The main purpose of this research was to investigate the women pregnancy healthy status and behaviors in Eastern-Azerbaijan province referred to the treatment health centers in 2012. The present study was a cross-section study. So 30
married women between 15-49 years old have been taken up randomly for family adjustment and mother health and pregnancy care. A questionnaire including the demographic features and other questions about the status and behavior of the
pregnancy health affairs were used to collect the results. The obtained data of these questionnaires were analyzed by SPSS software. The results that showed 63.8% had itching or the vaginal stimuli and 34.9% (52 ones) had bad-smelling secretions and
36.9% (55 ones) had intense pain around the abdominal area. The investigation of these infectious diseases through sexual path showed that about 0.5% (3 ones) are challenging with these mentioned disorders. The results of the barrenness showed that about 8.7% (52 ones) tried to get pregnant but they did not get pregnant.
Perceptions of tertiary students on the prevention of sexually transmitted di...iosrjce
The purpose of the study was to evaluate tertiary student’s sexual behaviour and their knowledge and attitudes
towards STDs, among students of University for Development Studies (UDS).
The research design: data was collected by using a quantitative survey using self-answered questionnaire, from
a sample of one hundred and thirty-four (n=134) out of a total student population of 3,881, using the simple
random sampling technique in the data gathering process.
Results/findings: out of the sample size of 134 students aged 15-44, 46.3% were males and 53.7% were females.
About 24.6%, (n=33) have ever had sex without a condom. The study revealed that 99.3% ever heard of STDs,
85.1% had either below or average knowledge about the causes of STDs, 55.2% had knowledge above average
on the prevention of STDs and more than 90% of the student sampled indicated that STDs are very common.
Interestingly, 6.7% of the sampled population said STDs are mainly female infections.
Recommendations: There is need for wider education at various levels of the educational system on STDs by
health care providers, and effective collaboration among health care providers, social activists, NGOs and
tertiary students to promote peer education on STDs prevention among students.
“Morbidity profile of children [6-11 years] attending Municipal Corporation P...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
ABSTRACT- Background: Women of all races and ethnicities are at risk of cervical cancer. India, around 0.95 million new cases are detected yearly with high burden of 0.63 million. India bears about one fifth of the world’s burden of cervical cancer. Although fatality is high but cancers are largely preventable by effective screening programmes. Design: The present quasi-experimental study was conducted among female students studying in degree colleges from Feb. 2013 to Sept. 2013. Intervention: Educational intervention was conducted through sessions of participatory learning approach which included lectures using power-point, chalk and talk and question-answers method. Data was collected twice by administering predesigned questionnaire and conducting focus group discussion. Data Analysis: Data entered and analyzed using Epi Info 2000. To analyze qualitative information Atlas ti software was used. Paired t-test was used to measure the effect of intervention. Results: Total 149 students were the part of the study and successfully followed. Mean age of the participant was 18.5 years. Out of the 149 participants 4.1% had family history of the cancer. In the study it was observed that 18.8% had not ever heard about the cancer. In the post intervention test significant improvement was seen in all three parameters viz knowledge, attitude and practices. Conclusion: Continuing Educational interventions should be started at all level which highlights the importance of screening and prevention of cancer in women. Key-words- Cervical Cancer, Women, Perception Barriers, Effectiveness
The main purpose of this research was to investigate the women pregnancy healthy status and behaviors in Eastern-Azerbaijan province referred to the treatment health centers in 2012. The present study was a cross-section study. So 30
married women between 15-49 years old have been taken up randomly for family adjustment and mother health and pregnancy care. A questionnaire including the demographic features and other questions about the status and behavior of the
pregnancy health affairs were used to collect the results. The obtained data of these questionnaires were analyzed by SPSS software. The results that showed 63.8% had itching or the vaginal stimuli and 34.9% (52 ones) had bad-smelling secretions and
36.9% (55 ones) had intense pain around the abdominal area. The investigation of these infectious diseases through sexual path showed that about 0.5% (3 ones) are challenging with these mentioned disorders. The results of the barrenness showed that about 8.7% (52 ones) tried to get pregnant but they did not get pregnant.
