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Fulltext Chronic hepatitis C infection associated with neuromyelitis optica and antinuclear antibodies

Earnest BS, Men LC, Sukvinder Kaur G, Alias RB, Sunita Devi H

J Assoc Physicians India, 2010 Feb;58(2):118-20.
PMID: 20653157

The neurological manifestations of chronic hepatitis C is most often a peripheral sensory neuropathy characterised by numbness, burning and sensation of "pins and needles". Peripheral motor neuropathy, mononeuropathy, mononeuropathy multiplex and transverse myelitis also occur. Ischemic stroke and transient cerebral ischemia have also been reported. Anterior ischemic optic neuropathy is seen, often following interferon therapy. We report an exceptional case of neuromyelitis optica in chronic hepatitis C infection in the absence of interferon therapy.

Matched MeSH terms: Menopause
Fulltext The effects of Tualang honey on female reproductive organs, tibia bone and hormonal profile in ovariectomised rats--animal model for menopause

Zaid SS, Sulaiman SA, Sirajudeen KN, Othman NH

BMC Complement Altern Med, 2010;10:82.
PMID: 21194469 DOI: 10.1186/1472-6882-10-82

Honey is a highly nutritional natural product that has been widely used in folk medicine for a number of therapeutic purposes. We evaluated whether Malaysian Tualang honey (AgroMas, Malaysia) was effective in reducing menopausal syndrome in ovariectomised female rats; an animal model for menopause.

Matched MeSH terms: Menopause/drug effects*
Fulltext Clinical behaviour, pathological findings, survival and prognostic factors in young woman in comparison to menopausal women with Epithelial ovarian malignancy

Rusinahayati, M., Sivanesaratnam, V., Jayalashmi, Noraihan, M. N.

Malaysian Journal of Medicine and Health Sciences, 2010;6(1):19-32.
MyJurnal

Objective: The purpose of this study was to evaluate the clinical behaviour, pathological findings, survival and prognostic factors in young women in comparison to menopausal women with epithelial ovarian malignancy. Methods: A retrospective analysis of 141 patients (67 for age below 40 years and 74 menopausal) treated between 1980 and 2000 was conducted. Results: Irrespective of the stage, the most common clinical presentation was abdominal distension in both young (78%) and menopausal women (66%). In young women, 52% presented at an early stage of the disease and in menopausal women this was seen in 22% (p-value

Matched MeSH terms: Menopause
The menopausal experience among indigenous women of Sarawak, Malaysia

Syed Alwi SA, Lee PY, Awi I, Mallik PS, Md Haizal MN

Climacteric, 2009 Dec;12(6):548-56.
PMID: 19905907 DOI: 10.3109/13697130902919519

OBJECTIVES:
To document the common menopausal symptoms and quality of life in indigenous women of Sarawak in Malaysia.

METHODS:
A face-to-face interview using the Menopause-specific Quality of Life questionnaire was conducted with 276 indigenous Sarawakian women aged 40-65 years to determine the mean age of menopause and common symptoms (divided into vasomotor, psychosocial, physical and sexual domains) associated with menopause.

RESULTS:
The mean age at menopause of postmenopausal women was 50.78 +/- 2.47 years (range 47.3-58.2 years). The most common symptoms reported were aching in muscles and joints (82.6%), lack of energy (77.5%) and low backache (77.2%). The typical menopausal symptoms of hot flushes, night sweats, sweating and vaginal dryness were experienced by 42.4%, 34.8%, 29.7% and 49.3%, respectively of the women studied. Perimenopausal women (n = 114) experienced the most physical and psychosocial symptoms, while postmenopausal women (n = 102) experienced most sexual symptoms. Perimenopausal and postmenopausal women were reported to suffer more than premenopausal women (p < 0.001) within the four domains of symptoms (vasomotor, psychosocial, physical and sexual).

