Journal of Mid-life Health最新文献

Background: Abnormal uterine bleeding (AUB) is a prevalent gynecological complaint with diverse underlying etiologies, ranging from benign endometrial changes to malignancy. Early identification of malignant pathology is critical for effective management. This study aims to evaluate the histopathological spectrum of endometrial abnormalities in women with AUB and assess the diagnostic utility of endometrial thickness (ET) and endometrial volume (EV) in predicting endometrial carcinoma.

Methods: This retrospective study included women presenting with AUB who underwent transvaginal ultrasound and endometrial sampling. Histopathological findings were categorized into benign, polypoidal, hyperplastic, and malignant groups. Receiver operating characteristic (ROC) curve analysis was used to determine optimal ET and EV cutoff values for predicting endometrial malignancy.

Results: Disordered proliferative endometrium was the most common histological finding (38.0%), followed by endometrial hyperplasia (14.0%) and endometrial carcinoma (8.7%). Malignancy was significantly associated with age >50 years (46.2%, P = 0.002), higher body mass index (mean 35.6, P = 0.024), and hypertension (HTN) (84.6%, P < 0.001). ROC analysis showed that an EV cutoff of 15 ml had superior diagnostic accuracy (area under the curve [AUC] =0.96, sensitivity = 90.2%, specificity = 95.4%) compared to an ET cutoff of 12 mm (AUC = 0.90, sensitivity = 78.0%, specificity = 96.3%).

Conclusion: Age, obesity, and HTN are significant risk factors for endometrial carcinoma in patients with AUB. EV demonstrates superior diagnostic performance compared to ET and holds promise as a valuable, noninvasive marker in the evaluation of endometrial malignancy. Incorporating EV into routine diagnostic algorithms improves early cancer detection and reduces the need for invasive procedures.

Cervical cancer has been acknowledged as one of the major global public health problems, especially in developing nations where access to screening and treatment modalities, is limited. The objectives of the current article are to identify the potential barriers that can limit cervical cancer screening in rural areas and propose targeted interventions to overcome them to improve the overall uptake of these screening services. In rural settings, with limited number of healthcare establishments, it becomes difficult for women to access screening services, and the limited number of specialists and trained healthcare personnel further augments the concern. Acknowledging the magnitude of the problem and the preventable nature of the disease, it is the need of the hour to strengthen cervical cancer screening programs and integrate these activities into rural healthcare delivery systems. In conclusion, the implementation of screening for cervical cancer in rural settings can play a huge role in the early detection and improvement of the overall prognosis. This calls for the need to identify potential barriers and implement specific interventions to improve early detection of cervical cancer and reduce disparities in access to screening in rural settings.

Background: Despite their pivotal role in healthcare delivery, physicians often neglect their own health. Growing evidence suggests that healthcare professionals face elevated risks of noncommunicable diseases due to occupational stress, sedentary behavior, and inadequate preventive practices. However, comprehensive health data on physicians, especially in low- and middle-income countries like India, remain scarce.

Objectives: The objective of this study was to assess the lifestyle behaviors, chronic disease prevalence, medication usage, and preventive health monitoring patterns among practicing physicians across various specialties in India.

Methods: A cross-sectional, online survey was conducted among 265 licensed physicians using a structured, self-administered questionnaire. The study protocol was reviewed and approved by the Institutional Human Research Ethics Committee and assigned approval number HREC-AARC/67. Variables assessed included demographics, smoking and alcohol use, physical activity, presence of hypertension, diabetes, thyroid and heart disease, medication use, recent values or testing history for HbA1c, low-density lipoprotein cholesterol, and blood pressure. Descriptive statistics were computed on aggregated frequency-based data.

Results: Hypertension (47.9%) and diabetes (23.0%) were highly prevalent. Among hypertensive participants, only 62.9% reported controlled blood pressure. Thyroid disorders affected 21.5% of physicians. A notable 11.7% reported never exercising, and 30.2% consumed alcohol occasionally. Statin use (42.3%) and antiplatelet therapy (37.7%) were common; however, only 48.7% had tested their HbA1c within the past 3 months. Despite access to medical knowledge, suboptimal adherence to preventive monitoring and chronic disease control was evident.

Conclusions: Physicians, although well-informed, are not immune to the growing burden of lifestyle-related disorders. The findings call for institutional reforms to promote self-care, occupational wellness programs, and structured health surveillance mechanisms targeting the physician workforce.

Background: Menopause is a critical transition in a woman's life, often accompanied by physiological and psychological challenges that affect quality of life (QoL). Rural women in India, particularly those from socioculturally distinct communities like the Rajput women of Agra, experience unique health burdens due to limited healthcare access, socioeconomic constraints, and cultural perceptions. This study examines the distribution and severity of menopausal symptoms and their impact on psychological well-being (PWB) in this population.

Materials and methods: A cross-sectional study was conducted in the Khandauli block of Agra, Uttar Pradesh, using a sample of 109 Rajput women aged 35-60 years, selected through snowball sampling. Menopausal status was classified based on the Study of Women's Health Across the Nation criteria. Data collection was performed using a semi-structured interview schedule, incorporating the Menopausal Rating Scale to assess symptom severity and the PWB Scale (PWB-18) to evaluate mental health. Statistical analyses, including Chi-square tests and Spearman correlations, were conducted using IBM SPSS v26.

Results: Postmenopausal women exhibited a significantly higher prevalence of severe somatic (38.2%) and psychological (35.3%) symptoms compared to premenopausal women. A strong negative correlation was found between PWB and symptom burden, particularly in postmenopausal women (P < 0.05). However, urogenital symptoms showed no significant variation between groups.

