, they constitute the critical group leading the fight against the present pan- demic on the ground but their under-representation in its global leadership and cost paid at individual and collective level remain as a concern. The present review highlights the differential impact of Covid-19 pandemic on women and girls in terms of their access to livelihoods, technology, education, healthcare, and dual burden (with additional care work) and incidence of gender-based violence reported in India and outside. They highlight the importance of addressing gender inequality and the inclusion of gender-sensitive strategies while managing a public health crisis
146 Analysis of Excessive Day Time Sleepiness in Adolescent Girls Pursuing Professional Courses , Ravi Sunder R  and Neelima P
Excessive daytime sleepiness may range from drowsiness to uncontrollable diurnal sleep attacks called narcolepsy. Though many causes can be attributed to day time sleepiness, most common physiological reason could be late night interrupted sleep. With the advent of smartphones and gaming hobbies adolescents become the vulnerable age group to be victimized for the day time sleepi- ness. Literature is scanty on the assessment of sleepiness score from north coastal Andhra Pradesh. This study has been done to evaluate the sleepiness in medical and dental girl students from north coastal Andhra Pradesh. Epworth sleepiness score has been used as a tool to assess the person’s average sleep propensity. It consists of eight questions and the score is interpreted basing on the individual’s response. The aim of study has been explained to the participants. After taking informed consent,164 girl students from 1 st year medical and dental courses with age between 17-20 years, participated in the study. Identity was kept anonymous and the score calculated. 2 girls got a maximum score of 19 which was interpreted as severe excessive daytime sleepiness using Epworth Sleepiness Score. The minimum score obtained from the study was 2 points given by 2 girls. This is named as lower normal daytime sleepiness. The study group was addressed after analyzing the results. Most of the students admitted that they sleep late in the night and the main culprit disturbing their sleep was the smartphone. They were advised to follow healthy sleep patterns for a wholesome healthy life and also to retain memory and increase attention span to achieve academic excellence. The present study reflects the average sleep propensity of the adolescent girl students of north coastal Andhra Pradesh
147 Women’s Knowledge About Indoor Air Pollution in Nepal , Swikriti Acharya  , Madhu Koirala Dhital , Kiran Sapkota , Ganesh Shrivastav and Shalik Ram Dhital
Introduction: Indoor air pollution (IAP) is a major public health challenge in developing countries like Nepal. Annually, approxi- mately 4.3 million people die due to IAP. In Nepal, 80% of rural households use biomass fuel for cooking without ventilation. This study to explore knowledge about IAP among women in the Dang district of Nepal. Methods: A cross-sectional study was conducted in Tulsipur municipality of Nepal in 2016. Systematic random sampling was used, and data were collected using a structured questionnaire about IAP at their household level. The study population was among wom- en living in a household. The descriptive analysis was done using SPSS software and statistical analysis carried out in frequencies and percentages and data are shown in table, pie chart and bar graph. Each study variable was labeled, coded, and measured systemati- cally. Results: The total study participants were 196 women aged 15 years and above. This study showed that approximately 90% of women had heard about IAP. Of these 28% and 24% of women said IAP is mainly caused due to cooking habits and poor ventilation respectively. Approximately 53% of women were aware of ventilation and 46% agreed to have proper ventilation in the kitchen. Twenty-seven percentages of women agreed that health effects such as eye irritation was due to IAP where by headache 23%, respi- ratory diseases 20% and so on. Conclusion: Knowledge about IAP is a pragmatic way to prevent and mitigate the effects of IAP in the Dang, Nepal.
148 COVID19 Non-compliance; Maslow’s Theory of Needs and the Human Spirit: Are they Linked? , Manfred Mortell RN
The coronavirus disease 2019 (COVID-19) began in Wuhan, China in 2019. The COVID-19 pandemic incarnates a significant world- wide health emergency, with international governments endorsing COVID-19 safeguard actions; which necessitated a noteworthy change in public behavior. However, non-compliance with safeguard processes, such as the “lockdown”, social and physical distanc- ing, hand-hygiene conformity, and the use of personal protective equipment, such as facemasks were prevalent. Distinguishing and comprehension of the structure of human needs was crucial for the operational preparation and implementation of COVID-19 safety strategies. In order to increase community compliance with COVID-19 pandemic safeguards, reducing defiant behaviors, and protect- ing lives, Abraham Maslow’s theory of human needs could explain public non-compliance behavior. Maslow’s theory of human needs proposes a structure which illuminates why human beings are motivated, how they thrive, and why they may become non-compliant with COVID19 safety guidelines which are employed as safety measures.
149 Correction of Cardio-hemodynamics and Endothelial Function Disorders in Pregnant Women with Connective Tissue Dysplasia , Viktoria Yuriivna Dobrianska , Svitlana Mykolaivna Heryak and Mykola Ivanovych Shved
Objectives: The negative impact of undifferentiated connective tissue dysplasia (UCTD) in myocardial contractility and endothelial microvascular dysfunction and their frequent combination with cardiac arrhythmias suggests an unfavorable course to pregnancy and childbirth due to the formation of uteroplacental dysfunction. The Aim of the Study: To reduce the incidence of obstetric complications in pregnants with UCTD by carnitine-arginine complex. Materials and Methods: There were examined 58 pregnants with UCTD, including mitral valve prolaps with and without frequent extrasystoles, and 14 pregnants of control group. Metabolic support by intravenous infusion of L-arginine and L-carnitine complex. Results: There are violations of morpho-functional parameters of the heart with the development of moderate systolic-diastolic myocardial dysfunction and endothelial microvascular dysfunction and significantly more often diagnosed with obstetrics complica- tions in pregnant women with MVP and extrasystolic arrhythmia on the background of UCTD. There was a significant reduction of arrhythmias in patients with MVP and frequent ventricular (90.6%) or mixed extrasystoles (77.8%) under the influence of complex drug treatment with L-arginine and L-carnitine. Conclusion: There are violations of morpho-functional parameters of the heart with the development of moderate systolic-diastolic myocardial dysfunction and endothelial microvascular dysfunction, which are triggers of complicated pregnancy and childbirth in pregnant women with MVP and extrasystolic arrhythmia on the background of UCTD in the initial state. The inclusion of L-arginine and L-carnitine led to a significant improvement in the parameters of central cardiohemodynamics and restoration of endothelial function of microvessels and pregnancy complications.
150 First-time Renal Stone Sufferer - A Autobiographical Case Report , Sachin GGand Suresh Kishanrao
Kidney stone disease (KSD) is a type of solid hard mass formation by aggregation of tiny particles in the kidneys. It’s a develop- ing urinary tract system disease increasing the risk of chronic kidney disease (CKD) and end-stage renal disease (ESRD), compelling the need for kidney transplantation. CKD is a well-known complication of kidney stones because of genetic illness called primary hyperoxaluria, Dent disease, 2-8-hydroxyadenine crystalluria, and cystinuria 3-5. This leads a progressive decrease in Glomerular Filtration Rate (GFR) and early setting of ESRD. Calcium oxalate, forms at Randall’s plaque on the renal papillary surfaces, is the most frequent type of kidney stone. I present my autobiographical case of suffering of left kidney renal calculi with left hydro-uretero-nephrosis. I presented with acute severe pain in left groin and difficulty to walk, tiredness, to a private multi-speciality hospital in Shimoga, Karnataka. I was treated with plenty of oral fluids and medication of potassium citrate, magnesium citrate and vitamin B12 Oral solution syrup and tab Spasmoproxivon 1 BD for a week, Tab Tamsulosin 0.4mg for 1 week has been advised to continue medication
151 Impact of Endometrium Receptivity on Blastocyst Transfer , Agnes Immanuel, Sarat Battina  and Reeta Janet Jessy
IVF treatments highly motivate infertility patients to achieve pregnancy. The decades ago worldwide the researchers performed day 2 or day 3 transfers in order to increase the pregnancy success rate. The embryologists selected randomly the 3-4embryos on the basis of cleavage. So it often easily leads to multiple pregnancy (triplet or quadruplet) and it reaches at high risk of life threatening premature newborn. Slowly the researchers were moved on extending culture from day 3 to day 5, blastocyst stage to avoid the risk of multiple preg- nancy. Then it was recognised as the survival of good quality embryos percentage is higher to the fifth or sixth day of post insemina- tion. Likely, the selection of one or two good embryos is based on the formation of blastocyst. Ultimately it leads to higher pregnancy rate. To optimise the success rate the grading and selection of embryos are eventually needed. The advantage of blastocyst transfer includes better synchronisation between endometrium lining and the blastocyst. The endometrium is the inner line of the uterus. Every month of the female menstrual cycle the endometrium size will be chang- ing their thickness. The progesterone and oestrogen plays a major role for the endometrium thickness. The growth and shedding of the endometrium through menstruation cycle the pregnancy does not occur. The ultrasound monitoring is necessary for the mea- surement of the endometrium line. The endometrium thickness is necessary and this acts as host of the embryo. The aim of this study was to compare between the conventional blastocyst transfer and blastocyst transfer after ERA biopsy.
152 Raising Legal Age of Marriage for Women: The Law, The Reasons and The Criticism , K Suresh
The Prohibition of Child Marriage (Amendment) Bill, 2021, which was introduced in Lok Sabha on 21 December 2021, seeks to increase the minimum age of marriage of females to 21 years from the current 18 years, to bring parity in the age of marriage for both men and women in the country. Marriage is an instrument of social control, but often become a route of escape from conservative shackles for many women in rural India. No girl below the age of 18 can be considered to have given consent to sex, according to the existing law. Raising the age of marriage and age of consent have both been considered as progressive measures to favour women, for historical reasons in India. The law prescribes a minimum age of marriage to essentially outlaw child marriages and prevent the abuse of minors. Personal laws of various religions have their own standards, often reflecting respective customs. For Hindus, The Hindu Marriage Act, 1955 sets 18 years as the minimum age for the bride and 21 years as the minimum age for the groom. In Islam, the marriage of any girl who has attained puberty is considered valid. The Special Marriage Act, 1954 and the Prohibition of Child Marriage Act, 2006 also prescribe 18 and 21 years as the minimum age of consent for marriage for women and men, respectively. According to the draft Bill, the proposed law will apply to all communities and once enacted, will supersede existing marriage and personal laws. India would, however, be amongst the few countries globally where the legal age of marriage for women would be 21. In neigh- bouring China, it is 20, while in countries like the UK and US, it is 18 but with exceptions and variations. For the new era of avoiding gender discrimination, in all social and economic participation the laws are to be amended and imple- mented. The current government has decided to propose an increase in the age for marriage for girls from 18 to 21 as for boys. The reasons put forth include i) gender-neutrality, ii) poor nutritional levels of mothers and their children following early marriages, iii) their overall health and mental wellbeing iv) other population and health reasons include high Infant Mortality Rate and Maternal Mortality Rate among teen age pregnancies v) Socio-economic reasons of empowerment of women who are denied access to educa- tion and livelihood after an early marriage. People resisting this amendment quote autonomy as the concerns of implementing the law. Their plea is if women are considered adults at 18 for voting, why not for marriage decisions as well?” Some advocate achieving gender parity by making 18 the age for marriage for all genders. For them the government move is an attempt to replace all religious civil codes by a uniform civil code. However, the rationality in increasing the marriage age for women without spelling out plans to improve health and education is a puzzle, but can be addressed which might be detailed once the law is passed
153 Polycystic Ovarian Syndrome - A Pain for Young Women? An Autobiographical Case Studies , Jyotsna Gupta  and Suresh Kishanrao
Polycystic ovary syndrome (PCOS) is a common endocrine disorder predominantly affecting young women of reproductive age. Current Diagnostic Criteria as per NIH, USA International PCOS Guidelines 2018, 2 of 3 ensuing criteria are needed i) Hyperan- drogenism 2) Oligo-and/or anovulation 3) Polycystic ovaries. In 1990 NIH recommended presence of both Hyperandrogenism and Chronic Anovulation. Changes in the diagnostic criteria greatly affect the prevalence of PCOS. Prevalence rates have been reported as low as 1.6% using a combination of all three criteria and as high as 18% in USA [1]. Studies of PCOS in India carried out in conve- nience samples reported a prevalence of 3.7% to 22.5%, with 9.13% to 36% prevalence in adolescents only. World Health Organiza- tion (WHO) estimates that PCOS had affected 3.4% of women worldwide in 2012. Globally, prevalence estimates of PCOS are highly variable, ranging from 2.2% to as high as 26%. The condition is often misdiagnosed and poorly understood, is a lifelong disorder that can be managed with appropriate medi- cal care. Most common symptoms are Missed periods, excess body hair including the face (hirsutism) and Weight gain in especially around the abdomen, more Acne during the periods, baldness, or thinning hair occurs and Infertility occurs if not treated for long. Hormonal assessment and Ultrasonography that shows large ovaries and multiple cysts in the ovary clinch the diagnosis. The man- agement protocol depends upon hormonal therapy and monitoring associated metabolic syndromes like weight gain, Diabetes, Obe- sity and Cardiovascular symptoms. We present an autobiographical case of myself, a 25-year girl now, presenting the current and third episode of PCOS. I consulted a gynecologist at a private hospital in GADAG, Karnataka, 582101, with the complaints of white discharge, backache, hirsutism and hair fall, acne, feeling stressed apart from irregular periods and adding fat around my waist since 13 JANUARY 2021. She on clinical examination found breasts normal but with darkening of areola and nipple, a few hairs, and some milk like fluid oozing on squeezing the nipple. My blood pressure was 13090 mm hg, pulse rate - 102/minute, RR - 20/ minute, weight 63 kg, height - 155.4 cm. Based on increased testosterone, low FSH, elevated LH, elevated estrogens, increased prolactin, and USC showing bilateral enlarged ovaries with multiple cysts with more than 15 follicles, I was diagnosed as a case of PCOS and put on hormonal therapy. I was first put on oral contraceptive pill for 3 months and then on Myo-Inositol (Myo Inositol, D-Chiro Inositol with Folic Acid) one tablet twice a day for 3 months, once a day for the last 2 months. All signs have disappeared now except for periodical episodes of headache and my menstrual cycles are normal for last 2 months.
