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Effect of Pain Neuroscience Education with Conventional Physiotherapy via Telerehabilitation on Pain Catastrophizing and Function in Patients with Osteoarthritis Knee: A Randomized Controlled Trial 通过远程康复进行常规物理治疗的疼痛神经科学教育对骨关节炎患者疼痛发作和功能的影响:一项随机对照试验
Q3 Social Sciences Pub Date : 2023-01-01 DOI: 10.4103/jmh.jmh_33_23
Hiral Manohar Supe, Sanket S. Mungikar, Goutami A. Katage, Kapil A. Garg, Surendra Kiran Wani
Aim: By explaining to the patient the biological processes underneath their pain condition, pain neuroscience education (PNE) is a form of educational intervention that aims to relieve pain and impairment. Materials and Methods: Patients with knee osteoarthritis (OA) referred to outpatient physiotherapy clinic in India during August 2021 to June 2022 were asked to participate. Out of the eligible patients, 35 were randomly assigned to PNE group and 35 to the control group. Self-reports of Pain Catastrophizing Scale (PCS), Patient Specific Function Scale (PSFS), and Numerical Pain Rating Scale (NPRS) were recorded at baseline (T1) and at 2 weeks (T2). Results: After 2 weeks of follow-up, all the three outcome measures were found to be significant in the PNE group. The results of the unpaired t-test revealed statistically significant result posttest for PCS (mean difference 11.4) and NPRS (mean difference 1.20). There was no mean difference found in the patient function (PSFS) between groups. Conclusion: The results suggest that adding a program of PNE to conventional physiotherapy exercises led to a greater reduction in pain catastrophization, patient-specific function, and pain intensity rather than conventional physiotherapy alone in patients with knee OA at 2 weeks’ follow-up.
目的:疼痛神经科学教育(PNE)是一种旨在减轻疼痛和损伤的教育干预形式,通过向患者解释其疼痛状态下的生物过程。材料与方法:研究对象为2021年8月至2022年6月在印度门诊物理治疗诊所就诊的膝关节骨关节炎(OA)患者。在符合条件的患者中,35例随机分配到PNE组,35例分配到对照组。分别在基线(T1)和2周(T2)记录疼痛灾变量表(PCS)、患者特异性功能量表(PSFS)和数值疼痛评定量表(NPRS)的自我报告。结果:随访2周后,PNE组3项指标均显著。非配对t检验结果显示PCS(平均差值11.4)和NPRS(平均差值1.20)后测结果具有统计学意义。两组患者功能(PSFS)无平均差异。结论:结果表明,在2周的随访中,在常规物理治疗运动中加入PNE方案比单独进行常规物理治疗更能减少膝关节OA患者的疼痛灾难、患者特异性功能和疼痛强度。
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引用次数: 0
Validity and Reliability of the Turkish Male Andropause Symptoms Self-Assessment Questionnaire. 土耳其男性更年期症状自我评估问卷的有效性和可靠性。
IF 1.2 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2023-01-01 Epub Date: 2023-07-07 DOI: 10.4103/jmh.jmh_196_22
Ahmet Mesut Çetin, Burhan Baylan, Muhammet Abdurrahim Imamoglu, Türkan Akbayrak

Objective: This study was planned to examine the validity and reliability of the Turkish version of the Male Andropause Symptoms Self-Assessment Questionnaire (MASS-Q).

Materials and methods: One hundred and twenty-five men with a mean age of 54.24 ± 6.51 years participated in the study. First, participants' demographic data were recorded. Then, the MASS-Q was adapted to Turkish. The assess the reliability and validity of the Turkish MASS-Q, internal consistency, test-retest reliability, and criterion validity analyses were administered. For the reliability test, the scale was readministered 1 week later. Test-retest reliability was examined with the intraclass correlation coefficients (ICCs). Internal consistency was defined by Cronbach's alpha. Regarding the validity analysis, content validity was determined according to expert opinions. For criterion validity, the Aging Male Symptoms-Questionnaire (AMS-Q) was used.

Results: According to the results of the analysis, the ICC values between the test-retest scores of the total and subdimensions (sexual, somatic, psychic, and behavior) of the MASS-Q were found to be 0.987, 0.939, 0.973, 0.951, and 0.887, respectively (P < 0.05). Cronbach's alpha values of the total and subdimensions (sexual, somatic, psychic, and behavior) of the MASS-Q were calculated as 0.924, 0.870, 0.747, 0.865, and 0.667, respectively. According to the ICC values obtained, it was found that the MASS-Q had a high degree of reliability. According to the internal consistency results, the sexual and psychic subdimensions were found to be quite reliable, whereas the somatic and behavioral subdimensions were found to be sufficiently reliable. According to the criterion validity results, a very high and high correlations were found between the AMS-Q scores and the MASS-Q scores (r = 0.636-0.938, P = 0.001).

