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ORIGINAL ARTICLE
G Ganitha, PB Premalatha, Iyanar Kannan

A Study of the Age of Menopause and Menopausal Symptoms among Women in a Rural Area of Tamil Nadu, India

[Year:2017] [Month:July-December] [Volumn:5 ] [Number:2] [Pages:73] [Pages No:87-91][No of Hits : 1136]


ABSTRACT

Aim: The aim of this study is to determine the age and symptoms of menopause, and attitude and perception of postmenopausal women toward menopause in a rural area of Tamil Nadu.

Materials and methods: This is a cross-sectional observational study of 500 women in a rural area of Tamil Nadu. Women aged 40 to 55 years who had attained natural menopause and had cessation of menses for at least 1 year were included in the study. Women who had attained surgical menopause or menopause secondary to medical illness were excluded from the study. A self-structured questionnaire was used to collect information.

Results: The mean age of attaining menopause was 45.75 ± 3.83 years; 87% women were symptomatic with at least one symptom. Majority of women (78.2%) had psychosomatic symptoms followed by vasomotor symptoms (55.8%); 68.4% women welcomed menopause with positive attitude; 19.4% women were indifferent and 12.2% women had negative attitude toward menopause. About 24% women felt that the symptoms of menopause were distressing; 23.2% women availed some form of treatment for their symptoms.

Conclusion: Many women are affected by menopausal symptoms. Some women are affected severely by these symptoms. Lack of awareness, economic factors, sociocultural factors, myths, and inaccessibility to health services can negatively affect the attitude of women toward menopause.

Clinical significance: Menopause is an important transitional phase of life in all women. The waning ovarian hormone level causes several symptoms, some of which can be distressing to some women. Age and symptoms of menopause are influenced by several factors. Attitude and perception of women toward menopause reflect the awareness and health care accessibility in the community. Creating awareness of menopausal symptoms can improve utilization of health services and the quality of life of postmenopausal women.

How to cite this article: Ganitha G, Premalatha PB, Kannan I. A Study of the Age of Menopause and Menopausal Symptoms among Women in a Rural Area of Tamil Nadu, India. J South Asian Feder Menopause Soc 2017;5(2):87-91.

Keywords: Menopausal symptoms, Menopause, Postmenopausal women, Psychosomatic symptoms, Vasomotor symptoms.

Source of support: Nil

Conflict of interest: None

Date of received: 22 July 2017

Date of acceptance: 9 August 2017

Date of publication: December 2017


 
Review Article
Preeti Yadav, Meena Dayal

Management of Postmenopausal Vaginal atrophy: Review of Literature

[Year:2017] [Month:January-June] [Volumn:5 ] [Number:1] [Pages:70] [Pages No:51-57][No of Hits : 751]


ABSTRACT

Aim: As there is dilemma for treatment of postmenopausal vaginal atrophy, effort has been made to review the literature for the same.

Background: About half of all postmenopausal women will experience symptoms related to urogenital atrophy. Vaginal atrophy becomes clinically apparent 4 to 5 years after menopause, and subjective complaints as well as objective changes are present in 25 to 50% of all postmenopausal women.

Review results: Measures could be taken for not only treatment but also prevention of atrophy before symptoms become troublesome, but establishment of this prevention principle globally would require a formal cost-effective analysis and further research.

Conclusion: Treatment with local estrogen is simple, safe, and can transform a woman’s quality of life.

Clinical significance: Women experiencing sexual and urinary symptoms as a consequence of vaginal atrophy should be diagnosed and treated without delay in order to avoid a cascade of events which do not resolve spontaneously.

Keywords: Local estrogen, Postmenopausal, Vaginal atrophy.

How to cite this article: Yadav P, Dayal M. Management of Postmenopausal Vaginal atrophy: Review of Literature. J South Asian Feder Menopause Soc 2017;5(1):51-57.

Source of support: Nil

Conflict of interest: None

Date of submission: 15 February 2017

Date of acceptance: 28 March 2017

Date of publication: June 2017


 
Original Article
Nidhi Gupta

Hormone Replacement Therapy for Surgical Menopause: Is there an Ideal Drug? A Comparative Study of Conjugated Equine Estrogens and Tibolone

[Year:2017] [Month:January-June] [Volumn:5 ] [Number:1] [Pages:70] [Pages No:11-15][No of Hits : 705]


ABSTRACT

Objective: To compare the effects of continuous combined conjugated equine estrogens (CEE) with those of tibolone on symptom control, lipid profile, and tolerability in women with surgical menopause.

Materials and methods: This was a randomized controlled trial study conducted in the Department of Obstetrics and Gynaecology of Global Rainbow Hospital Pvt. Ltd., Agra (2014-2016) comprising 150 women. Generally, healthy postmenopausal women having undergone total abdominal hysterectomy with bilateral salpingo-oophorectomy irrespective of age and indication of surgery and no absolute contraindications to hormone replacement therapy (HRT) or tibolone were enrolled. Fifty subjects did not receive any HRT, 50 were treated with CEE 0.625 mg, and 50 were given tibolone 2.5 mg for 13 treatment cycles, each of 28 days. Results were statistically analyzed regarding drug efficacy in amelioration of menopausal symptoms and side effects at follow-up periods of 1, 6, and 12 months.

Results: A total of 150 subjects were enrolled and received at least one dose of the study medication, of which 134 (89.4%) subjects completed the study (n = 40 in CEE and n = 44 in tibolone). The incidence of postmenopausal symptoms decreased significantly over time in the treatment groups, compared with baseline, including significant decreases in the incidence of urogenital and sexual health symptoms, with p-values 0.001 and 0.004 in cases that received CEE and tibolone respectively.
Significant differences in symptom control (other than hot flashes) were observed between treatment groups in a few different cycles for different symptoms, but no consistent or clinically

Conclusion: Women treated with CEE and tibolone showed significant improvement of climacteric symptoms, including urogenital and sexual health symptoms. Treatment with either preparation significantly improved subjective wellbeing, vasomotor symptoms, and vaginal dryness.
The CEE and tibolone each induced a different mix of beneficial changes in the lipid profile.
It is seen that tibolone seems to be effective on estrogen withdrawal symptoms and with its acceptable androgenic side effects can be an appropriate selection for HRT in postmenopausal women with decreased sexual desire.

Keywords: Conjugated equine estrogens, Menopausal hormone therapy, Tibolone.

How to cite this article: Gupta N. Hormone Replacement Therapy for Surgical Menopause: Is there an Ideal Drug? A Comparative Study of Conjugated Equine Estrogens and Tibolone. J South Asian Feder Menopause Soc 2017;5(1):11-15.

Source of support: Nil

Conflict of interest: None

Date of submission: 06 March 2017

Date of acceptance: 13 May 2017

Date of publication: June 2017


 
RESEARCH ARTICLE
Nikhitha Chandrashekar, Jyothi GS, Prasanna Shetty

Pipelle Endometrial Biopsy vs Dilatation and Curettage to Diagnose Endometrial Diseases in Abnormal Uterine Bleeding

[Year:2017] [Month:July-December] [Volumn:5 ] [Number:2] [Pages:73] [Pages No:123-128][No of Hits : 688]


ABSTRACT

Aim: The objective of this study was to assess the adequacy of the sample aspirated in order to make a definite diagnosis of endometrial disease in abnormal uterine bleeding (AUB) and to draw comparisons between the histopathological findings of Pipelle endometrial aspiration biopsy and dilatation and curettage (D&C).

Materials and methods: Pipelle endometrial biopsy and D&C samples were collected from 100 patients with AUB in the Department of the Obstetrics and Gynecology and sent to the Department of Pathology of a tertiary care hospital for adequacy of the sample and for histopathological analysis.

Results: The Pipelle sample was adequate in 73% of the cases and inadequate in 27% compared with D&C, which showed 85% and 15%, respectively. About 53% of cases were comparable between D&C and Pipelle and 37% were discordant. For endometrial hyperplasia using Pipelle aspirator, the sensitivity was 58.8%, specificity was 91.6%, positive predictive value (PPV) was 58.8%, negative predictive value (NPV) was 91.6%, and concordance was 86%. For detection of endometrial carcinoma using Pipelle, the sensitivity was 50%, specificity was 99%, PPV was 50%, NPV was 99%, and concordance rate was 98%.

Conclusion: It is more convenient and cost-effective for patients to undergo pipelle biopsy to confirm normalcy and rule out endometrial hyperplasia rather than undergoing D&C initially. Out of the 27% of inadequate samples, 14.8% had fibroids and 11.1% had polyps, thus showing that tumors localized to a polyp or a small area of endometrium went undetected with Pipelle.

Clinical significance: Due to the high specificity and NPV and low sensitivity and PPV in diagnosing endometrial lesions and carcinomas, pipelle is suitable for women with a low risk of cancer. In cases where the diagnosis is hyperplasia on Pipelle, the patients are advised to undergo hysteroscopic-guided D&C following pipelle to confirm the diagnosis. This is also applicable for cases of polyps and fibroids.

Keywords: Abnormal uterine bleeding, Dilatation and curettage, Endometrial biopsy, Pipelle de Cornier.

How to cite this article: Chandrashekar N, Jyothi GS, Shetty P. Pipelle Endometrial Biopsy vs Dilatation and Curettage to Diagnose Endometrial Diseases in Abnormal Uterine Bleeding. J South Asian Feder Menopause Soc 2017;5(2):123-128.

Source of support: The authors extend their most sincere gratitude to the Medical Education and Research Trust (MERT) for granting funds of 10,000 INR to pursue this study.

Conflict of interest: None

Date of received: 26 July 2017

Date of acceptance: 19 September 2017

Date of publication: December 2017


 
Case Report
Mamta Gupta, Vandana Saini, Rita Jindal, Supriya Kumari, Namrata Nargotra

Vaginal Leiomyoma: Case Report and Literature Review

[Year:2017] [Month:January-June] [Volumn:5 ] [Number:1] [Pages:70] [Pages No:62-65][No of Hits : 601]


ABSTRACT

Introduction: Leiomyoma arising from the vagina is a rare entity with varied presentations.

Case Report: A woman 44 years of age presented with complaints of something coming out vaginally, polymenorrhea, and pain in abdomen. A mass arising from the right posterolateral wall of vagina was seen. Ultrasound reported it to be cervical fibroid. The mass was enucleated through vaginal route. Histopathology confirmed it to be a leiomyoma. Review of literature revealed that it has a varied presentation. Diagnosis is often missed.

Conclusion: The condition should always be kept in mind whenever coming across any mass in vagina.

Keywords: Cervical fibroid, Mass in vagina, Vaginal fibroid, Vaginal leiomyoma.

How to cite this article: Gupta M, Saini V, Jindal R, Kumari S, Nargotra N. Vaginal Leiomyoma: Case Report and Literature Review. J South Asian Feder Menopause Soc 2017;5(1):62-65.

Source of support: Nil

Conflict of interest: None

Date of submission: 21 February 2017

Date of acceptance: 07 April 2017

Date of publication: June 2017


 
Original Article
Amar K Karia, Kshama V Kedar, Radha P Munje

Effect of Menopause on Pulmonary Functions: An Analysis

[Year:2017] [Month:January-June] [Volumn:5 ] [Number:1] [Pages:70] [Pages No:16-18][No of Hits : 560]


ABSTRACT

Background: Sex hormones play an important role in women’s health. There is a close relationship between female sex hormones and lung function in postmenopausal women. Deterioration of lung function is observed more after menopause. Estrogen deficiency after menopause accelerates adverse effects of biological aging on lung mechanics in postmenopausal women. Our study uses spirometer to analyze and evaluate these effects of menopausal aging.

Objective: To study the effects of menopause on pulmonary function tests in women of perimenopausal age group.

Materials and methods: This study was carried out in the Department of Obstetrics and Gynecology in Indira Gandhi Government Medical College & Hospital, Nagpur, India. A total of 50 women each in premenopausal and menopausal age group were included in our study. Venous blood was collected under aseptic precaution on 10 to 14 days and 18 to 23 days corresponding to follicular and luteal phase of menstrual cycle in premenopausal women and in postmenopausal women, and serum estrogen and progesterone levels were estimated by microparticle enzyme immunoassay. Pulmonary function of all subjects was measured with digital micro spirometer and data collected. Peak expiratory flow rate (PEFR), forced expiratory flow (FEF)25-75, forced expiratory volume in 1 second, and forced vital capacity were studied and correlated with symptoms. Data analysis was done using Student’s unpaired t-test and chi-square test.

Results: The mean percentage of predicted values of FEF25-75 and PEFR were lower in postmenopausal women compared with premenopausal women. Mean serum estrogen levels were significantly lower in postmenopausal women as compared with premenopausal women. Progesterone levels were lower in postmenopausal women and in proliferative phase of premenopausal women as compared with luteal phase of menstrual cycle.

Conclusion: As menopause sets in decreased hormonal levels leads to decreased lung capacity as evident by pulmonary function test. Decreased pulmonary function test can be attributed to lower levels of sex hormones estrogen and progesterone in postmenopausal women.

Keywords: Estrogen, Menopause, Progesterone, Pulmonary function test, Spirometry.

How to cite this article: Karia AK, Kedar KV, Munje RP. Effect of Menopause on Pulmonary Functions: An Analysis. J South Asian Feder Menopause Soc 2017;5(1):16-18.

Source of support: Nil

Conflict of interest: None

Date of submission: 20 March 2017

Date of acceptance: 29 April 2017

Date of publication: June 2017


 
Research Article
Setu Rathod, Sunil K Samal, Sunita Samal, Seetesh Ghose

Knowledge and Awareness of Cervical Cancer and Human Papilloma Virus Vaccine among Medical Students: A Cross-sectional Study

[Year:2017] [Month:January-June] [Volumn:5 ] [Number:1] [Pages:70] [Pages No:41-44][No of Hits : 552]


ABSTRACT

Aim: Cervical cancer is still one of the most common cancers affecting females in India, leading to a lot of mortality and morbidity. Since it is a preventable cancer, the study is aimed to assess the knowledge and awareness of cervical cancer and human papilloma virus (HPV) vaccine among medical students.

Materials and methods: This is a cross-sectional study conducted among the medical students in a tertiary care center in Mahatma Gandhi Medical College & Research Institute, Puducherry, India. Three hundred students were administered a validated 53-point questionnaire regarding knowledge of cervical cancer, its risk factors, preventive measures, HPV vaccine, and screening tests. Data were kept confidential and the results were analyzed by Statistical Package for the Social Sciences software version 16.

Results: The results show 93.3% of students were aware that cervical cancer is caused by HPV, but only 61.4% knew that HPV vaccine was available. Majority of the students were uncertain about age group, number of doses, and side effects of vaccine. Only 11.74% felt the need to get vaccinated in future; 96.64% of students knew that pap smear was used to screen for cervical cancer, but only 57.72% opted to screen themselves or family members in future as they believed that they were not at risk. The common obstacle against vaccination was worry about complications, inadequate information, and efficacy of vaccine.

Conclusion: The study showed that there were misconceptions among medical students regarding cervical cancer, vaccine, and screening, which have to be cleared. Creating awareness among health care workers on risk factors, vaccination, and current methods for cervical cancer screening is a necessary step toward implementing effective prevention programs in the society.

Keywords: Cervical cancer, Human papilloma virus, Primary prevention.

How to cite this article: Rathod S, Samal SK, Samal S, Ghose S. Knowledge and Awareness of Cervical Cancer and Human Papilloma Virus Vaccine among Medical Students: A Cross-sectional Study. J South Asian Feder Menopause Soc 2017;5(1):41-44.

