Journal of Mid-life Health Journal of Mid-life Health
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   2010| January-June  | Volume 1 | Issue 1  
    Online since August 3, 2010

 
 
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ORIGINAL ARTICLES
Prevalence of cardiovascular risk factors in postmenopausal women: A rural study
Vishal R Tandon, Annil Mahajan, Sudhaa Sharma, Anil Sharma
January-June 2010, 1(1):26-29
DOI:10.4103/0976-7800.66993  PMID:21799635
Aim: The present observational, cross-sectional prospective study was conducted during the period of 1 year in one of the rural health centers to study prevalence of conventional cardiovascular disease risk factors (CVRFs) in postmenopausal women. Materials and Methods: Five hundred consecutive postmenopausal women were screened for detailed information regarding common menopausal symptoms, the presence or absence of conventional CVRFs. Physical activity was measured, and dietary lifestyle was also assessed. Use of hormone replacement therapy (HRT) and other drugs were also noted. Knowledge regarding their menopause was also evaluated. Results: Mean age at menopause was 49.35 years, Mean number of menopausal symptoms was 6.70 ± 5.76, and mean duration since menopause was (MDSM = 4.70 years)). Fatigue, lack of energy (70%), cold hand and feet, rheumatology-related symptoms (60%) cold sweats, weight gain, irritability, and nervousness (50%), palpitation of heart, excitable/anxiety (30%) each were common complaints. Hypertension was diagnosed or a person was a known hypertensive (56%). Diabetes was diagnosed or a person was known diabetic in 21%, and BMI was found to be 25 kg/m 2 in 78%. Truncal obesity with waist-hip ratio >0.8 in 68% females, whereas abdominal obesity with waist size >88 cm was in 60% women. Dyslipidemia was seen in 39%. It was defined by the presence of high TC (=200 mg/dL) in 30%, high LDL-c (=130 mg/dL) in 27%, low HDLc (<40 mg/dL) in 21% or high TG (=150 mg/dL) in 31%. Metabolic syndrome was present in 13% of cases. CRP was found positive in 12 out of 39 total evaluated women, and serum uric acid was found >6.5 mg/dL in 4%. Smoking (0.5%), alcohol (0%,), tobacco chewing (4%), and family history of premature heart disease (9%) were recorded. Lifestyle was active in 35%, hectic in 10%, and sedentary in 55% of postmenopausal women (PMWs). Only 5% of women were receiving HRT, 0.5% isoflavone-containing phytoestrogens, 0.4% tibolone, 24% anti-HT, 9% anti-diabetic, 8% lipid-lowering drugs, and only three patients were on anti-obesity along with dietary and lifestyle management. Out of 68 patients, who were advised for electrocardiography (ECG), 23 were found positive for ischemic changes on ECG and out of 12 women advised for treadmill test (TMT), only four were found positive for ischemic heart disease (IHD). Risk factor count of more than four was found in 11%. Over all 96% of women were affected by menopause or related problems. Only 9% were aware about their menopause, 3% for importance of lifestyle modification, weight and dietary management programs to ameliorate menopause or menopause-compounded CVRFs. Conclusion: This study showed alarmingly high prevalence of most of the conventional CVRFs, especially diabetes, hypertension, dyslipidemia, obesity, and other risk factors in postmenopausal women from rural areas.
  10 9,905 1,065
Bone mineral density in women above 40 years
Jyothi Unni, Ritu Garg, Rajeshwari Pawar
January-June 2010, 1(1):19-22
DOI:10.4103/0976-7800.66989  PMID:21799633
The prevalence of osteoporosis in India is high and osteoporotic fractures are thought to occur early in Indian women. The aim was to study the prevalence of osteopenia and osteoporosis in women aged above 40 years. Women aged above 40 years attending the out patient department of this hospital were offered bone densitometry. A significant positive correlation was found between age and time since menopause and bone mineral density (BMD). Differences in the prevalence of osteoporosis were noted on the basis of socioeconomic strata. There was no statistically significant difference observed in BMD for many of the other accepted risk factors such as age at menarche, lactation, and exercise.
