Deficiency In Women Research Articles

Bone mass in Saudi women aged 20-40years: the association with obesity and vitamin D deficiency.

Not attaining peak bone mass is one crucial factor contributing to the risk of developing osteoporosis and suffering fractures in later life. The objectives of this study were to describe the normal range of bone mineral density (BMD) and bone mineral content (BMC) in premenopausal Saudi women in relation to obesity and vitamin D insufficiency. A cross-sectional study involving 312 healthy Saudi women aged 20-40. All women were clinically examined. BMD (g/cm2) and BMC (g) assessed at total body (TB), femoral neck (FN) and lumbar spine (LS) were performed using dual-energy X-ray absorptiometry (DXA). Obesity was defined as BMI ≥ 30kg/m2 and vitamin D deficiency defined as 25(OH)D < 50nmol/L. Almost half of the studied women were obese, and the majority (86.2%) were deficient in vitamin D. Mean BMD in TB 1.060 ± 0.091, FN 0.918 ± 0.153 and LS 1.118 ± 0.123g/cm2, while TB-BMC 2077 ± 272g. When classified by BMI, the proportion with low bone density was 2-3 times higher among the normal weight compared to the obese women, p < 0.001. In the cohort overall, ~ 19% of these young premenopausal women had osteopenia or osteoporosis at the femoral neck, but 26% in normal weight, vitamin D deficient women. This study shows low bone density in premenopausal Saudi women, particularly those with normal weight. While obesity appears to confer some protection against vitamin D deficiency at this age, this is assumed to change in later life.

Thyroid homeostasis in iodine deficient healthy pregnant women from 10 villages of bihar, india

Thyroid homeostasis in iodine deficient healthy pregnant women from 10 villages of bihar, india

Prevalence of Vitamin-D Deficiency and its Associations with Skin Color In First Trimester Pregnant Women

Background: Background and Aim: Vitamin D deficiency during pregnancy has negative clinical consequences, such as associations with glucose intolerance, pre-eclampsia, preterm birth and intra-uterine growth retardation. The rate of vitamin D deficiency in first trimester pregnant women differed depending on their skin colour. Objective: The present study aimed to determine the prevalence of vitamin-D deficiency and its association with skin color in first trimester pregnant women, at a tertiary care hospital in Karachi. Methodology: This descriptive cross-sectional study was carried out on 156 vitamin-D deficient first trimester pregnant women at Derma Clinic, Fatimiyah Hospital, Karachi from during the period from July 2021 to March 2022. Ethical approval was taken from the hospital’s ethical committee. All the twin pregnancy women &gt;18 years with parathyroid history, chronic malabsorption, HIV, liver disease, and suspected drug use were excluded. Vitamin-D deficiency was referred to as &lt;20 ng/mL against sufficient &gt;20 ng/mL. Written informed consent was taken from each individual. During routine examination of pregnancy, approximately 10 mL blood sample was collected and centrifuged. Serum was extracted and analyzed for vitamin-D deficiency. SPSS version 25 was utilized for data analysis. Results: The overall mean age in vitamin D sufficiency and deficiency was 30.45 and 28.91 years respectively. The incidence of vitamin D deficiency was 53.8% (n=84). Of the total, about 72 (46.2%) pregnant women were vitamin D sufficient. The mean serum concentration (25- hydroxyvitamin D) was 25.9 ng/mL (95% CI, 24.5-27.5) in vitamin-D sufficient group and 10.7 ng/mL (95% CI, 9.5-11.5) in vitamin-D deficient group women. Deficiency in Vitamin-D was significantly found in dark-skinned women compared to light-skinned women (OR 2.56; 95% CI 1.1-6.35) based on the most parsimonious model when adjusted for vitamin D supplement, age, smoking, BMI, and parity. Conclusion: The present study found that the prevalence of vitamin D deficiency in pregnant women was 53.5%. The differences in prevalence and 25-OH vitamin D levels mainly rely on maternal skin color, highlighting the need for supplementation programs and consequent screening for pregnant women particularly, dark-skinned pregnant women. Keywords: Vitamin D deficiency, Skin Color, First Trimester, Pregnant women