Source of support: Nil

Conflict of interest: None

Date of submission: 08 March 2017

Date of acceptance: 13 May 2017

Date of publication: June 2017


 
Research Article
Romana Idrees, Zakia Sheikh, Uzma Chishti, Tahira Y Malik, Aliya B Aziz, Naila Kayani

Role of Intraoperative Frozen Section in Surgical Management of Ovarian Masses

[Year:2016] [Month:July-December] [Volumn:4 ] [Number:2] [Pages:39] [Pages No:65-68][No of Hits : 5641]


ABSTRACT

Introduction: Accuracy of intraoperative frozen section diagnosis is very important in ovarian masses as the diagnosis and course of surgery is usually determined by frozen section examination. There is scant data on this topic from this part of the world.

Aims and objectives: To determine accuracy of intraoperative frozen section for appropriate surgical management of ovarian masses and discuss the reasons for discordancy.

Materials and methods: Retrospective analysis of all patients subjected to the exploratory laparotomy for suspected ovarian mass who underwent intraoperative frozen section at Aga Khan University Hospital from January 2006 till December 2014.

Results: Data from 295 patients were analyzed. The mean age was 40.7 years. The final histologic diagnosis revealed benign lesion in 232 (78.6%), borderline in 17 (5.8%), and malignant in 46 (15.6%) cases. The final histologic diagnosis agreed with the frozen section in 288 cases with an accuracy of 97.6%. In seven discordant cases, there were no false positives, and the false negative rate was 2.4%. Sensitivity was highest in the benign and borderline group (100%) and lowest in the malignant group (93.4%), while specificity was highest in malignant (100%) and lowest in the benign group (92%). Tumor size more than 10 cm, borderline, or mucinous histology were significant predictors for discordancy in our study.

Conclusion: Intraoperative frozen section with its high accuracy is a sensitive tool to guide us regarding the surgical management of patients with ovarian masses. This technique is less reliable when we are dealing with large >10 cm masses, mucinous, or borderline tumors.

Keywords: Frozen section, Ovarian neoplasm, Surgery.

How to cite this article: Idrees R, Sheikh Z, Chishti U, Malik TY, Aziz AB, Kayani N. Role of Intraoperative Frozen Section in Surgical Management of Ovarian Masses. J South Asian Feder Menopause Soc 2016;4(2):65-68.

Source of support: Nil

Conflict of interest: None

Date of submission: 04 April 2016

Date of acceptance: 16 June 2016

Date of publication: July 2016


 
Research Article
Salini Lisa Cyriac, Lekha Viswanath, Anju T Philip

Menopausal Problems among Postmenopausal Women

[Year:2016] [Month:July-December] [Volumn:4 ] [Number:2] [Pages:39] [Pages No:88-92][No of Hits : 1018]


ABSTRACT

Introduction: Menopause is a universal occurrence in every women and the severity of menopausal problems is increasing day by day.

Aim: The purpose of the study is to identify the menopausal problems among postmenopausal women and find association between menopausal problems and selected variables.

Materials and methods: Research design adopted for the study was descriptive survey design. Probability one-stage cluster sampling technique was carried out to select 108 postmenopausal women. After getting consent from the participants, data pertaining to individual characteristics and menopause-related information among postmenopausal women was collected using a semi-structure interview.

Results: The mean age at menopause was 49 years and 46.2% had attained menopause between 45 and 50 years of age and the age of menopause ranged between 43 and 57 years. Among the 108 participants, all of them faced with vasomotor problems like hot flashes and night sweat. Other common symptoms were muscle and joint pain (92.7%), headache (88%), loss of interest in most things (87.9%), feeling dizzy or faint (86.1%), and loss of interest in sex (84.3%) respectively. It was found that all of them experienced vasomotor symptoms, and among the vasomotor dimensions, majority of them (51.9%) experienced mild vasomotor symptoms.

Conclusion: The study results show that as all the menopausal women experience menopausal problems, there is a need to address the menopausal problems and measures for its prevention and management.

Keywords: Health promotion behaviors, Menopausal problems, Menopause, Postmenopausal women.

How to cite this article: Cyriac SL, Viswanath L, Philip AT. Menopausal Problems among Postmenopausal Women. J South Asian Feder Menopause Soc 2016;4(2):88-92.

Source of support: Nil

Conflict of interest: None

Date of submission: 07 April 2016

Date of acceptance: 29 May 2016

Date of publication: July 2016


 
Case Report
Priya Sharma, Neelam Swaroop, Kalpana Kumari, Arun Nagrath

A Case of Giant Cervical Fibroid Polyp Prolapsed outside Introitus in Menopausal Women: Presenting as Diagnostic Dilemma

[Year:2016] [Month:January-June] [Volumn:4 ] [Number:1] [Pages:36] [Pages No:47-49][No of Hits : 918]


ABSTRACT

Cervical fibroid polyps are great masqueraders and can frequently cause diagnostic dilemmas. Due to their rarity, especially in menopausal women, the management can be quite challenging. Here we report a case of giant cervical fibroid polyp prolapsed outside introitus in menopausal women: presenting as diagnostic dilemma. Hospitalization, thorough evaluation, and excluding other differential diagnosis along with meticulous surgery under appropriate anesthesia led to the successful management.

Keywords: Menopause, Polypectomy, Prolapsed cervical fibroid.

How to cite this article: Sharma P, Swaroop N, Kumari K, Nagrath A. A Case of Giant Cervical Fibroid Polyp Prolapsed Outside Introitus in Menopausal Women: Presenting as Diagnostic Dilemma. J South Asian Feder Menopause Soc 2016;4(1):47-49.

Source of support: Nil Conflict of interest: None

Date of submission: 09 August 2015

Date of acceptance: 19 December 2015

Date of publication: January 2016


 
Research Article
Madhulika Gupta, Geeta Jain, Saurabh Shukla

Comparison of Transvaginal Ultrasonography with Hysteroscopy taking Endometrial Biopsy as Gold Standard in Perimenopausal Patients with Abnormal Uterine Bleeding

[Year:2016] [Month:July-December] [Volumn:4 ] [Number:2] [Pages:39] [Pages No:93-96][No of Hits : 576]


ABSTRACT

Background: Abnormal uterine bleeding (AUB) is an important cause of ill health in perimenopausal women. Accurate diagnosis of the causative factor of AUB in this age group is of utmost importance so that appropriate management can be established.

Objectives: The purpose of our study was to determine the diagnostic accuracy of transvaginal ultrasonography (TVS) and hysteroscopy (HYS) compared with histopathology in women with perimenopausal bleeding.

Study design: This is a nonrandomized, purposive sampling and prospective study.

Setting: This study was carried out in the Department of Obstetrics and Gynaecology of Dr Susheela Tiwari Memorial Hospital, Haldwani, Nainital district of Uttarakhand.

Materials and methods: We included those patients of perimenopausal age group who attended the gynecology department with the complaint of AUB during 18 months of our study period and in whom we were able to do all the three diagnostic modalities from January 2014 to July 2015.

Results: In the present study, mean age of patients was 49.56 ± 4.48 years. Maximum patients (41.05%) were in age group of 41 to 45 years, while the least number (9.5%) of patients were in the age group 35 to 40 years. In our study, >5 mm was the cutoff for postmenopausal patients, and >12 mm was for perimenopausal patients. Accuracy rates of HYS for diagnosing all lesions were better than TVS. Both sensitivity and specificity were found to be more for HYS.

Conclusion: Our results showed that HYS is a powerful tool for evaluating the endometrial cavity for focal abnormalities, such as endometrial polyps or submucosal fibroids. Hysteroscopy with directed biopsy is the “gold standard” approach for the most accurate evaluation of the endometrium to rule out endometrial carcinoma.

Clinical significance: The TVS can be used as a routine firststep diagnostic technique, but HYS followed by histopathology should be considered as a gold standard for evaluation of abnormal vaginal bleeding.

Keywords: Abnormal uterine bleeding, Histopathology, Hysteroscopy, Transvaginal ultrasonography.

How to cite this article: Gupta M, Jain G, Shukla S. Comparison of Transvaginal Ultrasonography with Hysteroscopy taking Endometrial Biopsy as Gold Standard in Perimenopausal Patients with Abnormal Uterine Bleeding. J South Asian Feder Menopause Soc 2016;4(2):93-96.

Source of support: Nil

Conflict of interest: None

Date of submission: 06 May 2016

Date of acceptance: 17 June 2016

Date of publication: July 2016


 
Guest Editorial
S Shantha Kumari, Ruchika Garg, Kiranmayi Deviyani, Rekha Rani

Prophylactic Oophorectomy: Yes/No Risk vs Benefits

[Year:2016] [Month:January-June] [Volumn:4 ] [Number:1] [Pages:36] [Pages No:1-3][No of Hits : 567]


ABSTRACT

How to cite this article: Kumari SS, Garg R, Deviyani K, Rani R. Prophylactic Oophorectomy: Yes/No Risk vs Benefits. J South Asian Feder Menopause Soc 2016;4(1):1-3. Date of received: 07 September 2015

Date of acceptance: 10 November 2015

Date of publication: January 2016


 
Research Article
Ramneet Kaur, Kshama V Kedar

Evaluation of Abnormal Uterine Bleeding and Critical Analysis of Diagnostic Modalities

[Year:2016] [Month:July-December] [Volumn:4 ] [Number:2] [Pages:39] [Pages No:75-80][No of Hits : 547]


ABSTRACT

Aim: The purpose of this prospective study was to compare various diagnostic modalities in the evaluation of abnormal uterine bleeding (AUB) and judging the place of hysteroscopy (HYS) in obtaining the cause of AUB. This is done by correlating the findings on HYS and those found on dilation and curettage (D&C) and transvaginal sonography (TVS).

Materials and methods: This prospective study was performed in the Department of Obstetrics and Gynecology, Indira Gandhi Government Medical College and Hospital, Nagpur, Maharashtra, India. In this study, 60 cases of perimenopausal age group with AUB were chosen based on inclusion and exclusion criteria. The patients were subjected to routine investigations, TVS, HYS, and D&C in proliferative phase. The findings of the three were statistically analyzed by comparing with final histopathology diagnosis and test performances were calculated.

Results: Abnormal uterine bleeding was the commonest between 40 and 44 years (44%). Menorrhagia was the commonest presenting complaint (46%). Hysteroscopy was a better diagnostic tool than TVS and D&C for focal lesions. The diagnostic ability of HYS was higher, with sensitivity of 90.57% and specificity of 85.7% and diagnostic accuracy of 90% than TVS (sensitivity 79%, specificity 71.4%, and diagnostic accuracy 78.3%) in diagnosing intrauterine lesions in AUB.

Conclusion: This study reveals that HYS is superior in evaluating patients with AUB, when compared with D&C and ultrasonography (USG). Office hysteroscope, wherever available, must be used for evaluation of patients with AUB as an outpatient department (OPD) procedure along with clinical examination.

Clinical significance: There is rampant use of multiple diagnostic modalities in a single patient with AUB. So the need of the hour is to narrow down to a single diagnostic modality with maximum efficacy. There is a conflict between clinicians over use of TVS and HYS as a primary modality during evaluation of AUB. In this study, we attempted to find a solution.

Keywords: Abnormal uterine bleeding, Histopathology, Hysteroscopy, Perimenopausal women, Transvaginal sonography.

How to cite this article: Kaur R, Kedar KV. Evaluation of Abnormal Uterine Bleeding and Critical Analysis of Diagnostic Modalities. J South Asian Feder Menopause Soc 2016;4(2):75-80.

Source of support: Nil

Conflict of interest: None

Date of submission: 08 March 2016

Date of acceptance: 19 April 2016

Date of publication: July 2016


 
Review Article
Jaideep Malhotra, Ruchika Garg

Hormone Replacement Therapy: Recent Recommendations

[Year:2016] [Month:January-June] [Volumn:4 ] [Number:1] [Pages:36] [Pages No:17-21][No of Hits : 528]


ABSTRACT

How to cite this article: Malhotra J, Garg R. Hormone Replacement Therapy: Recent Recommendations. J South Asian Feder Menopause Soc 2016;4(1):17-21.

Source of support: Nil Conflict of interest: None

Date of submission: 03 October 2015

Date of acceptance: 10 November 2015

Date of publication: January 2016


 
Case Reports
Nihar Ranjan Bhoi, Chintamani Mohanta, Sudha Agrawal, Amulya Kumar Panda

Large Cystic Degeneration of Subserosal Fibroid and Diagnostic Dilemma

[Year:2015] [Month:July-December] [Volumn:3 ] [Number:2] [Pages:31] [Pages No:60-63][No of Hits : 1979]


Abstract

Introduction: Leiomyoma of the uterus is the most common tumor arising from uterine smooth muscle. The size varies from microscopic to giant. We report an unusual case of a large myoma with cystic degeneration mimicking an ovarian tumor.

Presentation of case: A 49-year-old nulliparous woman presented with a history of dull aching lower abdominal pain and gradual swelling of abdomen for a period of approximately 6 months. She had no history of serious illness or surgical procedures and no family history of malignancies. Clinical examination revealed a cystic mass spreading all the quadrants of abdomen and no shifting dullness could be elicitated. Sonography examination showed a large mass that filled the abdomen. A provisional diagnosis of a benign ovarian tumor was made. The patient underwent laparotomy, an enlarged, complex and predominantly cystic tumor arising from the posterior wall of uterus with bilateral normal tubes and ovaries. Total hysterectomy and bilateral salpingo-oophorectomy was done. The histology revealed a leiomyoma with cystic degeneration.

Discussion: Cystic degeneration of large fibroid mimics ovarian tumor both clinically and ultrasonographically.

Conclusion: Pedunculated leiomyomas should be considered in the differential diagnosis of a multilocular and predominantly cystic adnexal mass.

Keywords: Adnexal mass, Cystic degeneration, Elastography, Giant myoma, Uterine leiomyoma.

How to cite this article: Bhoi NR, Mohanta C, Agrawal S, Panda AK. Large Cystic Degeneration of Subserosal Fibroid and Diagnostic Dilemma. J South Asian Feder Menopause Soc 2015;3(2):60-63.

Source of support: Nil

Conflict of interest: None

Date of submission: 19 April 2015

Date of acceptance: 17 June 2015

Date of publication: December 2015


 
ORIGINAL ARTICLE
Kavita Babbar, Sangeeta Jogi, RC Arya

Clinical Pattern and Spectrum of Endometrial Pathologies in Abnormal Uterine Bleeding in Perimenopausal and Postmenopausal Women: Experience in a Tertiary Care Institute

[Year:2015] [Month:January-June] [Volumn:3 ] [Number:1] [Pages:33] [Pages No:9-14][No of Hits : 1343]


ABSTRACT

Background Abnormal uterine bleeding (AUB) is defined as any alteration in the pattern or volume of menstrual blood flow. It is the common presenting complaint in gynecology outpatient department (OPD) in all age groups. It is due to the anovulatory cycles which are commonly seen in extremes of age reproductive age groups in adolescent and perimenopausal women. Abnormal uterine bleeding is caused by wide variety of organic or nonorganic causes. Histopathological evaluation of the endometrial samples plays a significant role in the diagnosis of abnormal uterine bleeding.

Aim To assess the clinical picture and endometrial pattern of abnormal uterine bleeding in perimenopausal and postmenopausal age groups.

Materials and methods: The study included analysis of 127 cases of endometrial samples obtained from patients of abnormal uterine bleeding above 40 years of age. The specimens were routinely processed and hematoxylin and eosin (H&E) stained slides were studied. Patients were categorized in two age groups perimenopausal (41–50 years) and postmenopausal (>50 years).

Results The predominant age of presentation in AUB was perimenopausal age group 95 (74.8%). It was seen more frequently in grandmultiparous women. Most common presentation was menorrhagia (62.1%) of cases in the perimenopausal age group, whereas other group presented as postmenopausal bleeding. A total of 127 specimens of endometrium were analyzed. In perimenopausal age group predominant histopathological pattern was proliferative endometrium (34.7%) followed by disordered proliferative (15.8%). Atrophic endometrium (28.3%) was the most frequent finding followed by endometrial hyperplasia (25%) in postmenopausal age group. Two cases (6.2%) of endometrial carcinoma were reported in postmenopausal age group and one case (1%) in perimenopausal age group.