Perceptions of tertiary students on the prevention of sexually transmitted di...iosrjce
The purpose of the study was to evaluate tertiary student’s sexual behaviour and their knowledge and attitudes
towards STDs, among students of University for Development Studies (UDS).
The research design: data was collected by using a quantitative survey using self-answered questionnaire, from
a sample of one hundred and thirty-four (n=134) out of a total student population of 3,881, using the simple
random sampling technique in the data gathering process.
Results/findings: out of the sample size of 134 students aged 15-44, 46.3% were males and 53.7% were females.
About 24.6%, (n=33) have ever had sex without a condom. The study revealed that 99.3% ever heard of STDs,
85.1% had either below or average knowledge about the causes of STDs, 55.2% had knowledge above average
on the prevention of STDs and more than 90% of the student sampled indicated that STDs are very common.
Interestingly, 6.7% of the sampled population said STDs are mainly female infections.
Recommendations: There is need for wider education at various levels of the educational system on STDs by
health care providers, and effective collaboration among health care providers, social activists, NGOs and
tertiary students to promote peer education on STDs prevention among students.
“Morbidity profile of children [6-11 years] attending Municipal Corporation P...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
ABSTRACT- Background: Women of all races and ethnicities are at risk of cervical cancer. India, around 0.95 million new cases are detected yearly with high burden of 0.63 million. India bears about one fifth of the world’s burden of cervical cancer. Although fatality is high but cancers are largely preventable by effective screening programmes. Design: The present quasi-experimental study was conducted among female students studying in degree colleges from Feb. 2013 to Sept. 2013. Intervention: Educational intervention was conducted through sessions of participatory learning approach which included lectures using power-point, chalk and talk and question-answers method. Data was collected twice by administering predesigned questionnaire and conducting focus group discussion. Data Analysis: Data entered and analyzed using Epi Info 2000. To analyze qualitative information Atlas ti software was used. Paired t-test was used to measure the effect of intervention. Results: Total 149 students were the part of the study and successfully followed. Mean age of the participant was 18.5 years. Out of the 149 participants 4.1% had family history of the cancer. In the study it was observed that 18.8% had not ever heard about the cancer. In the post intervention test significant improvement was seen in all three parameters viz knowledge, attitude and practices. Conclusion: Continuing Educational interventions should be started at all level which highlights the importance of screening and prevention of cancer in women. Key-words- Cervical Cancer, Women, Perception Barriers, Effectiveness
Background: Adolescents are exposed to several reproductive health challenges including early marriage, unwanted pregnancies, unsafe abortions and sexually transmitted infections. An estimated 14 million adolescents give birth annually of which more than 90% of these occurs in developing countries. Adolescents in the Sub-Saharan Africa have low family planning utilization rates, limited knowledge of reproductive health services and very high pregnancy rates which is not unrelated to the negative attitude of some health care providers towards the provision of Sexual and Reproductive Health (SRH) services and information to adolescents.
Knowledge and attitudes towards complementary and alternative medicine among ...home
Majority of the medical students were familiar with the CAM methods widely used in Turkey, while
most of them had positive attitudes towards CAM as well as willingness to receive training on the subject, and they
were likely to recommend CAM methods to their patients in their future professional lives. With its gradual scientific
development and increasing popularity, there appears a need for a coordinated policy in integrating CAM into the
medical curriculum, by taking expectations of and feedback from medical students into consideration in setting
educational standards
The negative impacts of adolescent sexuality problems among secondary school ...lukeman Joseph Ade shittu
This study was conducted to focus on the negative health outcomes related to sexual behaviour in adolescents and young adults attending public school in the Oworonshoki region of Lagos, Nigeria, Africa. Since, there is a relative dearth of knowledge on adolescents who face unique and challenging economics, health and education problems in our society. Data on the socio-demographic characteristics, prevalence and knowledge towards STD including HIV/AIDS, prevalence of sexual abuse practice/sexual behaviour, family planning awareness and acceptance including abortion practice were sorted out using self structured questionnaires and administered to 60% of student’s population using a stratified random sampling technique. 55.8% lived with both parents. While, 50.3% of the mothers had basic secondary school qualifications, 72.4% of them are traders. 61.5% had sex education were from misinformed friends/peers while 51% had no basic knowledge about sexual behavioral practice and attitude towards STDs/AIDS (HIV). STD has a prevalence of 34 and 41% of boys used condoms for preventing STI/HIV transmission and unwanted pregnancies. One out of every five sexually active teenagers has experienced forced sex, especially among the circumcised girls who were more sexually active than the uncircumcised girls. 60% of girls between ages of 12 and 18 years had more than one unsafe abortion with severe vaginal bleeding (haemorrhage) as the chief complication. However, 65% of the girls did abortion for fear of leaving school and financial hardship as the reasons.