ESR2 expression in subcutaneous adipose tissue is related to body fat distribution in women, and knockdown impairs preadipocyte differentiation

ABSTRACT Oestrogen receptor 2 (ESR2) expression has been shown to be higher in subcutaneous adipose tissue (SAT) from postmenopausal compared to premenopausal women. The functional significance of altered ESR2 expression is not fully known. This study investigates the role of ESR2 for adipose tissue lipid and glucose metabolism. SAT biopsies were obtained from 44 female subjects with or without T2D. Gene expression of ESR2 and markers of adipose function and metabolism was assessed. ESR2 knockdown was performed using CRISPR/Cas9 in preadipocytes isolated from SAT of females, and differentiation rate, lipid storage, and glucose uptake were measured. ESR2 expression was inversely correlated with measures of central obesity and expression of some fatty acid oxidation markers, and positively correlated with lipid storage and glucose transport markers. Differentiation was reduced in ESR2 knockdown preadipocytes. This corresponded to reduced expression of markers of differentiation and lipogenesis. Glucose uptake was reduced in knockdown adipocytes. Our results indicate that ESR2 deficiency in women is associated with visceral adiposity and impaired subcutaneous adipocyte differentiation as well as glucose and lipid utilization. High ESR2 expression, as seen after menopause, could be a contributing factor to SAT expansion. This may support a possible target to promote a healthy obesity phenotype.

Relationship Between Pregnant Women's Diet With The Event Of Chronic Energy Lack

Based on a report from the Lany Jaya District Health Office in December 2020, there were 161 pregnant women, 9 of whom experienced SEZ with 1 stillbirth. SEZs in Lanny Jaya Regency can be seen based on the patterns of people's daily lives. The people of Lanny Jaya consume sweet potatoes as their main source of carbohydrates, while most of the protein is obtained from vegetables. The purpose of the study was to determine the relationship between the diet of pregnant women and the incidence of chronic energy deficiency. Methods This research uses quantitative with cross sectional design, observational approach, or data collection. The research subjects are pregnant women with chronic energy deficiency and normal pregnant women. The results of this study are that there is a relationship between diet and the incidence of chronic energy deficiency pregnant women in Tiom District, Lanny Jaya, Papua with a p value of 0.03. The conclusion is that there is a significant relationship between diet and the incidence of chronic energy deficiency in pregnant women.

Relationship of Vit D deficiency with obesity, metabolic abnormalities and Insulin resistance in patients with POS

Background: Polycystic ovary syndrome (PCOS) is the leading endocrine disorder that affects women in their reproductive age with global prevalence of 6 to 26%. Many different studies have established a firm relationship between levels of vitamin D and various symptoms of PCOS that includes subfertility, cycle regulation, insulin resistance and hirsutism. Aim: To validate the correlation of insulin resistance and obesity with vitamin D deficiency in women suffering with PCOS. Methodology: A cross-sectional study was conducted including 110 PCOS patients. Anthropometric measures, demographics details, dietary and menstrual history were collected from the patients. Blood samples were also collected and analyzed for parameters of biochemical and hematological nature along with its hormone profile. All the data was analyzed statistically. Results: Low Levels of vitamin D were observed to be greater in people considered overweight/obese as per their BMI. . The vitamin D deficient patients had significantly higher body weight (p = 0.05), BMI (0.01), testosterone (p = 0.03), LH (p=0.03) and serum calcium (p &lt;0.0001). Univariate correlation analysis among all the important parameters and 25-hydroxyvitamin D revealed no significant correlation. Conclusion: Vitamin D deficiency is quite commonly observed in patients dealing with PCOS and aggravates the abnormalities related to metabolism. For the prevention of adverse consequences, screening of PCOS patients for deficiency of 25-hydroxyvitamin D holds importance so that a suitable replacement therapy can be initiated. Keywords: Vit. D deficiency, obesity, polycystic ovarian syndrome, insulin resistance

