scholarly journals Comparative evaluation of menstrual patterns and hormonal profiles in normal and abnormal perimenopause

2019 ◽  
Vol 8 (9) ◽  
pp. 3556
Author(s):  
Harshiba Kaur ◽  
Neerja Goel
Keyword(s):  
Comparative Evaluation ◽  
Clinical Symptoms ◽  
Solid Phase ◽  
Abnormal Uterine Bleeding ◽  
Preventive Therapy ◽  
Menopausal Symptoms ◽  
Significant Difference ◽  
Reproductive Ageing ◽  
The Difference ◽  
Post Menopausal

Background: Currently there is only one marker to objectively establish perimenopause ie menstrual irregularities. Due to the wide variation in hormones like LH, FSH, estradiol, they become unreliable in predicting approaching menopause. This study was conducted to study and compare the patterns of LH, FSH and Estradiol in normal and abnormal perimenopause using the Stages of Reproductive Ageing Workshop (STRAW) criteria.Methods: A comparative evaluation was done after enrolling 200 patients out of which 100 women were in normal perimenopause (early-25 and late perimenopause-75, depending upon menstrual characteristics as defined by STRAW criteria) and 100 having AUB. Sociodemographic data, presence of menopausal symptoms were recorded. S. LH, S.FSH and S. estradiol we determined by adapted solid phase direct sandwich ELISA.Results: FSH was in menopausal ranges (>20IU/L) in early and late perimenopause. LH and FSH in women with AUB ranged from pre to post menopausal ranges. There was significant difference in LH and FSH between normal perimenopause and abnormal uterine bleeding. Estradiol levels showed a significant difference between late perimenopause and AUB p=0.015.Conclusions: This study shows that there is a progressive incremental trend in FSH and LH and decremental trend in Estradiol from early to late perimenopause due to decrease in ovarian follicular reserve, although the difference is not significant. Clinical symptoms present in 50% of late perimenopausal women showed that besides menstrual characteristics we can correlate these menopausal symptoms with raised FSH and low Estradiol. These women can be picked up and preventive therapy may be provided.

scholarly journals The Connection of the Level of Estradiol in Serum and Obesity with the Endometrial Bleeding in Postmenopausal Women

2019 ◽  
Vol 7 (1) ◽  
pp. 88-91 ◽  
Author(s):  
Valentina Tofiloska ◽  
Maria Krstevska ◽  
Ana Daneva-Markova ◽  
Viktorija Jovanovska
Keyword(s):  
Endometrial Cancer ◽  
Statistical Significance ◽  
Abnormal Uterine Bleeding ◽  
Control Group ◽  
Prospective Clinical Study ◽  
Study Group ◽  
Gynecology And Obstetrics ◽  
Increased Risk ◽  
Significant Difference ◽  
Post Menopausal

BACKGROUND: Postmenopausis is a period that begins one year after the last menstrual period. Abnormal uterine bleeding could be of different origins. AIM: This study aimed to determine the association of serum estrogen hormone levels and obesity with the occurrence of endometrial bleeding in post-menopausal women. MATERIAL AND METHODS: Prospective clinical study involving 120 postmenopausal patients treated at the University Clinic for Gynecology and Obstetrics-Skopje, divided into two groups: control and study. The control group consisted of 40 postmenopausal patients without endometrial bleeding, hospitalised and operated due to urogenital pathology. The study group consisted of 80 patients with endometrial bleeding who were divided into three subgroups according to the thickness of the endometrium: from 5-8 mm, 8-11 mm and above 11 mm. In all subjects, estradiol and BMI was determined. RESULTS: Estradiol levels were statistically higher in the study group compared to control while statistically significant difference among the three subgroups according to the thickness of the endometrium about the levels of estradiol in blood is not found. About BMI, the results showed that there was no statistical significance between the two examined groups. CONCLUSION: Patients with endometrial bleeding have increased levels of estradiol and are at increased risk of endometrial cancer about controls, the likelihood of endometrial cancer significantly increases by 1,108 times.