Gender Differences in Motivational Factors towards Medical Career Choiceiosrjce
The present study aims to study motivations of students in choosing the medical profession and
whether these motivations are different, gender wise along with their demographic features. The study was
conducted on 150 students of MIMER Medical College, Pune. Demographic result of the study indicated that
enrolment in medical faculty was more by girls (83) than by boys (67) and majority of students came from
medical family. A primary motivation factor in girls was patient care, interest in science, career opportunity
and personal skills. While in boys it was patient care, interest in science, status –security, self-employment. To
pursue the medical profession other motivating factors was number of attempts in medical entrance exam held,
there was no difference found in both gender statistically. But statistically significance was found gender wise,
in getting encouragement from family, in girls it was more encouragement. Also statistic significance was found
in girls for deciding the career choice before X classes compare to boy students, indicating girls are early
decider
Undernutrition and Mortality Risk Among Hospitalized Childrenasclepiuspdfs
Background: Malnutrition remains one of the most common causes of morbidity and mortality among children in low- and middle-income countries, being responsible for 45% of deaths among children younger than 5 years. Objectives: This study aimed to assess the frequency of undernutrition and to evaluate the effect of simultaneous presence of underweight, wasting, and stunting on child mortality. Methods: A retrospective observational review of files for patients admitted from September 1, 2015, to February 29, 2016, in a single ward treating children with diarrheal diseases and severe acute malnutrition (SAM).
The influence of barriers on the active sports Participation among medical an...Dr. Mohammed Abou Elmagd
Physical activity barriers can affect the student’s participation in sports in response to the concern that medical college students face different difficulties and fall under tremendous stressors, which can interfere with the desired academic performance. The current study aimed to identify the barriers hindering the effective students’ participation in physical activities at RAK Medical and Health Sciences University. The study demonstrated significant negative correlation between physical activity and overload of study (r = -0.305 p<0.001). However, the correlation was higher for female students with significant difference. Correlation among colleges showed significant correlation with the lack of facilities. This study will allow concerned people to find solutions and increase students participation in physical activities, which in turn promotes positive self-esteem and gives them confidence to do things and confront social challenges and ultimately improve their academic performance.
Background: Adolescents are exposed to several reproductive health challenges including early marriage, unwanted pregnancies, unsafe abortions and sexually transmitted infections. An estimated 14 million adolescents give birth annually of which more than 90% of these occurs in developing countries. Adolescents in the Sub-Saharan Africa have low family planning utilization rates, limited knowledge of reproductive health services and very high pregnancy rates which is not unrelated to the negative attitude of some health care providers towards the provision of Sexual and Reproductive Health (SRH) services and information to adolescents.
Knowledge and attitudes towards complementary and alternative medicine among ...home
Majority of the medical students were familiar with the CAM methods widely used in Turkey, while
most of them had positive attitudes towards CAM as well as willingness to receive training on the subject, and they
were likely to recommend CAM methods to their patients in their future professional lives. With its gradual scientific
development and increasing popularity, there appears a need for a coordinated policy in integrating CAM into the
medical curriculum, by taking expectations of and feedback from medical students into consideration in setting
educational standards
The negative impacts of adolescent sexuality problems among secondary school ...lukeman Joseph Ade shittu
This study was conducted to focus on the negative health outcomes related to sexual behaviour in adolescents and young adults attending public school in the Oworonshoki region of Lagos, Nigeria, Africa. Since, there is a relative dearth of knowledge on adolescents who face unique and challenging economics, health and education problems in our society. Data on the socio-demographic characteristics, prevalence and knowledge towards STD including HIV/AIDS, prevalence of sexual abuse practice/sexual behaviour, family planning awareness and acceptance including abortion practice were sorted out using self structured questionnaires and administered to 60% of student’s population using a stratified random sampling technique. 55.8% lived with both parents. While, 50.3% of the mothers had basic secondary school qualifications, 72.4% of them are traders. 61.5% had sex education were from misinformed friends/peers while 51% had no basic knowledge about sexual behavioral practice and attitude towards STDs/AIDS (HIV). STD has a prevalence of 34 and 41% of boys used condoms for preventing STI/HIV transmission and unwanted pregnancies. One out of every five sexually active teenagers has experienced forced sex, especially among the circumcised girls who were more sexually active than the uncircumcised girls. 60% of girls between ages of 12 and 18 years had more than one unsafe abortion with severe vaginal bleeding (haemorrhage) as the chief complication. However, 65% of the girls did abortion for fear of leaving school and financial hardship as the reasons.
