Journal of Mid-life Health最新文献

{"title":"Comparison of Sexual Function in Patients Undergoing Hysterectomy through Laparoscopic versus Abdominal Method: A Systematic Review.","authors":"Avir Sarkar, Vartika Sharma, Malvika Dixit, Suman Sandeep Samal, Divesh Maniar","doi":"10.4103/jmh.jmh_214_25","DOIUrl":"10.4103/jmh.jmh_214_25","url":null,"abstract":"<p><p>Uterus is the symbol of femininity; thus, hysterectomy is an important decision in a woman's life. It can create certain physical, psychological, and sexual impacts in the relationship between the couple. This review has tried to analyze the effect of hysterectomy on postoperative sexual outcomes through a comparison between laparoscopic versus abdominal routes of surgery. An initial systematic search identified 247 studies. After screening the title and abstracts, 243 studies were included, out of which 213 articles were assessed for eligibility. A careful analysis resulted in 15 studies being rendered out for the review. Extracted information included study design, menopausal status, use of hormone replacement therapy, and sexual function outcome parameters following laparoscopic and abdominal hysterectomy. Data were also retrieved at the time of assessment of sexual outcome after surgery, and any significant difference between the two techniques of hysterectomy was analyzed. Different articles evaluated sexual function using different validated scores such as female sexual function satisfaction score, Arizona Sexual Experiences Scale, and Brief Index of Sexual Functioning for Women to include different components of female sexuality. Due to differences in sexual function outcome scales, meta-analysis could not be performed. The majority of the studies indicated a similar impact of hysterectomy on sexuality, irrespective of the route, while a few of them showed improvement with laparoscopic method. Assessment of sexual function is a complex task. Women undergoing hysterectomy need good psychological counseling and assessment before choosing the route and method of hysterectomy. Further multicentric studies are needed to draw a final conclusion.</p>","PeriodicalId":37717,"journal":{"name":"Journal of Mid-life Health","volume":"17 1","pages":"31-41"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13160519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uterine Leiomyosarcoma in a Case of Leiomyoma: A Rare Encounter with Review of Newer Diagnostic Modalities.","authors":"Vinod G Nair, Roshni Abichandani, Abhijeet Kumar, Eshwarya Jessy Kaur","doi":"10.4103/jmh.jmh_40_24","DOIUrl":"10.4103/jmh.jmh_40_24","url":null,"abstract":"<p><p>Uterine leiomyoma is the most common benign tumor in women[1] and a frequent outpatient finding by gynaecologists, whereas leiomyosarcomas (LMSs) comprise <1% of female genital tract malignancies. We present the case of a 37-year-old female who underwent fertility sparing surgery for uterine leiomyoma and was postoperatively diagnosed as LMS. She subsequently underwent a completion surgery for the same. The diagnostic challenges in a case of suspected sarcoma of the uterus are manifold. It may assist the clinician to use keep a high degree of suspicion in certain cases and explore newer scoring systems and biomarkers preoperatively.</p>","PeriodicalId":37717,"journal":{"name":"Journal of Mid-life Health","volume":"17 1","pages":"185-187"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13160542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Giant Lipoleiomyoma of Cervix Mimicking as Schwannoma: First Case Report of a Dual Morphologic Variant.","authors":"Manupriya Sharma, Anita Chaudhary, Chanderdeep Sharma, Harpreet Kaur","doi":"10.4103/jmh.jmh_175_25","DOIUrl":"10.4103/jmh.jmh_175_25","url":null,"abstract":"<p><p>Leiomyomas with schwannoma-like features are very rare and can resemble peripheral nerve sheath tumors, particularly if the characteristics of Verocay bodies and nuclear palisading are present. Inclusion of mature adipose tissue (lipomatous differentiation) within similar tumors is uncommon. To our knowledge, no case with cervical leiomyoma that simultaneously presents schwannoma-like and lipomatous differentiation has been reported. A 54-year-old perimenopausal woman was operated upon for assumed fibroid uterus with total abdominal hysterectomy and bilateral salpingo-oophorectomy. Grossly, the specimen had a giant (20 cm), well-circumscribed cervical mass with bosselated surface. The cut surface was firm, grey-white with focal yellowish spots. Histology revealed a spindle cell tumor with striking nuclear palisading and Verocay body-type features, intermixed with mature adipose tissue. At first, these features were suggestive of schwannoma; however, immunohistochemistry exhibited diffuse smooth muscle actin (SMA) and desmin positivity, with S100 negativity, outlining smooth muscle lineage and categorically excluding neural origin. Lack of atypia, necrosis, or anaplastic cell proliferation further consolidated the diagnosis as benign. This represents the first documented case of a benign cervical leiomyoma exhibiting this dual morphologic pattern, underscoring the importance of recognizing such rare variants to avoid misdiagnosis.