Context: Adnexal masses represent a spectrum of disorders arising from the ovaries, fallopian tubes, broad ligament and soft tissues surrounding the uterus. They can be classified as gynaecological or non-gynaecological, benign, borderline or malignant. Symptomatology of adnexal mass ranges from completely vague symptoms to acute abdomen hence early diagnosis and management can lead to favourable outcomes. Objectives: To study the clinical profile of post- menopausal women undergoing surgicalintervention for adnexal masses and to classify adnexal masses as benign and malignant based on clinical, biochemical and radiological criteria. Settings and Design: This is a retrospective study design carried out at a tertiary care rural medical college in Gujarat. Subjects and Methods: Data was collected from medical record files of all post-menopausal women admitted to our hospital for surgical management of adnexal mass. Clinical profile, radiological, biochemical and histopathological records of these patients were studied in detail. Statistical Analysis: Statistical programme used for analysis was STATA 14.2. Results: 16 patients fulfilled the inclusion criteria. About 13 patients with adnexal mass had presented with abdominal pain as chief complain. And 4 patients having post-menopausal bleeding. Most common site of origin of adnexal masses was ovary followed by fallopian tube. Most common adnexalmass on histopathological diagnosis was serous variety (9 cases, 56.25%) followed by mucinous cyst adenoma (3 cases, 18.75%), mature cystic teratoma (1 case, 6.25%), paraovarian cyst (1 case, 6.25%), hydrosalpinx (1 case, 6.25%), fibroma (1 case, 6.25%). Among 16 patients, 4 (25 %) patients were diagnosed with borderline or high-grade ovarian tumours. In the search of malignant adnexal mass Sensitivity of Ca125 (Cancer antigen- 125) was 75% and Specificity of Ca-125 was found to be 81%. Sensitivity of RMI (Risk of Malignancy Index) >100 was 75% and specificity was 75 while Sensitivity and Specificity of RMI>200 was 75% and 91% respectively.

Conclusion: Adnexal masses have been a challenge for the treating gynaecologist. Detailed history, clinical examination, biochemical markers & imaging gives a fair idea about the site of origin & also helps in differentiating benign from malignant masses. Ovarian origin of adnexal masses is the most common & majority of them are benign but a high index of suspicion should be kept for malignancy in case of post-menopausal age group. Ca-125 and RMI definitely helps to differentiate between benign and malignant potential.

Objective: There has been an interest in the relationship between ABO blood groups and infertility. We explored the relevance of blood type to ovarian reserve, as reflected by early follicular phase FSH levels The design: This study was a retrospective analysis of the association between ABO blood type and ovarian reserve and included 872 women at Basra teaching for Maternity and Childhood hospital and Al mawany teaching hospital / Iraq between 2013 and 2016. Methods: In this retrospective study, we analyzed basic characteristic and blood group data from 872 women who classified into 417 infertile women who were undergoing fertility evaluation at Basra teaching for Maternity and Childhood hospital, Basra speciality center for IVF between 2013 and 2016 fertility evaluation and 455womenwho visited the labor word at Al Mawany teaching hospital between 2013 and 2016. The patients’ age was procured just for those between 30 and 45 years of age. Early follicular phase serum FSH level (IU/L) was collected for infertile women then they were classified into the following two groups based on their S.FSH level: The diminished ovarian reserve group (S.FSH≥10 IU/L) and Non- diminished ovarian reserve group (S.FSH<10 IU/L). We analyzed the distributions of basic symptoms and different blood types within these two groups to investigate the association between the blood group and ovarian reserve. Results: among 872 women prevalence of blood groups according to the order of frequency was A (25.5%), B (28%), AB (15.9%) and O (30.6%).There was a statistically significantly higher percentage of blood group O among those with follicle-stimulating hormone (FSH) levels ≥ 10 IU/L compared with those with FSH levels <10 IU/L. Conversely, the women with blood groups A and B had a protective effect against diminished ovarian reserve; while blood group AB had no association with ovarian reserve. Conclusion: The O blood group appears to be associated with diminished ovarian reserve, whereas The A and B blood group appears to be protective for ovarian reserve. Further studies are needed to establish causality and identify the underlying mechanisms for the association.