Conclusion: As a result, it was determined that the Turkish version of the MASS-Q is a valid and reliable scale that can be used in Turkish men.

目的:本研究旨在检验土耳其版男性更年期症状自我评估问卷(MASS-Q)的有效性和可靠性。材料和方法:125名平均年龄为54.24±6.51岁的男性参与了本研究。首先,记录参与者的人口统计数据。然后,MASS-Q被改编成土耳其语。对土耳其MASS-Q的信度和有效性、内部一致性、重测信度和标准有效性进行了评估分析。对于可靠性测试,该量表在1周后重新输入。用组内相关系数(ICCs)检验测试-再测试的可靠性。内部一致性由Cronbachα定义。关于有效性分析,根据专家意见确定内容的有效性。标准有效性采用老龄男性症状问卷(AMS-Q)。结果:根据分析结果,MASS-Q的总维度和子维度(性维度、躯体维度、心理维度和行为维度)的重测得分之间的ICC值分别为0.987、0.939、0.973、0.951和0.887(P<0.05),分别为0.870、0.747、0.865和0.667。根据获得的ICC值,发现MASS-Q具有高度的可靠性。根据内部一致性结果,性和心理子维度被发现是相当可靠的,而身体和行为子维度被认为是足够可靠的。根据标准有效性结果,AMS-Q评分与MASS-Q评分之间存在非常高的相关性(r=0.636-0.938,P=0.001)。
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引用次数: 0
Prevalence and Risk Factors of Urinary Incontinence among Elderly Women Residing in Kochi Corporation: A Community-based Cross-sectional Study. 高知公司老年女性尿失禁的患病率和危险因素:一项基于社区的横断面研究。
IF 1.1 Q3 Social Sciences Pub Date : 2023-01-01 Epub Date: 2023-07-07 DOI: 10.4103/jmh.jmh_184_22
T T Carmel Regeela Mainu, Sobha George, Arun Raj, Midhun Rajiv

Background: A study was done on the prevalence, risk factors, and treatment-seeking behavior of elderly women with urinary incontinence (UI) residing in Kochi Corporation, Kerala, India. The community-based cross-sectional study was done in Kochi on 525 elderly women aged 60 years and above, selected by cluster random sampling, after getting consent, using a questionnaire. The overall prevalence of UI was found to be 64% (95% confidence interval (CI) 59.5-67.6). The most common type of UI was found to be the urge type of incontinence (38.3%, 95% CI, 34.14-42.45). Chronic cough (odds ratio [OR] 1.754, 95% 1.170-2.631), chronic constipation (OR: 1.563, 95% CI: 1.030-2.373), obesity (OR: 1.591, 95% CI: 1.110-2.280), diabetes (OR: 1.517, 95% CI: 1.036-2.222), and taking medications for diabetes and hypertension (OR: 1.476, 95% 1.008-2.163) were found to be risk factors of UI. Multiparity (OR: 1.757, 95% CI: 1.073-2.876), delivery at home (OR: 1.761, 95% CI: 1.205-2.575), undergoing any pelvic surgery (OR: 1.504, 95% CI: 1.052-2.150) were the gynecological and obstetric factors associated with UI.

Context: Very few community-based studies are available on UI among elderly women.

Aim: The primary objective of the study was to estimate the prevalence of UI among elderly women residing in the Kochi corporation. The secondary objective was to determine the risk factors of UI.

Settings and design: A community-based cross-sectional study was done in the Kochi Corporation of Ernakulam district.

Subjects and methods: A pilot study was conducted and based on this, the sample size was computed to be 72.41. Data from 525 individuals were collected using cluster random sampling. A questionnaire for urinary incontinence diagnosis questionnaire was used for assessing the type of UI.

Statistical analysis used: Percentage prevalence, Chi-square test.

Results: The overall prevalence of UI was found to be 64%. The most common type of UI was found to be the urge type of incontinence. Chronic cough, chronic constipation, obesity, diabetes, taking medications for diabetes, and hypertension were found to be risk factors of UI. Multiparity, delivery at home, and undergoing any pelvic surgery were the gynecological and obstetric factors associated with UI.

