Effect of Absenteeism on Student's Performance in Different Components of Examinations - A Comparison of Online Verses Offline Teaching.

Background: The In online learning, more responsibility is shifted towards students in learning according to their needs. However there is a need to assess which component of teaching can be shifted online for future hybrid teachings. Objective: This study aims to compare the students' performance in difference components of the exams and compare them in online vs offline. Methods: It was a quantitative study comparing onsite and online groups academic performance in individual components of assessment for a duration of 6 months. Estimates were reported per standard deviation (SD) increase or decrease. Taking absenteeism rate as a predictor, models with group and gender on their own was fitted in univariable models, before including all three predictors (absenteeism rate, group and gender) in the final model. Results: Students who studied online, had a 0.49SD higher grade than their counterparts who attended physically (p < 0.001), each SD increase in the absenteeism rate was associated with a 0.26SD lower overall score, and this was significant, p < 0.001. While comparing both groups in MCQ part students who studied online, had a 0.6SD higher grade than their counterparts (p < 0.001), also in continuous assessment students who studied online, had a 0.49 SD higher grade than their counterparts who attended physically (p < 0.001). Conclusion: Positive effect of the online teaching was clear in the (MCQs) and the final result, while no significant gender variation detected in this study.

Follicle Stimulating Hormone (LH: FSH) Ratio in Polycystic Ovary Syndrome (PCOS) - Obese vs. Non- Obese Women.

INTRODUCTION: Polycystic Ovary Syndrome (PCOS), the most common endocrinological problem among women in the reproductive age, is characterized by chronic ovulatory dysfunction, hyperandrogenism, and raised Luteinizing hormone : Follicle Stimulating Hormone (LH:FSH) ratio. Obesity and insulin resistance have been linked to PCOS. However, there is recently a growing population of thin, lean women who are diagnosed with PCOS. AIM: This study aimed to compare normal and high Body mass index (BMI) women with PCOS and to investigate the correlation between BMI and LH/FSH ratio. METHODS: It was a case -control study at the Department of Obstetrics and Gynaecology, Qassim University clinic, Saudi Arabia. Women with PCOS were included in the study and were classified according to their BMI. Their computerized records were retrieved for the demographic, clinical, and laboratory data. The study groups were compared by the t-test and the Spearman correlation between BMI and LH/FSH ratio was calculated. RESULTS: A total of 63 women were included in this study (normal BMI group: n=30, and high BMI group: n=33). There was no difference between the two groups in terms of the LH/FSH ratio (2.76 vs. 2.79, P=0.48). There was no significant correlation between BMI and LH/FSH ratio, prolactin, or Thyroid stimulating hormone (TSH ) levels (Spearman correlation with P>0.05). CONCLUSION: The data suggests that the body mass index was not correlated with increased LH/FSH ratio. Since LH/FSH ratio was the same in normal BMI women, healthcare professionals need to think about ways to normalize this ratio beyond weight reduction.

Association Between Maternal Obesity and Cesarean Delivery Complications.

Background Several studies suggest that maternal obesity might be associated with intraoperative and postoperative complications of cesarean delivery. However, these results are not validated in the Pakistani population. Aim We aimed to assess the association between maternal obesity and intraoperative and postoperative complications of cesarean delivery. Methods We performed a retrospective observational study recording the prevalence of intraoperative and postoperative complications in women undergoing cesarean delivery. For all consecutive cesarean deliveries in Fehmida Sarfaraz hospital, Sialkot, Pakistan, we recorded the data of the maternal age, weight, body mass index (BMI), gestational age at delivery, intraoperative and postoperative complications, and the adverse pregnancy outcomes. We used the chi-square test, Spearman correlation, and linear regression to test the relationship between the study variables. Results We included 245 women in this study (non-obese group: n = 83; obese group: n = 162). BMI positively correlated with the incidence of deep venous thrombosis (DVT; r = 0.249), endometritis (r = 0.148), pyrexia (r=0.139), and wound infections (r = 0.155). Also, BMI could significantly predict DVT (Beta coefficient 2.886, P = 0.003), hospital stay (Beta coefficient 0.801, P = 0.001), pyrexia (Beta coefficient 0.819, P = 0.003), and wound infection (Beta coefficient 0.449, P = 0.049). Conclusion Our data suggest that BMI was significantly correlated with several cesarean section (CS) delivery complications. Obese women undergoing CS delivery are at higher risk of several CS delivery complications. Also, they had a longer hospital stay and higher birth weight for their neonates compared with non-obese women. Future multicentre studies are needed in our population to determine the magnitude of risk across different BMI subgroups.

