Home
|
About us
|
Editorial board
|
Search
|
Ahead of print
|
Current Issue
|
Past Issues
|
Instructions
|
Online submission
|
Subscribe
|
Advertise
Users Online: 88
Export selected to
Endnote
Reference Manager
Procite
Medlars Format
RefWorks Format
BibTex Format
Access statistics : Table of Contents
2021| October-December | Volume 12 | Issue 4
Online since
January 20, 2022
Archives
Previous Issue
Next Issue
Most popular articles
Most cited articles
Show all abstracts
Show selected abstracts
Export selected to
Viewed
PDF
Cited
PICTORIAL REVIEW
Endometrium at menopause: The pathologist's view
Meenakshi Swain, Aditya D Kulkarni
October-December 2021, 12(4):310-315
DOI
:10.4103/jmh.jmh_218_21
Endometrium at menopause is inactive and free of cyclical changes that are characteristics of the reproductive age. At the same time, menopausal endometrium is subject to a variety of disease processes, the most sinister of which are the endometrial malignancies. In the present pictorial review, we briefly discuss the various morphologic patterns of diseases affecting the menopausal endometrium. With an aim to provide insights from the pathologists' point of view, multiple pictures for each of the disorders are shared. We highlight the finer points a pathologist looks for, to ensure proper treatment and welfare of postmenopausal women.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
4,341
177
-
REVIEW ARTICLES
Sclerostin inhibition: A novel target for the treatment of postmenopausal osteoporosis
Suruchi Aditya, Aditya Rattan
October-December 2021, 12(4):267-275
DOI
:10.4103/jmh.JMH_106_20
Osteoporosis, a widespread skeletal disorder with a substantial economic load, is characterized by increased porosity of the bones resulting in vulnerability to fractures. When activated, the canonical Wnt signaling pathway results in osteoblastogenesis and bone formation. A Wnt ligand forms a complex with low-density lipoprotein receptor-related proteins 5 and 6 (Lrp5/6) and stimulates intracellular signaling cascades, leading to nuclear translocation of β-catenin and transcription of downstream molecules involved in osteoblast differentiation, maturation, and survival. Sclerostin (SOST), a glycoprotein produced by osteocytes, is an extracellular Wnt antagonist that blocks the binding of Wnt ligands to Lrp5/6, preventing the activation of the pathway and osteoblast-mediated bone formation subsequently. Inhibition of SOST represents a new therapeutic paradigm for the treatment of osteoporosis. Monoclonal antibodies to SOST include romosozumab, blosozumab, and setrusumab. With its unique dual effect of increasing bone formation (anabolic action) and decreasing bone resorption, the Food and Drug Administration approved romosozumab as a promising new treatment for postmenopausal osteoporosis. Its efficacy and safety have been established in trials. However, patients at high risk of cardiovascular or cerebrovascular events should not be prescribed romosozumab.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
2,626
344
3
Influence of female sex hormones in different stages of women on periodontium
Ramanarayana Boyapati, Sai Abhishiktha Cherukuri, Ruparani Bodduru, Ambati Kiranmaye
October-December 2021, 12(4):263-266
DOI
:10.4103/jmh.jmh_142_21
The primary etiologic factor for periodontal diseases is “Dental plaque.” Although pathogenic bacteria in dental plaque are required for the incidence of periodontal disease, a susceptible host is also very important. The susceptibility of the host can be modified by many systemic factors with hormones level being one. The periodontium shows an exaggerated inflammatory response to plaque modified by female sex hormones during puberty, pregnancy, in women taking oral contraceptives, and at the postmenopausal stage. This review provides an in detail analysis of how periodontium is influenced by the fluctuation in sex steroid hormones of females during different phases of their lifetime and to discuss how much the same hormone at different ages and stages shows an exaggerated gingival response to plaque.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
2,597
351
2
Screening tools for osteoporosis in India: Where do we place them in current clinical care?