Conclusions: The prevalence of UI among elderly women in this study was found to be 63.9%. The most common type of UI was found to be urge type of incontinence 38.3%, followed by mixed incontinence 32.3%, and stress incontinence 29.3%. Chronic cough (OR: 1.754), chronic constipation (OR: 1.563), obesity (OR: 1.591), diabetes (OR: 1.517), and taking medications for diabetes and hypertension (OR: 1.476) were found to be risk factors for UI. Multiparity (OR: 1.757), delivery at home (OR: 1.761) and undergoing any pelvic surgery (OR: 1.504) were the

背景:对居住在印度喀拉拉邦Kochi公司的老年女性尿失禁(UI)的患病率、危险因素和寻求治疗行为进行了研究。这项基于社区的横断面研究是在高知市对525名60岁及以上的老年妇女进行的,她们在获得同意后通过整群随机抽样,使用问卷进行选择。UI的总患病率为64%(95%置信区间(CI)59.5-67.6)。最常见的UI类型是冲动型失禁(38.3%,95%CI,34.14-42.45)。慢性咳嗽(比值比[OR]1.754,95%1.170-2.631)、慢性便秘(OR:1.563,95%CI:1.030-2.373)、肥胖,服用糖尿病和高血压药物(OR:1.476,95%1.008-2.163)是UI的危险因素。多发性(OR:1.757,95%CI:1.073-2.876)、在家分娩(OR:1.761,95%CI:1.205-2.575)、接受任何骨盆手术(OR:1.504,95%CI:1.552-2.150)是与UI相关的妇科和产科因素。背景:很少有关于老年妇女UI的社区研究。目的:本研究的主要目的是评估居住在高知公司的老年妇女UI的患病率。次要目的是确定UI的危险因素。设置和设计:在Ernakulam区的Kochi公司进行了一项基于社区的横断面研究。受试者和方法:进行了一项试点研究,基于此,样本量计算为72.41。采用整群随机抽样法收集了525名个体的数据。尿失禁诊断问卷用于评估UI类型。使用的统计分析:患病率百分比,卡方检验。结果:UI的总患病率为64%。最常见的UI类型是冲动型失禁。慢性咳嗽、慢性便秘、肥胖、糖尿病、服用糖尿病药物和高血压是UI的危险因素。多胎性、在家分娩和接受任何骨盆手术是与UI相关的妇科和产科因素。结论:在本研究中,老年女性UI的患病率为63.9%。最常见的UI类型是催促型失禁38.3%,其次是混合型失禁32.3%,压力性失禁29.3%。慢性咳嗽(OR:1.754)、慢性便秘(OR:1.563)、肥胖(OR:11.591)、糖尿病(OR:1.1517),服用糖尿病和高血压药物(OR:1.476)是UI的危险因素。在本研究中,多胎性(OR:1.757)、在家分娩(OR:1.761)和接受任何骨盆手术(OR:1.504)是与老年妇女UI相关的妇科和产科因素。慢性咳嗽(调整比值比[aOR]1.64,95%CI:1.08-2.50)、肥胖(aOR:1.64,95%CI:1.13-2.39)、盆腔手术(aOR+1.64,95%CI:1.13-2.39)和在家分娩(aOR=1.89,95%CI:12.7-2.82)被发现是老年妇女UI的独立危险因素。
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引用次数: 0
Histopathological Study of Spectrum of Lesions of Uterine Cervix 子宫颈病变谱的组织病理学研究
Q3 Social Sciences Pub Date : 2023-01-01 DOI: 10.4103/jmh.jmh_28_23
Aditi Jadhav, Vandana Sanklecha, Ashwini Natekar, Richa Mahra
Context: Uterine cervix is a gateway to several neoplastic and nonneoplastic lesions. Cervical carcinoma accounts for 20%–25% of all cancers and 80%–85% of all genital tract cancers worldwide. It is the most common malignancy in Indian women. Aim: The aim of this study was to study the histopathological spectrum, incidence, and distribution with respect to the age of various cervical lesions and to determine their clinicopathological correlation. Settings and Design: A prospective observational study of 200 cases of cervical lesions was carried out in the histopathology section of the Department of Pathology for the duration of 2 years after obtaining permission from the Institutional Ethics Committee. Materials and Methods: Study participants were selected from the study population admitted at the study center based on the inclusion and exclusion criteria. Statistical Analysis Used: Statistical software GraphPad InStat.v3.0 was used for statistical analysis. Results: In our study, 49.5% of cases were malignant and 50.5% of cases were benign. The most common malignant lesion on histopathological examination was squamous cell carcinoma (SCC). Majority of the lesions were in the 41–50 years of age group. Clinicopathological agreement was noted in 93.5% of cases. Twenty-eight out of 30 cases of SCC (93.33%) were positive for p16 staining. Agreement between Pap smear findings and histopathological diagnosis was 100% in cases of malignant and premalignant lesions of the cervix. Conclusion: Histopathological examination is important not only for confirmation of the preoperative diagnosis but also in evaluating the incidence and age-wise distribution of both neoplastic and nonneoplastic cervical lesions. Early and accurate diagnosis of cervical lesions provides an opportunity for appropriate interventions to prevent further complications.
背景:子宫颈是多种肿瘤和非肿瘤病变的通道。宫颈癌占全世界所有癌症的20%-25%,占所有生殖道癌症的80%-85%。它是印度妇女中最常见的恶性肿瘤。目的:本研究的目的是研究各种宫颈病变的组织病理谱、发病率和分布与年龄的关系,并确定其临床病理相关性。背景和设计:获得机构伦理委员会的许可后,在病理系组织病理学部对200例宫颈病变进行了为期2年的前瞻性观察研究。材料和方法:根据纳入和排除标准,从研究中心接受的研究人群中选择研究参与者。使用统计软件GraphPad InStat.v3.0进行统计分析。结果:本组病例中恶性肿瘤占49.5%,良性肿瘤占50.5%。组织病理学检查中最常见的恶性病变是鳞状细胞癌(SCC)。大多数病变发生在41-50岁年龄组。93.5%的病例临床病理一致。30例SCC中p16染色阳性28例(93.33%)。宫颈恶性和癌前病变的子宫颈涂片检查结果与组织病理学诊断的一致性为100%。结论:组织病理学检查不仅对术前诊断有重要意义,而且对评估宫颈肿瘤和非肿瘤病变的发生率和年龄分布也有重要意义。宫颈病变的早期和准确诊断为适当的干预提供了机会,以防止进一步的并发症。
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引用次数: 0
Determinants of Malnutrition among Elderly Women Living in Institutional Care 生活在机构护理中的老年妇女营养不良的决定因素