Conclusion: Menopausal transition significantly affects QoL and PWB among Rajput women in rural Agra, highlighting the need for targeted health interventions. Improved healthcare access, culturally sensitive awareness programs, and mental health support are essential to enhancing the well-being of menopausal women in rural India.

Introduction: Menopause is defined by the World Health Organization as the permanent cessation of the menstrual cycle for 12 consecutive months in women, due to a deficiency of estrogen caused by ovarian failure. It brings about biological and behavioral changes that can negatively impact the Quality of Life (QOL). The average age of menopause for Indian women is 46.2 years. Given the increasing life expectancy and population of menopausal women in India, prioritizing menopausal health is crucial.

Aim: The aim of this study is to assess the QOL among postmenopausal women using the menopause-specific QOL (MENQOL) questionnaire.

Subjects and methods: A descriptive cross-sectional study was conducted at a tertiary care center, South India. Data were collected using a two-part questionnaire. In Part I, sociodemographic information was collected using a structured questionnaire. In Part II, postmenopausal symptoms were assessed using the validated MENQOL questionnaire in women up to 65 years of age. Frequencies and proportions, mean, and standard deviation were calculated. The Chi-square test was used to determine significance. A sample size of 250 was determined at a 5% alpha error and 99% confidence level.

Results: In the present study, we included 250 postmenopausal women aged up to 65 years. In that, 39.2% of women were in the age group of 50-54 years. Prevalence levels of the classical menopausal symptoms such as hot flashes, night sweats, vaginal dryness, and joint discomfort in women were 33.2%, 4%, 17.2%, and 58.8%, respectively. The overall MENQOL mean total score was found to be 8.26 ± 2.553.

Conclusion: Based on the findings of the present study, we conclude that physical symptoms related to menopause are most commonly reported by women in the middle-old age group. MENQOL can be used to assess quality of life and guide optimal care to menopausal women.

The irreversible cessation of menstruation, menopause, is a significant event in a woman's life. Its timing varies widely across populations and is influenced by genetic, environmental, and lifestyle factors. Data from various Asian countries such as India, Pakistan, China, Sri Lanka, Malaysia, Indonesia, Japan, South Korea, Thailand was synthesised to examine the average age of menopause and identify regional variations, and explore associated determinants. Systematic review and metaanalysis were conducted following PRISMA guidelines. Datawere gathered from electronic databases including PubMed, Scopus, Web of Science, and Google Scholar. The analysis included population based and cohort studies reporting mean age at natural menopause, whereas those focusing on premature ovarian insufficiency or surgical menopause were excluded. Random-effects models were applied for pooled estimates, and subgroup analyses were performed based on socioeconomic status, residence, body mass index, smoking, and education. The results revealed pooled mean age of menopause ranged from 46.36 years in Pakistan to 52.0 years in Indonesia. Urban women experienced later menopause than rural women (49 vs. 46.5 years). Higher BMI, socioeconomic status, parity, and education were associated with delayedmenopause, whereas smoking, alcohol use, stressful and physically demanding workload, and early menarche were linked with earlier onset. These findings highlight that the age at menopause varies significantly.

Objectives: Laparoscopic sacrocolpopexy (LSC) and transvaginal mesh surgery (TVM) have been shown to effectively treat pelvic organ prolapse (POP). However, their effects on urinary incontinence (UI) remain unknown, particularly when conducted on patient groups with similar backgrounds. We here aimed to compare the postoperative UI-related symptoms between patient groups without preoperative statistical differences.

Materials and methods: We retrospectively evaluated 243 patients with POP who underwent LSC or TVM at our hospital. Ninety-six patients were treated by LSC, whereas 147 were treated by TVM. After using nearest-neighbor propensity score matching, we compared the postoperative UI-related symptoms between the matched 67 LSC-treated patients and 67 TVM-treated patients.

Results: Following propensity score matching, the matched LSC and TVM groups did not demonstrate significant differences in terms of the explanatory factors. In both matched groups, the overactive bladder symptom score (OABSS) and International Consultation on Incontinence Questionnaire Short-Form (ICIQ-SF) score were significantly decreased at 3-12 months postoperatively compared with preoperative variables. The 60-min pad weight test revealed a significant decrease in the LSC and TVM groups at 12 months postoperatively. When comparing the results at 1 year postoperatively with preoperative values, the matched LSC and TVM groups demonstrated no significant differences in changes of the 60-min pad weight, OABSS, and ICIQ-SF score.

Conclusion: TVM appears to be a more favorable option for managing all types of POP than LSC, considering its shorter operative time and lower complication rate, as shown using nearest-neighbor propensity score matching analysis.

Background: Osteoporosis is a systemic skeletal disease characterized by a low bone mass and bone architectural derangements, leading to an increased fracture risk. Once osteoporosis has developed, then it is less likely to completely restore the bone strength of the patients. The prevalence of osteoporosis is increasing as the global population ages rapidly. Osteoporosis affects women more than men, and its incidence worldwide is very high.

Objective: To estimate the proportion of postmenopausal Indian women at risk for osteoporosis using the Osteoporosis Self-Assessment Tool for Asians (OSTA), a validated screening tool".

Materials and methods: The study was included 174 post-menopausal women; Osteoporosis self-assessment tool was explained to the subject. The height and weight were measured and put into OSTA formula ((body weight in kg - age in years) × 0.2). Administration of the score were monitor and OSTA was used to assess incidence of Osteoporosis.

Results: The study result shows that in middle age women 90% low risk of osteoporosis and those BMI in between 20 to 30 the P value is <0.0001. In this age group no high risk of osteoporosis. In old age women having 18.51% high risk of osteoporosis and those BMI in between 19 to 21 is the P value 0.2.

Conclusion: Indian The study concluded that overweight women was low risk for osteoporosis than normal and underweight women.