Journal of Mid-life Health Journal of Mid-life Health
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   2012| January-June  | Volume 3 | Issue 1  
    Online since July 20, 2012

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Various treatment options for benign prostatic hyperplasia: A current update
Alankar Shrivastava, Vipin B Gupta
January-June 2012, 3(1):10-19
DOI:10.4103/0976-7800.98811  PMID:22923974
In benign prostatic hyperplasia (BPH) there will be a sudden impact on overall quality of life of patient. This disease occurs normally at the age of 40 or above and also is associated with sexual dysfunction. Thus, there is a need of update on current medications of this disease. The presented review provides information on medications available for BPH. Phytotherapies with some improvements in BPH are also included. Relevant articles were identified through a search of the English-language literature indexed on MEDLINE, PUBMED, Sciencedirect and the proceedings of scientific meetings. The search terms were BPH, medications for BPH, drugs for BPH, combination therapies for BPH, Phytotherapies for BPH, Ayurveda and BPH, BPH treatments in Ayurveda. Medications including watchful waitings, Alpha one adrenoreceptor blockers, 5-alpha reductase inhibitors, combination therapies including tamsulosin-dutasteride, doxazosin-finasteride, terazosin-finasteride, tolterodine-tamsulosin and rofecoxib-finasteride were found. Herbal remedies such as Cernilton, Saxifraga stolonifera, Zi-Shen Pill (ZSP), Orbignya speciosa, Phellodendron amurense, Ganoderma lucidum, Serenoa Repens, pumpkin extract and Lepidium meyenii (Red Maca) have some improvements on BPH are included. Other than these discussions on Ayurvedic medications, TURP and minimally invasive therapies (MITs) are also included. Recent advancements in terms of newly synthesized molecules are also discussed. Specific alpha one adrenoreceptor blockers such as tamsulosin and alfuzosin will remain preferred choice of urologists for symptom relief. Medications with combination therapies are still needs more investigation to establish as preference in initial stage for fast symptom relief reduced prostate growth and obviously reduce need for BPH-related surgery. Due to lack of proper evidence Phytotherapies are not gaining much advantage. MITs and TURP are expensive and are rarely supported by healthcare systems.
  17,737 2,302 7
Aggressive angiomyxoma of the vulva
Debabrata Barmon, Amal Chandra Kataki, JD Sharma, Judy Bordoloi
January-June 2012, 3(1):47-49
DOI:10.4103/0976-7800.98820  PMID:22923982
Aggressive angiomyxoma is a rare, benign neoplasm occurring in 3 rd to 5 th decade of life that can be mistaken both clinically and on microscopy for several other conditions, it should be included as a differential diagnosis for any vaginal mass. These lesions have a predilection for female pelvic soft tissues, slow in growth, and are characterized histologically by a predominantly myxoid stroma and an abundance of thin and thick walled vascular channels. This is a deep soft tissue tumor, which as the name suggests, may have a locally aggressive course. Most tumors occur in women and are large, usually greater than 10 cm, slowly growing, and painless. Standard of care treatment for angiomyxoma has been surgery. Some authors believe that it is the only possible treatment, but surgery is often radical and can be mutilating, with massive blood loss.
  7,414 487 -
Burning mouth syndrome at menopause: Elusive etiology
Rama Vaidya
January-June 2012, 3(1):3-4
DOI:10.4103/0976-7800.98809  PMID:22923972
  6,225 567 2
Menopause versus aging: The predictor of obesity and metabolic aberrations among menopausal women of Karnataka, South India
Shruti Dasgupta, Mohammed Salman, S Lokesh, D Xaviour, S Yaseen Saheb, BV Ravi Prasad, Biswanath Sarkar
January-June 2012, 3(1):24-30
DOI:10.4103/0976-7800.98814  PMID:22923976
Context: Increased incidences of cardiovascular disorder and metabolic syndrome particularly after menopause have raised curiosity for the underlying factors. However, it is still a debate whether age or menopausal transition is a greater contributor. Aims: To elucidate the inter-relationships of age, menopause, and associated obesity and to assess their independent effects on aggravation of cardio metabolic risk factors in postmenopausal women. Settings and Design: Four hundred two women aged between 30 and 75 years were recruited in a cross-sectional study from Southern India. Three hundred sixteen participants exempting exclusion criteria, comprising of 169 premenopausal and 147 postmenopausal women were finally included. Materials and Methods: Anthropometric measurements such as weight, height, waist circumference (WC), hip circumference (HC), fat percentage, basal metabolic rate (BMR), and blood pressure were taken. Fasting plasma glucose, postprandial glucose, glycated hemoglobin (HbA1c), lipid profile, and C-reactive protein (CRP) were also measured. Statistical Analysis Used: Independent t-test, Analysis of covariates (ANCOVA), Pearson's correlation coefficients and multiple stepwise linear regression model analysis were done. Results: A significant increase in physical and metabolic factors was observed in postmenopausal women compared to premenopausal women except WC and HbA1c. Contrastingly, high-density lipoprotein cholesterol (HDL) levels and BMR were significantly decreased. After adjusting for BMI and age, the significant differences in the variables through the menopausal transition persisted, including an increase in WC. Significant correlation was observed between age and measures of general obesity such as BMI (P < 0.05) and fat percentage (P < 0.001) but not with central obesity indices. Menopausal status and WC exerted an independent effect on most of the metabolic risk factors (P < 0.001 or P < 0.01). Fat percentage was the predicting variable for CRP, HbA1c, diastolic blood pressure (P < 0.001), and HDL (P < 0.01). But Age showed independent effect only on HbA1c. Conclusions: Menopausal transition brings about anomalies in total body composition characterized by an increased body fat mass and central adiposity. This creates a compatible atmosphere for abnormal metabolism and aggravated cardio metabolic risk factors. Thus, menopausal status and associated obesity is the major predictor of metabolic aberrations over age in menopausal women.
