Vitamin D supplementation reduces risk of maternal comorbidities and helps improve neonatal outcomes.

INTRODUCTIONMenstrual irregularities affect 2-5% of childbearing women, a number that is considerably higher among females under constant stress during a cycle [1]. A woman's menstrual cycle typically follows a 28-day cycle and ends with the shedding of uterine lining leading to bleeding. The normal menstrual cycle indicates the proper functioning of hormones, having a normal menstrual cycle signifies a healthy hypothalamo-pitutary axis with a normal uterus. However, a number of conditions such sudden weight loss, over-exercising, medical conditions and even stress can interfere with a woman's ability to experience a normal menstrual cycle. Both longer duration of menstrual bleeding and cycle irregularity are associated with major depression.Although there appears to be a relationship between the type and severity of the stress and the proportion of women who develop menstrual problems, in practice it is difficult if not impossible to identify a threshold at which stress will interfere with the normal cycle. The individual response to abnormality in body function is heightened due to psychobiological characteristics [2][3]. This study was planned to establish a correlation between the levels of perceived stress and its effect on the menstrual cycle. MATERIALS AND METHODSThis cross-sectional study was conducted in the undergraduate girl's hostel of a medical college. Hundred female students aged above 18 years were the target population of the study. The students with current medical, psychiatric or gynaecological problems like pregnancy and amenorrhea were excluded from the study.The participants were given liberal verbal explanations plus description letters about the topic and the aim of the study with attached consent forms. After the students had duly signed the consent form, a questionnaire along with the PSS (available freely online) [4] and PBAC (prior permission taken) [5] was provided to them.The questionnaire dealt with anthropometric data, lifestyle, menstrual history, and menstrual health status. Body Mass Index (BMI) was calculated using self-reported data on height and weight. The students were then asked to record their menstrual pattern on the PBAC for the next menstrual cycle and fill the PSS for the month. Based on the answers, PSS was calculated for each participant.The PSS is the most widely used psychological instrument for measuring the perception of stress [4]. It is a measure of the degree to which situations in one's life are appraised as stressful. Items were designed to tap how unpredictable, uncontrollable, and overloaded respondents find their lives. The scale also includes a number of direct queries about current levels of experienced stress. The questions in the PSS ask about feelings and thoughts during the last month. In each case, respondents are asked how often they felt a certain way. 5, 7, & 8) and then summing across all scale items. The subjects who scored ≤20 on the PSS were categorized to have low stress levels, while subjects with score >20 were categorized to have hig...

ObjectivesSelf-collected vaginal swabs can facilitate diagnosis of vaginal discharge (VD) in resource-limited settings, provided reliability of the method is established. The aim of this study was to evaluate the concordance between self-collected and physician-collected vaginal swabs for aetiological diagnosis of VD and to determine the prevalence of bacterial vaginosis (BV), vulvovaginal candidiasis (VVC) and trichomonas vaginitis (TV).MethodsA total of 550 females (median age: 32 years; range: 18–45 years) attending two sexually transmitted infection/reproductive tract infection (STI/RTI) clinics with VD from January 2015 to May 2016 were included in the study after obtaining written informed consent. Swabs were self-collected by patients after instructions and subsequently by a physician under speculum examination. Samples were processed for standard bedside tests, Gram staining, wet mount and culture (gold standard) according to the national guidelines. Concordance between the two methods was determined by the Cohen’s kappa value.ResultsBV, VVC and TV were diagnosed in 79 (14.4%), 144 (26.2%) and 3 (0.5%) patients, respectively. VVC coexisted with BV in 58 (10.5%) patients. There was no coinfection of TV with BV or VVC.Candida albicanswas isolated in 84 (58.3%) VVC cases. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of self-collected swabs for diagnosing BV was 91.1%, 100%, 100% and 98.5%, respectively, while for theC. albicansVVC and TV, sensitivity, specificity, PPV and NPV all were 100% as compared with physician-collected swabs. Highly concordant results were obtained between two methods by the Kappa values of 0.95 (BV), 0.99 (VVC) and 1.0 (TV).ConclusionThe comparative performance of self-collected and physician-collected vaginal swabs establishes self-collection of samples for BV, VVC and TV as a viable alternative tool in the management of STIs/RTIs, especially in peripheral and resource-constrained settings. This would be effective in implementing the diagnostic approaches for STIs/RTIs in community-based surveillance studies at national or regional level and therefore strengthening the National STI/RTI Control Programme.

Visualisation of strings after postplacental vaginal insertion is more common than after intra-caesarean insertion. Pelvic ultrasonography can be used to verify the presence of the device in cases of missing strings.

No abstract