Journal of Mid-life Health最新文献

Introduction: Breast cancer significantly influences women's health and overall well-being, necessitating comprehensive assessments to guide effective supportive care during cancer treatment. This study utilizes the EuroQoL-Visual Analog Scale (EQ-VAS) to systematically evaluate the health status and quality of life in women undergoing treatment for breast cancer.

Materials and methods: A study was conducted on a sample of 100 patients with breast cancer who were treated at a tertiary care hospital in New Delhi. The EQ-VAS, a part of the EuroQoL five-dimension instrument, was used to evaluate the participants. It measures the participants' self-rated health on a vertical visual analog scale, with 0 representing the worst possible health and 100 representing the best health.

Results: The participants' mean EQ-VAS score was 46.95 (standard deviation = 9.4), which denotes low self-perceived health. There were notable differences in EQ-VAS ratings between the various stages of breast cancer, with advanced stages exhibiting lower scores. Patients who underwent surgery for breast cancer were reported with high EQ-VAS scores (52.00 ± 16.71).

Conclusion: The results emphasize the different health experiences of women suffering from breast cancer and the value of individualized care programs during cancer care. The EQ-VAS has shown to be a valuable instrument for gathering patient self-perceived health status, providing important information for healthcare professionals to improve supportive care and the overall health of women struggling with breast cancer.

Aim and background: This study explores the correlation of blood levels of organochlorine pesticides (OCPs) between PCOS and non-PCOS women, considering the endocrine-disrupting properties of OCPs and their potential role in PCOS pathogenesis.

Materials and methods: A case-control study was conducted at Sarojini Naidu Medical College, Agra, from September 2022 to March 2024. Serum samples from 110 women diagnosed with PCOS and 110 age- and weight-matched controls were analyzed for 17°CP residues using gas chromatography. Clinical examination to calculate height, weight, body mass index, and waist-hip ratio was conducted. Signs of hyperandrogenism, such as acne and hirsutism, along with acanthosis nigricans, were documented. Hormonal profiles through chemiluminescence immunoassay were assessed. Correlation analysis entails examining connections between OCP and polycystic ovarian syndrome (PCOS) through the application of the Pearson correlation coefficient.

Results: PCOS patients exhibited significantly higher levels of several OCPs, including Alpha BHC, Beta BHC, Gamma BHC, Delta BHC, Heptachlor, Heptachlor Epoxide, Endosulfan I, Endosulfan II, Endosulfan Sulfate, Aldrin, Endrin, Endrin Aldehyde, PP-DDE, PP-DDT, and PP-DDD (P < 0.05) in comparison to their age- and weight-matched controls. Dieldrin levels showed no significant difference in both cohorts. Elevated OCP levels correlated with increased androgens, insulin resistance, menstrual irregularities, and disrupted gonadotropin secretion in PCOS patients while no association was measured in controls.

Conclusion: The findings suggest that environmental exposure to OCPs is associated with PCOS exacerbates the disease by disrupting hormonal balance and acting as endocrine disruptors. Further research is needed to confirm these associations and inform targeted interventions.

Clinical significance: This study highlights the potential role of OCPs in association with PCOS, emphasizing the need for public health measures to reduce exposure to these harmful chemicals, which may help manage PCOS symptoms and improve health outcomes for affected women.

In this meta-analysis and systematic review, the effectiveness and safety of single-dose fosfomycin were evaluated in comparison to other antibiotics for treating uncomplicated urinary tract infections (UTIs) in women, including asymptomatic bacteriuria (ASB) in pregnant women. Two independent reviewers conducted an electronic search on until December 2023 to search for randomized controlled trials that studied the efficacy and safety of fosfomycin for management of uncomplicated UTI in women or ASB in pregnant women and included those that fulfilled the eligibility criteria. The results showed that single-dose fosfomycin was comparable with other antibiotic agents in clinical resolution of uncomplicated UTI (odds ratio [OR]: 1.11, 95% confidence interval [CI] 0.88-1.41, I ² = 0%, P = 0.37, moderate certainty). Moreover, single-dose fosfomycin was equal to other antibiotics in the microbiological resolution of uncomplicated UTI (OR: 1.02, 95% CI: 0.83-1.25, I ² = 34%, P = 0.88, moderate certainty) and ASB among nonpregnant women (OR: 0.76, 95% CI: 0.45-1.28, I ² = 0%, P = 0.30, moderate certainty). The incidence of adverse events too was similar in patients receiving fosfomycin or other antibiotics (OR: 0.97, 95% CI: 0.77-1.23, I ² = 41%, P = 0.82, moderate certainty). Administering a single dose of fosfomycin is just as safe and effective as other antibiotics in treating uncomplicated UTIs in women. Prescribing a single dose of fosfomycin (3 g) as a regular practice may result in higher compliance rates and a reduced likelihood of antibiotic resistance.