Gender Differences in Motivational Factors towards Medical Career Choiceiosrjce
The present study aims to study motivations of students in choosing the medical profession and
whether these motivations are different, gender wise along with their demographic features. The study was
conducted on 150 students of MIMER Medical College, Pune. Demographic result of the study indicated that
enrolment in medical faculty was more by girls (83) than by boys (67) and majority of students came from
medical family. A primary motivation factor in girls was patient care, interest in science, career opportunity
and personal skills. While in boys it was patient care, interest in science, status –security, self-employment. To
pursue the medical profession other motivating factors was number of attempts in medical entrance exam held,
there was no difference found in both gender statistically. But statistically significance was found gender wise,
in getting encouragement from family, in girls it was more encouragement. Also statistic significance was found
in girls for deciding the career choice before X classes compare to boy students, indicating girls are early
decider
Undernutrition and Mortality Risk Among Hospitalized Childrenasclepiuspdfs
Background: Malnutrition remains one of the most common causes of morbidity and mortality among children in low- and middle-income countries, being responsible for 45% of deaths among children younger than 5 years. Objectives: This study aimed to assess the frequency of undernutrition and to evaluate the effect of simultaneous presence of underweight, wasting, and stunting on child mortality. Methods: A retrospective observational review of files for patients admitted from September 1, 2015, to February 29, 2016, in a single ward treating children with diarrheal diseases and severe acute malnutrition (SAM).
The influence of barriers on the active sports Participation among medical an...Dr. Mohammed Abou Elmagd
Physical activity barriers can affect the student’s participation in sports in response to the concern that medical college students face different difficulties and fall under tremendous stressors, which can interfere with the desired academic performance. The current study aimed to identify the barriers hindering the effective students’ participation in physical activities at RAK Medical and Health Sciences University. The study demonstrated significant negative correlation between physical activity and overload of study (r = -0.305 p<0.001). However, the correlation was higher for female students with significant difference. Correlation among colleges showed significant correlation with the lack of facilities. This study will allow concerned people to find solutions and increase students participation in physical activities, which in turn promotes positive self-esteem and gives them confidence to do things and confront social challenges and ultimately improve their academic performance.
On 12 July 2016, the FINAL AWARD in the South China Sea Arbitration Case brought by the Republic of the Philippines against the People's Republic of China was promulgated by the Arbitral Tribunal under the auspices of the Permanent Court of Arbitration.
TRIDENT DEFENSE held a READING SESSION and ROUND TABLE DISCUSSION to review the disposition of the Arbitral Tribunal and share its preliminary analysis on the Final Award.
TRIDENT DEFENSE aims to inform and influence stakeholders on the critical importance and impact of the Final Award in the life of the Philippines.
Coraline presentation (using art of the title)LauraKN
This is my textual analysis of Coraline includes the different fonts used and why they are used, also the movement of the titles and what effect it has on the viewer. It also includes the different shots used, how it's effective, and the order of the titles.
The purpose of this research was to investigate the students' attitude and consciousness degree regarding the pregnancy health in 2013 in Eastern-Azerbaijan Province. So, 300 students in different semesters have been taken up as accidentally from Tabriz, Marand, Bonab, Maragheh and Ahar have been taken up in this study. The WHO illustrative questionnaire for interview-questionnaire designed by John Cleland surveys with young people has been applied in this study. The statistical data has been completed by the help of SPSS software and descriptive and t-test statistical cases. The results showed the attitude score from the family adjustment is significantly higher than the determined degree positively. The results showed the sexual diseases are significantly higher than the fixed determined degree positively. Also it showed there is no observed any significant difference between the degree of the conscious and the students' attitude based on their marital status The results did not show any significant difference regarding the degree of the attitude among students.
