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Amniotic band syndrome (ABS) is a rare congenital condition, occurring as an outcome of entanglement of fetal parts with amniotic bands during intrauterine life resulting in anatomical abnormalities. ABS should be considered in every newborn with congenital malformations. In this report, a case of a preterm female baby delivered to a diagnosed (Preterm pre-labour rupture of membranes) PPROM mother, with abnormalities of the extremities due to ABS is discussed.

Objective: The main objective of this study is to assess the feasibility in replacing the portfolio in a low resource setting and its acceptance amongst the students and staff. Synopsis: The objective for the study with regards to using portfolios: is it feasible for the 2 month professorial appointment in a low resource setting and its acceptance amongst the students and staff. Methods: The study was conducted on 259 final year medical students for a period of two years from 2016 to 2018, using the student portfolio maintained by them during their professorial gynaecology and obstetrics appointment which is of 8 weeks duration, and the feedbacks provided by students and staff. Results: Around 2 mini clinical evaluation exercise (CEX) were completed for gynaecology and obstetrics and 1 OSAT each was completed of the five different technical skills by all students. All of them completed the objective structured assessment of technical skills (OSATS) in episiotomy suturing, urine catherization and cannulation, 96% of the students were assessed on their skills for artificial rupture of membrane (ARM) and in setting up as an intravenous drip. Students managed to obtain feedback from patients, peers and nursing officers.100% positive feedback was given by the patients, 97% from peers and 92% from the nursing officers. 80% of all the logs in the portfolio were completed by the students. On an average 2 reflective writings were completed per student. 97% of the students found it as a useful tool and 97% stated that it can be easily completed. Conclusion: Introduction of a portfolio for the obstetrics and gynaecology professorial appointment for medical students is possible, with good student satisfaction despite higher number of student: staff ratios.

Women's delay in seeking medical advice for abnormal vaginal discharge can cause serious effects such as infertility, ectopic pregnancy, and advanced cervical cancer. Family healthcare workers are in a unique position to help in the promotion of vaginal health. A nonrandomized controlled trial was conducted among a sample of family healthcare workers in the intervention (n = 37) and a control (n = 37) group to assess the effectiveness of an educational intervention, which was a 2-day intensive workshop combining reading materials. Data were analyzed using SPSS software (version 20), and the effectiveness of the intervention was determined using a mixed between-within subjects analysis of variance. The total knowledge and attitude scores were significantly greater for family healthcare workers in the intervention group immediately and at 3 and 6 months after the educational intervention, compared to the control group. A substantial main effect was observed concerning the time, showing an increase in family healthcare workers' knowledge and attitude scores across the four time periods. A statistically significant difference in the median overall health education competency score across the two groups was also observed. The mean score differences in all sub-competencies in health education were significantly higher among the intervention group, compared to the control group between second postintervention and the baseline. The educational intervention had revealed successful and sustainable improvements in family healthcare workers' knowledge, attitude on vaginal discharge, and health education competency. This can be implemented as an in-service program for family healthcare workers to improve health education practices.

Objective: Vulvo-vaginal discharge, which is a common gynaecological complaint, can be a normal phys- iological discharge or a symptom of an underlying reproductive tract infection, genital tract neoplasm, or other reproductive tract disorder. It is pertinent to differentiate physiological discharge from a pathological vulvo-vaginal discharge in order to prevent complications of untreated reproductive tract infections. Women are not seeking health advices for most of their gynaecological health issues and have different cultural practices to manage them. This study was conducted to explore the different cultural practices associated with vulvo-vaginal discharge among females aged 18–49 years living in an estate community in Colombo district, Sri Lanka. Methods: This descriptive qualitative study used three Focus Group Discussions (FGDs) with a total number of 20 women. Transcribed verbatim data were analyzed using qualitative content analysis. Results: Majority of the participants were Indian Tamils (n = 17, 85%) and Hindu (n = 15, 75%). Most (65%) of women were employed in the estate labour and educated up to grade 11 (n = 13). The major themes identified in the present study were difficulty in differentiating normal from abnormal vaginal discharge, lack of knowledge on causative factors, cultural influences and beliefs, unstable/limited source of income, fear of disclosing, and lack of support system. Many participants explained that they have difficulty in accessing health care as they are busy with their employment, household work, fear of internal examination, and fear of being admitted to the hospital ward. The common practice was to use home remedies such as polpala herbal drink (Balipoovu, Aerva lanata) or Neeramulliya (Asteracantha longifolia Linn) herbal drink, king coconut, Sauw (sago) Kanji, Uluhal (Fenugreek), and Aloe vera juice prior consulting medical advice for abnormal vaginal discharge. Conclusions: The findings of this study revealed the need of support for women in estate sector for their repro- ductive and sexual health matters. There is a high need of public health care worker’s guidance and counselling to overcome barriers for health care utilization in this community.

The article's abstract is no available.

