Pelvic organ prolapse is the downward descent of the pelvic floor organs and has a prevalence of 3%–6% and can even reach to 50% if defined by a vaginal examination. The anatomical concepts of pelvic diaphragm, lateral attachment of vagina to arcus tendineus fascia pelvis, and intrinsic and extrinsic sphincter control mechanisms are elaborated. The anatomic and physiological mechanisms of autonomic and voluntary control of continence are discussed. The clinical and urodynamic tests and their implications in guiding the management are explained. Finally, uroflowmetry, cystometry, urethral pressure profile, postvoid urine measurement, leak point pressure (LPP) test, video urodynamic tests, and electromyography studies of pelvic floor are discussed as an integral part of the assessment.

Background: Leiomyomata causing symptoms have a deleterious effect on the health of women during reproductive age. Mifepristone, a progesterone antagonist was studied for reduction of symptoms in leiomyomata in perimenopausal women. Material and Methods: Mifepristone was adminstered to 7 women aged 47-50 years. Another 3 women less than 47 years were taken up for comparison of benefit of Mifepristone on leiomyomata related symptoms. Mifepristone was given in a stepwise declining dose for a period of 9 months to 1 year . The treatment was begun with 25 mg and the dose was reduced every 3 months. Every 3 months, the size of myomas, bleeding pattern, location of myomas, endometrial thickness, haemoglobin, and any side effects were all recorded. Results: There was considerable amelioration in the symptoms in both premenopausal as well as perimenopausal women, while mifepristone was continued. The reduction in myoma size was found to be statistically significant. After stoppage of drug in women aged 40-45 years, i.e. premenopausal group, the symptoms returned. However, in perimenopausal women, in 6 out of 7 women the symtoms abated completely and they had a smooth transition to menopause. Conclusion: Mifepristone is a very promising drug for conservative management of leiomyomata, especially in perimenopausal age (47years or more), where hysterectomy was averted in all 7 women.

Context: Anemia has a high prevalence among postmenopausal Indian females. Aim and Objective: The aim of this study was to evaluate dietary intake, prevalence, and the effect of anemia on various morphophysiological variables among postmenopausal women. Setting and Design: This was a community-based sample survey. Materials and Methods: A total of 250 postmenopausal women aged 45–80 years from various parts of North India participated in the study. Anthropometric measurements, hemoglobin concentration, and bone mineral density (BMD) (using dual-energy X-ray absorptiometry) of each participant were assessed. A 24-h dietary recall method for three consecutive days was employed. Statistical Analysis: The Statistical Package for the Social Sciences version 20 was used for statistical considerations. Results: An age-associated decline in the mean values of hemoglobin concentration and the prevalence of anemia was reported to be 85.2% among postmenopausal women. Anemic women were lighter and had lesser circumferential measurements as well as lower BMD than their nonanemic counterparts. The intake of nutrients such as protein, calcium, and iron and energy was lower among anemic women than nonanemic women. Binary logistic regression analysis identified age (odds ratio = 1.04, 95% confidence interval = 1.00–1.09)* as the possible predictor of anemia. Conclusions: Anemia was not only the result of aging process but also inadequate and unbalanced dietary intake.

Aim: The study aims to find out the prevalence of obesity and its consequences on the health of middle-aged (45–59 years) women in slum areas. Methodology: The present study includes 559 women between 45 and 59 years of age from slums of Pune city, Maharashtra. Data were collected using a structured questionnaire, anthropometric measurements, physical activity using International Physical Activity Questionnaire long version, information on dietary habits, chronic illnesses, etc., Univariate analysis and further multiple logistic regressions were used to determine associations and risk estimates using Statistical Package for the Social Science version 16. Results: About 60% had body mass index (BMI) above normal, 39% were overweight, and 21.3% obese. The percentage of obesity increased with increasing age. Obesity was significantly associated with working status (P = 0.042), hypertension (P = 0.013), knee pain (P = 0.029), squatting (P = 0.001), walking (P = 0.001), climbing stairs (P = 0.004), and rising from chair (P = 0.040). Functional decline was reported by 62.8% women. Odds of having high blood pressure 1.8 (95% confidence interval [CI]: 1.1–3.0), difficulty in squatting, walking was 1.5 (95% CI: 1.0–2.4) and 1.9 (95% CI: 1.0–3.6) respectively more in overweight. Higher odds of having blood pressure 1.8 (95% CI: 1.0–3.3) and difficulty in walking 2.4 (95% CI: 1.2–4.6) was observed in obese women as compared to women in normal BMI category. Conclusion: The study shows that the prevalence of obesity is higher among women even in the low-income areas. This indicates a need for specific interventions targeted to women in urban slum. The inclusion of multicomponent intervention will prove to be beneficial at the community level.

