Prevalence and risk factors of urinary incontinence in Khon Kaen menopausal women.

OBJECTIVE: To determine the prevalence and risk factors of urinary incontinence in menopausal women. STUDY DESIGN: Prospective Descriptive study. SETTING: Menopausal clinic and gynecological outpatient unit, Department of Obstetrics and Gynecology, Srinagarind Hospital, Faculty of Medicine Khon Kaen University. STUDY POPULATION: Menopausal women attending the menopausal clinic and gynecological outpatient unit. MATERIAL AND METHOD: Between April 23 and July 15, 2004, 229 menopausal women were interviewed by pre-validated questionnaire and in-depth interview to determine the prevalence and risk factors of urinary incontinence. RESULTS: The average age of the study group was 55.8 years. The prevalence of urinary incontinence was 38.86%, the most common type was mixed urinary incontinence (82.02%) followed by stress urinary incontinence (12.36%), and urge urinary incontinence (5.62%). The risk factors of urinary incontinence were vaginal delivery, menopause before 50 years old, and postmenopausal women who had never used hormone therapy. CONCLUSION: The prevalence of urinary incontinence in menopausal women was 38.86%. Mixed urinary incontinence was the most common type. Associated risk factors were vaginal delivery, menopause before 50 years old, and postmenopausal women who had never used hormone therapy.

Effect of hormone therapy on lipid profile in menopausal women.

OBJECTIVE: To study lipid profile of menopausal women with hormone therapy. MATERIAL AND METHOD: Two hundred and sixty eight menopausal women in good health conditions, separated into natural and surgical menopause group, received service at Menopausal clinic in Srinagarind Hospital, Faculty of Medicine, Khon Kaen University since 1996-2004. They regularly took a single type of hormone therapy for about 12 months and obtained blood cholesterol levels for pre- and post-hormone therapy of about 12 months period. The data were analyzed with SPSS v. 10.0.5. RESULTS: The average age of the sample groups were 50.91 +/- 5.93 years and 52.83 +/- 5.28 respectively. Both sample groups have similar mean level of cholesterol levels during pretreatment period. Surgical menopausal group has greater HDL level than the naturally menopausal group with the average level of 64.24 +/- 15.32 mg/ dl. and 58.80 +/- 17.20 mg/dl. respectively. However after taking hormone therapy, blood cholesterol level was significantly changed in both groups. The mean level of LDL decreased (8.59% and 11.49% respectively) and mean level of HDL increased (15.43% and 6.89% respectively). CONCLUSIONS: Hormone therapy in menopausal women can improve cholesterol levels by decreasing LDL and increasing HDL with statistical significance (p < 0.05).

Preoperative vaginal preparations for abdominal hysterectomy for the prevention of febrile morbidity: savlon douching vs povidone-iodine painting.

OBJECTIVE: To compare the effectiveness between savlon solution was douching and povidone-iodine solution painting for reducing febrile morbidity after total abdominal hysterectomy. Study design: Clinical trial. MATERIAL AND METHOD: One hundred and fifty patients at Srinagarind Hospital were scheduled for total abdominal hysterectomy (TAH). All subjects were non-randomly allocated to receive either savlon (1:1000 solutions) douching or povidone-iodine (1% solution) painting as pre-operative vaginal preparations. They also received Cefazolin 1 gm. intravenously before the operation. The principal outcome of the study was febrile morbidity. RESULTS: The overall rate of febrile morbidity was 21 percent. The incidence of febrile morbidity in the savlon vs. povidone-iodine groups was 16 (12/75) and 25 (19/75) percent, respectively. No statistically significant difference was found between the two groups (p-value = 0.16). The odds ratio was 1.78 (95%CI 0.79 to 3.99) and adjusted odds ratio was 2.09(95%CI 0.86 to 5.10) CONCLUSION: The effectiveness between savlon solution douching and povidone-iodine solution painting in conjunction with a prophylactic antibiotic before TAH for reducing febrile morbidity was not significant different.