Conclusion Histopathological evaluation with clinical correlation of endometrium is especially indicated in women over the age of 40 years to rule out preneoplastic lesions and malignancies. Careful screening can detect early cancer of endometrium which has excellent prognosis and improve quality of life.

Keywords Abnormal uterine bleeding, Endometrium, Perimenopause.

How to cite this article: Babbar K, Jogi S, Arya RC. Clinical Pattern and Spectrum of Endometrial Pathologies in Abnormal Uterine Bleeding in Perimenopausal and Postmenopausal

Women Experience in a Tertiary Care Institute. J South Asian Feder Menopause Soc 2015;3(1):9-14.

Source of support: Nil

Conflict of interest: None

Date of submission: 8 Feb 2015

Date of acceptance: 29 May 2015

Date of publication: June 2015


 
ORIGINAL ARTICLE
Ruchika Garg, Rajani Rawat, Manisha Pathak, GM Lalitha, Renu Rajwanshi

Menopausal Symptoms among Postmenopausal Women of North India: A Cross-sectional Study

[Year:2015] [Month:January-June] [Volumn:3 ] [Number:1] [Pages:33] [Pages No:3-5][No of Hits : 1236]


ABSTRACT

Introduction Menopausal health is a major problem in India because of rising population of postmenopausal women.

Objectives The aim was to determine the mean age of attaining menopause and the prevalence of various menopausal symptoms.

Materials and methods: A cross-sectional study was conducted in SNMC of Agra on 218 postmenopausal women from March 2012 to 2015.

Results The mean age of attaining menopause was 48.26 years. Prevalence of symptoms among ladies were muscle and joint pains (70%), mood swings (65%), low backache (46.7%), hot flush and excessive sweating (45%), change in sexual desire (44%), dryness of vagina (41%), urinary symptoms (35%) and anxiety and irratibility in (11%) females.

Conclusion Thus, study stated that all the women were suffering from one or more number of menopausal symptoms. Women should be made aware of these symptoms, their causes and treatment respectively.

Keywords Menopausal symptoms, Postmenopausal women, Urinary symptom.

How to cite this article: Garg R, Rawat R, Pathak M, Lalitha GM, Rajwanshi R. Menopausal Symptoms among Postmenopausal Women of North India: A Cross-sectional Study. J South Asian Feder Menopause Soc 2015;3(1):3-5.

Source of support: Nil

Conflict of interest: None

Date of submission: 18 Feb 2015

Date of acceptance: 22 Feb 2015

Date of publication: June 2015


 
CASE REPORT
Priyanka Mehta, Vasanthalakshmi Gonnabaktula Naga, B Pushpalatha

Cerebral Venous Thrombosis following Oral Contraceptive Pill Use for Menorrhagia: Management Dilemma

[Year:2015] [Month:January-June] [Volumn:3 ] [Number:1] [Pages:33] [Pages No:27-28][No of Hits : 914]


ABSTRACT

Women on oral hormonal therapy for menorrhagia are at risk of cerebral venous thrombosis (CVT). This condition is characterized by intravascular clotting in the venous system of brain. In this case which is being presented for its rarity, the patient developed CVT following use of low dose estrogen progesterone combination pill; hence, treatment was stopped. Withdrawal of oral contraceptive pill (OCP) was associated with profuse vaginal bleed. Emergency hysterectomy was risky as patient was unstable. Levonorgestrel intrauterine system (LNG-IUS) proved to be a safe effective innovative option in this situation.

Keywords Oral contraceptive pills, Cerebral venous thrombosis, Menorrhagia, Levonorgestrel intrauterine system.

How to cite this article: Mehta P, Naga VG, Pushpalatha B. Cerebral Venous Thrombosis following Oral Contraceptive Pill Use for Menorrhagia: Management Dilemma. J South Asian Feder Menopause Soc 2015;3(1):27-28.

Source of support: Nil

Conflict of interest: None

Date of submission: 12 Feb 2015

Date of acceptance: 20 April 2015

Date of publication: June 2015


 
ORIGINAL ARTICLE
Meenal Jain, Amit Agarwal, Ruchika Garg

A Comparative Study of Use of Zoledronic Acid and Teriparatide in Postmenopausal Osteoporosis

[Year:2015] [Month:January-June] [Volumn:3 ] [Number:1] [Pages:33] [Pages No:6-8][No of Hits : 883]


ABSTRACT

Aim To study and compare the effect of zoledronic acid and teriparatide on bone mineral density in postmenopausal women with osteoporosis.

Materials and methods: One hundred postmenopausal patients having BMD score ≤ 1 were selected from the outpatient department of gynecology, SN Medical College, Agra. The study was undertaken in collaboration with orthopedician, randomly divided into two groups: group A-Fifty patient given 5 mg Iv zoledronic acid infusion, two such doses were given at 6 months interval, group B-Fifty patient given 20 ìg/day teriparatide by subcutaneous injection for 3 months.
Follow-up at 12 months and BMD score compared.

Observations There was significant increase in BMD in both the groups over a period of 1 year but increase was more significant in teriparatide group (8 to 10%) as compared to 4 to 6% increase in zoledronic acid group. Clinical symptoms improved in both groups with fewer side effects in teriparatide group.

Conclusion Both teriparatide and zoledronic acid are good options for management of postmenopausal osteoporosis with teriparatide having better clinical efficacy and less side effects though it is expensive and requires daily administration.

Keywords Bone mineral density, Postmenopausal osteoporosis, Teriparatide, Zoledronic acid.

How to cite this article: Jain M, Agarwal A, Garg R. A Comparative Study of Use of Zoledronic Acid and Teriparatide in Postmenopausal Osteoporosis. J South Asian Feder Menopause Soc 2015;3(1):6-8.

Source of support: Nil

Conflict of interest: None

Date of submission: 8 Feb 2015

Date of acceptance: 1 May 2015

Date of publication: June 2015


 
REVIEW ARTICLE
Piyusha M Atapattu

Vasomotor Symptoms: What is the Impact of Physical Exercise?

[Year:2015] [Month:January-June] [Volumn:3 ] [Number:1] [Pages:33] [Pages No:15-19][No of Hits : 875]


ABSTRACT

Vasomotor symptoms (VMS) or hot flushes are the commonest and the most troublesome symptoms during the menopausal transition. Though usually transient, VMS is the leading menopausal symptom presenting for medical attention. Hormone replacement therapy (HRT) is the most effective treatment for VMS, but many women are reluctant to use HRT and wish to pursue alternative therapy.
Physical exercise of different types has been used as a mean of alleviating VMS. The potential for physical exercise to improve VMS can be explained by its effects on the postulated pathophysiologcal mechanisms of VMS. However, individual studies on the influence of physical exercise on VMS show conflicting results, with positive, negative or no effects being reported, and the review of evidence is inconclusive. The many differences in the study designs may be a reason for the varying outcomes of the studies.
Physical exercise, however, have multiple benefits in postmenopausal women, in reducing cardiovascular risk factors, improving bone density and preventing osteoporosis, enhancing muscle mass and has a positive effect on overall health. Regular physical activity should, therefore, be promoted in all postmenopausal women, though they may not derive a significant improvement of VMS.

Keywords Hot flushes, Pathophysiology, Physical activity, Physical exercise, Vasomotor symptoms.

How to cite this article: Atapattu PM. Vasomotor Symptoms: What is the Impact of Physical Exercise? J South Asian Feder Menopause Soc 2015;3(1):15-19.

Source of support: Nil

Conflict of interest: None

Date of submission: 15 Jan 2015

Date of acceptance: 18 Feb 2015


 
Review Articles
Jaideep Malhotra, Ruchika Garg, Prabhat Agrawal, Rekha Rani

Sleep Disorders and Menopause.

[Year:2015] [Month:July-December] [Volumn:3 ] [Number:2] [Pages:31] [Pages No:54-57][No of Hits : 700]


Abstract

One-fourth to half of all postmenopausal women will suffer from sleep disturbances. The incidence of sleep disorders increases from 16–42% to 39–47% at perimenopause and 35 to 60% at postmenopause. The prevalence of sleep disturbance is higher in perimenopausal, postmenopausal, and surgical menopausal, women than in premenopausal women. There is an independent relationship between menopausal stages and sleep disturbance beyond the effects of aging and other confounders, although the magnitude of the relationship is small. Culture, ethnicity, or both might affect the levels of sleep disturbance at various menopausal stages.

Keywords: Insomnia, Menopause, Sleep.

How to cite this article: Malhotra J, Garg R, Agrawal P, Rani R. Sleep Disorders and Menopause. J South Asian Feder Menopause Soc 2015;3(2):54-57.

Source of support: Nil

Conflict of interest: None

Date of submission: 14 March 2015

Date of acceptance: 28 May 2015

Date of publication: December 2015


 
REVIEW ARTICLE
Urvashi Verma, Ruchika Garg, Rekha Rani

Menopausal Osteoporosis

[Year:2015] [Month:January-June] [Volumn:3 ] [Number:1] [Pages:33] [Pages No:24-26][No of Hits : 636]


ABSTRACT

Every woman faces menopause and many dread its approach fearing the onset of uncomfortable physical side effects and loss of their youth. With the increasing longevity (life expectancy), more women are liable to live more years with menopause. Menopausal women spend one-third of their life after menopause amounting to almost 30 years. The menopause should be the time for new learning, development, more freedom and to look forward with more confidence. Its management should start before its arrival with the practice of healthy habits and minor modifications in life style.

Keywords Bone mineral density, Menopause, Osteoporosis, T-score.

How to cite this article: Verma U, Garg R, Rani R. Menopausal Osteoporosis. J South Asian Feder Menopause Soc 2015;3(1):24-26.

Source of support: Nil

Conflict of interest: None

Date of submission: 10 Jan 2015

Date of acceptance: 28 Mar 2015

Date of publication: June 2015


 
CASE REPORT
GS Anitha, M Prathiba, Mangala Gowri

Primary Ovarian Leiomyosarcoma with Metastasis: A Rare Case Report

[Year:2015] [Month:January-June] [Volumn:3 ] [Number:1] [Pages:33] [Pages No:29-30][No of Hits : 574]


ABSTRACT

Primary ovarian leiomyosarcoma is an extremely rare malignant smooth muscle neoplasm with less than 50 case reports in literature. We report a case of a primary leiomyosarcoma of the ovary managed at our institution.

Keywords Adjuvant chemotherapy, Metastasis, Primary ovarian leiomyosarcoma.

How to cite this article: Anitha GS, Prathiba M, Gowri M. Primary Ovarian Leiomyosarcoma with Metastasis: A Rare Case Report. J South Asian Feder Menopause Soc 2015;3(1):29-30.

Source of support: Nil

Conflict of interest: None

Date of submission: 8 Feb 2015

Date of acceptance: 8 Mar 2015

Date of publication: June 2015


 
Original Articles
Syeda Batool Mazhar, Yasmeen Mansha Kayani, Shagufta Yasmin

Sexuality among Postmenopausal Women and its Relation to Menopause Rating Scale

[Year:2015] [Month:July-December] [Volumn:3 ] [Number:2] [Pages:31] [Pages No:39-43][No of Hits : 537]


Abstract

Background: There has been a misperception that menopausal women automatically lose interest in sexual life. At menopause, women have low estrogen levels; the vagina becomes thinner with less lubrication resulting in discomfort and lack of sensation with dyspareunia. There was a lack of standardized scales to measure the severity of menopausal symptoms and their effect on the healthrelated quality of life (HRQoL). So, in the 1990s menopausal rating scale (MRS) was developed to measure the severity of these problems. The MRS scores will be correlated with sexuality among postmenopausal women in this study.

Objective: To study psychosexual health issues and attitudes toward sexuality among postmenopausal women and correlate it with MRS.

Materials and methods: A cross-sectional study was conducted among 100 postmenopausal women who presented in maternal and child healthcare (MCH) centre as a patient or accompanying person. Divorced, widow or women separated from their husbands were not included in the study. It was questionnaire-based convenience sampling conducted from 1st March to 31st August 2012 in MCH centre, Pakistan Institute of Medical Sciences (PIMS). The results were analyzed on Statistical Package for the Social Sciences(SPSS) version 17.

Results: The mean age of participants was 53 years and the mean age at menopause was 47 years. All the women had engaged in sexual intercourse in the past 6 months. A total of 93% women reported sexual activity, two to three times in a month while 2% were active more than four times. Only five having sex to make their partner happy. Seventy-four percent had reduced libido and 72% had diminished sexual response. The mean MRS was 11.2% with a range from 5 to 26. On analyzing MRS, the most frequent reported symptoms were anxiety, physical and mental exhaustion (90%), hot flushes (89%), night sweats (87%), anxiety (85%), irritability (83%) and depressive mood (82%). Vaginal dryness and sleep problems (74%), heart discomfort (71%), sexual problems (70%) and 41% had bladder problems were less frequent. On correlation of sexual functioning with MRS, women with higher MRS score (16–26) had significantly reduced sexual response (p = 0.046) compared to women with scores lower than or equal to 15 while there was no relation of MRS with importance of sexual relations in marital life.

Conclusion: Sexual dysfunction in postmenopausal women was found to be quite high, but despite of these problems most of the women were satisfied with their sexual life. The MRS is a valuable for the assessment of menopausal complaints and had some correlation with sexuality.

Keywords: Climacteric, Dyspareunia, Libido, Menopause, Orgasm, Sexuality.

How to cite this article: Mazhar SB, Kayani YM, Yasmin S. Sexuality among Postmenopausal Women and its Relation to Menopause Rating Scale. J South Asian Feder Menopause Soc 2015;3(2):39-43.

Source of support: Nil

Conflict of interest: None

Date of submission: 20 May 2015

Date of acceptance: 14 August 2015

Date of publication: December 2015


 
ORIGINAL ARTICLE
Smriti Gupta, Anita Sitimani, Anjali Gupta

Public Awareness about Cancer Cervix and Human Papilloma Virus Vaccines

[Year:2015] [Month:January-June] [Volumn:3 ] [Number:1] [Pages:33] [Pages No:1-2][No of Hits : 517]


ABSTRACT

Purpose To know the level of awareness among women about cervical cancer and human papilloma virus (HPV) vaccines for its prevention.

Method Questionnaire-based observational study of 500 women.

Results Our study revealed that public awareness about cancer cervix in India is hardly 34% and that about HPV vaccines and their role in preventing cancer cervix a meagre 12%.

Conclusion According to our study, only a minority of our women are aware about cancer cervix and hardly a handful know about HPV vaccines. By directing our efforts in further increasing this awareness and hopefully including these vaccines in immunization protocol, can we ever imagine fighting this gigantic problem in India?

Keywords Awareness, Cancer cervix, HPV vaccines, Health awareness, Health policy.

How to cite this article: Gupta S, Sitimani A, Gupta A. Public Awareness about Cancer Cervix and Human Papilloma Virus Vaccines. J South Asian Feder Menopause Soc 2015;3(1):1-2.

Source of support: Nil

Conflict of interest: None

Date of submission: 14 Jan 2015

Date of acceptance: 23 Mar 2015

Date of publication: June 2015


 
Original Article
Bahar Kohli, Shashi Bala Arya, Jai Kishan Goel, Mridu Sinha, Jayanti Kar, Isha Tapasvi

Comparison of Pap Smear and Colposcopy in Detection of Premalignant Lesions of Cervix

[Year:2014] [Month:January-June] [Volumn:2 ] [Number:1] [Pages:56] [Pages No:5-8][No of Hits : 3943]


ABSTRACT

Objective: Comparison of papanicolaou (pap) smear and colposcopy in detection of premalignant lesions of cervix.

