Premature Ejaculation patients and their partners: arriving at a clinical profile for a real optimization of the treatment.

The aim of the study is to extrapolate clinical features of Premature Ejaculation (PE) patients and female partners of men affected with PE, in order to get a profile that can be of assistance for physicians within the dynamics of a couple, one of which is a PE patient. An observational, non-interventional, cross-sectional epidemiological study entitled IPER (Italian Premature Ejaculation Research) was conducted and included two different cohorts of subjects that were randomly sampled from a patient dataset of selected General Practitioners: 1. IPER-M sub-cohort (1.104 subjects) was made of male subjects in which they were then distinguished patients with or without PE based on the score of the PEDT questionnaire; IPER-F sub-cohort (1.109 subjects) was made of female subjects from an independent sample of women (therefore not the partners of the IPER-M males) in which they then distinguished those partners of a male subject with PE or not. In addition to an identical general questionnaire to explore demographic aspects and habits, each subcohort was then evaluated using validated questionnaires. No differences were noted between PE+/PE- patients in terms of alcohol consumption, smoking habits, physical activity nor stress condition in everyday life, employment, socio-economic class and marital status. While the prevalence of PE proportionally increased with age, excluding the 50-59 and 70-80 years decades, in the IPER-M group an overall statistically significant difference for the mean age between the PE+ and PE- groups (p = 0.002) was detected, but without reaching any difference amongst the different age classes in the IPER-F group. The PE+ patients reported a significantly lower frequency rate of sexual intercourse, worse QoL (p = 0.006 and p < 0.0001, respectively), and increased anxiety status (p < 0.0001 for both subgroups). This study shows that, rather than talking with a patient affected by PE it would be advisable to introduce the concept of couple counseling with the person patient and his partner, because it is only through classification of both partners as one couple and a full understanding of their mutual sexual experience that PE treatment can be optimized and its results measured accurately.

Awareness and acceptance of various contraceptive methods among postpartum women in a tertiary care center

Background: This study was conducted to know awareness and acceptance of contraceptive methods among post-partum women in the tertiary care centre of Chhattisgarh.Methods: A cross-sectional interview-based study was conducted on a sample of 440 post-partum women. The interview included socio demographic profile, awareness and acceptance of contraceptive methods in postpartum period and factors affecting its use.Results: In our study, we observed that 95.9% were aware of some method of contraception. This knowledge increased with increasing education, socioeconomic class. 90.9 % accepted one of the contraceptive methods during their hospital stay. The most common contraceptive method chosen was IUCD (80.8%). Major source of information was health care worker (83.88%). The main reason for non-acceptance of contraception was fear of side effects.Conclusions: High level of persistent motivation is required, so initiation of motivation regarding post-partum contraception should be done in antenatal visits and reinforcement in post-partum period should be done. Proper counseling regarding possibility of milder side effects and way of coping with them should be reinforced, continued motivation and reassurance will give positive attitude for acceptance of contraception. Reinforcement of awareness in society (family and friends/neighbor) this may give positive impact on awareness and acceptance. There is need of couple counseling for better acceptance. Emphasis is required for involvement of men/head of the family for it.

'A STUDY TO ASSESS THE AWARENESS & FACTORS AFFECTING ACCEPTANCE OF PPIUCD IN SELECTED HOSPITAL OF DADRA & NAGAR HAVELI'

Background: Population explosion is one of the major problems in India. It is a result of prevailing high birth rates and unmet need of birth controlling methods. The Government of India under National Health Mission has taken an initiative to provide PPIUCD in immediate postpartum period. In spite of several training programmes & awareness activities across the country, the acceptance & utilization of PPIUCD is very low. Hence, this study was conducted to determine proportion of women accepting PPIUCD & describe the factors affecting acceptability & non-acceptance of PPIUCD in selected hospital of DNH. Method: It was an exploratory study conducted at Shri Vinoba Bhave Civil Hospital, Silvasssa from January to February 2020. The sample size of the study was 90. The data was collected under 1)Antenatal mothers with term pregnancies 2)Immediate postnatal mothers delivered normally 3)Immediate postnatal mothers delivered through CS. Thirty(30) samples were selected in each category using convenient sampling technique. Result: The awareness about PPIUCD was only 23.33%. The acceptance rate of PPIUCD was very low (22.22%). The most common reasons for non-acceptance were (i) refusal from relatives &(ii) refusal from husband, (iii) prefer natural method of contraception, (iv) religious belief among Muslim women, (v) fear of obesity & (vi) lack of experience of PPIUCD. Conclusion: The emerging factors for less acceptance of PPIUCD are low literacy rate among women of DNH & infrequent counseling & education during antenatal period. Integration of a PPIUCD counseling service at every delivery point with provision of couple counseling can improve the success of this programme.