The Relationship Between the Weight of the Placenta, Body Mass Index and Fetal Birth Weight Among Sudanese Women.

Introduction: Accurate estimation of fetal birth weight is essential for the management of labor and delivery. The predictability of fetal weighs by clinical assessment and ultrasound is limited. Aim: The study aimed to evaluate the association between fetal birth weight and placental weight and other demographic characteristics. Methods: a total of 369 live born of a singleton term pregnancies (37 to 42 weeks gestations) were included in the study. Immediately after delivery, the placenta was weighed with cord and membranes. A linear regression was used to examine the effect of placental weight and other variables on fetal birth weight. Results: The mean of birth weight was 3122.5±477.8 grams. Placenta weight had a mean of 556.92±112.488 grams. The mean gestational age was 39.0543±.89642 weeks. The association between the placental weight and the birth weight was significant, and we found that for each gram increase in placental weight, birth weight is increased by 2.848g (SE = 0.178, p < 0.01). Similarly, there was a significant association between placental weight and fetal birth weight, and we found that for each kg increase in maternal weight, birth weight is increased by 17.018 g (SE = 5.281, p =0.001). Conclusion: Placenta weight and BMI are independent predictors of fetal birth weight.

A Cross-sectional Study of the Myths Regarding Room Ventilation in Puerperium Among Saudi Women.

Background Despite the advances in medical health care services, people still believe and follow their traditions. Some of the traditional postpartum practices are harmful to women's health contrary to the common belief. The objective of this study is to investigate the prevalence of myths regarding room ventilation (MRV) among Saudi women.  Methods We conducted an observational cross-sectional study on 355 women in the postpartum period from the outpatient clinic of Mother and Child Hospital (MCH), Al-Qassim, Saudi Arabia. The investigators interviewed all the study participants to fill the proformas and collect all the study data. We analyzed the study data to estimate the prevalence of MRV in our sample as well as the factors associated with MRV. Results Most of our study participants were above 30 years (45%), multigravida (85%), and went through a cesarean section (78%). There was a significant association between MRV and education (P<0.001), occupation (P<0.001), and parity (P<0.001) but not with age (P=0.136). The prevalence of MRV dropped from 80% in women who had primary education only to 13% in women who had high school and college education. Also, it differed according to the participant's occupational status. MRV was prevalent in 56% of housewives vs. only 17% of the employed women. Moreover, it showed a substantial change with parity status. MRV increased from 23% in primiparous to 53% in multigravida. Conclusion Our results showed that the MRV is highly prevalent in the Saudi Arabia community and higher levels of education were negatively associated with the beliefs in the MRV. These findings highlight the importance of proper health education of pregnant women as well as the need for a prompt response from the Ministry of Health towards the MRV to eliminate it and spread the proper postpartum health care practices.

Intrapartum Fetal and Maternal Complications in Low-Risk Pregnancy: Experience of a Tertiary Hospital in Low-Income Countries.

AIM: To determine the frequencies of intrapartum fetal and maternal complications in women without the identified prenatal risk factor. METHODS: We conducted a prospective cross-sectional investigation from January to June 2017 at Khartoum North Maternity Hospital in women categorised pregnancies as low risk (no prenatal risk factors). We evaluated adverse intrapartum fetal and maternal outcomes. RESULTS: Among 600 pregnancies, of these, 12.5% (n = 75) developed fetal or / and maternal complications. The Frequency of primary cesarean delivery, forceps, and ventose among low-risk pregnancies in this study were 16%, 3%, and 2% respectively. Other adverse pregnancy outcomes were PPH (5%), Blood transfusion (4.5%), admission to ICU (1.8%), while perineal tear, cesarean hysterectomy, and re-laparotomy have equal weight (0.3%). Among all births, the most common adverse fetal outcomes were birth asphyxia (3.8%), low birth weight (2%), admission to the neonatal intensive care unit (1.8%), and fresh stillborn babies (1.3%). CONCLUSION: Of all low-risk pregnancies, 12.5% were reported to have serious obstetrics and neonatal complications. This information is essential for evaluating resources in delivery centres and hospitals and to provide equipment and further training of medical personnel to provide optimal quality care and patient safety.