Health-related quality of life in iron deficient young women

BACKGROUND: The most important cause of anemia in the world is iron deficiency. Young women are more susceptible to the formation of latent iron deficiency and iron deficiency anemia in comparison with other population groups. Iron deficiency conditions can lead to a deterioration in exercise tolerance and adaptation to them, however, the effect of latent iron deficiency and iron deficiency anemia on cognitive functions, emotional status and quality of life is still a subject of discussion, which may be due to the small number of studies in which iron deficiency conditions are studied in the absence of concomitant chronic diseases.&#x0D; AIM: Evaluate the effect of latent iron deficiency and iron deficiency anemia on the quality of life in young women.&#x0D; MATERIALS AND METHODS: a cross-sectional simultaneous study was conducted in women aged 1821 years. The occurrence of iron deficiency conditions was assessed, a study of the quality of life was conducted using the SF-36 questionnaire. In the statistical processing of the results obtained, the assessment of normality within each group was carried out using Shapiro-Wilk test. For an intergroup comparison of the results obtained between two independent groups, MannWhitney test was used, and Wilcoxon test was used when comparing the results of two dependent groups. The intergroup comparison between the three groups was carried out using KruskalWallis test. When detecting deviations from the null hypothesis, a posteriori analysis was carried out using MannWhitney test with Bonferroni correction.&#x0D; RESULTS: 68 subjects aged 1821 took part in the study. The median age was 18 years [18; 21]. 25 (36.7%) women were diagnosed with ID, 16 (23.5%) with IDA. The level of C-reactive protein in all subjects was 5 mg/l, median 2.4 [1.2; 3.1] mg/l. During a posteriori analysis, comparable indicators of the total blood count between the groups of healthy women and those with ID were revealed. At the same time, there were no differences in ferritin levels between the ID and IDA groups. In the study of quality of life, statistically significant intergroup differences between the study groups were obtained in the scales of general health, vital activity, role functioning due to emotional state, mental health and general mental well-being. When conducting a posteriori analysis, the number of points in the questionnaire scales turned out to be comparable between groups of healthy women and those with ID.&#x0D; CONCLUSIONS: data on the high incidence of latent iron deficiency and iron deficiency anemia in young women have been obtained. The presence of latent iron deficiency does not independently affect the quality of life associated with health. Mild iron deficiency anemia moderately reduces the quality of life due to the emotional component.

A Cross-Cultural Systematic Review of Vitamin D Deficiency in Women

A Cross-Cultural Systematic Review of Vitamin D Deficiency in Women

Determine the Prevalence of Vitamin D Deficiency in Individuals with PCOS Who are Admitted to a Tertiary Care Hospital

Aim: The purpose of this research was to study vitamin D deficiency in women with polycystic ovary syndrome. Study Design: Observational/cross-sectional study Place and Duration: The study was conducted at Gynaecology &amp; Obstetrics department of Chandka Medical Hospital, Larkana and Naimat Begum Hamdard University Hospital, Karachi during the period from June 2021 to January 2022. Materials &amp; Methods: In this research, 88 women with polycystic ovarian syndrome between the age of 20 and 40 years participated. Patients' data including age, body mass index, illness duration, parity and residency were recorded once they gave their permission. Vitamin D insufficiency was defined as a serum 25-hydroxy vitamin D level &lt;20 ng/ml. SPSS 22.0 was used to analyze the data. Results: In our study majority of the patients 35 (39.8%) was aged between 26-30 years, followed by 31-35 years 25 (28.4%) patients. Mean BMI of the patients was 29.23±7.55 kg/m2. We found that 60 (68.2%) patients had vitamin D deficiency. Conclusion: According to the findings of this research, patients with polycystic ovarian syndrome had a higher than expected incidence of vitamin D deficiency. Keywords: Vitamin D, Deficiency, PCOS, Polycystic ovarian

A Study on Assessment of Nutritional Awareness among the Migratory Tribal Pregnant Women of Punjab