scholarly journals Association of Viral Load in SARS-CoV-2 Patients With Age and Gender

2021 ◽  
Vol 8 ◽  
Author(s):  
Waleed H. Mahallawi ◽  
Ali Dakhilallah Alsamiri ◽  
Alaa Faisal Dabbour ◽  
Hamdah Alsaeedi ◽  
Abdulmohsen H. Al-Zalabani
Keyword(s):  
Viral Load ◽  
Clinical Symptoms ◽  
Age Groups ◽  
Global Public Health ◽  
Surveillance Network ◽  
Ct Value ◽  
Significant Difference ◽  
The Difference ◽  
Mean Differences ◽  
Age And Sex

Background: The coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is a global public health emergency. Age and sex are two important factors associated with risks and outcomes of various diseases. COVID-19 morbidity also seems to be affected by patient age and sex. It has been found that older age groups have more severe COVID-19 symptoms and higher fatality rates while children tend to have lower prevalence and milder symptoms than adults.Methods: The study reviewed electronic medical records of COVID-19 patients from Madinah city, Saudi Arabia. The study included all cases who tested positive (n = 3,006) between March 20 and May 22, 2020. Data were obtained from the Health Electronic Surveillance Network (HESN) database.Results: Approximately 80% of the study sample were males and half were in the 30–40-year-old age group. The Ct value of the whole sample ranged from 15.08 to 35, with a mean of 27.44 (SD: 5.23; 95% C.I. = 27.25–27.66). The means of Ct values varied between age groups from 27.05 to 27.82. Analysis of the mean differences between age groups using one-way ANOVA indicated no statistically significant difference among the groups (F6,2999 = 1.63; p-value = 0.135). A comparison of mean Ct values of males (n = 2,422) and females (n = 584) revealed that males had a statistically significant higher mean Ct value (27.61 ± 5.20) than females (26.72 ± 5.31). The difference between the means of the two groups was −0.89 (95% C.I. = −1.36 to −0.42; t-test −3.71; df = 3,004; p-value < 0.001).Conclusion: The study found no statistically significant difference in viral loads between age groups. It showed that females had a higher SARS-CoV-2 viral load compared to males. The findings have implications for preventive strategies. Further studies are needed to correlate viral load with clinical symptoms and outcomes.

Endometrial biopsy in women with abnormal uterine bleeding: inadequate and unassessable categorisation is not clinically relevant

2014 ◽  
Vol 67 (8) ◽  
pp. 673-677 ◽  
Author(s):  
Ayman A A Ewies ◽  
Kadry A A Shaaban ◽  
Reena Merard ◽  
Ulises Zanetto
Keyword(s):  
Endometrial Thickness ◽  
Abnormal Uterine Bleeding ◽  
Final Diagnosis ◽  
Median Number ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Initial Finding ◽  
Significant Difference ◽  
The Difference ◽  
Clinical Records

AimsInadequate endometrial biopsy comprises a dilemma for gynaecologists and histopathologists alike. This study was conducted to assess the clinical merit of classifying scant endometrial biopsy into inadequate and unassessable using McCluggage criteria.MethodsWe retrospectively classified 268 endometrial biopsies, initially reported as inadequate, into inadequate (n=74) and unassessable (n=174) using McCluggage criteria after excluding 20 cases; all taken from patients aged ≥50 years with abnormal uterine bleeding attending Sandwell and West Birmingham Hospitals, UK from 1 January 2007 until 30 September 2012. The electronic clinical records were reviewed to find out the consequent clinical decisions and final outcomes. The follow-up period was 15 months after including the last patient.ResultsThe median age was 57 years (range: 50–97), and the median number of visits to hospital till the diagnosis was achieved was 2 (range: 1–4). The final diagnosis of endometrial hyperplasia or cancer was reported in 9 cases; 5 (7.1%) with an initial finding of inadequate and 4 with unassessable (2.4%); the difference was statistically insignificant (p=0.13). More patients in the inadequate category (82.4%) underwent further investigations when compared with the unassessable category (68.4%); the difference was statistically significant (p=0.029). There was no statistically significant difference in the inadequate to unassessable ratio when the endometrial thickness was ≥5 mm or <5 mm within the Pipelle group (p=0.46) or the curettage group (p=0.34).ConclusionsOur findings suggest that categorising scant endometrial specimens into inadequate or unassessable has no clinical implications. The gynaecologist should interpret the histopathology report in the light of clinical scenario.