Impact of Maternal Obesity and Mobile Phone Use on Fetal Cardiotocography Pattern.

BACKGROUND: The fetal heart rate (FHR) is a good marker of fetal well-being during labour. Cardiotocography is used to record the FHR and uterine contractions and can detect possible fetal hypoxia. Mobile phones use, and obesity is suggested to influence the FHR and cardiovascular development. AIM: The present study aimed to study the differences in FHR pattern between fetuses of obese vs non-obese groups when using a mobile phone. METHODS: We conducted a clinical trial to test the impact of mobile phone use on FHR using a single mobile phone with Specific Absorption Rate rating of 0.99 W/kg for 10 minutes. Data from this clinical trial were analysed to compare the FHR pattern between fetuses of obese women (exposed group) vs those of non-obese women (control group). The two study groups (obese vs non-obese) were compared regarding four. FHR PATTERNS: baseline FHR, variability, acceleration and deceleration scores. Data were analysed by SPSS software version 23.0 using the independent-samples t-tests. RESULTS: Sixty-nine women were included in the final analysis (obese group: n = 22 and non-obese group: n = 47). Fetuses of the obese women had significantly higher baseline FHR and less FHR variability scores when compared with fetuses of the non-obese women (mean difference 2.9 and 3.18, respectively). CONCLUSION: Fetuses of obese women had abnormal FHR pattern compared with fetuses of non-obese women. The use of mobile phone slightly influenced the FHR variability score. These results highlight the importance of proper management of obesity in women within the childbearing period.

Efficacy of Foley's Catheter and the Effect of Histopathology, Age and Endometrial Thickness Relative to the Measured Outcomes in Menorrhagia.

INTRODUCTION: Menorrhagia adversely affects the quality of life. Hysterectomy is the definitive treatment for menorrhagia however, a number of conservative alternatives are available. AIM: Hysterectomy is the definitive treatment for menorrhagia however, a number of conservative alternatives are available. A thermal balloon is an effective but costly option. We used a Foley's catheter as an alternative to commercially available thermal balloons. If effective, it will provide a cheap alternative to the thermal balloon. MATERIALS AND METHODS: A Foley's catheter was placed in the uterine cavity for 10 minutes using 0.9% saline. The measured outcomes were amenorrhea, eumenorrhea, oligomenorrhea or failure of the therapy. Endometrial thickness, age and endometrial biopsy results were also measured to determine if these variables had any effects on the outcome. RESULTS: Out of the total 42 participants, nearly half had amenorrhea (42.9%, n=18). Furthermore, 28.6% had oligomenorrhea (n=12) and 26.2% experienced eumenorrhea (n=11). Only one participant failed to respond (2.4%, n=1). There were no differences in outcomes between the different forms of histopathology. This means that thermal balloon therapy is effective in causing amenorrhea. No significant relationships existed between participants' measured outcomes and a model containing predictor variables (age and endometrial thickness), R=0.313, R2=0.098, p=0.141. CONCLUSION: A Foley's catheter is effective with reasonable measured outcomes in cases of menorrhagia.

URINARY PROBLEMS AMONGST GYNECOLOGICAL CONSULTATIONS. ASSOCIATION BETWEEN PROLAPSE, GYNECOLOGICAL SURGERY AND DIABETES.