</p>","PeriodicalId":37717,"journal":{"name":"Journal of Mid-life Health","volume":"17 1","pages":"178-181"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13160521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PISA: Inflamed Surface Area of Gums Triggering Systemic Hyperinflammation.","authors":"Himani, Shalini Kapoor, Amit Bhardwaj","doi":"10.4103/jmh.jmh_172_25","DOIUrl":"10.4103/jmh.jmh_172_25","url":null,"abstract":"<p><p>Periodontitis, a chronic inflammatory disease, causes progressive loss of periodontal tissues. Traditional measures like clinical attachment loss and probing pocket depth fail to quantify the inflammatory burden accurately. The Periodontal Inflamed Surface Area (PISA) quantifies the surface area of bleeding pocket epithelium, offering a better measure of inflammation. This review explores the association between PISA and systemic disorders such as cardiovascular disease, diabetes, dementia, and rheumatoid arthritis (RA). Studies show higher PISA levels correlate with elevated systemic inflammatory markers, including high-sensitivity C-reactive protein and vascular stiffness. In Type 2 diabetes mellitus, PISA is positively associated with HbA1c levels, indicating a dose-response relationship. Additional links have been identified between PISA and conditions like dementia, RA, and diabetic complications. These findings underscore PISA's value in assessing the systemic impact of periodontitis, advocating for its integration into holistic patient care and further research to standardize its use.</p>","PeriodicalId":37717,"journal":{"name":"Journal of Mid-life Health","volume":"17 1","pages":"71-78"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13160546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baseline Vulnerabilities in Women with Gynecologic Cancer: A Case for Prehabilitation in Resource-limited Settings.","authors":"Eshwarya Jessy Kaur, Abhijeet Kumar, Sanjay Singh, Vinod G Nair, Arnab Bandyopadhyay, Mayuri Jain","doi":"10.4103/jmh.jmh_241_25","DOIUrl":"10.4103/jmh.jmh_241_25","url":null,"abstract":"<p><strong>Background: </strong>Prehabilitation is a proactive strategy aimed at optimizing physical, nutritional, and psychological reserves before initiating cancer treatment. While emerging evidence supports its effectiveness in improving perioperative outcomes in oncology, data specific to gynecologic cancers and low- and middle-income country (LMIC) settings remain limited.</p><p><strong>Materials and methods: </strong>A prospective analytical cohort study was conducted at a tertiary care center in North India from July 2023 to April 2025. A total of 183 women with newly diagnosed or suspected gynecological malignancies were assessed prior to treatment. Parameters included performance status (Eastern Cooperative Oncology Group [ECOG]), frailty (Modified Frailty Index-11), nutritional markers (body mass index [BMI], hemoglobin, and albumin), and psychological well-being (Patient Health Questionnaire-9 depression scale). Time taken from presentation to diagnosis was also recorded and analyzed.</p><p><strong>Results: </strong>Among 183 women with gynecologic cancers, cervical (45.9%) and ovarian (33.3%) malignancies predominated. Baseline vulnerabilities were highly prevalent: anemia (76.0%), low BMI (40.4%), hypoalbuminemia (31.1%), high frailty (52.5%), and moderate-severe depression (67.2%). The mean hemoglobin was 10.9 g/dL, BMI 22.2 kg/m², and albumin 3.73 g/dL. The mean diagnostic delay was 30.2 ± 7.4 days (range: 12-41). On multivariable regression, higher ECOG status (β =4.44 days per point, <i>P</i> < 0.0001), lower albumin (β = -3.75 days per g/dL, <i>P</i> < 0.0001), and higher frailty (β =0.38 days per unit, <i>P</i> < 0.0001) independently predicted longer delays (<i>R</i> ² = 0.62). Subgroup analysis confirmed significantly prolonged delays among frail patients (<i>P</i> < 0.0001).