scholarly journals Evaluation of Serum Human Epididymis Secretory Protein 4 (HE4) in Benign Endometrial Disease and Endometrial Cancer

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
S S Mohamed ◽  
M A Abdelhafeez ◽  
H F Mohamed ◽  
F M Abukra
Keyword(s):  
Endometrial Cancer ◽  
Abnormal Uterine Bleeding ◽  
Secretory Protein ◽  
Pelvic Lymphadenectomy ◽  
Younger Women ◽  
Human Epididymis ◽  
Significant Difference ◽  
Abnormal Bleeding ◽  
The Difference ◽  
Endometrial Pathology

Abstract Objective The incidence of endometrial cancer is constantly growing. More aggressive types of endometrial cancer as well as the incidence in younger women are being observed. More than 80% of cases are diagnosed in early stages due to early symptoms like abnormal bleeding. Aim of our study to evaluate the ability of serum HE4 concentration to differentiate between benign endometrial disease and endometrial cancer and ass’s correlation it with prognosis of EC. Material and methods Serum HE4 level was measured in 85 patients with abnormal uterine bleeding. Based on histology after curettage the study group was divided into the benign and malignant endometrial pathology groups. Statistical analysis was performed using Mann-Whitney test Results The difference of serum HE4 level between benign endometrial pathology and cancer was significant (p = 0.000) and the cut-off for identification of patients with endometrial cancer was 62 pmol/l. There was a significant difference between Stage (I – II) endometrial cancer, and Stage (III – IV) p = 0.01, Patients who needed lymphadenectomy had significantly higher HE4 level than those who had no indications for this procedure (p = 0,001). Conclusion HE4 is a useful biomarker in diagnosing endometrial cancer. HE4 is associated with high grade endometrial cancer. It can also serve as an useful preoperative counseling tool to identify patients, who may require pelvic lymphadenectomy.

scholarly journals Comparative Study Gallbladder Contractility Index Using Ultrasound in Patients with and without Liver Cirrhosis

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Hari Soekersi ◽  
Leni Santiana ◽  
Fetty Fatmawaty
Keyword(s):  
Liver Cirrhosis ◽  
Clinical Symptoms ◽  
T Test ◽  
Gallbladder Motility ◽  
Cross Sectional ◽  
Gallbladder Volume ◽  
Gallbladder Contractility ◽  
Significant Difference ◽  
The Difference ◽  
Cross Sectional Design