154 An Update on the Role of Bone Morphogenetic Protein and Growth Differentiation Factor on Follicular Generation in Human Menstrual Cycle with Clinical Impact on ART Success and PCOS Pathogenesis/ Therapy-a Systematic Review , Kulvinder Kochar Kaur , Gautam Allahbadia and Mandeep Singh3
Background: With the initiaI identification of capacity of generation of heterotopic bone Bone morphogenetic proteins (BMP) rep- resent growth factors that possess numerous functions from the transforming growth factor beta (TGF-β) super family, With the uti- lization of cellular along with molecular genetic approaches, more recently studies have implied that that intraovarian BMP ‘s work as robust functional controllers of ovarian follicular function. The crosstalk that takes place in a `bidirectional manner of the oocytes besides the somatic cells surrounding them is a must for the normal follicular generation along with maturation of the oocytes. Thus we reviewed the existent information regarding the physiological part as well as the molecular determining factors of these ovarian controlling factors amongst the germline somatic -controlling loop. Aim: The control of ovarian function has been ill characterized amongst humans, as whereas the elemental event of follicular genera- tion along with maturation of the oocytes is akin in different species, with maximum knowledge in the context of control of ovarian follicular function gets derived via rodent studies. Hence the concentration was on studies where utilization of human biological materials done for getting insight in the context of human ovarian biology for the generation of strategies with the aim of avoidance, diagnosis therapy treatment, diagnosis besides treatment of these aberrations. Methods and Results: The outcomes studies with utilization of human biological materials documented the expression of BMP ‘s or GDF’s in addition to their respective receptors along with their molecular signaling in the basic cells (oocytes, cumulus/granulosa cells (GCs) besides theca/stroma cells) of the ovarian follicles right through generation. On the existence of recombinant BMP ‘s/ GDF’s along with generation the physiological functional part of human intraovarian BMP ‘s/GDF’s have been illustrated in each aspect of function of ovary ranging from i) follicle generation ii) steroidogenesis iicell-cell contact, iv) maturation of the oocytes v) ovulation and luteal function. Moreover, crosstalk amongst these ovarian controllers and endocrine signaling system. Impairment or natural mutations amongst the BMP system might result in numerous female reproductive diseases. With the generation of recombi- nant BMP, synthetic BMP inhibitors, gene therapy, tools meant for BMP ligand concealment, has seen to it that the BMP pathway has become a probable therapeutic target in some fertility pathological disorders. Nevertheless, further clinical trials are required. More recently GDF 8 has been demonstrated to be an intraovarian factor that might play an innovative part in control of ovarian functions in human ovary
155 Extended Interrupted Education Due to COVID 19: Some Cases of Deprived Girl Child , Geeta Rani  and Kavita Baliyan
We have observed cases of gendered impact of extended school closure during COVID-19. Past experience reveals to us that public health outbreaks have distinct gender dimensions and these crises underplay a role in widening inequalities. While COVID-19 is pri- marily affecting public health, spill over effects can be observed in education, stemming largely from extended school terminations. Out of the total population of students enrolled in education globally, UNESCO estimates that over 89% are currently out of school and this includes nearly 743 million girls. According to census estimates of India, the literacy rate has continued to climb to 73% in 2011; however, the gender gap has only narrowed slightly, with women still at literacy levels 16% below men (GOI 2011). Along with other marginalized populations, for girls, especially from minority groups, getting an education is already a struggle. Longer school closures could result in an increased risk of dropout for girls, particularly from lower income groups. Education is lifesaving for them and provides protection as well as instils hope for a brighter future. Therefore in this paper we focused to find out the major constraints faced by the school going girls particularly those who belongs to the marginalised section of the society during the COVID 19 pandemic. The paper is based on the selected case studies developed to support the observations regarding vulnerability of girl child during stressed situations to continue education in state of Uttar Pradesh in India. To get an overview of the problems, cases have been selected from different categories - students of primary level, secondary level and senior secondary level. Further, from each category student from rural, urban and the peri-urban areas of the state has been selected for the case studies.
156 Advanced Cervical Cancer During Pregnancy: Case Report and Review of the Literature , Imen Ganzoui, Dorsaf Nouri and Mariem Balti
A 37-year-old primigravid patient, at 20 weeks of gestation, was referred to gynecology and obstetrics department for pelvic pain and vaginal bleeding. At speculum examination, she had a cervical bleeding mass. The transvaginal ultrasound showed a complex left pelvic masses. A pelvic MRI was performed, revealing an extended cervical cancer with lymph node metastasis. The patient was diagnosed with an invasive locally advanced tumor of the cervix. After multi-disciplinary reunion, pregnancy was interrupted, and the patient had hysterectomy, adnexectomy and lymphadenectomy associated with adjuvant chemotherapy. The early follow up did not reveal any complication.
157 Women and Public Health , Abbas Jedariforoughi
Women and public health issues can not be neglected when we talking about health promotion and social equalities and subse- quently inequities.
158 Women and Public Health , Abbas Jedariforoughi
Women and public health issues can not be neglected when we talking about health promotion and social equalities and subse- quently inequities
159 Maternal First Trimester Gestational COVID-19 Infection is Associated with Increased Placental Maternal Vascular Malperfusion, But Not Clinical Morbidity or Mortality , Paul H Hartel;Weronika Wudarczyk
Maternal COVID-19 infection during pregnancy has been associated with a myriad of pathologic placental changes. Clinically, rare studies have highlighted intrauterine growth restriction (IUGR), pre-term birth, intrauterine fatal demise and stillbirth in association with maternal gestational COVID-19 infection. Third trimester infants should be protected from acquiring COVID-19 infection since there is a paucity of the required angiotensin-converting enzyme (ACE) receptors present in the placenta, and earlier maternal gestational infections theoretically pose higher risk. We reviewed the total of 20 placentas from first trimester maternal COVID-positive pregnancies and clinical outcomes in the Sligo University Hospital catchment area from 2020-2021 to add to the literature of COVID-19 clinical and pathologic findings. Clinical audit was performed on placentas from maternal COVID-positive pregnancies from 2020-2021. Anonymised data from patient pathology reports including maternal and gestational age, clinically provided morbidity and maternal and neonatal outcome data and placental pathologic findings were reviewed. Haematoxylin and eosin-stained slides were available in all cases and reviewed by a consultant pathologist. All variables were compared with known background incidenceand a cohort of 20 randomly selected non-COVID cases from the same time period. Maternal age ranged from 20-41 years (m =31), and gestational age from 25 to 41 weeks (m = 36). All maternal COVID-19 positive results were from first trimester. Placentalweights ranged from 312 to 897 grams (m = 594). All cases showed increased peri-villous fibrin deposition with 3 showing extensive fibrin. Ten cases had infarctions and 2 with extensive infarctions (>15% of placenta). Five cases had increased syncytial knotting.Our results support that placental pathology from early maternal gestational COVID-19 infection is associated with maternal procoagulopathic state, not fetal or ‘placental’ infection.
160 Feto-maternal Outcome of Anemia in Pregnancy at the Gambian Tertiary Hospital , Anyanwu Matthew; Romaric Nyuyfoni Nsaidzeka
Background/Objective: A lot of people are affected by anaemia worldwide, with the most vulnerable group being children and pregnant women. The highest prevalence of anaemia is found in the developing nations. The objective was to determine the prevalence of stillbirth, preterm delivery, low birth weight, low Apgar score in anaemic pregnant women compare with non-anaemic pregnant women at Edward Francis Small Teaching hospital from July to September 2019. Methodology: A prospective cross sectional study was conducted and the sample size was calculated with G-power 3.1. Recruitmentoccurred irrespective of gestation age. At the time of delivery, obstetric and neonatal characteristics were entered into computerdatabase. The data was analysed with SPSS version 25. Inference was from a descriptive statistics at significant level of 0.05. Result: A total of 210 mothers, 105 anaemic and 105 non-anaemic controls were in the study. The age range was between 19 to 35 years. The prevalence of mild and severe anaemia was 71.4% and 2.9% respectively. The measured adverse outcome includes; LowBirth Weight; 30.2% Vs 27.6%; P- 0.650. Preterm delivery; 32.4% Vs 23.8% p- value 0.169; stillbirth 10.5% Vs 7.6% p-value 0.473,low Apgar score at 5 minutes 29.5% vs 25.7% p-0.539 and NICU admission of 16.2% vs 13.3% p- 0.329; Postpartum haemorrhage19.0% Vs 15.2% p- 0.466; Cardiac failure 0% Vs 1.5% p- 0.157 showed no statistical differences.In secondary analysis of the data it became evident that poor pregnancy outcomes were highest in severe anaemia. That commonsignificant risk factor and complication of anaemia was illiteracy and postpartum haemorrhage respectively. Conclusion: There was no significant difference in the feto-maternal outcomes for the anaemic and non-anaemic women. Severe anaemia was associated with some significant adverse outcome among those with anaemia  
161 Prevention's Model of Teenage Pregnancy , Nantaporn Srimekarat ;Tawan Khetpanya
This research studied was a systematic review research aims to 1) study the situation and problems of teenager’s pregnancy inKalasin Province 2) analyze the situation of teenager’s pregnancy and 3) synthesize research results from literature to utilizations. Conduct to quantitative and qualitative reviews of literature and research. The results was 1) the situation and problem of teenager’spregnancy in Kalasin province had the lower teenager’s pregnancy and birth rate. But the incidence of pregnant women death in2020 found that there were 2 teenager’s mothers and teenagers mothers terminating their pregnancies in 2017-2019 was 18, 7and 12 cases, respectively. 2) An analysis of the situation of teenager’s pregnancy was found that there was factors involved whichis a common problem in teen pregnancy and the impact of teenager’s pregnancy. There are many models or methods of managing teenager’s pregnancy problems. 3) Results of research synthesis to provide adaptation it was preventive patterns of teen pregnancywere reflected. The factors that premature pregnancy are beliefs, values and attitudes that are important to the environment fromfamily, friends, technology and media levels and activities promoting the prevention of teenager’s pregnancy include learning activi-ties teenager’s pregnancy prevention program. Through providing information and prevention model to solve the problem of pre-teenager’s pregnancy with public health agencies as the main. However, the effects of teenager’s pregnancy consist of effects on thatindividual level. The impact on the family level national impact. Suggestion should be promoted to work both proactive and reactivein both hospitals and departments. They should also be designed to prevent teenager’s pregnancy. In addition, policies should bepromoted to prevent teenager’s pregnancy both nationally and internationally. Community and family and there should be a devel-opmental study in order to change attitudes towards teen pregnancy.
162 Examination of the Newly Developed Labioplasty Technique , Esra Cabuk Comert
Introduction: Labiaplasty refers to the surgical reduction of the labia minora. Labiaplasty has become increasingly popular in recent years. There is no widely accepted guideline for labiaplasty and it is done for a variety of reasons. Material and Methods: This is a prospective study. A technique different from the current techniques used in labiaplasty has been developed in our clinic. The new technique has been completely developed in our clinic. The participants were followed up. Processes cover a period of approximately three years. 112 participants, to whom the technique we developed was applied, were included in the study. Results: Considering the reasons leading the participants to the operation, the most common reason was “Aesthetic concern due to deformity. In the first week controls of the participants, it was determined that the wound area of 60 (53.6%) was clean and edema- tous. When the operation status of the patients after one week is examined, it is seen that 96 (85.7%) of the participants did not need to perform any procedure. Conclusions: It is evaluated that the technique we have developed can be used in a wider area with the studies to be planned  
163 Obesity - Eat Great, Move A Bit and Loose Weight! , Deeksha Singh
Since generations obesity is a big problem and has been a focus of our life! Being overweight is really common nowadays! But what is obesity and overweight and how are they different? Our nation is plagued with obesity and a host of digestive problem! There are likely so many remedies for obesity i.e. hurt burn, indigestion, gas, belching and bloating! Abundance of research available on these health issues! Basic idea behind writing this article is are we alleviating our national health issues i.e. obesity and intestinal difficulty? The answer is absolutely no! Most of us are getting fatter and develop health issues! And we spend loss of money hoping that things will improve! Solution to obesity lies in what we eat, how we should move! So is above article include a weekly diet and exercise plan to beat out obesity! Three rules of before starting anything: 1. Motivation is primary tool! 2. Know your ideal body weight! 3. Work on water retention! 4. Move your body! Change your lifestyle 1. Avoid crash diet! 2. Start food packets whole day! 3. Split size food! 4. Separate food items! 5. Eliminate the funky foods!  
164 Cervix Cancer Management and Challenges in Coming Years. How to Deal After FIGO 2018 Staging Update, SENTICOL I-II and LACC Studies Results? , MA Jellouli;J Mathis
As the 4 th most common cancer and the 4 th cause of cancer death in women in the world, Cervix cancer still occupy an important part of oncological centers activity and has benefited fromseveral changes in its Management over the past 4 years.Cervix cancer is classified according to the International Federation of Gynecology and Obstetrics (FIGO) staging system, whic has been updated in 2018 [1]. It established, in addition to physica examination, information obtained from imaging modalities. The new FIGO cervix staging is more based on MRI as a method of accurately measuring tumor size and detecting parametrial involvement. Also, the inclusion of lymph node detection, thanks to special imaging in fluorodeoxyglucose PET/CT, has an increasing role in the detection of nodal disease. In addition, lymph node status infinal histology can upstage the patient
165 Insight of Process of Oogenesis , Poonguzhalai S
A sound knowledge of oogenesis help us to understand the menstrual cycle. Ovarian follicle is the functional unit of ovary.
166 The Courageous Story of Dr. Kamala Sohonie , Maithili A Athavale
Over the years a woman has overcome many obstacles and made a mark in every walk of life. It was not at all a very smooth road for the very first woman to put her first step and make a way for others. Scientific research was one such field. Earlier women were denied of the opportunities to learn and pursue science as a carrier.
167 Interpregnancy Interval and Labour Outcomes After Previous One Cesarean Section , Humaira Bibi ;Naila Nasr Malik ; Rubina Qadeer;Shamim Akhter ;Saba Nasir;
High rates of c section increases not only maternal and perinatal morbidity and mortality but also increased burden on already overcrowded hospitals. VBAC not only reduces rates of cesarean sections and maternal morbidity but the hospital load of patients is also lessened. Aim: To compare the labour outcomes of short vs long interpregnancy intervals in women with previous cesarean section. Methods: It was a prospective Cross-sectional study conducted in Kuwait teaching and Mercy teaching hospitals of Peshawar from June 2020 to June 2021. Patient`s data were collected from patient`s record register. Patients who had lower segment cesarean section previously and singleton pregnancy with a cephalic presentation in present pregnancy were included in the study. Patients who had previous two or more cesarean sections, multiple gestations, Malpresentation in this pregnancy, and previous upper segment cesarean section were excluded from the study. Outcomes including vaginal delivery, cesarean section, postpartum hemorrhage, scar dehiscence, low Apgar score < 7 in five minutes, and NICU admission were recorded. The percentages and frequencies were calculated for categorical variables while mean and standard deviation were calculated for numerical variables. Student’s t test was applied to find out p value. Results: Patients were divided in two groups with group 1 with interval less than 18 months and second group more than 18 months duration. There were no statistical difference of VBAC, Emergency repeat Cesarean section, PPH and scar dehiscence in both groups (p value 0.26, 0.21, 0.18, 0.19) respectively while NICU admissions is high in short interpregnancy interval p-value 0.05. Conclusion: There is no difference of VBAC success and emergency Cesarean section rate, PPH and scar dehiscence on interpregnancy interval in women with previous one Cesarean section but low APGAR score and NICU admission of neonates is high in women with short interpregnancy interval than long interpregnancy interval in women with previous one Cesarean.  
