Journal of Mid-life Health最新文献

Background: Women who have gone at least a year without having their monthly period are considered as menopausal. Despite the fact that it is a physiological occurrence, its psychological, bodily, and sexual effects last for the entire postreproductive period. That's why it is important to research its various aspects and the different parameters associated with their quality of life (QoL).

Objective: To find the association of the QoL among menopausal women in Lucknow with various socio-demographic variables, body mass index, chronic disease status, and other lifestyle parameters.

Materials and methods: A community-based cross-sectional study was conducted from February 2020 to January 2021 among 200 Menopausal women of 45-65 years by using a pretested semi-structured questionnaire. The study was carried out in rural and urban field practice areas of the Community Medicine Department, King George's Medical University, UP, Lucknow.

Results and conclusion: The mean score of vasomotor domains was found higher in the age group of 45-49 years, who had higher education level, upper and upper middle class of socioeconomic status, and for obese study participants. The mean score of the sexual domain was found to be higher among the age group 55-59 years, married study participants, for those who were educated above secondary, and for overweight and obese. The mean scores for all domains, i.e., vasomotor psychosocial physical and sexual domains were higher for those who had chronic diseases. Overall, the menopause specific QoL score was higher for those who did not use lifestyle modification as compared to those who used lifestyle modification and the difference was found to be highly significant (P < 0.001).

Background: Elderly population in India is growing around 3% annually and is supposed to triple by 2050 than that at the time of 2011 census, according to a country report published by the UN Population Fund (UNFPA, 2017). A better quality of life (QOL) of the elderly has become a major public health challenges of the 21^st century, so timely emphasis on maintenance of physical health and psychological issues is crucial. Therefore, the aim of the present study is to measure QOL among the elderly population and to find out the association with sociodemographic factors.

Materials and methods: This is a cross-sectional study done among the elderly population of an urban health training center. The study includes the World Health Organization Quality of Life Questionnaire-Brief version and a questionnaire for sociodemographic variables. Univariate and multivariate analyses were used to determine associations and P value.

Results: The overall QOL scores ranged between 52 and 110, with a mean score of 78.59 ± 12.6. Good QOL was observed among 64.9%of the elderly, excellent was observed among 19.8%; and the rest 15.3% had fair/average, while none of the elderly had poor QOL. Determinants significantly associated with QOL with P < 0.05 are age, educational status, professional status, marital status, and behavior of children with them and the elderly with comorbidities.

Conclusion: This study shows the association of multiple factors with QOL among the elderly. Factors such as age, educational status, professional status, marital status, and behavior of children with them and the elderly with comorbidities significantly affect the QOL of the elderly. Hence, strengthening the health-care system, increase in level of education, encouraging social interaction, social security systems, and better environmental infrastructure could potentially increase QOL of the elderly population.

Copper-containing intrauterine device (IUD) is a common method of contraception with a low failure rate and high acceptability. However, complications could follow its use including expulsion and migration of the device out of the uterus. When migration occurs, the device could pierce other structures in the pelvis such as the rectum, sigmoid colon, small bowel, or urinary bladder. The pattern of the patient's complaints will guide the clinician on the possible organ involved and the manner of care. This case report presents a 44-year-old woman with IUD migration into the urinary bladder with resulting stone formation. She presented with pelvic pain and hematuria. Following ancillary investigations, she had laparotomy and removal of the IUD along with bladder stones. She had a satisfactory recovery after the surgery and had a complete resolution of all her preoperative symptoms.

Background: Metabolic syndrome (MS) is a spectrum of disorders that includes dysglycemia, dyslipidemia, central obesity, and hypertension. South Asian Indians are more prone to harbor MS at a younger age compared to Caucasians. However, there is a lack of large-scale data correlating menopause to MS in South Asian settings.

Aims and objectives: The study aimed to determine the prevalence of MS and its components in pre- and postmenopausal women. It also assessed the relationship of age, menopausal status, personal and family history, anthropometric parameters, and biochemical markers to MS.

Materials and methods: It was an interim analysis of a multicountry cross-sectional study in the South Asian Federation of Menopause Society (SAFOMS) countries: India, Pakistan, Bangladesh, Nepal, and Sri Lanka conducted through both online and physical methods. The survey questionnaire consisted of questions about details of personal history, demographics, and family history related to MS. Anthropometric measurements such as height, weight, basal metabolic index (BMI), waist circumference, and blood pressure readings were noted. Relevant history, history of polycystic ovarian syndrome, hypertensive disorders of pregnancy, and vasomotor symptoms were enquired. Biochemical evaluation of markers associated with MS was undertaken.

