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2010| July-December | Volume 1 | Issue 2
Online since
January 28, 2011
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ORIGINAL ARTICLES
Menopause and metabolic syndrome: A study of 498 urban women from western India
Shefali Pandey, Manisha Srinivas, Shubhada Agashe, Jayashree Joshi, Priti Galvankar, CP Prakasam, Rama Vaidya
July-December 2010, 1(2):63-69
DOI
:10.4103/0976-7800.76214
PMID
:21716770
Introduction:
Metabolic syndrome (MS) is a cluster of risk factors for future development of type 2 diabetes mellitus and cardiovascular diseases. Menopausal transition with its incidental hormonal changes is considered to contribute to the development of MS. However, age is known to influence MS risk factors.
Objective:
The present study explores the prevalence of MS in pre- and postmenopausal women from western India.
Methods:
Four hundred and ninety eight women above 35 years of age, participating in women's health care program were assessed for the prevalence of MS using two criteria- International Diabetes Federation criteria (IDF) and Harmonization (H_MS) criteria.
Results:
Prevalence of MS amongst postmenopausal women was significantly higher (
P
< 0.001) than that in premenopausal women by both, IDF (premenopausal 45% and postmenopausal 55%) and H_MS criteria (premenopausal 44% and postmenopausal 56%). However, this significance disappeared when data was adjusted for the confounding variable of age.
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CASE REPORTS
Lipoleiomyoma of uterus in a postmenopausal woman
Hanumanthappa Krishnappa Manjunatha, Anikode Subramanian Ramaswamy, Bylappa Sunil Kumar, Sulkunte Palaksha Arun Kumar, Lingegowda Krishna
July-December 2010, 1(2):86-88
DOI
:10.4103/0976-7800.76219
PMID
:21716761
Lipoleiomyomas are uncommon benign neoplasms of uterus and are considered to be a variant of uterine myomas. Their reported incidence varies from 0.03 to 0.2%. Lipoleiomyoma consists of variable proportion of mature lipocytes and smooth muscle cells. These tumors generally occur in asymptomatic obese perimenopausal or menopausal women. We report this case of uterine lipoleiomyoma because of its rarity.
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REVIEW ARTICLE
Yoga
and menopausal transition
Nirmala Vaze, Sulabha Joshi
July-December 2010, 1(2):56-58
DOI
:10.4103/0976-7800.76212
PMID
:21716773
With increased life expectancy, today, women spend one-third of their life after menopause. Thus more attention is needed towards peri- and post-menopausal symptoms. Estrogen replacement therapy is the most effective treatment, however, it has its own limitations. The present need is to explore new options for the management of menopausal symptoms. Yogic life style is a way of living which aims to improve the body, mind and day to day life of individuals. The most commonly performed
Yoga
practices are postures (
asana
), controlled breathing (
pranayama
), and meditation (
dhyana
).
Yoga
has been utilized as a therapeutic tool to achieve positive health and control and cure diseases. The exact mechanism as to how
Yoga
helps in various disease states is not known. There could be neuro-hormonal pathways with a selective effect in each pathological situation. There have been multiple studies that have combined the many aspects of
Yoga
into a general
Yoga
session in order to investigate its effects on menopausal symptoms. Integrated approach of
Yoga
therapy can improve hot flushes and night sweats. There is increasing evidence suggesting that even the short-term practice of
Yoga
can decrease both psychological and physiological risk factors for cardiovascular disease (CVD). Studies conclude that our age old therapy,
Yoga
, is fairly effective in managing menopausal symptoms
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ORIGINAL ARTICLES
Normal BMD values for Indian females aged 20-80 years
Ranu Patni
July-December 2010, 1(2):70-73
DOI
:10.4103/0976-7800.76215
PMID
:21716763
Background:
Dual-energy X-ray absorptiometry is presently considered the gold standard for measuring bone mineral density (BMD). The International Osteoporosis Foundation and World Health Organization have recommended National Health and Nutrition Examination Survey III database values for women aged 20-29 years to be followed as reference BMD values worldwide. However, the BMD may differ for different populations.
Objective:
The objective of the present study was to plot BMD values in the hip (neck) and lumbar spine (L1-L4 AP view) in Indian women aged 20-80 years. Also, BMD values in the 20-60-year-old females were compared with reference American/European population.