A Study on Assessment of Knowledge of Reproductive Health Education among the...AnuragSingh1049
Adolescence is a life’s essential transition phase starting around 10, 11 or 12 years and concludes between the age of 18-21 years. Deficiency of reproductive health information and sexual experimentations in this stage of storm and stress expose adolescents to grave health pressure. Adolescents must have access to logical Reproductive Health information to increase healthy attitude towards Reproductive Health issues. The aim of writing this paper was to assess the the knowledge of adolescent students studying in Jammu region of Jammu and Kashmir state towards Reproductive Health Education and to be familiar with reproductive health issues among adolescents. The present study was carried out on 400 Adolescent Higher Secondary School students of Jammu region using a well designed pre-tested questionnaire. The results of our study showed that students had constructive attitude towards Reproductive Health Education as majority (boys = 86.0%, girls=84.5%) of respondents recommended Reproductive Health Education in school curriculum. Further, 40.0% boys and 35.5% girl respondents were of the opinion that lecture by expert is a preferred method of imparting Reproductive Health Education, 32.0% boys and 28.5% girl students under study favored to communicate with Doctors/Health Workers followed by parents brothers/sisters (23.0%) in case of girls and friends (23.5%) in case of boys concerning Reproductive Health issues. Further, the study revealed that girl students (51.5%) favored to get married under 24 years as they were of the belief that it is the prime of life, and can give birth without much troubles whereas majority of boys understudy (65.5%) told that they prefer to get married above 24 years as they desire to complete education first and find a appropriate job in order to feed family unit. Majority of the respondents (58.5%) believed that youth living in urban areas possesses more knowledge about reproductive health than youth living in rural areas. Further, majority of the students possesses good knowledge about HIV/AIDS and STDs. It is concluded from our study that there is a requirement of providing proper scientific information to teenagers concerning reproductive health by incorporating Reproductive Health Education in school syllabus and lectures by experts in order to advance their awareness and consequently reproductive health condition.
Prevalence of Congenital Malformations in Newborns Delivered in a Rural Medic...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Factors Hindering Adolescents from Utilizing Reproductive Health Services in ...PUBLISHERJOURNAL
Factors Hindering Adolescents from Utilizing Reproductive Health Services in Kampala International University Teaching Hospital
Emannuel Gutaka 1, Martin Odoki 2, Francis Okedi 3 and *Emmanuel Ifeanyi Obeagu4
1Kampala International University Teaching Hospital and Research (KIU-THR), P.O Box 71, Bushenyi, Uganda.
2Department of Microbiology, Kampala International University Western Campus (KIU-WC), P.O Box 71, Bushenyi, Uganda.
3Department of Surgery, Kampala International University Teaching Hospital and research (KIU-THR) , P.O Box 71, Bushenyi, Uganda.
4Department of Medical Laboratory Science, Kampala International University, Uganda.
________________________________________
ABSTRACT
In Uganda, only 19% of adolescents utilize adolescents’ reproductive health services yet complications of pregnancy, abortions, and childbirth are the leading cause of disability and death among the same age group. The purpose of this study was to assess factors that were contributing to the low utilization of adolescents’ reproductive health services. A quantitative cross-sectional study employed simple random sampling among 85 adolescents that were attending Kampala international university outpatient clinic. Results found out that majority 46(53.4) of adolescents were aged from 15-16 years, 46(53.4%) were male, 28(32.5%) were Catholics most 81(94.1%) were single. 18(36%) had got the information from their friends, 28(56%) of adolescents said that the information about adolescents' reproductive health services was not freely shared in their communities and 33(66%) said that their communities did not accept adolescents sexual reproductive health services where 7(50%) gave a reason they expected to be young to have sexual intercourse. 43(86%) of adolescents were from within 1-5km, 28(73.8%) mentioned lack of privacy at the facility, and 30(79%) said that health workers segregated adolescents that needed similar reproductive health services. In conclusion, factors that were contributing to the low hindering utilization of adolescents’ reproductive health services were both demographic, socio-economic, and facility related.