Results: In this interim analysis, 638 women were recruited. Out of them, 406 (63.6%) women were premenopausal and 232 (36.4%) were postmenopausal. 392 (61.4%) women had MS, while 246 (38.6%) women did not have MS. Increasing age, BMI, and visceral adiposity (waist circumference) were significantly correlated with incidence of MS. Raised fasting blood sugar, hemoglobin A1C, total cholesterol, low-density lipoprotein, serum triglyceride, and reduced high-density lipoprotein levels were significantly associated with the incidence of MS in both pre- and postmenopausal women. Peri- and postmenopausal hot flashes, night sweats, and sleep disturbances were also significantly associated with MS. Personal history of hypertension, diabetes, and dyslipidemia were the strongest factors to be associated with MS with a significantly high odds ratio.

Conclusion: The study has highlighted the role of BMI and waist circumference as the first warning signs, which will encourage to go for regular biochemical screening through lipid profile and fasting blood glucose measurements. Our study is a stepping stone for all future studies for relation of menopause to MS.

Background: Most middle-aged women in the menopausal period consider sexuality an important part of life. The aim of the present study was to investigate the factors affecting the quality of sexual life and attitudes toward menopause in postmenopausal women and the effects of their attitudes toward menopause on the quality of sexual life.

Materials and methods: This cross-sectional study was conducted with postmenopausal women in the Turkish Republic of Northern Cyprus between July 2021 and April 2022. The research sample consisted of 255 postmenopausal women. The Attitudes Toward Menopause Scale and the Sexual Quality of Life Scale (SQLS) were used to collect data. The questionnaire forms were administered online. The data were analyzed using the independent t-test, analysis of variance, Tukey's test, Pearson's correlation, and linear regression analysis.

Results: The mean score of the participants on the SQLS was 43.54 ± 12.56 and the mean score of the Attitudes Toward Menopause Scale was 60.39 ± 16.29. The study revealed that variables such as age, level of education, employment status, duration of menopause, and knowledge about menopause have an effect on women's sexual life quality. In addition to the listed variables, income level was found to affect attitudes toward menopause. A positive attitude toward menopause causes an increase in the level of sexual life quality (β = 0.544, R² = 0.30, F = 106.260, R = 0.544, P = 0.001).

Conclusions: The attitudes of postmenopausal women toward menopause are an important determinant of their sexual life quality. For this reason, it is recommended to develop and implement training programs that can improve sexual health of women and their attitudes toward menopause.

Purpose: Patient education is one of the important components of reducing the morbidity of osteoporosis. The aim of this study is to validate the Hindi version of the Osteoporosis Knowledge Assessment Tool (OKAT-H) among a hospital-based sample in the age group of 18-44 years of age.

Methods: The study was conducted in two phases - translation and adaption of the OKAT in Hindi followed by its validation. The translated tool was analyzed by Flesch reading ease, McNemar test, Cronbach alpha, difficulty index, discrimination index, and principal factor analysis.

Results: Two hundred and sixty women with a mean age of 28.3 ± 17.2 years were enrolled in the study. The mean score of the OKAT-H tool obtained in the study was 11.3 ± 2.1. A significant difference was noted in the scores based on educational qualification or with any family history of either osteoporosis or fracture (P < 0.05). The Flesch score for the OKAT-H tool was 86. Inter-item correlation for all the items ranged between 0.15 and 0.5. The Cronbach's alpha measured 0.892 suggesting high internal consistency. Items number 6, 7, 8, 9, 13, and 14 showed a significant difference on the McNemar test questioning its consistency on test-retest.

Conclusion: A new shorter version of the tool may be developed since six items showed low consistency. The use of such an instrument in local language would help spread awareness about the disease as well as help the population in adopting osteoprotective strategies and also to seek help and advice regarding treatment.

Background: Middle age is a link between adulthood and old age, which requires special attention. During middle age among females, changes like menopause occur, which is responsible for causing various physical, vasomotor, psychological, and social changes, which may affect overall well-being and positive mental health status. Hence, the present study has been planned to assess the prevalence of menopausal symptoms among middle-aged females.

