Journal of Mid-life Health最新文献

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.

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.

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.

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.