Keywords: Adolescents, Reproductive, Health Services, Uganda.
The relationship between prenatal self care and adverse birth outcomes in you...iosrjce
Birth outcomes refer to the end result of a pregnancy. The purpose of this study was to examine the
relationship between self care practices during pregnancy and adverse birth outcomes in young women aged 16
to 24 years at a provincial maternity hospital in Zimbabwel. A descriptive corelational design was used. Orem’s
Self Care theory was used to guide the study. Eighty pregnant women were selected using systematic random
sampling and, data was collected using interviews from the 1 March - 31 April 2012. Permission to carry out
the study was obtained from the provincial maternity hospital, the Department of Nursing Science and the
Medical and Research Council of Zimbabwe. Findings revealed such adverse birth outcomes as prematurity
(between 28-32 weeks) 10 (12.5%), still births, 3 (3.75%), low apgar 17 (21.2%) and low birth weight 16 (20%).
Adverse birth outcomes in the mothers included high blood pressure 32 (40%), HIV infection 20 (25%) and post
partum hemorrhage 7 (8.8%) Twenty-four (30%) participants had not booked for antenatal care, 1 (1.8%)
booked for antenatal care at less than 12 weeks while only 1 (1.8%) disclosed her pregnancy at above 29 weeks’
gestation. There was a moderate significant positive correlation between self care practices and adverse birth
outcomes, r=.340. This meant that birth outcomes improved as self care practices increased. Significant R2
. was
.115 meaning self care practices explained 11.5% of the variance observed in birth outcomes. Midwives should
advocate delay in sexual debut in young women to reduce adverse birth outcomes.
Oral cancer awareness and knowledge in adults attending a dental hospital in ...Apollo Hospitals
Cancer, being one of the most common causes of death after
coronary heart diseases, causes nearly 7 million deaths each
year worldwide and according to WHO, presently, almost 25
million people are suffering from cancer, and by 2020 it is
projected that there may be 16 million new cancer cases and
ten million cancer deaths reported every year.1 In most
countries, one to ten cases per 1,00,000 people are diagnosed
with oral cancer every year. Though, it accounts for only two
percent of all cancers reported worldwide, it is the second
most common cancer in males and the fourth most common
cancer in females in South-Central Asia, accounting for seven
percent of the total cancers diagnosed in this region, ranking
among the three most common types of cancers reported in
the region.2 With 75,000e80,000 new cases of oral cancers
being reported every year, India has the highest prevalence of
oral cancer in the world. According GLOBOCON 2012 report,
oral cancer is a third most frequent cancer after breast and
cervix with an estimated 5-year prevalence rate of 6.6%.3 In
India, Northeast India including Assam accounts for more
than 40% of these cases.4 Oral cancer has a higher cure rate
when detected early and treated accordingly, but unfortu-
nately most oral cancers are diagnosed in advanced stages,
requiring aggressive treatment and associated morbidity,
resulting in higher mortality rates.
Similar to Prevalence of genitalia malformation in Iranian children findings of a nationwide screening survey at school entry (2) (20)
2. Armanian, et al.: Prevalence of ambiguous genitalia in Iran
2 Advanced Biomedical Research | 2014
Ambiguous genitalia is a congenital disorder that
usually requires early attention and detection. The
finding of ambiguous genitalia in a neonate is a
situation that could be difficult to manage, not only
because of complications such as salt-losing, but also
due to the importance of sex determination before
psychological gender could be established.[3,4]
Physical
examination, particularly chary palpation to find
gonads at the genital folds or in the inguinal region
is the most important way to detect.
