Journal of Mid-life Health最新文献

Background: The use of large language model (LLM) chatbots in health-related queries is growing due to their convenience and accessibility. However, concerns about the accuracy and readability of their information persist. Many individuals, including patients and healthy adults, may rely on chatbots for midlife health queries instead of consulting a doctor. In this context, we evaluated the accuracy and readability of responses from six LLM chatbots to midlife health questions for men and women.

Methods: Twenty questions on midlife health were asked to six different LLM chatbots - ChatGPT, Claude, Copilot, Gemini, Meta artificial intelligence (AI), and Perplexity. Each chatbot's responses were collected and evaluated for accuracy, relevancy, fluency, and coherence by three independent expert physicians. An overall score was also calculated by taking the average of four criteria. In addition, readability was analyzed using the Flesch-Kincaid Grade Level, to determine how easily the information could be understood by the general population.

Results: In terms of fluency, Perplexity scored the highest (4.3 ± 1.78), coherence was highest for Meta AI (4.26 ± 0.16), accuracy of responses was highest for Meta AI, and relevancy score was highest for Meta AI (4.35 ± 0.24). Overall, Meta AI scored the highest (4.28 ± 0.16), followed by ChatGPT (4.22 ± 0.21), whereas Copilot had the lowest score (3.72 ± 0.19) (P < 0.0001). Perplexity showed the highest score of 41.24 ± 10.57 in readability and lowest in grade level (11.11 ± 1.93), meaning its text is the easiest to read and requires a lower level of education.

Conclusion: LLM chatbots can answer midlife-related health questions with variable capabilities. Meta AI was found to be highest scoring chatbot for addressing men's and women's midlife health questions, whereas Perplexity offers high readability for accessible information. Hence, LLM chatbots can be used as educational tools for midlife health by selecting appropriate chatbots according to its capability.

Background: Body mass index (BMI) rises in correlation with endometrial cancer incidence as obesity rates among women have risen in recent years. In this study, we sought to evaluate the relationship between BMI and the perimenopausal ladies' aberrant and normal endometrial pathology. We also evaluated the correlation of transvaginal ultrasonography findings with histopathological findings.

Methodology: A prospective analytical study was conducted in a Tertiary care centre of Northern India over a period of 12 months from June 2022-May 2023 on women aged 40-55 years with Abnormal Uterine Bleeding (AUB) according to PALM-COEIN criteria. Patients were divided into two groups according to endometrial biopsy findings; women in group 1 were diagnosed with endometrial hyperplasia or carcinoma, while women in group 2 had normal endometrium, according to WHO classification. BMI, Endometrial biopsy pathology and transvaginal ultrasonography findings were noted. Data was analysed using SPSS version 24.0.

Results: Out of 72 patients, 22 patients had histopathological findings of Adenocarcinoma (3, 13.6%) and endometrial hyperplasia (19, 86.4%) and rest 50 patients had normal proliferative (13, 26%). On the basis of BMI, 51.5% (32/72) were overweight, 31.9% (23/72) were of Normal BMI, 11.1% (15/72) were Obese. The mean age in Group A and B was 52.37 ± 2.68 and 48.74 ± 7.98 respectively (P value- 0.003). Significant association between obesity and endometrial hyperplasia or carcinoma (P value-0.033). Correlation of Transvaginal Ultrasound (TVS) findings with that of histopathology was statistically significant (P value-0.002). Adenomyosis and Polyp and 100% correlation percentage on TVS and Histopathology.

Conclusion: There is a direct link between a high body mass index and AUB due to endometrial hyperplasia. Importance of physical activity as a preventative factor against AUB, endometrial cancer, and hyperplasia should be promoted. TVS is also a suitable diagnostic technique for the assessment of AUB as an initial procedure.

Menopause marks a significant transition in a woman's life, characterized by hormonal changes that influence metabolism, cardiovascular health, and overall well-being. As women approach menopause, managing these changes becomes crucial for maintaining health and quality of life. Among various dietary interventions, intermittent fasting has emerged as a promising strategy, not only for weight management but also for addressing hormonal imbalances and mitigating age-related risks such as cardiovascular disease and cognitive decline.

Introduction: The incidence of endometrial cancer is on the rise in India, particularly in Kerala. A comprehensive understanding of the clinicopathological profile of endometrial cancer can help identify the underlying factors driving this trend and facilitate the development of targeted preventive strategies and effective management policies.

Materials and methods: This register-based retrospective study analyzed clinicopathological patterns in endometrial cancer patients at a tertiary care hospital in Kerala from 2013 to 2019, with Institutional Review Board and Scientific Committee clearance.