Objective: This study aims to determine the association of dyslipidemia and increased insulin resistance (IR) with increased breast cancer (BC) risk. Materials and Methods: The study group comprised 110 premenopausal and 143 postmenopausal, untreated female BC patients in the age range of 29–72 years. Control group consisted of 117 premenopausal and 141 postmenopausal healthy females in the age range of 23–75. Approximately 8-ml blood samples were drawn to measure various biochemical parameters. Serum glucose, total cholesterol, triglyceride (TG), and high-density lipoprotein-cholesterol were measured. Very low-density lipoprotein-cholesterol (VLDL-C) and LDL-C were calculated using Friedewald's formula. Serum insulin and serum CA 15-3 were estimated by immune enzymatic assay. IR was assessed using homeostasis model assessment IR index (HOMA-IR). Results: Clinical variables in the case and control groups were compared using the unpaired Student's t-test. The crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by binary logistic regression analysis. Pearson's correlation analysis was used to determine the association between CA 15-3 and variables of interest. Total cholesterol, TG, LDL, VLDL, serum glucose, serum insulin, HOMA-IR, and serum CA 15-3 were significantly higher (P < 0.001) in BC patients compared to those in controls. Significant adjusted ORs with 95% CI were found to be fasting glucose, total cholesterol, and TGs. We also found a significant positive correlation between total cholesterol, TG, LDL, serum glucose, serum insulin, HOMA-IR, and serum CA 15-3. Conclusion: This study confirms the association between dyslipidemia, IR, and increased BC risk.

Background: Menstrual disorder accounts for 5%–10% of the women presenting with iron deficiency anemia (IDA) in the perimenopausal age group. Heavy menstrual bleeding in this age group leads to severe anemia and frequently requires blood transfusion which has its own adverse effects. We today have ferric carboxymaltose (FCM) as a safer alternative to blood transfusion. Objective: The objective of the study is to evaluate the safety and efficacy of FCM in treating anemia in patients of menorrhagia. Thus avoiding blood transfusion. Materials and Methods: It was an open, single arm observational study including 90 women of age more than 30 years with definitive diagnosis of menorrhagia with IDA and hemoglobin (Hb) levels between 4 gm% and 11 gm%. Intravenous FCM (500–1500 mg) was administered, and the improvement in blood indices was assessed after 3 weeks of total dose infusion. Menorrhagia was controlled by medical treatment till Hb improvement was achieved and definitive surgical intervention was done. Result: Most of the women were in the age group of 40–50 years. Blood indices measured pre-FCM and 3 weeks post-FCM showed a mean increase in Hb from 8.33 ± 1.10 to 10.89 ± 1.02 with a statistically significant P < 0.01. There was a statistically significant rise of packed cell volume, serum ferritin, and serum iron in the post-FCM blood levels after 3 weeks. No serious life-threatening adverse events were observed after FCM administration. Conclusion: Intravenous FCM is an effective and a safe treatment option for IDA with a single administration of high dose without serious adverse effects obviating the need for blood transfusion before surgery.

Introduction: Older people are at risk for polypharmacy due to multiple chronic diseases. Considering the lack of information in this regard, the aim of this study was to investigate the state of polypharmacy among the elderly in the city of Amirkola in northern part of Iran. Materials and Methods: This descriptive/analytical cross-sectional study is a part of Amirkola Health and Aging Project that was conducted on 1616 individuals aged 60 years and over. The data about medications were gathered through interviews and observation of prescriptions and medications consumed by patients. The data were analyzed by SPSS software version 18, and P ≤ 0.05 was regarded significant. Results: In this study, 1616 individuals including 883 men (54.6%) and 733 women (45.3%) were investigated. The average age of individuals was 69.37 ± 7.42. Among the investigated individuals, 526 including 368 men (41.7%) and 158 women (21.6%) consumed no medications. The prevalence of polypharmacy in this study was 23.1%, which was 32.7% in women and 15.2% in men (odds ratio = 1.51, 95% confidence interval: 1.10–1.93). The most prevalent group of medications used in both genders was cardiovascular drugs. Conclusions: Regarding the considerable prevalence of polypharmacy among the elderly, especially in aged women, serious efforts are required to manage polypharmacy. Provision of educational programs for physicians, personnel of pharmacies, and the staff of health-care centers in order for appropriate and safe consumption of medications in aged people is absolutely necessary.

Pseudocarcinomatous hyperplasia of the fallopian tube is a rare, reactive response to an underlying inflammatory or neoplastic process. Only a few cases have been reported in literature. It is a benign condition that mimics a malignant neoplasm clinically and radiologically. Thus, a preoperative diagnosis of this entity is important to avoid radical surgical treatment. We report a case of pseudocarcinomatous hyperplasia of the fallopian tube in a 27-year-old female, which was clinically and radiologically thought to be a tubal neoplasm. The approach to such a case and the differentiating features from adenocarcinoma have also been discussed.

One of the major manifestations of methimazole-induced neutropenia or agranulocytosis is diffuse gingival ulceration and necrosis. The aim of this case report is to be familiar with drug-induced neutropenia and its associated oral manifestations and the healing of the gingiva after proper treatment.