Nutritional deficiency in women is of particular concern because they may get pregnant and face the added nutritional, physical, and emotional demands of pregnancy, childbirth, and nursing. The objective of the study is to assess the nutritional awareness among the migratory tribal pregnant women of Punjab. The interview method was used to investigate the nutritional awareness of tribal pregnant women. Three hundred pregnant women were selected as sample population from four different tribal groups of Punjab. Structured questionnaire was used as a tool. The majority of the respondents 272 (90.67%) did not have knowledge about the nutritional requirement of the pregnant women, government policies of Iron, and Vitamin A supplementation for pregnant women for combating anemia, iron Vitamin-A-rich rich food, addition of citrus fruits in their diet, the importance of germinated food grains, folic acid-rich foods, nutritional deficiency disease during pregnancy, iodine deficiency during pregnancy, consumption of Iron and Folic acid Supplements in their diet, quantity of food intake during pregnancy, harmful effects of Under Nutrition, source of carbohydrates, protein, iron, vitamin and minerals, importance of nutrition in fetus growth, weight gain during pregnancy, water intake during pregnancy, absorption of Calcium and Iron in the body, the need of Vitamin-C in the body, and need of Zinc in the body.

EDUCATION OF ADDITIONAL FEEDING (MT) BISCUITS TOWARDS FETAL WEIGHT IN PREGNANT MOTHERS CHRONIC ENERGY LACK AT PUSKESMAS SEI SUKA

Chronic Energy Deficiency (KEK) is a nutritional problem caused by a lack of food consumed for a long time, a matter of years. Lack of energy intake of macronutrients (carbohydrates, protein and fat) and micronutrients, especially vitamin A, vitamin D, folic acid, iron, zinc, calcium and iodine as well as other micronutrients. The implementation of PkM activities for pregnant women is carried out through notifications via social media by filling out a google form with a sample of 20 pregnant women who are in the Work Area of the Sei Suka Health Center. The results showed that the increase in the body mass index of pregnant women who experienced SEZ increased by 65% and did not increase by 35%. There is an increase in understanding related to Education on Supplementary Food Giving (Mt) biscuits to fetal weight in chronic energy deficient pregnant women (KEK) in the Work Area of the Sei Suka Health Center

Analysis of Determinan of Stunting Prevalence among Stunted Toddlers in Indonesia

Stunting is regarded as one of the nutritional problems in Indonesia. The prevalence of stunted toddlers in Indonesia showed a decline from 37.2 percent in 2013 to 30.8 percent in 2018. However, this was still far from the WHO target, which should be less than 20 percent. There were two objectives of this study, firstly, to determine the general condition of health and nutrition of toddlers as well as the general condition of households in Indonesia. The second one was to examine the determinants of stunting in toddlers. The data were obtained from Riskesdas 2018, Podes 2018, and population projections per district/city from Statistics Indonesia. The method was carried out using descriptive and inferential analysis. The findings showed that all regions in Indonesia, excluding DKI Jakarta, experienced cases of stunted toddlers categorized in high and very high categories. The regression results confirmed that the prevalence of malnutrition toddlers, the prevalence of obese toddlers, complete basic immunization coverage, the prevalence of chronic energy deficiency in women of childbearing age, the proportion of villages that had adequate midwives per population, as well as the coverage of access and clean water sources had a significant effect on the prevalence of stunted toddlers in Indonesia. The case of stunted toddlers was mainly caused by poverty, bad lifestyle, inadequate health services, and low access to clean water. Therefore, the government policies are then needed, especially those related to socio-economic determinants.

Role of polymorphic loci &lt;i&gt;VDR&lt;/i&gt; rs10735810, &lt;i&gt;MTHFR&lt;/i&gt; rs1801131, &lt;i&gt;MTHFR&lt;/i&gt; rs1801133, &lt;i&gt;MTR&lt;/i&gt; rs1805087,&lt;i&gt; MTRR&lt;/i&gt; rs1801394 AND &lt;i&gt;VEGFA&lt;/i&gt; rs3025039 in missed abortion: A prospective cohort study