Kripa Elizabeth Cherian, Nitin Kapoor, Meeta Meeta, Thomas Vizhalil Paul
October-December 2021, 12(4):257-262
DOI
:10.4103/jmh.jmh_216_21
The prevalence of osteoporosis is about 40%–50% in postmenopausal women and 20% in older men. The limited availability of dual-energy X-ray absorptiometry (DXA) scanners across the country calls for the presence of alternate risk assessment tools to identify those at high risk for osteoporosis. Some of the screening tools available for osteoporosis include Simple Calculated Osteoporosis Risk Estimation and Osteoporosis Risk Assessment Tool for Asians (OSTA), and Fracture Risk Assessment Tool to assess fracture risk. Clinical parameters that may serve as surrogates include dentition and anthropometric indices. Although screening tools do not supplant the assessment of bone mineral density by DXA, they help identify individuals at high risk for osteoporosis who may be selectively referred for confirming the same.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
2,346
311
1
PERSPECTIVE
Dual-energy X-ray absorptiometry scanning in practice, technical aspects, and precision testing
Kripa Elizabeth Cherian, Nitin Kapoor, Meeta Meeta, Thomas Vizhalil Paul
October-December 2021, 12(4):252-256
DOI
:10.4103/jmh.jmh_215_21
The last three decades have witnessed considerable progress in the field of bone densitometry. Osteoporosis may be diagnosed in postmenopausal women and in men aged 50 and older if the bone mineral density (BMD) T-scores of the lumbar spine, total hip, or femoral neck are −2.5 or less. For reporting T-scores, the Hologic dual-energy X-ray absorptiometry (DXA) scanner uses the Caucasian (nonrace adjusted) female normative database for women and men of all ethnic groups although reference database used does have an impact on the categorization of BMD and must be chosen judiciously considering the regional and ethnic characteristics of the population. The quality control for DXA systems should be periodically done in accordance with manufacturer guidelines for DXA. Beyond conventional BMD assessment, DXA may also be utilized to assess the trabecular bone score, hip structural analysis, vertebral fractures, and body composition.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
1,934
262
-
ORIGINAL ARTICLES
Relationship between osteoporosis, multiple fractures, and egg intake in healthy elderly
Roberta Pujia, Yvelise Ferro, Samantha Maurotti, Rosario Mare, Franco Arturi, Tiziana Montalcini, Arturo Pujia, Elisa Mazza
October-December 2021, 12(4):287-293
DOI
:10.4103/jmh.jmh_118_21
Context:
The role of dietary patterns in the prevention of osteoporosis has been investigated in many studies, but few have examined the association between consumption of specific food and whole-body (WB) bone mineral density (BMD). Recent evidence suggests that whole eggs contain bioactive compounds that could have beneficial effects on BMD. BMD is also expressed as the T-score, which is used for the clinical diagnosis of osteoporosis and to evaluate the effectiveness of drugs.
Aims:
We conducted a study to assess the association between eggs consumption and bone density in a population of the elderly.
Settings and Design:
This cross-sectional study included 176 individuals of both genders and aged ≥65 years.
Subjects and Methods:
Egg intake was ascertained by a combination of dietary intake assessment, and a dual X-ray absorptiometry scan was performed to measure WB T-score.
Results:
In our study, among all the food groups and nondietary factors evaluated, we find a positive association between the WB T-score and egg consumption (B = 0.02;
P
= 0.02), gender (B = 0.85;
P
< 0.001), and body mass index (B = 0.04;
P
= 0.03). Multiple fractures were associated with the daily intake of eggs (B = ‒0.26;
P
= 0.02) and high-density lipoprotein-cholesterol (B = 0.09;
P
= 0.03).