Q3 Social Sciences Pub Date : 2023-01-01 DOI: 10.4103/jmh.jmh_26_23
Jessica Subashini Moses, Sheila John, Sarah Jane Monica, S. Priyadarshini
Background: Healthy aging and well-being are largely influenced by nutrition. Objective: The objective of the study was to evaluate the risk of malnutrition in elderly women residing in institutional care and its contributing factors. Methodology: One hundred institutionalized women aged 60 years and above were screened for malnutrition using Mini Nutritional Assessment (MNA) tool. Details on sociodemographic profile, physical activity, medical conditions, and food habits were gathered through researcher administered survey method. Results: The study participants had an average height of 149.70 cm (±7.31), weight of 50.72 kg (±9.11), body mass index of 22.77 kg/m 2 (±4.68), body fat percentage of 31.30% (±8.99), mid-arm circumference of 27.36 cm (±7.84), calf circumference of 30.11 cm (±7.51), MNA score of 10.42 (±4.06), and hand grip strength score of 18.69 kg/lbs (±3.80). Upon analyzing the MNA scores, it was found that 9% of elderly women were well nourished, 62% were at risk of malnutrition, and 29% were malnourished. A significant difference was observed in the mean MNA scores ( P < 0.05). Age, education level, body fat percentage, appetite, and dental problems were significantly associated with malnutrition ( P < 0.05). Conclusion: Geriatric residents in old-age homes require adequate nutrition to maintain health. This can be achieved by providing individualized meal planning, reducing barriers to eating, and incorporating nutrient-dense foods.
背景:健康老龄化和幸福在很大程度上受营养的影响。目的:本研究的目的是评估居住在机构护理的老年妇女营养不良的风险及其影响因素。方法:采用迷你营养评估(MNA)工具对100名60岁及以上的住院妇女进行营养不良筛查。通过研究人员管理的调查方法收集了社会人口统计资料、体育活动、医疗状况和饮食习惯的详细信息。结果:研究参与者平均身高149.70 cm(±7.31),体重50.72 kg(±9.11),身体质量指数22.77 kg/ m2(±4.68),体脂率31.30%(±8.99),中臂围27.36 cm(±7.84),小腿围30.11 cm(±7.51),MNA评分10.42(±4.06),手部握力评分18.69 kg/lbs(±3.80)。在分析MNA评分后,发现9%的老年妇女营养良好,62%有营养不良风险,29%营养不良。MNA平均评分差异有统计学意义(P <0.05)。年龄、受教育程度、体脂率、食欲和牙齿问题与营养不良显著相关(P <0.05)。结论:老年人需要充足的营养来维持健康。这可以通过提供个性化的膳食计划,减少进食障碍,并纳入营养丰富的食物来实现。
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引用次数: 0
Transcutaneous Temperature Controlled Radiofrequency: Groundbreaking Technology – Female Stress Urinary Incontinence and Overactive Bladder Can Be Treated Noninvasively and with Vulvovaginal Rejuvenation? 经皮温控射频:突破性技术-女性压力性尿失禁和膀胱过度活动可以无创治疗和外阴阴道再生?
Q3 Social Sciences Pub Date : 2023-01-01 DOI: 10.4103/jmh.jmh_19_23
Vineet V. Mishra, Smit Bharat Solanki, Nita Vineet Mishra, Red M. Alinsod
It has long been difficult to treat vulvovaginal laxity, genitourinary syndrome of menopause, stress urine incontinence, overactive bladder (OAB), and other indications of sexual dysfunction because women traditionally find it difficult to discuss these difficulties with clinicians and because society generally accepts these diseases. Originating in esthetic medicine, noninvasive feminine rejuvenation that targets vaginal tissue with energy-based methods has recently become more popular. A more youthful-looking vulva, the restoration of vaginal elasticity and “tightness,” a significant improvement in stress urinary incontinence, a reduction in symptoms of OAB, and a decrease in sexual dysfunction are all benefits of transcutaneous temperature-controlled radiofrequency (TTCRF) therapy at the vulvovaginal region. It is also becoming more popular as a mild-to-moderate stress urinary incontinence and OAB noninvasive therapy option. Women will likely always be appreciative of their gynecologist for managing stress urinary incontinence with TTCRF therapy without making an incision, it would appear.
长期以来,治疗外阴阴道松弛、更年期泌尿生殖系统综合征、压力性尿失禁、膀胱过动症(OAB)和其他性功能障碍的迹象一直很困难,因为妇女传统上很难与临床医生讨论这些困难,而且社会普遍接受这些疾病。起源于美容医学,以能量为基础的方法针对阴道组织的无创女性年轻化最近变得更受欢迎。更年轻的外阴,恢复阴道弹性和“紧绷”,显著改善压力性尿失禁,减轻OAB症状,减少性功能障碍,这些都是外阴阴道区域经皮温度控制射频(TTCRF)治疗的好处。作为一种轻中度压力性尿失禁和OAB的非侵入性治疗选择,它也越来越受欢迎。这样看来,女性可能会一直感激她们的妇科医生用TTCRF治疗压力性尿失禁而不做切口。
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引用次数: 0
Diagnostic Role of Transvaginal Sonography and Magnetic Resonance Imaging in Adenomyosis of the Uterus and its Correlation with Histopathology. 经阴道超声和磁共振成像对子宫腺肌病的诊断作用及其与组织病理学的相关性。
IF 1.1 Q3 Social Sciences Pub Date : 2023-01-01 Epub Date: 2023-07-07 DOI: 10.4103/jmh.jmh_230_22
Shivi Jain, Kamlesh Kumar, Ram Chandra Shukla, Madhu Jain