Furthermore, hormonal, genetic, radiographic,
and molecular scrutiny is required to find out the
etiology.[3,5]
Presentations of ambiguous genitalia may include
“bilateral cryptorchidism, perineal hypospadias,
clitoromegaly, posterior labial fusion, phenotypic
female appearance with a palpable gonad (with or
without inguinal hernia), hypospadias, and unilateral
no palpable gonad”.[6]
Given the importance of the issue, awareness
of the prevalence of ambiguous genitalia can
affect the attitude and attention of physicians and
related medical personnel about disease in different
communities. There are inadequate data on the
prevalence of ambiguous genitalia;[1]
it is expected
that the overall frequency of ambiguous genitalia
is one in 5500.[7,8]
The etiologies of almost 50% of all
cases of ambiguous genitalia in the neonatal period are
congenital adrenal hyperplasias and mixed gonadal
dysgenesis.[9]
Abnormalities, which could be quickly
assessed, were observed in approximately one in 4500
live births, in another study.[10]
It is possible that the ambiguous genitalia are not
found at birth examinations, for any reason; or may
be denied by parents to prevent emotional problems
for their child. Therefore careful evaluation and
consideration seems to be necessary in another
proper setup as office-based physical examination or
screening through school-based screening programs.
Thus, examination of the genitalia is considered as
part of the school entry screening programs in Iran.
The current nationwide study aimed to determine
the prevalence of ambiguous genitalia among school
students.
MATERIALS AND METHODS
This nationwide study was conducted in 2009-2010 as
part of the routine screening examinations at school
entry in Iran. This screening program is conducted
every year by the Iranian Ministry of Health and
Medical Education and the Ministry of Education and
Training. Implementation of this program was the
responsibility of the University of Medical Sciences
in each province.
The examinations were performed for all students at
entry to three school levels, that is, at the age of 6 years
(at entry to elementary school), 12 years (at entry to
middle school), and 15 years (at entry to high school).
The examination consisted of two parts: preliminary
assessment by school health care providers and then
medical examinations by physicians.
Some diseases or defects was evaluated with this
method such as gum disease and dental caries,
endocrine disorders, heart and vascular disease,
abdominal disease, growth disorders, behavioral
disorders, ambiguous genitalia, undescended testes
(UDT), vision and hearing problems, spinal deviation
and etc. This examination is performed in Iran at
the various school levels by physicians and medical
personnel. Among the diseases that had great
importance in the national screening program were
ambiguous genitalia and UDT. Therefore, trained
health personnel for symptoms of genital ambiguity
started the physical examinations, and patients were
referred to specialists.
Here, we report the results of detection of ambiguous
genitalia and UDT (for boys) in routine examination
(screen) for ambiguous genitalia (for all students at
entry to three school levels).
In this study, statistical analysis was performed by
descriptive statistics. In this regard, the prevalence of
diseases was evaluated in provincial and national levels.
RESULTS
The medical screening examinations had a coverage of
84.4% in the whole country, consisting of 94.7% in the
elementary schools, 85.2% in the middle school, and
74.5% in the high school students [Figure 1].
On average, the prevalence of ambiguous genitalia
was 0.04% at the national level. The prevalence of
ambiguous genitalia was 0.03%, 0.05%, and 0.03% at
entry to elementary school, at entry to middle school,
and at entry to high school, respectively. Therefore, the
prevalence of ambiguous genitalia was not significantly
different according to age group. Also the prevalence
of ambiguous genitalia was similar according to living
area, that is, urban versus rural (0.04% vs. 0.03%,
respectively). Nevertheless, responsible universities
for screening program in each province reported
different results with regard to prevalence.
[Downloaded free from http://www.advbiores.net on Saturday, February 15, 2014, IP: 198.144.116.173] || Click here to download free Android application for this jou
3. Armanian, et al.: Prevalence of ambiguous genitalia in Iran
Advanced Biomedical Research | 2014 3
University of Kashan, East Azarbayjan, and North
Khorasan reported the highest rate of genital
ambiguity (0.22%, 0.18%, and 0.16%, respectively).
This prevalence was also higher than national average
in University of South Khorasan, Jahrom, Markazi,
and Razavi Khorasan [Figure 2].
The average percentage of UDT prevalence in the
whole country was 0.13%. The prevalence of UDT at
Qom University, North Khorasan, Razavi Khorasan,
Jahrom, Hamedan, Kurdistan, South Khorasan,
Shiraz, West Azerbaijan, Golestan, Hormozgan, and
Markazi had a rate higher than the national average
[Figure 3]. The prevalence of UDT was higher at the
elementary school level than in the other two levels
(0.26% vs. 0.07% and 0.02%).