Serum concentration of undercarboxylated osteocalcin and the risk of osteoporosis in thai elderly women.

The elevation of undercarboxylated osteocalcin (ucOC) means vitamin K insufficiency is significantly increased in elderly women, and is associated with high skeletal turnover, low BMD, and increased risk of osteoporotic fracture. The objective of the present study was to find out the level of ucOC and the prevalence of vitamin K deficiency in elderly Thai women. The upper limit of normal premenopausal ucOC level was 2.314 ng/ml, represented the cut-off level for vitamin K deficiency, 39.1% of elderly women had serum ucOC concentration above this level. Women with high serum ucOC level had a significantly lower BMD of ultradistal radius, distal 1/3 of radius and 25(OH)D level, higher serum PTH and alkaline phosphatase activity than women with a normal ucOC (p<0.05). Serum ucOC was correlated positively with PTH (r = 0.411, p< 0.001), modest negatively with serum 25(OH)D (r = -0.17, p= 0.013). The ucOC level of urbanized elderly was higher than that of rural elderly. It was concluded that vitamin K deficiency is one of the risks of osteoporosis with high prevalence in the Thai elderly especially urbanized ones, the supplement of vitamin K should be recommended in Thai osteoporotic patients especially the urbanized elderly.

Singh index screening for femoral neck osteoporosis.

The present study included 130 elderly women living in Khon Kaen, Thailand, and all but one underwent both DEXA-BMD and AP radiographs of the left hip joint. The mean (SD) of age, weight, height and BMI of the 129 participants was 72.5 (5.3) years, 49.8 (10.3) kg, 1.49 (0.06) m, and 22.21 (4.13) kg/m2, respectively. The authors found both poor sensitivity and a positive predictive value for a Singh grade of < or = 4 or < or = 3 (viz. 58 and 29 or 19 and 43 percent, respectively). The ROC curve showed the poor diagnostic value of the Singh index since the area under the curve was approximately 40% the Singh index is therefore a poor screening tool for femoral neck osteoporosis.

Difference in serum calcidiol and parathyroid hormone levels between elderly urban vs suburban women.

The present study initially included 106 volunteers, elderly women living in urban or suburban Khon Kaen, Thailand. One case was excluded because of extremely high levels of alkaline phosphatase. The means (+/- SD) of the serum calcidiol and the PTH concentrations in the urban vs suburban groups were 31.45(+/- 1.15) ng/mL vs 36.15(+/- 2.4) pg/mL and 41.53(+/- 3.94) ng/mL vs 17.43(+/- 2.88)pg/mL, respectively. The urban group had a higher percentage and a higher risk of hypovitaminosis D and osteoporosis of the femoral neck than the suburban group, an odds ratio of more than 4 times higher.

Effectiveness of intravenous meperidine for pain relief in the first stage of labour.

OBJECTIVE: To determine the effectiveness and side effects of intravenous meperidine in labour pain relief. MATERIAL AND METHOD: A double blind, randomized controlled trial was conducted in 84 parturients, using normal saline as control. Visual analogue scale, postpartum parturients' opinion of effectiveness, sedative scores, nausea/vomiting, dizziness, delivery method, Apgar scores, and naloxone prescription were assessed. RESULT: There were no statistically significant differences between the mean and median of visual analogue scale of meperidine and control group. In addition, the sedative scores, nausea/vomiting and dizziness in the meperidine group occurred more than those in the control group significantly. Even mean of the pain increment in the meperidine group was less than those in the control group (p < 0.05). The parturients' opinion on the effectiveness of pain relief during labor within 24 hours of the first postpartum day was only 23.80 per cent in the meperidine group, however, it was statistically significantly different when compared to 7.10 per cent in the control group. CONCLUSION: Intravenous meperidine exhibited the effectiveness of pain relief of only 23.80 per cent of the subjects, in addition, it may cause many side effects.