Materials and methods: A prospective clinical study was conducted in a tertiary care referral institute in 100 symptomatic, sexually active women of 20 to 60 years. All women were subjected to pap smear, colposcopy and cervical biopsy to confirm the diagnosis.

Results: Out of 49 positive on pap smear, 24 were true positives and 25 were false positives. Out of 51 negative pap smear findings, 45 were true negatives and 6 were false negatives.
Thirty percent women had positive histopathology and colposcopic findings. Forty percent women had normal colposcopy with negative histopathology whereas 30% had positive colposcopic findings but negative histopathology. Nineteen percent of women with negative cytology were positive on colposcopy and histopathology.

Conclusion: PAP smear had a sensitivity of 80% and a specificity of 64.29% with positive predictive value of 48.98% and negative predictive value of 88.24% while sensitivity and specificity of colposcopy were 100 and 57.14% respectively and positive predictive value and negative predictive value of colposcopy were found to be 50 and 100% respectively.

Keywords: Pap smear, Colposcopy, Premalignant lesions of cervix.

How to cite this article: Kohli B, Arya SB, Goel JK, Sinha M, Kar J, Tapasvi I. Comparison of Pap Smear and Colposcopy in Detection of Premalignant Lesions of Cervix. J South Asian Feder Menopause Soc 2014;2(1):5-8.

Source of support: Nil

Conflict of interest: None


 
Original Article
N Anjaly, Lekha Viswanath, T Anju Philip

Assess the Knowledge on Menopausal Self-care among Perimenopausal Women

[Year:2014] [Month:July-December] [Volumn:2 ] [Number:2] [Pages:60] [Pages No:55-58][No of Hits : 3003]


ABSTRACT

Perimenopause which generally begins more than 5 years before the permanent cessation of menses, it is a time of transition characterized by unstable endocrine physiology and highly variable, unpredictable hormone profiles. The purpose of the study is to assess the knowledge on menopausal self-care among perimenopausal women in selected wards of Nayarambalam Panchayath, Ernakulam. Quantitative approach with descriptive survey design is used for the study. Sample consists of 120 perimenopausal women of 35 to 50 years, residing in selected wards of Nayarambalam Panchayath, Ernakulam. The knowledge regarding menopausal self-care is poor among 71% of perimenopausal women, average among 28% of perimenopausal women and 1% of them have good knowledge. Mean knowledge score is 8.04, SD is 5.09 and maximum score is 30. No significant association was found between knowledge and variables like age, educational status, family income and menopausal status. Perimenopausal women have inadequate knowledge on menopausal self-care. Findings of the study highlight the need of educational intervention for improving the knowledge of self-care among perimenopausal women.

Keywords: Knowledge on menopausal self-care, Perimenopausal women, Selected variables.

How to cite this article: Anjaly N, Viswanath L, Philip TA. Assess the Knowledge on Menopausal Self-care among Perimenopausal Women. J South Asian Feder Menopause Soc 2014;2(2):55-58.

Source of support: Nil

Conflict of interest: None


 
Case Report
Vijay Kumar, Kusuma Vijay Kumar, KH Krishnamurthy, Rajesh Kumar

A Rare Case Report of Microperforate Hymen with Difficulty in Penetration

[Year:2014] [Month:July-December] [Volumn:2 ] [Number:2] [Pages:60] [Pages No:97-98][No of Hits : 2891]


ABSTRACT

A rare case of 26-year-old women with microperforate hymen reported a difficulty in intercourse. Hymenectomy is the surgical treatment for imperforate hymen and microperforate hymen. A knife or electrocautery can be used to excise hymenal tissue.

Keywords: Microperforate hymen, Pin-hole hymen, Vaginismus, Electrocautery.

How to cite this article: Kumar V, Kumar KV, Krishnamurthy KH, Kumar R. A Rare Case Report of Microperforate Hymen with Difficulty in Penetration. J South Asian Feder Menopause Soc 2014;2(2):97-98.

Source of support: Nil

Conflict of interest: None


 
Review Article
Shikha Seth, Rajani Rawat, Vaibhav Kanti, Pragati Mishra, Suniya Vishwakarma

Clear Cell Carcinoma of Endometrium: A Clinical Review

[Year:2014] [Month:January-June] [Volumn:2 ] [Number:1] [Pages:56] [Pages No:15-19][No of Hits : 2355]


ABSTRACT

Clear cell carcinoma of endometrium is a rare (1-6%) but aggressive malignancy with high propensity of early extra-uterine spread. The usual presentation is postmenopausal bleeding and discharge as with other endometrial cancers but it does not have preceding hyperplastic stage, instead it develops from thin atrophic endometrium, therefore impossible to identify by the screening measures like Pap smear and transvaginal sonography. First step for early diagnosis of such unfavorable endometrial cancer should be endometrial biopsy. Histopathological diagnosis is mandatory to confirm the clear cells present in the endometrial sample before planning the management. Clinical staging is highly erroneous in clear cell endometrial cancer and should not be taken into consideration in management plan. Being a rare cancer, there is lack of true evidence on its management protocol. Here, we had tried to provide the review about the clear cell endometrial (CCE) cancer diagnosis and management along with a case report for clinical perspective.

Keywords: Clear cell carcinoma, Postmenopausal bleeding, Endometrial malignancy, Chemoradiation.

How to cite this article: Seth S, Rawat R, Kanti V, Mishra P, Vishwakarma S. Clear Cell Carcinoma of Endometrium: A Clinical Review. J South Asian Feder Menopause Soc 2014;2(1):15-19.

Source of support: Nil

Conflict of interest: None


 
Original Article
Ruchika Garg, Saroj Singh, Rekha Rani, Mohita Agrawal, Renu Rajvanshi

A Clinicopathological Study of Malignant Ovarian Tumors in India

[Year:2014] [Month:January-June] [Volumn:2 ] [Number:1] [Pages:56] [Pages No:9-11][No of Hits : 2209]


ABSTRACT

Ovarian cancer is the leading cause of death from gynecological cancer.

Material and method: Surgical staging of all cases of ovarian cancer were done.

Result and conclusion: Of the 50 cases of ovarian tumors operated 44% were malignant.duration of symptoms was 1 month or less in majority of patients.Bilaterality was found in 27.3% of tumors. The most common histotype was serous. Early diagnosis and treatment can reduce the morbidity and mortality if the clinician keeps this in mind.

Keywords: Ovarian tumor, Malignant, Symptom.

How to cite this article: Garg R, Singh S, Rani R, Agrawal M, Rajvanshi R. A Clinicopathological Study of Malignant Ovarian Tumors in India. J South Asian Feder Menopause Soc 2014;2(1):9-11.

Source of support: Nil

Conflict of interest: None


 
Original Article
Urvashi Verma, Ruchika Garg, Shivani Singh, Poonam Yadav, Rekha Rani

Diagnostic Approach in Perimenopausal Women with Abnormal Uterine Bleeding

[Year:2014] [Month:January-June] [Volumn:2 ] [Number:1] [Pages:56] [Pages No:12-14][No of Hits : 2071]


ABSTRACT

Introduction: Abnormal uterine bleeding (AUB) is very common problem in patient attending outpatient department, especially in perimenopausal group.

Objective: To study prevalence of abnormal uterine bleeding and its type in perimenopausal women as well as to compare diagnostic efficacy of ultrasonography, hysteroscopy and histopathology.

Material and method: The study was carried out in Department of Obstetrics and Gynecology, Era Medical College, Lucknow, in 100 patient attending outpatient department with AUB in perimenopausal age group.

Observation: Most of the patients were multiparous, more than 50% belong to socioeconomic class III and IV and mean age was 43.05 ± 4.09 years. Commonest complaint was menorrhagia (45%) followed by metrorrhagia in 19% and menometorrhagia in 14%. Majority of patients (85%) had uterine volume between 151 and 250 cm3. Only three patient had uterine volume more than 252 cm3. Endometrial hyperplasia was diagnosed in 14% with ultrasonography, 11% on hysteroscopy while in 15% on hystopathological examination.

Conclusion: In perimenopausal women with AUB, ultrasonography should be first investigation because of its freely availability, noninvasiveness and cost effectiveness.

Keywords: Perimenopause, Abnormal uterine bleeding, Hysteroscopy.

How to cite this article: Verma U, Garg R, Singh S, Yadav P, Rani R. J South Asian Feder Menopause Soc 2014;2(1):12-14.

Source of support: Nil

Conflict of interest: None


 
Case Report
Keerthi Patturu Radhakrishna, Vasantha Lakshmi, Pushpalatha

Role of Uterine Artery Embolization and Methotrexate in Cervical Pregnancy

[Year:2014] [Month:January-June] [Volumn:2 ] [Number:1] [Pages:56] [Pages No:35-37][No of Hits : 1946]


ABSTRACT

Cervical ectopic pregnancy in a 33-year-old gravida 8 para 1 live 1 abortion 6 following spontaneous conception at 6 weeks presented with mild vaginal spotting with no abdominal cramps. On pelvic exam, cervix slightly distended with no uterine enlargement and minimal bleeding at external orifice noted. Managed conservatively with three doses of methotrexate (MTX) and uterine artery embolization (UAE). The case is presented here for its rarity and to conclude successful conservative management is possible with MTX and UAE in treating early cervical pregnancy with mild vaginal bleeding with fetal heart allowing preservation of fertility.

Keywords: Cervical pregnancy, Methotrexate, Uterine artery embolization, Conservative management.

How to cite this article: Radhakrishna KP, Lakshmi V, Pushpalatha. Role of Uterine Artery Embolization and Methotrexate in Cervical Pregnancy. J South Asian Feder Menopause Soc 2014;2(1):35-37.

Source of support: Nil

Conflict of interest: None


 
Case Report
Mehul Sukhadiya, Shweta Varade Grover

Unexplained Unilateral Absence of Fallopian Tube and Ovary

[Year:2014] [Month:January-June] [Volumn:2 ] [Number:1] [Pages:56] [Pages No:46-47][No of Hits : 1859]


ABSTRACT

Objective: To present a case of right-sided unilateral tubal and ovarian absence, along with laparoscopic images.

Patient: A 23-year-old patient presented with primary infertility of 4 years’ duration. Right adnexal structures were not visualized on transvaginal ultrasound and laparoscopy.

Intervention: Diagnostic laparoscopy and hysteroscopy.

Main outcome measure: Complete absence of the right fallopian tube together with ovary was detected during laparoscopy. Subsequent urinary tract evaluation with intravenous pyelography was planned.

Result: Ipsilateral absence of the fallopian tube and ovary without any other system anomalies were detected.

Conclusion: Torsion or congenital defect might be the possible etiologic factors. However, vascular accident stands in the forefront of suggested etiologies. Laparoscopy is a feasible option as a diagnostic tool for these kinds of cases.

Keywords: Unilateral absence, Fallopian tube, Ovary, Congenital anomaly.

How to cite this article: Sukhadiya M, Grover SV. Unexplained Unilateral Absence of Fallopian Tube and Ovary: A Rare Occurrence. J South Asian Feder Menopause Soc 2014;2(1): 46-47.

Source of support: Nil

Conflict of interest: None


 
Case Report
Pushpa Dahiya, Krishna Dahiya, Shaveta Jain, Nupur

Imperforate Hymen: A Case Report

[Year:2014] [Month:January-June] [Volumn:2 ] [Number:1] [Pages:56] [Pages No:52-53][No of Hits : 1797]


ABSTRACT

Imperforate hymen is relatively rare but it is the most frequently encountered of the mulleriananomalies of the female genital tract with an incidence of about 0.1%. The clinical presentation varies significantly from patient to patient depending on the age at diagnosis but in most cases, the diagnosis is missed in early childhood delaying the diagnosis upto puberty, when the patient presents with hematocolpos, hematometra or both. When this happens, the presentation could even be misleading because of unlikely presenting symptoms like, urinary retention and bowel obstruction leading to unnecessary urology and gastroenterology referral without any conclusive evidence of the condition furthering the delay in diagnosis and increasing the presentation with complications. This case is an illustration that there is quite often a considerable delay before a proper diagnosis is reached. The aim of this communication is to increase awareness of imperforate hymen among clinicians examining adolescent girls with lower abdominal pain.

Keywords: Imperforate hymen, Hematocolpos, Hematometra.

How to cite this article: Dahiya P, Dahiya K, Jain S, Nupur. Imperforate Hymen. J South Asian Feder Menopause Soc 2014;2(1):52-53.

Source of support: Nil

Conflict of interest: None


 
Review Article
Sumbul Sohail

Menopause and the Asian Woman

[Year:2014] [Month:January-June] [Volumn:2 ] [Number:1] [Pages:56] [Pages No:23-25][No of Hits : 1779]


ABSTRACT

Menopause is an event that typically occurs in women in midlife. For some women, the accompanying symptoms can significantly disrupt their daily activities and sense of well being. It has long been known that menopause is much easier for Asian women than for westerners. A systematic review of articles on Asian women is done, the objective of which is to find out evidence on Asian women experience and perception of menopause.

Keywords: Menopause, Hot flushes, Asian, Lifestyle, Ethnic difference.

How to cite this article: Sohail S. Menopause and the Asian Woman. J South Asian Feder Menopause Soc 2014;2(1):23-25.

Source of support: Nil

Conflict of interest: None declared


 
Original Article
Uma Gupta, Kumkum Shrivastava, Gunjan Katiyar, Ayesha Arif, Narendra Kumar Gupta

Study of Efficacy and Safety of Ormeloxifene in the Management of Dysfunctional Menorrhagia

[Year:2014] [Month:January-June] [Volumn:2 ] [Number:1] [Pages:56] [Pages No:1-4][No of Hits : 1520]


ABSTRACT

Objective: To assess the efficacy and safety of ormeloxifene in the medical management of dysfunctional menorrhagia.

Methodology: Fifty women with menorrhagia were recruited for the study. Ormeloxifene 60 mg twice a week for 3 months from first day of periods and once a week for next 3 months was given. Mean blood loss (MBL) was assessed using pictorial blood loss assessment chart (PBAC). Ultrasonography (USG) and blood hemoglobin levels were done as baseline and at 2, 4 and 6 months of treatment. Side-effects of the drug were recorded. Changes in PBAC scoring, endometrial thickness (ET) and hemoglobin levels (Hb) were analyzed by student’s paired ‘t’ tests using SPSS 17.0 version. p value ≤ 0.05 was taken as significant.

Results: The pretreatment PBAC score was 360, which reduced to 209.5 at 2 months, 88.7 at 4 months and 68.2 at 6 months of treatment, which was statistically significant (p-value ≤ 0.001). The rise in hemoglobin and decrease in ET, in women on ormeloxifene was also statistically significant (p-value ≤ 0.001).

Conclusion: Ormeloxifene is an effective and safe therapeutic option for the medical management of menorrhagia.

Keywords: Dysfunctional uterine bleeding, Menorrhagia, Ormeloxifene.

How to cite this article: Gupta U, Shrivastava K, Katiyar G, Arif A, Gupta NK. Study of Efficacy and Safety of Ormeloxifene in the Management of Dysfunctional Menorrhagia. J South Asian Feder Menopause Soc 2014;2(1):1-4.