168 Pelvic Varicose Veins - Do Women know Enough? , Pritee Sharma;Edwin Stephen2
Pelvic varicose veins also known as Pelvic Congestion Syndrome is one of the most neglected cause of chronic abdominal pain in women. It is estimated that approximately 30% women experience symptoms due to pelvic varicose veins at some point in their lifetime. It typically presents in the 20 to 45 years age group. There is no genetic or ethnic predisposing factor, however, common in multiparous women, probably due to repeated child birth causing damage to pelvic veins. The engorged pelvic veins result in stretching of the intima, distortion of endothelium and smooth vessels lining the pelvic veins. Consequently, vasoactive substances like Substance P, Neurokinin A, and Neurokinin B are released that contribute to inflammatory reaction and pain. The engorged veins also cause a mass effect causing irritation of adjacent nerves
169 Breast Cancer Survivors: Rehabilitation and Quality of Life , Marcos J P Renni1;Marcos V Machado Rego ; Leonardo Freire de Andrade
Background: Breast cancer is the most common neoplasm in women, and it is worth highlighting not only the aspects of the treatment itself, but also its psychological effects on the patients. Currently, breast cancer survivors represent a significant population, and a considerable number of them have developed heart failure due to oncologic treatment. Numerous damages may occur from cancer treatments, besides the cardiovascular effects. These women may present sarcopenia and osteoporosis, depression, anxiety, sexual dysfunction, sleep disorders, cognitive problems, fatigue. Development: Exercise interventions are well established as safe and beneficial for individuals receiving cancer [10]. The credibility of a possible role of exercise in improving quality of life, reducing the risk of relapse, and increasing survival in cancer patients is increasing today. Physical activity may reduce risk of cardiovascular disease, which is a major cause of death for many people who have survived cancer. Conclusion: Regarding the benefits of physical exercise, there is no doubt that in patients undergoing oncological treatment, as well as in cancer survivors, it contributes significantly, improving the response to treatment and reducing the adverse effects of the therapy in question.  
170 Amblyopia, Anisometropia without Strabismus , Abbas Jedariforoughi
Amblyopia (anisometric) was regarded to exist when isoacuity at far was not reached despite the glasses, part-time occlusion therapy of the good eye was prescribed. Amblyopia was present in 86% of the cases and was detectable with all types of anisometropia. It was more aggravate in anisohyperopia and/or anisoastigmatism. After relevant treatment, amblyopia was clinically resolved or less severe in 78% of the patients
171 Caesarean Scar Pregnancies , Sahana SM;Nandita ; Priyam P; Vishakha A; Nirzarini V
Majority cases of Caesarean Scar Pregnancies (CSP) reported till date involves singleton pregnancy. This case series discusses two Caesarean Scar Pregnancies. Initial presentations, diagnosis and management of a rare case of advanced heterotopic pregnancy in which CSP coexisted with intrauterine pregnancy and another case of grade 4 CSP are discussed here in detail. Both patients discussed here underwent laparotomy followed by hysterectomy because of continued severe hemorrhage and recovered well during postoperative follow up visits A brief review of published literatures regarding diagnostic modalities and management options for CSP was performed and discussed here  
172 The Role of Preceptors in Clinical Practice: Student Midwives' Knowledge, Perspectives and Challenges in Koforidua and St. Patricks Nursing and Midwifery Training Colleges, Eastern and Ashanti Regions of Ghana , Alberta David Nsemo;Odei-Opoku;Hannah Durowaa;Daisy Afra Lumour;Josephine Opokua Osei; Juliet Dwomoh ;Evita Ama Serwah
Midwifery is a practice-based discipline, therefore learning experiences in the clinical setting are integral to the preparation of registered midwives. Preceptors are experienced nurses and midwives who work in a variety of clinical and academic settings. They are assigned to a new or a novice midwife to guide them through an orientation process and a transition to their new role. Hence, their primary responsibility to the midwifery student in the clinical setting is to provide meaningful and relevant learning experienc- es. This study sought to examine student midwives' knowledge and perspectives of the role of the preceptor as well as the challenges faced by the students in Koforidua and St. Patricks Nursing and Midwifery Training Colleges, Eastern and Ashanti Regions of Ghana. Social learning theory was used to guide the study. The study utilized the descriptive survey design with simple random sampling to get information from 269 second and third-year midwifery students from both schools using a structured questionnaire. Data was analysed using the SPSS version 22 and presented in frequency tables and Bar charts. The study findings revealed the majority of midwifery students (60.0%) have knowledge of the preceptorship and encounters preceptors during their clinical work. Most of them (57.3%) perceived that it is the role of a preceptor to help them bridge the gap between classroom and clinical areas. Majority (68.8%) of the student midwives expectations of their preceptors was to help them develop midwifery skills and knowledge. They however faced some challenges with the preceptors in the course of the clinical practice such as lack of student-preceptor relation- ship, unavailability and inaccessibility of some preceptors, inadequate time to spend with the preceptors and inadequate supervision form preceptors during clinical practice. The study concluded that preceptorship might be a new concept in midwifery education, it is a module that is known to most students and is perceived as an integral part of their training. Based on the findings, the recommen- dations included Training of more clinical preceptors on their roles for improvement of students' clinical learning outcome among others.
173 Compliance and Barriers of Vitamin A Supplementation for Under Five Children: A Cross Sectional Study , Anchu BG Nair1;Betty Baby; Karthika TS;Mercy Janet L;Preetha MA;Sheeja VS;Sunitha SS;Asha KV
Vitamin A is required for the normal functioning of the visual system, maintenance of cell function for growth, epithelial integrity, production of red blood cells, immunity and reproduction. Vitamin A Deficiency (VAD) increases vulnerability to a range of illness including xerophthalmia, keratomalacia, and blindness in children. Preventive program against Nutritional Blindness related to vita- min A insufficiency was initiated in India in 1970 with the purpose of protection against nutritional blindness as a result of kerato- malacia. The present study was conducted for the assessment of Compliance and barriers of Vitamin A Supplementation Programme (VASP) among under five children associated with a teaching hospital of Thiruvananthapuram district of Kerala. A descriptive cross sectional study was conducted among 118 children. Consecutive cases were selected as sample based on the inclusion criteria. A structured interview schedule was used to collect data on compliance to VASP. The study revealed that47.46% of children had full compliance to VASP, 51.7% of children had partial compliance and 0.85% of children had noncompliance. Among the children who have partial compliance, majority (18.64%) have received only 3 doses of vitamin A. The major reason for partial and non-compli- ance were health related problems (33.4%) and 30.64% of the participants in partial or non-compliance group reported lack of awareness regarding the VASP as reason for noncompliance. Findings of the study reveal the necessity for strengthening of VASP at the implementation level to reduce the morbidity associated with VAD
174 A Case of Telogen Effluvium as COVID Sequelae , Gurdeep Singh; Sarthak Parikh; Ujval Choks
Telogen effluvium (TE) is a reversible form of hair loss which is an identified sequela of COVID-19 infection. Generally diagnosed by a hair-pull test or a modified wash test, it can cause a non-scarring shedding of hair for months after the resolution of COVID-19. The pathophysiology of TE secondary to COVID-19 is still being understood. Here, we describe a 45-year-old unvaccinated female who was diagnosed with a severe case of telogen effluvium approximately 3 months after her COVID-19 diagnosis, with hair loss that exceeded 80% of her total hair.
175 Anaemia Mukt Bharat - A Desirable Goal or National Myth? , K Suresh
Anaemia is a condition with either the number of red blood cells or the concentration of haemoglobin within the blood cells less than normal. Anaemia is the cause of poor cognitive and motor development in children, low work capacity in adults resulting in lower productivity and poorer country’s economic development compared to its potential. Global anaemia estimates in 2019 indicate a prevalence of anaemia in women 29.9% of women aged 15-49 years, 39.8% of chil- dren aged 6-59 months years. Out of a total of 633 thousand of anaemia burden worldwide, Southeast Asia contributes the most 37% followed by Africa (15%) Western Pacific (11.7%), Eastern Mediterranean (9%) and Europe and America (6% each) each of anaemic women and children. Prevalence of Anaemia among pregnant women in India has been hovering around 68-70% and has come down by only 7% over period of 20 years between 1989-90 (NFHS2) and NFHS 5 (2019-21). The leading causes of anaemia in India are poverty, caste factors and poor sanitation. Frequent occurrences of malaria and worm infestations, a vegetarian diet is also implicated with iron-deficiency anaemia. National efforts since 1970 have yielded very little benefit, therefore it has launched an initiative called Anaemia Mukt Bharat in 2018. It aims reducing of anaemia prevalence among young children and women of the reproductive age group, though indicative of socio-economic inequality in anaemia among men in India. The Covid 19 Pandemic since early 2020 has disrupted, this initiative like many other national programs Most community research in India has shown that improving green leafy vegetables in daily diet, IFA supplementation, menstrual awareness and services and birth spacing are important in achieving Anaemia Mukt Bharat. The reality is most urban slum and rural population, worse the tribal people either have no access or poverty prevents to procure the most need green leafy vegetables and fruits to supplement and iron and other minerals and vitamins for haemoglobin synthesis. The need of the next decade is to encour- age children, adolescents, pregnant and lactating women and all reproductive age women and men in developing countries including India into the habit of eating more of green leafy vegetables and other Iron and vitamins rich foods. Better to go from doing nothing to doing something to ameliorate the challenge Materials and Methods: This article analyses the burden of anaemia, trends of anaemia over last 20 years, challenges, national efforts so far, and road ahead. The data available in last 5 years from the global estimates, Global burden of diseases (2005-06 and 2015-16) national surveys like comprehensive national nutritional survey, national Family health surveys and local surveys, AMB- September 21-Scorecard and some published papers in the recent past have been used.  
176 Human Breast Milk Banking , Sunil Malhar Kulkarni
In nature solutions come first and then questions or problems. Breast milk is ready before birth of baby. In nature we saw one mother feeds her milk to other’s newborn or even newborn of other species. In present study the author has taken very impor- tant and essential topic for research is “Assess the effect of Planned Teaching on Knowledge Regarding human milk banking among the staff nurses in selected hospitals of Pune city
177 Jalil Mammadguluzadeh and Gender Inequality: An Issue to be Focused on? , Dunya Suleymanova
Unfortunately, gender inequality remains one of the most complicated issues of the contemporary world. Despite the major prog- ress towards gender equality achieved in the 21st century, women are still disadvantaged compared to men in terms of access to social and economic opportunities [7]. Interestingly, most people think of Western society, when they hear about women’s liberation move- ments that are taking place throughout the history. In contrast, extremely strict dress codes, forced and early marriages, struggle for gender equality are things coming to the mind while speaking about Eastern culture. In order to understand what was happening at that time in Eastern culture, it is important to go back to the origins of struggles for women’s rights, economic, and gender justice
178 HPV Test As Primary Screening Tool , Priya Ganesh Kumar
WHO Mission statement of Cervical cancer Elimination by 2030 has been a historic moment and has created an impactful global awareness regarding this deadly disease. The triple formula of 90-70-90 has been designed to have a 30% reduction in mortality from cervical cancer to be achieved by 2030. The goal of Cervical cancer elimination is to bring down the cases of cervical cancer below 4 per 100,000 woman. To achieve this goal the targets laid down is 90% coverage of girls fully vaccinated with HPV Vaccine by 15 years of age, 70% of women screened with an HPV test at 35 and 45 years of age and all managed properly, 90% of women identified with preinvasive disease receive adequate treatment and follow up. It is now an established fact that cervical cancer is caused by persistent infection with high-risk HPV strains. 4 out of 5 women in our country is affected with HPV, HPV being a sexually transmitted virus. Persistent high risk (HR) HPV is necessary for development of precursor lesions and cervical cancer. The major steps in cervical carcinogenesis include HPV infection, HPV persistence for a certain period of time, progression to precancer and invasion
179 The Relationship of Physical Activity with Menstrual Patterns of Adolescents Senior High School in Bogor West Java , Erika Yulita Ichwan; Fernanda Dian Shafira;Winancy, Diana Hartaty Anggraini
Menstruation is a series of physiological processes that allow disruption of the menstrual pattern, such as the menstrual cycle, menstrual duration, the amount of menstrual blood, and pain during menstruation (dysmenorrhea). One of the factors which affect the disruption of menstrual patterns is physical activity. Physical activity is any movement of the body produced by skeletal muscle that requires energy expenditure. According to WHO (World Health Organization) 2018 data, 84% of women do less physical activity than men. Female adolescent still pays less attention to physical activity and disturbances during menstruation. This study aims to find out the menstrual pattern of female adolescent, depicting of physical activity, and to find out the relationship between physical activity and menstrual patterns of female adolescent at 1 Cibinong Senior High School in Bogor Regency. This research is a quantita- tive study with a cross sectional design. Random sampling technique is used to gather the sample. The sample in this study consist of 75 students on 11th grade at 1 Cibinong Senior High School. Questionnaire is used as data collection instrument. Bivariate and multivariate are used to analyze the data. Based on the results of the bivariate test, there was a significant relationship between physical activity and menstrual patterns, namely the menstrual cycle p = 0.000 < 0.05 (alpha) and disorders during menstruation with dysmenorrhea p = 0.019 < 0.05 (alpha). There is a relationship between physical activity and menstrual patterns. Education about the importance of paying attention to physical activity every day is needed, so that adolescents can prevent experiencing dis- turbances in menstrual patterns.