Result:
It was found that the BMD of Indian females was 1.5-2 standard deviation (SD) s lower than that of the reference Western population in all the comparative age groups.
Conclusion:
It is reasonable to conclude that BMD values of the hip and spine among comparative Indian and Western female age groups show significant differences. Hence, different normals should be followed for each population.
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Attitudes and practices of gynecologists in Jaipur toward management of menopause
Shuchita Meherishi, Sunila Khandelwal, ML Swarankar, Prabhleen Kaur
July-December 2010, 1(2):74-78
DOI
:10.4103/0976-7800.76216
PMID
:21716769
Background:
In earlier days, hormone replacement therapy (HRT) was recommended for menopause symptoms and also gained much popularity. However, the Women's Health Initiative (WHI) studies suggested an increased risk of cardiovascular and Alzheimer's disease. These findings led to a dramatic decrease in hormone therapy (HT) prescriptions all over the world. However, the WHI conclusions remain debatable especially because of contradictory results from antecedent studies. Inspite of these controversies, post-WHI, most gynecologists refrain from prescribing MHT (menopausal hormone replacement therapy, MHT). Furthermore, many Indian gynecologists prefer to prescribe alternative treatments that would help alleviate symptoms and thus avoid HRT. We decided to carry out a survey and document the current opinions regarding indications of HRT and alternative therapies and prescribing practices of Jaipur-based gynecologists.
Objective:
This study was designed to find out the current attitudes and practices of gynecologists (Jaipur) towards management of menopause.
Materials and Methods:
A questionnaire concerning attitudes, management strategies, and use of HT was mailed out to gynecologists, and they are asked to complete the questionnaire. Data were analyzed using the total number of respondents (
n
= 321). The results were analyzed using a simple percentage method as this was most suitable for this kind of studies.
Results:
From the results, 69.04% gynecologists were currently prescribing MHT. Hot flashes were the most common indication for MHT prescriptions and 78.57% were familiar with controversies surrounding WHI study. Also, 61.9% would consider using MHT for themselves. Alternative therapy was adopted by 83.48% in their prescribing practice. The reason cited by 71% for preferring alternative therapies was that it was safer and less controversial.
Conclusions:
The prescribing practices of Jaipur gynecologists in lieu of ongoing controversies surrounding HT have shifted and now also support alternative therapies for menopause management. In this era of phasic prescriptions, for immediate relief of hot flashes and mood swings, MHT was favored. However, for long-term management of women with poor compliance, alternative therapies were considered a safer option.
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CASE REPORTS
Post-salpingectomy endometriosis: An under-recognized entity
Indranil Chakrabarti, Nilanjana Ghosh
July-December 2010, 1(2):91-92
DOI
:10.4103/0976-7800.76221
PMID
:21716859
We report a case of a 48-year old lady, who presented with complaints of lower abdominal pain and menorrhagia for the last four months. The patient had undergone bilateral salpingectomy four years back by the Pomeroy technique. Ultrasonography revealed an ovarian cyst on the right side. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed and the specimen was sent for histopathological examination. It revealed that the normal mucosa of the tubectomy stump was completely replaced by endometrial tissue. Tubal endometriosis remains an under-recognized entity, due to less extensive routine sampling of the fallopian tubes, and they may be also be associated with other pathologies, as was in the present case.
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Acute abdomen with hemoperitoneum in a postmenopausal woman
Tulon Borah, Ananya Das, Subrat Panda, Ahanthem Santa Singh
July-December 2010, 1(2):89-90
DOI
:10.4103/0976-7800.76220
PMID
:21716764
Gynecological emergencies may be encountered in postmenopausal ladies like that of ruptured ectopic pregnancy in the reproductive age group. We report a case of ruptured granulosa cell tumor in a 70-year-old woman who presented with acute abdomen and hemoperitoneum.