Background and objective: The prevalence of adenomyosis of the uterus varies from 5% to 70%, and there is no clear consensus on its imaging diagnostic criteria. The objective of this study was to evaluate the role of transvaginal sonography (TVS), combined TVS and color Doppler (TVS-CD), and magnetic resonance imaging (MRI) in the diagnosis of adenomyosis.

Materials and methods: This was a tertiary care hospital-based prospective study, in which 365 clinically suspected cases of adenomyosis were enrolled. All three types of imaging (TVS, TVS-CD, and MRI) were done in 233/365 patients, followed by hysterectomy in 50. Imaging features were correlated with the histopathological examination (HPE), which was taken as the gold standard for the diagnosis. The diagnostic performance of each imaging modality was assessed.

Results: Among patients who underwent hysterectomy, 36/50 (72%) had adenomyosis on HPE, with or without associated benign gynecological abnormalities. Sensitivity, specificity, positive predictive value (PPV), negative PV (NPV), and diagnostic accuracy (DA) of MRI were higher than that of TVS-CD (91.67% vs. 77.78%, 85.71% vs. 78.57%, 94.29% vs. 90.32%, 80% vs. 57.89%, and 90% vs. 78%, respectively). TVS alone had lower diagnostic performance (specificity: 64.29%, PPV 84.85%, NPV 52.94%, and DA74%) than TVS-CD, but equal sensitivity (77.78%). Heterogeneous myometrium was the most sensitive (80.56%), while myometrial cyst was the most specific (92.86%) TVS feature. The maximum junctional zone thickness ≥12 mm was the most sensitive (97.22%), while the hyperintense myometrial focus was the most specific (100%) MRI feature.

