Women's Quality Research Articles

Monocyte and Macrophage in Follicular Liquid: Predictive Markers of Embryo Quality in Women with Obesity and Infertility.

Over the past five years, the pregnancy rate in assisted reproductive technology (ART) programs in Russia has remained relatively stable. The aim of this study was to assess the distribution of monocyte and macrophage subsets in the blood and follicular fluid of infertile women undergoing assisted reproductive technology. The study involved 45 women with a mean age of 35 ± 4.66 years. Monocytes and macrophages were identified using flow cytometry. We observed a decrease in the CD68+CD163+CD206+ and the CD68+CD163-CD206+ cells in patients with a body mass index (BMI) >25 by 0.19 times and 6.56 times, respectively, compared to the group with a BMI <25 (p = 0.031). Patients with fair oocyte quality had 3.6 times more oocytes than those with poor quality (p = 0.010). The relative content of CD14+163-206+ monocytes was found to be 24.15 times higher in the follicular fluid of women with poor embryo quality compared to the group with good embryos (p = 0.010). We also noted that the number of oocytes increased in women with male factor infertility (p = 0.020) and those with unspecified infertility when compared to tubal infertility. An increase in the relative content of CD14+163+206+ in the blood was higher in women with other causes of female infertility compared to those with male factor infertility (p = 0.010). The relative content of M2-monocytes (CD14+163+206-) in the blood was 4.38 times higher in women with male factor infertility than in women with unexplained infertility (p = 0.010). A critical component of the inflammatory reaction in patients undergoing in vitro fertilization (IVF) involves more than just the activation of pro-inflammatory cells in response to ovarian stimulation. Our research shows that changes in the distribution of monocytes and macrophages can influence embryo implantation success and pregnancy outcomes in women. These processes are influenced by various infertility-related factors, including those mentioned above. However, these findings are preliminary and require further investigation.

Efficacy and safety of Matricaria chamomilla intervention in managing menopausal symptoms: a triple-blind clinical trial.

Menopausal symptoms can significantly impact women's quality of life. Herbal interventions like Matricaria chamomilla (chamomile) have been suggested as potential remedies. However, their efficacy and safety remain underexplored. This triple-blind clinical trial enrolled 80 postmenopausal women meeting specific criteria. Inclusion criteria included participants in early or late perimenopause, defined by a symptom score >15, FSH levels >40, or 2 years since menopause, with no significant comorbidities. Participants were randomly assigned to intervention and placebo groups. In a triple-blind clinical trial with 80 postmenopausal women (aged 47-62) from Babol City Health Center, participants were randomly assigned to receive either chamomile (100 mg capsules with 1.2% apigenin, four times daily) or a placebo over 12 weeks. Symptoms of menopause were assessed using the Australian Menopause Association's Scorecard Symptom Questionnaire. Over 12 weeks, they received either chamomile or placebo capsules, with side effect assessments every 4 weeks. Notable differences were found between the intervention and control groups in the overall scores on the symptom scorecard from baseline to 12 weeks' postintervention (-10.36; 95% confidence interval [CI], -13.84 to -6.92; P < 0.001). Specific subscores also improved in the intervention group: vasomotor (-2.25; 95% CI, -3.09 to -1.42; P < 0.001), psychological (-3.74; 95% CI, -5.29 to -2.20; P < 0.001), locomotor (-2.70; 95% CI, -3.63 to -1.77; P < 0.001), and urological (-1.89; 95% CI, -2.77 to -1.00; P < 0.001). Both groups showed significant changes in total symptom scores over time (P < 0.001). Two participants experienced side effects, including mouth sores, skin spots, and itching, in the chamomile group, which led to their dropping out of the study. Chamomile intervention shows promise in alleviating menopausal symptoms, but its use warrants caution due to associated side effects. Further research is necessary to optimize dosage and mitigate adverse reactions for safer and more effective management of menopausal symptoms.