DISCUSSION
Ambiguous genitalia and UDT should be diagnosed
in the neonatal period; however, we found cases with
undiagnosed disorders till school age. This highlights
the importance of accurate physical examination
at birth and in further medical visits of children.
Clinicians and other professionals should diagnose the
disorder whenever there is an opportunity.
a
b
c
Figure 1: Frequency of examined students in various parts of Iran in 2009-2010. (a) At entry to primary school; (b) at entry to middle school;
(c) at entry to high school
[Downloaded free from http://www.advbiores.net on Saturday, February 15, 2014, IP: 198.144.116.173] || Click here to download free Android application for this jou
4. Armanian, et al.: Prevalence of ambiguous genitalia in Iran
4 Advanced Biomedical Research | 2014
The prevalence of ambiguous genitalia was 1/5500
live births in the study by Sax et al.[8]
Although
adequate data is not available on the prevalence
of ambiguous genitalia, in some studies such as
Hughes’s study in Philadelphia, the disease occurs
in approximately one in 4500 live births[10]
and in
Karbasi et al.’s, study the prevalence of ambiguous
genitalia and UDT at birth was 3.18% and 1.36%,
respectively, in Yazd, Iran.[11]
In our study the overall
prevalence of ambiguous genitalia at school ages
in the whole country was 0.04% and prevalence of
ambiguous genitalia and UDT at school ages was
0.01% and 0.08%, respectively, in Yazd, Iran.
Hack et al., found in their study that the
occurrence of UDT for 6 year, 9 year, and 13 year
olds was 1.2, 2.2, and 1.1%, respectively, in the
Netherlands.[12]
Sijstermans et al concluded that
“At birth, in term and/or birth weight >2.5 kg
infants, the UDT rate ranged from 1.0% to 4.6%,
and in premature and/or birth weight <2.5 kg
infants from 1.1% to 45.3%. At the age of 1 year,
UDT in term and/or birth weight >2.5 kg infants
was seen in 1.0%-1.5%, at 6 years in 0.0-2.6%, at
11 years in 0.0-6.6%, and at 15 years in 1.6-2.2%
of boys” in a systematic review.[13]
In our study the
overall prevalence of UDT in the whole country
was 0.13% (0.00-0.37%). We found that occurrence
Figure 2: Comparison of the frequency of ambiguous genitalia in students screened in different cities in Iran
Figure 3: Comparison of the frequency of undescended testes in students screened in different cities in Iran
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5. Armanian, et al.: Prevalence of ambiguous genitalia in Iran
Advanced Biomedical Research | 2014 5
of UDT for 6 year, 12 year, and 15 year olds was
0.26, 0.07, and 0.02%, respectively, in the in whole
country. The difference in our results with some
other studies may be due to differences in the
accuracy of the examination. Therefore, higher
prevalence in other studies may indicate the need
for more precision in our medical examinations.
Yegane et al studied 3205 school boys. They detected
retractile testes in 1.22% boys, UDT in 1.12% boys,
and hydrocele in 0.87% boys, but no ambiguous
genitalia were seen in that study in the west of
Iran. The interesting thing was that 60.1% of the
parents were not conscious of their male children’s
abnormalities.[14]
Ozoemena and Mbah et al recorded 6.8% of congenital
abnormalities of external genitalia (a high prevalence
rate) on school age students, which were undiscovered
from birth in a study in Nigeria.[15]
Therefore, to find the ambiguous genitalia or UDT,
medical examinations and informing parents should
be considered seriously.
It is noteworthy to mention that although all
health professionals received similar training for
doing the physical examinations in this screening
survey, some differences in the prevalence rates
of abnormalities reported in various cities might
be because of the differences in the accuracy of
physical examination by clinicians with different
expertise levels.
CONCLUSION
Although the prevalence of genitalia abnormalities was
not high in the school students in the whole country,
such disorders should be diagnosed in early life and
even the low prevalence of abnormalities documented
in this study are of crucial importance. Therefore,
given the importance of issue and in order to find the
ambiguous genitalia or UDT, medical examinations
and parental notification should be taken seriously at
an earlier age.
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Source of Support: Data of a national screening program were used in this
study, Conflict of Interest: None declared.
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