Permanent Cessation Research Articles

Assess the Psychological Problem and Coping Strategies Adopted among Post Menopausal Women at Tribal Area of Bhandardara

Background: Menopause is Universal phenomenon and is permanent cessation of menstruation resultingto loss of ovarian follicle development. Menopause is most striking feature during the period of transitionfrom the reproductive to the non-reproductive stage of life due to hormonal changes women experience widerange of physical, psychological and social problem. Psychological symptoms causes effect of daily lifeand also most often neglected. Stress due to transition includes a adjusting to the changing self, alterationin sexuality caused by hormonal changes. Coping strategies help women to overcome these problems andlead a normal lifes.1Aim of the study: Assess the psychological problem and coping Strategies adopted among Post menopausalwomen. Methods: A cross sectional survey of 250 post menopausal women, selected by non-probabilitypurposive sampling technique. Survey was conducted by structure questionnaire at tribal area of Bhandardara.Result: Majority (30%) women from 45-55 years of age. Overall mean score for psychological problemwere (60.26±14.13) whereas for coping strategies mean score was (106.79±22.60). Nearly half (50%)women under study had mild to moderate psychological problems. There is statistical significant correlationbetween psychological problems and coping strategies adopted by menopausal women at 0.05 level.Conclusion: Study findings shows most of the women had mild to moderate psychological symptoms andvery few women adopted the coping strategies to reduce the psychological problem.

Temporary cessation of ibrutinib results in reduced grade 3-4 infections and durable remissions-Interim analysis of an on-off-repeat Phase 1b/2 study in patients with chronic lymphocytic leukemia.

Ibrutinib is used continuously in CLL. This phase 1b/2 study interim analysis explored on‐off‐repeat dosing to reduce toxicity. After 12 months, 16/22 patients (73%) remained in first off‐phase irrespective if initial CR/PR or TP53 aberration. Grade 3‐4 infections were reduced from 55% to 5% during a similarly long off‐phase (P < .01). Treg and exhausted T‐cells increased (P = .01). Six patients restarted ibrutinib at early progression and remain drug‐sensitive. Our interim analysis shows a durable off‐phase in most patients, with reduced infections and cost‐saving potential. If toxicity‐driven permanent cessation of ibrutinib will be affected will be explored in the extended study.

Understanding menopause-postmenopausal complications, management and quality of life

Menopause is a commonly occurring transition that all women go through with advancing age. The permanent cessation of menstruation is defined as natural menopause it happens with the termination of a woman’s final menstrual period. Variations in race and ethnicity may be a reason for different menopausal onsets in women which may also be affected by lifestyle and demographic factors. A negative effect on the common health and quality of life (QOL) as well as the contentment of middle-aged women may occur due to Menopause and associated biological changes. From one individual to another, symptoms of menopause and their severity differ due to the effects of different factors such as social status, lifestyle, psychological status, and body composition. QOL in women may be diminished due to Menopausal symptoms, mostly sexual and vasomotor symptoms.

Death: Ethical, Medical and Theological Interconnectedness

Death is a biological phenomenon, define as the permanent and irreversible cessation of all biological functions of a being. Many people are afraid of discussing, thinking, or planning their own deaths because of we do not know about death and why death occur. If we know what is death we can think for planning our life, preparing a will, or deciding whether we will remain home or seek help before death. Moreover, after death, we transfer to another world passing out along with funeral according to religious. People seek help to religious cleric, as there is vast information regarding death in religion. As the death is the inevitable system and part and percale of life, therefore we must aware of what death is. We need do good deed in term of one day we will die and after death we will be nowhere but our benevolent works remain and may make us eternal or we will be rewarded heaven or hell or transmigrate to a new body according to our conduct.

