New advances in menopause symptom management.

Vasomotor symptoms (VMS) are characteristic of menopause experienced by over 75% of postmenopausal women with significant health and socioeconomic implications. Although the average duration of symptoms is seven years, 10% of women experience symptoms for more than a decade. Although menopausal hormone therapy (MHT) remains an efficacious and cost-effective treatment, its use may not be suitable in all women, such as those at an increased risk of breast cancer or gynaecological malignancy. The neurokinin B (NKB) signaling pathway, together with its intricate connection to the median preoptic nucleus (MnPO), has been postulated to provide integrated reproductive and thermoregulatory responses, with a central role in mediating postmenopausal VMS. This review describes the physiological hypothalamo-pituitary-ovary (HPO) axis, and subsequently the neuroendocrine changes that occur with menopause using evidence derived from animal and human studies. Finally, data from the latest clinical trials using novel therapeutic agents that antagonise NKB signaling are reviewed.

Self-efficacy, self-care behaviors and glycemic control among type-2 diabetes patients attending two private clinics in Yangon, Myanmar.

This cross-sectional study aimed to estimate the prevalence of glycemic control and its associated factors among type-2 diabetes patients attending two private clinics in Yangon, Myanmar. Two hundred sixty-six diabetes patients attending two private diabetes clinics in Yangon during February and March, 2009 were included in the study. The participants completed a structured questionnaire. HbA(1c) was used as the index for glycemic control. The prevalence of successful glycemic control (HbA(1c) < or =7%) was 27.1%. The median HbA(1c) value was 7.8%. About 62.0% of patients had high self-efficacy levels, and 30.8% had good self-care behavior. Multiple logistic regression analysis revealed four variables associated with glycemic control: age > or =60 years (OR 2.46, 95% CI 1.17-5.21), taking one oral hypoglycemic agent (OHA) (OR 2.56, 95% CI 1.26-5.19), being overweight (OR 2.01, 95% CI 1.02-3.95) and having a high self-efficacy level (OR 5.29, 95% CI 2.20-12.75). Interventions to increase diabetic patient self-efficacy levels and self-care behavior, especially related to diet and exercise, are needed to reduce poor glycemic control.