Liver cirrhosis leads to impairment of gallbladder contractility resulting in bile stasis and facilitate the development of gallstones that will aggravate the clinical symptoms of the patients. The gallbladder contractility index is an indicator of gallbladder motility measured using ultrasound as the radiological choice of modality. This study aims to determine differences in the gallbladder contractility index using ultrasound in patients with and without liver cirrhosis. This study was an observational study of comparative analytic with cross-sectional design with sampling conducted by consecutive admissions sampling at Dr. Hasan Sadikin General Hospital Bandung from December 2017 to February 2018. Statistical analysis than performed by using an independent t test to find out the difference of gallbladder contractility index in patients with and without liver cirrhosis. A total of 22 subjects, 12 men, 10 women, with the youngest 37 years old and the oldest 70 years old. The result of the study was obtained mean fasting gallbladder volume (35.56±22.16 mL) and postprandial (21.25±16.08 mL) in patients with liver cirrhosis higher than without liver cirrhosis with mean fasting gallbladder volume (16.50±4.14 mL) and postprandial (5.44±2.10 mL). The average gallbladder contractility index on patients with liver cirrhosis (41.64±24.52%) smaller than without liver cirrhosis (66.73±9.19%). The result of the statistical test showed that there was a significant difference in the gallbladder contractility index on patients with liver cirrhosis than without liver cirrhosis (p=0.007, p≤0.05). In conclusion, there was a significant difference in the gallbladder contractility index that measured by using ultrasound between the patients with and without liver cirrhosis. PERBEDAAN INDEKS KONTRAKTILITAS KANDUNG EMPEDU MENGGUNAKAN ULTRASONOGRAFI PADA PENDERITA SIROSIS HATI DAN TANPA SIROSIS HATISirosis hati menyebabkan gangguan indeks kontraktilitas kandung empedu yang mengakibatkan stasis cairan empedu dan memudahkan kejadian batu empedu yang akan memperberat gejala klinis pasien. Indeks kontraktilitas kandung empedu merupakan indikator motilitas kandung empedu yang diukur menggunakan ultrasonografi (USG) sebagai modalitas pilihan radiologi. Penelitian ini bertujuan mengetahui perbedaan indeks kontraktilitas kandung empedu menggunakan ultrasonografi pada pasien sirosis hati dan tanpa sirosis. Penelitian ini menggunakan studi observasional analitik komparatif dengan rancangan cross-sectional dan pengambilan sampel dilakukan secara consecutive admissions sampling di RSUP Dr. Hasan Sadikin Bandung dari bulan Desember 2017 hingga Februari 2018. Uji statistik menggunakan independent t test. Subjek penelitian berjumlah 22, laki-laki 12 dan perempuan 10, serta usia termuda 37 tahun dan tertua 70 tahun. Hasil penelitian didapatkan volume rerata kandung empedu puasa (35,56±22,16 mL) dan pascaprandial (21,25±16,08 mL) pada pasien sirosis hati lebih besar daripada tanpa sirosis hati dengan volume rerata kandung empedu puasa (16,50±4,14 mL) dan pascaprandial (5,44±2,10 mL). Indeks kontraktilitas rerata kandung empedu penderita sirosis hati (41,64±24,52%) lebih rendah dibanding dengan tanpa sirosis hati (66,73±9,19%). Hasil uji statistik menunjukkan terdapat perbedaan bermakna antara indeks kontraktilitas kandung empedu penderita sirosis hati dan tanpa sirosis hati (p=0,007; p≤0,05). Simpulan, terdapat perbedaan bermakna antara indeks kontraktilitas kandung empedu menggunakan USG pada penderita sirosis hati dan tanpa sirosis hati.

The role of 7-hydroxymatairezinol in modulation of estrogen metabolism and therapy for mastopathy

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (4) ◽  
pp. 43-48
Author(s):  
Anna N. Rubashkina ◽  
Nina P. Lapochkina ◽  
Ivan Yu. Torshin ◽  
Olga A. Gromova
Keyword(s):  
Clinical Symptoms ◽  
Solid Phase ◽  
Clinical Aspects ◽  
Estrogen Metabolism ◽  
Microsoft Excel ◽  
Quantitative Estimates ◽  
Daily Urine ◽  
Post Menopausal ◽  
Standard Sets

Quantitative estimates of the effect of 7-hydroxymatairesinol (7-HMR) intake on estrogen balance and clinical aspects of the course of fibrocystic mastopathy have been carried out. Aim. Assessment of effects 7-HMR on metabolism of estrogen (16a-OHE1, 2-OHE2, 2-OHE1, 2-OMEE1, 4-OMEE2, 4-OHE1, a ratio 2-OHE1/16a-OHE1, 2-OHE1/2-OMeE1 and 4-OHE1/4-OMeE1) and progesterone in daily urine at patients with fibrous and cystous mastopathy in the post-menopausal period. Materials and methods. The analysis of metabolites of estrogen (16a-OHE1, 2-OHE2, 2-OHE1, 2-OMEE1, 4-OMEE2, 4-OHE1, ratios 2-OHE1/16a-OHE1, 2-OHE1/2-OMeE1 and 4-OHE1/4-OMeE1) and progesterone in daily urine with use of solid-phase immunofermental set (IFA) of Amerscham International on the analyzer of Amerkard by means of standard sets is carried out. Statistical 10.0 and Microsoft Excel spreadsheets were used in statistical material processing. Results. It was found that taking 7-HMR (60 mg/day, 1 month) contributes to normalizing estrogen metabolism (decreasing estradiol, estrone, estriol, 16a-OHE1) and improves the clinical symptoms of mastopathy. Conclusions. In patients with FCM, 7-HMR contributes to a decrease in hyperestrogenia-related tumor risks by lowering estrogen metabolites levels.