BACKGROUND: Urinary incontinence is the inability of a woman to maintain bladder control. Symptoms range from urgency, frequency, nocturia to urge incontinence (1). It limits functional and social activities and leads to depression and social withdrawal. (2). This observational study aimed to describe the common urinary problems amongst gynecological consultations. It also describes the relationship of urinary incontinence with history of diabetes, previous gynecological surgery and prolapse. METHODS: The study was conducted as a descriptive cross sectional study from Jan-May 2015 at Qassim University Clinic, Buraidah. Women with urinary problem and those without urinary problems were compared for risk factors including diabetes, prolapse and previous gynecological surgery. The Statistical Package for the Social Sciences 22 (SPSS 22) was used to conduct proportion z-tests to determine the association of prolapse, gynecological surgeries and diabetes with urinary incontinence. To test the hypothesis, differences between two groups on the aforementioned factors were examined. The groups included participants that reported having urinary problems (n = 111) and those who do not have urinary problems (n = 100). RESULTS: The most frequent complaints of participants with urinary problems were urgency (n = 66, 59.46%), Stress incontinence (SI) (n = 65, 58.56%) and frequency (n = 62, 55.86%). For participants with a urinary problem, 89.19% have not had a gynecological surgery (n = 99) and the remaining 10.81% of participants had a gynecological surgery (n = 12). For participants without a urinary problem, 97.0% have not had a gynecological surgery (n = 97) and the remaining 3.0% had a gynecological surgery (n = 3). For participants with a urinary problem, 72.97% did not have diabetes (n = 81) and the remaining 27.03% of participants did have diabetes (n = 30). For participants without a urinary problem, 92.0% did not have diabetes (n = 92) and the remaining 8.0% did report having diabetes (n = 8). For participants with a urinary problem, 91.89% had not experienced a prolapse (n = 102) and the remaining 8.11% of participants had experienced a prolapse (n = 9). For participants without a urinary problem, 98.0% have not experienced a prolapse (n = 98) and the remaining two participants had experienced a prolapse. CONCLUSION: Gynecological conditions such as prolapse of the uterus, surgery involving the pelvic floor as well as medical conditions such as diabetes mellitus are some of the key risk factors for urinary incontinence. Therefore control of these risk factors can avoid development of urinary incontinence. Bladder retraining, Kegel exercises, drinking of less fluids are some of the preventive measures to avoid development of this embarrassing condition.

Urinary Problems Amongst Gynecological Consultations. Association Between Prolapse, Gynecological Surgery and Diabetes.

BACKGROUND: Urinary incontinence is the inability of a woman to maintain bladder control. Symptoms range from urgency, frequency, nocturia to urge incontinence (1). It limits functional and social activities and leads to depression and social withdrawal. (2). This observational study aimed to describe the common urinary problems amongst gynecological consultations. It also describes the relationship of urinary incontinence with history of diabetes, previous gynecological surgery and prolapse. METHODS: The study was conducted as a descriptive cross sectional study from Jan-May 2015 at Qassim University Clinic, Buraidah. Women with urinary problem and those without urinary problems were compared for risk factors including diabetes, prolapse and previous gynecological surgery. The Statistical Package for the Social Sciences 22 (SPSS 22) was used to conduct proportion z-tests to determine the association of prolapse, gynecological surgeries and diabetes with urinary incontinence. To test the hypothesis, differences between two groups on the aforementioned factors were examined. The groups included participants that reported having urinary problems (n = 111) and those who do not have urinary problems (n = 100). RESULTS: The most frequent complaints of participants with urinary problems were urgency (n = 66, 59.46%), Stress incontinence (SI) (n = 65, 58.56%) and frequency (n = 62, 55.86%). For participants with a urinary problem, 89.19% have not had a gynecological surgery (n = 99) and the remaining 10.81% of participants had a gynecological surgery (n = 12). For participants without a urinary problem, 97.0% have not had a gynecological surgery (n = 97) and the remaining 3.0% had a gynecological surgery (n = 3). For participants with a urinary problem, 72.97% did not have diabetes (n = 81) and the remaining 27.03% of participants did have diabetes (n = 30). For participants without a urinary problem, 92.0% did not have diabetes (n = 92) and the remaining 8.0% did report having diabetes (n = 8). For participants with a urinary problem, 91.89% had not experienced a prolapse (n = 102) and the remaining 8.11% of participants had experienced a prolapse (n = 9). For participants without a urinary problem, 98.0% have not experienced a prolapse (n = 98) and the remaining two participants had experienced a prolapse. CONCLUSION: Gynecological conditions such as prolapse of the uterus, surgery involving the pelvic floor as well as medical conditions such as diabetes mellitus are some of the key risk factors for urinary incontinence. Therefore control of these risk factors can avoid development of urinary incontinence. Bladder retraining, Kegel exercises, drinking of less fluids are some of the preventive measures to avoid development of this embarrassing condition.

Relationship between mode of delivery and development of urinary incontinence: A possible link is demonstrated.