Conclusions:
This study provides novel evidence of a positive link between whole egg consumption and bone health. If results observed in this study will be confirmed through future randomized controlled trials, whole eggs may represent a viable strategy to prevent osteoporosis and reduce the risk of fractures in the elderly.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
1,958
184
-
The addition of active stretching to balance strategy exercise is the most effective as a home-based exercise program in improving the balance of the elderly
Govinda Vittala, Luh Putu Ratna Sundari, Nur Basuki, R A Tuty Kuswardhani, Susy Purnawati, I Made Muliarta
October-December 2021, 12(4):294-298
DOI
:10.4103/jmh.jmh_184_21
Background:
The decreased balance in the elderly increases the risk of falling. An effective type of exercise is needed to improve balance for the elderly.
Aims:
The purpose of this study was to determine the difference in the effectiveness of adding active stretching with dynamic stretching to balance strategy exercise as a home-based exercise program in improving the balance for the elderly.
Participants and Methods:
This research was a randomized control trial. The participants were 36 elderly selected based on the inclusion and exclusion criteria, divided into three groups. Group 1 was given dynamic stretching exercises to balance strategy exercises, Group 2 was assigned active stretching exercises to balance strategy exercise, and Group 3 was given balance strategy exercise only as a control group. Each group was given different exercises three times a week for 6 weeks. The balance ability of the elderly is measured using a Berg balance scale (BBS).
Results:
The mean difference scores of BBS before and after exercise with paired sample
t
-test increased in both groups with
P
< 0.05. It means that all groups had a significant impact, where the highest different score is in Group 2. The one-way ANOVA test showed a significant difference in the average posttest BBS value between the groups. Furthermore, the data were analyzed by the LSD
post hoc
test, where the results showed that all groups have significant differences against other groups (
P
< 0.05), with the best group being Group 2.
Conclusion:
According to the results, the addition of active stretching exercise to the balance strategy exercise as a home-based exercise program is the most effective in improving balance for the elderly.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
1,860
217
-
EDITORIAL
John studd—A tribute
Meeta Meeta, Vishal R Tandon
October-December 2021, 12(4):251-251
DOI
:10.4103/jmh.jmh_1_22
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
1,841
235
-
ORIGINAL ARTICLES
One-year mortality rates and factors affecting mortality after surgery for fracture neck of femur in the elderly
Mohit Dhingra, Tarun Goyal, Arvind Yadav, Arghya Kundu Choudhury
October-December 2021, 12(4):276-280
DOI
:10.4103/jmh.jmh_208_20
Context:
Fractures around hip in elderly are associated with significant morbidity and mortality.
Aim:
This sudy aims to investigate 1-year mortality rates and risk factors associated with this mortality. Effect of delay in surgery on mortality rates will also be studied. Our null-hypothesis was that there is no association between common comorbid conditions or delay in surgery on 1-year mortality rates.
Study Settings and Design:
Patients 60-years and above who underwent operative treatment for fracture of neck of femur between January 2018 and February 2019 were included in this retrospective study.
Materials and Methods:
Demographic and clinical data were collected from hospital information system and inpatient case records. Patients were followed up with quality of life (QoL) assessment with short form-12 (SF-12) at 1 year. Mortality during this period was also evaluated.
Statistical Analysis:
Continuous factors were expressed as means, standard deviations. Different risk factors between the patients alive and dead were studied using Fisher's exact test.
Results:
Nineteen out of 95 patients died at the end of 1 year. Smoking, hypertension, diabetes, low hemoglobin, raised total leukocyte count, low serum albumin, delay in surgery (>1 week), higher American Society of Anesthesiologist grade, and postoperative blood transfusion were significantly associated with higher mortality rates. Mean SF-12 QoL scores at 1 year was 35.6 ± 6.3.
Conclusion:
Hip fractures in elderly are associated with higher mortality rates. Results of this study indicate that patients at a higher risk of mortality may be identified and help in preoperative optimization with the aim to reduce mortality. However, these findings need to be verified by further studies with a relatively larger sample size and longer follow-up period.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
1,654
235
1
Lean body mass, body fat percentage, and handgrip strength as predictors of bone mineral density in postmenopausal women
Khatri Om Prakash, Raghuveer Choudhary, Govind Singh
October-December 2021, 12(4):299-303
DOI
:10.4103/jmh.jmh_21_21
Objective:
This study was conducted to assess lean body mass, body fat percentage, and handgrip strength in the prediction of bone mineral density (BMD) in postmenopausal women.