Under Construction (2015): A Sketchy Attempt to Depict Female Subjectivity

This article investigates the role and representation of the female characters in Rubaiyat Hossain’s critically acclaimed feminist film Under Construction (2015). This qualitative and explorative study uses textual analysis and approaches to representation by Stuart Hall as the methodology. This study deploys the concept of feminist political economy, women and economics, and subjectivity as the theoretical framework. Findings show that female characters in the film either adhered to traditional gender roles or were financially dependent on others. Hence, they were prone to being exploited by male-dominated systems due to their limited choices and lack of control. This study delves into the experiences of three women characters, examining their behavior in response to societal norms and the perceptions they encounter from others. Its goal is to grasp the fundamental concepts of feminist political economy, women and economics, and subjectivity to assess their relevance in contemporary society. Social Science Review, Vol. 41(1), June 2024, Page 73-90.

The benefits and harms of oral iron supplementation in non-anaemic pregnant women: a systematic review and meta-analysis.

Iron deficiency during pregnancy poses a significant risk to both maternal and foetal health. Current international guidelines provide discrepant advice on antenatal iron supplementation for non-anaemic women. We aimed to quantify the benefits and harms of routine antenatal supplementation in non-anaemic women. The Cochrane Library, MEDLINE, Embase, and clinical trial registries were searched for randomized controlled trials and observational studies comparing oral iron supplementation with placebo or no supplement in non-anaemic pregnant women. Risk of bias was assessed for each study and the results were synthesized via meta-analysis. Twenty-three eligible studies were identified with 4492 non-anaemic pregnant women. Supplemented groups had higher haemoglobin [mean difference = 6.95g/l, 95% confidence interval (CI): 4.81-9.09, P < .001, moderate certainty, I2 = 91%] and ferritin (mean difference = 12.22ng/ml, 95% CI: 6.92-17.52, P < .001, moderate certainty, I2 = 87%) and were at lower risk of anaemia (relative risk = 0.50, 95% CI: 0.34-0.74, P < .001, high certainty, I2 = 42%, number needed to treat (NNT) = 10). There was no difference in birth weight, preterm birth, and rate of caesarean section. Reporting on harms was inconsistent and there was insufficient evidence to determine an association between iron supplements and any negative outcome. Prophylactic iron supplementation likely results in a large reduction in maternal anaemia during pregnancy. Future research should qualify the impact of this benefit on women's quality of life and determine which subpopulations benefit most. Evidence surrounding the harms of iron supplementation in the non-anaemic population is poor quality and inconsistent. Randomized controlled trials quantifying the risk of gastrointestinal (GI) disturbance and iron overload are essential to inform iron supplement use and reduce unwarranted variations in international guidelines.

How Hormonal Balance Changes Lives in Women with Psoriasis.

Psoriasis is a chronic, immune-mediated skin disease significantly impacting women, with disease severity often modulated by hormonal fluctuations. This review examines the influence of hormonal changes on the course of psoriasis in women, focusing on key life stages-including the menstrual cycle, pregnancy, postpartum, and menopause-and their impact on disease progression and symptomatology. Estrogen, the principal female sex hormone, plays a critical role in immune modulation. Variations in estrogen levels, which occur naturally throughout a woman's life, are associated with fluctuations in psoriasis severity. Low estrogen levels, as seen during menstruation or menopause, are linked to symptom exacerbation, while elevated levels during pregnancy may reduce symptoms in some women. However, responses are variable, with others experiencing no change or worsening during pregnancy. Postpartum, the rapid decline in estrogen often triggers severe flare-ups, while menopause, marked by a sustained estrogen reduction, frequently correlates with increased disease severity and flare frequency. The review also addresses the profound impact of psoriasis on women's quality of life, including physical discomfort, psychological distress, and social stigma. Additionally, fertility concerns are discussed, as severe psoriasis and associated treatments may increase the risk of adverse pregnancy outcomes. Consideration is given to hormonal therapies, lifestyle modifications, and their effects on psoriasis, underscoring the need for personalized treatment approaches that account for hormonal influences. Understanding these hormonal dynamics is essential for developing targeted, effective management strategies that enhance quality of life for women affected by psoriasis.

Gynecological complications and treatment strategies in patients after hematopoietic stem cell transplantation.