180 Undetectable HIV Equals Untransmittable HIV (U = U) Statement in Women. Are we there Yet? , Justyna D Kowalska; Dagny C Krankowska3 ;Agnieszka Wróblewsk; Ewa Firląg-Burkacka
Introduction: The “undetectable equals untransmittable” (U = U) statement confirms that a HIV positive person on effective antiretroviral therapy is not transmitting HIV to his/her sexual partner. Poor adherence to treatment can jeopardize this benefit. Women living with HIV (WLWH) are more at risk of having suboptimal adherence than men. Objectives: To compare the characteristics of women on effective cART with those who have a detectable HIV viral load (VL), in order to understand the differences in behavioral patterns and to better address the U = U statement among women. Methods: Women with HIV using gynecological services in the Out-Patient Clinic in Warsaw participated in a survey about sexual behavioral patterns and history of sexually transmitted infections (STIs). The data about HIV VL, status of HCV, HPV and other STIs was exported from the medical database. Characteristics of women with HIV RNA>50 copies/ml and women with HIV RNA<50 copies/ml were compared using non-parametric tests as appropriate. Results: The study included 97 WLWH with median age 39 years and 82 (84.5%) with undetectable HIV VL. The median number of sexual partners in both groups was five (IQR: 3.5-8.5 and 3-10 for those with VL<50 and VL>50 respectively). Most characteristics were comparable between study groups except that more women with detectable VL did not use condoms (66.7% vs. 39%, p = 0.0244). Conclusions: More attention should be drawn to reasons of poor adherence to cART in WLWH. Same efforts in educating about safe sex and U = U should be made in WLWH as for other key populations.
181 Initiation and Quit of Smoking Among University Students in Bangladesh , Rufaida Mubaraka;Mahmuda Ansari;Rabeya Yasmin;Mainul Alam Chaklader;Mahmud Hossain Faruquee
The purpose of this cross-sectional study was to find out initiation and quit of smoking habit among the university level students of Bangladesh. A total of 374 Bangladeshi university students, aged 18-26, enrolled in this study. Among the students’ females were 191 who were never smoker, out of 183 male students 107 (58.47%) were smoker. The majority (91.3%) of the smoker and ever smoker- initiated smoking under influence of their friends. The majority (62.9%) of the smoker and ever smoker-initiated smoking under the age of 18 years. Among the self-reported health problems by the smoker respondents, chest pain (59.6%), cough (57.7%), breathing problem (57.7%), asthma (38.5%), and loss of appetite (40.4%) were prominent. among the current smoker respondents 22.3% showed their willingness to quit smoking and 77.7% yet not decided. Among the current smoker respondents 26.6% attempted to quit smoke and rest 73.4% not attempted. Among the smoker respondents it was reported that 39.4% smoke up to 10 times per day and 60.6% smoke more than 10 times per day. Health education programs is an effective tool for reducing the initiation and giving up this bad habit smoking among university students
182 Study of Obstetric and Gynecologic Emergencies in Adolescents In Covid-19 Pandemic , Bijoya Mukherjee;Vaishali Suraiya
Study Objective: To find out the obstetric and gynecological emergencies with which adolescents present in the COVID-19 pandemic. Design: This is a retrospective observational study. Setting: The study has been carried out in casualty of the Department of Obstetrics and Gynecology in VMMC and Safdarjung Hospital for a period of 3 months during the COVID-19 pandemic. Participants: Information regarding 228 adolescent patients attending the emergency has been taken from the records maintained at the emergency department and has been analyzed and tabulated into obstetric and gynaecological emergencies. Intervention: No intervention has been done in this study. Outcome Measure: The obstetric emergencies and gynecological emergencies of adolescents in the COVID-19 pandemic. Results: 148 patients (64.9%) have attended with obstetric emergencies and 80 patients (35.1%) with gynecological emergencies. True labour pain and abortions (25%) are the most common obstetric emergencies with which the adolescents present at casualty. Post dated pregnancy (10.1%) and preterm labour (9.4%) are found to be the most significant complications associated with teenage pregnancy, the important other ones being prelabour rupture of membrane, pre eclampsia and antepartum haemorrhage. Menstrual disorders (40%) comprise the most important gynecological emergency out of which dysmenorrhoea is the major cause; followed by ovarian tumors (18.75%) and sexual assault (16.25%). Conclusions: It is necessary to improve the health education, the availability of resources (online and offline) for the adolescents to overcome the dire obstetric and gynecological emergencies and offer them a healthy life instead, keeping in mind the possibility of future waves of COVID-19 pandemic.
183 When Love Turns Hate: Consequences of Marital Discord, Marital Dissolution and HCW's under Risk , Mahendra Kumar
Life is a path usually travelled with a partner. Marriage is the foundation of any healthy society and family basic forms of interpersonal social relationship. Marriage as a union of trust and happiness among husband and wife. Conflict in intimate human relationships, such as marriage, is inevitable especially whenever two people get together some of their traits and habits annoy other and eventually leads to disagreements and conflicts. This uneasy relationship could easily put the couple in the unenviable situation of getting separated. Regarding its consequences, divorce doesn’t come with a limited effect on the couple but affects the entire family economically, emotionally, and physically. Children if present are the immediate victims who face the possible consequences. This paper is discussing about impact of divorce among family, children and individuals health.
184 Most Common, Preventable, Early Diagnosable, Cancer Caused Deaths, in Women , Girish J Kotwal
Cancer remains a leading cause of death in baby boomers as well as elderly men and women [1]. There are 5 leading cancer related deaths among women which are preventable if there is early detection of genetic predisposition, early diagnosis, prompt intervention and follow up. Common cancers affecting women are breast, colorectal, endometrial, cervical, skin and ovarian cancers [2]. Out of the common cancers, the five that result in a high percent of deaths are breast cancer (15%), lung and bronchus cancer (21%), colorectal cancer (8%), pancreatic cancer (8%), uterine/ovarian cancer (8%), thyroid cancer (5%) and liver cancer (4%) [3]. Multiple factors could be root cause of cancers ranging from genetic predisposition to certain cancers, to smoking (including second-hand smoke), excessive alcohol consumption, infectious agents like human papilloma virus, noncommunicable diseases like type II diabetes, overweight/obesity, poor lifestyle choices etc. Prevention is better than cure and cancers are largely preventable, if not, diagnosed early by regular check-ups and paying close attention to signs of abnormal lumps, enlargements, pain, protrusion and in consultation with physicians to get prompt screening of abnormal findings. Surgical removal of tumors along with breast removal before onset of breast cancer could be a way to prevent death due to breast cancer [4]. It is very important to ensure health insurance coverage because the cost of treatment can be very high. It is equally important to be pro active about own health as health is wealth and kicking self-destructive habits and having a healthy lifestyle can contribute to longevity
185 A Gendered Woman in the COVID-19 Pandemic: Being a Mother , Semra Söngüt
Many different health problems have been seen throughout human history. One of them is the pandemic. Pandemic is defined as an epidemic disease that spreads around the world and causes many people to get sick and die. The most recent example of these is the coronavirus (COVID-19) pandemic, which broke out in China at the end of 2019 and still affects the whole world. Since this pan- demic causes a large number of deaths worldwide and creates an important source of social and individual stress, it causes individu- als to be psychologically, socially and economically affected [
186 The Crucial Calcium, Maithili A Athavale
The calcium obtained from our diet is absorbed from the gut into the bloodstream. However, to absorb this calcium we also require adequate levels of Vitamin D. When the blood levels of the calcium falls, our body produces parathyroid hormone, which increases the absorption of calcium from bone. In short, the calcium is drained out from our bones to balance the calcium levels in the blood
187 A Study to Assess Knowledge Regarding Obesity and its Complications Among Nursing Students in selected Nursing Colleges at Mysuru, Munirathnamma , Lingaraju CM , Mamatha G and Sunitha PS
Living a healthier life can not only extended our life, it can also improve the quality of life. Felling physically better and having control over life can greatly increases our mental health as well. Although there are some aspects of physically and mental health that are beyond an individual’s control, there are many things that people can do to improve their quality of life. Obesity is leading preventable causes of death worldwide, with the increasing prevalence in adult and children, and authorities view it as of the most serious public health problems of the 21st century. The Objective of the study is “The aim of the study is to assess the knowledge regarding obesity and its complications among nursing student in selected nursing college at Mysore. Methodology of the present study is descriptive survey design and non-probability convenience sampling technique was used to select 60 nursing student in JSS college of nursing Mysore. Pilot study was conducted the tool and study design were found to be feasible. The structured knowledge questionnaire used to collect the data. Collected data was analysed by using descriptive and inferential statistics. Findings of the study revealed that, the majority of the study subject 66.6% Nursing students had average knowledge, 25% had adequate knowledge and 8.33% had inadequate knowledge regarding obesity and its complications. Study findings also revealed that there is no significant association between knowledge Score of nursing students and their selected personal variables like age in year, religion, gender, income of the family, diet, physical activity. The finding of this study revealed that there is average knowledge regarding obesity and Its complications among nursing student. It is essential to stress the increasing responsibilities of health professional in planning, implementing, various educational strategies to improve the knowledge regarding obesity and its complications.
188 Post Myomectomy Scar Dehiscence, Rana A Choudhary; Pallavi Viswanadh; Manjusha Ganla; Sanket V Pisat ; Kedar N Ganla
A 36-year primigravida presented at 16 weeks of gestation after a spontaneous conception for antenatal registration after pri- mary infertility of 10 years. She had a history of myomectomy done by laparoscopy, 2 months before conception for a 10 cm posterior intra mural fibroid. At 33 weeks and 4 days of gestation, she had started leaking per vagina with left upper side abdominal pain. Her NST showed spontaneous decelerations and emergency LSCS was done. Intra operatively, there was hemoperitoneum due to uterine dehiscence at left cornua which was the previous myomectomy scar site. Baby was delivered and the lower segment uterine scar and dehiscence site were sutured in layers. The patient and baby recovered well.
189 Lung Cancer in Asian Women, Kanakeswary Karisnan; Sellaiah Sithambaram
Lung cancer is an aggressive and heterogeneous disease. A global epidemic of lung cancer in women is sweeping the globe. Although cigarette smoking is the leading cause of lung cancer in both women and men, several studies have found significant gender differences. Lung cancer is becoming more common among nonsmokers, particularly Asian women. This mini review summarizes the epidemic of lung cancer in Asian women and the importance of screening with the use of low-dose CT for early detection and thus reduce lung cancer mortality rate.
190 Nutrition in Patients with Chronic Obstructive Pulmonary Disease (COPD), María Fe Ojeda Ibañez; María Isabel Vera Talledo
Chronic obstructive pulmonary disease (COPD) is a serious public health problem worldwide, whose statistics have unfortunately been increasing, projected to be the third cause of death in the year 2030. The nutrition of a patient with COPD is decisive to ensure a good prognosis of recovery, so an adequate, comprehensive and timely evaluation should be made to all patients with this diagnosis and a low-carbohydrate and high-fat dietary regimen should be indicated. There is evidence that the use of nutritional supplements would improve quality of life in people with COPD
191 Effectiveness of Structured Teaching Programme on Knowledge Regarding First Aid for Burns and its Prevention in Children Among Mothers of Under-five Children, R Indira; K Sesha Kumar;V R Pushpa Jyothi ; T Nagamani ; Mohammed Ajmal Khadeer
Burn injuries are major cause for hospitalization, associated with significant morbidity and mortality, especially in children under the age of four years. A study was conducted to assess the knowledge and effectiveness of structured teaching programme among mothers of under-five children regarding first aid for burns and its prevention in children. Evaluative research approach was adopted, the research design used was pre-experimental (one group pretest, post-test design). The data was collected by structured interview schedule among 60 under five children mothers using structured knowledge questionnaire, the participants were selected by purposive sampling technique. The pre test mean score was 9.4 with the standard deviation of 4.5 and the post test mean score was 26.7 with the standard deviation of 2.8. The difference in mean score was 17.3. The calculated paired ‘t’ value was 24 (in 59 degrees of freedom) which is (P < 0.001 level). Hence there was a significant difference between pre and post-test knowledge scores regarding first aid for burns and its prevention in children among mothers of under five children. There was no significant association found between pre-test level knowledge scores with their selected demographic variables. The findings of the study showed that structured teaching programme was effective
192 Culture and Grieving in a Pandemic Context: The Role of Women, A Personal Experience and Food for thought, Janet Michel
Death is a universal, persistent, inescapable, unavoidable and undeniable fact of life. The meaning of death and what happens after death though, varies from culture to culture. The Shona and many African cultures believe that life does not end with death, but continues in another realm. What role do women play in dealing with death and loss. Death has been identified as a uniting event in the African culture as relatives travel, irrespective of distance, to pay their last respects and provide emotional support to the family. Grieving is a process. It starts best with collective grieving. A collective acknowledgement that we have lost someone precious, that we are connected in our loss and in our pain. The relief that is achieved through this collective grieving, carries through into the individual grieving phase. COVID-19 has indeed changed burial rituals world-wide. The authorities and the communities need to join hands and find legal, safe and amicable ways as the pandemic lingers and other pandemics threaten.
193 Short Communication on Enviro-Bhakti, Rashmi A Bapat
Today is an era of science and technology with human rights, rituals and heritage. From many yugas the science of yoga, devotion and human ultimate happiness and supreme love is carried and transferred from generations to next generation. Many research and re-research on vedic sciences and ydnyas and ydnaya bhumiies (Vedic Astika Karama Kanada Part) apart from vedas have been studied and researched. Any google scholar engine if the key words like the effect of ‘Yadnya Vedic Rituals’ or’ yoga like devotion’ on mindfulness, concentration, memory, happiness or joyfulness of mind and lifestyle changes, we get an anonymous list of publications, articles, research papers, but what is the outcome of doing all the as loss of memory or anxiety, poor concentration with today’s stressful life style, all the hardship business at the cost of, if the joyfulness and happiness of nature is lost.
194 The Relationship Between Leptin Levels and the Leptin Gene Promoter Polymorphism G-2548A at the Onset of Preeclampsia, Roza Sriyanti ;Masrul ; Johanes C Mose ; and Netti Suharti
Introduction: Preeclampsia is one of the complications of pregnancy that often increases maternal morbidity and mortality. The influence of the leptin gene promoter polymorphism G-2548A plays a role in the development of preeclampsia. Objective: This study was to determine the relationship between leptin levels and the leptin gene promoter polymorphism G-2548A at the onset of preeclampsia. Methods: This study used a cross sectional comparative study design which was conducted from May 2018 - April 2019 in the Obstetrics and Gynecology section/SMF of General Hospital Dr. M. Djamil Padang, Achmad Mochtar Hospital, Solok Hospital, Reksodiwiryo Hospital. Sampling with consecutive sampling consisting of 69 pregnant women met the inclusion and exclusion criteria. Examination of the promoter polymorphism of the G-2548A leptin gene was carried out by sequencing method. Results: From the results of the study, the highest leptin levels were found in EOPE compared to LOPE and normal pregnancies. In EOPE, the highest leptin levels were found in the AA genotype (52.81 ± 66.14), in LOPE it was found in the GG genotype (47.40 ± 44.29), and in normal pregnancy the highest leptin levels were found in the AA genotype (18.78 ± 29.75). Conclusion: There was no significant relationship between leptin levels and the leptin gene promoter polymorphism G-2548A at the onset of preeclampsia.
