Journal of Mid-life Health最新文献

Primary peritoneal serous carcinoma (PPSC) is an extremely rare tumor mostly idiopathic in nature arising from the peritoneal layers of the abdominal cavity. We present here a unique case of a 72-year-old female with a history of abdominal swelling and difficulty in micturition and defecation for 3 months. Diagnostic imaging and histopathological examinations led to the diagnosis of PPSC. Simultaneously, the patient also has a space-occupying lesion involving the left ovary which on histopathological examination was found to be mucinous cystadenoma. We present this case as PPSC with synchronous mucinous cystadenoma of the left ovary, an extremely rare phenomenon. This combination has not been reported in the literature yet to the best of our knowledge.

Introduction: While mastectomy a crucial procedure in preventing and treating breast cancer is essential, it significantly impacts the emotional well-being, dignity, and overall quality of life (QoL) of survivors. Dealing with the physical challenges of mastectomy is emotionally demanding as it requires adapting to the changes in one's body following breast cancer.

Objective: The objective of this study was to assess the impact of mastectomy on the QoL among cancer survivors.

Subjects and methods: A hospital-based cross-sectional study was carried out in the outpatient departments of oncology at two tertiary care hospitals in Mysuru. Women diagnosed with breast cancer in the year 2021-2022 and who have undergone mastectomy of at least one breast were chosen for the study. The QoL was measured by the European Organisation for Research and Treatment of Cancer - C-30 and BR (breast specific) - 23 modules.

Results: Emotional, physical, social, and cognitive functioning scores assigned a maximum number of participants in the average to good QoL category. The survivors scored lower in sexual enjoyment (10.758 ± 29.73), sexual functioning (32.024 ± 45.35), future perspective (57.419 ± 38.773), and body image (57.309 ± 32.51) and reported lower QoL which was also related to their menstruation status and age. However, a small group of participants had a positive body image despite their transformed bodies. Symptoms such as fatigue (80.43 ± 24.84), nausea/vomiting (116.39 ± 64.7), insomnia (73.43 ± 38.85), and financial difficulties (65.28 ± 45.46) negatively affected the QoL. The study also highlighted that poor QoL was associated with hair loss (85.48 ± 34.60), side effects of systemic therapy (42.08 ± 22.28), arm symptoms (83.16 ± 23.67), and breast symptoms (20.71 ± 30.45).

Conclusion: Survivors face physical and psychological changes that significantly impact their QoL. QoL assessments offer insights into the impact of the disease during and after treatment.

Breast cancer (BC) is the most common malignancy among women globally, with high mortality rates in India. Early detection of BC significantly increases survival rates and reduces mortality. Raising awareness about BC is crucial for educating the public about screening, symptoms, and treatment to help recognize early signs and seek prompt treatment. This article aims to describe a case of breast primary lymphedema and emphasizes the importance of public awareness regarding risk factors, clinical manifestations, and self-examination for early detection and mortality reduction.

The first step to decreasing the occurrence of morbidity and mortality associated with cardiovascular disease (CVD) in women is raising awareness. The aim of this narrative review is to obtain relevant insights into women's awareness and intervention models for CVD. Data were collected through a comprehensive literature search across reputable databases, including PubMed, Crossref, Scopus, and Google Scholar. Inclusion criteria focused on CVD, knowledge, awareness, education, mobile health (mHealth), and women. The researchers reviewed 36 articles, and based on the results, CVD awareness remains low in several countries, particularly among young women. Some factors influencing knowledge, awareness, and preventive behaviors for CVD include age, education level, marital status, occupation, number of children, and urban/rural residence. Digital technology-based applications, specifically mHealth interventions, have been developed to prevent and control CVD risks in women. Examples include SMARTWOMAN™, HeartBeat, Smart Walk, Diet Tracking, TRIANGLE, and FitBit. Digital interventions, such as text messaging, websites, and emails, serve as primordial prevention tools, offering health information and medication adherence reminders to reduce CVD risks in women. Therefore, recognizing the importance of enhancing CVD awareness in young women through health education, specifically using mHealth applications, is important.

Background: Menopause brings about significant hormonal changes that can affect various aspects of women's health, including nasal function. However, the specific impact of menopause on nasal health in Indian women remains underexplored. This study aims to compare nasal function using the Nasal Obstruction Symptom Evaluation (NOSE) score between premenopausal and postmenopausal Indian women.

Materials and methods: A comparative cross-sectional study was conducted involving 107 premenopausal and 111 postmenopausal women recruited from a tertiary care hospital in India. Demographic data, medical history, and NOSE scores were collected. Statistical analyses including Wilcoxon rank-sum test, Chi-squared test, logistic regression, and receiver operating characteristic curve analysis were performed.

Results: Postmenopausal women were significantly older with higher body mass index (BMI) compared to premenopausal women. Postmenopausal women consistently had higher NOSE scores indicating worse nasal function across various time points. Logistic regression revealed menopausal status as a significant predictor of severe nasal obstruction (odds ratio: 1.45, 95% confidence interval: 1.10-1.90, P = 0.015), independent of age, BMI, and other factors.

Conclusion: Menopause is associated with a significant decline in nasal function in Indian women, as evidenced by higher NOSE scores in postmenopausal women. Addressing nasal symptoms in postmenopausal women may improve their quality of life. Further research is needed to develop targeted interventions for managing nasal obstruction in this population.