BACKGROUND: Urinary incontinence is a major problem faced by many mothers and has been traditionally linked to diverse ways of delivery. However, there is still a lack of clinical data, which can corroborate this notion. Thus, the present study was conducted to evaluate the correlation of urinary incontinence developed in women under different modes of delivery that have been used during childbirth. The study was conducted by considering three ways of delivery such as vaginal, cesarean section and the use of instruments during childbirth. The results were compared in each group in terms of number of women that developed or experienced urinary incontinence with those who have no problem at all or have minor problems. METHODS: The study was conducted at Qassim University Clinic, and Maternity and Child Hospital Buraidah from Jan-May 2015 as a descriptive cross sectional study. The objective was to determine the core reasons as to why women tend to develop some urinary incontinence after delivery. First 111 women without urinary incontinence and 100 women with urinary incontinence were asked retrospectively about the number of vaginal deliveries they had underwent. Then another group (111 without urinary incontinence and 100 with urinary continence were asked about the number of instrumental deliveries they had undegone. The same was repeated (111 women without urinary incontinence and 100 with urinary incontinence) for women with cesarean section. RESULTS: Having five or more vaginal births had a significantly (p<0.001) high risk for development of urinary incontinence (n=74, 66.67%) as compared to no urinary incontinence (n=8, 8.0%). In the group who had no cesarean section, there was a significantly (p <0 .001) larger proportion of participants with urinary problems (n = 100, 90.09%) than those without urinary problems (n = 61, 61.0%). For participants who have had an instrumental delivery, there was a significantly (p =0 .014) larger proportion of participants with urinary problems (n = 22, 19.82%) than those without urinary problems (n = 8, 8.0%). However, for participants that have not had an instrumental delivery, there was a significantly larger amount of participants without urinary problems than those with urinary problems (p <0 .001). CONCLUSION: Women with 5 or more vaginal deliveries as well as instrumental deliveries were more liable to develop urinary incontinence in this study. This may be because vaginal deliveries and instrumental deliveries lead to perineal damage. This is further supported by the results of this study showing that women who never had cesarean section were more likely to report urinary incontinence.

Effect of Age, Educational Status, Parity and BMI on Development of Urinary Incontinence - a Cross Sectional Study in Saudi Population.

BACKGROUND: The research article looks at the background of women with urinary incontinence and exposed to different demographic factors. Women who had urinary incontinence and women without urinary incontinence were compared with regards to their demographic features and risk of development of urinary problems. These risk factors can either cause short term or temporary urinary incontinence or they can cause long term or permanent urinary incontinence. This article explores the association of age, educational status, body mass index (BMI) and parity on the development of urinary incontinence. AIM OF STUDY: This study aimed at conducting an analysis into the risk factors that are related to urinary incontinence. RESULTS AND ANALYSIS: Z-tests were conducted for every demographic factor and the results are then discussed comprehensively citing various studies that have been conducted before. Analysis shows that age and BMI increase chances of urinary infection and consequently urinary incontinence. Women of lower educational levels record more cases of urinary incontinence due to lack of general information about the condition. Women with higher parity levels also record more cases of urinary infections and subsequently urinary incontinence. CONCLUSION: From the analysis above, it can be seen that these factors usually play great roles in the existence and absence of urinary incontinence especially in women in Saudi Arabia. Most important is that, its prevention is mostly by use of the risk factors mentioned here in the research. This will usually involve observing a given risk factor to a state that makes it unfavorable for urinary incontinence to occur.

Rates and indicators of Continuous Electronic fetal monitoring - A study from Saudi Arabia.

BACKGROUND: This observational study aimed to describe the rates and indicators for continuous electronic fetal monitoring (EFM) during normal labour and to compare them between women who have had one pregnancy (PG) and women who have already delivered two or more children (G2 and above). METHODS: The study was conducted at Mother and Child Hospital, Buraidah from July-Sept, 2013 as a descriptive cross sectional study. RESULTS: Seventy four percent of labouring women had EFM and 25.7% had intermittent auscultation. Amongst the EFM group 62% were Primigravidas and 37.9% were multigravidas. When compared between PG and multigravidas, maconium staining (14.18vs 1.22, p value=0.001), maternal concerns for fetal heart rate (14.93 vs 6.10 p value=0.049), and syntocinon usage (14.18 vs 2.44 p value=0.005) were significantly prominent indications for Primigravidas. However trial of scar (0.00vs 15.85 p value <0.001) and associated medical problems (6.72 vs 19.51 p value 0.004) were the most frequent indications for G2 and above. For a large population of women including 13 PG and 18 Multigravidas (Overall 14.3%) there was no particular indication assigned for EFM and this was more frequent amongst Gravida2 and above (P < 0.013). CONCLUSION: Electronic fetal monitoring is a very common obstetric intervention. It remains a challenge to review its rates and indications in order to identify areas that needs improvement.