Materials and Methods:
This cross-sectional study included 102 postmenopausal women aged between 45 and 80 years (mean age 58) who were screened for osteoporosis using a dual-energy X-ray absorptiometry scan at the lumbar spine. The lean body mass, body fat percentage, and handgrip strength were calculated.
Results:
The lean body mass, body fat percentage, and handgrip strength were having a positive association (correlation coefficient: 0.48, 0.29, and 0.3, respectively) with BMD.
Conclusion:
Lean body mass, body fat percentage, and handgrip strength can detect early loss of BMD in postmenopausal women leading to early screening for osteoporosis resulting in early interventions minimizing BMD loss over a much longer period after menopause.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
1,579
247
2
Bone alkaline phosphatase and urine hydroxyproline assay in pre and postmenopausal women in the state of sikkim and its correlation with bone mineral density
Anne Deborah Rai, Mingma L Sherpa, Amumacha Singh, SG Thejaswi, Rinchen D Bhutia
October-December 2021, 12(4):304-309
DOI
:10.4103/jmh.jmh_73_21
Introduction:
Osteoporosis could be viewed as a metabolic disease. The WHO guidelines for diagnosing osteoporosis reflect structural damage only and not the metabolic imbalance that leads to it. Biochemical markers of bone turnover have been shown to provide valuable information for diagnosing and monitoring metabolic bone disease. The present study analyzed bone-specific alkaline phosphatase (BALP) and urinary hydroxyproline in pre- and postmenopausal women and correlated them with changes in bone mineral density (BMD) in the state of Sikkim. The study also intended to know the ethnicity-based disease burden in Sikkim.
Materials and Methods:
A hospital-based cross-sectional study was done at a tertiary hospital in Sikkim. Blood and 24-h urine samples from 50 premenopausal and 50 postmenopausal women were analyzed for total alkaline phosphatase (ALP), BALP, and Urine Hydroxyproline. BMD was measured using the quantitative ultrasound technique by Achilles densitometer.
Results:
There was a statistically significant increase in serum calcium (
P
= 0.01), ALP (
P
= 0.01), and urine hydroxyproline (
P
= 0.03) levels in postmenopausal women as compared to premenopausal women. Although ALP was higher in postmenopausal women, BALP isoform was more elevated in premenopausal women (
P
= 0.001). BMD was significantly lower in postmenopausal women (
P
< 0.001). It was also noted that there was a significant difference in BMD between tribal and nontribal populations (
P
= 0.003). Total ALP and BALP as the bone formation marker and urine hydroxyproline as a bone resorption marker added statistically significant r to BMD prediction (
P
< 0.05).
Conclusion:
In this study, BALP combined with Urine Hydroxyproline was helpful as a screening biomarker to predict osteoporosis in postmenopausal women.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
1,348
144
1
Endocervicoscopy with office hysteroscope for complete visualization of transformation zone in cases of invisible squamocolumnar junction on colposcopy
Priyanka Meena, Amita Suneja, Richa Aggarwal, Neelam B Vaid, Kiran Mishra
October-December 2021, 12(4):281-286
DOI
:10.4103/jmh.JMH_137_19
Aim:
To evaluate the role of endocervicoscopy for the visualization of the T3 transformation zone (TZ) on colposcopy.
Materials and Methods:
Forty patients with either abnormal Pap smear or positive VIA-VILI and T3 TZ on colposcopy were recruited from the colposcopy clinic and subjected to endocervicoscopy with a 4-mm office hysteroscope. The view of the endocervical canal was recorded before and after the application of 5% acetic acid and the squamocolumnar junction was identified in its entirety. An endocervical curettage was taken in all the cases and compared with the final histopathology report.