Materials and methods: The present study was a cross-sectional study carried out in rural and urban areas of district Dehradun among 400 females. A stratified systematic random sampling technique method was used. All the females fulfilling the inclusion criteria and aged 40-60 years were included in the study. The Menopause-Specific Quality of Life (MENQOL) questionnaire was used to assess the prevalence of menopausal symptoms.

Results: A total of 400 women were recruited in the study, 200 from rural and urban areas each. The mean age of the total study participants was 50.00 ± 0.32 years. Among 400 middle-aged women, 189 were premenopausal and 211 were postmenopausal. The frequencies of occurrence of menopausal symptoms were explored in 189 premenopausal and 211 postmenopausal women. The mean age of premenopausal women was 44.21 ± 2.35 and postmenopausal was 54.39 ± 4.21. Females experienced varying grades of MENQOL symptoms.

Conclusions: It was found that majority of the females' quality of life were found to be affected with different grades of menopausal symptoms. With increasing age, symptoms also increase and are significantly high among postmenopausal women.

Background: Breast cancer is the most common cancer in women worldwide, with an estimated 2.26 million new cases diagnosed in 2020. The important genes associated include BRCA1, BRCA2, CHEK2, PTEN, TP53, and ataxia-telangiectasia mutated (ATM). ATM is responsible for repairing double-strand breaks in DNA making it a significant candidate in breast cancer predisposition. ATM variant, c.1066-6T>G, has been associated with an increased risk of breast cancer in some but not all studies. The Indian studies on the allele IVS10-6T>G are very limited. The present study was undertaken to evaluate the associations between c.1066-6T>G ATM gene variant and breast cancer incidence in Indian women and its correlation with histological grade, stage, and surrogate molecular classification.

Materials and methods: Routine histopathological processing was done after adequate fixation of the specimen followed by staining with hematoxylin and eosin and immunohistochemistry for ER, PR, Her2neu, and Ki67. Single-nucleotide polymorphism for ATM allele IVS10-6T>G was studied after DNA extraction, polymerase chain reaction amplification, and restriction enzyme digestion.

Results: All cases were found to be negative for ATM allele IVS10-6T>G mutation. Maximum number of patients (19 cases; 52.78%) had pT2 stage tumor followed by 11 patients (30.56%) with pT3. Majority of cases were luminal B (11; 30.56%) followed by triple negative (10; 27.78%).

Conclusion: Although the results obtained by mutational analysis in the present study are not in agreement with the previous study on Indian women it agrees with the numerous previous studies and meta-analyses done on women with breast carcinoma in the Western world.

Background: Menopause is a natural stage in a woman's life marked by the cessation of menstrual periods. Common symptoms include hot flashes, mood swings, and vaginal discomfort, among others. These climacteric symptoms lead to a compromised quality of life affecting physical, biological, psychological, and social well-being. There are concerns with long-term clinical use of Hormone replacement therapy (HRT) and alternative therapies that are devoid of adverse risks are required. This study aimed to evaluate the safety and efficacy of EstroG-100®, containing a mixture of standardized extracts of Cynanchum wilfordii, Phlomis umbrosa, and Angelica gigas, on menopausal symptoms and its impact on quality of life.

Methodology: This was a prospective, single-center, single-arm, interventional study. Sixty female subjects, with confirmed menopause and moderate-to-severe symptoms, were enrolled and treated with EstroG-100® twice daily, for 12 weeks. Improvement in the climacteric symptoms was evaluated using the Menopause Rating Scale-11 and Menopause Symptoms Treatment Satisfaction Questionnaire (MS-TSQ). All the results were evaluated by the SPSS software version 23.0.

Results: A significant improvement was noticed in the somatic, urogenital, and psychological climacteric symptoms from baseline to 6 weeks (P = 0.001) and a highly significant improvement after 12 weeks (P = 0.0001) of treatment. 96.5% of patients were satisfied with the treatment outcome evaluated by the MS-TSQ. No changes in blood pressure and body mass index were reported. No side effects were reported during the study.

Conclusion: The first study of EstroG-100® in Indian menopausal women demonstrated a statistically significant improvement in climacteric symptoms. A 12-week treatment proved safe and effective in enhancing postmenopausal women's quality of life. The remedy was well-tolerated and effectively alleviated menopausal symptoms.