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Umbilical Endometriosis in a Surgically Naïve Multiparous Young Female. 一名未经手术治疗的年轻多产妇的脐带子宫内膜异位症
IF 1.1 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-01-01 Epub Date: 2024-04-04 DOI: 10.4103/jmh.jmh_172_23
Renu Singh, Sushma Bharti, Harpreet Kaur, Saroj Kumar Yadav

The existence of functional endometrial tissue outside the uterus is known as endometriosis. It is a benign estrogen-dependent gynecological condition that affects 5%-10% of women who are of reproductive age. Endometriosis often affects the ovary and fallopian tubes, although it can also occur in nonpelvic areas. The most typical location for extra-pelvic endometriosis is the abdomen. Umbilical endometriosis is a rare condition accounting for 0.5%-1.0% of all cases of endometriosis. In 3% of cases, there is a chance of malignant change. This disorder's precise etiology is uncertain. Recurrent discomfort and swelling around the umbilicus are the classic manifestations. In this instance, we describe a patient with primary umbilical endometriosis (PUE) who had cyclical bleeding and swelling over the umbilicus and was surgically naive. This case will demonstrate how, particularly in surgically naïve instances, diagnosis of PUE is frequently delayed due to ignorance of the entity.

存在于子宫腔外的功能性子宫内膜组织被称为子宫内膜异位症。这是一种依赖雌激素的良性妇科疾病,影响 5%-10%的育龄妇女。子宫内膜异位症通常会影响卵巢和输卵管,但也可能发生在非盆腔部位。盆腔外子宫内膜异位症最典型的发病部位是腹部。脐带子宫内膜异位症是一种罕见病,占子宫内膜异位症病例总数的 0.5%-1.0%。3%的病例有恶变的可能。这种疾病的确切病因尚不确定。脐周反复出现不适和肿胀是其典型表现。在本病例中,我们描述了一名原发性脐部子宫内膜异位症(PUE)患者,她有周期性出血和脐部肿胀,而且没有进行过手术。本病例将说明,特别是在手术不成熟的情况下,由于对该实体的不了解,PUE 的诊断往往会被延误。
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引用次数: 0
Enigma of Ovarian Cancer - Early detection Challenges and Solutions! 卵巢癌之谜--早期检测的挑战与解决方案!
IF 1.1 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-01-01 Epub Date: 2024-04-04 DOI: 10.4103/jmh.jmh_52_24
Yashodhara Pradeep
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引用次数: 0
Solitary Pancreatic Metastasis from an Ovarian Carcinoma: A Diagnostic Perplexity. 卵巢癌的孤立性胰腺转移:诊断之谜
IF 1.1 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-01-01 Epub Date: 2024-04-04 DOI: 10.4103/jmh.jmh_234_23
Arti Agarwal, Sonam Sharma

Ovarian cancer presenting as an isolated pancreatic metastasis after years of treatment is extremely rare. Most such patients are easily misdiagnosed as a case of primary pancreatic cancer. We herein describe a unique case of posttreatment high-grade serous papillary ovarian carcinoma metastasizing to the pancreas that mimicked primary pancreatic cancer and caused a diagnostic dilemma. The approach to such a case, pathogenesis, differential diagnosis, management, and a brief literature review is also presented.

卵巢癌经过多年治疗后出现孤立的胰腺转移极为罕见。大多数此类患者很容易被误诊为原发性胰腺癌。我们在此描述了一例独特的治疗后高级别浆液性乳头状卵巢癌转移至胰腺的病例,该病例模仿原发性胰腺癌,造成了诊断难题。本文还介绍了处理此类病例的方法、发病机制、鉴别诊断、处理方法以及简要的文献综述。
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引用次数: 0
From the Desk of Editor. 来自编辑的信息
IF 1.1 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-01-01 Epub Date: 2024-04-04 DOI: 10.4103/jmh.jmh_51_24
Yashodhara Pradeep, Maninder Ahuja
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引用次数: 0
BOTRROID Embryonal Rhabdomyosarcoma with Uterine Cervix in a Postmenopausal Woman: An Unusual Case Report. 一名绝经后妇女的子宫颈胚胎性横纹肌肉瘤:罕见病例报告。
IF 1.1 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-01-01 Epub Date: 2024-04-04 DOI: 10.4103/jmh.jmh_215_23
Saeed Karimkhani, Monireh Mirzaie, Soheila Sarmadi, Zahra Kolangdari