CONCLUSIONS:
The menopausal symptoms in this study correspond to those in other studies on Asian women but the prevalence of typical and classical menopausal symptoms was lower compared to studies on Caucasian women. The perimenopausal women had the most significant decrease in quality of life, followed by postmenopausal women and premenopausal women. Vasomotor symptoms had a predominant influence on the quality of life.

Matched MeSH terms: Menopause/physiology*; Menopause/psychology; Postmenopause/physiology; Postmenopause/psychology
Impact of cancer on psychosexuality: cultural perspectives of Asian women

Khoo SB

Int J Nurs Pract, 2009 Dec;15(6):481-8.
PMID: 19958401 DOI: 10.1111/j.1440-172X.2009.01797.x

Cancers and related treatments have devastating effects on psychosexual life of patients. This study helps us to understand the cultural perspectives of 50 Asian women diagnosed with cancer. Median age was 50+ years. Median duration of time from diagnosis to interview was 23 months. Thirty-eight per cent stopped sex before illness, 36% stopped sex completely whereas 18% stopped gradually after diagnosis; 8% continued to have sex till time of interview. Overall, 70% were living with spouse but not engaged in sexual intercourse; 31.4% slept in different room, 48.6% slept in the same room but without any form of sexual contact. Thirty-eight per cent believed sexual activity could cause cancer recurrence, and 30% believed cancer could be sexually transmitted. Eighty-two per cent reported acceptance of changes to physical appearance. Approximately 70-86% did not discuss sexuality with their doctor or spouse; 90% agreed doctors should ask about psychosexual issues on a routine basis. Approximately 74.4% reported good cooperation from spouse. Cultural beliefs of Asians pose as barriers to providing and receiving psychosexual affection between women diagnosed with cancer and their spouse. However, these beliefs also serve as protective factors in their mutual acceptance of change in psychosexual activities. Health-care professionals need to be sensitive to the vast cultural differences in psychosexual expressions and needs of women diagnosed with cancer.

Matched MeSH terms: Menopause
Depressive symptoms in middle-aged women in peninsular Malaysia

Zainal NZ

Asia Pac J Public Health, 2008;20(4):360-9.
PMID: 19124330 DOI: 10.1177/1010539508322538

A household survey was carried out in Peninsular Malaysia to determine the prevalence rate of depressive symptoms in middle-aged women and to explore its associated factors. Women aged 45 to 60 years were assessed on sociodemographic profiles, menopausal status, depressive symptoms, marital dissatisfaction, and coping strategies. A total of 3934 women participated, and the mean age was 51 years. The prevalence rate of depressive symptoms was 54.2%. Of the married women, 38.4% had poor to very severe problems in their marriage. Depressive symptoms were significantly associated with marital status (P < .001), ethnicity (P < .001), educational levels (P < .001), occupational status ( P < .001), domicile (P < .001), and menopausal status ( P < .05). Depressive symptoms were correlated with marital dissatisfaction scores. Women who consulted professionals, shared with relatives, kept problems to themselves, or consulted parents/siblings had higher mean scores on depressive symptoms compared with those who did not use these coping strategies.

Matched MeSH terms: Menopause/psychology
Probiotics: a critical review of their potential role as antihypertensives, immune modulators, hypocholesterolemics, and perimenopausal treatments

Liong MT

Nutr Rev, 2007 Jul;65(7):316-28.
PMID: 17695372

The conventional use of probiotics to modulate gastrointestinal health, such as in improving lactose intolerance, increasing natural resistance to infectious diseases in the gastrointestinal tract, suppressing traveler's diarrhea, and reducing bloating, has been well investigated and documented. Most of the mechanisms reported to date are mainly caused by the suppression of pathogenic bacteria. Currently, the potential applications of probiotics are being expanded beyond alleviating gastrointestinal disorders to include benefits involving antihypertension, immunomodulation, improving serum lipid profiles, and the alleviation of postmenopausal disorders. Although they seem promising, most of these postulated benefits are based on in vitro evaluations, and the lack of in vivo evidence and/or incompatible outcomes between in vitro experiments and in vivo trials has led to inconclusive claims. This present review highlights some of the previous roles of probiotics on gut health and addresses several potential roles currently being investigated.