Rates and Indicators for Episiotomy in Modern Obstetrics - a study from Saudi Arabia.

BACKGROUND: This observational study aimed to describe the rates and indicators for practice of episiotomy during normal labour and to compare them between women who have had one pregnancy (PG) and women who have already delivered two or more children (G2 and above). METHODS: The study was conducted at Mother and Child Hospital, Buraidah from October- December 2013 as a descriptive cross sectional study. RESULTS: Overall rate of Episiotomy was 51.20%. Amongst the Primigravidas all went through episiotomies however in G2 and above only 7 patients (4.69%) delivered with episiotomy. Proportions tests revealed that there were significant differences between gravidity groups on two indications of episiotomy (vaginal breech p <0.001 and previous history of perineal tear p < 0.001). G2 and above had episiotomy for breech delivery (1 of 7 = 14.29%) significantly more often than PG participants (0 of 142 = 0.0%). And G2 and above participants experienced episiotomy for previous perineal tear (2 of 7 = 28.5% as compared to none in PG No other significant differences were found on indications of episiotomy. CONCLUSION: Episiotomy is a very common obstetric intervention (51.20%). The PG experience episiotomy significantly more often than G2 and above women. Efforts should be made to reduce its rates. This can be done by reviewing the indications and rates at repeated intervals and setting guidelines for these indications.

Rates and indicators for amniotomy during labor--a descriptive cross sectional study between primigravidas and gravida 2 and above.

BACKGROUND: Artificial rupture of membranes (Amniotomy) is a common obstetric intervention. Its rates and indications had been subjected to criticism in medical literature. The current practices recommend to reduce its rate and keep the birthing process as natural as possible. AIM: This observational study aimed to describe the rates and indicators for practice of artificial rupture of membranes (Amniotomy) during normal labor and to determine if any significant differences existed between women who have had one pregnancy (PG) and women who have already delivered two or more children (G2 and above) on this obstetric interventions: artificial rupture of membranes (ARM). RESULTS: There were no PG participants with ruptured membranes whereas slightly more than half of the G2 and above participants (n = 88) had ruptured membranes. The most frequent cause for ARM was active management of latent phase of labor (PG n = 20 and G2 and above n = 9). Furthermore, slow progress of labor (PG n = 17 and G2 and above n = 7) and concerns with fetal heart rate (PG n = 13 and G2 and above n = 5) had the next highest number of occurrences. Results from the proportions tests revealed that there was one significant difference between gravidity groups on the frequency of APH (p = 0.039). That is, G2 and above participants had amniotomy done for APH (5 of 32 = 15.63%) significantly more often than PG participants (4 of 89 = 4.49%). And although not statistically significant (p = 0.084), there were 21 cases within the PG group where ARM was performed for no specific reason (21 of 89 = 23.6%) compared to three cases within the G2 and above group (3 of 32 = 9.4%). CONCLUSIONS: Although ARM is a commonly performed procedure during labor, there is not much difference between its indications between PG and G2 and above. The only significantly different indication was antepartum hemorrhage which was higher in G2 and above. Amniotomy was also performed without any clear indication in 26.4% of PG and 9.4% of G2 and above. Considering ARM as obstetric intervention efforts should be done to reduce its rates. There is a need for arranging normal labor workshops to revise the indications and reviewing the rates after these workshops to reduce the rates of ARM.

Demographic factors and determinants of physical activity and breast feeding practices during puerperium in saudi women.