</p><p><strong>Conclusions: </strong>A high prevalence of frailty, nutritional risk, and psychological distress was identified among gynecologic oncology patients in this LMIC setting. These domains are interrelated and represent modifiable targets for structured prehabilitation. Future research and policy efforts should prioritize the implementation of cost-effective, multidisciplinary prehabilitation models tailored to resource-constrained environments.</p>","PeriodicalId":37717,"journal":{"name":"Journal of Mid-life Health","volume":"17 1","pages":"141-145"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13160548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Surface: Diagnostic Significance of Parabasal Cells in Cervical Cytology.","authors":"Gunvanti Rathod, Sai Swetha, B Nalini, Alisha Khan","doi":"10.4103/jmh.jmh_176_25","DOIUrl":"10.4103/jmh.jmh_176_25","url":null,"abstract":"<p><p>Parabasal cells, typically observed in postmenopausal cervical smears, are often overlooked in cytological evaluation. However, their presence in reproductive-aged women is an atypical finding that may indicate hypoestrogenism, epithelial trauma, or underlying endocrine dysfunction. These cells, due to their high nuclear-to-cytoplasmic ratio, can mimic high-grade squamous intraepithelial lesions, leading to diagnostic dilemmas and potential overtreatment. This short communication underscores the importance of recognizing the clinical relevance of parabasal cells, advocating for detailed clinical correlation and appropriate investigations. Accurate interpretation is essential to avoid misdiagnosis and to identify potentially reversible hormonal or systemic abnormalities.</p>","PeriodicalId":37717,"journal":{"name":"Journal of Mid-life Health","volume":"17 1","pages":"191-193"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13160528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CORRIGENDUM: CLINICAL PRACTICE GUIDELINES FOR MENOPAUSE: *AN EXECUTIVE SUMMARY AND RECOMMENDATIONS: INDIAN MENOPAUSE SOCIETY 2026.","authors":"","doi":"10.4103/jmh.jmh_115_26","DOIUrl":"10.4103/jmh.jmh_115_26","url":null,"abstract":"<p><p>[This corrects the article on p. S12 in vol. 17, PMID: 41767293.].</p>","PeriodicalId":37717,"journal":{"name":"Journal of Mid-life Health","volume":"17 1","pages":"194-197"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13160537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive Function in Middle-aged Postmenopausal Women: A Cross-sectional Study.","authors":"Nandani Goswami, M D Motlag, Mehul Mukhi","doi":"10.4103/jmh.jmh_159_25","DOIUrl":"10.4103/jmh.jmh_159_25","url":null,"abstract":"<p><strong>Introduction: </strong>Cognitive decline following menopause is a well-documented phenomenon, with women at significantly greater risk for dementia than men. This decline is multifactorial, linked not only to estrogen depletion, which directly affects brain tissue, but also to menopausal symptoms such as sleep disturbances, mood changes, and hot flashes. Endocrine aging has been associated with elevated Alzheimer's biomarkers and observable MRI changes, reinforcing the vulnerability of postmenopausal women to cognitive impairment. This study utilizes the Addenbrooke's Cognitive Examination-III (ACE-III) to assess domain-specific cognitive decline and identify correlates of Mild Cognitive Impairment (MCI).</p><p><strong>Aims and objectives: </strong>This study aims to evaluate cognitive function in middle-aged postmenopausal women, assess the prevalence of MCI, identify the most affected cognitive domains, and correlate cognitive scores with the duration of menopause and comorbidities such as hypertension, diabetes, and obesity.</p><p><strong>Setting and design: </strong>A descriptive cross-sectional study was conducted in a tertiary care hospital in India among 90 postmenopausal women aged 41-60 years. Cognitive assessment was carried out using ACE-III, evaluating five domains: attention, memory, fluency, language, and visuospatial abilities. Exclusion criteria included surgical menopause, hormone replacement therapy, and preexisting neurological or psychiatric conditions.</p><p><strong>Results: </strong>The prevalence of MCI was 78.88% (<i>n</i> = 71), with memory and fluency emerging as the most affected domains. A strong negative correlation was found between duration since menopause and total ACE-III score (<i>r</i> = -0.7192, <i>P</i> < 0.001). Diabetes was significantly associated with poorer memory (<i>P</i> = 0.03), and obesity with reduced visuospatial abilities (<i>P</i> = 0.05). No significant association was observed with hypertension. These findings highlight the need for early cognitive screening and focused peri-menopausal attention.