Bombay Hospital

Mental health during the menopausal transition requires focused attention to ensure supportive experiences for women. This review presents the International Federation of Gynecology and Obstetrics (FIGO) recommendations and summarizes the evidence, addressing 13 key questions framed by members of the FIGO Committee on Women at Menopausal Age. Although the literature on mental health during menopause is extensive, a gap exists in consolidated best practice recommendations. The FIGO committee members assessed the evidence quality and recommendation strength using a 5-point Likert scale. Over 70% of the experts agreed with a strong recommendation level (score of 5) for eight questions, while five questions were agreed with high and moderate recommendations. Symptoms of anxiety and depression are prevalent during the perimenopause. Menopause-related mental health issues are often overlooked in low- and middle-income countries. Mental health issues impact quality of life, necessitating psychological support during menopause care. Early detection requires training primary care providers to identify symptoms. Treatment should be individualized and may include lifestyle changes, cognitive-behavioral therapy, and hormone therapy. Transdermal estradiol is preferred for managing mood swings, particularly in women with metabolic risks. Escitalopram and venlafaxine effectively manage depressive symptoms and vasomotor instability in patients with major depressive disorder. Non-pharmacological interventions, such as lifestyle changes, therapy, mindfulness, and exercise have shown benefits. Partner and family support helps reduce the stigma associated with mental health issues during menopause. Advocacy is required for policies that support menopause awareness and mental health.

Predicting disease progression at the individual level is essential for personalized medicine. We previously developed machine-learning tools to estimate 5-year progression risk in people with multiple sclerosis (PwMS). Such models should account for disease-modifying therapy (DMT) and objective outcome definitions. In a retrospective multicenter case–control study, we evaluated adults with relapsing–remitting multiple sclerosis (RRMS) at baseline. Using machine-learning, we developed two complementary tools for individualized 5-year risk estimation: DAAE-M, optimized for transparency, software-neutral use, and mitigation of indication bias, and ELIE, optimized for dynamic landmark-based modeling, complex treatment histories, and mitigation of immortal-time bias. Disease progression was defined using both a clinical outcome (RRMS-to-progressive MS) and an objective outcome (late-stage confirmed progression independent of relapse activity). Among 34,510 people with RRMS (72.6

Background: Low back stability and trunk muscle endurance are critical components of athletic performance, particularly in sports requiring repetitive spinal loading and postural control (McGill, 2007). The erector spinae muscle group plays a vital role in maintaining spinal alignment, controlling trunk movements, and resisting fatigue during prolonged physical activity (Biering-Sørensen, 1984). Methodology: This study was conducted as an experimental pre-post design involving 30 college level athletes aged between 18 to 25 years. Participants were recruited from the students studying in college and from City Hospital, based on the inclusion criteria such as regular participation in sports activities and absence of current low back pain or spinal pathology. The consent was taken from the authority of the institutions from which the participants were taken for the experiment. The athletes suffering from infection, systemic disease, rheumatologic or neurologic disease, Spinal fracture or any known spinal deformities, tumors or radicular symptoms or Low back pain in last 6 months, Body mass index > 25 and Pregnancy were excluded from the study. Result: The results indicate a significant improvement in erector spinae muscle endurance following isometric trunk extension training. Conclusion: Isometric trunk extension training significantly improves erector spinae muscle endurance in college-level athletes. The intervention enhances fatigue resistance, contributing to better spinal stability and potential injury prevention.

IntroductionThe outcomes of pollicization is cases with severe radial longitudinal deficiency in younger children have rarely been studied. The study is focused on the functional outcomes of early pollicization in children with radial longitudinal deficiency and anomalous index fingers.MethodologyWe conducted a retrospective analysis of data involving children with radial longitudinal deficiency who underwent pollicization with a minimum follow-up period of 1 year, and a control group of age-matched children with typical hand development. The objective assessment comparing cases and controls included assessment of hand function by modified Percival score, angle of first web space, pre-op presence of index finger anomaly, maximum abduction of pollicized finger, and PIP joint flexion of the pollicized finger.ResultsThe study group consisted of 18 patients and 22 pollicizations. The results of the modified Percival score was 13.73(SD 1.88) in the study group and 15.65(SD 1.04) in controls. Even though differences between the study group and controls were significant (p 0.0002), the functional outcome was averaged at good according to modified Percival score. The angle created at the first web and maximum radial abduction of the pollicized finger were comparable to the control group. Proximal interphalangeal joint flexion remained unchanged post-operatively in comparison to controls (mean 30.1, SD 7.56).ConclusionPollicization significantly improves hand function in severe cases of radial longitudinal deficiency, even in the presence of anomalies of the digits if done early enough, and is a truly worthwhile life-changing option. Future studies may focus on refining surgical techniques and post-operative rehabilitation protocols to further optimize outcomes.