In women after hematopoietic stem cell transplantation (HSCT), complications associated with the original disease and therapies used both before and after transplantation often occur, which significantly affects their quality of life. The most common gynaecological complications include secondary cancers, premature ovarian insufficiency (POI), infertility and chronic graft-versus-host disease (cGVHD). Cervical cancer is the most common secondary genital cancer in patients after HSCT. Regular screening and vaccination against HPV (Human Papillomavirus) can significantly reduce the risk for its occurrence. The specific complication after allogeneic hematopoietic stem cell transplantation is graft-versus-host disease (GVHD), the genital form of which can lead to labial and vaginal adhesions, significantly reducing the women's quality of life. The basis of treatment is local steroid therapy and immunosuppression. A consequence of chemotherapy and radiation therapy may be damage to the gonads leading to premature ovarian insufficiency and the onset of menopause symptoms. The basis of treatment is systemic hormone therapy used until middle age when natural menopause is reached. Women after HSCT who are of reproductive age also suffer from infertility. An important role of the doctor is to educate patients about the risk for infertility and to suggest appropriate methods of preserving fertility before starting treatment. The recommended procedure for fertility preservation is cryopreservation of embryos or oocytes. The freezing and retransplantation of ovarian tissue is becoming an increasingly popular method of fertility protection. Preventive examinations and early detection and treatment of gynaecological complications significantly improve the comfort of life and health of women after HSCT.

Desertar de la heterosexualidad. Embrujada e Isabel Sarli como máquina de guerra

This article analyzes the figure the character of Isabel Sarli based on the idea of desertion from the heterosexual regime. To do so, the starting point is the film Embrujada (1969), that establishes connections with other areas of her cinema. The goal is to see in those, the production of the domestic woman in capitalism, modernity, and Western society in tension with myths, beliefs, and cultures that generate other temporalities, pre-modern, pre-capitalist, or pre-industrial. That way, a questioning of family and motherhood can be seen, intertwined with contradictory moral messages. Embrujada and other contemporary films articulate characters of strong, aggressive, and deviant women who challenge traditional masculinity, leading to the emasculation of patriarchal and capitalist power. Thus, certain elements of her cinema contribute to the creation of the Sarli myth, enabling twisted interpretations and sex- dissident resignifications.

Turkish Validation and Reliability Analysis of the International Female Coital Incontinence Questionnaire.

Coital incontinence (CI) is an important problem that negatively affects women's quality of life and is often underreported owing to embarrassment, indicating the importance of its assessment with validated questionnaires. The aim of this study was to validate the Turkish-translated version of the International Female Coital Incontinence Questionnaire (IFCI-Q) for the objective evaluation of women with CI in Turkish-speaking populations. Ninety women with CI filled out the Turkish-translated version of IFCI-Q. Confirmatory factor analysis (CFA), Cronbach's alpha, and intraclass correlation coefficients (ICCs) were evaluated for the construct validity, internal consistency, and test-retest reliability, respectively. Known group validity, which is the ability of the scale to reveal the expected difference according to patients' demographics and PISQ-12 scores, was evaluated. The construct validity was confirmed after excluding the first and third items of the questionnaire (CFI 0.966, TLI 0.944). The first item was excluded from the CFA as all women who completed the IFCI-Q had CI and therefore answered this item questioning the existence of CI as "yes." The third item was eliminated because its factor loading was below 0.20. Cronbach's alpha value for the scale was 0.67. ICC was calculated as 0.97 (0.95-0.98; p < 0.001), indicating a strong positive agreement between the test scores at two time points 2 weeks apart. The Turkish version of IFCI-Q seems to be a reliable, consistent, and valid instrument in the screening and assessment of CI in a gynecology outpatient clinic-based cohort of Turkish-speaking women.

Recent Advances in Vaginal Atresia: A Literature Review.