A Cross-Sectional Study to Determine Effect of Menopause on Quality of Life and Pain in Women Aged 40-60 Years

Background: Menopause means the permanent cessation of menstruation at the end of reproductive life dueto loss of ovarian follicular activity. Menopause has a profound impact on a woman’s physical and mentalhealth as a whole. Quality of life and pain are measured to study and compare the effect of menopause onthem.Objective: The aim of this study was to compare quality of life and pain among pre-, peri- and postmenopausalwomen and find the effect of menopause on the above-mentioned factors.Methodology: This cross-sectional study included 258 women between the age group of 40-60 years whowere classified according to their menstrual status into premenopause, perimenopause and postmenopause.They were selected on the basis of inclusion and exclusion criteria. All the participants agreed to participatein the study. Outcome measures SF-20, VAS was measured. Statistical analysis of the data was performedusing SPSS version 20 through application of descriptive statistics, t-test and multivariate analysis.Result: The data measure of outcome variables of the premenopausal, perimenopausal and postmenopausalgroups was compared using descriptive statistics, multivariate analysis and t-test. The components of SF-20which were significantly reduced for postmenopausal women as compared to premenopausal were physicalfunctioning (p=0.000), role functioning (p= &lt;0.00001), social functioning (p= &lt;0.00001), mental health (p=0.0000), health perception (&lt;0.00001). The component of pain was significantly increased (p = 0.0158) inpostmenopausal women compared to premenopausal women.Conclusion: Thus, we can conclude there is significant deterioration in components of quality of life andpain in postmenopausal women as compared to premenopausal women even after controlling for age. Thesefindings will help to add valuable input to current research on menopause.

Modeling the Impact of Creating New Investments in the Small and Medium Enterprises Sector on Its Competitiveness in Algeria: A Standard Analytical Study Using the Panel Data Analysis Model

This study aimed at analyzing and modeling the impact of new investments in the small and medium enterprises sector on their competitiveness, according to the various economic activity sectors operating in them in Algeria, through the factors of time and development in the number of institutions, The results of the study have demonstrated that the weak competitiveness of small and medium enterprises through their permanent cessation of activity is positively related to the development of re-activity for small and medium enterprises, and the increase in the volume of investments through the creation of new institutions, which explains an increase in the volume of production and competition.

English

BACKGROUND Menopause is defined as the permanent cessation of menstruation following loss of ovarian activity. One of the most important problems associated with menopause is osteoporosis. This study was conducted to evaluate the relationship between bone mineral density, body mass index, age, serum calcium, and serum magnesium in 120 women. METHODS Present study was an observational study done from Feb 2017 to July 2017 in Pt. J.N.M. Medical College to evaluate the relationship of bone mineral density with age, body mass index (BMI), obesity and serum magnesium in 120 postmenopausal women. A detailed medical, obstetrical, menstrual, and drug history was recorded in a proforma designed for the study. Past fracture history, family history of fracture and osteoporosis, socioeconomic status, occupation, educational level and weightbearing exercises were collected and recorded. RESULTS Average age of women with normal bone health was 30.5 + 0.58 years, while the age of osteopenic and osteoporotic women was 43.11 + 6.79 years and 54.64 + 11.92 years respectively. Most of the osteopenic women belonged to the age group of 40 – 49 years. Osteoporotic patients (78.57 %) had a high (&gt; 0.85) waist-hip ratio, while women with normal bone mineral density had a normal waist-hip ratio. Most of the women with normal bone mineral density (100 %), osteopenia (85.29 %) and osteoporosis (57.14 %) had normal serum magnesium levels. CONCLUSIONS We found that the bone mineral density reduced with advancing age, decreasing BMI and obesity, while we found no correlation of serum magnesium level with bone mineral density (BMD). KEY WORDS Bone Mineral Density, Body Mass Index, Perimenopause, Magnesium, Calcium

Determinants of enhanced vulnerability to Covid-19 in U.K. cancer patients: Results from the OnCovid study.