Results:
Squamocolumnar junction was visible in all the 40 cases; however, in two patients (5%), cervical dilatation had to be done. The positive predictive value (PPV) of endocervicoscopy in our study was 33.3% and negative predictive value (NPV) was 100%. Dense acetowhitening/irregular polypoidal endocervical mucosa with dilated blood vessels was significant in predicting the premalignant and malignant lesions with PPV of 67% and NPV of 100%.
Conclusion:
Endocervicoscopy allows a panoramic view of the endocervical canal. It is a safe, effective, and feasible technique for visualization of squamocolumnar junction with 5% acetic acid in cases of T3 TZ on colposcopy.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
1,252
127
-
CASE REPORTS
Choriocarcinoma in post-menopausal women- 3 case reports with review of literature
Upasana Baruah, Roma Jethani, Debabrata Barmon, Dimpy Begum, Haelom Liegise, Megha Nandwani
October-December 2021, 12(4):319-322
DOI
:10.4103/jmh.jmh_38_21
Gestational trophoblastic neoplasia is of uncommon occurrence in postmenopausal women, unlike in the reproductive age group. The diagnosis is based on levels of beta-human chorionic gonadotropin (hCG) in serum. The management is similar to that in premenopausal women. First case, fifty-two-year-old, P8 L4A3 postmenopausal female, presented with postmenopausal bleeding. Diagnosis of choriocarcinoma was made in view of raised serum betah-CG levels with uterine lesion with lung metastasis. The patient started on Multi-agent chemotherapy. The patient succumbed to death due to Grade III hematological toxicity while on the first cycle of the EMA/CO regimen. Second case, forty-two-year-old, P2 L2, postmenopausal, with a history of Choriocarcinoma 20 years, back presented with postmenopausal bleeding. After metastatic workup, the patient started on EMACO regimen. She is asymptomatic and on regular follow-up after 8 cycles of chemotherapy. Third case, forty-seven-year-old, P4 L4, postmenopausal, presented with histopathology report suggestive of choriocarcinoma after hysterectomy. After evaluation, lung metastasis was detected. The patient responded to eight cycles to Multi-agent chemotherapy and is on regular follow-up. Choriocarcinoma is a rare gynecological malignancy in postmenopausal women. High index of suspicion is required for its diagnosis. The prognosis of the disease is not encouraging as compared to the premenopausal woman
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
1,252
126
-
LETTERS TO THE EDITOR
Comments on “The effect of mindfulness on quality of life among women with premature ovarian insufficiency: A randomized clinical trial”
Payal Sharma, Sriloy Mohanty, Aman Agarwal, Ranjana Rana
October-December 2021, 12(4):323-323
DOI
:10.4103/jmh.jmh_195_21
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
1,254
116
-
CASE REPORTS
Postmenopausal bleeding as a late sequela of pelvic fracture
Neha Agrawal, Navdeep Kaur Ghuman, Pratibha Singh, Priyanka Kathuria, Sumit Banerjee, Pawan Kumar Garg, Ankit Rai
October-December 2021, 12(4):316-318
DOI
:10.4103/jmh.jmh_99_21
Postmenopausal bleeding is one of the common presenting complaints in the gynecological outpatient department. The common causes of which are atrophic endometritis, vaginitis, estrogen therapy, cancer endometrium, and cancer cervix. Hereby, we present a rare case of a 65-year-old female presented with postmenopausal bleeding who had history of trauma 1 year back with pelvic bone fracture. The cause of postmenopausal bleeding, in this case, is abnormal bony protrusion secondary to malunited pelvic fracture causing laceration of the right lateral vaginal wall. The case was managed by local osteotomy and vaginal wall repair.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
1,242
118
-
LETTERS TO THE EDITOR
Response from the author
Parvin Abedi
October-December 2021, 12(4):324-324
DOI
:10.4103/0976-7800.336147
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
1,132
71
-
Feedback
Subscribe
Advertise
Sitemap
|
What's New
|
Feedback
|
Disclaimer
|
Privacy Notice
© Journal of Mid-life Health | Published by Wolters Kluwer -
Medknow
Online since 1
st
March, 2010