Conclusion: TVS-CD should be used as an initial diagnostic imaging modality in clinically suspected cases of adenomyosis; however, MRI due to better diagnostic efficacy should be the imaging modality of choice before subjecting such patients to hysterectomy.

背景与目的:子宫腺肌症的患病率在5%-70%之间,其影像学诊断标准尚未达成明确共识。本研究的目的是评估经阴道超声(TVS)、TVS和彩色多普勒(TVS-CD)以及磁共振成像(MRI)在子宫腺肌病诊断中的作用。材料和方法:这是一项基于三级护理医院的前瞻性研究,纳入了365例临床疑似子宫腺肌病病例。所有三种类型的成像(TVS、TVS-CD和MRI)在233/365名患者中进行,然后在50名患者中子宫切除。影像学特征与组织病理学检查(HPE)相关,后者被视为诊断的金标准。评估了每种成像模式的诊断性能。结果:在接受子宫切除术的患者中,36/50(72%)患有HPE子宫腺肌症,伴有或不伴有相关的良性妇科异常。MRI的敏感性、特异性、阳性预测值(PPV)、阴性PV(NPV)和诊断准确性(DA)均高于TVS-CD(分别为91.67%对77.78%、85.71%对78.57%、94.29%对90.32%、80%对57.89%和90%对78%)。TVS单独的诊断性能(特异性:64.29%,PPV 84.85%,NPV 52.94%,DA74%)低于TVS-CD,但敏感性相同(77.78%)。不均匀性子宫肌层是最敏感的(80.56%),而肌层囊肿是最特异的(92.86%)TVS特征。最大交界区厚度≥12mm是最敏感的(97.22%),而高信号肌层病灶是最特异的(100%)MRI特征。结论:TVS-CD应作为临床可疑子宫腺肌病的初步诊断影像学模式;然而,在对此类患者进行子宫切除术之前,MRI由于更好的诊断效果应该是首选的成像方式。
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引用次数: 0
Differences in the Presentation and Outcome between Premenopausal and Postmenopausal Primary Hyperparathyroidism Indian Women: A Single-Center Experience 印度妇女绝经前和绝经后原发性甲状旁腺功能亢进症的表现和结果的差异:单中心经验
Q3 Social Sciences Pub Date : 2023-01-01 DOI: 10.4103/jmh.jmh_142_22
Aasim N. Maldar, Nishitkumar F. Shah, Phulrenu H. Chauhan, Murad Lala, Milind V. Kirtane, Manoj Chadha
Introduction: Primary hyperparathyroidism (PHPT) is an endocrine disorder wherein enlargement of one or more of the parathyroid glands causes autonomous overproduction of the parathyroid hormone (PTH), which leads to high serum calcium levels. Objective: The objective of this study was to compare the clinical, laboratory, and operative variables between premenopausal (pre-M) and postmenopausal (post-M) women with PHPT. Materials and Methods: A retrospective analysis of the data of female patients who underwent surgery for PHPT at a single center, from January 2011 to December 2020, was done. Patients with familial PHPT and secondary hyperparathyroidism were not included. Results: Of the 130 women with PHPT, 44.6% were pre-M and 55.4% were post-M. A significantly higher number of pre-M females were symptomatic compared to post-M females (pre-M vs. post-M, 84.5% vs. 68.1%, P = 0.031). Renal calculi were more common in pre-M women (34.5% vs. 18.1%, P = 0.032), while the rest of the clinical features were comparable between the two groups. The proportion of women with osteoporosis (6.7% vs. 19.4%, P = 0.071), hypertension (13.8% vs. 34.7%, P = 0.012), and diabetes mellitus (3.5% vs. 16.7%, P = 0.033) was lesser in the pre-M group. Elevated serum alkaline phosphatase levels were significantly more prevalent in the pre-M group (37.9% vs. 20.8%, P = 0.032). The mean serum calcium (12.35 ± 1.28 vs. 11.96 ± 1.22 mg/dL, P = 0.079), median serum PTH (334 vs. 239 pg/mL, P = 0.051), and median weight of the operated adenomas (1.75 vs. 1.45 g, P = 0.075) were also higher in pre-M females. The proportion of ectopic adenomas and multiple adenomas, presurgery adenoma localization rates, and disease cure rates did not differ according to the menopausal status. The occurrence of postoperative hungry bone syndrome was higher in the pre-M women (15.5% vs. 1.4%, P = 0.008). Conclusion: The majority of women with PHPT are post-M, but symptomatic presentation is more common in pre-M females. The severity of the disease appears to be more in pre-M women; however, imaging and operative variables generally did not significantly differ between the two groups.