Intrauterine contraceptive device (IUD) is one of the most commonly used long-term contraceptive methods worldwide. Migration of IUD is one of the rare complications of IUD insertion. Migrated IUD with calculus formation is a rarer long-term complication of IUD. A 55-year-old postmenopausal woman attended the outpatient clinic with complaints of continuous dribbling of urine. On examination, there was pooling of urine in the posterior fornix of the vagina, and the calcified vertical stem of the IUD was visualized through the cervical os. On evaluation, a giant calculus was noted within the bladder arising from the perforated IUD arm with vesicouterine fistula. Vesical lithotripsy followed by fistulous tract excision with repair of bladder wall was done.

Background: Midlife health poses stress to women. Perceived Stress Scale (PSS) score allows subjective assessment of perceived stress whereas heart rate variability (HRV) gives electrocardiogram (ECG)-based quantification of cardiac autonomic function, but the relation between these two is scarcely studied. Hence, the association between PSS and HRV was studied in middle-aged women.

Methodology: A cross-sectional study was done in midlife premenopausal (n = 51), perimenopausal (n = 59), and postmenopausal (n = 82) women. Perceived stress was interviewed by PSS score. ECG-based 5 min HRV was done by Variowin HR Software for frequency domain, time domain, and geometric HRV parameters. PSS and HRV were further compared or associated in subgroups, taking P < 0.05 as statistically significant.

Results: HRV was reduced in all three groups which had a prevalence of PSS grade 0, 1, 2 44%, 53%, and 3%, respectively, without intergroup difference. Diabetic and/or hypertensive subgroups exhibited reduced HRV than nondiabetic nonhypertensive subgroups. No significant correlation was found between PSS score and HRV parameters in either group. HRV did not associate with PSS grade-based subgroups in pre-, peri-, or postmenopausal stage.

Conclusion: Lack of HRV to perceived subjective stress association was observed in 40-55-year-old women with mild confounding by diabetes and/or hypertension. We suggest HRV total power and low-frequency: high-frequency ratio as best HRV parameters and consideration of age, reproductive health stage, and presence of comorbidities as a weak confounder for both HRV and PSS studies of middle-aged women. Further studies are warranted to consolidate the utility of HRV and PSS for the assessment of these two different types of stress.

Introduction: A menopausal transition is a stressful event in a woman's life affecting health and quality of life. Spousal awareness of menopausal changes can help them support their wives in coping with the menopausal transition. No studies have explored men's awareness of menopause in India. Therefore, this study aimed to find the men's awareness of menopause and its associated factors. The study also explored men's awareness of the management of symptoms and partner support.

Materials and methods: This cross-sectional study of husbands of menopausal women aged 45-60 years in eastern India evaluated their awareness of menopause by a structured questionnaire. A semistructured interview schedule assessed the men's awareness of menopause, management of symptoms, and partner support.

Results: Four hundred and twenty consenting men fulfilling inclusion criteria were recruited for the study. The mean age of the husband was 50.7 ± 3.9 years. The mean age of the wife was 56.6 ± 4.4 years. Most men reported symptoms of joint pain (69.3%), low energy level (68.8%), decreased physical strength (63.3%), tiredness (61%), and low backache (51%) in their wives. The overall knowledge of menopause among husbands was inadequate (91.42%). Men reported that their wives avoiding sexual intimacy (85.7%), irritability (58.6%), and mood swings (43.1%) affected their marital relationship. The husband's knowledge was associated with education (P = 0.014), the wife's education (P < 0.001), occupation (P < 0.001), family income (P < 0.001), and socioeconomic status (P < 0.001).

Conclusion: Indian husbands lacked information on menopause. Men need information on menopause to support their menopausal spouses.

Cervical fibroids are relatively rare compared to fibroids that develop in other parts of the uterus, accounting for nearly 1%-2% of all fibroids. They typically originate from the supravaginal or vaginal portions of the cervix. One histological variant is angiolipoleiomyoma (ALLM), a benign mixed mesenchymal neoplasm composed of smooth muscle, mature adipose tissue, and abnormal blood vessels. While there are case reports of ALLM occurring in the kidneys, its presence in the female genital tract is extremely uncommon. Furthermore, here, we present a novel case of a 40-year-old postmenopausal female who presented with a long history of vaginal bleeding. Ultrasound revealed a fibroid located at the cervix; however, with histopathology revealing it to be a lymphangiolipoleiomyoma with a plethora of lymphatics. To the best of our knowledge, this is the first such case described in the medical literature.

We report the case of a 51-year-old female with an unusual presentation of a cutaneous granular cell tumor (GCT) on the lower back. The lesion was asymptomatic, well-defined, and firm, with an initial clinical differential of dermatofibroma, pilomatricoma, or leiomyoma. Histopathological examination revealed a dermal tumor composed of large polygonal cells with granular eosinophilic cytoplasm and uniform nuclei, without atypia or necrosis. Immunohistochemistry confirmed the diagnosis with strong S100 and CD68 positivity. Due to tumor extension tumor extension to the deep resection margin, close follow-up was advised. Accurate diagnosis of cutaneous GCTs relies on histopathology and immunohistochemistry, as clinical and dermoscopic findings are often nonspecific. Complete surgical excision is the primary treatment, with a generally favorable prognosis. Awareness of malignant potential and proper surgical management is crucial for optimal outcomes.