Aims and background: Being both underweight and overweight in women are major risks for maternal and fetal outcomes. This study aimed to find the double burden of malnutrition (DBM) in Pakistan, Bangladesh, Nepal, and Myanmar women, and sociodemographic factors involved. Materials and methods: Data were taken from the latest Demographic and Health Survey (DHS) datasets. Frequencies, percentages, and multinomial logistic regression analyses were done to assess the effects of sociodemographic variables on body mass index (BMI). Results: About 50% of women from Pakistan and Nepal, 65% from Bangladesh, and 71% from Myanmar lived in rural areas were involved in this study. About 50% of women from Pakistan, whereas less than 28% from Bangladesh, Nepal, and Myanmar had no formal education. About 40–50% of women from all four countries were poor. About 60% of women from Pakistan, whereas 30–40% from the other three countries had ≥3 “children ever born.” About 67% of women from Pakistan, whereas 40–50% from the other three had BMI ≥ 23, whereas 7.5–14% of women from all four countries had BMI <18.5. Multinomial regression showed increasing BMI with an increase in women's age and socioeconomic status in all countries. Higher BMI was associated with urban residence in Pakistan and Myanmar, with higher education in Nepal, Bangladesh, and Myanmar, and with ≥3 children in Nepal and Myanmar. Conclusion: Younger age, less education, rural residence, less wealth, and lesser number of children were major risk factors for underweight women, and opposite factors were risks for overweight. Clinical classical significance: The nutritional status of women in developing countries should be improved to improve the health of future generations.

Introduction: Increased cardiac output, decreased systemic vascular resistance, and left ventricular hypertrophy are among the cardiovascular alterations brought on by pregnancy. Pregnancy-related heart problems can increase the risk of morbidity and death in both the mother and the newborn. The aim of this research is to characterizing the characteristics of pregnant women with heart disease patients in RSUP Prof. Dr. I.G.N.G. Ngoerah, Denpasar, Indonesia. Methods: This research is included in the type of retrospective descriptive research using medical record data at this hospital from 1 January 2020 to 31 December 2021 with a total sampling method. Inclusion criteria include all cardiac disease in pregnancy cases. Cases with incomplete data were excluded. Data were subsequently analyzed with SPSS 26th edition. Results: There were 46 cases of cardiac disease in pregnancy recorded and 4 cases were excluded. The prevalence in pregnancy was 2.68%. The characteristics of most of the cases were in 20–35 years old group (71.4%), high school graduates (69.0%), normal body mass index (38.1%), multigravida (64.3%), diagnosed at ≥37 gestational age (52.4%), booked case (85.7%), with known previous cardiac disease (54.8%), diagnosed with congenital heart disease (23.8%), WHO class IV (33.3%), underwent cesarean section (71.4%), birth weight <2,500 gram (52.4%), vigorous baby (71.4%), used IUD as postpartum contraception (45.2%), hospitalized in intensive ward after delivery (52.4%) and length of stay were 5–10 days (45.2%). There were 4 maternal mortality cases with case fatality rate (CFR) of 9.52% caused by respiratory failure, sepsis and cardiogenic shock. Discussion: There was a slight increase in prevalence and decrease of CFR of cardiac disease in pregnancy in our hospital compared to previous data in 2016–2017 which may cause by better referral system and patient care. Conclusion: In general, the characteristics of patients in our study were similar to previous studies in developing countries.

Background: Retained products of conception (RPOC) is an intrauterine tissue that has developed during conception and is still persisting after miscarriage, medical, or surgical termination of pregnancy and vaginal or cesarean delivery. Retained products of conception is one of the most common causes of postpartum bleeding. Materials and methods: It is a prospective comparative study conducted in the Department of Obstetrics and Gynaecology at Mahatma Gandhi Mission's Hospital, Kalamboli, over a span of 2 years in 60 pregnant women who were diagnosed by ultrasound to have RPOC >3 cm. A total of 60 cases were included in the study. Cases were randomly recruited and randomized into two groups of hysteroscopy group and Dilatation and evacuation (D&E) group. In this study, we have observed the patients for complications such as postoperative pain in abdomen was assessed using visual analog scale, vaginal bleeding was assessed by visual estimation, fever, injury to cervix, perforation of uterus, and ultrasonography evidence of no RPOC. Results: In our study, hysteroscopic removal has better safety and efficacy when compared with standard D&E procedure. Conclusion: The study shows that hysteroscopic removal of RPOC is more effective and safer procedure compared with blind D&E. We recommend that it may be used as first line of treatment for RPOC.