原发性甲状旁腺功能亢进(PHPT)是一种内分泌疾病,其中一个或多个甲状旁腺肿大导致甲状旁腺激素(PTH)的自主过量产生,从而导致血清钙水平升高。目的:本研究的目的是比较绝经前(pre-M)和绝经后(post-M) PHPT妇女的临床、实验室和手术变量。材料与方法:回顾性分析2011年1月至2020年12月在同一中心接受PHPT手术的女性患者的资料。不包括家族性PHPT和继发性甲状旁腺功能亢进患者。结果:130例PHPT患者中,m前44.6%,m后55.4%。m前女性出现症状的人数明显高于m后女性(m前vs. m后,84.5% vs. 68.1%, P = 0.031)。肾结石在m前女性中更为常见(34.5% vs. 18.1%, P = 0.032),而其余临床特征在两组之间具有可比性。骨质疏松症(6.7% vs. 19.4%, P = 0.071)、高血压(13.8% vs. 34.7%, P = 0.012)、糖尿病(3.5% vs. 16.7%, P = 0.033)的女性比例在m前组较低。血清碱性磷酸酶水平升高在m前组更为普遍(37.9%比20.8%,P = 0.032)。平均血清钙(12.35±1.28 vs. 11.96±1.22 mg/dL, P = 0.079)、血清甲状旁腺激素中位数(334 vs. 239 pg/mL, P = 0.051)、腺瘤中位数重量(1.75 vs. 1.45 g, P = 0.075)均高于m前女性。异位性腺瘤和多发性性腺瘤的比例、手术性腺瘤定位率和疾病治愈率没有因绝经状态而差异。术后饥饿骨综合征的发生率在m前妇女中较高(15.5% vs. 1.4%, P = 0.008)。结论:PHPT多数发生在m后,但症状表现多见于m前女性。这种疾病的严重程度似乎在m前妇女中更为严重;然而,两组之间的影像学和手术变量一般没有显著差异。
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引用次数: 0
Menopause Osteoporosis and Bone Intervention Using Lifestyle Exercise: A Randomized Controlled Study 绝经期骨质疏松和骨质干预使用生活方式运动:一项随机对照研究
Q3 Social Sciences Pub Date : 2023-01-01 DOI: 10.4103/jmh.jmh_27_23
Jacky J. Forsyth
Background: The aim of the study was to examine the feasibility for postmenopausal women of a bone-strengthening jumping intervention, which has been previously successful for premenopausal women. Materials and Methods: Forty-nine participants (mean ± standard deviation [SD] age = 57.8 ± 4.3 years) were randomized into either an exercise intervention or sham-control group in a double-blinded fashion. The intervention consisted of 10 maximal, rest-inserted countermovement jumps, performed three times a week on a hard surface without shoes for 8 months. Sham-control participants performed unilateral balance exercises of equivalent duration. Results: The jumps were well tolerated, with women in the jumping group completing 95% of the prescribed exercise. Of the participants who completed the study ( n = 23 intervention, n = 16 control), there were no significant differences in broadband ultrasound attenuation (BUA) using quantitative ultrasound (QUS) of the calcaneum within and between groups (mean ± SD BUA = 64.9 ± 7.3 and 66.6 ± 6.5 dB/MHz for intervention pre- and post-trial, respectively, versus mean ± SD BUA = 63.6 ± 4.2 and 64.4 ± 4.5 dB/MHz for sham-controls pre- and post-trial, respectively) or for any QUS parameters, although there was a 3% increase in BUA for intervention participants. Conclusions: Recruitment and participation rates were feasible for this duration of study and the exercise was acceptable. For a future study of this nature, 48 participants would be required to ensure adequate power, especially as lifestyle variations and post-menopausal hypoestrogenism prevent substantial gains in bone strength with high-impact exercise.
背景:本研究的目的是检查绝经后妇女进行骨强化跳跃干预的可行性,该干预先前在绝经前妇女中取得了成功。材料与方法:49名参与者(平均±标准差[SD]年龄= 57.8±4.3岁)采用双盲法随机分为运动干预组和假对照组。干预包括10个最大的,休息插入的反向动作跳跃,每周进行三次,在坚硬的表面上不穿鞋,持续8个月。假对照组的参与者进行了同等时间的单侧平衡练习。结果:跳高组的女性接受程度良好,跳高组的女性完成了95%的规定运动。参与者完成了研究(n = 23干预,n = 16控制),没有明显差异在宽带超声衰减(BUA)使用定量超声(屈原)跟骨内和组间(均值±SD BUA = 64.9±7.3,66.6±6.5 dB / MHz干预前和试验后,分别与均值±SD BUA = 63.6±4.2,64.4±4.5 dB / MHz sham-controls预处理和试验后,分别)或任何什么参数,尽管干预参与者的BUA增加了3%。结论:在这段研究期间,招募率和参与率是可行的,训练是可以接受的。对于这一性质的未来研究,需要48名参与者来确保足够的力量,特别是生活方式的变化和绝经后雌激素水平低下会阻碍高强度运动对骨骼强度的实质性提高。
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引用次数: 0
Huge Abdominopelvic Mass Arising from Cervical Fibroid around an Infected Cervical Diverticulum: A Very Rare Case and a Review of Literature. 受感染的子宫颈分流器周围的子宫颈纤维瘤引起的巨大腹侧肿块:一个非常罕见的病例和文献综述。
IF 1.1 Q3 Social Sciences Pub Date : 2023-01-01 Epub Date: 2023-07-07 DOI: 10.4103/jmh.jmh_119_22
Arpita De, Reva Tripathi, Abhinav Jain, Safia Rana