Matched MeSH terms: Menopause
Relationship between reproductive exposures and age-related cataract in women

Noran NH, Salleh N, Zahari M

Asia Pac J Public Health, 2007;19(2):23-8.
PMID: 18050560

The objective of this study is to evaluate the relationship between reproductive exposures and age-related cataract among women. This was a hospital based case-control study. The study population included female patients, aged 50 years and above who attended the Eye clinic at the University of Malaya Medical Centre. The outcome measurement was based on ophthalmologic examination by an ophthalmologist. The data on exposure was obtained from face to face interview using a structured questionnaire. In order to reduce the recall bias, patients' medical records were used to substantiate the exposure status. Multiple logistic regression was used to assess the association of age-related cataract with exogenous estrogen usage (HRT and OCP) and duration of menses. Important confounders such as age, history of diabetes, cigarette smoking and steroids usage were controlled for in the analysis. Females with 29 years or less of endogenous estrogen exposure of, have almost three times the risk of developing age related cataract (adjusted OR 3.42: 95% CI: 1.28, 9.16), similarly among those with exposure of 30-32 years (adjusted OR 3.64: 95% CI: 1.08, 12.26). Hormone Replacement Therapy used for more than three years was found to be a protective factor of age-related cataract. There is evidence that reproductive exposure may play a role in reducing the occurrence of age-related cataract among Malaysian women.
Study site: Eye clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Menopause
Fulltext A survey of knowledge and perceptions of menopause among young to middle-aged women in Federal Territory, Kuala Lumpur, Malaysia

Wong, L.P., Nur Liyana, A.H.

JUMMEC, 2007;10(2):22-30.
MyJurnal

Prevalence and signs and symptoms of menopause have been extensively studied among Malaysian women but no one had investigated the level of knowledge and perception of menopause. This study aimed to examine the knowledge and perception of menopause among young to middle aged women (15 to 49 years old). A cross-sectional survey using 20-items questionnaire was conducted in three randomly chosen districts in Federal Territory, Kuala Lumpur. Women in this survey were aware of the meaning of the term menopause and its symptoms. However, the majority lacked comprehensive understanding about the health risks associated with menopause. Commonly cited sources of knowledge were magazines and family members. Lack of official sources for accurate information on menopause was reported. Communication with health care personnel regarding menopause was uncommon. An exploration into respondents' perceptions on menopause revealed that the majority displayed positive thinking towards menopause. Young respondents seemed to have better perception regarding menopause compared to middle aged women. Although the women had good knowledge about menopause, they expressed feelings of sadness and nervousness upon the approach of their own menopause. Our data provides insight on the knowledge and perception of menopause that will guide future public health initiatives for premenopausal women in order for them to cope better when approaching this stage of life cycle.

Matched MeSH terms: Menopause
Prevalence of menopausal symptoms in women in Kelantan, Malaysia

Dhillon HK, Singh HJ, Shuib R, Hamid AM, Mohd Zaki Nik Mahmood N

Maturitas, 2006 Jun 20;54(3):213-21.
PMID: 16326052

The aim of the study was to document the prevalence of 16 symptoms commonly associated with menopause, in women living in Kelantan.

Matched MeSH terms: Menopause*
Diet, nutritional knowledge and health status of urban middle-aged Malaysian women

Pon LW, Noor-Aini MY, Ong FB, Adeeb N, Seri SS, Shamsuddin K, et al.