  5,277 684 4
Effect of menopause on women's periodontium
Amit Bhardwaj, Shalu Verma Bhardwaj
January-June 2012, 3(1):5-9
DOI:10.4103/0976-7800.98810  PMID:22923973
Steroid sex hormones have a significant effect on different organ systems. As far as gingiva is concerned, they can influence the cellular proliferation, differentiation and growth of keratinocytes and fibroblasts. Estrogen is mainly responsible for alterations in blood vessels and progesterone stimulates the production of inflammatory mediators. In addition, some micro-organisms found in the human mouth synthesize enzymes needed for steroid synthesis and catabolism. In women, during puberty, ovulation, pregnancy, and menopause, there is an increase in the production of sex steroid hormones which results in increased gingival inflammation, characterized by gingival enlargement, increased gingival bleeding, and cervicular fluid flow and microbial changes.
  4,851 717 5
A study of predictors of anxiety and depression among stroke patient-caregivers
Yatan Pal Singh Balhara, Rohit Verma, Srikant Sharma, Shachi Mathur
January-June 2012, 3(1):31-35
DOI:10.4103/0976-7800.98815  PMID:22923977
Context: Caregivers play an important role in supporting people with illness either acute or chronic. It is important to explore caregiver's emotional turmoil as it helps in exploring their burden which can have impact on the patient's illness and functioning apart from their own. Aims: The current study aimed at assessing the predictors of anxiety and depression among caregivers of patients with stroke. Settings and Design: Seventy-five consecutive patient-caregiver dyads were recruited in the study. Materials and Methods: Patients and caregivers were assessed using a semi-structured proforma for the sociodemographic details. Subsequently these dyads were assessed for anxiety and depression levels using the Hospital Anxiety and Depression Scale. Statistical Analysis Used: Chi-square tests (for categorical variables) were used to find difference between the patients and the caregivers on different variables. Additionally Cramer's V-test and phi test were used for 2*4 contingency tables. Linear regression model was used. Results: Linear regression revealed that anxiety level in caregivers was predicted by the sex of care giver. Conclusions: Caring for the patients with stroke presents increased burden to the care givers which manifests as increased rate of anxiety and depression among them. It is important to assess the care givers along with the patients for emergence of these negative affective states. One needs to be extra cautious if the patient happens to be the primary earning member of the family.
  4,853 681 6
Efficacy of levonorgestrel releasing intrauterine system for the treatment of menorrhagia due to benign uterine lesions in perimenopausal women
Rathnamala M Desai
January-June 2012, 3(1):20-23
DOI:10.4103/0976-7800.98812  PMID:22923975
Aims: To evaluate the efficacy of levonorgestrel-releasing intrauterine system (LNG-IUS, Mirena, Bayer Healthcare) in the treatment of menorrhagia caused by benign lesions of the uterus in perimenopausal women. Settings and Design: A prospective observational study was conducted to study the efficacy of levonorgestrel intrauterine device in the treatment of menorrhagia due to benign lesions of the uterus in perimenopausal women. Materials and Methods: Forty women with menorrhagia, due to benign conditions like idiopathic menorrhagia, fibroid (not more than 12 weeks size) or adenomyosis, attending our out-patient department were included in the study. All the women underwent a PAP smear, transvaginal sonography and endometrial biopsy. Endometrial carcinoma and cervical carcinoma were excluded. LNG-IUS was inserted in the postmenstrual phase. Blood loss was assessed by pictorial blood loss assessment chart (PBAC). They were followed up after 3 months, 6 months, and after 1 year. Results: Majority of the women had menstrual spotting for 3-4 months followed by infrequent menstruation, scanty menstruation or amenorrhoea. LNG-IUS was removed because of continued bleeding in two cases and was removed because of displacement in one case. It was expelled spontaneously in four cases. Thirty-three women continued to use LNG-IUS. Conclusion: LNG-IUS is a safe and effective option for women with menorrhagia due to benign lesions of the uterus in perimenopausal women.