1574 Background: Despite high contagiousness and rapid spread, SARS-Cov-2 has led to heterogeneous outcomes across affected nations. Within Europe, the United Kingdom is the most severely affected country, with a death toll in excess of 100.000 as of February 2021. We aimed to compare the national impact of Covid-19 on the risk of death in UK cancer patients versus those in continental Europe (EU). Methods: We performed a retrospective analysis of the OnCovid study database, a European registry of cancer patients consecutively diagnosed with Covid-19 in 27 centres from February 27 to September 10, 2020. We analysed case fatality rates and risk of death at 30 days and 6 months stratified by region of origin (UK versus EU). We compared patient characteristics at baseline, oncological and Covid-19 specific therapy across cohorts and tested these in multivariable Cox regression models to identify predictors of adverse outcome in UK versus EU patients. Results: Compared to EU patients (n = 924), UK patients (n = 468) were characterised by higher case fatality rates (40.38% versus 26.5%, p &lt; 0.0001), higher risk of death at 30 days (hazard ratio, HR 1.64 [95%CI 1.36-1.99]) and 6 months after Covid-19 diagnosis (47.64% versus 33.33%, p &lt; 0.0001, HR 1.59 [95%CI 1.33-1.88]). UK patients were more often males, of older age and more co-morbid than EU counterparts (p &lt; 0.01). Receipt of anti-cancer therapy was lower in UK versus EU patients (p &lt; 0.001). Despite equal proportions of complicated Covid-19, rates of intensive care admission and use of mechanical ventilation, UK cancer patients were less likely to receive anti-Covid-19 therapies including corticosteroids, anti-virals and interleukin-6 antagonists (p &lt; 0.0001). Multivariable analyses adjusted for imbalanced prognostic factors confirmed the UK cohort to be characterised by worse risk of death at 30 days and 6 months, independent of patient’s age, gender, tumour stage and status, number of co-morbidities, Covid-19 severity, receipt of anti-cancer and anti-Covid-19 therapy. Rates of permanent cessation of anti-cancer therapy post Covid-19 were similar in UK versus EU. Conclusions: UK cancer patients have been more severely impacted by the unfolding of the Covid-19 pandemic despite societal risk mitigation factors and rapid deferral of anti-cancer therapy. The increased frailty of UK cancer patients highlights high-risk groups that should be prioritised for anti-SARS-Cov-2 vaccination. Continued evaluation of long-term outcomes is warranted.

Beyond “Safe and Effective”: The urgent need for high-impact smoking cessation medications

Smoking cessation medications (SCMs) are an evidence-based cornerstone of comprehensive tobacco control programs globally. However, the impact of SCMs on population smoking prevalence is controversial, with inconsistencies between randomized controlled trials (RCTs) and population-based observational studies. We estimated SCM impact on permanent cessation and population smoking prevalence by extrapolating efficacy estimates from meta-analyses of RCTs, using the standard population impact formula: efficacy*reach. We calculated the potential SCM impact under a range of assumptions for permanent cessation (20%,14%), behavioral support (yes/no), reach (40%–2%), and underlying smoking prevalence. Assuming behavioral support for all, depending on reach, 8%–0.3% of smokers are expected to quit permanently. Without behavioral support, permanent cessation is estimated to be 6.4%–0.2%. Assuming an underlying population smoking prevalence of 14%, (current U.S. prevalence), the maximum impact on population smoking prevalence is 1.12%. Impact on prevalence increases with increasing underlying country-specific levels of prevalence. With current U.S. levels of reach, behavioral support and smoking prevalence, we estimate that, based on a single course of treatment, 2.3% of smokers would quit permanently, contributing to a 0.3% decrease in population level smoking prevalence. Even under ideal conditions, the potential of current first-line SCMs to increase cessation in a substantial proportion of smokers, and reduce population smoking prevalence, is limited. In order to avert the predicted billion tobacco-caused deaths in this century, “safe and effective” medications are not sufficient: SCMs with high population impact are urgently needed. Policies to ensure the availability and accessibility of highly efficacious SCMs, with behavioral support, are crucial.

