Effects of non-vaginal route hormonal replacement therapy on vaginal maturation index in postmenopausal women.

Objective: To evaluate the estrogenic effect on the maturation index of hormonal replacement therapy (HRT) in postmenopausal women (PMW). Methods: The maturation indexes (MI) were evaluated based on vaginal cytology which was classified into no, low, moderate and high MI. Results: There were 70 PMW who were not on HRT evaluated for controls. There were 66%, 23%, 7% and 4% of them had no, low, moderate and high MI. There were 18 PMW who used transdermal estrogen patch or gel. It was found that 0%, 66%, 17% and 17% of them had no, low, moderate and high MI. There were 42 PMWs who were given oral hormonal tablets. It was found that 7%, 33%, 53% and 7% of them had no, low, moderate and high MI. Conclusion: Hormonal replacement therapy whether via patch, gel or oral intake resulted in changes in maturation index in postmenopausal women.

Effectiveness of recombinant activated factor VII (rFVII a) for controlling intractable postpartum bleeding: report of two cases and literature review.

BACKGROUND: Recombinant activated factor VII is used for the treatment in patients with inherited or acquired hemophilia with inhibitors and congenital factor VII deficiencies. OBJECTIVE: Using recombinant activated factor VII in primary postpartum hemorrhage. MATERIAL AND METHOD: Two cases of women who had postpartum hemorrhage and were treated with recombinant activated factor VII after all conventional treatment failed. RESULTS: The intractable hemorrhage stopped after treatment with recombinant activated factor VII CONCLUSION: The present report showed that massive postpartum hemorrhage that failed to all procedures was controlled successfully by recombinant activated factor VII.

Impact of women's health initiative study on attitude and acceptance of hormone replacement therapy in Thai women attending menopause clinics.

OBJECTIVE: To assess the attitude and acceptance of Thai women attending menopause clinics on hormone replacement therapy (HRT) after the Women's Health Initiative (WHI) publication. MATERIAL AND METHOD: A standardized questionnaire was used to assess attitude and acceptance of HRT in 1,206 women who visited menopause clinics in six hospitals between September 2005 and February 2006. RESULTS: Of the total respondents, 92% were in the age of 40-70 years, 75% were in their peri- and post menopause, 25% were current users and the average duration of hormone use was 5.6 +/- 5.3 years. The women's perception of hormone benefits on osteoporosis prevention, skin improvement, and hot flashes treatment were 39.1%, 31.7%, and 28.9%, respectively. The most common concern of hormone use was malignancy. Hormone side effects were found to be the most common reason for switching hormone regimen. Of all the past users, 85% stopped HRT because they changed to another treatment regimen. Only 3.7% had been aware the WHI, of which 43.5% were influenced by its results. The most common source of HRT information was from doctors. For the ever users, 72.3% had some knowledge about HRT. CONCLUSION: The present survey revealed that very few women had been aware of the WHI study. Nevertheless, the prevalence of HRT current users was lower compared to a prior survey before the WHI publication. Doctors appeared to be the important source of HRT information, which may indirectly have an influence over women's attitude and acceptance on HRT.