Aim: To evaluate the degree of awareness and its associated factors regarding the danger signs of pregnancy and childbirth among antenatal women in a tertiary care hospital. Introduction: A woman's pregnancy is a natural phase of life that is sometimes considered a significant risk that can lead to negative effects for both the fetus and the mother. There are several warning indicators during pregnancy and childbirth. Awareness regarding these warning signals is necessary in aiding the antenatal women in recognizing the signs and approaching a health care center to reduce the risk of maternal morbidity and mortality. Methodology: The subjects provided written, informed permission. A cross-sectional questionnaire-based study was done on antenatal women visiting the tertiary care hospital. The data were analyzed statistically by SPSS IBM software and evaluated. Results: From the study, nearly 76.8% of the total participants knew that there are danger signs present during pregnancy, and about 57.6% of the total participants knew that there are danger signs present during childbirth, among which they listed excessive vaginal bleeding as the most frequent warning sign. It was found that women who come from urban areas have higher education levels and an increased number of antenatal visits knew more regarding the alarming signs of pregnancy and childbirth. Conclusion: This study shows that a moderately good proportion of women are aware of the risks associated with pregnancy and childbirth, but there is still a significant gap in understanding them. More focused formal antenatal education regarding the danger signs must be emphasized, and improved strategies must be practiced among all healthcare professionals to ensure increased awareness among the antenatal women. This can be done by applying a majority of focus on strengthening health education by mandating health awareness counseling for all the antenatal women and addressing the danger signs.

Background and aim: Pelvic floor dysfunction (PFD) is linked to pelvic floor muscle dysfunction, which can cause symptoms and anatomical changes. Conservative treatment is the first approach, but surgery may be required if traditional methods fail. However, surgery often results in complications. Stem cell therapies for PFD have been developed to tackle this problem. Therefore, we wanted to review recent studies on stem cell therapies for PFD. Methods: Comprehensive research was conducted in PubMed, Embase, Cochrane Library, and Google Scholar using specific search terms that included “Stem Cells” and “Pelvic Floor Dysfunction.” Only full-text publications in English or Indonesian were included in this review. Pelvic floor dysfunction refers to the changes and anatomical symptoms that arise from impaired function of the pelvic floor muscles. Review: Stem cells are cells that have unlimited or prolonged self-renewal potential. In recent years, different treatment strategies for PFD using stem cells have been studied in vivo. Since PFD can result from muscle function and integrity loss, rebuilding muscle from the cellular level presents an ideal treatment concept. At first, it was believed that transplanted cells would differentiate and bring about functional regeneration. However, current hypotheses suggest that this could be due to direct stem cell transplantation and muscle regeneration, localized agglomeration impacts, trophic effects brought about by the secretion of stem cell growth factors, or immune modulation leading to improved tissue healing. Summary: Pelvic floor dysfunction refers to the physical symptoms and changes due to a weakened pelvic floor. Scientists have studied various therapeutic techniques involving stem cells to address PFD in living organisms. Stem cells are known for their ability to renew themselves, differentiate into different cell types, secrete growth factors, and modulate the immune system.

Urinary tract infections (UTIs) are highly prevalent, resulting in 7 million outpatient visits, 1 million emergency department visits, and 100,000 hospitalizations annually. They predominantly affect females aged 20–50. Antibiotics are the primary treatment, but about 30% of treated females experience recurrence (rUTI). Regular antibiotic use also increases the risk of antibiotic resistance and side effects. Moreover, antibiotics can cause dysbiosis of the intestinal and vaginal flora, increasing the risk of recurrence. Therefore, nonantibiotic treatments are worth considering reducing antibiotic use and side effects. Nonantibiotic options such as cranberry juice, D-mannose, probiotics, and potassium magnesium citrate can alleviate UTI symptoms and reduce recurrence risk. Studies indicate that combining these non-antibiotic treatments, which work through different mechanisms, leads to better clinical outcomes. This review explores the role of each non- antibiotic treatment, the rationale for their combination, and supports their effectiveness with clinical evidence. Thus, the combination of non-antibiotic treatments may provide a better outcome for patients with UTI and rUTI.