Background. Premature termination of pregnancy, including miscarriage, remains among the critical problems in modern obstetrics and gynaecology practices. In the context of early gestational failure and the notion that 80% of early miscarriages are triggered by genetic reset — some natural filter — an analysis of current knowledge of the genetic aspects of missed abortion (MA) appears relevant.Objectives. A study of the haplotype frequencies for VDR rs10735810, MTHFR rs1801131, MTHFR rs1801133, MTR rs1805087, MTRR rs1801394 and VEGFA rs3025039 polymorphic loci and their association with vitamin D deficiency in women with missed abortion.Methods. A total of 178 women aged 18 to 41 years were examined. The main cohort consisted of MA patients (n = 101) who were divided between cohort I (n = 58; patients with primary MA) and cohort II (n = 43; patients with recurrent MA). The control cohort (n = 77) consisted of women with a successful pregnancy (Z34.0) entailing a term and live birth. Genotyping of polymorphic loci VDR rs10735810, MTHFR rs1801131, MTHFR rs1801133, MTR rs1805087, MTRR rs1801394 and VEGFA rs3025039 was performed in 177 patients. Total serum 25(OH) D (n = 99) was determined by mass spectrometry. Statistical analysis was carried out using the Statistica v. 10 data analysis software (StatSoft, Russia; TIBCO, USA). Results. No differences were revealed for the frequencies of studied haplotypes between MA women and those who gave birth to healthy full-term newborns (p &gt;0.1). No association was found between first-trimester MA and the presence of polymorphic loci variants (p &gt;0.1). The GG haplotype of gene VDR is even less frequent in recurrent MA patients than in control (14.0% vs. 23.7%; OR = 2.29; 95% CI: 0.738–7.075). The GG haplotype of gene MTR has a 2-fold higher frequency in primary MA patients compared to control, albeit at no statistical significance (8.6 vs. 4.0%). Haplotype TT of the gene VEGF polymorphism occurs even less frequently in primary MA patients than in control (3.5 vs. 7.9%, respectively). Patients with first-trimester MA exhibited an association between vitamin D deficiency and the frequency of polymorphic variants VDR rs10735810 (p = 0.0304) and MTHFR rs1801133 (p = 0.0180). The other studied genes did not reveal such an association.Conclusion. The study demonstrates a pathogenetic association of polymorphic variants VDR rs10735810 and MTHFR rs1801133 with missed abortion and vitamin D deficiency.

FREQUENCY OF FOLIC ACID DEFICIENCY IN WOMEN OF CHILDBEARING AGE PRESENTING AT AYUB TEACHING HOSPITAL, ABBOTTABAD

Folic acid deficiency is one of the most common deficiencies among women of childbearing age. It can lead to neural tube defects, a significant cause of disability and mortality among infants. Therefore, the main objective of this study was to determine a folic acid deficiency in women of childbearing age in Ayub Teaching Institute, Abbottabad. This cross-sectional study was carried out in Ayub Teaching Institute, Abbottabad from January to June 2020. In this study, a total of 193 women of childbearing age were included through consecutive sampling. In this study 193 women of childbearing age were included. Mean age was 30±4.87 years. Out of 193 patients, 56.7% were found to be anemic and 38.9%were found to have folic acid deficiency. Our study concludes that the majority of women of child bearing age are anemic in our set up. Moreover, the frequency of folic acid deficiency is 38.9 % which is high.

Prevalence of vitamin A deficiency in women of childbearing age in Brazil: a systematic review and meta-analysis.

Vitamin A is an essential micronutrient, especially during pregnancy. We aimed to assess the prevalence of vitamin A deficiency in Brazilian women of childbearing age. We conducted a systematic review with meta-analysis of studies that assessed vitamin A deficiency in women of childbearing age following the registered protocol (CRD42020171856). Independent peer researchers selected the studies retrieved from MEDLINE, Embase, Scopus and other sources. Data from the eligible studies were extracted in pairs and assessed for methodological quality. The prevalence of vitamin A deficiency (< 0·70 µmol/l or <0·20 µg/dl) and 95 % CI was combined by meta-analysis, and heterogeneity was estimated by I2. Out of 3610 screened records, thirty-two studies were included, which assessed 12 577 women from 1965 to 2017, mostly in maternity hospitals. Main limitations of the studies were in sample frame (30/32) and sampling method (29/32). Deficiency occurred in 13 % (95 % CI 9·4, 17·2 %; I² = 97 %) of all women and was higher in pregnant women (16·1 %; 95 % CI 5·6, 30·6 %; I² = 98 %) than non-pregnant women (12·3 %; 95 % CI 8·4, 16·8 %; I² = 96 %). The prevalence increased according to the decade, from 9·5 % (95 % CI 1·9–21·6 %; I² = 98 %) up to 1990, 10·8 % (95 % CI 7·9, 14·2 %; I² = 86 %) in the 2000s and 17·8 % (95 % CI 8·7, 29·0 %; I² = 98 %) in the 2010s. Over 10 % of Brazilian women in childbearing age were deficient in vitamin A. Higher prevalence was observed in pregnant women, and deficiency seemed to be increasing over the decades. Low representativeness of the studies, mainly based on convenience sampling that included pregnant, postpartum, lactating and non-pregnant women, as well as high heterogeneity, limits the findings.