Vaginal atresia is a rare anomaly of the female reproductive tract that significantly impacts women's reproductive health and quality of life. Although there has been relatively extensive research on the clinical manifestations and differential diagnosis of vaginal atresia, there is a paucity of literature specifically addressing the genetic background, treatment protocols, and psychological status of patients with vaginal atresia, indicating a need for further investigation. In this context, this article systematically reviews the epidemiological characteristics of vaginal atresia and explores its etiology from multiple perspectives, including developmental processes, genetic factors, and environmental factors, emphasizing the importance of genetic susceptibility and environmental interactions in the pathogenesis of the condition. Building upon a summary of the clinical presentations, classification, and diagnostic methods of vaginal atresia, this article provides an overview of current treatment strategies for both partial vaginal atresia and complete vaginal atresia, discusses the psychological status of affected patients, and examines fertility outcomes and sexual function. The aim is to offer insights and recommendations for future research on vaginal atresia, ultimately striving to enhance the quality of life for affected individuals.

New Rat Model Mimicking Sacrocolpopexy for POP Treatment and Biomaterials Testing via Unilateral Presacral Suspension.

Pelvic organ prolapse (POP) impacts women's health and quality of life. Post-surgery complications can be severe. This study uses rat models to replicate sacrocolpopexy and test materials for pelvic support, verifying the 4-week postoperative mortality rate, the mechanical properties of the mesh tissue, and the collagen content. Twenty-one 12-week-old female Wistar rats were used. Eighteen rats were subjected to POP induction by cervical suction and constant traction. One week after prolapse modeling, 18 prolapsed rats underwent unilateral presacral suspension (UPS) surgery with polycaprolactone (PCL) scaffolds, decellularized porcine small intestinal submucosa (SIS) scaffolds, or polypropylene (PP) meshes (n = 6 each). UPS rats were compared with normal rats (n = 3). After 4 weeks, conditions and mortality were recorded. The rats were then euthanized for biomechanical testing and collagen analysis. Ultimate load (N) was defined as the highest load before the failure of the target sample. The UPS procedure requires 42.9 ± 4.5min with no complications or deaths over 4 weeks. SIS was the stiffest mesh (14.53 ± 0.86 N), followed by PP (8.43 ± 0.40 N), and PCL was the least stiff (0.66 ± 0.05 N). After 4 weeks, the ultimate load of the PCL complex increased to 1.71 ± 0.41 N (p = 0.0120), but showed no significant difference from parametrial fascia (1.25 ± 0.85 N) and uterosacral ligament (0.66 ± 0.41 N). The ultimate load of the SIS complex decreased to 5.99 ± 0.37 N, still higher than native tissue. The PP complex's ultimate load (10.02 ± 1.80 N) showed no significant difference from PP alone. The collagen ratio of the PCL complex (48.11 ± 9.88%) was closest to that of the uterosacral ligament (36.66 ± 11.64%), whereas SIS and PP complexes had significantly higher collagen ratios than USL. Unilateral presacral suspension mimics classical surgery for human POP in rats. First, this procedure can investigate the mechanical properties of pelvic floor tissues at the cellular level after correcting POP. Second, it can be used to validate new materials for the surgical treatment of POP, including but not limited to foreign body reactions with surrounding tissues, absorption time, etc. Third, it can be used to study the biological mechanisms of mesh exposure.

Nyai’s Rebellion: When the Author and Translator Unchained the Woman Character from Men’s Domination (A Critical Discourse Analysis)

Nyai’s Rebellion: When the Author and Translator Unchained the Woman Character from Men’s Domination (A Critical Discourse Analysis)

Determination of Human Development Index Based on Classification of Indonesian Women in 2015-2023

Gender equality and women's empowerment are key elements in achieving sustainable social, economic and cultural development. This research aims to analyze the factors that influence the Human Development Index (HDI) of women in Indonesia using a multiple regression model. The independent variables used in this research are the percentage of women's poverty (X1) and women's life expectancy (X2), which were chosen based on their relevance to improving women's quality of life. The data used is sourced from the Indonesian Central Statistics Agency and covers the relevant period for analysis. The analysis tool uses multiple regression. This research evaluates the extent to which these two variables influence women's HDI in Indonesia. The results of the analysis show that variables X1 and X2 have different influences on women's HDI. Based on the research results, it is recommended that women's development policies focus more on reducing poverty, increasing access to education for women of productive age, and improving the quality of life to increase women's life expectancy. This research provides insight for policy designers in formulating more effective programs to improve the quality of life of women in Indonesia.