English

BACKGROUND Universally every woman faces menopause and feeling of onset of uncomfortable physical, psychological and emotional changes. Many fear about their loss of beauty and sexual life. The word menopause has come from Greek word “Menos” meaning menstruation and “Pause” meaning stopping of the menstrual period. 1 The loss of ovarian follicular activity or the dwindling function of ovaries at the end of reproductive life which leads to permanent cessation of menstruation is known as menopause or climacteric. The period of time when women passes from reproductive to non–reproductive stage is menopause transition. The life after menopause is the stage of postmenopausal period. In majority of women, menopause occurs without any physical or psychological symptoms. But in some of the women there will be marked physical and psychological symptoms. Symptoms of the climacteric are multiple and vague. These climacteric symptoms are due to decrease in oestrogen level and increase in Gonadotrophin level in the body, but the exact mechanism is unknown. The climacteric symptoms are grouped into vasomotor symptoms (hot flushes, night sweats), cardiovascular symptoms and cerebro-vascular effects (hypertension, palpitation, heart disease), neurological &amp; psychological symptoms (anxiety, depression, insomnia, irritability, malaise, loss of libido / lethargy), general symptoms (fatigue, headache, general weakness, vertigo, breast tenderness, skin pigmentation, dyspareunia, indigestion or constipation, obesity), physical symptoms / changes (atrophy of secondary sexual characters, atrophy of internal genital organs, osteoporosis, skin becomes thick and coarse, straggling growth of hair).2 KEY WORDS Flax Seed, Climacteric Symptoms, Menopause

Determinants of enhanced vulnerability to coronavirus disease 2019 in UK patients with cancer: a European study

BackgroundDespite high contagiousness and rapid spread, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to heterogeneous outcomes across affected nations. Within Europe (EU), the United Kingdom (UK) is the most severely affected country, with a death toll in excess of 100,000 as of January 2021. We aimed to compare the national impact of coronavirus disease 2019 (COVID-19) on the risk of death in UK patients with cancer versus those in continental EU. MethodsWe performed a retrospective analysis of the OnCovid study database, a European registry of patients with cancer consecutively diagnosed with COVID-19 in 27 centres from 27th February to 10th September 2020. We analysed case fatality rates and risk of death at 30 days and 6 months stratified by region of origin (UK versus EU). We compared patient characteristics at baseline including oncological and COVID-19–specific therapy across UK and EU cohorts and evaluated the association of these factors with the risk of adverse outcomes in multivariable Cox regression models. FindingsCompared with EU (n = 924), UK patients (n = 468) were characterised by higher case fatality rates (40.38% versus 26.5%, p < 0.0001) and higher risk of death at 30 days (hazard ratio [HR], 1.64 [95% confidence interval {CI}, 1.36–1.99]) and 6 months after COVID-19 diagnosis (47.64% versus 33.33%; p < 0.0001; HR, 1.59 [95% CI, 1.33–1.88]). UK patients were more often men, were of older age and have more comorbidities than EU counterparts (p < 0.01). Receipt of anticancer therapy was lower in UK than in EU patients (p < 0.001). Despite equal proportions of complicated COVID-19, rates of intensive care admission and use of mechanical ventilation, UK patients with cancer were less likely to receive anti–COVID-19 therapies including corticosteroids, antivirals and interleukin-6 antagonists (p < 0.0001). Multivariable analyses adjusted for imbalanced prognostic factors confirmed the UK cohort to be characterised by worse risk of death at 30 days and 6 months, independent of the patient's age, gender, tumour stage and status; number of comorbidities; COVID-19 severity and receipt of anticancer and anti–COVID-19 therapy. Rates of permanent cessation of anticancer therapy after COVID-19 were similar in the UK and EU cohorts. InterpretationUK patients with cancer have been more severely impacted by the unfolding of the COVID-19 pandemic despite societal risk mitigation factors and rapid deferral of anticancer therapy. The increased frailty of UK patients with cancer highlights high-risk groups that should be prioritised for anti–SARS-CoV-2 vaccination. Continued evaluation of long-term outcomes is warranted.