Background: The hormonal shifts and physiological changes during menopause, including perimenopause and postmenopause, significantly affect women's mental health, often causing depression and sleep disruptions. The objectives of this study are to estimate the prevalence of depression and sleep disturbances among perimenopausal and postmenopausal women and to find the associated risk factors.

Materials and methods: In a community setting, 462 women aged 45-60 years were chosen from 23 clusters using probability proportional to size sampling. Sociodemographic information was collected through standardized surveys, whereas depression levels were measured with Beck's Depression Inventory-II and sleep quality with the Pittsburgh Sleep Quality Index. Statistical analysis was done using SPSS version 21.

Results: The prevalence of depression among the study participants was 33.3% (95% confidence interval [CI]: 29%, 37%), whereas poor sleep quality was found in 37% (95% CI: 36%, 39%). Factors such as low socioeconomic status (adjusted odds ratios [aOR] =1.64), recent negative life events (aOR =2.27), lack of social media usage (aOR =2.77), and being unmarried/widowed (aOR =2.1) were identified as independent predictors of depression. Living in urban areas (aOR =1.69), low socioeconomic status (aOR =1.96), and inadequate intake of fruits and vegetables (aOR =0.43) were identified as independent predictors for sleep disturbances.

Conclusions: This study highlights a notable burden of depression and sleep disruptions among menopausal women. Tackling these challenges necessitates accessible mental healthcare, educational workshops on stress management and sleep habits, nutritional guidance, and peer support networks. Incorporating these measures into health initiatives and policies holds promise for mitigating these concerns and enhancing overall well-being.

Uterine arteriovenous malformation (UAVM) is an infrequent occurrence among postmenopausal women. Our review of the literature revealed only a few documented cases of UAVM in this demographic. Treatment options for these patients encompass uterine artery embolization (UAE), medical management, and hysterectomy. We encountered a case involving a 54-year-old woman, postmenopausal for 9 years, who presented with a history of postmenopausal bleeding over the preceding 3 months. Imaging studies confirmed the presence of UAVM. Despite an attempted UAE, the procedure proved unsuccessful, leading to the decision to perform a hysterectomy with meticulous attention to minimizing blood loss. Notably, UAE may not consistently achieve favorable outcomes in addressing UAVM in postmenopausal women, thereby underscoring the consideration of hysterectomy as a safe alternative - treatment option without any excessive intraoperative bleeding.

Cystic adenomyosis, a rare variant of adenomyosis, poses diagnostic challenges due to its resemblance to other uterine pathologies. We present the case of a 37-year-old multiparous woman with a history of cesarean sections, who presented with heavy menstrual bleeding and progressive pelvic pain. Despite initial medical management, symptoms persisted, prompting further investigation. Ultrasonography initially suggested fibroid degeneration or a neoplastic change, later confirmed by magnetic resonance imaging which showed degenerative changes in fibroid. However, worsening symptoms and failed medical management led to surgical intervention. The patient underwent a total abdominal hysterectomy, revealing cystic spaces filled with altered blood within the myometrium. Histopathological analysis postsurgery confirmed the diagnosis of cystic adenomyosis. This case highlights the diagnostic challenges and therapeutic considerations in managing cystic adenomyosis in multiparous women.

Background: The elderly are disproportionately affected by depression, a devastating mental health illness that is common and causes significant impairment and a poor quality of life. In a community setting in India, this study sought to evaluate the prevalence of depression, degrees of associated disability, healthcare use patterns, health-seeking behavior, and awareness of government initiatives of mental health and care for the elderly.

Objectives: This study was aimed to determine the prevalence of depression and to assess the health-seeking behavior among the geriatric population aged ≥60 years in the study area during the study period.

Methodology: A cross-sectional community study including 450 senior citizens aged ≥60 years living in urban slums was carried out. Data were collected through structured interviews, utilizing the Geriatric Depression Scale using 30 items for assessing depression, the Sheehan Disability Scale for evaluating disability levels, and questionnaires on healthcare utilization, health-seeking behavior, and knowledge of government programs.

Results: The prevalence of depression was high, with 129 (28.67%) participants suffering from mild depression and 33 (7.33%) from severe depression. Moderate to marked disruptions in their work (17, 51.52%), social life/leisure pursuits (24, 72.73%), and social responsibilities (family life) (27, 51.52%) were reported in a significant proportion of those with severe depression. Additionally, a substantial percentage reported feeling impaired and unproductive for most days of the week (P < 0.001). While the majority (358, 79.56%) visited healthcare providers, with 333 (93.02%) visiting government providers and 330 (92.18%) visiting community-level providers, the utilization of mental health services (10, 2.79%) and treatment for depression with antidepressants (7, 4.32%) was minimal. In addition, just 26 people (5.78%) and 3 people (0.67%) knew about the National Programme for Health Care of the Elderly and the Mental Healthcare Act of 2017, respectively, indicating a lack of knowledge regarding government initiatives pertaining to mental health and geriatric care.

Conclusion: The study highlights the significant burden of depression, associated disabilities, and inadequate health-seeking behavior among the elderly population in the study setting. Efforts should focus on strengthening community-based mental health services, improving awareness and access to existing health services and government programs and addressing the various risk factors responsible for the emergence and persistence of depression, and poor health-seeking behavior in the aforementioned vulnerable group.