</p>","PeriodicalId":37717,"journal":{"name":"Journal of Mid-life Health","volume":"17 1","pages":"100-105"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13160529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seromucinous Cystadenoma and Benign Brenner Tumor: A Unique Collision Tumor of Ovary with Contralateral Benign Brenner Tumor.","authors":"Shirish Sahebrao Chandanwale, Madhuri Singh, Jigna Solanki, Archana Buch","doi":"10.4103/jmh.jmh_208_25","DOIUrl":"10.4103/jmh.jmh_208_25","url":null,"abstract":"<p><p>Collision tumors of ovary are uncommon neoplasm characterized by the coexistence of two distinct tumors in ovary without histological mingling. Although various combinations have been reported, we report a new combination of seromucinous cystadenoma and benign Brenner tumor. Due to solid cystic nature of the lesion on radiology, they can be mistaken as malignant tumor. They are difficult to diagnose preoperatively. We report a case of 61-year-old female who presented with abdominal pain and hematuria. Magnetic resonance imaging suggested malignant lesion with possibility of serous cystadenocarcinoma or borderline malignant tumor. Histopathological examination of radical hysterectomy revealed collision tumor of right ovary composed of seromucinous cystadenoma and benign Brenner tumor with contralateral benign Brenner in the left ovary.</p>","PeriodicalId":37717,"journal":{"name":"Journal of Mid-life Health","volume":"17 1","pages":"182-184"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13160517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Different Diagnostic Modalities for Screening and Molecular Characterization of Human Papillomavirus Causing Cervical Cancer.","authors":"Arti Agrawal, Archana, Pragya Shakya, Urvashi Verma, Ruchika Garg, Pooja Agrawal, Ankur Goyal, Gargi Tyagi","doi":"10.4103/jmh.jmh_271_25","DOIUrl":"10.4103/jmh.jmh_271_25","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer remains a major global health challenge, ranking as the fourth most common cancer and a leading cause of cancer-related deaths among women. Persistent infection with human papillomavirus (HPV) is recognized as the primary etiological factor. Effective screening methods such as HPV DNA testing, Papanicolaou (Pap) smear cytology, and visual inspection with acetic acid (VIA) are critical for early detection, particularly in resource-limited settings.</p><p><strong>Aim: </strong>This study evaluated the performance of different diagnostic approaches for cervical cancer screening and assessed the prevalence and distribution of HPV genotypes among symptomatic women in northern India, with special emphasis on high-risk genotypes beyond HPV16 and 18.</p><p><strong>Materials and methods: </strong>A cross-sectional observational study was conducted over 21 months, which enrolled 200 symptomatic females attending a tertiary care center. Cervical specimens were analyzed using real-time polymerase chain reaction for HPV, including 14 high-risk genotypes. VIA and Pap smear tests were concurrently performed. Associations between variables and HPV status were analyzed using Pearson's Chi-square and Fisher's exact tests.</p><p><strong>Results: </strong>High-risk genotypes were detected in 22 participants (11%). HPV16 was the predominant genotype (6%), followed by HPV39 (3.5%). Other oncogenic types, including HPV45, 51, 56, 58, and 66, were also detected. Significant associations were found between HPV positivity and VIA results (<i>P</i> < 0.001) as well as abnormal Pap smear findings, notably low-grade squamous intraepithelial lesion, atypical squamous cells of undetermined significance, and carcinoma cervix (<i>P</i> < 0.001). No significant correlations were noted with most sociodemographic or behavioral risk factors.</p><p><strong>Conclusion: </strong>HPV DNA testing demonstrated superior diagnostic accuracy, confirming its role as the gold standard for cervical cancer screening. VIA and Pap smear remain cost-effective alternatives in low-resource settings. The detection of high-risk genotypes beyond HPV16 and 18 emphasizes the need for broader-spectrum HPV vaccines and tailored screening strategies to reduce cervical cancer burden in northern India.</p>","PeriodicalId":37717,"journal":{"name":"Journal of Mid-life Health","volume":"17 1","pages":"111-116"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13160524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}