Cultural differences, attitudes and perceptions regarding menopause

Menopause, in many parts of the world, is considered as an important issue in a woman's life. It begins with the permanent cessation of menstruation and is a period of transition and adaptation to a new condition characterized by lack of estrogen and loss of reproductive capacity of the woman. The transition to this new reality is accompanied by a series of biological and psychosocial changes with a variety of physical and emotional symptoms. As every woman is different, so the experience of menopause varies. According to the literature, although the emergence of symptoms is a global phenomenon, women from different cultural backgrounds report different symptoms. The same applies to perceptions about the meaning of menopause. The aim of the present paper was to investigate, through recent literature data, these different perceptions and symptoms that women of different cultures attribute to menopause. The review showed important differences between women of different countries but also between women living in the same country.

Adverse impact of smoking on the spine and spinal surgery.

Background: Tobacco smokers and companies are well aware that smoking increases the risks for cancers, vascular morbidity, and early mortality. This is a review of the plethora of adverse effects chronic smoking has on spinal tissues and spinal surgery.Methods: Medline (PubMed) and Google Scholar databases were searched for pertinent literature through keywords related to smoking, spondylosis, and spinal surgery.Results: Smoking accelerates spondylosis by impairing spinal tissue vascular supply through atherosclerosis and thrombosis, while inducing local hypoxia, inflammation, proteolysis, and cell loss. It, thus, compromises disc, cartilage, synovium, bone, and blood vessels. It can lead to early surgery, delayed wound healing, increased surgical site infection, failed fusion, more re-operations, and chronic spinal pain.Conclusion: There is ample evidence to support surgeons’ declining to operate on chronic smokers. The need for immediate and permanent smoking cessation and its potential benefits should be emphasized for the patient considering or who has undergone spinal surgery.

Looking Beyond the Provision of Injecting Equipment to People Who Use Anabolic Androgenic Steroids: Harm Reduction and Behavior Change Goals for UK Policy

Understanding of the choices and motivations of people who use anabolic androgenic steroids (AAS) for muscular enhancement has increased greatly in the past thirty years, along with understanding of a wide range of health harms associated with this form of drug use in the community. During this period the predominant public health intervention for this population in the UK has consistently remained the provision of injecting equipment to prevent blood borne virus (BBV) transmission. The study explored the health professionals’ and other stakeholders’ perceptions on: whether the current UK public health response is sufficient to address the needs of people who use AAS, and if not, what other needs they might have. This included an exploration of whether there were gaps in harm reduction strategies or other behavioral outcomes and interventions that were needed. Interviews with 27 stakeholders who provide support to people who use AAS in a variety of roles established consensus on the need for a range of interventions to reduce harm and risk in those that choose to use AAS, to prevent initiation, to motivate and support cessation, and to prevent relapse. Study findings indicate that while providing sterile injecting equipment remains essential, it should be considered a bare minimum. The challenge is to develop and deliver a range of harm reduction interventions that look beyond BBV prevention to provide appropriate support to who choose to use AAS at all points in their cycles of use and ultimately for those choosing the temporary or permanent cessation of use.

Menopause

The female reproductive system matures in a continuous, natural process from menarche to menopause as the finite numbers of oocytes produced during fetal development are gradually lost to ovulation and senescence. Menopause is defined as the permanent cessation of menses; by convention, the diagnosis of menopause is not made until the individual has had 12 months of amenorrhea. Menopause is thus characterized by the menstrual changes that reflect oocyte depletion and subsequent changes in ovarian hormone production. However, hormonal changes, rather than the cessation of menstruation itself, cause the manifestations that occur around the time of menopause. Therefore, a woman who has undergone a hysterectomy but who retains her ovaries can experience normal menopausal symptoms as oocyte depletion leads to changes in estrogen levels, even though cessation of menstruation occurred with surgery. This review covers definitions, natural menopause, menopausal transition and postmenopausal symptom management, and premature ovarian insufficiency. Figures show stages of reproductive aging, serum concentrations of hormones during menopausal transition and postmenopause, hormonal changes associated with reproductive aging, symptoms of menopausal transition and menopause, treatment algorithm(s), and Women’s Health Initiative findings: risks and benefits of estrogen alone and estrogen plus progestin by age group: 50 to 59, 60 to 69, and 70 to 79 years. Tables list target tissues, physical manifestations, and menopausal symptoms; selective estrogen receptor modulators used in postmenopausal women; differential diagnosis and evaluation of common menopausal symptoms; estrogen doses; progestogen dosing for endometrial protection; nonhormonal pharmaceutical hot flash therapies; and pharmacologic therapy for genitourinary atrophy. This review contains 6 figures, 8 tables, and 122 references.