195 The Effects of Nobiletin and Devil’s Claw in Hela Cervical Cancer Cell Lines, Ozlem Ozgur Gursoy;Hulusi Goktug Gurer; Ceren Yildiz Eren; Canan Vejselova Sezer;
Cervical cancer is the fourth most common type of cancer diagnosed in women. Devil’s Claw (Harpagophytum procumbens) is a traditional medicine that has been used for a long time. Nobiletin (3′,4′,5,6,7,8-hexamethoxyflavone) is an important component of polymethoxylated flavones found in citrus peels. HeLa cells were cultured in EMEM medium. HeLa cells were seeded in 96 well plates. After the incubation, plates were read at 570 nm on ELISA reader. Annexin-V technique, based on detection of translocated phosphatidylserine to the outer side of cellular membrane, was used to test the apoptosis promoting ability of test agents on HeLa cells. The Caspase 3/7 activation abilities of test agents on HeLa cells were analysed with caspase 3/7 detection technique. Devil’s claw, nobiletin and the combination of these 2 agents were found to be cytotoxic on human cervix adenocarcinoma cells, HeLa. The cytotoxic effects of all agents were in dose and time dependent. The highest growth inhibiton was detected at the applied highest dose. IC50 values for 24 hours were found to be 51.12, 49.03 and 39.2 μg/mL, respectively. This values for 48 hours of application were 43.23, 45.12 and 30.65 μg/mL for Devil’s claw, nobiletin and the combination. Today, combined therapy has come to the fore in the treatment of cancer patients. Nobiletin and devil’s claw may be candidates for inclusion in treatment protocols as well as being used alone.
196 The Demographical Survey Study of Nature of Menstrual Hygiene Among Adolescents’ Girls in St. Theresa’s Upper Basic School, Kanifing, The Gambia, Edet Rebecca Edem;Dr Baboucarr Cham ;and Mariama Keita
Menstrual hygiene is an important issues that every girl and woman has to deal with in life. Although menstruation is a normal physiological process, it is still surrounded with social taboos, supernatural beliefs, misconceptions and malpractices which are very challenging for every girl. Adolescent school girls in low-income and middle-income lack appropriate facilities and support in school to manage menstruation. Therefore, the objective of this study is to assess the Demographical Survey study of Nature of Menstrual Hygiene among Adolescents’ Girls in St. Theresa’s Upper Basic School, Kanifing, The Gambia. Method: A cross- sectional quantitative study involving 140 adolescent girls who were sampled randomly from grade (8) class using a self-administered questionnaire as a data collection tools. The data was analyzed using descriptive and the result was presented in frequency tables and percentages. The analysis of the data was done using SPSS version 20. The approval to conduct the research project was given by The St Theresa’s Upper Basic School Principal. Results: Mothers were found to be the main source of information on menstrual hygiene. 92% (n = 129) of the respondents lack knowledge on the organs from which menstrual blood comes from. 63.6% (n = 89) had traditional believe that influences their menstrual practices and 20% (n = 28) experienced secondary stigma as a result of menstruation. 7.1% reported using antiseptic to clean the genital and 56.4% (n = 22) reported flushing of the soiled absorbents in the school toilets. 70% (n = 98) reported lack of adequate facilities in school and about 4.3% (n = 6) reported being restricted from going to school when menstruating
197 Women Empowerment: A Literature Review, Deepthy James
Most females are not involved in economic and political decision-making, equitable involvement in the formal economy is constrained, less salary, and have unequal distribution of assets and property. Moreover, for a huge portion of women, the day when she gives birth becomes the most dangerous days of her lives. Inequalities are seen in all the nook and corners of the world which differ from country to country and region to region. The impediments and imbalance that women and girls experience frequently arise as they do not have control over their own lives and futures and are mainly due to gender inequalities in power relations. Women empowerment, this can only be achieved if from the very basic we nurture our children without any gender bias during their developmental stage by providing appropriate training, education, awareness, building self–confidence to women and girls, also providing them free reign to expand their choices, strengthen their voices and transforming power to claim their true right in the society, community and in their own lives
198 Women and Cancer Cervix - Can it be Prevented?, Savita Rani Singhal
Carcinoma cervix is the third most common cancer in women worldwide and the second most common cause of cancer related deaths in women in developing countries. In India it contributes to 16.5% all cancers in women, every year about 1.2 lakh women are diagnosed and more than 65000 die from carcinoma cervix.
199 What is PCOS? Why is it so Common Now?, Prachi Sharda Jhawar
Polycystic ovary syndrome (PCOS) is a hormonal disorder involving infrequent or irregular menstrual periods and often excess male hormone (androgen) levels which causes acne, hirsutism (excessive hair growth on face, back, chest etc), male pattern hair loss. Some patients complain of increasing obesity and infertility as well
200 Use of Anticoagulants During Pregnancy Prevent Gestational Diabetes?, Ozlem Ozgur Gursoy; Ceren Yildiz Eren;Hulusi Goktug Gurer ; Ozge Godek
Background: Nowadays, the use of anticoagulants during pregnancy has increased It is used nearly in all of the advanced maternal age and multifetal pregnancies. It is important to study the effects of this increasingly popular treatment modality on other diseases. The purpose of this study is to research the effect of the usage of anticoagulants on the prevalence of gestational diabetes. Material and Methods: Our study is retrospective. The participants consist of a group of pregnant women. Pregnant women using anticoagulants formed the case, and randomly selected pregnant women not using anticoagulants formed the control group. The study consisted of 800 participants, 400 case and 400 control. The descriptive statistics are age, number of pregnancies and body mass index. A Chi-Square test was performed to study the effect of the usage of anticoagulants on gestational diabetes. Results: Other than the body mass index of the groups, other descriptive statistics are similar There was no relationship between the participants with and without gestational diabetes in the case group in terms of gestational age, number of pregnancies and body mass index (p > 0.05). In the control group, statistically significant relationship was found (p < 0.01). A statistically significant relationship was found between the case and control groups in terms of gestational diabetes frequency (p < 0.01). Conclusions: Our study is one of the first studies to research the effect of anticoagulants had on the development of gestational diabetes. The findings of our study show that the usage of anticoagulants decrease the gestational diabetes development rate
201 Impact of Antenatal Interventions on Neonatal Outcomes Among High Risk Pregnant Women, Prof Dr P Vadivukkarasi Ramanadin; Prof Dr Pity Koul ;Mr Ebbie Thomas
Introduction: According to WHO, Globally preterm delivery is one of the leading causes of death among under-fives. Preterm babies face the difficulties after their delivery that includes visual, hearing and learning problems [1]. Aim: Evaluate the effectiveness of selected antenatal interventions on neonatal outcomes among high risk pregnant women. Hypothesis: There is a difference in neonatal outcomes between control and experimental group of high - risk pregnant women after implementation of selected antenatal interventions at 0.05 level of significance. Methodology: Quantitative research approach, Quasi Experimental multiple time series control group design was used. Sampling technique used for the study was non probability, purposive sampling technique. All High risk pregnant women attended antenatal OPD at Sub District Hospital and District Hospital who met the inclusion criteria were. In total 322 were selected, out of which 161 were in Experimental group and 161 were in Control group. Analysis of the study was done with the sample size of 299 since there was attrition of 23. Selected antenatal interventions were Video assisted teaching on antenatal care and prevention of preterm delivery, Daily monitor sheets for antenatal interventions and exercise, Telephonic confirmation for follow up, Information booklet on antenatal care and prevention of preterm delivery, Minimum eight antenatal visits and Measurement of cervical length. Results: Findings of the study revealed the gestational age in the control group was 32.36 ± 1.16 whereas in experimental group 39.46 ± 2.34 and the obtained student t’ test value is t (299, 0.05) = 17.6696, 0.0001: p < 0.005. Birth weight of the baby is less in control group (2.107 ± 0.77 gms) compare to experimental group (2.849 ± 0.54 gms) and t’ value is t(299, 0.05) = 9.9109, 0.0001: p < 0.005. The number of days newborn hospitalized in control group is 15.46 ± 17.752 days whereas in experimental group it is 1.0188 ± 0.082 days and t’ test value is t (299, 0.05) = 9.05, 0.0001: p < 0.005. Conclusion: Findings of the study shows that selected antenatal interventions were effective in terms of reduction of preterm delivery, low birth weight and number of day neonatal hospitalization.
202 Health and Environment Security through ‘Ujjwala’: A Study of Peri-urban Areas of Uttar Pradesh , Moni Chandra
Cooking in the absence of clean fuels is not only injurious to health of the household but affects environment as a whole. In India, majority of the households especially in rural areas depend primarily on wood, crop residue and cow dung for cooking. LPG, the modern cooking fuel, is still a distant dream for them. LPG has many benefits like, it eliminates household air pollution, reduces the drudgery of firewood collection and checks deforestation and depletion of forest resources. Besides, those who use it are able to dedicate more time on educational and economic pursuit. And for this purpose, PMUJ was launched in May, 2016 to prevent the negative health implications from traditional cooking fuel. Hence, there is need to study and investigate as to how ‘Ujjwala’ Yojana is contributing in removing the health hazards involved with traditional cooking methods and is saving the time and cost of cooking apart from improving environmental quality and sustainability.
203 Early Breast Lump Detection Using the Intelligent Bra "IN-bra", Victory Elias; A Rabih ; G Nassar
This paper proposes a new smart Bra concept to detect any potential strange lumps in women’s breasts by ultrasounds waves. These suspicious lumps can be a cyst, Abscess, Fibroadenoma, or Tumor. This system consists of 18 transducers positioned in a specific way, distributed on a ring, with a 5 MHz central frequency while respecting the anatomy of the breasts. We aim to minimize the main lobe’s beamwidth (BW) and maximize the radiation field along the side lobes (SLL) of the transducer, with this wide lateral diffraction caused by the piezoelectric, we can detect any strange corps in the breast. Our hypothesis was confirmed by the correlation coefficient formula, where two signals are compared according to their spatial resemblance potentially. According to our findings, there are no suspicious lumps in the breast, while the correlation coefficient is as high as 0.2.
204 Nursing Students’ Perception of the Clinical Environment in a Metropolitan Area in Ghana, Odei-Opoku HD; Bam V ; Acheampong K;Kusi-Amponsah DA; Lomotey A and Odei O
Clinical learning experience in healthcare facilities is widely accepted as a significant part of nursing education, and has therefore been described in literature as the heart of nurses’ professional training. The aim of the study was to determine student nurses’ view of the clinical learning environment and its contribution to achieving clinical learning outcomes. A cross-sectional descriptive survey design was used, and a self-administered questionnaire was used to collect data from 317 respondents who were sampled using random sampling technique. Data was analysed using Statistical Package for Social Sciences (SPSS) Version 25. The study found that: clinical students were given opportunity to experience work at various units of the health facilities, they were not very satisfied with the learning environment, and thus perceived clinical learning not that effective. Clinical learning was challenged by students’ anxiety and stress due to lack of orientation for students. Results indicate a positive correlation between clinical learning and students’ self- efficacy and the integration of theory and practice, both with p < 0.001. However, preceptors’ method of teaching has insignificant correlation with student clinical competence (0.137). Student nurses’ clinical learning experience positively correlates with their learning outcomes. It is recommended that nursing training institutions and clinical learning facilities ensure students are given the opportunity to experience work at various units or departments, integrate theories learnt in the classroom into actual practice and modify teaching methods for student nurses in clinical practice so as to sustain effective clinical learning experiences.
205 Can 18F-FDG PET/CT Replace Bone Marrow Biopsy in the Rhabdomyosarcoma Patients?, Shantanu Pande;Nihit Mhatre; and Ipsita Dhal
Objectives: To evaluate role of 18F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18F-FDG PET/ CT) in assessing bone marrow involvement in rhabdomyosarcoma (RMS) patients, and whether 18F-FDG PET/CT findings render invasive bone marrow biopsy (BMB) unnecessary. Materials and Methods: This retrospective study included 20 patients (age < 20 years) with biopsy-proven RMS who underwent 18F-FDG PET/CT and BMB for initial staging between August 2018 to December 2020. The 18F-FDG PET/CT scans were evaluated for bone marrow involvement and compared with the BMB results. Results: The 18F-FDG PET/CT findings and BMBs excluded bone marrow involvement in 19/20 patients. In the remaining patient, 18F-FDG PET/CT suggested metastatic bone marrow involvement, and BMB detected marrow invasion by malignant cells. Thus, for evaluation of bone marrow involvement, 18F-FDG PET/CT showed a specificity and negative predictive value of 100%, suggesting that BMB may be unnecessary. Conclusions: 18F-FDG PET/CT showed a high specificity and high negative predictive value for detecting bone marrow metastasis in RMS patients, and its use could preclude the need for invasive BMB. However, further studies are required, as our present work had certain limitations.
206 It is Possible to Establish Quickly a Smart-phone Calculator for Optimal Gestational Weight Gain Specific for Indian Pregnant Women, Pierre-Yves Robillard
International IOM 2009 recommendations for gestational weight gain during pregnancy are highly contested in Asia by Indians and East-Asian scholars (China, Korea, Japan etc..). They even use “Asian adapted” overweight and obese classifications (e.g. obesity ≥ 27.5 kg/m² instead of 30 kg/m²). We have demonstrated 4 years ago that if we chose as perequisite rationale that the maternal optimal gestational weight in term pregnancies (optGWG) is to have Appropriate for Gestational Age (AGA) term newborns (by definition 80% of a neonatal population, with 10% of SGA -small for gestational age- as well as 10% of LGA -Large for gestational age-), there is an association with maternal PRE-pregnancy Body Mass Index (ppBMI), and that this association is a linear curve (y= ax+b). We propose then an alternative solution for Indian scientists/epidemiologists to confirm in the Indian population our preceding findings and establish in India their specific linear equation knowing the specific SGA-LGA definitions of term newborns in India. It will be easy to make this linear equation accessible everywhere on smartphones for health workers and women themselves. The Indian calculator will give therefore indispensable councils since the beginning of pregnancy to each pregnant woman, and should be useful also for the great “Indian diaspora” around the planet (e.g. Mauritius, Trinidad and Tobago, Fiji, French overseas territories etc...), where obesity is a huge rising problem in this community.
