Journal of Mid-life Health Journal of Mid-life Health
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  Citation statistics : Table of Contents
   2014| October-December  | Volume 5 | Issue 4  
    Online since November 21, 2014

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Dermatosis associated with menopause
Pragya A Nair
October-December 2014, 5(4):168-175
DOI:10.4103/0976-7800.145152  PMID:25540566
Menopause is defined as permanent irreversible cessation of menses brought by decline in ovarian follicular activity. Hormonal alteration results in various physical, psychological, and sexual changes in menopausal women. Associated dermatological problems can be classified as physiological changes, age-related changes, changes due to estrogen deficiency and due to hormone replacement therapy. Dermatosis seen due to estrogen deficiency includes Atrophic Vulvovaginitis, Vulvar Lichen Sclerosus, Dyaesthetic Vulvodynia, Hirsutism, Alopecia, Menopausal Flushing, Keratoderma Climactericum, Vulvovaginal Candidiasis. Dermatologists and gynecologists need to be familiar with the problems of menopausal women, as with increase in life expectancy, women passing through this phase is rising.
  5 5,152 1,398
Pattern of palpable breast lesions on fine needle aspiration: A retrospective analysis of 902 cases
Shirish S Chandanwale, Kanika Gupta, Arpana A Dharwadkar, Sukanya Pal, Archana C Buch, Neha Mishra
October-December 2014, 5(4):186-191
DOI:10.4103/0976-7800.145164  PMID:25540569
Background : Breast lumps constitute a significant proportion of surgical cases in women of both developed and developing countries. The aim of this study is to look the frequency distribution of various breast lesions on fine needle aspiration (FNA). Materials and Methods : The 902 patients who presented with palpable breast lump, irrespective of age and sex were included in the study. Frequency distribution of various breast lesions with respect to age and sex was studied. Cytology grading in breast carcinoma was correlated in 69 cases with histology grading. Results : The majority (N = 871) of patients were females with maximum (N = 566) patients between second and third decade. The 773 patients had benign breast lesions and maximum (N = 341) patients were in the second decade. Fibroadenoma was the commonest benign lesion followed by fibrocystic change and mastitis. Out of 119 malignant breast lesions, 31.93% [N = 38] were between 41-50 years of age, 28.57% [N = 34] in 51-60 years and 22.68% [N = 27] in between 31-40 years of age. Out of 119 malignant breast lumps and majority were infiltrating ductal carcinoma (N = 108). Cytology grading correlated maximum with histology grade in Grade I followed by Grade II and Grade III. Conclusion : With experienced hands, FNA is safe, cost effective and a reliable technique for preoperative evaluation of palpable breast lumps. FNA features are more informative when combined with physical and radiology findings (Triple test). Fibroadenoma, fibrocystic change and mastitis form the major bulk of benign breast lesions. Epithelioid cells when seen in inflammatory breast FNA smears, tuberculosis must be ruled out. In India, breast carcinoma arises in younger patients as compared to western countries. Grading of breast carcinomas must be done on FNA smears for selecting neoadjuvent therapy. Clinical breast examination and mammography screening in females should be encouraged in developing countries from the third decade onwards for early detection of breast carcinoma.
  4 3,114 373
Squamous cell carcinoma arising in mature cystic teratoma of ovary
Ranu Patni
October-December 2014, 5(4):195-197
DOI:10.4103/0976-7800.145169  PMID:25540571
Squamous cell carcinoma of the ovary is a rare condition and usually arises in mature cystic teratoma (MCT) or dermoid cyst of the ovary. The reported incidence of malignant transformation in MCT is approximately 2%. A case of squamous cell carcinoma arising in a dermoid cyst of the ovary presenting at an early stage is presented here. A 53-year-old postmenopausal lady, presented with the complaint of pain in right lower abdomen since one month and a large complex abdomino-pelvic mass on examination and investigations. Final histopathology was reported as squamous cell carcinoma of left ovary arising from dermoid cyst and a benign dermoid cyst in the right ovary. The patient was assigned to squamous cell carcinoma of the ovary arising in a mature cystic teratoma, surgical stage Ic2. In view of the poor prognosis, adjuvant chemotherapy was started.