scholarly journals Endometrial tissue sampling using pipelle versus dilatation and curettage for the assessment of endometrium in patients of perimenopausal and post-menopausal age: a prospective study

2018 ◽  
Vol 7 (10) ◽  
pp. 3951
Author(s):  
Nina Navakumar ◽  
Dhanya Dinesh ◽  
P. K. Syamala Devi
Keyword(s):  
Confidence Interval ◽  
Mode Of Delivery ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Tissue ◽  
Tissue Sampling ◽  
Endometrial Sampling ◽  
Study Population ◽  
The Difference ◽  
Post Menopausal ◽  
A Prospective Study

Background: The aim of this study is to compare the accuracy and adequacy of endometrial sampling using pipelle biopsy with dilatation and uterine curettage (D and C) and hysterectomy specimen in the assessment of endometrium in patients of perimenopausal and postmenopausal age.Methods: One hundred fifty patients of perimenopausal and postmenopausal age who attended the Gynecology OPD of KIMS Hospital from June 2012 to May 2014 with complaints of abnormal uterine bleeding or who were found to have abnormally thickened endometrium by ultrasonography were included in the study.Results: Adequate specimen could be obtained through pipelle biopsy in 86.7% of the patients, compared to 76% with adequate sample in case of D and C. Comparing histopathology reports between Pipelle and DandC specimens, the confidence interval was 92.7%, 95% lying in the range between 86.54% to 96.53%. 68 of the 150 patients had undergone hysterectomy for various reasons. Comparing histopathology reports between Pipelle and hysterectomy specimens, the confidence interval was 94.2%; 95% of study population lies within the C.I range of 84.05 %-98.79% while accounting for the whole population, which shows that Pipelle endometrial sampling can be considered to be almost accurate as HPE by hysterectomy specimen. Comparing the difficulty of the procedure, Pipelle biopsy was found to be easier in perimenopausal patients when compared to post-menopausal patients and the difference was statistically significant. Mode of delivery did not seem to affect the ease of Pipelle endometrial sampling as per present observations.Conclusions: Endometrial tissue sampling using Pipelle was found to be as reliable as D and C and hysterectomy specimen on histopathologic examination for the assessment of endometrium in perimenopausal and post-menopausal age group. Pipelle endometrial sampling was found to be yield adequate specimen when compared with D and C. 

scholarly journals Concentration of Transforming Growth Factor-beta 1 in Chronic Periapical Lesions / Ispitivanje koncentracije transformišućeg faktora rasta beta 1 u hroničnim periapeksnim lezijama

2015 ◽  
Vol 32 (1) ◽  
pp. 43-49 ◽  
Author(s):  
Jelena Popović ◽  
Tatjana Cvetković ◽  
Tanja Džopalić ◽  
Aleksandar Mitić ◽  
Marija Nikolić ◽  
...  
Keyword(s):  
Transforming Growth Factor Beta ◽  
Transforming Growth Factor ◽  
Clinical Symptoms ◽  
Periapical Lesion ◽  
Periapical Lesions ◽  
Three Samples ◽  
Significant Difference ◽  
Tissue Homogenates ◽  
Growth Factor Beta ◽  
The Difference