Romantic attachment, unforgiveness and relationship satisfaction in couples: A dyadic mediation analysis

Adult romantic attachment is strongly associated with couple relationship functioning, and many efforts have been made to identify the mechanisms underlying this link. Nevertheless, no previous study considered unforgiveness when investigating the relationship of romantic attachment with relationship satisfaction in couples. We used the actor–partner interdependence mediation model to explore the associations between romantic attachment and relationship satisfaction as mediated by unforgiveness (i.e., avoidance and revenge motivations) in a convenience sample of 104 Chilean couples. The couples completed self-report measures of romantic attachment, unforgiveness, and relationship satisfaction. Actor insecure attachment was associated with lower relationship satisfaction directly and indirectly. Indirectly, higher actor levels of attachment anxiety and avoidance were linked, respectively, to greater revenge and avoidance motivations, and thus to lower relationship satisfaction. Partner attachment avoidance was associated with lower relationship satisfaction only directly. Higher partner levels of attachment anxiety were associated with lower avoidance motivation, and thus with higher relationship satisfaction. These dyadic findings further attest to the detrimental role of attachment avoidance and unforgiveness against the couple’s functioning. The novel finding that attachment anxiety may indirectly promote a couple’s relationship satisfaction deserves further investigation. The implications for couple counseling and therapy are discussed.

Provision of Onco-Fertility Support

The chapter considers issues where oncologic therapy can lead to partial or complete damage to the gonads (ovaries or testes), thus impairing fertility or reducing the fertile lifespan. We discuss the relatively new discipline of onco-fertility, which considers patients’ psychosocial needs, including sexual health, intimate relationships, and the affordability of fertility-preservation measures. Referral and counseling for fertility preservation should be performed as soon as possible after the cancer diagnosis. Assessment of reproductive potential should be offered to all cancer patients. Healthcare professionals should be proactive regarding fertility-preservation counseling. A multidisciplinary team consisting of oncologists, fertility specialists, specialized nurses, mental health professionals, psycho-oncologists, social workers, and support groups should be available when dealing with infertility as a side effect of cancer therapy. Shared decision making regarding fertility preservation is an important issue. Partners may need psychological counseling referrals as well, or couple counseling on communication and sexuality.

The burden of traditional neonatal uvulectomy among admissions to neonatal intensive care units, North Central Ethiopia, 2019: A triangulated crossectional study

Background Traditional neonatal uvulectomy is unsupervised, unscientific and potentially dangerous cultural malpractice. This malpractice is often accompanied with life threatening neonatal morbidities such as infection, anemia, aspiration and oropharyngeal injury. However, there is no current regional and even national data about the burden, associated factors and perception of traditional uvulectomy among neonatal admissions to neonatal intensive care units. Methods A quantitative cross sectional study supplemented with phenomenological study was employed on 422 mother-neonate pairs admitted to Debre Tabor General Hospital from September 2018 to August 2019. Eight women who were not included in the quantitative part were involved for the qualitative study. Systematic and purposive sampling methods were used to select study participants for the quantitative and qualitative study respectively. Binary logistic regression models were fitted to declare statistical significance at p-value ≤ 0.05 and 95% CI. Result Complications of traditional uvulectomy contributed 15.90% of the overall neonatal admissions. At admission, most of the victim neonates had septic presentation (88.1%) followed by anemia (55.2%). From multivariable analysis, having male neonate [AOR= 4.87; 95% CI: 1.10, 21.59], antenatal couple counseling about traditional neonatal uvulectomy [AOR=0.053; 95% CI: 0.01, 0.35], home delivery [AOR= 6.02 ; 95% CI: 1.15, 31.61], postnatal couple counseling about traditional neonatal uvulectomy [AOR= 0.101; 95% CI: 0.02, 0.65], prior history of traditional neonatal uvulectomy [AOR= 7.15; 95% CI: 1.18, 43.21] and knowing at least one disadvantage of traditional neonatal uvulectomy [AOR= 0.068; 95% CI: 0.01, 0.44] were independent predictors of the malpractice. Furthermore, maternal perception of no modern medicine to treat elongated uvula was the most explained reason to do the malpractice. Conclusion The burden of traditional uvulectomy was high. Fortunately, its predictors are modifiable. Therefore, different community groups including women health development armies, elders, religious fathers, health professionals and criminal prosecutors should be actively mobilized against this malpractice. Besides, parental couple counseling about the key message of no traditional neonatal uvulectomy should be properly implemented in the routine antenatal and postnatal programs of the health care delivery system at south Gondar zone.