THE PREVALENCE OF URINARY INCONTINENCE AMONG PREGNANT WOMEN OF SECOND TRIMESTER IN TERTIARY CARE HOSPITALS PESHAWAR

Background: A urinary incontinence (UI) is when urine is removed or leaked without conscious control. This common and embarrassing issue costs people significantly in terms of socioeconomic costs, loss of quality of life, and morbidity. During this time before giving birth, women frequently experience their first UI. Objectives: To check urinary incontinence among different aged groups of female with multiple pregnancy. Methods: After the approval of research proposal from graduate committee, permission was obtained from head of departments of all the specific departments in hospitals. In order to achieve a higher number of women in a shorter period of time, we collected the data from those patients who were admitted in wards. Patients meeting inclusion criteria were recruited in the study. The data was collected using the International Consultation on Incontinence Questionnaire (ICIQ). Results: Mean age of subjects is 29.36 with a standard deviation of 7.96. Urinary incontinence is more prevalent in age group of 30-39 years with the percentage of 70 %. In second trimester the prevalence of urinary incontinence is 60.1%. It is also common once or twice during a day with the percentage of 26.7%. Estimates of the prevalence of incontinence in women are highly variable. These inconsistent results can be largely attributed to the adoption of various incontinence definitions. Conclusions: As the number of gestational week’s increases, UI symptoms in pregnancy become more common. In the majority of cases, the most common type of SUI causes only a small amount of urine loss. Several studies have found that UI causes pregnant women to experience mild to moderate amounts of discomfort. UI has a major negative impact on pregnant women's quality of life.

О‘ZBEK VА INGLIZ MАQОLLАRIDА AYOL ROLINING IFОDАLАNISHI

This article compares Uzbek and English proverbs from a semantic and linguocultural perspective, analyzing the expression of gender semantics in them, especially the attitude towards women in society. Examples of proverbs expressing the female gender in the two languages ​​are given, and their similarities and differences are explained. Proverbs are analyzed based on the social status, marital status, intelligence, character, and moral standards of women in peoples belonging to different language families and different social societies.

Pelvic Floor Muscle Training vs. Vaginal Vibration Cone Therapy for Postpartum Dyspareunia and Vaginal Laxity.

Background and Objectives: Pelvic floor dysfunction and sexual health issues are common postpartum due to weakened pelvic muscles, significantly impacting women's quality of life (QoL). Pelvic floor muscle training (PFMT) is a widely used approach to address these issues. This study aimed to compare the effectiveness of two rehabilitation methods-vibrating vaginal cones (VCG) and PFMT exercises (CG)-in improving pelvic floor muscle strength, reducing dyspareunia, and enhancing sexual function in postpartum women. Materials and Methods: This 1-year retrospective observational analysis evaluated 57 postpartum women presenting with perineal muscle relaxation and sexual dysfunction. Participants were assessed 3 months postpartum (T0) and after 3 months of therapy (T1) at the Pelvic Floor Rehabilitation Clinic of Santa Chiara Hospital, Pisa. Outcomes were measured using the pubococcygeus (PC) test for pelvic floor strength and the Female Sexual Function Index (FSFI) for sexual function. Results: The results revealed significant improvements in pelvic floor muscle strength and sexual function across both groups. While both interventions effectively reduced dyspareunia, the VCG group demonstrated superior outcomes, with 96.67% of participants reporting no pain compared to 80.95% in the CG. FSFI scores improved significantly in both groups, with greater enhancements in arousal, desire, and pain domains observed in the VCG group (p < 0.01). Vaginal cone therapy also resulted in slightly higher gains in overall pelvic floor strength. Conclusions: These findings suggest that vibrating vaginal cones may be a promising option for postpartum pelvic floor rehabilitation, with potential benefits for improving sexual satisfaction and reducing pain.