  7 6,107 668
GUIDELINES
Third consensus meeting of Indian Menopause Society (2008): A summary
Jyothi Unni
January-June 2010, 1(1):43-47
DOI:10.4103/0976-7800.66987  PMID:21799640
  6 6,437 817
ORIGINAL ARTICLES
Role of gray scale and color Doppler in differentiating benign from malignant ovarian masses
Dhwani Desai, VA Desai, RN Verma, A Shrivastava
January-June 2010, 1(1):23-25
DOI:10.4103/0976-7800.66991  PMID:21799634
Objectives: To evaluate prospectively the relative usefulness of color Doppler and gray scale sonography in differentiating benign from malignant ovarian masses and evaluation of scoring systems Sassone and Alcazar for differentiating benign from malignant ovarian masses. Methods: Study was conducted during the period of Jan 2006 to Oct 2007 in department of obstetrics and gynaecology, New civil Hospital, Surat. The study was conducted mainly with the help of department of radio-diagnosis. The study include 100 patient clinically suspected to have ovarian neoplasm and referred to department of radio-diagnosis where evaluation with Ultrasonography and Doppler was done. The efficacy of scoring systems were evaluated by histopathological examination of mass or fine needle aspiration cytology or presence of malignant cells in ascetic fluid. Results: Sassone's scoring system was able to identify 72 out of 78 benign masses and 18 out of 22 malignant masses.where as Alcazar system with use of colour Doppler was able to identify 75 out of 78 benign and 21 out of 22 malignant ovarian masses. Sensitivity and specificity of sassone is 81.8%,92.3% respectively, where as that of Alcazar is 95.5%, 96.2% respectively. Conclusion: Using both gray scale and colour Doppler in differentiating benign from malignant ovariam masses is giving results with more accuracy and Alcazar system is better performing than sassone's scoring systems.
  3 4,725 544
Prevalence of premenstrual symptoms: Preliminary analysis and brief review of management strategies
JV Joshi, SN Pandey, P Galvankar, JA Gogate
January-June 2010, 1(1):30-34
DOI:10.4103/0976-7800.66995  PMID:21799636
Objective: To determine the prevalence of premenstrual cyclic symptoms in perimenopausal age. Subjects and Methods: Women attending Bhavan's SPARC Maitreyi's Health Care Programme (HCP) for women around 40 years of age were included in the study. Last 200 women who attended from April 2002 to October 2004 are included for analysis. Out of these 107 qualified for final analysis as others were post hysterectomy or post menopausal. Thirty five symptoms listed under premenstrual tension syndrome were analysed. Results: Forty one women (38.3%) had 3 or more symptoms whilst 15 (14.0%) had 5 or more cyclic symptoms. Five women (4.7%) reported that the symptoms were severe. Eleven women had seeked treatment for premenstrual tension syndrome (PMTS). The commonest symptom was mastalgia or heaviness of breasts. Next was whilst also was reported by several women. Women reported anger attacks and reported depression. Conclusion: PMTS was common between 36 and 55 years. About half of them have experienced 3 more symptoms and 1 in 20 may require treatment.
  3 6,736 751
REVIEW ARTICLES
Does ovarian autoimmunity play a role in the pathophysiology of premature ovarian insufficiency?
Vrinda Khole
January-June 2010, 1(1):9-13
DOI:10.4103/0976-7800.66986  PMID:21799631
Premature Ovarian Failure (POF) is an important cause of amenorrhoea and infertility. However some women may spontaneously ovulate and conceive. Primary ovarian insufficiency (POI) is thus the preferred term. POF / POI is multifactorial in etiology. Autoimmunity is an important mechanism for accelerated destruction of ovarian follicles. The present review focuses on the role of autoimmunity in the pathophysiology of POI. Antibodies to multiple ovarian antigens have been proposed as markers of ovarian autoimmunity. However, there has been lack of clinically proven sensitive and specific serum tests to confirm autoimmune involvement in POI. The review details recently developed specific test for antiovarian antibodies (AOA) that has enabeled identification of different molecular antigenic targets in the ovary. The application of this specific test for AOA has brought to light the need for screening for autoimmunity prior to patients undergoing IVF technique.