207 Torsion Ovarian Cyst with Impending Rupture During Early Pregnancy and Outcome of Laparoscopic Management, Papa Dasari
A young primigravida at 10+4 weeks of gestation suffered from acute onset of pain abdomen of 4 days duration with vomiting. She was suspected to have torsion Ovarian cyst with pregnancy and undergone USG elsewhere which showed free fluid in abdomen and an echogenic adnexal mass along with intrauterine pregnancy and hence she was referred to our tertiary care Institute. After 12 hours of admission, she developed tachycardia and hypotension and had guarding and rigidity of abdomen. Abdominal USG showed left sided complex adnexal mass with absent arterial blood flow on Doppler. Live Intrauterine pregnancy corresponded to 9+2 weeks. Emergency Laparoscopy showed impending rupture of Ovarian mass which was edematous and bluish black with breach in the capsule and there was hemorrhagic fluid in pelvis. Detorsion was done successfully gently and cystectomy was deferred as it appeared very friable. Pregnancy support was given with vaginal progesterone and she was discharged after 5 days. She was followed up by teleconsultation due to COVID pandemic and she was admitted at 38 weeks with PROM and delivered an alive healthy male baby without any congenital malformations which weighed 2.8 kg.
208 Role of Clinical Decision Support System in Identifying Women Health Issue After COVID Infection, Anurag Sahu and Sachidanand Singh
Like other pandemics with in ~four months after the first case reported as covid, World Health Organisation (WHO) declared CO- VID-19 as a pandemic in March 2020. As per the records reported by WHO, Women’s health has suffered greatly because of this pan- demic. The Covid-19 pandemic is putting a continuous pressure on healthcare systems around the world, with far-reaching health repercussions [1]. Women around the globe are still facing specific health risks and outcomes even after getting recovered from covid infections. Hence, considering the above said objective, the goal of this narrative review is to show how these disparities are ampli- fied in the Covid-19
209 A Study to Assess the Knowledge Regarding Care of Mentally Retarded Children, Priyank Bhatt
“Intellectual disability is a disability characterized by significant limitations in both intellectual functioning and in adaptive behavior which covers many everyday social and practical skills. This disability originates before the age of 18”. (American association on intellectual and development disabilities). Aggression, self-injury and mood problems are now and again related to the disability. The severity of the signs and the age at which they first appear depend upon the reason. Children who’re mentally retarded attain developmental milestone drastically later than predicted, if retardation is caused by chromosomal or other genetic problems. It is often apparent from infancy. The research layout followed turned into Non-Experimental studies design. The conceptual framework based on Hochbaum Health notion version 1950. The examine has been performed in selected special school of Rajkot. Non-randomized handy sampling approach has been adopted to pick out the desired pattern. The sample size changed into 30. The instrument used for producing vital information become questionnaires. The records acquired have been analyzed and interpreted statistical in terms of mean and Chisquare. Among the selected demographic variables the following have been having significant association religion, type of parental marriage, source of previous knowledge
210 Early Life Adversities are Associated with Sleep Quality During Pregnancy and the Postnatal Period: A Longitudinal Study in Tunisia, Sana El Mhamdi ; Imene Mlouki; Arwa Ben Salah ;Briana N DeAngelis;Ines Bouanene;and Mustafa al’Absi
The objective of our study was to investigate the relationship between ELAs and sleep disturbances among pregnant women in Tunisia. We performed a prospective study on a sample of pregnant women in Primary Healthcare Centers in Tunisia during a year. ELAs were evaluated using the Adverse Childhood Experiences-International Questionnaire. Common Mental Disorders were evaluated using an Arab version of the Self-Reporting Questionnaire. Postpartum Depression was assessed using the Edinburgh Postnatal Depression Scale. Sleep disturbances were assessed using the Pittsburgh Sleep Quality Index. The sample included 593 women. One out of three women endorsed four adversities, including household dysfunction (58.3%), physical abuse (40.0%), community violence (40.0%), and peer violence (39.3%). Half of the participants (52.4%) were exposed women to secondhand tobacco smoke. Our findings confirm that ELAs and secondhand smoke predict sleep disturbances during pregnancy and the postpartum period.
211 To Kegel or Not to Kegel?, Deeksha Singh
I hear it all the time, ‘my doctor, friend, mom, aunt told me to just do more Kegels’. I guess because it’s the only exercise most people are aware of for their pelvic floor, they just do it for everything and if it doesn’t work, they try more of them. I can’t tell you how many women I treat that are doing 100’s of Kegels per day and are no better! It’s crazy to me. Arnold Level, MD, never designed his eponymous pelvic floor exercises as a one-way street; in fact he instructed his patient to release their pelvic floor muscles as well as they squeeze them. The contraction should be a gentle lift- not a vice grips. And also the exercise should engage more than just a urethra muscle. So the advice many doctors give to their patient like stopping and then restarting the flow of urine- is incorrect. I agreed on appoint that these exercises can benefit women, especially those who have hypotonic or loose muscles and stress incontinence
212 Modify Expression or Emotion of Inpatient Ward Nurse: The Effect of Emotional Labor Strategy on Burnout Mediation by Job Demand, Resekiani Mas Bakar;Irwan Widiyanto
Background: Inpatient nurses have responsibilities with high task complexity and emotional interaction with patients. The nurse feels high task demands and tends to experience burnout. Previous research used the JD-R Model, which stated that the imbalance between job demand and job resources could lead to burnout. Emotional labor strategies (surface versus deep acting) are commonly used as job demand and job resources. Purpose: This study examines the effect of surface acting and deep acting on burnout, mediated by job demand. Methods: The research design was a quantitative survey with 120 inpatient ward nurses. The instrument in this study used the emotional labor, job demand, and burnout scales. This study uses the mediation model technique by Hayes Process. Results: The results showed that deep acting and surface acting have a positive effect on job demand and have an impact on increasing burnout. Surface acting has a direct effect on burnout. Nurses who use surface acting and deep acting indirectly affect the increase in burnout through job demand mediation. The exciting thing in this study is that, unlike previous studies, deep acting is not proven to reduce job demand, so the nurses still experience burnout. Conclusion: Deep acting and surface acting both affect increasing burnout through job demand. This study differs from previous studies that used the JD-R model with deep acting as a job resource. Because the inpatient department has a high work complexity, it is possible that nurses may not consider deep acting a job resource because changing positive emotions is not enough to reduce burnout. This research implies strengthening job resources through external support from hospitals.
213 A Narrative Review of the Individual Benefits of Maternal Exercise or PUFA Supplementation During Pregnancy: Are We Missing Something?, Cody J Strom ;Samantha M McDonald ;Kimberly A Kew ;Joseph A Houmard ; David A Tulis ;Roman Pawlak ;George A Kelley; Lisa Chasan-Taber;Edward Newton; Christy Isler ;James DeVente; Breanna Wisseman; and Linda E May
Evidence indicates that poor nutrition and physical inactivity during pregnancy are associated with increased risk of the child developing obesity, type 2 diabetes, and/or heart disease later in life. Current research demonstrates that maternal aerobic exercise and supplementation of Docosahexaenoic acid (DHA) and Eicosapentaenoic acid (EPA) during pregnancy are associated with improved maternal lipid profiles and infant outcomes, such as a decreased risk of childhood obesity and improved infant cardiac autonomic function (i.e., lower heart rate (HR), increased heart rate variability (HRV)). Currently, the relationships between maternal DHA and EPA with maternal exercise on maternal lipids, infant body composition, and infant cardiac autonomic development are not known. The purpose of this literature review is to synthesize the current state of scientific evidence regarding the effects of prenatal aerobic exercise and maternal DHA and EPA concentrations on maternal lipids as well as infant body composition and cardiac autonomic health. In this review, we examine the individual influence of maternal exercise or DHA and EPA supplementation on maternal lipid profiles, infant body composition, and infant heart outcomes.
214 Octonians Cross Ratios and Spins Cross Procduct, Gudrun Kalmbach HE
In her research project MINT-Wigris the author developed models for the quantum range. She discovered that spin and rgb- gravitons which she defined as superposition of three color charges of quarks in a nucleon require measures whihc cannot be transformed into one another. For a spacial calculus, spin uses SU(2) with the three Pauli 2x2-matrices as xyz-space generators. They are for the physics 4-vectors of spacetime. Color charges require the doubling of them to octonians since rgb-gravitons require the uses of complex Moebius transformations, having as invarinats the six cross ratios for color charges. Color charges are in octonians an independent force. The last octonian coordinates is for the electromagnetic interaction, a Kaluza-Klein rolled U(1) circle as coordinate.
215 Quark Triangle Coordinates, Gudrun Kalmbach HE
Octonians are used for a geometrical unification of the standard model with gravity. The method is that color charges are added to the forces of physics as an additional force using for them complex cross ratios
216 Cancer and Exercising - What Should be Considered?, Marcos J P Renni; Marcos V Machado Rego ;and Leonardo Freire de Andrade
Background: With the growing advances in the field of oncology, more effective treatments have been implemented that provide more chances of cure patients. Cachexia and asthenia commonly coexist in the course of treatment and can persist for months or years. In this context, we propose some physical exercises correlating them to the patient’s clinical status, based on the Ecog scale. Discussion: We can make some considerations about the data described in cancer patients and adapt them to other patients. Conclusion: We believe that the benefits of physical exercise practice in those patients undergoing cancer treatment are unquestion- able, as well as in cancer survivors
217 Public Perception on the Influence of De-radicalisation and Reintegration of the Repentant Boko Haram in North East Nigeria, Bashir Adam Yakasa; David Markus Shekwolo ; Taiwo Adeola Wellington;and Hassana Bashir Yakasai
The study investigated the public perception of the de-radicalisation and the reintegration of the repentant Boko Haram members in Nigeria. The survey design was adopted for the study, a total of 300 participants received questionnaires electronically and directly, and 292 returned validly. The data was analyzed using inferential statistics. Hypothesis one showed a significant positive perception of the respondent’s knowledge of de-radicalization and effective reintegration (X2(1) = 4.830, P < 0.05). Furthermore, hypothesis two did not yield any significant age difference in the perceived influence of de-radicalisation of repentant Boko Haram members on counter Terrorism in Nigeria (F (3, 289) = 0.619, P > 0.05). Hypothesis three analysis revealed a statistically significant difference between male and female respondents’ perception of de-radicalisation (t (290) = -4.244, P < 0.05). In conclusion, the program has been deemed relevant and recommended that monitoring and evaluation from the start should be a priority in the management, especially for women and children returnees.
218 Clinical Results of Chemoradiation Therapy and Adjuvant Chemotherapy of Locally Advanced Cervix Cancer, Kravets OA*
Purpose: This study reported clinical results of patients with locally advanced cervical cancer who treated with radiotherapy and image-guided adapted brachytherapy and combinations of cytotoxic drugs. Material and Methods: This study included 190 patients with cervical cancer IIb, IIIb, IVb (metastases in para-aortic lymph nodes) during 2011-2015 treated with external-beam radiotherapy or chemoradiotherapy, total dose for D95 50Gy for 25 fractions following Image-guided brachytherapy HDR with prescribing dose for CTV-HR D90 7.5 Gy weekly 4 fractions. Total dose CTV-HR D90 40 Gy (EQD2). Total dose for HR-CTV D90 was 95.0 ± 0.67 Gy (EQD2). Presented group A (n = 72) - radiation therapy, B (n = 40) - chemoradiation therapy with cisplatin C (n = 39) - chemoradiation therapy with a combination of irinotecan + cisplatin, 2 courses of adjuvant chemotherapy D (n = 39) - chemoradiation therapy with a combination of paclitaxel + cisplatin, 2 courses of adjuvant chemotherapy. Clinical outcomes including local control (LC), cancer-specific survival (CSS), overall survival (OS), and toxicity were analyzed. Results: Three-year OS and CSS in groups A were: 88.4% ± 4.5% and 64.4% ± 7.3%; B - 77.7% ± 7.6% and 77.5% ± 7.1%; C - 69.8% ± 9.6% and 66.3% ± 8.9%; D - 81.3% ± 6.4% and 62.1% ± 8.0%, respectively (p> 0.05). The use of chemoradiotherapy in the groups did not increase the 3-year OS in cervical cancer stage IIIb: in group A - 84.0% ± 7.5%, B - 76.2% ± 9.4; C - 77.2% ± 9.1% and D - 84.9% ± 7.0% (p> 0.05). But CSS was higher on the 1st year of observation in group C - 96.3% ± 3.6% compared with group A - 74.2% ± 7.5% (p = 0.049). With a 3-year observation - 75.7% ± 9.6% and 59.0% ± 11.4%, respectively (p = 0.31). Combined chemoradiation therapy in patients with cervical cancer increases the time to progression: from 9.5 months (in groups A and B) up to 19.4 months and 16.4 months (in groups C and D), respectively (p = 0.05). A decrease in the number of local relapses during 3 years was obtained in groups B and D compared with group A (100% versus 90.3%, p = 0.05). Local control within 3 years among 190 patients was 94.7% ± 1.6%. Gastrointestinal early toxicity was noted higher in group C compared to A, B, D (rectites G2-3 - 25.7% versus 5.6%, 5.0% and 2.6%, respectively, p = 0.05). Late cystitis G2-3 is higher in groups B, C, D compared with group A (15.4% versus 4.2%, p = 0.07). Conclusion: The study showed high efficiency of treatment of patients with cervical cancer due to the introduction of modern technologies in radiotherapy, as well as chemoradiotherapy programs with acceptable toxicity.
219 What is the Disadvantage of the Apgar Score? What is the Advantage of the Obstetric Stange Test?, Natalya A Urakova ;Aleksandr L Urakov;and Anastasia P Stolyarenko
Every woman since childhood dreams of giving birth to a healthy, intelligent and capable child and guesses from a young age that this is determined by parental genes and largely depends on the conditions of fetal development during pregnancy. At the same time, physiological childbirth is not usually included in the group of factors influencing the mental capacity of a newborn child. This is supported by the public opinion that future childbirth is the “health strength” test factor for pregnant women only. To prove this point, reference is usually made to the Bible, which cites the following phrase of the Lord after Adam and Eve were expelled from paradise for their original sin: “To the woman He said, I will surely multiply your pain in childbearing; in pain you shall bring forth children”
220 Feminization of Pedagogical Education and its Outcomes, Leyla Hasanova ; Dunya Suleymanova
Nowadays, modernization has covered almost all countries of the world. Big changes are taking place in all areas of life, and education is not an exception. Against the backdrop of ongoing political, social and financial changes, the content of gender roles in education is also undergoing modification. In this context, it is important to study the gender distribution when high school students choose the profession of a teacher, and, in particular, a teacher of mathematics. In fact, this profession is currently one of those that are most prone to gender segregation. As a result, the purpose of this article is to explore the relationship between gender and career choice as a mathematics teacher among young people in Azerbaijan, and to illustrate the results. The article pays special attention to one Azerbaijani university - Baku State University, and statistics are built on its basis. The study revealed important results that demonstrate the existence of a certain relationship between gender and the choice of a mathematics teacher as a profession, which may negatively affect future education.