Rhabdomyosarcoma (RMS) is one of the most common soft-tissue sarcomas that engage the embryonal skeletal muscle cells as the female reproductive tract. Embryonal RMS (ERMS) is the most prevalent subtype of RMS in the female genital tract. Botryoid RMS is a rapidly growing rare malignancy and a polypoid variant of ERMS that occurs in childhood and constituting approximately 3% of all RMSs among young children and 1% among adolescents and young adults. A 50 year old menopause woman who had been vaginal discharge and bleeding for about 2 years without dysuria, dyspareunia, or postcuital bleeding was informed consent for presenting. A vaginal examination, pathology examination, sonography, magnetic resonance imaging, immunohistochemistry, surgery and radical hysterectomy, radiation therapy, and two sessions of brachytherapy were performed. After 22 months of follow-up, the patient had no evidence of recurrence or any problem in sexual activity. Oncological surgical treatment based on the carcinoma site and adjuvant chemotherapy is helpful for the treatment of RMS. However, applying the standard treatment guidelines is essential, although it is very scarce and difficult.

横纹肌肉瘤(RMS)是最常见的软组织肉瘤之一,主要侵犯女性生殖道的胚胎骨骼肌细胞。胚胎性横纹肌肉瘤(ERMS)是女性生殖道横纹肌肉瘤中最常见的亚型。类肉芽肿瘤是一种生长迅速的罕见恶性肿瘤,也是 ERMS 的多形性变异,多发于儿童期,约占幼儿所有 RMS 的 3%,占青少年和年轻成人 RMS 的 1%。一名 50 岁的绝经期妇女,阴道分泌物和出血约 2 年,无排尿困难、排便困难或性交后出血,在知情同意的情况下前来就诊。患者接受了阴道检查、病理检查、超声波检查、磁共振成像、免疫组织化学检查、手术和根治性子宫切除术、放射治疗以及两次近距离放射治疗。经过 22 个月的随访,患者没有复发迹象,性生活也没有任何问题。基于癌变部位的肿瘤外科治疗和辅助化疗有助于治疗 RMS。然而,应用标准治疗指南是至关重要的,尽管它非常稀缺且困难重重。
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引用次数: 0
Factors Associated with Quality of Life among Menopausal Women in Lucknow - A Cross-Sectional Study. 勒克瑙更年期妇女生活质量的相关因素--一项横断面研究。
IF 1.1 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2023-10-01 Epub Date: 2024-02-23 DOI: 10.4103/jmh.jmh_152_22
Ginic Gupta, Reema Kumari, Prabhaker Mishra, Bandna Gupta

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).

背景:至少一年没有来月经的妇女被视为绝经。尽管更年期是一种生理现象,但其对心理、身体和性的影响会持续整个生育后时期。因此,研究更年期的各个方面以及与更年期妇女生活质量(QoL)相关的不同参数非常重要:目的:了解勒克瑙市更年期妇女的生活质量与各种社会人口变量、体重指数、慢性病状况和其他生活方式参数的关系:2020 年 2 月至 2021 年 1 月,通过使用预先测试的半结构式问卷,对 200 名 45-65 岁绝经妇女进行了社区横断面研究。研究在勒克瑙市乔治国王医科大学社区医学系的农村和城市实地实践区进行:发现血管运动领域的平均得分在 45-49 岁年龄组、受教育程度较高、社会经济地位处于中上层和中上层以及肥胖的研究参与者中较高。性功能领域的平均得分在 55-59 岁年龄组、已婚研究参与者、受过中等以上教育者、超重和肥胖者中较高。患有慢性疾病的人在所有领域,即血管运动心理社会生理领域和性领域的平均得分都较高。总体而言,与采用改变生活方式的人相比,未采用改变生活方式的人的更年期特定 QoL 得分更高,且差异非常显著(P < 0.001)。
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引用次数: 0
A Study on Quality of Life among the Elderly at Urban Health Center in North Delhi. 北德里城市医疗中心老年人生活质量研究。
IF 1.1 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2023-10-01 Epub Date: 2024-02-23 DOI: 10.4103/jmh.jmh_82_22
Gunjan Mahaur, Archana Dwivedi, Deepika Joshi, Nidhi Dwivedi