Source of support: Nil

Conflict of interest: None


 
Case Report
Disha Paryani, Ajesh Desai, Kunur Shah, Swati Nilay Patel

A Case Report of Recurrent Fibrosis in Case of Transverse Vaginal Septum

[Year:2014] [Month:January-June] [Volumn:2 ] [Number:1] [Pages:56] [Pages No:42-43][No of Hits : 1504]


ABSTRACT

Transverse vaginal septum is a rare mullerian duct anomaly due to vertical fusion defect. A 21-year-old female presented with secondary amenorrhea and lower abdominal pain for 6 years. She had past history of hematocolpos due to transverse vaginal septum 6 years back and was operated twice for the same. First, the hematocolpos was aspirated, the tract was dilated and evacuation of hematocolpos was done. Fibrosis occurred after 2 months and amenorrhea persisted for 6 years. Second, incomplete resection of the fibrosed transverse vaginal septum was done and a mold was kept for 1 year. On examination, recurrent fibrosis of transverse vaginal septum leading to hematometra and hematocolpos was found. Complete resection of septum with double breasting of vaginal mucosa was done. Drain was kept in vagina for 7 days. Patient was advised to keep the mold for 1 and half year.

How to cite this article: Paryani D, Desai A, Shah K, Patel SN. A Case Report of Recurrent Fibrosis in Case of Transverse Vaginal Septum. J South Asian Feder Menopause Soc 2014;2(1):42-43.

Source of support: Nil

Conflict of interest: None


 
Case Report
S Prathima, CSBR Prasad, Udaya Kumar, M Narayanswamy

An Uneventful Pregnancy and Delivery in a Patient with Chronic Myeloid Leukemia

[Year:2014] [Month:January-June] [Volumn:2 ] [Number:1] [Pages:56] [Pages No:33-34][No of Hits : 1281]


ABSTRACT

The concomitant occurrence of chronic myeloid leukemia and pregnancy is estimated to be one in 75000-100000 pregnancies annually. We present a case of 28 years old lady with 36 weeks of gestation diagnosed as chronic myeloid leukemia in chronic phase. Her pregnancy and delivery was uneventful. She breast fed the baby for 3 weeks before initiating treatment. Close vigilance and relevant investigations are of paramount importance in recognizing this extremely rare disease during pregnancy.

Keywords: Pregnancy, Chronic myeloid leukemia, Delivery.

How to cite this article: Prathima S, Prasad CSBR, Kumar U, Narayanswamy M. An Uneventful Pregnancy and Delivery in a Patient with Chronic Myeloid Leukemia. J South Asian Feder Menopause Soc 2014;2(1):33-34.

Source of support: Nil

Conflict of interest: None


 
Original Article
K Sangeetha, G Usha Rani, O Syamala, Rukshana, Pushpalatha

Vaginal Reconstruction in Müllerian Agenesis with User-Friendly Indigenous Prosthetic Vaginal Dilators

[Year:2014] [Month:July-December] [Volumn:2 ] [Number:2] [Pages:60] [Pages No:75-78][No of Hits : 1268]


ABSTRACT

Objective: Vaginal reconstruction in Müllerian agenesis through nonsurgical method, using serial vaginal dilators which were worn by the patients with the help of a T-shaped perineal bandage.

Materials and methods: Seven patients with Müllerian agenesis had attended the outpatient clinic between 2008 and 2013. The age of women ranged from 18 to 30 years. This clinical report describes the use of prosthesis, fabricated by a maxillofacial prosthodontist that enabled the patients to have custom made personalized vaginal dilators of increasing dimensions which they could wear with comfort with a tight perineal T-bandage.

Results: Seven women with Müllerian agenesis had consented for nonsurgical mode of vaginal reconstruction. Vagina was serially dilated with tailor made prosthesis worn using tight perineal T-bandage for a period of 3 to 4 months. Post dilatation average vaginal length was 11 to 13 cm which allowed introduction of Sims speculum with ease.

Conclusion: Nonsurgical vaginal dilatation using prosthetic vaginal dilators kept in place with tight perineal T-bandage is a well-accepted custom made and a successful technique in the creation of neovagina.

Keywords: Müllerian agenesis, Primary amenorrhea, Prosthetic vaginal dilator, Perineal T-bandage.

How to cite this article: Sangeetha K, Rani GU, Syamala O, Rukshana, Pushpalatha. Vaginal Reconstruction in Müllerian Agenesis with User-Friendly Indigenous Prosthetic Vaginal Dilators. J South Asian Feder Menopause Soc 2014;2(2):75-78.

Source of support: Nil

Conflict of interest: None


 
Review Article
Megha Snehal Patel, Khyati Mitesh Kakkad, Snehal Vitthalbhai Patel

Human Papilloma Virus Vaccination: Recent Trends in Prevalence and Recommendations in India

[Year:2014] [Month:January-June] [Volumn:2 ] [Number:1] [Pages:56] [Pages No:26-30][No of Hits : 1232]


ABSTRACT

Cervical cancer, mainly caused by human papilloma virus (HPV) infection, is the leading cause of cancer mortality and morbidity in Indian women. Vaccination being the most effective preventive option, and with the availability of two vaccines, quarries and controversies have stirred much debate and excitement regarding the mandatory vaccination, safety, boosters and cost effectiveness, especially in the Indian scenario.

Keywords: Human papilloma virus vaccine, Cervical cancer, Indian scenario.

How to cite this article: Patel MS, Kakkad KM, Patel SV. Human Papilloma Virus Vaccination: Recent Trends in Prevalence and Recommendations in India. J South Asian Feder Menopause Soc 2014;2(1):26-30.

Source of support: Nil

Conflict of interest: None


 
Case Report
Prakash Kumar Nath, Mamata Samal, Kumudini Pradhan, Chintamani Mohanta, Sanjaya Mahapatra

Youssef's Syndrome

[Year:2014] [Month:July-December] [Volumn:2 ] [Number:2] [Pages:60] [Pages No:113-114][No of Hits : 1221]


ABSTRACT

Vesicouterine fistula (Youssef’s syndrome), a rare complication of cesarean section is presented. A 35-year-old female had vesicouterine fistula with symptoms of apparent amenorrhea, cyclic hematuria and meconuria following cesarean section. The patient was treated by abdominal hysterectomy and the fistula tract was repaired.

Keywords: Vesicouterine fistula, Hematuria, Meconuria.

How to cite this article: Nath PK, Samal M, Pradhan K, Mohanta C, Mahapatra S. Youssef’s Syndrome. J South Asian Feder Menopause Soc 2014;2(2):113-114.

Source of support: Nil

Conflict of interest: None


 
Original Article
Vineeta Gupta, Archna Tandon, Anuja Nanda, Arti Sharma, Neeta Bansal, Mini Singhal

Correlation between Cytology, HPV-DNA Test and Colposcopy in Evaluation of Cervical Intraepithelial Lesions

[Year:2014] [Month:July-December] [Volumn:2 ] [Number:2] [Pages:60] [Pages No:71-74][No of Hits : 1186]


ABSTRACT

Objectives: The present study was undertaken to correlate cytology, HPV-DNA test and colposcopy in evaluation of cervical intraepithelial lesions.

Materials and methods: Patients were subjected to Pap smear, HPV-DNA detection, colposcopy and directed cervical biopsy if required. The various screening methods were correlated and evaluated by standard statistical methods.

Observations: A total of 324 patients were included in the study. Colposcopy was done in 263, Pap smear in 214, HPVDNA in 100 and HPE in 116 patients. Sensitivity and specificity of Pap smear test, colposcopy and HPV-DNA testing were calculated to be 66.66, 93.54, 86.84, 86.32, 90 and 84.61% respectively. Their positive predictive value and negative value were 75, 90.60, 67.34, 95.28, 69.23 and 95.66% respectively. The percentage of false negative and false positive were calculated to be 33.33, 6.45, 8.95, 13.67, 10 and 15.38% respectively.

Conclusion: Various screening methods for evaluation of cervical intraepithelial lesions are complimentary to each other and need to be carried out depending on the clinical findings, patient’s convenience and compliance, facilities and set-up available.

Keywords: Cytology, HPV-DNA test, Colposcopy, Cervical intraepithelial lesions.

How to cite this article: Gupta V, Tandon A, Nanda A, Sharma A, Bansal N, Singhal M. Correlation between Cytology, HPV-DNA Test and Colposcopy in Evaluation of Cervical Intraepithelial Lesions. J South Asian Feder Menopause Soc 2014;2(2):71-74.

Source of support: Nil

Conflict of interest: None


 
Case Report
Dhaval Gunvantray Swaminarayan, Sakshi Surinder Nanda, Maliniben Ramaniklal Desai

A Case Report on Placenta Percreta involving Urinary Bladder

[Year:2014] [Month:January-June] [Volumn:2 ] [Number:1] [Pages:56] [Pages No:38-39][No of Hits : 1172]


ABSTRACT

Placenta percreta involving urinary bladder is a lethal condition which can lead to significant blood loss. It is the one of the leading cause of intractable postpartum hemorrhage requiring obstetric hysterectomy. It is associated with increase in morbidity and mortality of both mother and fetus. It is significantly associated with previous cesarean delivery or uterine curettage. Hence, presenting a case report on placenta percreta involving bladder who underwent obstetric hysterectomy.

Keywords: Placenta previa, Placenta percreta, Urinary bladder.

How to cite this article: Swaminarayan DG, Nanda SS, Desai MR. A Case Report on Placenta Percreta involving Urinary Bladder. J South Asian Feder Menopause Soc 2014;2(1):38-39.

Source of support: Nil

Conflict of interest: None


 
Case Report
Shamim Khandaker

Successful Pregnancy outcome with Glioblastoma multiforme of the brain

[Year:2014] [Month:January-June] [Volumn:2 ] [Number:1] [Pages:56] [Pages No:31-32][No of Hits : 1132]


ABSTRACT

Brain tumors in pregnancy are uncommon occurrences. A 30-year-old female at 35 weeks of gestation presented with headache, left sided weakness and parasthesias. Brain imaging (MRI) studies revealed a left sided enhancing temporoparietal lesion with perilesional vasogenic edema and mass effect toward right side. She underwent an elective cesarean delivery. Glioblastoma multiforme is a rare diagnosis during pregnancy which may present as neurologic symptoms.

Keywords: Pregnancy, Brain tumor, Glioblastoma multiforme.

How to cite this article: Khandaker S. Successful Pregnancy Outcome with Glioblastoma Multiforme of the Brain. J South Asian Feder Menopause Soc 2014;2(1):31-32.

Source of support: Nil

Conflict of interest: None


 
Review Article
Prabhat Agrawal, Ayush Agarwal, Omkar Singh, Manish Bansal

Topical Nitroglycerin: A New and Safe Treatment Option for Osteoporosis

[Year:2014] [Month:January-June] [Volumn:2 ] [Number:1] [Pages:56] [Pages No:20-22][No of Hits : 1113]


ABSTRACT

Osteoporosis is a progressive bone disease characterized by a decrease in the bone mass and density, which can lead to an increased risk of fracture. Multiple treatments have been formulated for it like calcium, vitamin D supplements, bisphosphonates, raloxifine, hormone replacement therapies, teriparatide and calcitonin. However, all of these have their own shortcomings. Topical nitroglycerin is a cost-effective, novel medication that not only increases bone formation but also decreases its resorption, and also has the potential to decrease vertebral fractures more than that provided by the existing treatments. Therefore, it could be the answer to the need of an efficacious, cost-effective, affordable, safe and a convenient form of therapy for the prevention of post-menopausal bone loss and osteoporosis as a whole. Therefore, we recommend that individuals with osteoporosis be treated with topical nitroglycerine ointment (15 mg/day).

Keywords: Topical, Nitroglycerin, Osteoporosis, Bone mineral density (BMD), Fracture.

How to cite this article: Agrawal P, Agarwal A, Singh O, Bansal M. Topical Nitroglycerin: A New and Safe Treatment Option for Osteoporosis. J South Asian Feder Menopause Soc 2014;2(1):20-22.

Source of support: Nil

Conflict of interest: None


 
Case Report
Nusrat Mahmud, Naushaba Tarannum Mahtab, TA Chowdhury, Anjan Kumar Deb

Successful Uterovaginal Anastomosis in an Unusual Presentation of Congenital Absence of Cervix

[Year:2014] [Month:July-December] [Volumn:2 ] [Number:2] [Pages:60] [Pages No:105-110][No of Hits : 1081]


ABSTRACT

Cervical agenesis or dysgenesis (fragmentation, fibrous cord and obstruction) is an extremely rare congenital anomaly. Conservative surgical approach to these patients involves uterovaginal anastomosis, cervical canalization and cervical reconstruction. In failed conservative surgery, total hysterectomy is the treatment of choice. We report what we believe to be the first successful end-to-end uterovaginal anastomosis of an unusual case of congenital cervical agenesis. A 25-yearold female presented complaining of primary amenorrhea and primary subfertility for the same duration. At laparoscopy, complete separation between the cervix and the body of the uterus was found and hanging from surrounding supports. Both ovaries and fallopian tubes were anatomically positioned. There was another muscular tissue of 2 cm in diameter at the pouch of Douglas which was attached with lateral pelvic wall by transverse cervical ligament. Upon readmission, laparotomy was performed under general anesthesia in a semilithotomy position allowing both abdominal and vaginal approaches. Uterovaginal anastomosis was done by the restoration of the genital tract by direct suturing of the isthmus uteri to the vagina. Insertion of a 16F Foley catheter transvaginally through the vaginal opening into the endometrial cavity and was inflated with 5 ml of fluid into the catheter balloon. There were no postoperative complications. Foley catheter was kept in situ for 21 days. Patient had her first menstruation on 11th day of surgery and that was continued for 5 days with regular flow. Consecutive 3-cycles follow-up has been done and the patient is having her normal menstruation.
In the presence of cervical anomaly with functional uterus and intact vagina, uterovaginal anastomosis is feasible and effective and should be applied as a first-line treatment option.

Keywords: Cervical fragmentation, Cervical agenesis, Cervical aplasia, Uterine malformation, Uterine reconstruction, Primary amenorrhea, Reconstruction of vagina.

How to cite this article: Mahmud N, Mahtab NT, Chowdhury TA, Deb AK. Successful Uterovaginal Anastomosis in an Unusual Presentation of Congenital Absence of Cervix. J South Asian Feder Menopause Soc 2014;2(2):105-110.

Source of support: Nil

Conflict of interest: None


 
Original Article
Josei Baral, Ashma Rana, Geeta Gurung

Rice Grain in Uterine Cavity: Rare Presentations in Rural Nepalese Postmenopausal Farmer with Uterovaginal Prolapse

[Year:2014] [Month:July-December] [Volumn:2 ] [Number:2] [Pages:60] [Pages No:79-82][No of Hits : 1069]


ABSTRACT

Background: Foreign bodies are less common in uterine cavity than vagina, and are less frequently seen in older women than prepubertal or premenarchal girls. When found in the uterus, these foreign bodies are usually forgotten intrauterine contraceptive device or retained fetal bones, objects which were introduced in the former case or the remnants of conceptus parts that was inadvertently retained as in the latter circumstances. Here, we are going to concentrate in foreign body that made its way into the uterine cavity unaided.

Aim: To study rice grain as retained intrauterine foreign body in women with prolapsed uterus.

Methods: Collection of series of cases of rice grain in the uterine cavity of women exposed to vaginal hysterectomy and pelvic floor repair for uterine prolapse from the year 2004 till date, from the Department of Obstetrics and Gynecology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.

Results: The rice grains as foreign body were entirely seen in postmenopausal multiparous women with the long standing cases of major degree of uterovaginal prolapse, chronicity affirmed by cervical hypertrophy and keratinization. These intrauterine rice grains, 1 to 3 in numbers were found at various level within the uterine cavity with resultant pyometra formation and urinary retention posing surgical difficulties in two cases.

Conclusion: Possibilities of rice grain as foreign body must be kept in mind in the complicated cases of uterovaginal prolapse posted for hysterectomy.

Keywords: Intrauterine foreign body, Rice grain, Uterine prolapse, Pyometra.

How to cite this article: Baral J, Rana A, Gurung G. Rice Grain in Uterine Cavity: Rare Presentations in Rural Nepalese Postmenopausal Farmer with Uterovaginal Prolapse. J South Asian Feder Menopause Soc 2014;2(2):79-82.