Asia Pac J Clin Nutr, 2006;15(3):388-99.
PMID: 16837432

The objective of the study was to assess nutritional and health status as well as nutritional knowledge in urban middle-aged Malaysian women. The impact of menopause on diet and health indices was also studied. The study included 360 disease free women, non users of HRT,aged > or =45 years with an intact uterus recruited from November 1999 to October 2001. Personal characteristics, anthropometric measurements and blood sample were acquired followed by clinical examination. Nutrient intake and nutritional knowledge was determined by a quantitative FFQ and KAP. The findings showed that urban middle-aged women, aged 51.65+/-5.40 years had energy intakes (EI) 11% below RDA, consisting of 53% carbohydrates, 15% protein and a 32% fat which declined with age. The sample which comprised of 42.5% postmenopausal women had a satisfactory diet and healthy lifestyle practices. Premenopausal women consumed more dietary fat (6%) with other aspects of diet comparable to the postmenopausal women. Iron intake was deficient in premenopausal women, amounting to 56% RDA contributing to a 26% prevalence of anaemia. Overall, calcium intake reached 440 mg daily but dairy products were not the main source. The postmenopaused had a more artherogenic lipid profile with significantly higher total cholesterol (TC) and LDL-C, but more premenopausal women were overweight/obese (49% versus 35%). EI was the strongest predictor for BMI and waist circumference (WC), with WC itself an independent predictor of fasting blood sugar and TC with BMI strongly affecting glucose tolerance. High nutritional knowledge was seen in 39% whereas 20% had poor knowledge. Newspapers and magazines, followed by the subject's social circle, were the main sources of nutritional information. Nutritional knowledge was positively associated with education, household income, vitamin/ mineral supplementation and regular physical activity but inversely related to TC. In conclusion, middle-aged urban women had an adequate diet with low iron and calcium intakes. Nutritional knowledge was positively associated to healthier lifestyle practices and lower TC. A comparable nutrient intake and lifestyle between pre and postmenopausal women suggested that health changes associated with menopause was largely independent of diet.

Matched MeSH terms: Menopause; Postmenopause
The age of menopause and the menopause transition in a multiracial population: a nation-wide Singapore study

Loh FH, Khin LW, Saw SM, Lee JJ, Gu K

Maturitas, 2005 Nov-Dec;52(3-4):169-80.
PMID: 16257608

To describe the prevalence of menopausal symptoms, define the mean age of menopause, and determine contributory factors, which influence the experience of symptoms among Singaporean women of different racial groups.

Matched MeSH terms: Menopause/ethnology*; Menopause/physiology*
Fulltext Prevalence of menopausal symptoms among female teachers in Seremban, Negeri Sembilan

Mohd Zulkefli NA, Mohd Sidik S

Asia Pac Fam Med, 2003;2(4):235-238.

Background: Menopause is a condition that every woman faces in later life and can have many associated effects which might disrupt the quality of life.
Aim: To determine both the prevalence of menopause and menopausal symptoms in a group of employed Malaysian women and to determine their sources of information regarding menopause.
Methods: A cross sectional study was conducted among female teachers aged 35 and above in Seremban, Negeri Sembilan, Malaysia between 1 June and 31 December 2000. A total of 550 self administered questionnaires were distributed to teachers selected through simple random sampling of selected schools.
Results: The response rate was 78.9%. The prevalence of menopause was 21.9%. There was a high prevalence of skin dryness (44.2%), hot flushes (43.2%), fatigue (41.0%) and excessive sweating (34.7%) among the menopausal respondents and there was a significant difference between menopausal and non menopausal symptoms of respondents (p<0.05).
Conclusion: The prevalence of menopause and each menopausal symptom are high in the present group of women. Improved health care programs about the menopause might help give women a better quality of life.