The objective of this study was to describe the sociodemographic aspects, presenting symptoms and findings of clinical examination of laboratory confirmed cases of trichomoniasis. Cases of trichomoniasis were studied, focusing on the sociodemographic aspects and presenting symptoms and signs at clinical examination. There were 29 laboratory confirmed cases of trichomoniasis. The infection was prevalent in equal proportions in all age groups (36-45, 15-25, 26-35 years- 38%, 31%, and 31%). The majority (76%) were married. There were 35% house wives and 28% sex workers. Contraceptives were not used by 48%. Only 41% were symptomatic at the time of detection. Out of those with a vaginal discharge, 50% complained of greenish yellow discharge and 34% a whitish thick discharge. In addition to the discharge, 7% had itching. None of the patients who were positive complained of dysuria. Findings at the clinical examination were mostly different to the symptoms described by the patients. On examination, the majority (81%) of T vaginalis infected women had a serous vaginal discharge and 14% a greenish yellow discharge. Twenty eight percent of infected females did not have any discharge. Presence of typical symptoms or type of vaginal discharge on examination cannot be used as the sole criterion for the diagnosis of trichomoniasis. These results indicate that treatment of patients based on symptoms per se can lead to over usage of metronidazole. This also shows the importance of laboratory support to diagnose T vaginalis infection. DOI: http://dx.doi.org/10.4038/sljid.v3i1.4690

Objectives: Public Health Midwife (PHM) is the key health care provider at the domiciliary level in Sri Lankan health care system. They indulge in maternal and childcare services in the Sri Lankan community setting. This study was carried out to assess knowledge and attitudes towards health education activities of the PHMs related to vaginal discharge.

Background: Vaginal discharge is a common gynecological complaint among women in the reproductive age group. Objective: The aim of this study was to explore cultural practices and health-seeking behaviors related to vaginal discharge among women living in a socially marginalized community in Colombo district, Sri Lanka. Methods: A descriptive qualitative design was used in this study. Three focus group discussions (FGDs) were conducted in an urban slum community among women who had a previous history with vaginal discharge. A total of 23 women of different ethnicities and religions were included. FGDs were audio recorded and field notes were taken. Verbatim transcripts were analyzed on the basis of qualitative content analysis. Results: Six themes emerged from the data, namely, confusion in differentiating normal from abnormal vaginal discharge, effects on day-to-day life, confusion toward the causative factors, difficulties in disclosing, neglecting behaviors, and socio-cultural influences toward health-seeking behaviors. Majority of women expressed that they use home remedies before consulting a doctor for abnormal vaginal discharge. Conclusions: Women are unable to differentiate normal from abnormal vaginal discharge. Thus, it is important for nurses and primary healthcare workers to plan health education activities for women to empower them with adequate knowledge and improve their health-seeking behaviors.

Background: Trichomoniasis is a sexually transmitted parasitic infection. The World Health Organization (WHO) advocated flow charts for curable sexually transmitted infections (STIs) to improve the care. In this study, an attempt was made to evaluate the validity and reliability of WHO syndromic algorithm for vaginal discharge against trichomonas immunochromatographic test (ICT). Trichomonas ICT is a test with high validity, reliability, and feasibility. Objectives: The objective was to evaluate the validity and reliability of WHO syndromic algorithm for vaginal discharge against trichomonas ICT as a screening tool for trichomonas infection among women of reproductive age in the Western Province, Sri Lanka. Materials and Methods: This cross-sectional study was conducted in sexually transmitted disease clinics, well woman clinics, gynecology clinics, and institutional health clinics in the Western Province, Sri Lanka. We enrolled 100 women in the age group of 15-45 years using the stratified random sampling method. They were interviewed and examined and the specimens were collected to identify trichomoniasis by culture and ICT. Two-stage analyses were done to evaluate the performance of the WHO algorithm against Trichomonas ICT. Results: In a two-stage analysis, the specificity of syndromic algorithm improved from 80.9% to 94.4% while false positive rate reduced from 19.1% to 5.6%. The net effect of specificity was 98.7% while the false positive rate was 1.3%. Conclusion: The validity and reliability of WHO syndromic algorithm as a diagnostic tool for trichomoniasis can be improved by adding trichomonas ICT.

Introduction: Caesarean section is a major surgical operation and its rate is on the rise in Sri Lanka as well as in the world. It is recommended to lower the Caesarean section rate due to the risk of potential complications and burden on the health care system. Previous Caesarean is a common indication for planned Caesarean section and vaginal birth after Caesarean section (VBAC) is considered a safe alternative for many women. This audit study was aimed at determining the success rate of VBAC in a local setting and to identify the factors that are associated with failure in this study population. Method: An audit study was carried out in two obstetric units if South Colombo Teaching hospital, Kalubowila and De Soysa hospital for women, Colombo 8 to assess the success rate among women who underwent VBAC. The unit policies included patient choice for decision to undergo VBAC and non-usage of medication either for induction or augmentation of labour. The audit standards were set as a VBAC success rate of 72% (RCOG Green-top guidelines) and a low APGAR (

As a majority of the trichomoniasis patients are asymptomatic, laboratory tests are crucial in case detection. The usefulness of culture and immunochromatographic technique (ICT) compared to microscopy for detection of trichomoniasis in Sri Lanka was assessed. Females (16-45 years) from Colombo district were screened for Trichomonas vaginalis using three laboratory tests namely, microscopy of wet smear, Trichomonas liquid culture and ICT (OSOM® trichomonas rapid test). Trichomoniasis by at least one test being positive was 4.8%. Microscopy, culture and ICT detected 2.8%, 4.2% and 10% cases respectively. Microscopy missed 32% of culture positives. ICT is a simple, practical and reliable alternative to microscopy in laboratory diagnosis of trichomoniasis. DOI: http://dx.doi.org/10.4038/cmj.v58i3.6105 Ceylon Medical Journal 2013; 58 : 122-123

DOI: http://dx.doi.org/10.4038/sljog.v34i3.4862 Sri Lanka Journal of Obstetrics and Gynaecology 2012; 34: 73-78