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 21st 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.

背景:根据联合国人口基金发布的一份国家报告(UNFPA,2017 年),印度老年人口每年增长约 3%,到 2050 年将比 2011 年人口普查时增长三倍。提高老年人的生活质量(QOL)已成为 21 世纪公共卫生领域的一项重大挑战,因此及时关注老年人的身体健康和心理问题至关重要。因此,本研究旨在测量老年人群的 QOL,并找出其与社会人口学因素的关联:这是一项横断面研究,研究对象是城市卫生培训中心的老年人口。研究内容包括世界卫生组织生活质量问卷-简易版和社会人口变量问卷。研究采用单变量和多变量分析来确定相关性和 P 值:总体 QOL 得分介于 52 分和 110 分之间,平均得分为 78.59 ± 12.6。64.9%的老人QOL良好,19.8%的老人QOL优秀,其余15.3%的老人QOL一般,没有老人QOL较差。年龄、教育状况、职业状况、婚姻状况、子女的行为以及患有合并症的老人的行为与 QOL 有明显相关性(P<0.05):本研究表明,老年人的 QOL 与多种因素有关。年龄、教育状况、职业状况、婚姻状况、子女的行为以及患有合并症的老年人等因素对老年人的 QOL 有着显著的影响。因此,加强医疗保健系统、提高教育水平、鼓励社会交往、社会保障制度以及改善环境基础设施都有可能提高老年人口的 QOL。
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引用次数: 0
Uterovesical Migration of Copper-containing Intrauterine Device Complicated by Bladder Stone Formation. 含铜宫内节育器子宫腔移位并发膀胱结石形成。
IF 1.1 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2023-10-01 Epub Date: 2024-02-23 DOI: 10.4103/jmh.jmh_182_23
Ayodeji Sylvester Adeyanju, Jamiu Adelani Ogunsola, Gbolahan Oladele Obajimi

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.

含铜宫内节育器(IUD)是一种常见的避孕方法,失败率低,接受度高。然而,使用后可能会出现一些并发症,包括宫内节育器脱出和移出子宫。当发生移位时,装置可能会刺入骨盆中的其他结构,如直肠、乙状结肠、小肠或膀胱。患者的主诉模式将指导临床医生确定可能涉及的器官和护理方式。本病例报告介绍了一名宫内节育器移入膀胱并导致结石形成的 44 岁女性。她出现盆腔疼痛和血尿。经过辅助检查后,她接受了开腹手术,取出了宫内节育器和膀胱结石。术后她的恢复情况令人满意,术前的所有症状也完全消失。
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引用次数: 0
A Survey on Relation of Menopause to Metabolic Syndrome - SAFOMS STUDY (South Asian Federation of Menopause Societies) - Interim Analysis. 更年期与代谢综合征关系调查--SAFOMS 研究(南亚更年期协会联合会)--中期分析。
IF 1.1 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2023-10-01 Epub Date: 2024-02-23 DOI: 10.4103/jmh.jmh_17_24
Maninder Ahuja, Jai Bhagwan Sharma, Vanamail Perumal, Priyanka Sharma, Ramandeep Bansal, Avir Sarkar, Mohini Agrawal

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.