Matched MeSH terms: Menopause
Determining the best catheter for sonohysterography

Dessole S, Farina M, Capobianco G, Nardelli GB, Ambrosini G, Meloni GB

Fertil. Steril., 2001 Sep;76(3):605-9.
PMID: 11532488

OBJECTIVE: To compare the characteristics of six different catheters for performing sonohysterography (SHG) to identify those that offer the best compromise between reliability, tolerability, and cost.
DESIGN: Prospective study.
SETTING: University hospital.
PATIENT(S): Six hundred ten women undergoing SHG.
INTERVENTION(S): We performed SHG with six different types of catheters: Foleycath (Wembley Rubber Products, Sepang, Malaysia), Hysca Hysterosalpingography Catheter (GTA International Medical Devices S.A., La Caleta D.N., Dominican Republic), H/S Catheter Set (Ackrad Laboratories, Cranford, NJ), PBN Balloon Hystero-Salpingography Catheter (PBN Medicals, Stenloese, Denmark), ZUI-2.0 Catheter (Zinnanti Uterine Injection; BEI Medical System International, Gembloux, Belgium), and Goldstein Catheter (Cook, Spencer, IN).
MAIN OUTCOME MEASURE(S): We assessed the reliability, the physician's ease of use, the time requested for the insertion of the catheter, the volume of contrast medium used, the tolerability for the patients, and the cost of the catheters.
RESULT(S): In 568 (93%) correctly performed procedures, no statistically significant differences were found among the catheters. The Foleycath was the most difficult for the physician to use and required significantly more time to position correctly. The Goldstein catheter was the best tolerated by the patients. The Foleycath was the cheapest whereas the PBN Balloon was the most expensive.
CONCLUSION(S): The choice of the catheter must be targeted to achieving a good balance between tolerability for the patients, efficacy, cost, and the personal preference of the operator.

Matched MeSH terms: Menopause
Fulltext Profile of a menopause clinic in an urban population in Malaysia

Damodaran P, Subramaniam R, Omar SZ, Nadkarni P, Paramsothy M

Singapore Med J, 2000 Sep;41(9):431-5.
PMID: 11193115

The object of this study is to determine the status of an urban Malaysian woman in her menopause age group with reference to her menopausal symptoms, lipid profile, breast, pelvis and bone. One hundred and sixty four women attending the Menopause Clinic of University Hospital, Kuala Lumpur who had not previously been on hormone replacement therapy were studied. Forty nine women were perimenopausal, 74 women were in early menopause (within 5 years of menopause) and 41 women were in late menopause (after 5 years of menopause). The most common symptoms were hot flushes (56%) and generalised tiredness (49%). Eighty four percent (84%) of women had high cholesterol levels. Serum triglycerides were highest in the late menopause group. There were 2 cases of intraductal carcinoma diagnosed on routine mammography, with 8 cases of fibrocystic breast disease and 7 cases of suspicious breast lumps. Routine ultrasound (pelvic and abdominal) revealed two women with ovarian cysts, 6 women with an endometrial thickness of more than 5 mm and 8 women with uterine fibroids. Eighty five women (51.8%) had mild osteoporosis while four women had moderate osteoporosis on dual photon measurements for bone mineral density. Menopause clinics should aim at investigating a woman in her menopause as a whole. Vasomotor symptoms were common in the urban Malaysian menopausal woman. There was a high incidence of lipid abnormalities. Routine mammography, pelvic ultrasound examinations and bone mineral density tests detected significant pathology and abnormalities.
Study site: Menopause Clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Menopause*
Fulltext Menopause and hormone replacement therapy. Facts and misconceptions

Raman S, Damodaran P

Med J Malaysia, 1996 Dec;51(4):407-8.
PMID: 10968025
Matched MeSH terms: Menopause*
Climacteric and menopause in seven South-east Asian countries