Survival Pain of Women in Anita Desai's Works

Anita Desai’s women characters suffer because of their inability to strike an emotional chord with their spouses and to vent out their feelings freely. In this novel, Desai portrays Monisha, the protagonist’s plight very graphically and carefully relates it to “the women who are like the female birds in the cage”. All her novels revolve around the traditional status of women in the society dominated by the male chauvinists. As with the other feminist writers like Gita Mehta, Shashi Deshpande, Arundhati Roy etc. the crucial issue taken up by Desai is women’s freedom. Freedom which men always possess but is denied to women flatly. Monisha like a caged bird trapped in an incompatible marriage with Jiban yearns to put her “head out of the window” but the “bars are closely set”. And here Monisha is characterized by a remarkable quest for the self. But unlike Sarita in Deshpande’s “Dark Holds No Terrors” or even Ammu in Arindhati Roy’s “The God of Small Things”, Monisha succumbs to the existential problems within the family fold. The novel ending in the tragic death of Monisha is a grim pointer towards the typical predicament of women in our times. And this is the tragedy of Indian Women leading to strings of suicides day after day. The present paper aims to dilate over this poignant social problem crying for urgent attention and remedial measures in this direction.

Menopause Readiness in Perimenopausal Women in Tanjungpinang Region

Menopause is a natural phase in a woman's life that is faced with various physical and psychological changes. However, many women are not fully prepared for this transition. Lack of education and social support often affect their readiness to face menopause, especially in areas with low health literacy rates. Limited knowledge about perimenopause symptoms and how to manage them can impact a woman's quality of life during this time. This study aims to determine the level of preparedness of women in Tanjungpinang in facing menopause. Method: This study used a quantitative descriptive design. The sampling technique used was purposive sampling with a sample size of 51 women in the perimenopause age range. Data were collected through a questionnaire related to readiness to face menopause. Data analysis was carried out using descriptive statistics to describe the frequency distribution. Most respondents were in the age range of 50 years (27%), with the majority having secondary education (56.9%) and already having more than one child (86.3%). Smoking behavior was found in 96.1% of respondents. Although 54.9% of respondents felt ready to face menopause, there were still 45.1% who felt unprepared. Factors such as education level, number of children, and smoking behavior affect their readiness to face this transition. Women's readiness to face menopause in Tanjungpinang is influenced by various factors, including education, number of children, and smoking behavior. Further research is needed to identify effective interventions to improve women's readiness to face menopause, especially in diverse socio-cultural contexts.

Metaphorical Construction of Chinese Female Images in Media

Introduction. Media is closely related to discourse. Female metaphor in the media is not a simple reflection of the objective world, but a selective and conscious construction of female image in social reality. This study explores the metaphorical construction of Chinese female images in the blessings for women on “Women’s Day” through the media.Methodology and sources. While some words similar to the meanings of “Women’s Day” were selected as keywords, the researcher searched the Wechat platform for articles with the title including these keywords. Then, a total of 306 female metaphors were manually identified and selected as a corpus. With word frequency statistics of the corpus, this study sorted out the categories of Chinese female metaphors and analyzed female image constructed in the media.Results and discussion. It was found that the source domains of female metaphors mainly include plant, animal, daily object, fictional character, nature and environment. The female metaphors can be analyzed from the following categories: Woman is a Flower; Woman is Water; Woman is Half the Heaven; Woman is Light; Woman is a Fairy; Woman is a Book; Woman is a Tiger; Woman is a Jewel. Among them, “Woman is a Flower” is the most frequent one and dominates the female metaphors, while the beauty of “flowers” reflects the beauty of women, the blooming of “flowers” reflects the youth of women, and the aroma of “flowers” reflects the charming of women. “Woman is Water”, “Woman is Half of the Heaven”, “Woman is Light” are also frequent female metaphors, constructing the tenderness, high social status, unique charm and outstanding contribution of female. Other female metaphors also play a certain role in the construction of holiness, wisdom, independence, confidence, strength, precious character of female image. These metaphors construct diversified images in terms of the appearance, character, ability and value of women, and most of the women constructed are beautiful and gentle.Conclusion. It can be seen that the construction of female image in the media becomes diversified on the one hand, on the other hand it still follows the traditional thinking pattern. The paper suggests that gender discourse in the media has been diversified and improved, but still needs to strengthen the construction of equal female image in the harmonious society.

