Impact of yoga intervention on menopausal symptoms-specific quality of life and changes in hormonal level among menopausal women.

AIM: The menopause transition is experienced by women often involves troublesome symptoms due to changes in the level of reproductive hormones. Non-hormonal therapies are more commonly accepted by women than hormonal therapy for coping with the climacteric symptoms. The aim of the study was to evaluate the effects of yoga practice on menopausal symptoms, specific quality of life, and changes in hormonal levels among menopausal women. METHOD: A single-blinded randomized control trial was conducted among 80 participants aged 40 of 50 years and was randomly divided into two study arms, that is, Sudarshan Kriya Yoga (SKY) and brisk walking intervention, to find the effect on the hormonal changes and menopausal quality of life (measured by MENQOL tool). The significant improvements in the outcome measures were measured by using repeated measures analysis of variance and McNemar's test. RESULTS: Significant improvements in the menopausal-specific quality of life were observed in the domain of vasomotor, psychosocial, and physical symptoms (p < 0.05). The antioxidant enzymes (superoxide dismutase and glutathione peroxidase (GPX) were significantly elevated after 1 year of regular practice of SKY compared to walking intervention (p < 0.05). In contrast, no significant improvement was observed in follicle-stimulating hormone and dehydroepiandrosterone sulfate levels. The women reported no adverse events after SKY practice or brisk walking. CONCLUSION: The study concluded that 1 year of SKY practice could be one of the preferred non-hormonal, lifestyle-modifying regimens for improving the overall quality of life in menopausal women.

Prevalence and risk factors of obstetric fistula: implementation of a need-based preventive action plan in a South-eastern rural community of India.

BACKGROUND: The study was conducted to estimate the prevalence and risk factors of obstetric fistula in the rural area of the south eastern community of India and the training of community health workers for its prevention. METHODS: A population-based cross-sectional analytical study was conducted in the south eastern rural community of India. A total of 3939 women were included in the study and Probability proportional to size sampling was used in the study. Frequency distribution and logistic regression were computed to analyse the data using STATA version 11.2. RESULTS: Out of 3939 participants interviewed, 23.7% women reported obstetric fistula symptoms whereas after clinical diagnosis and speculum examination the obstetric morbidity pattern was: Obstetric fistula 0.3%, stress urinary incontinence 20.0%, pelvic inflammatory diseases 1.2%, uterine prolapse 1.4% and urinary tract infection 3.8%. The awareness level of the rural women regarding the obstetric fistula was assessed by a structured knowledge questionnaire and found to be very poor, hence community based fistula training was implemented among community health workers as a health system based strategy for its prevention. Obstetric fistula found to be more prevalent among women of poor educational level, low socioeconomic status, less no of antenatal visits, delay in accessing the emergency obstetric care and prolonged labour (p ≤ 0.05). CONCLUSION: Finding of the study indicated that the prevalence and risk of developing obstetric fistula was associated with less number of antenatal visits, prolonged labour, delay in timely intervention, delay in accessing emergency obstetric care and more number of movements from home to the delivery place. Finally, our study suggests that emphasis needs to be placed on training of community health workers to facilitate early screening for identification and referral of women with obstetric fistula.

Obstetric fistula: A challenge to public health.

Obstetric fistula (OF) is one of the most important consequences of a prolonged obstructed labor, a big issue for low-income countries (LICs) like India. The objective is to identify and explore the knowledge regarding OF as a public health problem in LICs from peer review literature. The PubMed, Google Scholar, and Science Direct databases were searched to identify the prevalence, risk factors, and management of OF in LICs. Quantitative evidence-based paper reviewed. Twenty-seven articles met the inclusion criteria. The 15 provided population-based OF prevalence data of OF and 12 provided risk factors and social causes of OF rates associated with the birth that caused an OF. OF has one of the big public health problems. There is a lack of scientific research on the prevalence and risk factors of OF in LICs. This review helps to eradicate or alleviate the problem of OF in LICs like India.

Impact of Community-Based Continuous Training on Promoting Birth Preparedness and Pregnancy Outcome in Rural Odisha, India: An Interventional Study.

BACKGROUND: Birth preparedness and complication readiness extends the maternal and neonatal health continuum of care and thus contributes to one of the important tools for pregnant women to experience better pregnancy outcome, strengthening family and community health, creating space for other interventions. The present study aimed to evaluate community-based birth preparedness and complication readiness training on pregnancy outcome. METHOD: The study adopted a quasi-experimental time series only one experimental design which was conducted in rural south-eastern India for 1 year among the reproductive age group 15-49 years (≤ 24 weeks pregnancy), and cases were followed up till postnatal period. A standardized birth preparedness assessment index (BPAI) was used to assess preparedness level of respondents. Community-based continuous training (CBCT) was introduced, and its effect was measured on birth preparedness level, involvement of family and their pregnancy outcomes. RESULT: CBCT interventional program was effective in promoting positive behaviors on birth preparedness and complication readiness as per BPAI: 13% of women were at level 1, 15% at level 2, 19% at level 3, 49% participants were at 4th level and 5% were at 5th level which represented the best level of preparedness for their present delivery. Pregnant mothers who completed their antenatal visits and were well prepared for delivery were found to be having two times favorable pregnancy outcome than those who had not (OR 2.79). CONCLUSION: BPCR intervention strategy can be utilized as a timely and effective community action plan for ensuring a favorable pregnancy outcome.