Summary Host response to antigen stimulation in chronic inflammatory periapical lesions is mainly controlled by the balance between proinflammatory and anti-inflammatory cytokines. The aim of this study was to determine the concentration of TGF-β1 in the tissue homogenates of periapical lesions and to analyse its level in relation to the symptomatology of the patients and size of the lesions. Ninety three samples of chronic periapical lesions were obtained after extraction of teeth. Samples were divided according to the clinical symptoms as symptomatic and asymptomatic, and according to the size as large and small. The concentration of TGF-β1 was analyzed using ELISA. The results showed increased production of TGF-β1 in symptomatic lesions compared to asymptomatic, but the difference was not statistically significant. Statistically significant difference in TGF-β1 concentrations was observed in large lesions compared to small (p<0,001). It seems that TGF-β1 have a modulating effect on bone tissue resorption activity under the influence of proinflammatory cytokines and can be molecular prognostic marker of periapical lesion healing.

scholarly journals The comparison of paroxetine and gabapentin in the management of postmenopausal symptoms

2021 ◽  
Vol 015 (02) ◽  
pp. 040-048
Author(s):  
Firoozeh Veisi ◽  
Tabassom Azadian ◽  
Maryam Zangeneh
Keyword(s):  
Rating Scale ◽  
Sleep Problems ◽  
Hot Flashes ◽  
Menopausal Symptoms ◽  
Treatment Groups ◽  
Memory Problems ◽  
Postmenopausal Symptoms ◽  
Significant Difference ◽  
Before And After ◽  
Post Menopausal

Objective: To compare the clinical efficacy of gabapentin, an anticonvulsant agent, and paroxetine, a selective serotonin reuptake inhibitor in the management of post-menopausal symptoms. Methods: In this clinical trial, two groups of patients with menopause who had hot flashes were included. One group received gabapentin (600 mg daily, 23 cases) for 8 weeks. The other group received paroxetine (one capsule daily at the morning or at bedtime, 23 cases) for 8 weeks. The MRS (Menopause Rating Scale) as well as the Beck’s Depression Inventory were used to assess the efficacy of the studied medications. Results: In paroxetine and gabapentin groups, hot flashes, sleep problems, muscle/joint pains, depression, irritability, anxiety, memory problems, and lack of concentration severity significantly decreased after 8 weeks of treatment. Only urinary problems in two treatment groups did not show any significant difference. There was no significant difference in dryness and burning sensation before and after gabapentin (P> 0.05). However, these changes were significant in paroxetine group (P <0.05). Conclusion: Both paroxetine and gabapentin were effective options in decreasing the severity of menopausal symptoms namely hot flashes, heart discomfort, sleep problems, and muscle/joint pains. In addition, the two medications had favorable results regarding psychological aspects of menopause.

scholarly journals Can Levothyroxine Be Taken as Evening Dose? Comparative Evaluation of Morning versus Evening Dose of Levothyroxine in Treatment of Hypothyroidism

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Rajesh Rajput ◽  
Sumanto Chatterjee ◽  
Meena Rajput
Keyword(s):  
Clinical Symptoms ◽  
Evening Dose ◽  
Similar Dose ◽  
Intergroup Comparison ◽  
Significant Difference ◽  
Drug Naïve ◽  
The Difference ◽  
Group 2 ◽  
Thyroid Profile ◽  
Group 1

152 drug naïve primary hypothyroid patients were divided into morning (Group 1) and evening (Group 2) dosing group and evaluated for change in biochemical profile, physical functioning and Quality of Life during the course of 12 weeks of study. At the end of 12 weeks 70 (90.90%) subjects in Group 1 and 72 (96%) in Group 2 achieved euthyroidism. On evaluation clinical symptoms and total clinical scores improved in both the groups at the end of 6 and 12 weeks. Significant improvement in thyroid profile was seen in both the groups at the end of 6 and 12 weeks (Pvalue <.0001). On intergroup comparison, no significant difference in thyroid profile was seen at 6 and 12 weeks between the morning and the evening dose group. Similar dose of levothyroxine was required to achieve euthyroidism in both the groups. Though an early restoration of euthyroidism was seen in evening group, the difference when compared to the morning group was not statistically significant. On assessment of QoL, statistically significant improvement in various parameters was seen in both the groups. Hence, from the study we inferred that evening dose is as efficacious as morning dose and provides an alternate dosing regimen.

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