  4,821 580 2
Posthysterectomy fallopian tube prolapse
Vandana M Sanklecha, Shantilal M Sisodia, Sameer A. H. Ansari, Smita Pol
January-June 2012, 3(1):40-41
DOI:10.4103/0976-7800.98817  PMID:22923979
Fallopian tube prolapse into the vaginal vault is a rare complication after hysterectomy with adnexal preservation. It can occur following vaginal and abdominal hysterectomy, and rarely following interposition and colpotomy. Histopathology is the only means of definitive diagnosis. Prevention of tubal prolapse can be achieved by suturing the adnexae high in the pelvis at abdominal hysterectomy, and the incidence decreases if the pelvic peritoneum is closed properly.
  4,630 345 1
Giant adrenal myelolipoma with hemorrhage masquerading as retroperitoneal sarcoma
Indranil Chakrabarti, Nilanjana Ghosh, Vaswati Das
January-June 2012, 3(1):42-44
DOI:10.4103/0976-7800.98818  PMID:22923980
Adrenal myelolipomas are functionally inactive, rare adrenal tumors which are usually small in size and are discovered incidentally. Giant symptomatic myelolipomas have rarely been reported in medical literature. Here, we describe the case of a 40-year-old female patient who presented to the surgical outpatient department with left flank pain. An ultrasonogram of the abdomen suggested a large retroperitoneal tumor which was then surgically resected. Histopathological examination of the resected specimen revealed a giant adrenal myelolipoma with intratumoral hemorrhage. The patient was relieved of symptoms and was free of any complaints in follow-up.
  4,123 360 3
Assessment of anxiety and depression in patients with burning mouth syndrome: A clinical trial
Rohit Malik, Sumit Goel, Deepankar Misra, Sapna Panjwani, Akansha Misra
January-June 2012, 3(1):36-39
DOI:10.4103/0976-7800.98816  PMID:22923978
Introduction: Burning mouth syndrome is a chronic pain syndrome primarily affecting elderly women with hormonal changes or psychological disorders. It is multifactorial in origin, often idiopathic and its etiopathogenesis, majorly being neuropathic, largely remains enigmatic. Aim: To determine the prevalence of burning mouth symptom, in elderly women and evaluate local and systemic causes responsible for burning sensation. Materials and Methods: 100 elderly postmenopausal women were included in the study out of which 56 had a chief complaint of burning sensation. These patients were evaluated for the levels of anxiety and depression by means of questionnaire. The severity of burning and the response to the treatment was assessed with a five point Visual Analog Scale. The results were analyzed using "Chi-square" test. Results: There was statistically significant increase in the levels of anxiety and depression in the study group. Conclusion: The present study clearly indicates that most of the patients had moderate to severe levels of depression, which suggests that anxiety and depression are constant features in postmenopausal female patients.
  3,937 473 1
Peeping thread from a laparotomy scar: Misery of an old man
Ramesh Aggarwal, Shridhar Dwivedi
January-June 2012, 3(1):50-51
DOI:10.4103/0976-7800.98821  PMID:22923983
Despite availability of modern methods of various surgical techniques for treating complicated patients, there are still some unreported incidents in day to day practice where simple surgical procedure ends up in unwanted complications. This may be attributed sometimes to the negligence of treating doctors and sometime to the patient himself. We present here one such case where unnecessary morbidity added to the patient after surgery.
  3,403 283 -
Modified shoe for adjusting hard stuffy and smelly sole: An uncommon accompaniment of hypothyroidism
Shridhar Dwivedi, Ramesh Aggarwal
January-June 2012, 3(1):45-46
DOI:10.4103/0976-7800.98819  PMID:22923981
Disorders of smell and taste are both neglected as well as underreported problems of hypothyroidism. A 35-year-old male presented with intolerance to cold, dryness of skin, and swelling of both feet and some foul smelling odor from his feet. When we examined his feet we found that instead of wearing his shoes properly he had just slipped his feet inside the shoe so that the odor from his feet is not smelled by us. Although this symptom was largely ignored by many doctors, the literature mentions that patients of hypothyroidism may perceive dysosmia (distortion of smell) and hyposmia (elevated threshold for detection of smell).
  3,311 276 -
Farewell from the Chief Editors
Rashmi Shah, Rama Vaidya
January-June 2012, 3(1):1-2
DOI:10.4103/0976-7800.98808  PMID:22923971
  2,940 334 -
Comment on "Glutathione peroxidase activity in obese and nonobese diabetic patients and role of hyperglycemia in oxidative stress"
Turgay Ulas, Mehmet Sinan Dal, Mehmet Emin Demir, Hakan Buyukhatipoglu
January-June 2012, 3(1):52-52
  2,686 277 -