Spectrum of gynecological disorders in elderly women

Introduction: Postmenopausal phase is important that primary care clinicians be aware of common gynecologic concerns and the potential impact of these on the function and quality of life of older women. Aim: This study was done to know dimensions of various gynecological disorders in women above 60 years and to emphasize on increasing the different screening programmes for early detection and management of cancers and also to show the necessity of establishing geriatric units for women to give better quality of life to elderly women. Materials and methods: A Prospective study done for 1 year. Out of 7156 patients, 273 women who were above 60 years were included in study. Both in patient, out patients and patients who referred to cancer hospitals and other hospitals were studied. Results: Among 7156 women attending our OPD in one year, 273 (3.81%) were above 60 years, including surgical (7%) and natural (93%) menopause. Pelvic organ prolapsed (43.2%) was the most common gynecological disorder in the study. Total out of 82 patients of post menopausal bleeding 48 (59%) (17.5% out of 273) were benign and Malignancy among the study group was 34 (41%) (12.4%, Out of 273). The commonest cancer was cancer cervix in about 22% among postmenopausal bleeding. Ovarian cancer is 13%. Pelvic organ prolapse was most common gynecological disorder in elderly women after 60 years was pelvic organ prolapse seen in 43%. Out of 63 Urogenital infections 24 (38.09%) were with Urinary tract infections. Conclusions: The responsibility of the gynecologist as the primary physician for geriatric patients increases, to detect the cancer earlier and manage it to decrease morbidity and mortality. There should B Aruna Kumari, Aruna Ramaiah, A.Suman Chandra. Spectrum of gynecological disorders in elderly women. IAIM, 2016; 3(11): 112-117. Page 113 be increased screening programmes for cancer making this available for all the women at all stages and at all levels.

Lag kinetics of tyrosinase: its physiological implications.

The various theories put forward to explain the characteristic lag kinetics of oxidation of L-tyrosine by tyrosinase a rate regulatory step in the biosynthesis of melanin are reviewed Examination of the evidence in the literature and from experiments in the author's laboratory indicate that one of the hypotheses, that is, competition of tyrosine and dopa for met-tyrosinase and the formation of a dead-end complex of met-enzyme with tyrosine as explanation for lag kinetics is not consistent with available information. The alternative hypothesis that tyrosinase is an allosteric enzyme with tyrosine having negative effector site on the enzyme and dopa competing for it as an explanation for lag kinetics of tyrosinase is not yet disproved. Irrespective of the actual explanation for the lag kinetics of tyrosinase, it is suggested that the highly conserved lag kinetics may serve a physiological function. It is suggested that this function is to keep the enzyme essentially inactive during its transport to the specific organelle, namely the melanosome, in which an acidic environment exists. Only at acidic pH is the enzyme able to catalyze the biosynthesis of melanin.