How common is new product failure and when does it vary?

This study aims to explore how common new product failure is in consumer packaged goods (CPG) categories and investigate the conditions in which the new product failure rate varies. This study analyzes 83,719 new stock-keeping units (SKUs), which were introduced over 8 years (2002–2009) across 31 CPG categories in the USA. Failure is the permanent cessation of sales, which is measured in consumer panel data. We find that one in four (25%) new SKUs are no longer bought 1 year later—a rate that increases to approximately 40% 2 years post-launch. New SKU failure was more likely for new launches that were introduced into higher revenue categories and by smaller share parent brands. Our findings can be used as a resource to aid marketing practitioners’ understanding regarding how common failure is for new CPGs and when there is greater associated risk.

Homoeopathy and menopausal syndrome: Health seeking behaviour of women aged 40-60 years in Chennai

Background: Menopause is the physiological process as it signifies the permanent cessation of menstruation and end to the reproductive potential. Menopause is the part of women’s life which plays a major role in second half of the women’s life where women face the transition phase from reproductive to non-reproductive phase of their lives. An estimated 80% of female’s experience physical or psychosocial symptoms while approaching menopause, leading to change in their quality of life (QOL). The previous outcome study and service evaluation of the homoeopathy service in 1999–2000, which found that 88% of patients reported clinically significant improvement in their primary symptoms of menopause. Objective: To assess the health seeking behaviour of women aged 40- 60 years for menopausal syndrome in homoeopathy.Methods: A cross-sectional survey was conducted among women aged between 40—60years during the period of March 2019 to May 2019(period of 3months) to know the health seeking behaviour of women approaching Homeopathy for menopausal symptoms. The Information was asked through direct personal interview.Results: The most common symptoms faced by women were mood swings (78.8%) and disturbance in the sleep (76.4%). Most of the respondents showed good prognosis w after homeopathic remedy (92.3%). The satisfaction gained through prescription of homoeopathic medicine was 96.2%.Conclusion: During this menopausal transition, women needs best counselling also the medicine to overcome her mental disturbances. RCT’s can be performed to prove this theory in future. In the conclusion, mood swings results suggest that homoeopathic remedies were effective in disturbed sleep and mood swings. Thus, homoeopathic medicine acts at mental plane. Further, studies should be done to prove with hypothesis.

Hepatobiliary and Pancreatic Adverse Events.

The expanded approval of immune checkpoint inhibitors (ICIs) for the treatment of multiple cancer types has offered patients more opportunities in treatment selection and survival.Hepatotoxicity is a well-recognized immune-related adverse event (irAE) associated with treatment with ICI. It is considered a type of drug-induced liver injury (DILI). Depending on the specific ICI and whether the patient receives single- or dual-drug therapy, the incidence of hepatotoxicity in general could be as high as 30%. As more patients receive treatment with ICI, more cases of hepatotoxicity are expected to occur. Clinicians must exercise close pharmacovigilance to recognize liver-related irAEs early.ICI-mediated hepatobiliary toxicity (or "IMH")generally presents as asymptomatic elevations of alanine transaminase and aspartate transaminase, with or without alkaline phosphatase elevation. Some patients may present with jaundice, fever, or malaise. Rarely, it may cause liver failure and death. The diagnosis of IMH is made after careful exclusion of other causes of acute hepatitis based on medical history, laboratory evaluation, imaging, and liver histological findings. In clinically significant cases of IMH, the management involves discontinuation of ICI followed by close monitoring and the initiationof immunosuppression. Current society guidelines, which are not based on robust evidence, specify treatment recommendations depending on the grade of liver injury, according to the Common Terminology Criteria for Adverse Events (CTCAE)version 5.0. However, our clinical experience suggests possible alternatives, including lower corticosteroid dosing with adjunct therapies. Whereas current guidelines endorse permanent cessation of future ICI treatment in patients diagnosed with grades 3-4 IMH, published clinical experience suggests potential for flexibility when assessing for candidacy of resuming ICI.Because histologic bile duct injury has been observed in cases ascribed to IMH, ICI-mediated cholangiopathic disease probably exists on a spectrum within IMH. Even extrahepatic bile duct involvement has been observed. This phenotype warrants special considerations in treatment and surveillance.ICI-related cholecystitis has been rarely reported in the literature. Management follows current standards of care for typical cases of cholecystitis. No relationship with ICI-mediated cholangiopathic disease has been observed.Assessing for and managing ICI-associated pancreatic injury remainchallenging to the clinician. Many cases of asymptomatic serum lipase elevation are detected on routine labs without clinical signs or symptoms of typical acute pancreatitis. However, symptomatic patients should be initially managed like traditional cases of acute pancreatitis requiring hospitalization for evaluation and inpatient management.