Primary uterine diverticula are a very rare congenital anomaly of the uterus with only 21 reported cases. Even rarer is the occurrence of primary cervical diverticula with only six cases reported so far. This is a unique case of a huge abdominopelvic mass arising from cervical fibroid around an infected cervical diverticulum. A 44 year-old, P4L4 came to the OPD with a eighteen weeks size abdomino-pelvic mass. She had a failed surgery 6 months back, attempted to remove the mass. Magnetic resonance imaging revealed a cervical diverticulum which possibly had a pus collection. Relaparotomy was done. It revealed a huge cervical fibroid with dense adhesions all around the mass. A pan hysterectomy was done. In the postoperative period, she developed high-grade fever owing to the development of a pelvic collection, which had to be drained by dilating the vault sutures. Histopathology report confirmed a cervical fibroid with an infected diverticulum within. Primary uterine or cervical diverticula are a very rare anamoly which possibly arise because of a weakness in the area where the two mullerian ducts fuse. Women with this rare condition may suffer from infertility, fever and pain abdomen, acute abdomen owing to torsion or hemoperitoneum, pregnancy complications, and menorrhagia. Diverticulectomy and cervical/uterine reconstruction can be done on nulliparous women while hysterectomy can be offered to perimenopausal women. To conclude, unless known by the gynecologists, radiologists, and the pathologists, this diagnosis can be easily missed out, leading to multiple preventable complications.

原发性子宫憩室是一种非常罕见的先天性子宫异常,仅有21例报告。更罕见的是原发性颈部憩室的发生,迄今为止只有6例报告。这是一个独特的病例,巨大的腹盆腔肿块是由受感染的子宫颈憩室周围的子宫颈纤维瘤引起的。一位44岁的P4L4患者带着一个18周大小的腹盆腔肿块来到了门诊部。6个月前,她进行了一次失败的手术,试图切除肿块。磁共振成像显示,她有一个颈部憩室,可能有脓液聚集。做了松解术。检查发现巨大的子宫颈纤维瘤,肿块周围有密集的粘连。进行了全子宫切除术。术后,由于盆腔积液,她出现了高烧,必须通过扩张拱顶缝合线来引流。组织病理学报告证实一个子宫颈纤维瘤内有一个受感染的憩室。原发性子宫或宫颈憩室是一种非常罕见的疾病,可能是由于两个穆勒管融合部位的无力引起的。患有这种罕见疾病的妇女可能患有不孕不育、腹部发热疼痛、腹部扭转或腹腔积血引起的急腹症、妊娠并发症和月经过多。未产妇可以进行分流器切除术和子宫颈/子宫重建,而围绝经期妇女可以进行子宫切除术。总之,除非妇科医生、放射科医生和病理学家知道,否则这种诊断很容易被遗漏,导致多种可预防的并发症。
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引用次数: 0
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Journal of Mid-life Health
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