Background: In the human, infertility is a serious reproductive health problem in the world and more than 15% couples are infertile. Male infertility is a highly complex phenomenon involving large number of factors including endocrine dysfunction, socioeconomic, lifestyle, use of alcohol, drugs, exposure with radiations, chemical (pesticides) and automobile fumes. The genetic factors like complex chromosome rearrangements (CCRs), microdeletion of Y-chromosome (AZF regions) and genes assigned on autosomal region of the chromosomes are also associated with male infertility. Objective: The role of Sycp3 gene mutation in infertile patients is not clear in Indian population. Therefore, the present study has been designed to evaluate the percentage frequency of synaptonemal complex protein-3 (Sycp3) gene mutation and simultaneously also assess the frequency of DNA copy number variations in nonobstructive azoospermic (NOA) cases. Materials and Methods: Genomic DNA was isolated followed by polymerase chain reaction (PCR) using two different sets of up and down stream amplicons, both from clinically diagnosed cases of NOA and controls of the same age group. Results: The present study shows mainly categorised, three type of Sycp-3 gene mutations i.e., the complete disappearance bands (absent), over expression and under expression. Interestingly, significant (p<0.05) individual variations were observed in the frequency (%) of complete disappearance (null) of 173bp (8.33%) and 568 bp (12.5%) amplicon followed by calculated value of odd ratio 6.45and 5.00 with confidence interval varies (C.I) at 95% interval 0.76-55.04 and 1.04-24.02, respectively in the cases of NOA when compared with controls. Similarly, the frequency of over expression (up regulation) in 173bp (5.55%) and 568bp (2.77%) amplicons were also showing significant variations (p<0.05). Further study was extended to calculate the DNA copy number variations, which again shows statistically significant differences (p<0.05) between NOA cases and controls. Conclusions. The present findings of Sycp-3 gene mutation using two different amplicons in cases of NOA concluded significant variations of Sycp-3 gene mutation of 568 bp amplicon along with DNA CNVs showing negative impact on spermatogenesis leading to male infertility.

Objective: The aim of this systemic review and meta-analysis was to examine the relationship between intestinal parasitic infection and anemia among pregnant women in Ethiopia. We include six studies in different regions of Ethiopia. We have done this study focusing on intestinal parasitic infection Materials and Methods: The databases searched were PUBMED and Advanced Google Scholar. on reference manager software reporting intestinal parasitic infection and anemia among pregnant women . Three researchers were carried out the data extraction and assessed independently the articles for inclusion in the review using risk-of-bias tool guided by PRISMA checklist. The combined adjusted Odds ratios (OR)) and 95% confidence intervals were calculated using random effect model Results: six observational studies involving 2838 participants, 557 pregnant women who have anemia were included. The combined effect size (OR) for anemia comparing pregnant women who have intestinal parasitic infection versus pregnant women women who did not have intestinal parasitic infection was 3.74 (ORMH = 3.74, 95% CI 2.58- 5.43) Heterogeneity: Tau² = 0.13; Chi² = 13.11, df = 5 (P = 0.02); I² = 62% Test for overall effect: Z = 6.94 (P < 0.00001) No publication bias was observed (Egger’s test: p = 0.074 , Begg’s test: p = 0.091 ). 23.99% (681) pregnant women have intestinal parasitic infection during current pregnancy In all studies, the proportion of anemia among pregnant women who have intestinal parasitic infection during current pregnancy was 227 (33.33%).

Conclusions: The likelihood of anemia among pregnant women is approximately four times higher among pregnant women who had intestinal parasitic infection than who did not have the infection in Ethiopia

Background: However, the placental growth depends on from SHP-2 protein, its main duty is still undefined. P38 MARK pathway is one of the main transducers within placental IGFs’ signal and is responsible for organogenesis and trophoblast differentiation. Objective: To define the activation of SHP-2 and p38 protein in post-term pregnancy placenta. Method: The protein concentrate from the placenta is defined through the BCA experiment kit and ELISA reader. SHP 2 protein and p-p38 protein activation are determined in normal and post-term pregnancy placental specimen using immunoblotting. Results: As a result of our study, we noticed that SHP protein synthesis increased unevenly in normal and postterm pregnancy. P38 protein phosphorus which is an inflammation transcription factor, is not determined in both pregnancy groups. Conclusion: SHP 2 protein synthesis is determined persistently in post-term pregnancy. P38 activation was detected in a placental tissue specimen.