A validated screening tool correctly identifies the majority of pregnant women at high risk of vitamin D deficiency.

The objective was to develop and validate a non-invasive screening tool to identify pregnant women at high risk of vitamin D deficiency. Data from the Swedish prospective cohort GraviD, 2125 pregnant women, were randomly split in halves; one for developing the screening tool, and one for validation. Risk factors of vitamin D deficiency (serum 25-hydroxyvitamin D<30nmol/L) were identified using logistic regression analyses and odds ratios were translated into scores. Cutt offs to indicate high risk of vitamin D deficiency were evaluated by receiver operator characteristics. Five variables (season, clothing, eye color, fortified milk intake and vitamin D supplement use) were included in the screening tool. The possible total score was 0-42. Mean (95% CI) area under the curve for classification of vitamin D deficiency was 0.921 (0.893-0.948) (p<0.001). A score of ≥15 points had 92% sensitivity and 76% specificity to identify women with 25OHD <30nmol/L. This cut off had a positive predictive value of 31% and a negative predictive value of 99%. This short non-invasive screening tool is valid as it correctly identified the majority of the vitamin D deficient pregnant women, who may benefit from further investigation for definite diagnosis and subsequent treatment.

Placental Ferroportin Protein Abundance Is Associated With Neonatal Rather Than Maternal Iron Status in Women at High Risk for Gestational Iron Insufficiency

ObjectivesMurine data suggest that the placenta prioritizes iron (Fe) for its own needs when Fe is limited by upregulating transferrin receptor 1 (TFR1) and downregulating the Fe exporter ferroportin (FPN). Human data on the impact of maternal and neonatal Fe status on placental FPN are conflicting. The study aims were to identify determinants of placental FPN protein abundance in women at risk of Fe insufficiency and to assess the utility of the placental Fe deficiency index (PIDI), which is the FPN/TFR1 ratio, as a measure of maternal/fetal Fe insufficiency.MethodsFPN and TFR1 protein abundance was measured by semi-quantitative western blots in placentae collected from 43 neonates born to teens (17.4 ± 1.1 y) carrying singletons (39.9 ± 1.3 weeks of gestation at birth) and from 57 neonates born to 26 women (31.3 ± 6.3 y) carrying multiples (35.5 ± 2.7 weeks of gestation at birth). Fe status biomarkers (Hb, SF, sTfR, TBI) and hormones (hepcidin, EPO, ERFE) were assessed in maternal and cord blood.ResultsFPN and TFR1 were detected in all samples analyzed between 30.4–41.7 weeks of gestation. In both cohorts, FPN protein abundance was associated with neonatal but not maternal factors. Higher FPN was associated with lower cord Hb (p = 0.03) in the multiples cohort and with higher cord EPO (p = 0.002) in the teens. In contrast, TFR1 was inversely associated with maternal Fe status; multiples cohort (SF, p = 0.01; sTfR, p = 0.01; TBI, p = 0.003; hepcidin p = 0.01), teens (SF, p = 0.01). The PIDI was predicted by maternal and neonatal Fe status but in opposite directions. In the multiples cohort, Fe deficient women (mid-gestation sTfR > 8.5 mg/L, delivery SF < 12 μg/L or TBI < 0 mg/kg) had a lower PIDI (p = 0.02, p = 0.003, p = 0.04) but lower cord Hb was associated with a higher PIDI (p = 0.004). In the teens, lower mid-gestation hepcidin was associated with a lower PIDI (p = 0.009) but higher cord EPO was associated with a higher PIDI (p = 0.006).ConclusionsPlacental FPN protein was inversely associated with neonatal Fe status. The PIDI captures fetal and maternal regulation of placental Fe trafficking as it reflects Fe export to the fetus relative to Fe import from maternal circulation. More data are needed to assess the utility of the PIDI as an indicator of Fe insufficiency during pregnancy and how it relates to neonatal outcomes that are driven by placental health.Funding SourcesUSDA, Gerber Foundation, NIH NICHD.