221 Fetal Hypoxia: Why Intrauterine Ventilation of Lungs Seems Like a Bad Idea Today, Aleksandr L Urakov; Natalya A Urakova; Anastasia P Stolyarenko
Fetal hypoxia during delivery is one of the most likely causes of brain cell damage, resulting in infantile cerebral palsy (ICP), encephalopathy and mental retardation [1,2]. Fetal hypoxia has been shown to occur most frequently in children subjected to surgical delivery (15-20%) and when physiological birth isprolonged beyond 12 hours in both cephalic and breech fetuses [2]. Typically, birth asphyxia develops in the first or second period of birth [3]. In severe cases, the diagnosis of neonatal asphyxia is made after birth only.
222 Parental Anxiety to Unexplained Bruising: A Case Report of Acquired Platelet Dysfunction with Eosinophilia, Muhamad Azamin Anuar;Nur Farah Izzati Misaridin and Muhammad Shafiq Safwan Md Latip
Bruising in the form of ecchymosis and purpura in a healthy child, should be taken into serious consideration when it occurs spontaneously with no logical explanation. Baseline blood investigations including blood film are mandatory to rule out malignancy. Thrombocytopenia is very common in pediatric population however platelet dysfunction is a challenging diagnosis that require extensive laboratory investigations. Acquired platelet dysfunction with eosinophilia is a syndrome that requires more awareness among pediatricians especially in Southeast Asia region to avoid parental anxiety. We report a three years old boy with a long history of spontaneous bruising that was eventually treated with anti-helminthic agent. The patient was een by many clinicians over a period of time but unable to justify parental expectation and relieve their anxiety
223 Histologic Correlates of Single Artery mbilical Cords with Clinical Implications, Danielle Walsh;Sandra Pawlus ; Patricia Commins and Paul H Hartel
Single artery umbilical cords have conventionally been studied in relation to clinical abnormalities such as intrauterine growth restriction (IUGR) and hromosomal abnormalities. Literature on the istopathologic correlates of single artery umbilical cords is lacking. We evaluated umbilical cord, foetal membrane and placental histopathologic findings in 26 placentas with single artery umbilical cords to characterise any differences compared to normal three-vessel umbilical cord control cases. We found a greater prevalence of funisitis and acute horioamnionitis, and greater prevalence of maternal vascular malperfusion. Umbilical cord and/ or foetal membrane nflammation and placental histology of maternal vascular malperfusion often orrelate with clinical infection and hypertension, respectively. Early in-utero detection of single artery umbilical cord may therefore help identify risk of potential infection and maternal/foetal hypertension and help prevent adverse clinical sequelae.
224 Distorted Time Perception Amongst Health Workers Treating SARS CoV-2 and the Repercussions on their Lives and Individual Performance, Zannini Rosalba; Silvia Battistoni ; and Di Prospero Filiberto
During the COVID-19 health emergency, there has been a lot of discussion regarding what should be done, unfortunately often in contradictory terms, while little has been said about the psychological, emotional and cognitive problems experienced by the health workers involved, particularly as regards the repercussions on their daily lives and individual performance.
225 A Case Study of 60-year-old female Patient of Rheumatoid Arthritis Treated Successfully Using Yoga Prana Vidya (YPV) Healing System as Complementary Medicine, Dharna Vasavda and Venkata Satyanarayana Nanduri
Introduction: Rheumatoid arthritis (RA) is an autoimmune disease prevalent worldwide and primarily affects joints. While the cause of RA is not clear, scientific opinion considers it as a combination of genetic and environmental factors. Several treatment options are available and this paper presents a case of one 60 years old female patient suffering for 8 years from chronic RA despite regular medication was healed successfully using Yoga Prana Vidya (YPV) protocols as complementary medicine. Materials and Methods: Case study method is used in this study going through patient’s medical records before and after YPV healing treatment given by a YPV healer. Results: Within 5 months of self-practice and daily healings given by a healer based at YPV Ashram, the patient fully recovered and is leading healthy life full of vitality, beyond her expectations. She is able to climb the stairs and also bend down, and perform all household chores normally. Conclusion: This case study documents the evidence gathered on the effective use of YPV in healing and treating Rheumatoid Arthritis. To produce holistic and optimum results, YPV uses a combination of approaches that include: Physical exercises, Rhythmic Yogic Breathing, Forgiveness Sadhana, Salt free diet and fruit diet, Meditation techniques, healing by trained and experienced healers, participation in group healing, regular self-practice of specified techniques. Recommendations include further research on the application of YPV as alternatively effective and low-cost medicine for various medical conditions using appropriate sample.
226 The Probiotics, Prebiotics and Woman’s Health, Maithili A Athavale
What are probiotics? Probiotics are live microorganisms that have health benefits when consumed. In short, they are beneficial bacteria that provide all sorts of powerful benefits for body and brain. Foods rich in Probiotics are Curd, Idli, Dosa, Pickles, Dhokala, Buttermilk, Cheese and Paneer.
227 Acute Unilateral Vision Loss and Optic Perineuritis (OPN) Associated with Mucormycosis Sinusitis in Geriatric Patient, Osama Osman ; Julie Gammack ;Lina Toledo-Franco;Takaaki Ishiyama ;Emily Reisenbichler;Shamseldeen Mahmoud ; Nongnooch Poowanawittayakom ;Connor Clarkston; Cinthia Pi ; Andrew J Polk;Osasu N Adah;Sydney O’Neal ;Jillian Drogin ; Sophie J Xie
Background: Optic Perineuritis (OPN) is an uncommon condition that has been reported with many systemic disorders. Methods: We report a geriatric patient who suffered from acute unilateral vision loss and OPN in association with mucormycosis. We also included a brief literature review pertinent to OPN. Results/Discussion: OPN has been reported in association with many systemic disorders, it has infrequently been reported with mucormycosis sinusitis. Conclusions: OPN may develop secondary to mucormycosis sinusitis.
228 A Prospective Comparative Interventional Study of Dydrogesterone (Progestin Primed Ovarian Stimulation) Versus Ganirelix Acetate (GnRh Anatgonist) for Freeze-all IVF/ICSI Cycles, Kedar Ganla;Rana Choudhary ;, Priyanka Vora ;Seema Pandey; Jayant Kamat ;Cyriac Pappachan; Anil Chittake
Background: With advancement in IVF technology and vitrification, use of progesterone and its derivatives to block the LH surge is increasing. This was a prospective randomized controlled trial, in a private reproductive medicine clinic to compare the efficacy of preventing LH surges by using progesterone primed ovarian stimulation (PPOS) against gonadotropin-releasing hormone (GnRH) antagonist, in women with good ovarian reserve undergoing in vitro fertilization (IVF). Method/Design: Study participants (n = 220) who met the inclusion criteria were randomized. Both group participants received hMG from day 2. Group 1 (hMG + DYG) received 10mg tablet Dydrogesterone, thrice a day, from day 2 of stimulation. Group 2 (hMG + GAN) received 0.25 mg of Ganirelix acetate, given subcutaneously from fifth day of stimulation till the day of trigger. Main Outcome Measure(s): The primary outcome measured was the incidence of premature LH surges. All embryos were frozen and transferred in the subsequent cycle. Participants were monitored by serial hormonal assays. Main Outcome Measure (s): The primary point of measurement was the incidence of premature LH surges. We also studied the number of oocytes retrieved, number of embryos formed, implantation and clinical pregnancy rate along with the additional cost per cycle as our secondary end parameters. Result (s): All subjects in both groups had well controlled LH levels suggesting good control over prevention of premature leutinisation. There was no significant difference in the number (mean ± SD) of oocytes retrieved [P = 0.0691] and viable embryos or the pregnancy rate (PR) after FET 48% {43.64, median (IQR)} versus 39% {(35.45, median (IQR)} (P = 0.215). The additional cost per cycle was significantly high in the antagonist group (p < 0.001). Conclusion: Our results suggest that Dydrogesterone effectively inhibited spontaneous ovulation, without affecting the number of retrieved oocytes, embryo quality, implantation and pregnancy rates (PR). The cost difference and patient acceptance between both the groups was significant with Dydrogesterone allowing lower costs and easier (oral) administration thus making IVF cycle more patient friendly.
229 Synchronous Multiple Colon Neoplasm. Case Report, Jorge Chehab Andrade;Héctor Montes Lainez;Vanessa Cruz; Pamela Vega Chanalata
Multifocal colorectal cancer is diagnosed in approximately 5% of all colorectal cancer patients, whether synchronous or metachronous; they have several risk factors including genetic predisposition, intraluminal spread due to tumor seeding, and chronic inflammation. We present the case of a 72-year-old woman who came to the clinic with a clinical picture of 2-year evolution characterized by constipation and sporadic rectal bleeding. A biopsy was performed through a colonoscopy, reporting poorly differentiated adenocarcinoma infiltrating a right colon tumor. and low-grade dysplasia in sigmoid colon polyps; reason for which a right hemicolectomy with sigmoidectomy and colorectal anastomosis was surgically intervened, the definitive pathological result reported adenocarcinoma in 3 different anatomical locations of the colon. This case illustrates the infrequent presentation of an adenocarcinoma present in different locations of the colon. There is still little knowledge of this form of presentation, but its prognosis is not encouraging.
230 Consequence of Diabetic Environment and Significance of Glycemic Control in Early Pregnancy: A Case Report, Shovandeb Kalapahar ; Nalini J Gupta ;Sunita Sharma ; Ratna Chattopadhyay;Hiralal Konar; Baidyanath Chakravarty ; Pratip Chakraborty
Microcephaly describes a structural defect of the fetal head circumference; causes being extensive, and heterogeneous including both known and undetermined etiologies. No conventional treatment/s is currently available to minimize the risk of anomaly. Maternal hyperglycemia is often associated with adverse perinatal outcomes upsetting embryonic development. A tight glycemic control possibly restructures interwined teratogenically capable pathways balancing the reactive oxidative species metabolism. However, only few studies have highlighted on changes in response to diet and metabolic conditions for increased risk for anomalies in diabetic and obese pregnancies. Management strategies often miss recommended preconception counseling in unplanned pregnancies. In this report, a patient of early pregnancy with bad obstetric history successfully responded to an optimized glycemic control to avoid a major congenital defect like microcephaly.
231 The Predictors Of Obstetric And Perinatal Complications In Pregnant Women With Chronic Obstructive Pulmonary Disease, Svitlana Heryak;Olena Oleksiak
It is widely known that the systemic inflammatory process is a pathogenetic link in most diseases among which the leading place is occupied by COPD which is increasingly diagnosed in the female half of the population, in particular in pregnant women. As a result of the negative impact of systemic inflammation on the body of pregnant women, various obstetric and perinatal complications often develop. The aim of our study was to establish the features of the relationship between systemic inflammation and the development of pregnancy complications in pregnant women with COPD. Materials and Methods: 7After the clinical and instrumentally confirmed diagnosis of COPD, 77 pregnant women were examined. For the convenience, pregnant women were divided into 2 subgroups depending on the degree of bronchial obstruction: IA - 43 pregnant women with FEV1 ≥80%, IB - 34 pregnant women with FEV1 50-79%. The control group included 27 pregnant women without comorbidities. The main inflammatory mediators were identified and correlation with the degree of bronchial obstruction and the frequency of obstetric and perinatal complications. The Results: We found that with an increase in the degree of bronchial obstruction, there is a more frequent diagnosis of such complications of pregnancy and childbirth as the threat of preterm birth in 9 (26.4%) pregnant women compared to 1 woman in the control (3.7%), preeclampsia was diagnosed in every 5 women (20.5%) compared to the control group where such pregnant women were absent, intrauterine growth retardation was detected in 8 women, which was 23.5% of the examined pregnant women of the IB subgroup, placental dysfunction was diagnosed in 3.4 times, preterm birth in 3.5 times, anemia in 3.1 times, premature rupture of membranes during childbirth in 4 times, fetal distress in 3 times more often compared to the control group. According to the results of correlation analysis, it was found that the development of these complications is based on chronic hypoxia and inflammation, which was manifested not only by an imbalance of interleukins in the form of increased levels of IL-1β, IL-6 and a decrease in IL-10 levels, but also an inverse correlation was between the level of FEV1 and the level of IL-1β (rI = -0.81, rII = -0.67, p < 0.01), FEV1 and IL-6 (rI = -0.88, rII = -0.78, p < 0.01), as well as a direct correlation between FEV1 and IL-10 (rI = 0.80, rII = 0.86, p < 0.01). Conclusion: In the main group of pregnant women with mild and moderate degree of bronchial obstruction in whom the diagnosis of COPD was confirmed, there was a significant increase in the level of proinflammatory cytokines - IL-1β (rI = -0.81, rII = -0.67), IL-6 (rI = -0.88, rII = -0, 78), which was directly proportional to the degree of bronchial obstruction and inversely proportional to the level of anti-inflammatory IL-10 (rI = 0.80, rII = 0.86), which may be a characteristic feature of the early development of obstetric and perinatal complications
232 Social Abuses and Health Risk Assessment of Female Garmentc, Md Rasel-Ud-Jaman; Feroj All Mozahid
This paper is an endeavor to depict the social abuses and health risks assessment of the female garment workers from two perspectives. One is social perspective and the other is health perspective. The objective is to explore socio economic condition of female workers and also know the maternal health problem of female garments workers. The analysis is based on the survey of 60 female workers of 3 garment industrial units located in different parts of Kanchpur are in Narayanganj. This study suggests that the frequency of sextual harassment against female garment workers is still in precarious condition and they are not free from social exploitation and face extreme difficulties in obtaining their basic needs for survival even. Most of all the study will inform the reader about unhappy condition of female garment worker at Kanchpur area in Narayanganj
233 Multidisciplinary Team Management of Breast Cancer Patients, Sie Thu Myint ; Khin Hsu Hlaing;Aung Myat ;Htun Thuya
Breast cancer is the most common cancer among women. Breast cancer presents in different oncotypes, in different staging, in different differentiation and with various comorbid conditions and it troubles a lot of patients, mostly women but also some men. A “one-size-fits all” treatment is not the appropriate management
234 Human Immunodeficiency Virus (HIV) in the Old Adult and Geriatric Women Population: Review, Alexis Hartman ; Lewis April; O Osman
With the improvement of Human immunodeficiency virus (HIV) treatment with Highly Active Antiretroviral Therapy (HAART), HIV patients living with HIV have an increased life expectancy, increased and now many of these patients live to see geriatric age. In 2019, the American population age 65+ was 54.1 million of which 30 million were geriatric women (55.4%). Data for HIV shows that ~ 50% of patients living with HIV are geriatric. Particularly amongst the female population, certain age-related issues, such as vulvovaginal atrophy and the associated disruption of the vaginal mucosa, put geriatric women at higher risk for HIV acquisition. Additionally, aging Geriatric Women are less likely to use contraception methods, which may also increase their risk of acquiring HIV. This review illustrates facts and data about HIV in the geriatric population, with an emphasis on women of geriatric age
235 Study of the State of the Vaginal Microbiota in Women with Risk and Threat of Preterm Birth, O Laba ; V Pyrohova*
In etiopathogenetic terms, premature birth is considered as a clinical syndrome characterized by polyetiological factors, the participation of the fetus in pathogenesis, a variety of clinical symptoms, and the involvement of genetic and environmental factors. At the same time, there is increasing evidence that the composition of a woman’s vaginal microbiota significantly affects her sexual and reproductive health, including the risk of adverse pregnancy outcomes, including miscarriage and preterm birth. The purpose of the work was to assess the state of the vaginal microbiota in women with risk factors and the threat of spontaneous premature birth. 150 women of reproductive age took part in the study. The inclusion criteria for the study were the presence of risk factors for preterm birth or the threat of preterm birth. Determination of the pH of vaginal contents, molecular biological, and bacterioscopic methods were used to assess the state of the vaginal microbiota. The conducted studies indicate a high risk of preterm birth in the presence of dysbiotic and inflammatory changes in the vaginal microbiota - odds ratio (OR) = 2.962 (95% CI 1.32-6.645). At the same time, for pregnant women with risk factors for preterm birth, OR makes up = 8.120 (95% CI 2.149-30.686), and for pregnant women with diagnosed threatened preterm birth - OR = 10.133 (95% CI 3.149-32.604). Thus, one of the risk factors for the development of spontaneous premature and threatened premature births is changes in the state of the vaginal microbiota, which requires the development of diagnostic and therapeutic measures to prevent premature termination of pregnancy and reduce the frequency of obstetric and perinatal complications.