Objective: To access the accuracy of visual inspection methods for diagnosing cervical dysplasia. Methods: This cross-sectional study was carried out between 1st December 2016 and 30th April 2017. All cases positive to Visual Inspections with Acetic acid (VIA) or with Lugol’s Iodine (VILI) as well as cases of macroscopic abnormal cervices, irrespective of the results of visual inspection, had a colposcopy-directed biopsy. Results: A total of 109 women out of 1127 screened for cervical dysplasia had both visual inspection and biopsy done. Te Sensitivity, Specificity, Positive predictive and Negative predictive values were 44.6%, 52.2%, 75% and 22.6% for VIA and 90.5%, 13.0%, 77.0% and 30% for VILI respectively. Conclusion: In our setting, the sensitivity of VILI in diagnosing cervical dysplasia is higher than that of VIA. Therefore, to reduce the rate of undiagnosed cervical dysplasia that might evolve to cancer, VILI should always be used in combination with VIA.

Background: Breastfeeding is a woman practice that usually feeds an infant with milk produced from the mammary glands of the nipple. Who described breastfeeding as an unparalleled way of infant survival, healthy growth, and development? We also recommend that you start breastfeeding within 1 hour of giving birth to your first milk. It promotes breastfeeding of the first milk and is not recommended for breastfeeding before the child. First, milk is 3 times richer in vitamin A and 10 times richer in mature beta-carotene. Objective: To assess the knowledge and practice of breastfeeding mothers of children under the age of 2 in Dilla Town, South Ethiopia, in 2020. Method: Cross-sectional community-based studies were used. The survey was conducted in the town of Dilla community and a sample size of 362 was used to collect the data. We performed this study using a simple random systematic random sampling technique and collected data from respondents using a structured, pretested questionnaire and an interview-guided method of data collection by the principal investigator. .. The data was entered and analyzed by manual aggregation method and frequency distribution tables, and some variables were described using static graphs. Results and discussion: A total of 362 women participated in the study in Dilla Town, and the effective rate was 100%. The average age of the study subjects was +27 years old, and about 136 (37.56%) were religious Protestants. Approximately 240 (56.3%) women had at least two children. This study shows that the largest proportion of research subjects have primary education level (28.17%), and their understanding of BF also depends on their education level. As the knowledge of breastfeeding improves, so does the level of education. Therefore, this research is consistent with the research conducted in developing countries. Conclusion: Mothers with an elementary level of education have lower breastfeeding practices than those with a higher education. A woman whose husband’s educated also influences the practice of breastfeeding. The higher the educational level of the husband, the more he practiced breastfeeding. Previous breastfeeding experience is helpful to facilitate the practice of breastfeeding.

Background: Ethiopia ratified its abortion law in 2005, primarily to reduce the incidence of unsafe abortion and the availability of safe abortion services has increased. However, service availability has not led to a significant reduction in unsafe abortion.
Aims: This study aimed to assess women’s perception about the accessibility of safe abortion care services at selected public institutions in Addis Ababa, Ethiopia.
Study design: Institution-based cross-sectional study was conducted.
Method: The study was conducted among 432 women of reproductive age at selected non- health sector public institutions in Addis Ababa, Ethiopia. Data were entered into Epi-data, cleaned, and exported to SPSS version 24.0 for data analysis. Data analysis involved descriptive statistics, independent-sample t-test, one-way analysis of variance (ANOVA), and linear regression. Statistical significance was set at 5%. To avoid issues associated with multicollinearity, we have checked to see if (a) the condition index was < 3, (b) that the variance inflation factors (VIF) were
< 5, and (c) tolerance was > 0.2.
Results: In this study, more than half (60.2%) of the participants reported that they had pregnancy at least once. Seventy-eight respondents (18.1%) had a history of previous miscarriage. Closely half of (46.2%) of the females who had miscarriage history were treated at governmental health institutions; followed by private clinics (35.9%) and
traditional methods (6.4%). Whereas, 11.5% of them did not get any abortion care service. There was a significant difference in mean scores of participants faced post-abortion complications and treated at the traditional healer, and particularly the respondents attended traditional healer makes the strongest unique contribution to explaining the perception score.
Conclusion: There is an urgent need for the government and other stakeholders to provide more awareness of the accessibility and advantage of safe abortion services in the community.

Introduction: Reproductive health and Family Planning (FP) services are a huge global concern especially in African countries where fertility rates are high. Many studies have acknowledged the critical role of men in increasing access to and utilisation of maternal health services
Methodology: It is an analytical cross-sectional study consisting of all consenting married men till the calculated sample size is achieved. Convenience sampling method was adopted. A self-administered semi structured questionnaire was developed and used to extract information from married men. A sample of about 15 questionnaires was pilot tested for the validity and reliability amongst the participants. SPSS version 23 was used for data entry and analysis. Approval was obtained from the research and ethics committee of the Nnamdi Azikiwe University Teaching Hospital.
Result: Findings from this study revealed that a birth spacing of 1-2 years among respondents was predominant (36.7%) and the desired number of children was between 3-4 and 1-2, with 68.3% and 20%, respectively. this study found out that most male respondents (86.7%) approve that their spouses use of family planning. The major reasons indicated by these men include that family planning is beneficial for birth spacing and avoiding unintended pregnancies.