背景:代谢综合征(MS)是包括血糖异常、血脂异常、中心性肥胖和高血压在内的一系列疾病。与白种人相比,南亚印度人更容易在年轻时罹患代谢综合征。然而,在南亚地区缺乏将更年期与多发性硬化症相关联的大规模数据:该研究旨在确定更年期前后妇女中多发性硬化症的患病率及其组成部分。研究还评估了年龄、绝经状态、个人和家族病史、人体测量参数和生化指标与多发性硬化症的关系:这是一项在南亚更年期协会联合会(SAFOMS)国家进行的多国横断面研究的中期分析:该研究是对南亚更年期协会联合会(SAFOMS)在印度、巴基斯坦、孟加拉国、尼泊尔和斯里兰卡开展的多国横断面研究的中期分析,研究通过在线和物理方法进行。调查问卷包括与多发性硬化症有关的个人病史、人口统计学和家族病史等问题。同时还记录了身高、体重、基础代谢指数(BMI)、腰围和血压读数等人体测量数据。询问了相关病史、多囊卵巢综合征病史、妊娠高血压疾病史和血管运动症状。对与多发性硬化症有关的标记物进行了生化评估:在这次中期分析中,共招募了 638 名妇女。结果:在这次中期分析中,共招募了 638 名妇女,其中 406 人(63.6%)为绝经前妇女,232 人(36.4%)为绝经后妇女。392名妇女(61.4%)患有多发性硬化症,246名妇女(38.6%)未患多发性硬化症。年龄、体重指数(BMI)和内脏脂肪含量(腰围)的增加与多发性硬化症的发病率显著相关。空腹血糖、血红蛋白 A1C、总胆固醇、低密度脂蛋白、血清甘油三酯水平升高和高密度脂蛋白水平降低与绝经前和绝经后妇女的多发性硬化症发病率明显相关。围绝经期和绝经后潮热、盗汗和睡眠障碍与多发性硬化症也有显著相关性。个人高血压、糖尿病和血脂异常病史是与多发性硬化症相关性最强的因素,其几率明显较高:这项研究强调了体重指数和腰围作为第一个预警信号的作用,这将鼓励人们通过血脂分析和空腹血糖测量定期进行生化筛查。我们的研究为今后研究更年期与多发性硬化症的关系奠定了基础。
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引用次数: 0
Quality of Sexual Life and Attitudes toward Menopause among Postmenopausal Women Living in Northern Cyprus: A Cross-sectional Study. 生活在北塞浦路斯的绝经后妇女的性生活质量和对更年期的态度:横断面研究。
IF 1.1 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2023-10-01 Epub Date: 2024-02-23 DOI: 10.4103/jmh.jmh_178_22
Fatma Uslu-Sahan, Asli Er-Korucu, Arzu Abic

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.

背景大多数处于绝经期的中年妇女认为性生活是生活的重要组成部分。本研究旨在调查影响绝经后妇女性生活质量和对绝经的态度的因素,以及她们对绝经的态度对性生活质量的影响:这项横断面研究是在 2021 年 7 月至 2022 年 4 月期间对北塞浦路斯土耳其共和国的绝经后妇女进行的。研究样本包括 255 名绝经后妇女。数据收集采用更年期态度量表和性生活质量量表(SQLS)。问卷通过网络发放。数据分析采用独立 t 检验、方差分析、Tukey 检验、皮尔逊相关分析和线性回归分析:参与者在 SQLS 量表中的平均得分为 43.54 ± 12.56,在更年期态度量表中的平均得分为 60.39 ± 16.29。研究显示,年龄、受教育程度、就业状况、绝经时间和绝经知识等变量对妇女的性生活质量有影响。除上述变量外,收入水平也会影响对更年期的态度。对更年期的积极态度会提高性生活质量水平(β = 0.544,R2 = 0.30,F = 106.260,R = 0.544,P = 0.001):绝经后妇女对更年期的态度是决定其性生活质量的重要因素。结论:绝经后妇女对更年期的态度是决定其性生活质量的重要因素,因此,建议制定并实施培训计划,以改善妇女的性健康及其对更年期的态度。
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引用次数: 0
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Journal of Mid-life Health
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