AIM: This cross-sectional study describes the practice of different myths regarding newborns and maternal physical activity among Saudi women during puerperium. MATERIAL AND METHODS: The study was conducted at Mother and Child Hospital, Buraidah from January to December 2011. RESULTS: The multinomial logistic regression (MRA) on age, education, occupation, parity and mode of delivery was statistically significant (χ(2) (60) = 487.656, p < .001). Individuals who were between 25 and 30, had education level primary or below, para2 -4 were more likely to limit household activities. Women in the age group of 25-30 were 41 times more likely to have no exercise. Women with parity 2-4 were 24 times more likely to abstain from sex during puerperium as compared to Para 5 and above. Individuals who had a normal vaginal birth were approximately 9 times less likely to be in the kofalaya's group. Individuals below college level education were more likely to believe that breast feeding in front of others may steal mother's milk. Women below 25 years of age and women with vaginal delivery were more likely to avoid colostrums feeding. CONCLUSION: Health Education programs are needed to encourage women to increase physical activity during puerperium and encourage breast feeding. Focus groups for improving physical activity should include age group 25-30 and women with primary and below level education. Women with cesarean delivery should be counseled against kofalayas and women with vaginal delivery should be encouraged for colostrums feeding.

Dietary practices of Saudi women during puerperium.

AIM: Poor maternal health sometimes can be a consequence of practicing different myths during puerperium. This cross-sectional study describes the practice of different myths regarding diet among Saudi women. MATERIAL AND METHODS: The study comprised women attending the postnatal clinic at the Mother and Child Hospital in Buraidah from January to December 2011. RESULTS: Almost 65.9% of women were using a combination of herbs such as ginger (zingiber officinale), hilba (fenugreek) and black seeds (nigella sativa). The multinomial logistic regression of herbs on age, education, occupation, parity and mode of delivery was statistically significant (χ² [48] = 214.645, P < 0.001). Hilba was more commonly used by women with instrumental delivery. It was common for women to avoid different fruits and vegetables (33.89%). Eggs were avoided by 16.5% of women and 11% avoided cold drinks. The multinomial logistic regression of diet on age, education, occupation, parity and mode of delivery was statistically significant (χ² [72] = 389.861, P < 0.001). Individuals below college level education were more likely to avoid fruits, vegetables and cold drinks in their diet. CONCLUSION: Health education programs are needed to improve knowledge about dietary malpractices during puerperium. This may help eliminate myths regarding avoidance of certain dietary components.

Co-infection with Toxoplasma gondii and Clostridium perfringens in a postpartum woman with uterine gas gangrene: a case report.

Toxoplasmosis is a protozoan infection caused by Toxoplasma gondii. We report a case of Toxoplasma gondii and Clostridium perfringens co-infection complicating uterine gas gangrene following a term pregnancy. The histological examination of the necrotic uterine tissues and uterine swab cultures obtained at laparotomy revealed T. gondii and C. perfringens, respectively. Treatment was administered with bactericidal activity against both pathogens and the patient had an uneventful post-operative recovery. Although there have been some cases that have documented an association between toxoplasmosis and non-uterine C. perfringens infection, such a relationship has not been established. It is of interest to determine if the presence of both organisms can explain the severe myonecrosis that occurs in some cases of uterine gas gangrene.

Cutaneous Manifestations of Hypothyroidism amongst Gynecological consultations.

OBJECTIVES: Many of the signs of hypothyroidism, affect the skin as well as the genital system of affected female cases. The aim of this study is to highlight the presenting dermatologic and gynecologic manifestations of firstly-diagnosed hypothyroid females. PATIENTS AND METHODS: This is a case control study that included 150 patients presenting for gynecological consultation. Out of them, 60 were affected with hypothyroidism and 90 were euthyroid based on clinical and laboratory investigation backgrounds. Their gynecologic and dermatologic findings were analyzed and compared statistically. RESULTS: Compared to euthyroid cases, hypothyroid ones were presenting mostly with amenorrhea (OR=7.76). Other gynecologic manifestations that were prominent in hypothyroid cases were dysparunia, PCO, PMS and Breast tenderness. On the other hand, rate of menstrual irregularities and infertility were non-significantly different in both groups. Hypothyroid women showed also significantly higher frequency of urticaria and puffiness of hands and feet (both were present in 16.7% in hypothyroid vs. 3.3% of euthyroid cases, p =0.007, OR=5.8). Hypothyroid cases showed also significantly higher frequency of yellow ivory skin (OR=5.4) and coarse rough dry skin (OR=3.8). On the other hand, alopecia and periorbital edema were observed only among cases of hypothyroidsm and none of euthyroid cases. CONCLUSION: A great index of suspicion should be always exerted to the diagnosis of disorders manifesting with subtle manifestations as hypothyroidism in female cases particularly having gynecologic and dermatologic disorders.