With the aging of the world's population, osteoporosis has emerged as a formidable health concern. Bone mineral density (BMD) is the only available clinical parameter for bone strength evaluation and is determined through the use of dual energy x-ray absorptiometry (DEXA), the gold standard for the diagnosis of osteoporosis, and peripheral DEXA, such as calcaneal quantitative ultrasonography (QUS). This is a cross-sectional, descriptive study which aimed to determine the prevalence of osteoporosis among Filipinos, based on T-scores utilizing calcaneal quantitative ultrasonography. Baseline bone mineral density of 20,726 Filipinos were gathered based on the T-scores from calcaneal quantitative ultrasound results. The WHO criteria standardized the classification of BMD based on T-scores. Results showed that 3 percent of Filipinos were osteoporotic, 22 percent were osteopenic, while the rest were normal. The female sex and advanced age were key determinants of osteoporotic risk wheareas geographic location appears to have no influence.
OSTEOPOROSIS ; CALCANEAL ; QUANTITATIVE ; ULTRASONOGRAPHY

Early feeding is advocated for the resolution of postoperative ileus. After gynecologic laparoscopy, patients usually resume regular diet once the anesthesia has resolved. Gum-chewing is a form of sham feeding which may stimulate gut motility via vagal cholinergic stimulation. This study aimed to determine if gum-chewing is comparable to early feeding in the resolution of postopreative ileus. Thirty patients undergoing elective gynecologic laparoscopic surgery surgery were randomized to the control group, who immediately resumed regular diet, and the gum-chewing group, who were asked to chew gum three times a day until passage of flatus. The mean was operative times were comparable. The time to passage of first flatus of the control group was 22.675 hours while that of the gum-chewing group was 23.174. The difference between the was not significant with a P value of 0.8185. Gum-chewing is comparable to early feeding in the resolution of postoperative ileus.
Human ; Male ; Female ; Adult ; Young Adult ; Adolescent ; LAPAROSCOPY ; ILEUS ; CHEWING GUM

Early feeding is advocated for the resolution of postoperative ileus. After gynecologic laparoscopy, patients usually resume regular diet once the anesthesia has resolved. Gum-chewing is a form of sham feeding which may stimulate gut motility via vagal cholinergic stimulation. This study aimed to determine if gum-chewing is comparable to early feeding in the resolution of postopreative ileus. Thirty patients undergoing elective gynecologic laparoscopic surgery surgery were randomized to the control group, who immediately resumed regular diet, and the gum-chewing group, who were asked to chew gum three times a day until passage of flatus. The mean was operative times were comparable. The time to passage of first flatus of the control group was 22.675 hours while that of the gum-chewing group was 23.174. The difference between the was not significant with a P value of 0.8185. Gum-chewing is comparable to early feeding in the resolution of postoperative ileus.

Although oral medroxyprogesterone acetate has been used in various gynecologic conditions in women, literature is scant on its use in adolescents. Hence, this article reviews the clinical indications of oral medroxyprogesterone in these young women.
MEDROXYPROGESTERONE ACETATE ; PROGESTINS

It remains controversial whether the day of initiation of clomiphene citrate (cc) has any impact on endometrial quality. Objective:To determine the correlation between time of administration of clomiphene citrate and its anti-estrogenic effects on endometrial thickness and endometrial pattern. Methods: Filipino women consulting at the Philippine General Hospital for difficulty in conceiving were randomized into two groups either to start CC on cycle day two or day five. Transvaginal ultrasonography was used to determine differences in endometrial thickness and endometrial pattern between the two groups. Students t-test and chi square were used for data analysis. Results: There was no difference in endometrial thickness between the two groups. There were significantly more subjects with trilaminar endometrium in the day two groups. Conclusion: Mean endometrial thickness was similar in both arms. Earlier administration, starting day two favors the development of trilaminar endometrium.
Human ; Female ; CLOMIPHENE

Perineal endometriosis is a rare complication of episiotomy. This is a case of a 44-year old woman with cyclic perineal pain and a history of episiotomy. A wedge biopsy of the perineal mass confirmed the diagnosis of endometriosis. Awareness of the occurrence of this rare type of extrapelvic pain during menses secondary to perineal cudometriosis is important.
Human ; Female ; Adult ; ANAL CANAL ; ENDOMETRIOSIS ; NEURALGIA

To study the profile of menopausal women, particularly age, reproductive history body mass index, abdominal circumference, smoking history, duration of menopause in years, type and duration of use of hormone replacement therapy, calcium intake, frequency of exercise, history of fracture and their bone mineral density.
Human ; Female ; Aged 80 and over ; Aged ; Middle Aged ; Adult ; OSTEOPOROSIS ; WOMEN ; ;