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EDITORIALS
Bone mineral density and reference standards for Indian women
Rama Vaidya, Rashmi Shah
July-December 2010, 1(2):55-55
DOI
:10.4103/0976-7800.76211
PMID
:21716767
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BOOK REVIEW
Reproductive endocrinology: A molecular approach
Jayashree V Joshi
July-December 2010, 1(2):96-96
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EDITORIALS
Diligent case reports: A rich reservoir for midlife healthcare and research
Rama Vaidya, Rashmi Shah
July-December 2010, 1(2):51-52
DOI
:10.4103/0976-7800.76209
PMID
:21716771
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The ongoing nosologic dilemma with the metabolic syndrome
Ashok D.B Vaidya
July-December 2010, 1(2):53-54
DOI
:10.4103/0976-7800.76210
PMID
:21716762
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EDITORS COMMENT
Editor's Comment
Rama Vaidya, Rashmi Shah
July-December 2010, 1(2):62-62
PMID
:21716765
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IMS NEWS
IMS News-1
July-December 2010, 1(2):97-97
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IMS News-2
Atul P Munshi
July-December 2010, 1(2):98-99
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JOURNAL FEEDBACK
Journal of Mid-Life Health: Words of appretiation
July-December 2010, 1(2):100-101
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JOURNAL SCAN
Synopsis of results from European male ageing study
SS Vasan
July-December 2010, 1(2):93-94
PMID
:21716768
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Calcium supplementation: Cardiac woes
Sharad Kumar
July-December 2010, 1(2):95-95
PMID
:21716772
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ORIGINAL ARTICLES
Non-conventional hormone therapy - Tissue-specific Tibolone-Caution
Jyotsna Potdar
July-December 2010, 1(2):59-62
DOI
:10.4103/0976-7800.76213
PMID
:21716774
Objectives:
The present retrospective study was undertaken to assess safety profile of long term Tibolone therapy when one of my patients developed carcinoma breast.
Methods:
Fifty patients who were put on Tibolone were studied as regards the indication for Tibolone therapy, age distribution, duration of therapy and side effects.
Results:
Although most subjects responded well to therapy without significant side effects two patients developed breast lump. One of the breast lumps was malignant, the other benign. It is possible that prolonged Tibolone therapy may have caused carcinoma breast as against the notion that Tibolone is breast protective. Few of recent studies like Million Women Study and LIBERATE study which was concluded in April 2010, have shown that Tibolone also increases risk of carcinoma breast.
Conclusion:
Tibolone when used for management of menopausal symptoms should be given for less than 4 years and regular follow up with mammography is must.
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Effective risk assessment tools for osteoporosis in the Indian menopausal female
Seema Sharma, Sunila Khandelwal
July-December 2010, 1(2):79-85
PMID
:21716766
Objectives:
This study was designed to assess the effectiveness of self-administered osteoporosis risk score sheet, body mass index (BMI), and bone mineral density (BMD) (ultrasound) in screening females with low bone mass, and how the results of the tools correlate with each other.
Materials and Methods:
The study was conducted on 536 postmenopausal women, who attended public awareness camps on Midlife Women Health held at the Menopause Research Unit, MGMCH, Sitapura, Jaipur. At these camps, in addition to several informational sessions on issues related to menopause, ultrasonic measurement of BMD was conducted on each participant. A broad questionnaire to identify midlife health problems was developed, and osteoporosis specific score sheet was designed to be self-administered. Patients were required to complete the osteoporosis specific risk score sheet and women health questionnaire (WHQ). BMI was determined. Statistical analysis was carried out to find the correlation between various variables. Sensitivity and specificity of the each risk score ascertained and cutoff risk score for identifying osteopenia was derived by comparing area under curve of each risk score on drawing receiver operational curve (ROC).
Results:
Sensitivity of risk score system was calculated to be 78.33% with 95% confidence interval being 73.24-82.86% and specificity was 27.12% with 95% confidence interval being 21.56-33.27%, keeping the cutoff point at nine. There was statistically significant inverse relationship between risk score and BMD values with Pearson correlation coefficient of (-) 0.22 and positive relationship between BMD and BMI with correlation coefficient of 0.192.
Conclusion:
By noting down the risk factors and BMI, we can screen out the women who require further evaluation and management, thus, it is an effective tool, particularly in developing countries like India, where most of the patients cannot afford expensive DEXA scans, although considered as the gold standard for BMD assessment. With the help of such scoring systems, health resources can be judiciously utilized.
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© Journal of Mid-life Health | Published by Wolters Kluwer -
Medknow
Online since 1
st
March, 2010