Results: A total of 476 patients were identified with endometrial cancer diagnosed and/or treated at our institution. The mean age was 57.9 years (standard deviation [SD] ± 9.5 years) with 73.3% (n = 349) postmenopausal, 14.1% (n = 67) perimenopausal/unknown status, and 12.6% (n = 60) premenopausal. Histopathological analysis showed 80.0% (n = 381) endometrioid, 8% (n = 38) carcinosarcoma, 6.3% (n = 30) serous, 3.6% (n = 17) clear cell, 1.9% (n = 9) un/dedifferentiated, and 0.2% (n = 1) a rare squamous cell carcinoma. Out of 406 patients with available tumor grading, 50% (n = 203) were classified as Grade 1, 15.8% (n = 64) as Grade 2, and 34.2% (n = 139) as Grade 3. There was a significant relationship between age and tumor grade; the mean age of occurrence of high grade was 61 years (SD ± 9.8), and low grade was 56.5 (SD ± 8.6) (P = <0.001). Age also correlated with the incidence of endometrioid or nonendometrioid tumors (mean age 56.7 ± 9.1 years vs. 62.2 ± 9.4 years, P = <0.001). Nonendometrioid tumors were diagnosed in advanced stages compared to endometrioid type (38.1% vs. 20.8% in Stage III/IV, P = 0.004). The tumor size was directly correlated with advanced stage, tumor grade, and myometrial invasion. Specifically, the likelihood of diagnosis at an advanced stage increased with tumor size: 0% for tumors smaller than 2 cm, 11% for tumors measuring 2-4 cm, and 21% for tumors larger than 4 cm (P = 0.001). The deep myometrial invasion occurred in 33.0% of tumors <4 cm versus 68.0% of tumors ≥4 cm (P = <0.001).

Conclusion: The most common type of endometrial cancer is the endometrioid type. Older age is associated with nonendometrioid as well as high-grade disease. Tumor size plays an important role in predicting myometrial invasion, grading, and stage of the disease.

Postmenopausal bleeding is an alarming symptom that needs careful consideration. Endometrial polyps co-existing in the background of endometrial hyperplasia/endometrial cancer is well-established. However, it has been very sparsely reported in the background of atrophic endometrium. The authors report a unique case of concurrent atypical endometrial polyp with cervical intraepithelial neoplasia (CIN) in the background of an atrophic endometrium. A 53-year-old multiparous, postmenopausal lady of Asian ethnicity presented with recurrent episodes of bleeding per vaginum. She did not give any history of exogenous estrogen intake, diabetes, hypertension, or any other surgical risk factors for endometrial malignancy. Her body mass index was 23.9 kg/m². Magnetic Resonance Imaging revealed a large cervical fibroid, endometrial thickness 8 mm (mixed with blood clots), and focal adenomyosis. Outpatient endometrial sampling was unsatisfactory. She underwent a total hysterectomy with bilateral salpingo-oophorectomy. An incidental hidden diagnosis of concurrent atypical endometrial polyp with CIN underlying the cervical leiomyoma was made. This is the first of its kind to be reported so far. It is not known whether such an association could be due to cervical leiomyoma or de novo.

Aim and objectives: The health of women in the menopausal age is often ignored by most healthcare programs in countries like India. The aim of this study is to estimate the prevalence and pattern of menopause-specific quality of life (MENQOL) and associated factors of rural women in Kerala, India.

Materials and methods: A cross-sectional community-based study was conducted among menopausal women in the Thiruvananthapuram district of Kerala using a multistage random sampling method. We collected details of basic sociodemographic and reproductive problems using a pretested semi-structured questionnaire. MENQOL questionnaire was used to measure the quality of life.

Results: We surveyed 250 women in the age group of 48-60 years. The average score of the overall quality of life was 12.4 ± 4.3. The mean MENQOL score was significantly poor for those with lower socioeconomic status (SES), those who had any morbidity, those who had bad perceived health status, and inactive women compared to their counterparts. The majority of women (92%) used self-care to alleviate their menopause symptoms. Women of lower SES, with any morbidity, poor perceived health status, and inactive, were more likely to report more symptoms in all domains (vasomotor, physical, and psychological). In addition, employed women reported more vasomotor and psychological symptoms compared to their counterparts.

Conclusion: Menopausal symptoms are common in the population studied, and self-care is the main strategy for alleviating these symptoms. It is important to educate women about common menopause symptoms and the importance of receiving proper medical care.

Perivascular epithelioid cell tumors (PEComas) have unique morphology comprised perivascular epitheloid cells and express both melanocytic and smooth muscle cell markers. Gynecological PEComas account for approximately 25% of all PEComas, and in most cases, the primary site of the tumor is the uterine body. Ovarian PEComa is exceptional. Here, we report a case of primary malignant PEComa of ovary in a 38 years female.

Background: Coping with menopause is always a troublesome issue in every woman's life. Most women, at the time of permanent cessation of menstruation, experience various symptoms due to hormonal fluctuations which may affect their quality of life (QOL) leading to anxiety and concern. This study is set to study the QOL among menopausal women in an urban low socioeconomic area of Guntur city.

Methodology: A descriptive cross-sectional study was conducted involving menopausal women between the ages of 40 and 60 years living in the urban field practice area of the Department of Community Medicine, NRI Medical College, using a predesigned semistructured schedule covering sociodemographic and QOL-related aspects.

Results: The study included 400 menopausal women with mean age of 51.98 ± 6.40. Most of the women were from the lower socioeconomic stratum. Two hundred and thirty-six (59%) women attained menopause naturally, whereas 164 (41%) had induced menopause. The mean age of attainment of menopause was 40.03 ± 8.32. The mean score for the physical domain of the QOL was 32.05 ± 11.73 (limits 15-75), the psychological domain of the QOL was 33.11 ± 13.33 (limits 14-70), and the social and environmental domain was 17.52 ± 5.89 (limits 10-50). Age above 50 years, poor educational levels, lower socioeconomic status, longer duration since menopause, poor awareness of menopausal symptoms, and comorbidities were significantly associated with overall QOL.

Conclusion: Women need sufficient knowledge and awareness about the symptoms of menopause. Menopausal women must be made aware that what they are going through is common to other women too and that medical help is available. The family and community must also be sufficiently sensitized to their healthcare needs.