Boulet MJ, Oddens BJ, Lehert P, Vemer HM, Visser A

Maturitas, 1994 Oct;19(3):157-76.
PMID: 7799822

The menopause is universal, but what about the climacteric? In an attempt to answer this question, a study was conducted in seven south-east Asian countries, namely, Hong Kong, Indonesia, Korea, Malaysia, the Philippines, Singapore and Taiwan. Samples of approximately 400 women in each country were questioned about a number of climacteric complaints, incontinence and dyspareunia, consultation of a physician, menopausal status and several background characteristics. Special care was taken to overcome linguistic and cultural problems, and the data collected were kept as objective as possible. From the results obtained we were able to show that the climacteric was indeed experienced in south-east Asian countries, although in a mild form. The prevalence of hot flushes and of sweating was lower than in western countries, but was nevertheless not negligible. The percentages of women who reported the more psychological types of complaint were similar to those in western countries. The occurrence of climacteric complaints affected perceived health status. A physician was consulted for climacteric complaints by 20% of the respondents, although this was most frequently associated with the occurrence of psychological complaints and less so with that of hot flushes and sweating. The median age at menopause (51.09) appeared to be within the ranges observed in western countries. Ethnic background and age at menarche were found to have a significant influence on age at menopause. The study clearly demonstrated that climacteric complaints occur in south-east Asia. The findings suggest, however, that vasomotor-complaint-related distress might be 'translated' into psychological complaints, which are more frequently considered to warrant consulting a physician.

Matched MeSH terms: Menopause/ethnology
The prevalence of symptoms in menopausal women in the Far East: Singapore segment

McCarthy T

Maturitas, 1994 Oct;19(3):199-204.
PMID: 7799826

Questionnaires (4000) on experience of menopausal symptoms in Singaporean women aged 40-55 were distributed by students. In total, 524 envelopes were returned (13.1%) and of these 420 were analyzed. Of these, 366 were classified as either pre-, peri- or postmenopausal on the basis of their menstrual patterns. Menopausal symptoms in this sample of Singaporean women were, in general, similar to those experienced in the West though the prevalence was low compared to European studies. No significant differences in individual symptoms were found between the 3 groups but, taken together, symptoms were significantly highest in the perimenopausal and lowest in the other menopausal groups. In the postmenopausal group 50% had been menopausal for at least 1 year at 50.5 years.

Matched MeSH terms: Menopause/ethnology
A study on the menopause in Malaysia

Ismael NN

Maturitas, 1994 Oct;19(3):205-9.
PMID: 7799827

In an attempt to gather data on the menopause in Malaysia, 400 women (13% Chinese, 70% Malays and 16% Indians), representing the three major ethnic groups in Malaysia, were interviewed. The majority (76%) of these women were still married and living with their husbands and 63% of them were working. Most of them (90%) had attained menarche by the age of 15 years and 50% of them had married before the age of 20. Their reproductive record was good, since 76% of them had 3 or more children who were still alive. The mean age at menopause in the Malaysian women studied was 50.7 years. Analysis of the climacteric symptoms reported showed significant differences in the vasomotor and nervosity indices in the perimenopausal and postmenopausal groups. Eighty percent (80%) of the women saw no need to consult a doctor about their climacteric symptoms. When they did, most of them (84%) received medication, but 43% of them did not comply with the prescribed treatment. Dyspareunia and urinary incontinence were evidently regarded as embarrassing complaints in all three groups, since around 80% of the women did not seek medical advice. This is not surprising in view of the fact that 89% of them rated their health as good.

Matched MeSH terms: Menopause/ethnology*
Fulltext Post-menopausal smear patterns--a review of vaginal smears in 480 women

Pillay B, Yap SK, Lim GL

Med J Malaysia, 1992 Mar;47(1):38-43.
PMID: 1387448

Cytohormonal evaluation was done on the vaginal smears of 480 normal, asymptomatic, post-menopausal women whose ages ranged from 36 to 74 years. About 50% showed atrophic smears consistent with total oestrogen lack. 41% had mild to moderately proliferative smears compatible with sub-optimal oestrogen stimulus. 9% showed a highly proliferative pattern typical of unopposed oestrogen effect and in this group two women had atypical endometrial cells in their smears, which subsequently were found to come from an atypical endometrial hyperplasia and an endometrial adenocarcinoma-in-situ. The clinical relevance of cytohormonal studies in post-menopausal women is briefly discussed.

Matched MeSH terms: Menopause*

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