Endometrial Thickness Measurement for Detecting Endometrial Cancer in Women with Postmenopausal Bleeding

Background: Postmenopause is defined as the permanent cessation of menstruation for one year due to failure of the ovarian follicular activity. Objective: This work aimed to study the role of endometrial thickness measured by transvaginal sonography in the detection of endometrial carcinoma in women with postmenopausal bleeding. Patients and Methods: A cross-sectional study was conducted on 120 women with postmenopausal bleeding admitted to the Obstetrics & Gynecology Department at Zagazig University hospitals through the period from September 2018 to September 2019. All cases were subjected to full history, full clinical examination, transvaginal sonography, and diagnostic endometrial biopsy which was taken for histopathological examination. We exclude premenopausal women and postmenopausal patients in HRT. Results: This study showed TVS evaluation of ET of the studied cases ranged from 1 to 20 mm with a mean of 9.65 mm. Also, 48.3% of the cases had endometrial thickness more than 10 mm, 34.2% had less than 5 mm, and 17.5% had from 5 to 10mm.that 34.2% of the studied cases had atrophic endometritis, 26.7% had an endometrial polyp, 17.5% had simple hyperplasia, 7.5% had atypical hyperplasia and 14.2% had endometrial adenocarcinoma. Conclusions: Transvaginal sonography evaluation of endometrial thickness is not sensitive enough to detect cancer of the endometrium and therefore couldn't replace histological evaluation of the endometrial tissue in women with postmenopausal bleeding.

Endometrial Thickness Measurement for Detecting Endometrial Cancer in Women with Postmenopausal Bleeding

Background: Postmenopause is defined as the permanent cessation of menstruation for one year due to failure of the ovarian follicular activity. Objective: This work aimed to study the role of endometrial thickness measured by transvaginal sonography in the detection of endometrial carcinoma in women with postmenopausal bleeding. Patients and Methods: A cross-sectional study was conducted on 120 women with postmenopausal bleeding admitted to the Obstetrics & Gynecology Department at Zagazig University hospitals through the period from September 2018 to September 2019. All cases were subjected to full history, full clinical examination, transvaginal sonography, and diagnostic endometrial biopsy which was taken for histopathological examination. We exclude premenopausal women and postmenopausal patients in HRT. Results: This study showed TVS evaluation of ET of the studied cases ranged from 1 to 20 mm with a mean of 9.65 mm. Also, 48.3% of the cases had endometrial thickness more than 10 mm, 34.2% had less than 5 mm, and 17.5% had from 5 to 10mm.that 34.2% of the studied cases had atrophic endometritis, 26.7% had an endometrial polyp, 17.5% had simple hyperplasia, 7.5% had atypical hyperplasia and 14.2% had endometrial adenocarcinoma. Conclusions: Transvaginal sonography evaluation of endometrial thickness is not sensitive enough to detect cancer of the endometrium and therefore couldn't replace histological evaluation of the endometrial tissue in women with postmenopausal bleeding.