  3 3,208 327
Uterine leiomyosarcoma: A case report
Khushpreet Kaur, Parneet Kaur, Arvinder Kaur, Atish Singla
October-December 2014, 5(4):202-204
DOI:10.4103/0976-7800.145175  PMID:25540573
Uterine leiomyosarcoma is a rare uterine malignancy that arises from the smooth muscles of uterine wall. It accounts for only 1-2% of uterine malignancies. We report a case of a 60-year-old female who presented with postmenopausal bleeding and was diagnosed later to be a case of leiomyosarcoma of uterus. The diagnosis of leiomyosarcoma is made by histopathological examination, and surgery is the only treatment. The prognosis for female with uterine sarcoma primarily depends on the extent of disease at the time of diagnosis and the mitotic index.
  3 3,636 263
Postmenopausal endometriosis: An enigma revisited
Duru Shah
October-December 2014, 5(4):163-164
DOI:10.4103/0976-7800.145189  PMID:25540564
  3 3,774 9,255
Sarcoma-like mural nodule in a borderline mucinous tumor of the ovary: A rare entity
Prithwijit Ghosh, Kaushik Saha, Sourav Bhowmik
October-December 2014, 5(4):192-194
DOI:10.4103/0976-7800.145168  PMID:25540570
Sarcoma-like mural nodule (SLMN) is a very uncommon and misleading benign entity which may be associated with benign, borderline or malignant mucinous neoplasm of the ovary. It should be distinguished from other malignant mural nodules with sarcoma, carcinosarcoma or anaplastic carcinoma for proper management. We report a rare case of SLMN in a borderline mucinous tumor of the ovary in a 30-year-old lady. In spite of having confusing histopathological features the final diagnosis was made depending on the younger age of the patient, well circumscription of the nodule, absence of vascular invasion and immunohistochemical profile.
  2 3,446 326
Geriatric care in India: A long way to go
Jaya Prasad Tripathy
October-December 2014, 5(4):205-206
DOI:10.4103/0976-7800.145176  PMID:25540574
  2 2,824 249
Effect of yoga therapy on physical and psychological quality of life of perimenopausal women in selected coastal areas of Karnataka, India
Gayathry Nayak, Asha Kamath, Pratap N Kumar, Anjali Rao
October-December 2014, 5(4):180-185
DOI:10.4103/0976-7800.145161  PMID:25540568
Background: Perimenopausal period is characterized by a continuous decline in ovarian function due to which women are vulnerable to various physical and psychological symptoms affecting their quality of life. Currently these symptoms are managed by hormone replacement therapy. However, hormonal therapy can cause complications including malignancy which has resulted in search for various alternative therapies to improve the quality of life (QOL). Yoga is one such alternative therapy shown to enhance the QOL at all stages of human life associated with the chronic illness. There are very few scientific studies regarding the effect of yoga on perimenopause and in this study we investigated the effects of yoga therapy on physical and psychological symptoms using the standardized questionnaire. Objective: To study the effect of yoga therapy on physical, psychological, vasomotor and sexual symptoms of perimenopause. Materials and Methods: It is a prospective non-randomized control study of 216 perimenopausal women with 12 weeks of intervention. The subjects were divided in two groups with either yoga therapy [n = 111] or exercise [n = 105] as the interventional tool. The symptoms control and QOL before and after intervention in both the groups were assessed by using the menopausal QOL questionnaire. Results: The perimenopausal symptoms in all the four domains were improved by yoga therapy, thus significantly improving the overall QOL compared to the control group. Conclusion: This study clearly demonstrates the effectiveness of yoga therapy in managing the distressing perimenopausal symptoms. It is easy, safe, non-expensive alternative therapy helping the well-being of perimenopausal women and must be encouraged in the regular management of perimenopausal symptoms.