Prevalence and Risk Factors of Osteoporosis: A Cross-Sectional Study in a Tertiary Center.

Background and Objectives: Osteoporosis is a common disease of the skeletal system that increases the risk of fracture. The prevalence of osteoporosis has been increasing as the aging population increases, affecting more than 200 million people worldwide. This study aimed to shed light on the clinical impact of osteoporosis on women's health and quality of life by evaluating the prevalence and risk factors for this disease among postmenopausal women, using a 10-year dataset from a tertiary center. Materials and Methods: This retrospective cohort study was conducted at Dokuz Eylül University, Department of Obstetrics and Gynecology, between 2010 and 2022. A total of 3289 postmenopausal women aged 50-60 years who were undergoing routine gynecological checkups were included in the study. Patients with a prior diagnosis, a history of medical conditions, or who were taking medications affecting bone mineral density (BMD) were excluded. Data on demographics, smoking status, diabetes status, body mass index (BMI), parity, and fracture history were collected. BMD scores were classified as normal, osteopenia, or osteoporosis. Results: The prevalence of osteoporosis was 10.4%. The median age of the patients was 56.0 years. Smoking, diabetes, and a history of bone fractures were found to significantly increase the risk of osteoporosis. BMI was found to have a protective effect against osteoporosis. According to multivariate analysis, the risk of osteoporosis increased by 2.46 times in patients who smoke, 3.78 times in patients with diabetes, and 6.23 times in patients with a history of fractures. Conclusions: Awareness of modifiable risk factors such as smoking is crucial for preventing osteoporosis-related complications. Diabetes, even when it is not complicated, increases the risk of osteoporosis. Physical exercise, calcium, and vitamin D intake are important, especially during young adulthood, as they are the primary contributors to peak bone mass. Because neck fractures are more common in patients with osteopenia, early diagnosis and routine screening can mitigate future complications.

Use of titanium implants in the surgical treatment of complete uterine or vaginal prolapse in elderly and senile patients after hysterectomy

BACKGROUND: With increasing life expectancy, the need to improve the quality of life in elderly and senile women has become more urgent. Pelvic organ prolapse is a significant concern, particularly because this pathology tends to progress in the postmenopausal period. Surgical treatment of pelvic organ prolapse using only the patient’s own tissues often results in recurrence of the disease. This highlights the need for developing new surgical techniques that utilize durable and biologically inert materials, such as titanium implants. AIM: The objective of this study is to analyze the effectiveness and reliability of surgical correction of complete uterine or vaginal prolapse after hysterectomy in elderly and senile women. MATERIAL AND METHODS: A total of 65 women, aged between 65 and 86 years old, were examined and underwent surgery using two newly developed original surgical techniques. Group I (31 patients) underwent surgery with the use of a titanium mesh implant, while Group II (34 patients) underwent surgery with the use of a combination of the aforementioned mesh implant with two non-absorbable ligatures. RESULTS: The outpatient follow-up was carried out on Months 1, 6, 12, 24, 36 and 48 after surgery. The comprehensive examination, comprising questionnaires, gynecological examination and transperineal post-surgery ultrasound, demonstrated that the surgical treatment was satisfactory, as evidenced by an improvement in the women's quality of life. During Month 1 after the surgery, 32 patients (49.2%) reported intermittent perineal pain and/or aches in the area of the inguinal folds, while 15 patients (65.0%) experienced frequent attempts to urinate. These symptoms abated with time. No recurrences of the disease or mesh-associated complications were recorded during the follow-up period. CONCLUSION: The study demonstrates the efficacy and reliability of newly developed surgical techniques for treating complete uterine and vaginal prolapse after hysterectomy in elderly and senile women. The accumulated clinical experience attests to the fact that severe pelvic organ prolapse in elderly patients with concomitant somatic diseases can be successfully treated via surgical intervention. This has the potential to relieve women from the range of symptoms associated with the disease and normalize the functioning of pelvic organs. The introduction of such surgeries into clinical practice will improve the quality of life of elderly and senile patients.