ObjectivesTo assess the pattern of contraceptive use and its determinants, knowledge regarding contraceptives including oral contraceptive pills and fertility intentions among tribal women in the reproductive age group.DesignCommunity-based cross-sectional study.SettingCommunity development blocks in a predominantly tribal district of Wayanad in Kerala, India.ParticipantsWomen in the reproductive age group (15–49 years) from the tribal groups in the district numbering 2495.Outcome measuresPrimaryPrevalence of contraceptive use and its determinants.SecondaryKnowledge regarding contraceptives in general, oral contraceptives and fertility intentions.ResultsThe mean age of the study participants was 30.8 years (SD=9.8) and belonged to various tribal groups such as Paniya (59.2%), Kurichiyar (13.6%) and Adiya (10.9%). Current use of contraceptive was reported by about a fourth, 658 (26.4%) (95% CI 27.9 to 24.9) of women. Following logistic regression, belonging to Paniya tribe (adjusted OR (aOR) 2.67, 95% CI 1.49 to 4.77; p<0.001) and age at menarche >13 years (aOR 1.69, 95% CI 1.14 to 2.52; p<0.009) had significantly higher use of contraceptives whereas social vulnerability as indicated by staying in a kutcha house had a lesser likelihood of use of contraceptive (aOR 0.55, 95% CI 0.31 to 0.95; p<0.03). Oral contraceptive use was low (4.8%) among this population and no abuse was observed.Less than half (47%) of the respondents had an above average knowledge on contraception. Multivariable logistic regression indicated that above average knowledge was 2.2 times more likely with higher education (95% CI 1.2 to 3.9), lesser among those who desired more than two children (aOR 0.59; 95% CI 0.38 to 0.94; p<0.02).Two children per family was the preferred choice for 1060 (42.5%) women. No gender bias in favour of the male child was observed.ConclusionAwareness and use of contraceptives are poor though the fertility is not commensurately high. Along with developing targeted responses to contraceptive use among Indigenous people with indigenous data, awareness also requires attention. Ethnographic studies are also necessary to determine the differences in contraceptive use including traditional methods among the various Indigenous groups.
Smegma pearls, also called smegmomas, are a natural secretion composed of epithelial cells, protein, and fat. Smegma pearls are not carcinogenic and do not induce damage or irritation. Despite the frequent occurrence of smegma pearls in uncircumcised children, no case among circumcised patients was reported. Here, we are presenting, for the first time, a case of smegma pearl in a circumcised patient. A 36-year-old circumcised male patient presented with a smegma pearl. The purpose of the present case report is to describe the diagnosis of this benign condition in circumcised patients, yet not described in the literature, and help physicians to enhance patient management and avoid needless investigations or treatments.
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