iosr-JDMS   Volume-24 ~ Issue-5 ~ May 2025

Abstract: We present the case of a 20-year-old female with primary amenorrhea who was evaluated for absent menstruation. On examination, breast development was normal (Tanner stage 5), but the patient had no vaginal orifice. Investigations, including hormonal assays, revealed elevated levels of testosterone, FSH, and LH. Imaging studies (ultrasound and MRI) showed the absence of the uterus and ovaries. Karyotyping confirmed a 46, XY chromosomal pattern, leading to the diagnosis of Complete Androgen Insensitivity Syndrome (CAIS). This case highlights the importance of considering AIS in the differential diagnosis of primary amenorrhea, especially in the presence of normal female secondary sexual characteristics and absence of menstruation. The appropriate workup, including hormonal testing, imaging, and karyotyping, is essential for the timely diagnosis and management of AIS.

Keywords:Primary amenorrhea, Androgen Insensitivity Syndrome, Disorder of Sexual Development.

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Abstract: Background Childhood immunization is a cornerstone of public health in low- and middle-income countries (LMICs), where vaccine-preventable diseases significantly contribute to child mortality. Despite global efforts, immunization coverage in many LMICs remains below target levels. This article examines the determinants of childhood immunization through the lens of the Socio-Ecological Model (SEM), considering influences at intrapersonal, interpersonal, organizational, community, and policy levels. By integrating findings from diverse studies, this analysis provides a.....

Keywords : Immunization; Socio-Ecological Model; LMICs; Secondary Data Analysis; Health Equity

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[3] Jones, C. E., Danovaro-Holliday, M. C., Mwinnyaa, G., Gacic-Dobo, M., Francis, L., Grevendonk, J., Nedelec, Y., Wallace, A., Sodha, S. V., & Sugerman, C. (2024). Routine Vaccination Coverage - Worldwide, 2023. MMWR. Morbidity And Mortality Weekly Report, 73(43), 978–984. Https://Doi.Org/10.15585/Mmwr.Mm7343a4
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[5] Wilson, Lindsay & Rubens-Augustson, Taylor & Murphy, Malia & Jardine, Cynthia & Crowcroft, Natasha & Hui, Charles & Wilson, Kumanan. (2018). Barriers To Immunization Among Newcomers: A Systematic Review. Vaccine. 36. 10.1016/J.Vaccine.2018.01.025