Source of support: Nil

Conflict of interest: None


 
Case Report
Neelima V Nair, Divya R Prasad, Sulekha PB Devi

A Case of Unilateral Dysmenorrhea

[Year:2014] [Month:January-June] [Volumn:2 ] [Number:1] [Pages:56] [Pages No:48-49][No of Hits : 1068]


ABSTRACT

A 16-year-old girl presented in outpatient department (OPD) with severe unilateral dysmenorrhea. This case highlights the importance of taking a thorough history and doing the relevant clinical examination and investigations.

Keywords: Unilateral dysmenorrhea, Uterine malformation, Rudimentary horn.

How to cite this article: Nair NV, Prasad DR, Devi SPB. A Case of Unilateral Dysmenorrhea. J South Asian Feder Menopause Soc 2013;2(1):48-49.

Source of support: Nil

Conflict of interest: None


 
Case Report
Nilopher Surti, Babu S Patel, Nimish C Pandya, Ishita Mishra

A Case of Disseminated Peritoneal Tuberculosis Mimicking Metastatic Ovarian Carcinoma

[Year:2014] [Month:January-June] [Volumn:2 ] [Number:1] [Pages:56] [Pages No:44-45][No of Hits : 1034]


ABSTRACT

Background: Mycobacterium tuberculosis affects about 30% of world’s population and infection occurs at a rate of one per second. In 2010, tuberculosis accounted for 8.8 million new cases, was responsible for 1.45 million deaths with majority of cases in developing countries. Tuberculosis is the most common cause of mortality in women of reproductive age. Peritoneal tuberculosis accounts for 4% of all extrapulmonary diseases and often mimics ovarian malignancy due to its nonspecific symptoms.

Case: A 25-year-old woman with ovarian mass and an elevated cancer antigen 125 (CA-125) underwent an exploratory laparotomy to search for ovarian tumor. The final pathological diagnosis was miliary abdominal tuberculosis.

Discussion: Peritoneal tuberculosis often mimics ovarian malignancy due to its nonspecific symptoms and is a major health problem in developing countries. There is no particular diagnostic test to differentiate this disease from advanced ovarian carcinoma, making it difficult to avoid extensive surgery. Laparoscopy is the diagnostic modality of choice.

Keywords: Tuberculosis, Ascites, Ovarian carcinoma.

How to cite this article: Surti N, Patel BS, Pandya NC, Mishra I. A Case of Disseminated Peritoneal Tuberculosis Mimicking Metastatic Ovarian Carcinoma. J South Asian Feder Menopause Soc 2014;2(1):44-45.

Source of support: Nil

Conflict of interest: None


 
Case Report
De Arpita, Archana Sharma

Ureterovaginal Fistula after Use of Harmonic Scalpel in Total Laparoscopic Hysterectomy: Possible Causes and Successful Management

[Year:2014] [Month:July-December] [Volumn:2 ] [Number:2] [Pages:60] [Pages No:111-112][No of Hits : 1027]


ABSTRACT

We report a case of a woman presenting with continuous dribbling of urine since her total laparoscopic hysterectomy with harmonic scalpel three months back. A clinical examination, three swab test and IVP confirmed a left sided uretrovaginal fistula. A ureteroneocystostomy was done and she recovered full bladder control. In this case we try to find the reasons and the finer points of harmonic use to prevent such an injury.

Keywords: Harmonic scalpel, Total laparoscopic hysterectomy, Uretrovaginal fistula.

How to cite this article: Arpita D, Sharma A. Ureterovaginal Fistula after use of Harmonic Scalpel in Total Laparoscopic Hysterectomy: Possible Causes and Successful Management. J South Asian Feder Menopause Soc 2014;2(2):111-112.

Source of support: Nil

Conflict of interest: None


 
Case Report
A Dilshath Meera, G Usha Rani, O Syamala, HN Rukshana

Adenomyosis in a Rudimentary Horn of a Mayer-Rokitansky- Kuster-Hauser Syndrome

[Year:2014] [Month:July-December] [Volumn:2 ] [Number:2] [Pages:60] [Pages No:102-104][No of Hits : 997]


ABSTRACT

The prevalence of congenital uterine malformations is about 0.5%. In Mayer-Rokitansky-Kuster-Hauser syndrome (MRKH), patients usually present with primary amenorrhea. Here, we report a case of adenomyosis in a rudimentary horn in a 37-yearold woman with MRKH syndrome who had cyclical abdominal pain with increasing frequencies since her 24th year. This case is an evidence for adenomyotic lesions in the myometrium of Mullerian remnant with no functioning endometrium.

Keywords: Mayer-Rokitansky-Kuster-Hauser syndrome, Adenomyosis, Endometrium.

How to cite this article: Meera AD, Rani GU, Syamala O, Rukshana HN. Adenomyosis in a Rudimentary Horn of a Mayer-Rokitansky-Kuster-Hauser Syndrome. J South Asian Feder Menopause Soc 2014;2(2):102-104.

Source of support: Nil

Conflict of interest: None


 
Case Report
Anushree Mittal, Rahul Manchanda, BC Manjula, Soma Ghoshal

A Rare Case of Trocar Site Endometriosis managed Laparoscopically

[Year:2014] [Month:July-December] [Volumn:2 ] [Number:2] [Pages:60] [Pages No:91-94][No of Hits : 889]


ABSTRACT

Abdominal wall endometriosis, also known as scar endometriosis, is extremely rare and mainly occurs at surgical scar sites. To our knowledge, 15 case reports related to trocar site endometriosis have been published in the English language and literature to date. The traditional age old management of scar endometriosis has been wide local excision leaving a healthy margin, but recently laparoscopy has emerged out to be the management of choice even in cases of scar endometriosis. Herein, we present the case of a 39-year-old woman (who had been previously operated on for left ovarian endometrioma 11 years ago by laparoscopy) with the complaint of a painful mass at the right suprapubic trocar site in a cyclic pattern. Consequently, the scar endometriosis was excised laparoscopically, following which the patient was completely relieved of her symptoms.

Keywords: Trocar site endometriosis, Laparoscopic excision, Abdominal wall endometriosis.

How to cite this article: Mittal A, Manchanda R, Manjula BC, Ghoshal S. A Rare Case of Trocar Site Endometriosis managed Laparoscopically. J South Asian Feder Menopause Soc 2014;2(2):91-94.

Source of support: Nil

Conflict of interest: None


 
Case Report
Savita Rani Singhal, Neetu Sangwan, Smiti Nanda, Suresh Kumar Singhal

Successful Pregnancy Outcome by Repeat Cesarean Section and Herniorraphy in a Case of neglected ruptured Incisional Hernia

[Year:2014] [Month:January-June] [Volumn:2 ] [Number:1] [Pages:56] [Pages No:50-51][No of Hits : 852]


ABSTRACT

Objective: Gravid uterus with incisional hernia is rarely encountered complication. Aim is to report a case of pregnancy with ruptured incisional hernia.

Case report: A 35-year-old woman, gravida three, para two presented at 30 weeks of gestation with ruptured abdominal incisional hernia. She had previous two emergency cesarean sections done for contracted pelvis, 3 and 2 years back, respectively. Emergency herniorrhaphy was done. Postoperative period was uneventful and pregnancy advanced well without complication. At 37 weeks of gestation, she had elective cesarean section with bilateral tubal ligation. She delivered a healthy female baby of 2.5 kgs and the postoperative period was uneventful.

Conclusion: If the woman was aware and had come earlier during antenatal period; she would have been put on conservative management (bed rest, binder, etc) which might had prevented rupture of the hernia and further the emergency herniorrhaphy which is additional risk factor for the mother and the baby.

Keywords: Pregnancy, Incisional hernia, Rupture.

How to cite this article: Singhal SR, Sangwan N, Nanda S, Singhal SK. Successful Pregnancy Outcome by Repeat Cesarean Section and Herniorrhaphy in a Case of neglected ruptured Incisional Hernia. J South Asian Feder Menopause Soc 2014;2(1):50-51.

Source of support: Nil

Conflict of interest: None


 
Original Article
Nidhi Gupta

Medical Management of Dysfunctional Menorrhagia: Is Ormeloxifene a Safe and Efficacious Therapeutic Choice?

[Year:2014] [Month:July-December] [Volumn:2 ] [Number:2] [Pages:60] [Pages No:65-70][No of Hits : 840]


ABSTRACT

Objective: To assess the efficacy and safety of ormeloxifene (centchroman) in the medical management of menorrhagia.

Materials and methods: One hundred and twenty women with menorrhagia were recruited for the study. One hundred women were analyzed. Ormeloxifene was given to each patient- 60 mg twice a week for 3 months and then once a week for 1 month. Patients were followed up at 2, 4, 6 months of therapy, then at 6 months after treatment was stopped. Menstrual blood loss (MBL) was measured objectively by a pictorial blood loss assessment chart (PBAC) score and subjectively by a visual analog scale (VAS).

Results: The mean age of the patients was 38.2 years with a mean parity of 2.4. The mean duration of menorrhagia was 13 months with 8 days as mean duration of bleeding and a mean cycle length of 26 days. 58.7% of the patients had bulky uterus on per vaginum examination done by the same observer. The mean endometrial thickness on transvaginal scan was 8.7 mm. The different study parameters were evaluated in patients treated with ormeloxifene and it showed a significant reduction in median PBAC score from 252 to 102.8, presence of clots from 64 to 12%, incidence of dysmenorrhea from 22 to 8% and mean endometrial thickness from 9.7 to 6.7 mm. There was also a significant elevation in the mean hemoglobin levels from 8.85 gm/dl to 10.6 gm/dl.
The menstrual pattern of patients treated with ormeloxifene were encouraging. Eight percent of the women became ammenorhoeic after 6 months of therapy, 22% had scanty period, 56% had average flow, 12% had heavy from and only 2% had very heavy flow.
It was further seen, that even though the PBAC score increased to 112.7 after stopping treatment for 6 months, but still it was lower than the pretreatment level (252). The percentage of patients who had an initial history of passage of clots during periods decreased from 64 to 12% and also 22% of patients who complained of mild to severe dysmenorrhea improved and only 8% of the patients complained of mild dysmenorrhea.

Adverse effects: Included ovarian cyst (14%), cervical erosion and discharge (11%), gastric upset (9%), headache (5%) and weight gain (3%).

Conclusion: Ormeloxifene is an effective and safe therapeutic option for the medical management of menorrhagia.

Keywords: Centchroman, Menorrhagia, Ormeloxifene.

How to cite this article: Gupta N. Medical Management of Dysfunctional Menorrhagia: Is Ormeloxifene a Safe and Efficacious Therapeutic Choice? J South Asian Feder Menopause Soc 2014;2(2):65-70.

Source of support: Nil

Conflict of interest: None


 
Case Report
Vineeta Gupta, Nidhi Kumari, Madhuri Srivastava, Anuja Nanda

Intrapartum Vaginal Myomectomy of a Prolapsed Cervical Fibroid

[Year:2014] [Month:July-December] [Volumn:2 ] [Number:2] [Pages:60] [Pages No:99-100][No of Hits : 837]


ABSTRACT

Cervical and vaginal fibroid may be seen in less than 1% of the pregnant women. During labor, they may be responsible for obstruction or cervical dystocia. Usually in such cases, cesarean section is done to deliver the baby. An extensive literature search has shown only few case reports outlining vaginal myomectomy of a prolapsed cervical fibroid during pregnancy and none during labor. We are reporting a case of cervical fibroid which prolapsed outside the introitus during early labor resulting in obstructed labor for which intrapartum vaginal myomectomy was done to facilitate vaginal breech delivery.

Keywords: Cervical fibroid, Intrapartum vaginal myomectomy, Vaginal breech delivery, Obstructed labor.

How to cite this article: Gupta V, Kumari N, Srivastava M, Nanda A. Intrapartum Vaginal Myomectomy of a Prolapsed Cervical Fibroid. J South Asian Feder Menopause Soc 2014; 2(2):99-100.

Source of support: Nil

Conflict of interest: None


 
Original Article
Shelly Agarwal , Samta Gupta, Nimmi Chutani, SS Gulati

Visual Inspection of Cervix with Acetic Acid as a Screening Test for Premalignant and Malignant Lesions of Cervix

[Year:2014] [Month:July-December] [Volumn:2 ] [Number:2] [Pages:60] [Pages No:62-64][No of Hits : 825]


ABSTRACT

Aims and objectives: To compare the efficacy of VIA and Pap smear for detection of premalignant and malignant lesions of cervix.

Materials and methods: Two hundred and forty women attending outpatient department of obstetrics and gynecology were subjected to detailed history taking, clinical examination, Pap smear and VIA, and biopsies were indicated.

Results: Of 240 patients, 27 patients (11.3%) were Pap positive and 28 patients (11.7%) were VIA positive. A total of 39 patients in whom either test was positive, had undergone cervical biopsy. Sensitivity of VIA and Pap smear was 92 and 84% respectively and specificity of VIA and Pap smear was 64.3 and 57% respectively.

Conclusion: The study concluded that sensitivity of VIA is comparable to Pap. Therefore, VIA is an efficacious and costeffective method to screen premalignant and malignant lesions of cervix, especially in developing countries like ours.

Keywords: Pap smear, VIA, Cervical biopsy.

How to cite this article: Agarwal S, Gupta S, Chutani N, Gulati SS. Visual Inspection of Cervix with Acetic Acid as a Screening Test for Premalignant and Malignant Lesions of Cervix. J South Asian Feder Menopause Soc 2014;2(2):62-64.

Source of support: Nil

Conflict of interest: None


 
Guest Editorial
Jaideep Malhotra, Ruchika Garg, Prabhat Agrawal

PHYTOESTROGENS-WHAT IS THE CURRENT EVIDENCE?

[Year:2014] [Month:January-June] [Volumn:2 ] [Number:1] [Pages:56] [Pages No:vi-vii][No of Hits : 822]


ABSTRACT

PHYTOESTROGENS-WHAT IS THE CURRENT EVIDENCE?

Foods phytoestrogen molecules can be divided into major chemical classes-isoflavones and coumestans. The isoflavones are found predominantly in soybeans, whereas coumestans are produced primarily by clovers and some legumes Genistein is a phytoestrogen found in leguminase. These molecules function as antioxidant in plants, but in mammalian tissues these natural products act as agonists or partial agonist of estrogens. Isoflavones including daidzin, diadzein, genistein and genistin are present in soyabean at a comparatively higher concentration.


 
Review Article
Jaideep Malhotra, Ruchika Garg, S Shantha Kumari, Amit Tandon, Meenal Jain, Neharika Malhotra

Managing Vasomotor Symptoms in Menopausal Women

[Year:2014] [Month:July-December] [Volumn:2 ] [Number:2] [Pages:60] [Pages No:87-90][No of Hits : 793]


ABSTRACT

Patients usually under-report symptoms of incontinence. Therefore, improved physician-patient communication is vital. Most urinary incontinence can be evaluated and treated after careful history and simple clinical assessment. Initial treatment, for both urge urinary incontinence and stress urinary incontinence, is lifestyle modification and pelvic floor muscle exercises. Urgency responds to bladder training and drug therapy with anticholinergic medication. Pharmacotherapy has a limited place in stress incontinence.

Keywords: Urinary incontinence, Overactive bladder, Anticholinergic drugs.

How to cite this article: Malhotra J, Garg R, Kumari SS, Tandon A, Jain M, Malhotra N. Managing Vasomotor Symptoms in Menopausal Women. J South Asian Feder Menopause Soc 2014;2(2):87-90.

Source of support: Nil

Conflict of interest: None


 
Case Report
Rukshana, Amulya, O Syamala, G Usha Rani

A Case Report of Ovarian Fibrothecoma mistaken for a Fibroid

[Year:2014] [Month:July-December] [Volumn:2 ] [Number:2] [Pages:60] [Pages No:101][No of Hits : 789]


ABSTRACT

Keywords: Fibrothecoma, Ovarian tumor, Edema.

