Introduction A significant number of postmenopausal women suffer from distressing problems because of urogenital atrophy secondary to the decline in circulating estrogen levels. Treatment with topical hormones may provide relief in such women when used judiciously. Aim To study the effects of local estrogen with or without local testosterone on urogenital and sexual health in postmenopausal women. Methods Seventy-five postmenopausal women symptomatic for urogenital atrophy and sexual dysfunction were randomly divided into two study groups and one control group. The women in study group 1 received local estrogen cream; study group 2 received local estrogen and testosterone cream; the control group received nonhormonal lubricant KY gel for 12 weeks. The urogenital and sexuality score, along with the vaginal health index and the vaginal maturation index (VMI), was calculated at the beginning of therapy and 12 weeks later. Main Outcome Measures Changes in the urogenital and sexuality score along with vaginal health index and VMI. Results After 12 weeks of therapy, there was a significant improvement in all the four study parameters, which correlated well with the improvement in symptoms of urogenital atrophy and sexual dysfunction in both the study groups as compared with the control group. Improvement in sexuality score was greatest with combined estrogen–androgen therapy. There were no adverse effects and the therapies were well accepted without any compliance issue. Conclusion Local estrogen either alone or with androgen is highly effective in relieving symptoms of urogenital atrophy and in improving sexual function in symptomatic postmenopausal women.

BV is a risk factor for increased neonatal morbidity. More research is needed for designing appropriate screening and treatment guidelines for prevention of adverse outcomes associated with BV.

Maternal serum IL-6 can be used as a biomarker to predict preclinical asymptomatic infection in PPROM with good sensitivity and specificity.

Objectives: To find the incidence and clinical implications of peripartum hysterectomy in a tertiary care centre of India. Methods: A retrospective study of all cases of caesarean and postpartum hysterectomy between January 2006 and December 2011. Maternal characteristics, method of delivery, indications for hysterectomy and complications were reviewed. Results: The rate of peripartum hysterectomy was 0.47:1000 deliveries. Most were operative deliveries. The main indications were placenta accreta (38.88%), massive atonic PPH (36.11%) and uterine rupture (22.22%). Half the hysterectomies were subtotal while the rest were total. Maternal morbidity was high and there were seven maternal deaths (19.44%). All deaths were in patients brought in a critical condition to the hospital after massive blood loss. Conclusion: Peripartum hysterectomy is potentially a life saving procedure but the mortality and morbidity is high, especially if performed late when the hemodynamic instability has already set in. DOI: http://dx.doi.org/10.3126/ajms.v4i1.6967 Asian Journal of Medical Sciences 4(2013) 5-9

The study has highlighted that yoga is a noninvasive, easy to learn mind-body medicine and complementary health practice, effective in alleviation of labor pain and possibly improving birth outcome.

Due to increased longevity and awareness, most women seek help of the clinicians for these symptoms. Estrogen therapy has been recommended to postmenopausal women for alleviation of symptoms and long-term benefits (3).However, recent evidence from studies of Women's Health Initiative showed that the combined estrogen and progestin therapy increased risks of coronary heart disease, stroke, pulmonary embolism and breast cancer (4). Recently, estrogen-like compounds from plants like soy proteins provide a new nutritional dimension to the management of short-term as well as long term effects of estrogen deficit (5). Epidemiological data suggest and indicate that only 25% of Japanese women complain of climacteric symptoms compared with 85% North American women and this difference has been attributed to soy protein consumption in Asian countries (6).The beneficial effects of soy protein have been attributed to its active component -the phytoestrogens or the isoflavones INTRODUCTIONMenopause is a normal life transition in a woman's life when reproductive capacity ceases due to loss of ovarian function resulting in a decrease in circulating estrogen levels (1). It is an objective hormonal event associated with subjectively perceived endocrine transition, resulting in various short-term vasomotor (hot flashes, mood swings, depression, nervousness, irritability) and urogenital symptoms (recurrent vaginitis, dysuria etc) and long-term sequelae-osteoporosis, Alzheimer's disease and Coronary Artery disease (CAD) (2).

Maternal serum IL-6 levels were significantly elevated in subjects with PPROM with infectious morbidity as compared to those without infectious morbidity in the present study. There was a significant rise in maternal serum IL-6 levels with increased duration of rupture of membranes and with evidence of histological chorioamnionitis and funisitis in the placenta.

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