Conclusion: The involvement of men in maternal health programs, globally, has been associated with positive reproductive health outcomes, such as increased contraceptive use and improved maternal health outcomes.

Objectives: This study demonstrates a short check laparoscopy (CL) following the vaginal hysterectomy (VH) in cases with known or suspected extrauterine pelvic pathology to detect and treat if any remnant pathology to fulfill the requirements of laparoscopy. VH is the least invasive and should be the preferred method of the hysterectomy. The vaginal hysterectomy may not be sufficient to surgically treat the high-level extrauterine pelvic pathologies in candidates with known or suspected extrauterine pelvic pathology.
Design: A prospective observational study was conducted on 169 cases from January 2019 through March 2020.
Participants/Materials, Setting, Methods: The study was conducted in a private setup. Consecutive candidates of the hysterectomy for benign indications with known or suspected extrauterine pelvic pathology such as chronic pelvic pain, dysmenorrhea, pelvic inflammatory diseases, previous pelvic surgeries, broad ligament fibroids, and adnexal diseases were recruited from January 2019 and to March 2020 for the study. Cases with uterine size above 16 weeks, associated ventrofixed uteri following previous CS, and associated prolapse uteri were excluded. Elected cases were allowed to undergo the below described CL following VH using electrosurgery. Preoperative,intraoperative and postoperative data were recorded and analyzed using descriptive statistics: percentage, mean, standard deviation, and 95% Confidence interval(CI).
The primary outcome of interest was to detect the remnant pathology following VH in these elected cases. Secondary outcomes of interest were laparoscopic operation time, and risk of CL following VH. 

Results: The check laparoscopy detected and surgically treated the vaginally unreached remnant extrauterine pelvic pathologies in 17.75% of cases. VH with additional surgeries was sufficient to surgically treat the vaginally reached extrauterine pathologies in the rest 82.24% cases. The mean laparoscopic operation time was 12.08±5.18(5-30) minutes (95% CI=11.29-12.87). The mean VH operation time was 75.81 ± 27.21(35-190) minutes (95% CI=71.99-79.95). The majority of vaginal work up to the level of adnexa and the minority of laparoscopic work above the level of adnexa minimised the laparoscopic time and minimised the risk of visceral injuries. There were no major perioperative complications.

Limitations: It requires a comparative study to compare the present VH plus CL with LAVH to access the benefit of the present approach.
Conclusions: A check laparoscopy following VH assists to find and treat the vaginally unreached high-up remnant pathologies in cases with known or suspected extrauterine pelvic pathology.Without CL,remnant pathologies will be retained in some of these patients. The CL assists a vaginal surgeon to complete the laparoscopic surgical requirements in these patients in a short laparoscopic operation time. Thus, VH plus CL was done in place of the direct laparoscopic hysterectomy in these cases. As a whole, a patient gets the benefit of least invasive VH by electrosurgery, and of less risky laparoscopy in this strategy. A comparative study of the present VH plus CL with LAVH in the future can ascertain the better clinical practice of the present approach.

Medical students suffer from stress during academic performance, and since stress negatively impacts various characteristics of the menstrual cycle, and reproductive health is an important indicator of a woman’s overall health, assessing such a phenomenon was of the utmost importance to carry out this study

Pain experienced during labor is probably the most painful event in the lives of women. Pain and stress resulting with stressful situations and factors that affect pain perception during labor. The purpose of this case study report was to assess the effect of LT on PP, effect on process labor, effects on baby after birth. LN Ebirim (2012) [1] state that the Lamaze technique, began as a prepared childbirth technique. The goal of Lamaze is to build a mother's confidence in her ability to give birth, through the providing LT to pregnant women understand how to cope with pain in ways that both facilitate labor and promote comfort, including relaxation techniques, movement and massage. Well planned intervention (LT) is given during 1st stage of labor ill the delivery of the baby. It shows that pain perception was moderate; mother looks relaxed during interval between contractions. As well as she was well active after the delivery of the baby no sign of exhaustion was seen. Baby was also active slept for 4-5 hours after taking 1st feed for 6-7 minutes