How to cite this article: Rukshana, Amulya, Syamala O, Rani GU. A Case Report of Ovarian Fibrothecoma mistaken for a Fibroid. J South Asian Feder Menopause Soc 2014;2(2):101.

Source of support: Nil

Conflict of interest: None


 
Case Report
Shazia Parveen, Seema Hakim

A Rare Presentation of Cervical Pregnancy

[Year:2014] [Month:January-June] [Volumn:2 ] [Number:1] [Pages:56] [Pages No:40-41][No of Hits : 785]


ABSTRACT

Cervical pregnancy is a pregnancy where implantation occurs in the cervix of uterus rather than occurring in the uterine cavity. It is a rare life-threatening condition so early diagnosis and treatment can save life. Here, we are reporting a case of cervical pregnancy which presented to us with amenorrhea and bleeding per vaginum after misoprostol intake.

Keywords: Ectopic pregnancy, Cervical pregnancy, Misoprostol.

How to cite this article: Parveen S, Hakim S. A Rare Presentation of Cervical Pregnancy. J South Asian Feder Menopause Soc 2014;2(1):40-41.

Source of support: Nil

Conflict of interest: None


 
Review Article
Saroj Singh, Ruchika Garg, Prabhat Agrawal, Neha Agrawal

Urinary Incontinence: The Distressing Problem

[Year:2014] [Month:July-December] [Volumn:2 ] [Number:2] [Pages:60] [Pages No:83-86][No of Hits : 764]


ABSTRACT

The prevalence of urinary incontinence (UI) in India is as high as 30%. Since, patients do not directly report the problem of incontinence leading questions regarding incontinence should be a routine part of history taking in gynecology.
Older patients may assume that UI is a normal consequence of aging. Incontinence is not a normal part of ageing, but it becomes a clinical problem in ageing women due to trauma of child birth, acute and chronic illnesses, loss of estrogenic stimulation at menopause and weaker pelvic support.
A stepped management strategy is recommended beginning with lifestyle modification, then behavioral therapy, then medications and finally surgery. First-line treatment to women with stress or mixed UI is pelvic floor exercises.1
Bladder training lasting for a minimum of 6 weeks should be offered as first-line treatment to women with urge or mixed UI. Most urinary incontinence can be evaluated and treated in the primary care setting after careful history and simple clinical assessment. Initial treatment, for both urge urinary incontinence and stress urinary incontinence, is lifestyle modification and pelvic floor muscle treatment. Urinary urgency responds to bladder training and pharmacotherapy with anticholinergic medication. Pharmacotherapy has a limited place in stress incontinence.

Keywords: Urinary incontinence, Stress urinary incontinence, Overactive bladder.

How to cite this article: Singh S, Garg R, Agrawal P, Agrawal N. Urinary Incontinence: The Distressing Problem. J South Asian Feder Menopause Soc 2014;2(2):83-86.

Source of support: Nil

Conflict of interest: None


 
Editor's Note
Rubina Sohail

Editor's Note

[Year:2014] [Month:January-June] [Volumn:2 ] [Number:1] [Pages:56] [Pages No:iv][No of Hits : 737]


ABSTRACT

Welcome to the Readers of the SAFOMS journal. The journal is still in its nascent phase. The editorial board is striving to gain from the experience of the senior faculty by having publications from them and to encourage young writers to bring their work for publication. We are also endeavoring to bring together and compose a journal, which has literature of high quality.


 
Original Article
Nahar Kamrun, Azad Lucky Tarana Tanjima

A Study on Clinical Presentation of Menopause and HRT

[Year:2014] [Month:July-December] [Volumn:2 ] [Number:2] [Pages:60] [Pages No:59-61][No of Hits : 675]


ABSTRACT

It is a prospective study done in a private clinic, Mymensingh, Bangladesh, to evaluate the clinical presentation, requirement of hormone replacement therapy (HRT) and outcome among the menopausal women so that attention can be given to address this problem. A total of 100 cases were analyzed during the period from January 2001 to December 2001. Out of 100, 28 had surgical menopause following hysterectomy with bilateral salpingo-oophorectomy and 72 had natural menopause. Treatment regimen were counseling, symptomatic treatment and HRT. Pap smear was done in all our cases. Out of 100 cases, 70 cases required HRT. Common clinical presentation was urogenital problem in our study. After 3 months follow-up, 56% were on HRT.

Keywords: Menopause, Clinical presentation, HRT.

How to cite this article: Kamrun N, Tanjima ALT. A Study on Clinical Presentation of Menopause and HRT. J South Asian Feder Menopause Soc 2014;2(2):59-61.

Source of support: Nil

Conflict of interest: None


 
Case Report
Mridu Sinha, Ruchee Khandelwal

A Case of Stump Carcinoma with Incisional Site Metastasis

[Year:2014] [Month:July-December] [Volumn:2 ] [Number:2] [Pages:60] [Pages No:95-96][No of Hits : 666]


ABSTRACT

An abdominal wall incisional metastasis from an internal malignancy is rare. In developing countries, carcinoma cervix is the most common genital malignancy in women, cutaneous involvement is rare.

Keywords: Incisional site metastasis, Cervical stump carcinoma.

How to cite this article: Sinha M, Khandelwal R. A Case of Stump Carcinoma with Incisional Site Metastasis. J South Asian Feder Menopause Soc 2014;2(2):95-96.

Source of support: Nil

Conflict of interest: None


 
Journal Scan
VW Henderson, BB Sherwin

Surgical vs Natural Menopause: Cognitive Issues

[Year:2014] [Month:January-June] [Volumn:2 ] [Number:1] [Pages:56] [Pages No:54-55][No of Hits : 635]


ABSTRACT

Objective

Women who undergo both natural and surgical menopause experience the loss of cyclic ovarian production of estrogen, but hormonal and demographic differences distinguish these two groups of women. Our objective was to review published evidence on whether the premature cessation of endogenous estrogen production in women who underwent a surgical menopause has deleterious consequences for cognitive aging and to determine whether consequences differ for women if they undergo natural menopause. Studies of estrogen-containing hormone therapy are relevant to this issue.

Design

We reviewed evidence-based research, including the systematic identification of randomized clinical trials of hormone therapy with cognitive outcomes that included an objective measure of episodic memory.

Results

As inferred from very small, short-term, randomized, controled trials of high-dose estrogen treatment, surgical menopause may be accompanied by cognitive impairment that primarily affects verbal episodic memory. Observational evidence suggests that the natural menopausal transition is not accompanied by substantial changes in cognitive abilities. For initiation of hormone therapy during perimenopause or early postmenopause when the ovaries are intact, limited clinical trial data provide no consistent evidence of short-term benefit or harm. There is stronger clinical trial evidence that initiation of hormone therapy in late postmenopause does not benefit episodic memory or other cognitive skills.

Conclusion

Further research is needed on the long-term cognitive consequences of surgical menopause and long-term cognitive consequences of hormone therapy initiated near the time of surgical or natural menopause. A potential short-term cognitive benefit might be weighed when a premenopausal woman considers initiation of estrogen therapy at the time of, or soon after, hysterectomy and oophorectomy for benign conditions, although data are still quite limited and estrogen is not approved for this indication. Older postmenopausal women should not initiate hormone therapy to improve or maintain cognitive skills.


 
Review Articles
Surveen Ghumman

Atrophic Vaginitis-Diagnosis and Treatment

[Year:2013] [Month:January-June] [Volumn:1 ] [Number:1] [Pages:44] [Pages No:4-12][No of Hits : 9775]


ABSTRACT

Atrophic vaginitis is an inflammation of the vagina which develops when there is a significant decrease in estrogen levels after menopause. The initial and most common symptom is often lack of lubrication during intercourse. Eventually, persistent vaginal dryness may occur leading to dyspareunia. The onset of symptoms may not be immediate and may occur 3 to 4 years after menopause. Nonhormonal treatment includes vaginal moisturizers for atrophy symptoms, lubricants for dyspareunia, hyaluronic acid vaginal tablets and phtoestrogens. Estrogens are known to increase vascularity, secretions and thickness of vagina and decrease vaginal pH. They can be given both systemically or vaginally. Local therapy has been found to be more efficacious than systemic therapy and has the advantage of not having systemic adverse effects. They can be given as pessaries, creams or rings. Delivery system used should be convenient to patient so that therapy is consistent, as that is critical for effect. Improvement in vaginal atrophy symptoms starts within a few weeks of starting vaginal estrogen but, some may need to use it for 4 to 6 weeks before adequate improvement is observed. Selective estrogen receptor modulator bazedoxifene may be combined with estrogens. Postmenopausal vaginal atrophy is a common cause of easily treatable distressing symptoms which severely affect quality of life.

Keywords: Menopause, Vaginitis, Atrophy, Dyspareunia, Estrogens, Hyaluronic acid.

How to cite this article: Ghumman S. Atrophic Vaginitis: Diagnosis and Treatment. J South Asian Feder Menopause Soc 2013;1(1):4-12.

Source of support: Nil

Conflict of interest: None declared


 
Original Articles
Ragweshwar Jyoti, Payal Gupta, Rohini Rao, PL Sood, Neelam Parasher

Correlation between Colposcopy, Cytology and Histopathology in High-risk Patients for Cervical Cancer in Perimenopausal Women in Himachal Pradesh, India

[Year:2013] [Month:January-June] [Volumn:1 ] [Number:1] [Pages:44] [Pages No:21-23][No of Hits : 4146]


ABSTRACT

Objectives: To determine the correlation between cytology, colposcopy and histopathology, individually and in combination, in high-risk patients for detection of early cancer of the cervix.

Materials and methods: A total of 200 high-risk patients in the age groups of 35 to 60 years were included in the study. Pap smear, colposcopy and colposcopically directed biopsies were taken from the suspicious area.

Results: Sensitivity, specificity and positive predictive value of Pap smear are 65.2, 96.3 and 89.3% respectively. Correlation between cytology and colposcopy was 81%, between colposcopy and histopathology was 90.6%, between cytology, colposcopy and histopathology was 90.6% and between cytology, colposcopy and histopathology was 87.3%.

Conclusion: Combination of various methods increases the diagnostic accuracy over that of each method separately.

Keywords: Cervical intraepithelial neoplasia, Low grade squamous intraepithelial lesion, High grade squamous intraepithelial lesion, Carcinoma in situ.

How to cite this article: Jyothi R, Gupta P, Rao R, Sood PL, Parasher N. Correlation between Colposcopy, Cytology and Histopathology in High-risk Patients for Cervical Cancer in Perimenopausal Women in Himachal Pradesh, India. J South Asian Feder Menopause Soc 2013;1(1):21-23.

Source of support: Nil

Conflict of interest: None declared


 
Original Articles
Shikha Seth, Ekta Singh, AS Mathur, Garima Gupta, Arun Nagrath

Low-dose Mifepristone (25 mg) in Treatment of Uterine Myoma in Perimenopausal Women

[Year:2013] [Month:January-June] [Volumn:1 ] [Number:1] [Pages:44] [Pages No:34-37][No of Hits : 3467]


ABSTRACT

Objectives:To evaluate the effect of low-dose mifepristone (25 mg) on symptomatic myoma in perimenoapausal women.

Study design: Prospective observational clinical trial.

Materials and methods: Ninety-three perimenopausal women of age 35 to 50 years having symptomatic myoma were selected from gynecology outpatient department and given 25 mg mifepristone once daily continuously for 3 months. Baseline uterine size, uterine volume, myoma size, volume, their number, position, characteristics, hemoglobin and blood parameters, were taken and followed monthly for 6 months. Bleeding and pain scores were checked on monthly visits. Change in above parameters were tabulated during the first 3 months treatment phase and then next 3 months post-treatment phase for analysis.

Statistical analysis: Done by calculating mean, standard deviation, standard error and percentage distribution of variables.

Results: Menorrhagia was the commonest symptom which led patients to report to hospital. Mean uterine volume reduced to 63.69% of baseline, mean dominant myoma volume reduced to 53.62% and hemoglobin level raised to 137% after complete treatment of 3 months. Changes persisted in next 3 months post-treatment follow-up, while hysterectomy was required in 10 (12.2%) cases.

Conclusion: Three months treatment of 25 mg mifepristone effectively controls bleeding, reduces the uterine and myoma volume and thus can avoid blood transfusion and hysterectomy in a lot of symptomatic myoma cases.

Keywords: Mifepristone, Myoma, Medical treatment, Antiprogesterone.

How to cite this article: Seth S, Singh E, Mathur AS, Gupta G, Nagrath A. Low-dose Mifepristone (25 mg) in Treatment of Uterine Myoma in Perimenopausal Women. J South Asian Feder Menopause Soc 2013;1(1):34-37.

Source of support: Nil

Conflict of interest: None declared


 
Case Report
Anuradha Kakani, Indradeep Bannerjee, Deepti Shrivastava

A Huge Dermoid Cyst in Postmenopausal Women with Third Degree Uterine Prolapse

[Year:2013] [Month:January-June] [Volumn:1 ] [Number:1] [Pages:44] [Pages No:43-44][No of Hits : 3340]


ABSTRACT

Germ cell tumors are derived from primordial germ cells of the ovary. Approximately 25 to 30% of all ovarian tumors are of germ cell origin and of these, 95% are benign and only 3 to 4% are malignant. They are seen mostly in women in their second and third decades of life and very rarely in postmenopausal women.
There are many reported cases of ovarian tumor in postmenopausal women but a huge dermoid cyst in postmenopausal women causing prolapse uterus is very rare. Here, we are presenting a rare case of large dermoid cyst in a 58-year-old postmenopausal multiparous woman with third degree uterine prolapse.

Keywords: Dermoid cyst, Prolapse uterus, Postmenopausal age.

How to cite this article:Kakani A, Bannerjee I, Shrivastava D. A Huge Dermoid Cyst in Postmenopausal Women with Third Degree Uterine Prolapse. J South Asian Feder Menopause Soc 2013;1(1):43-44.

Source of support: Nil

Conflict of interest: None declared


 
Original Articles
Saadia Mujahid, Afzal Ahmed Siddiqui, Rubina Hussain

Awareness of Menopausal Symptoms among Young Pakistani Women of Different Educational Backgrounds

[Year:2013] [Month:January-June] [Volumn:1 ] [Number:1] [Pages:44] [Pages No:18-20][No of Hits : 3001]


ABSTRACT

Menopause has significant effects on a woman’s quality of life. It is important that women realise these changes and are better equipped to look after their needs in this age group, to be able to postpone or prevent those risks. Educating them regarding these symptoms would definitely equip them better to avoid and reduce many adverse emotional and psychological symptoms of menopause.

Keywords: Menopause, Pakistan, Symptoms, Education.

How to cite this article: Mujahid S, Siddiqui AA, Hussain R. Awareness of Menopausal Symptoms among Young Pakistani Women of Different Educational Backgrounds. J South Asian Feder Menopause Soc 2013;1(1):18-20.

Source of support: Nil

Conflict of interest: None declared


 
Reflections
Behram S Anklesaria

The Staging of Menopause

[Year:2013] [Month:January-June] [Volumn:1 ] [Number:1] [Pages:44] [Pages No:1-3][No of Hits : 2759]


ABSTRACT

Staging of menopause not published and needed to be defined for long-term consequences and their management. This staging based on duration, event and action seems to be relevant. Each stage duration is highly variable, but a rough 5 years per stage calculation is clinically useful. Our ‘staging of menopause’ has now become the best method to understand the symptomatology, the complications and the management of a woman’s best years—the menopause!

Keywords: Menopause, Staging, Symptomatology.

How to cite this article: Anklesaria BS. The Staging of Menopause. J South Asian Feder Menopause Soc 2013;1(1): 1-3.