Objective: To determine which of the following factors at initial surgery-such as diameter of largest endometriotic cyst, number of cysts, diseases severity, type of surgery (laparoscopy versus laparotomy), or postoperative medical therapy-best correlated with the time of recurrence of ovarian endometrioma. Design: A retrospective descriptive study was performed on 25 patients who underwent initial surgical excision of endometriotic cyst and had cyst recurrence demonstrated either on ultrasound or repeat surgery. The clinical presentation of cyst recurrence was described. The operative findings of the first and second surgeries were compared. Factors which may affect the time of cyst recurrence were evaluated. Results: Cyst recurrence was demonstrated by ultrasound in 24 (96 percent) cases; repeat surgery for recurrence was done in only 10 (40 percent) cases. The different factors in the initial surgery: type of operation, size, number, and laterality of the endometriotic cyst, disease severity, adhesions and postoperative medical therapy, did not influence the time of recurrence of ovarian endometrioma. Disease severity was a significant factor on repeat surgery. Conclusion: The different factors aforementioned, which were present in the first surgery, did not influence the time of recurrence of ovarian endometrioma.
Human ; Female ; Adult ; ENDOMETRIOSIS ; RECURRENCE

Objectives: To compare the effects of clomiphene citrate with conjugated equine estrogen (early or beginning day 2 of menses vs. late or beginning day 7 of menses) and clomiphene citrate alone on endometrial thickness and pattern (i.e. trilaminar or non-trilaminar) among patients for induction of ovulation. Study Design: Prospective, randomized Setting: tertiary care hospital Inclusion criteria: Women aged 25-40 years old with infertility of at least 2 years duration who are candidates for ovulation induction. Exclusion criteria: Women on hormonal treatment 1 month prior to ovulation, with ovarian cysts, mullerian abnormalities, myomas or uterine cavity abnormalities. Results: Fifty-four women were included in the study with mean age 31.093 years +/- 4.655 (range 21 to 40 years), duration of infertility 4.954 +/- 3.228 (range 2 to 20 years), and day of the cycle when dominant follicle was noted was 11.907 +/- 1.751 (range of 8 to 16 days). Mean endometrial thickness was 0.960 cm in group I, 1.053 cm in group II and 0.850 cm in group III with a p value of 0.040625. There was significant improvement in thickness from baseline with a p value of 0.015166. There was no significant effect on endometrial pattern (p value = 0.236146). Conclusion: The addition of conjugated equine estrogens in ovulation induction with clomiphene citrate improves endometrial thickness.
Human ; Female ; Adult ; ESTROGENS, CONJUGATED (USP) ; CLOMIPHENE ; ENDOMETRIUM

Objective: To determine the ovulatory response of a cystectomized ovary sonographically in the first three cycles post-op in terms of the number and diameter of pre-ovulatory follicles, development of 18 mm follicle, development of corpus luteum, and their correlation to the type of operation, use of cautery, type of ovarian pathology, and use of ovulatory drugs. Design: Prospective study Methods: Thirty (30) patients who underwent ovarian cystectomy either by laparoscopy of laparotomy from February to May 1998 were included in the study. These patients had follicular monitoring for three cycles post-op at days 14, 16 and 18. The number of pre-ovulatory follicles (/- 12 mm), the diameter (mm) of the largest follicle, onset of development of 18 mm follicle, and onset of development of corpus luteum were noted. The onset of development of 18 mm follicle was correlated to the type of operation (laparoscopy versus laparotomy), use of cautery, type of ovarian pathology (endometrial versus dermoid), and use of ovulatory drugs post-op. Statistical analysis used was student t-test. Results: The mean number of pre-ovulatory follicles (/- 12 mm) during the first three cycles was 1-2 follicles. The mean diameter of the largest follicle during the first cycle post-op was 12-16 mm and increased to 14-18 mm during the second and third cycles. The earliest 18 mm follicle was observed on day 14 of the first cycle but 75.1 percent of patients had an 18 mm follicle by day 18 of the first cycle. The type of operation, use of cautery, type of ovarian pathology, and use of ovulatory drugs post-op did not significantly alter the onset of development of an 18 mm folicle. The earliest corpus luteum was noted on day 18 of the first cycle. Conclusion: There is an adequate ovulatory response after ovarian cystectomy in the first three cycles post-op.
CYSTECTOMY