  2 5,463 891
The effect of exercise on quality of life in postmenopausal women referred to the Bone densitometry centers of Iran University of Medical Sciences
Soghra Nikpour, Hamid Haghani
October-December 2014, 5(4):176-179
DOI:10.4103/0976-7800.145156  PMID:25540567
Background: One of the most critical stages of women's lives is menopause and one of the aims of health for all in the 21st century is the improvement of the quality of life. Aim and Objective: The aim of this study was to determine the effect of exercise on quality of life in postmenopausal women. Materials and Methods: This study was designed by a randomized-controlled trial. Eighty volunteer postmenopausal women who experienced the menopause period naturally and have been taking hormone replacement treatment (HRT) were divided into two groups randomly (exercise group n = 40, control group n = 40). The Nottingham Health Profile (NHP) was used to assess quality of life in both groups before and after 8 weeks. The exercise group participated in an exercise program, which was composed of sub-maximal aerobic exercises for an 8-week period 5 times a week. Quality of life in two groups was compared at the end of 8 weeks. Results: The results showed that there was a statistically significant difference in the exercise group for the NHP indicating an improvement in the quality of life (P < 0.05). Conclusion: We concluded that quality of life on postmenopausal women could be improved with a regular and controlled exercise program of 8 weeks. Thus, implementing appropriate educational programs to promote the quality of life in postmenopausal women is recommended.
  1 3,380 710
Sclerosing peritonitis with unilateral ovarian luteinized thecoma in a post-menopausal woman: A case report
Auradha De (Pati), Supti Mukhopadhyay, Ayandip Nandi, Indranil Das
October-December 2014, 5(4):198-201
DOI:10.4103/0976-7800.145173  PMID:25540572
A unique case of unilateral ovarian luteinized thecoma with sclerosing peritonitis is reported because the association between these two conditions is extremely rare. Etiology is not clearly known. A 50-year-old post-menopausal woman presented with pain abdomen and huge swelling. Pelvic contrast-enhanced computed tomography (CECT) revealed a heterogenous enhancing mass arising possibly from ovary and adherent to uterus, bowl loops, and omentum. A spindle cell neoplasm without definite features of malignancy was reported in computed tomography (CT)-guided fine-needle aspiration cytology (FNAC). Ascitic fluid was negative for malignancy. Her serum carcinoembryonic antigen (CEA) (1.1ng/ml) and CA125 (27.6μ/ml) level was within normal limits. Total abdominal hysterectomy with bilateral supracolic omentectomy, resection of part of colon, and supracolic omentectomy was done. Histopathological diagnosis was luteinized thecoma with sclerosing peritonitis. Tumor cells were immunoreactive to smooth muscle antigen (SMA) and CD 99 and non- reactive to ER, PR, Calretinine, and Cytokeratin. Patient developed post-operative sepsis and enterocutaneous fistula, which was managed conservatively and was kept in follow-up. According to current concept, in spite of its large size, wide-spread involvement, mitotic activity, and complications due to peritoneal involvement, behavior of this rare clinical entity is benign.
  - 3,408 259
Fertility preservation in young patients' with cancer
Sharmila Dudani, Apurva Gupta
October-December 2014, 5(4):165-167
DOI:10.4103/0976-7800.145148  PMID:25540565
Preservation of fertility is an important issue in the management of young cancer patients. Though embryo cryostorage is a well-established procedure, it can only be availed by couples. Recent studies have indicated increasing success rates with mature and immature oocyte cryopreservation. Cryostorage induces injuries on the human oocytes which can be minimized by slow freezing and vitrification. Selection of candiidates is crucial so that the most suitable technique can be offered without any delay in initiation of cancer therapy. Factors affecting suitability are age of patient, assessment of ovarian reserve, hormonal status and type and stage of neoplastic disease. Encouraging results have been obtained with oocyte in vitro maturation (IVM) followed by vitrification for cryostorage. Data on the use of vitrified eggs in routine in vitro fertilization (IVF) show that pregnancy rates can be comparable to those achieved with fresh oocytes.
  - 3,289 2,632