  3 5,966 725
GUIDELINES
Guidelines and recommendations on hormone therapy in the menopause
Amos Pines
January-June 2010, 1(1):41-42
DOI:10.4103/0976-7800.66990  PMID:21799639
  1 4,558 752
ORIGINAL ARTICLES
Comparative evaluation of raloxifene versus estrogen: Progestin on symptomatology, endometrium, and lipid profile in postmenopausal women
Anuradha Dogiparthi, Neelam Aggarwal, Vanita Suri, Radhika Srinivasan, Sarla Malhotra
January-June 2010, 1(1):14-18
DOI:10.4103/0976-7800.66988  PMID:21799632
The objective of the study was to evaluate the effects of raloxifene and estrogen progesterone (E + P) combination on symptoms, endometrium, and lipid profile in postmenopausal women. Ninety healthy postmenopausal women were enrolled and allocated to three groups namely E + P, raloxifene, and controls. These groups were given 0.625 mg conjugated estrogen and 2.5 mg medroxyprogesterone, 60 mg raloxifene and no therapy, respectively. Symptomatology and lipid profile were evaluated at 3, 6, and 12 months. Endometrial thickness was evaluated at 6 and 12 months, and endometrial biopsy was repeated at 12 months. The demographic profile of the women in the three different groups was comparable. In addition, the symptomatology, lipid profile, mean endometrial thickness, and endometrial biopsy categorization were comparable. E + P and raloxifene were equally effective in improving the postmenopausal symptoms and lipid profile. E + P had stimulatory effect on the endometrium, whereas raloxifene was found to be neutral.
  1 4,100 434
REVIEW ARTICLES
Calcitonin gene-related peptide and menopause
Sudhaa Sharma, Annil Mahajan, Vishal R Tandon
January-June 2010, 1(1):5-8
DOI:10.4103/0976-7800.66985  PMID:21799630
The review summarizes recent findings with respect to pathophysiological role of calcitonin gene-related peptide (CGRP), in postmenopausal symptoms and diseases, which has opened horizons in understanding pathophysiology of menopause in a better way. Current evidences strongly propose a need to develop CGRP receptor antagonists, which may prove beneficial in many prevalent menopausal symptom/diseases such as vasomotor symptoms, cardiovascular risk, obesity, and major depressive disorder, in which CGRP levels are elevated.
  1 4,196 499
EDITORIALS
Midlife health: A mission
Sunila Khandelwal
January-June 2010, 1(1):1-2
DOI:10.4103/0976-7800.66982  PMID:21799628
  - 3,171 412
"Brave old" motherhood: Beyond biological boundaries
Rama Vaidya, Rashmi Shah
January-June 2010, 1(1):3-4
DOI:10.4103/0976-7800.66984  PMID:21799629
  - 4,334 501
LETTER TO EDITOR
The Annual Conference of the British Menopause Society - June 2010
Duru Shah
January-June 2010, 1(1):48-50
DOI:10.4103/0976-7800.66983  PMID:21799641
  - 3,118 353
VIEW POINTS
Mid-career blues in healthcare workers: A physiological approach in ethical management
Amrith Pakkala
January-June 2010, 1(1):35-37
DOI:10.4103/0976-7800.66994  PMID:21799637
  - 3,187 358
Grandmother pregnancies: A medical hara-kiri?
Parul Kotdawala
January-June 2010, 1(1):38-40
DOI:10.4103/0976-7800.66992  PMID:21799638
  - 2,801 339
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