Evaluation of early Menopause symptoms in Post-Hysterectomy and Premature Ovarian insufficiency in women of reproductive age group

The present study was aimed at investigating early menopause symptoms in women of reproductive age with post-hysterectomy and premature ovarian insufficiency conditions. A total of 100 patients were included in the study after following inclusion and exclusion criteria. Data were collected by using a questionnaire (Menopause Rating Scale) based on the psychological, urogenital and somatic symptoms of the patients. The outcomes of study indicated that majority of women showed menopausal symptoms between 36 to 45 years of age, with a mean age of menopause was 42±3 years. While in premature menopause cases, the average age was 36 to 40 year with a mean age to attain it was 38±2 year. Further, the rate of psychological distress were highest in premature menopausal women as compared to normal menopausal women. The premature menopausal women experienced higher prevalence of somatic and urogenital symptoms as compared to normal menopausal women. Conclusively, premature menopausal women need to be considered in special category so that health care providers can plan strategies for them accordingly.

Management of iron deficiency in chronic heart failure

Iron deficiency is frequent in patients with chronic heart failure (CHF) with a prevalence of 50%, and its frequency varies depending on the study groups. The presence of iron deficiency limits erythropoiesis, leading to the development of anemia over time in patients with CHF, regardless of gender, race, and left ventricular ejection fraction (LVEF). Observational studies demonstrate a higher prevalence of iron deficiency in women and in patients with higher NYHA (New York Heart Association) functional class, decreased LVEF, increased brain natriuretic peptide (NT-proBNP), or increased high-sensitivity C-reactive protein. Iron deficiency and anemia in patients with CHF are independently associated with a decreased exercise capacity, hospitalizations for CHF, an increase in overall mortality and mortality from cardiovascular diseases. The clinical significance of iron deficiency requires the need to diagnose iron metabolism in all patients with CHF. Current guidelines for the diagnosis and treatment of CHF indicate the need to determine the level of ferritin and saturation of transferrin in all patients with a suspected diagnosis of heart failure. The use of oral iron therapy in patients with CHF demonstrates its low efficacy in correcting this condition according to the clinical trials. At the same time the use of intravenous iron therapy is safe and improves symptoms, exercise capacity and quality of life in patients with heart failure with reduced ejection fraction and iron deficiency, which has been shown both in international placebo-controlled trials and meta-analyses. The use of iron carboxymaltose should improve CHF symptoms, exercise capacity and quality of life in patients with CHF and LVEF45%. Intravenous iron therapy has also been shown to reduce readmissions for CHF in patients with an LVEF50% who have recently been hospitalized for worsening CHF.

Vitamin D and Obesity/Adiposity-A Brief Overview of Recent Studies.

Observational studies classically find an inverse relationship between human plasma 25-hydroxyvitamin D concentration and obesity. However, interventional and genetic studies have failed to provide clear conclusions on the causal effect of vitamin D on obesity/adiposity. Likewise, vitamin D supplementation in obese rodents has mostly failed to improve obesity parameters, whereas several lines of evidence in rodents and prospective studies in humans point to a preventive effect of vitamin D supplementation on the onset of obesity. Recent studies investigating the impact of maternal vitamin D deficiency in women and in rodent models on adipose tissue biology programming in offspring further support a preventive metabolically driven effect of vitamin D sufficiency. The aim of this review is to summarize the state of the knowledge on the relationship between vitamin D and obesity/adiposity in humans and in rodents and the impact of maternal vitamin D deficiency on the metabolic trajectory of the offspring.