Source of support: Nil

Conflict of interest: None declared


 
Original Articles
Nidhi Gupta

Adnexal Masses in Perimenopausal Women: How Effective is Color Flow Mapping and Pulse Doppler Waveform Studies in Detecting Malignancy Preoperatively?

[Year:2013] [Month:January-June] [Volumn:1 ] [Number:1] [Pages:44] [Pages No:27-33][No of Hits : 2734]


ABSTRACT

Objective:This prospective study was undertaken to assess the sensitivity and specificity of color flow mapping and pulse Doppler waveform in identifying malignancy preoperatively in adnexal masses in perimenopausal women.

Materials and methods: A total of 100 cases with adnexal masses in perimenopausal women were scanned, underwent color flow mapping and pulsed Doppler waveform studies. These cysts were divided into three groups according to their ultrasound appearance – cystic, mixed cystic and solid. All the adnexal mases were removed surgically and sent for histopathological study.

Results: The sensitivity and specificity of color flow mapping in identifying malignant ovarian tumors was 63.6 and 87.0% respectively. In the case of solid cysts, color flow mapping identified all malignant tumors. But, color flow mapping missed malignancies in cystic and mixed cystic masses. To improve detection rates, we used Doppler waveform studies and used resistance index less than 0.4 as the indicator of malignancy and found overall sensitivity and specificity of 90.9 and 92.3%, which was higher than that of color flow mapping.

Conclusion: To conclude ultrasonic color flow mapping and pulse Doppler waveform studies used preoperatively on adnexal masses in perimenopausal women are widely available, performed rapidly and relatively easily, cost-effective and a reliable noninvasive method to predict malignancy preoperatively.

Keywords: Adnexal masses, Color flow mapping, Neovascularization, Pulsed, Doppler waveform, Resistivity index.

How to cite this article: Gupta N. Adnexal Masses in Perimenopausal Women: How Effective is Color Flow Mapping and Pulse Doppler Waveform Studies in detecting Malignancy Preoperatively? J South Asian Feder Menopause Soc 2013;1(1):27-33.

Source of support: Nil

Conflict of interest: None declared


 
Review Articles
Sabera Khatun, Jannatul Ferdous

Menopause and Gynecological Malignancy

[Year:2013] [Month:July-December] [Volumn:1 ] [Number:2] [Pages:45] [Pages No:75-79][No of Hits : 2683]


ABSTRACT

Menopause is a consequence of biological aging. Menopause does not cause cancer, but the risk of developing cancer increase as a woman ages. Treatment of cancer can also cause premature menopause. Among the gynecological cancer, cervical cancer tops the list of common cancer. Postmenopausal women are prone to have persistent human papillomavirus (HPV) infection. There is no role of primary prevention of cervical cancer by vaccination in postmenopausal women. Secondary prevention by Paps smear only may provide false negative result as the cervix is often flushed with the vagina. So, scraping by Ayres spatula and using endometrial brush is necessary in these women. Unfortunately, symptoms of cervical cancer in postmenopausal women are nonspecific and associated with comorbidities. So, any symptom of cervical cancer in postmenopausal women should be properly evaluated. Ovarian cancer is the number one cancer of death among all gynecologic malignancies. Majority of the ovarian cancer in postmenopausal women present with vague symptom and have the advance stage at prevention. Currently, no reliable screening test is available. Yearly routine pelvic examination, transvaginal ultrasonography and serum CA-125 can be performed in selective high-risk women only. Endometrial cancer is the most common gynecologic cancer in the USA. Most endometrial carcinomas are diagnosed at an early stage and have a good prognosis. Though vulvar and vaginal cancer are rare malignancies, yet these are prevalent in postmenopausal women. Any postmenopausal women with long-term intense itching, pervaginal discharge or any ulcer of vulva or vagina should be evaluated properly.

Keywords: Menopause, Malignancy, Cervix, Ovary, Endometrium.

How to cite this article: Khatun S, Ferdous J. Menopause and Gynecological Malignancy. J South Asian Feder Menopause Soc 2013;1(2):75-79.

Source of support: Nil

Conflict of interest: None declared


 
Case Report
Tasneem Ashraf, Samia Haroon

Uterine Inversion in Postmenopausal Woman: A Rare Entity

[Year:2013] [Month:July-December] [Volumn:1 ] [Number:2] [Pages:45] [Pages No:88-90][No of Hits : 2139]


ABSTRACT

Uterine inversion in old age is a rare complication. Submucosal fibroid or polyp is mostly the cause of nonpuerperal inversion. Diagnosis can be made on physical examination but it may be difficult. Management consists of manual reposition of uterus or surgery either through abdominal or vaginal route.
We report a case of nonpuerperal uterine inversion in an unmarried nulliparous postmenopausal Baloch woman having lemon size submucosal fibroid and presented with complete prolapsed inversion. Diagnosis was made clinically and confirmed at laparotomy. At laparotomy inversion was corrected first then total abdominal hysterectomy with bilateral salpingooophorectomy was carried out.

Keywords: Uterine inversion, Nonpuerperal inversion, Menopausal, Fibroid polyp, Uterovaginal prolapse.

How to cite this article: Ashraf T, Haroon S. Uterine Inversion in Postmenopausal Woman: A Rare Entity. J South Asian Feder Menopause Soc 2013;1(2):88-90.

Source of support: Nil

Conflict of interest: None declared


 
Original Articles
Swaraj Rajbhandari, A Amatya, Kanti Giri

Relation of Ethnicity and Menopausal Symptoms in Nepal

[Year:2013] [Month:July-December] [Volumn:1 ] [Number:2] [Pages:45] [Pages No:50-55][No of Hits : 1980]


ABSTRACT

A cross-sectional study was conducted among women of different ethnic groups aged 40 to 60 years and health workers in different parts of Nepal using focus group discussions (FGDs), key informant interviews (KIIs) and clinical examinations to determine the symptoms and complains related to menopause.
The mean age at menarche was 15 years and the mean age of menopause was 47. The highest menarche and menopause (50 years) was found to be among the Gurung women. Mean age of menopause was found to be higher among currently older women (52 years among 60+ women vs 41 years among <45 years women) and unmarried women. Tharu perimenopausal women and Sarki, Gurung and Tharu postmenopausal women were found to have relatively more regular menstrual cycles. However, Tharu perimenopausal women were found to have excess bleedings during the menstrual cycle.
Most of the women had heard about menopause but did not have detailed knowledge on it. Loss of sexual interest (95.3%), decreased visual activity (58%), joint pain (31.3%) and body pain (31.3%) were the most commonly reported menopausal symptoms. Mean body mass index (BMI) was highest among the Gurung women (both perimenopausal and postmenopausal). Pap smear was normal in all 138 women but around 50% had some cervical and vaginal-related problems. One-third of Tharu postmenopausal women had atropic labia and onethird of Tamang women had leukoderma.
Since, very little knowledge is known about the postmenopausal symptoms and problems in Nepal, this study can serve as the basis for further researches in this area with an increased sample size.

Keywords: Ethnic groups, Menarche, Perimenopause, Postmenopause, Menopausal symptoms.

How to cite this article: Rajbhandari S, Amatya A, Giri K. Relation of Ethnicity and Menopausal Symptoms in Nepal. J South Asian Feder Menopause Soc 2013;1(2):50-55.

Source of support: Nil

Conflict of interest: None declared


 
Original Articles
Richa Singh, Saroj Singh, Anu Pathak, Prashant Lavania, Purnima

A Comparative Study of Urogenital Problems and Urodynamic Changes in Postmenopausal Women with Natural Menopause and Surgical Menopause

[Year:2013] [Month:January-June] [Volumn:1 ] [Number:1] [Pages:44] [Pages No:38-42][No of Hits : 1762]


ABSTRACT

Noninvasive urodynamics (UDS) consists of tests [voiding diaries, flowmetry, postvoid residual estimation and pad tests], which do not require any patient manipulation. In contrast, invasive UDS warrants the insertion of catheters, transducers, and/or needle sets into the patients. While noninvasive tests are useful for screening or diagnosis, invasive tests are necessary to confirm the diagnosis and refine the findings. Urodynamic evaluation is a good predictor of outcomes after therapeutic intervention.

Keywords: Natural menopause, Surgical menopause, Urodynamics.

How to cite this article: Singh R, Singh S, Pathak A, Lavania P, Purnima. A Comparative Study of Urogenital Problems and Urodynamic changes in Postmenopausal Women with Natural Menopause and Surgical Menopause. J South Asian Feder Menopause Soc 2013;1(1):38-42.

Source of support: Nil

Conflict of interest: None declared


 
Review Articles
Jaideep Malhotra, Ruchika Garg, Prabhat Agrawal

Urinary Incontinence: An Update

[Year:2013] [Month:January-June] [Volumn:1 ] [Number:1] [Pages:44] [Pages No:13-17][No of Hits : 1714]


ABSTRACT

Patients usually under-report symptoms of incontinence. Therefore, improved physician-patient communication is vital . Most urinary incontinence can be evaluated and treated after careful history and simple clinical assessment. Initial treatment, for both urge urinary incontinence and stress urinary incontinence, is lifestyle modification and pelvic floor muscle exercises.
Urgency responds to bladder training and drug therapy with anticholinergic medication. Pharmacotherapy has a limited place in stress incontinence.

Keywords: Urinary incontinence, Overactive bladder, Anticholinergic drugs.

How to cite this article: Malhotra J, Garg R, Agrawal P. Urinary Incontinence: An Update. J South Asian Feder Menopause Soc 2013;1(1):13-17.

Source of support: Nil

Conflict of interest: None declared


 
Review Articles
Jaideep Malhotra, Urvashi Verma, Ruchika Garg, Neharika Malhotra

Menopause—Nonhormonal Approach: What’s New?

[Year:2013] [Month:July-December] [Volumn:1 ] [Number:2] [Pages:45] [Pages No:70-74][No of Hits : 1705]


ABSTRACT

Like birth, menarche, puberty, pregnancy/delivery, menopause is also a very important natural biological event in any woman’s life. Practically it’s the time when a woman can enjoy life more freely with other responsibilities. As with increased life expectancy about one third of life span has to be spent without menstruation. For so long period a woman can not afford estrogen replacement especially because of its side effects and complications. That’s why we have to search for better and safer options.

Keywords: Menopause, Hormone replacement therapy, Osteoporosis, Phytoestrogens, SERM.

How to cite this article: Malhotra J, Verma U, Garg R, Malhotra N. Menopause-Nonhormonal Approach: What’s New? J South Asian Feder Menopause Soc 2013;1(2):70-74.

Source of support: Nil

Conflict of interest: None declared


 
Review Articles
Laila Arjumand Banu

Cognitive Changes in Menopause

[Year:2013] [Month:July-December] [Volumn:1 ] [Number:2] [Pages:45] [Pages No:80-81][No of Hits : 1644]


ABSTRACT

During menopause,women undergo many changes in their mind and body, building a sense of insecurity. Though the main symptoms are Hot flushes, osteoporosis, cardiovascular and urogenital, but the cognitive functions, like speeching tasks, processing of unfamiliar information, complex problem solving, delayed recall, mental flexibility, and perceptional manipulation tasks, tend to decline. This decline is lesser in women,who have been more mentally and physically active in their youth.

Keywords: Menopause, Cognitve changes, Alzheimers, HRT.

How to cite this article: Banu LA. Cognitive Changes in Menopause. J South Asian Feder Menopause Soc 2013;1(2):80-81.

Source of support: Nil

Conflict of interest: None declared


 
Original Articles
Hemantha Perera, Supipi Karunanayake, Pubudu De Silva

Relationship of Psychological Morbidity and Quality of Life in Professional Females

[Year:2013] [Month:January-June] [Volumn:1 ] [Number:1] [Pages:44] [Pages No:24-26][No of Hits : 1516]


ABSTRACT

During peri and menopause, a variety of psychological issues crop up and the most likely ones are depression, burnout, alcohol abuse and chronic fatigue. The aim of this study was to describe the prevalence of psychological disturbances in female health workers and female media personnel, and it was observed that, health workers, majority were anxious and depressed 51 years and above, compared to the media staff, where anxiety was mainly noticed between 41 and 50 years, and depression was common in less than 40 years.

Keywords: Depression, Anxiety, Media staff, Health workers.

How to cite this article: Perera H, Karunanayake S, de Silva P. Relationship of Psychological Morbidity and Quality of Life in Professional Females. J South Asian Feder Menopause Soc 2013;1(1):24-26.

Source of support: Nil

Conflict of interest: None declared


 
Review Articles
MDP Gooneratne

Coronary Heart Disease in South-Asian Women

[Year:2013] [Month:July-December] [Volumn:1 ] [Number:2] [Pages:45] [Pages No:84-87][No of Hits : 1458]


ABSTRACT

With the demographic transition in the South-Asian region coronary heart disease in post menopausal women is a major challenge. Women with myocardial infarction often have atypical presentation and have a higher mortality. In South-Asia there is high prevalence of coronary heart disease among women and there is an increasing incidence in both urban and rural areas. While obesity and lack of exercise contribute largely to traditional risk factors in South-Asian women in midlife, nontraditional newer risk factors seem to play a major role in increased prevalence and mortality. Early prevention strategies targeting diet, physical exercise and mental stress are important in preventing further increase of coronary heart disease in South- Asian women.

Keywords: Coronary heart disease, South-Asian women, Predisposition, Prevalence, Risk factors.

How to cite this article: Gooneratne MDP. Coronary Heart Disease in South-Asian Women. J South Asian Feder Menopause Soc 2013;1(2):84-87.

Source of support: Nil

Conflict of interest: None


 
Original Articles
Savita A Somalwar, Sulabha Joshi, Anjali Kawthalkar, Anuja Bhalerao, Sheela Jain, Ashutosh Somalwar

Analysis of Genital Tract Malignancies in Postmenopausal Indian Women

[Year:2013] [Month:July-December] [Volumn:1 ] [Number:2] [Pages:45] [Pages No:66-69][No of Hits : 1337]


ABSTRACT

Introduction: Genital malignancies in women varies widely from developed to developing countries. Postmenopausal women are at risk of developing various genital malignancies.

Objectives: (1) To determine frequency of genital tract malignancies in postmenopausal women, (2) to determine the type and stage of genital tract malignancies, (3) to create awareness of screening in women.

Materials and methods: This descriptive cross-sectional study was carried out over a period of 2 years from March 2010 to Feb. 2012. It included 200 postmenopausal women admitted with complaints like mass or fullness of abdomen, bleeding or discharge per vaginal and ulcer over vulva. They were evaluated clinically followed by relevant investigations. Malignancy was confirmed by histopathology report.

Results: Out of 200 postmenopausal women admitted during study period, malignancy was confirmed in 55 women (27.5%). The type of malignancy was cervical carcinoma (30, 54.54%), ovarian carcinoma (18, 32.72%), carcinoma endometrium (5, 9.09%), carcinoma vulva (1, 1.81%) and carcinoma vagina (1, 1.81%). Majority of carcinoma cervix and ovarian carcinoma were in advanced stage.

Conclusion: Carcinoma cervix was commonest genital malignancy found our study followed by carcinoma ovary. Importance of routine gynecological check-up in postmenopausal women was emphasised.

Keywords: Postmenopausal, Malignancy, Carcinoma.

How to cite this article: Somalwar SA, Joshi S, Kawthalkar A, Bhalerao A, Jain S, Somalwar A. Analysis of Genital Tract Malignancies in Postmenopausal Indian Women. J South Asian Feder Menopause Soc 2013;1(2):66-69.

Source of support: Nil

Conflict of interest: None declared


 
Original Articles
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[Year:2013] [Month:July-December] [Volumn:1 ] [Number:2] [Pages:45] [Pages No:63-65][No of Hits : 1183]