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JAYPEE JOURNALS
International Scientific Journals from Jaypee
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1.  ORIGINAL ARTICLE
Clinical Pattern and Spectrum of Endometrial Pathologies in Abnormal Uterine Bleeding in Perimenopausal and Postmenopausal Women: Experience in a Tertiary Care Institute
Kavita Babbar, Sangeeta Jogi, RC Arya
[Year:2015] [Month:January-June] [Volume:3 ] [Number:1] [Pages:33] [Pages No:9-14] [No of Hits : 611]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10032-1062 | FREE

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

 
2.  Case Reports
Large Cystic Degeneration of Subserosal Fibroid and Diagnostic Dilemma
Nihar Ranjan Bhoi, Chintamani Mohanta, Sudha Agrawal, Amulya Kumar Panda
[Year:2015] [Month:July-December] [Volume:3 ] [Number:2] [Pages:31] [Pages No:60-63] [No of Hits : 532]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10032-1074 | FREE

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

 
3.  ORIGINAL ARTICLE
Menopausal Symptoms among Postmenopausal Women of North India: A Cross-sectional Study
Ruchika Garg, Rajani Rawat, Manisha Pathak, GM Lalitha, Renu Rajwanshi
[Year:2015] [Month:January-June] [Volume:3 ] [Number:1] [Pages:33] [Pages No:3-5] [No of Hits : 519]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10032-1060 | FREE

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

 
4.  Original Article
Comparison of Pap Smear and Colposcopy in Detection of Premalignant Lesions of Cervix
Bahar Kohli, Shashi Bala Arya, Jai Kishan Goel, Mridu Sinha, Jayanti Kar, Isha Tapasvi
[Year:2014] [Month:January-June] [Volume:2 ] [Number:1] [Pages:56] [Pages No:5-8] [No of Hits : 2518]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10032-1023 | FREE

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

 
5.  Original Article
Assess the Knowledge on Menopausal Self-care among Perimenopausal Women
N Anjaly, Lekha Viswanath, T Anju Philip
[Year:2014] [Month:July-December] [Volume:2 ] [Number:2] [Pages:60] [Pages No:55-58] [No of Hits : 1632]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10032-1041 | FREE

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

 
6.  Original Article
Diagnostic Approach in Perimenopausal Women with Abnormal Uterine Bleeding
Urvashi Verma, Ruchika Garg, Shivani Singh, Poonam Yadav, Rekha Rani
[Year:2014] [Month:January-June] [Volume:2 ] [Number:1] [Pages:56] [Pages No:12-14] [No of Hits : 1465]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10032-1025 | FREE

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

 
7.  Original Article
A Clinicopathological Study of Malignant Ovarian Tumors in India
Ruchika Garg, Saroj Singh, Rekha Rani, Mohita Agrawal, Renu Rajvanshi
[Year:2014] [Month:January-June] [Volume:2 ] [Number:1] [Pages:56] [Pages No:9-11] [No of Hits : 1452]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10032-1024 | FREE

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

 
8.  Case Report
A Rare Case Report of Microperforate Hymen with Difficulty in Penetration
Vijay Kumar, Kusuma Vijay Kumar, KH Krishnamurthy, Rajesh Kumar
[Year:2014] [Month:July-December] [Volume:2 ] [Number:2] [Pages:60] [Pages No:97-98] [No of Hits : 1381]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10032-1052 | FREE

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

 
9.  Review Article
Clear Cell Carcinoma of Endometrium: A Clinical Review
Shikha Seth, Rajani Rawat, Vaibhav Kanti, Pragati Mishra, Suniya Vishwakarma
[Year:2014] [Month:January-June] [Volume:2 ] [Number:1] [Pages:56] [Pages No:15-19] [No of Hits : 1381]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10032-1026 | FREE

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

 
10.  Case Report
Unexplained Unilateral Absence of Fallopian Tube and Ovary
Mehul Sukhadiya, Shweta Varade Grover
[Year:2014] [Month:January-June] [Volume:2 ] [Number:1] [Pages:56] [Pages No:46-47] [No of Hits : 1363]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10032-1037 | FREE

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

 
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