Labial fusion is a state of partial or complete adhesion of the labia minora generally occurring in young girls or post-menopausal women but is extremely rare in females after attaining puberty. The relative hypoestrogenic environment is suggested as the main predisposing factor of this condition in the prepubertal girl. In adults, including postmenopausal women, labial fusion is associated with recurrent urinary tract infections, vulvovaginal infections, poor personal hygiene, genital trauma, hypoestrogenism, underlying dermatological disease, and lack of sexual activity. Labial adhesion is rare in females of the reproductive age-group due to the abundance of estrogen. It is generally asymptomatic but can also present with complaints of urine pooling in the vagina on voiding, followed by leakage from the vagina on activity after voiding or changes in the direction of the urine stream. In about 20% of girls, asymptomatic bacteriuria develops, and up to 40% experience symptomatic urinary tract infections. The condition usually resolves once they attain puberty, so aggressive treatment is not recommended unless the patient is symptomatic. Medical or surgical management options are available. Topical estrogen application is considered as the first line treatment for labial adhesions, especially for superficial labial adhesions in prepubertal girls and postmenopausal women. Conjugated estrogen cream or estradiol vaginal cream (0.01%) can be applied to the adhesions 1–2 times daily for several weeks until the adhesion resolves. Adverse systemic effects from estrogen application are rare and include local irritations, vulvar pigmentation, and breast enlargement. An alternative line of treatment is topical 0.05% betamethasone cream. One to three courses of twice-daily application of topical betamethasone for 4–6 weeks showed promising results. In addition, manual separation of adhesions with care and maintenance of local hygiene is also reported to resolve labial adhesions. Surgical adhesiolysis is the treatment of choice in pubertal girls and in patients with previous treatment failure. Local estrogen might not prove to be beneficial in such cases.

Leiomyomas are the most frequent benign gynecological tumors. Only 3–5% of fibroids occur exclusively in the cervix, while most are throughout the uterus. The literature documents various sizes and presentations of cervical fibroids, including those that resemble an inverted uterus or malignancy. Fibroids may outgrow their blood supply as they expand, resulting in various degenerations. Cystic degeneration, which affects 4% of cases, is a severe edema aftereffect. On the other hand, unusual looks that coincide with degenerative processes may lead to diagnostic ambiguity. Case 1: A 28-year-old female para 2 living 2 presented with complaints of mass per vagina with foul-smelling discharge clinically diagnosed as degenerative cervical fibroid polyp; on evaluation with ultrasound, showed hyperechoic lesion arising from cervix taking significant color Doppler likely neoplastic and magnetic resonance imaging showed hetero-intense lesion from endocervical canal with areas of calcification and cystic degeneration. Intra-op fibroid measuring 10 × 10 cm from posterior lip of cervix and degenerated part from fibroid as polyp measuring 20 × 10 cm. The medical team discharged the patient in good condition. The HPE revealed leiomyoma with secondary changes and fibro-collagenous tissue. Case 2: A 30-year-old female para 3 living 3 presented with complaints of intermenstrual bleeding with foul-smelling discharge clinically diagnosed with giant cervical fibroid with degenerative polyp measuring 10 × 4 cm. Ultrasound showed a large heterogeneous hypoechoic lesion from the cervical canal suggestive of cervical fibroid with degenerative change. On evaluation, magnetic resonance imaging (MRI) showed a large capsulated oblong mass lesion involving the cervix measuring 22 × 13.5 × 14 cm suggestive of giant fibroid of the uterus, so we would like to conclude that large pedunculated cervical fibroids typically manifest as cervical malignancy, uterine inversion, abdominal bulk, or imprisoned procidentia. Their successful care can be aided by radiological imaging, appropriate intraoperative demarcation of pelvic anatomy, and preoperative clinical evaluation. Therefore, one should be aware of the unusual ways cervical fibroid presents and consider it while making a differential diagnosis for any pelvic tumor.