236 YouTube as a Source of Information on Ectopic Pregnancy: A Qualitative and Quantitative Analysis, C Bulle ;M Lallemant ;C Rigori and R Ramanah
Objective: The aim of this study was to assess the quality and reliability of YouTube videos on ectopic pregnancies for the public. Method: We searched for the key terms “ectopic pregnancy”, “ectopic birth” and “extra uterine pregnancy” on YouTube. Each video that met the inclusion criteria was analyzed by two independent raters. Quantitative and qualitative metrics were recorded, and the videos were scored using the DISCERN instrument. Results: A total of 37 videos met the inclusion criteria. The mean overall DISCERN score was 44.5 ± 15.6. Videos had significantly a higher DISCERN score if they contained explanations on anatomy (pvalue
237 Evaluation of Incidence, Causes and Management of Neonatal Jaundice in Abia State Teaching Hospital Aba, Nigeria, Emeonye OP ;Nwatu Madukaibeya; Felix Chinwendu J; Nwakanma Odochi ; Obioma-Anosike Ugonma; Akunna Okorie
Background: Jaundice is the yellow discoloration of the skin and sclera that result from raised level of bilirubin in the blood and the commonest complication among newborn infant in Nigeria. When a baby has jaundice, either too much bilirubin is being produced or the liver does not get rid of it quickly enough due to immaturity of the liver. Objectives: The objectives were to ascertain the incidence, risk factors, management and preventive measures of neonatal jaundice. Methodology: Past medical record of the neonates from 2016 to 2018 were gotten from labor and Postnatal wards, and nursery units. Questionnaires were also used to collect data from nurses working in the same wards to ascertain the accuracy of the data collected. Results: The study revealed that neonatal jaundice is on the increase and had the highest incidence between 2016, On the causes of neonatal jaundice,40 (80%) said enzyme deficiency increase red blood cell breakdown, while 10(20%) of the respondents said that ABO incompatibility. On prevention, respondents agreed that putting baby to breast immediately after birth, administration of phenol barbitone prevents neonatal jaundice, 40(80%) had the highest response. 8(16%) respondents agreed that health educating the mother on breasting feeding, while 42 (84%) agreed that early detection and proper treatment given with phototherapy or exchange blood transfusion increases the chance of survival. Conclusions: To ascertain the incidence of neonatal jaundice in Abia State Teaching Hospital Aba between 2016-2018, The researchers concluded that this conduction is on increase and require intervention of health workers through health education, early antenatal visit, periodic check up of the pregnant women and prevention of toxic drugs.
238 HIV During Pregnancy: Downsizing Mother to Child Transmission, Asha KV
Yearly more than 1.3 million women with HIV get pregnant all over the world. There is a 15 - 45 percentage risk of transmitting of HIV to the newborn during pregnancy, labour and puerperium if left unattended. Thus prevention of mother to child transmission of HIV is highly recommended under the umbrella of maternal, newborn, child and adolescent health services and public health system. Appropriate management of mother during pregnancy, labour and puerperium definitely helps in reducing the transmission of HIV from mother to child. Antiretroviral therapy with combination of drugs is a legitimate intervention in order to minimise the risk of mother to child transmission. Special precautions are necessary while conducting delivery. As breast feeding increases the risk for transmission, it should be informed to the mother to make choice regarding this.Transmission rates can be reduced to below 5% with appropriate management.
239 My Experience in OPU (Oocyte Retrieval cases) of Giving Aanesthesia in Over 5000 Patients, Manjusha Ganla
Assisted reproductive technologies or in vitro fertilization (IVF) was developed primarily for couples with infertility issues to maximize the possibility of a viable pregnancy. During IVF (transvaginal) follicular aspiration or retrieval (TVOR) and oocyte retrieval is among the most delicate technically.
240 ICT and Tribal Women Empowerment, Priyanka; Satish Kumar
According to the Constitution of India, there are 645 distinct tribes in India. The 2011 census revealed that, with a population of over 40 lacs, the Bhil is our country’s largest tribe. Our culture is fundamentally made up of tribal communities and tribal people. Like in other communities, half of the population of the tribal community is made up of women. Like any other society, the tribal community’s well-being is significantly influenced by the position of its women. Most of the Tribal women are not aware of their rights and their literacy rate and health status are also low. Information and communication technology (ICT) can help women in society and alleviate gender inequality. This potential is becoming more widely acknowledged. As a result of socioeconomic, structural, psychological, and institutional hurdles, women utilize and have less access to ICT than males, and this is indicative of a considerable gender digital gap. This study focused to analyses role of ICTs in empowering tribal women. This study is to describe the uses of ICT for social and economic empowerment and government Schemes and strategy for tribal women economic empowerment. This study is based on secondary data and the Empirical Research methodology used. Most of the studies which were focused on the tribal society merely specifically studied tribal women. This study avails its relevance in the fact that it does not only focus on the ICT gap in tribal women’s society but also studies the implication of the digital gap on their socio-economic condition and their level of empowerment
241 Polycystic Ovary Syndrome: Effect of Inositols and Lipid Mediators. Pilot Study, García Manero Manuel; Ceamanos Montañes Carolina, Campo ;Ainhoa, Peru Gema
Objective: to evaluate the effect of the combination of inositiol derivatives and lipid mediators on the metabolic and inflammatory profile of women with polycystic ovary syndrome. Material and Methods: Experimental, prospective and longitudinal study carried out in patients diagnosed with polycystic ovary syndrome (Rotterdam criteria) without treatment or previous dietary intervention. The following nutritional preparations were administered orally daily: • Group A: 300mg D-chiro-inositol, 1099mg myo- inositol + 30mg lipinova • Group B: 4000 mg of myo -inositol + 30 mg of lipinova The metabolic profile is compared before and after 4 weeks of treatment in each patient, determining the insulin levels and the HOMA index. The inflammatory profile was analyzed by determining the levels of IL-6 before and after treatment. Results • 41 patients with polycystic ovary syndrome subdivided into 20 from group A and 21 from group B were studied. • Insulin levels before and after treatment were 17.9 +-9.3 SD and 10 +-4.09 SD, respectively, with statistically significant differences. • The HOMA index pre-treatment was 4.1 +-2.1 SD and 2.1+- 1.1 SD post-treatment, with significant differences • The level of IL-6 was pretreatment was 3.8 +- 1.5 Sd of 2.1 + -1.09 post treatment with significant differences Conclusion: The results of the study show the positive effect of the combined administration of inositolic derivatives and pro- resolution lipid mediators on the metabolic, clinical and inflammatory profile of patients with polycystic ovary syndrome
242 Health Insurance: Makes Safe Life and Saves the Life, Sunil Kulkarni*, Nilima Bhore and Manisha Kulkarni.
Nature is uncertain and unpredictable. The same is true with the life of an individual which is surrounded by risks and uncertainties in this volatile world. We spend money on many things, education, food, home, communication, recreation and so on. Have you thought on most vital for health and wealth topic of health insurance?
243 Innovative Therapeutic Strategies for the Treatment of Repeated Implantation Failure - An Update, Kulvinder Kochar Kaur*, Gautam Allahbadia and Mandeep Singh.
Inspite of the hurdles in evaluation of Recurrent implantation failure, there has been forward progression existent with regards to therapeutic strategies for aiding in these RIF patients. Of the maximum attractive approaches three like utilization of I) peripheral blood mononuclear cells (PBMC), ii) Subcutaneous administration of Granulocyte Colony –Stimulating Facto (G-CSF)r iii) Platelet rich plasma (PRP) hold major attraction. Here we have Concentrated mainly on these 3 innovative strategies besides detailing certain other immune therapies utilized in the past like Intrauterine Insemination of hCG, ii) intravenous immuoglobulins (IVIG), iii) intravenous intralipid as well as iv)heparin in addition to how they act.
244 Effectiveness of Structured Teaching Programme on Knowledge of Married Women Regarding Intra Uterine Devices, T Nagamani*, Rachel P George, P Venkata Suresh, K Sesha Kumar, P Bhargavi and PV Savitha.
India’s population, which crossed 1.21 billion in 2011, is projected to reach 1.53 billion by 2050, making it the most populous country in the world. Women of reproductive age group (15-45 years) make up approximately 248 million. The current strategy in Family Planning emphasizes importance on providing high quality contraceptive services among eligible clients on a voluntary basis. The main aim of the program is promoting adequate spacing of births and thereby promoting the health and wellbeing of the mother and child. India was the first country to launch a family planning programme in 1952. The gap between attitude towards the small family norm and knowledge and practice of family planning among Indian couple is intriguing. So this led the investigator for selecting this study on structrured teaching programme regarding Intra Uterine Devices, It was a Quasi-experimental one group pre-test and post-test study conducted in adusonnappanahalli community, Bengaluru. The sample size was 60, selected through convenient sampling technique. Among the 60 women 42(70%) of married women were having inadequate level of knowledge, 18(30%) of married women were having moderate knowledge regarding intra uterine devices before administering structured teaching programme. In post test, 52(86.7%) had adequate knowledge, 8(13.3%) had moderate knowledge and none of them had inadequate knowledge regarding intra uterine devices after the administration of the structured teaching programme.
245 Prevalence of Visual Acuity Among Adults (25 years) and Above in a Rural Community Area of Punjab, Palvi Bhunal and Raman Kalia*
Background: Vision is the main way of incorporation among the human being and the exterior surroundings. It consults to the means to recognize the shape and particulars of the things a person sees. Objectives: 1. To assess the prevalence of visual acuity among adults of selected community areas. 2. To determine the factors associated with low vision among study subjects. 3. To assess the visual function among adults of selected community areas. 4. To provide health education related to care of eyes using a pamphlet. Material and Methods: A ‘nonexperimental’ (Quantitative) descriptive design was used “to assess the prevalence of visual acuity among adults (25 years and above)”.The sample size was 200 adults from selected community areas. Samples were selected by convenience sampling technique. Snellen’s and E-chart was used for the evaluation of the ‘distance visual acuity’ and near vision chart (Snellen’s and E-chart) for testing ‘near visual acuity’. Assessment of factors associated with low vision, by interview method. Development of self-structured visual function questions for testing of visual function by interview method. Results: Analysis revealed that out of 200 subjects 57 subjects had distance visual impairment and 44 subjects had near visual impairment. From distance visual impairment of right eye of subjects there was only one significance associated with low vision and factors associated with it that is based on present eye disorder, from distance visual impairment of left eye of subjects there was only one significance associated with low vision and factors associated with it that is based on history of brain injury and other factors have no-significance associated with low vision and the factors associated with it at level of p < 0.05 level of significance. From near visual impairment of (right eye, left eye) of subjects there were no significance associated with low vision and the factors associated with it at level of p < 0.05 level of significance. Visual function question showed that 98.5% subjects had no visual function problem, 01.5% subjects had a little problems in visual function, and 00% subjects comes under cannot do at all. Conclusion: The conclusions were drawn on the basis of findings of the research. The results show that mainstream of subjects had normal vision but less than half of subjects had visual impairment which was associated with factors of low vision. Findings highlight the need for more intensive efforts to improve visual acuity so as to reduce the morbidity factors
246 The Experience of Being an Adolescent Mother of a High-Risk Newborn: Case Study, Jiménez-Quiroz Rosalía*, Toriz-Colín, María Fernanda, Conde-Reyes María de la Paz, Martínez de Roque Diana Cristina, Palencia-Romero Angélica, Ibarra Reyes Ma Del Pilar, Castro-Soto Laura and Guido-Campuzano Martina Angélica
Teenage pregnancy is considered a public health issue with high social impact. Mexico has the highest rates, ranking first place in the world. The implications on the lives of these women are diverse, affecting different areas of life. Objective: to learn about the experience of being an adolescent mother of a high-risk newborn. Methods: qualitative, descriptive, exploratory single case study with a categorical and phenomenological analytical strategy. The participant is a 20 year-old woman who became mother of twins at 17 years of age. A semi-structured interview was conducted and informed consent was obtained. The analysis consisted of the transcription and incoding of information. According to this the following analytical categories were obtained: perception of adolescent maternity, personal, familiar and social consequences, emotional sequelae, parenting and resignification of life. Conclusion: Adolescent mothers experience significant personal, social and family consequences upon motherhood. Further investigation is necessary regarding personal experiences in this population, in order to delve deeper into this problem. This will contribute to identifying modifications, meanings and guidelines that allow these mothers adapt to the conditions they are subjected to. Furthermore, this acknowledges the importance of support networks (in this case the family) for the restructuring and functioning of socioemotional development of the mother as well as her child.