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Mohamed RA, Taref NN, Osman NE, Keshta NHA, Alboghdady MA, Marzouk MM, Almowafy AA, Fadel EA. Effect of web-based health education on nursing students' knowledge, adaptive healthy measures and attitudes regarding polycystic ovary syndrome: a randomized controlled trial. BMC Nurs 2024; 23:479. [PMID: 39010089 PMCID: PMC11247781 DOI: 10.1186/s12912-024-02015-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 05/14/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a complex endocrine disorder affecting women of reproductive age, and it has emerged as a significant global public health issue. This study aimed to investigate the effects of web-based health education on nursing students' knowledge, adaptive healthy measures, and attitudes toward PCOS. METHODS A two-group randomized controlled trial (RCT) with pre-test and immediate post-test assessments was conducted. Study participants were recruited using a simple random sampling method from the Faculty of Nursing, Mansoura University, Egypt. A questionnaire consisting of six sections was developed to collect data, which was analyzed with the SPSS 23.0 using Student's t-test, Pearson's correlation test, and chi-square test analysis of variance. RESULTS The analysis revealed a significant increase in knowledge scores post-intervention, with the web-based learning groups (32.2 ± 10.5) outperforming the traditional learning group (22.1 ± 10.2), with (p < 0.05). Similarly, there was a notable improvement in adaptive healthy measures scores post-intervention, with the web-based learning group (8.9 ± 2.4) showing better results than the traditional group (6.5 ± 2.9), with (p < 0.05). In terms of attitudes toward PCOS, the web-based group (18.2 ± 4.9) displayed a significant improvement compared to the traditional group (11.7 ± 5.2), with (p < 0.05). CONCLUSIONS The findings suggest that web-based learning is more effective than traditional methods in enhancing nursing students' knowledge, adaptive healthy measures, and attitudes toward PCOS. TRIAL REGISTRATION This study was registered by Clinical Trials.gov Identifier: (NCT06192381|| https://www. CLINICALTRIALS gov/ ) on 5-1-2024.
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Affiliation(s)
- Rasha A Mohamed
- Community Health Nursing, Faculty of Nursing, Mansoura University, Mansoura, Egypt
- College of Applied Medical Sciences, University of Bisha, Bisha, Saudi Arabia
| | - Nagwa N Taref
- Community Health Nursing, Faculty of Nursing, Mansoura University, Mansoura, Egypt
| | - Nehmedo E Osman
- Woman's Health and Midwifery Nursing, Faculty of Nursing, Mansoura University, Mansoura, Egypt
| | - Nawal Hamdy Ahmed Keshta
- Department of Obstetrics and Gynecology, Faculty of Medicine, Girls Branch, Al Azhar University, Cairo, Egypt
| | - Mahmoud A Alboghdady
- Obstetrics and gynecology at ART unit, International Islamic institute Al-Azhar University, Cairo, Egypt
| | - Marzouk M Marzouk
- Public Health and Community Medicine, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Abeer A Almowafy
- International Islamic Center for Population Studies and Research, Al-Azhar University, Cairo, Egypt.
| | - Eman A Fadel
- Woman's Health and Midwifery Nursing, Faculty of Nursing, Mansoura University, Mansoura, Egypt
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Juber NF, Abdulle A, Ahmad A, AlAnouti F, Loney T, Idaghdour Y, Valles Y, Ali R. Associations between Polycystic Ovary Syndrome (PCOS) and Antibiotic Use: Results from the UAEHFS. Antibiotics (Basel) 2024; 13:397. [PMID: 38786126 PMCID: PMC11117232 DOI: 10.3390/antibiotics13050397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 04/21/2024] [Accepted: 04/22/2024] [Indexed: 05/25/2024] Open
Abstract
Women with polycystic ovary syndrome (PCOS) have a higher susceptibility to infections compared to those without PCOS. Studies evaluating antibiotic use based on PCOS status are scarce. Therefore, we aimed to (i) assess the associations between self-reported PCOS and antibiotic use, and (ii) whether PCOS treatment and the age at PCOS diagnosis modified the associations above. This cross-sectional analysis used the United Arab Emirates Healthy Future Study (UAEHFS) conducted from February 2016 to March 2023 involving 2063 Emirati women aged 18-62 years. We performed ordinal logistic regressions under unadjusted and demographic-health-characteristic-adjusted models to obtain the odds ratios (ORs) and 95% confidence intervals (CIs) to analyze PCOS and antibiotic use. Subgroup analyses were performed by treatment status and age at diagnosis. We found that women with PCOS were 55% more likely to frequently take a course of antibiotics in the past year (aOR 1.55; 95% CI 1.26-1.90). Similar likelihoods were also found among those being treated for PCOS and those without treatment but with a PCOS diagnosis at ≤25 years. Our study suggests that PCOS was associated with an increased use of antibiotics among Emirati women. Understanding the frequent antibiotic use susceptibility among those with PCOS may improve antibiotic use surveillance and promote antibiotic stewardship in these at-risk individuals.
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Affiliation(s)
- Nirmin F. Juber
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi P.O. Box 129188, United Arab Emirates; (A.A.); (A.A.); (Y.I.); (Y.V.); (R.A.)
| | - Abdishakur Abdulle
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi P.O. Box 129188, United Arab Emirates; (A.A.); (A.A.); (Y.I.); (Y.V.); (R.A.)
| | - Amar Ahmad
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi P.O. Box 129188, United Arab Emirates; (A.A.); (A.A.); (Y.I.); (Y.V.); (R.A.)
| | - Fatme AlAnouti
- College of Natural and Health Sciences, Zayed University, Abu Dhabi P.O. Box 19282, United Arab Emirates;
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health, Dubai P.O. Box 505055, United Arab Emirates;
| | - Youssef Idaghdour
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi P.O. Box 129188, United Arab Emirates; (A.A.); (A.A.); (Y.I.); (Y.V.); (R.A.)
| | - Yvonne Valles
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi P.O. Box 129188, United Arab Emirates; (A.A.); (A.A.); (Y.I.); (Y.V.); (R.A.)
| | - Raghib Ali
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi P.O. Box 129188, United Arab Emirates; (A.A.); (A.A.); (Y.I.); (Y.V.); (R.A.)
- MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0SL, UK
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Luo X, Dong Y, Zheng H, Zhou X, Rong L, Liu X, Bai Y, Li Y, Wu Z. CAPN2 correlates with insulin resistance states in PCOS as evidenced by multi-dataset analysis. J Ovarian Res 2024; 17:79. [PMID: 38610028 PMCID: PMC11015649 DOI: 10.1186/s13048-024-01407-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024] Open
Abstract
OBJECTIVE IR emerges as a feature in the pathophysiology of PCOS, precipitating ovulatory anomalies and endometrial dysfunctions that contribute to the infertility challenges characteristic of this condition. Despite its clinical significance, a consensus on the precise mechanisms by which IR exacerbates PCOS is still lacking. This study aims to harness bioinformatics tools to unearth key IR-associated genes in PCOS patients, providing a platform for future therapeutic research and potential intervention strategies. METHODS We retrieved 4 datasets detailing PCOS from the GEO, and sourced IRGs from the MSigDB. We applied WGCNA to identify gene modules linked to insulin resistance, utilizing IR scores as a phenotypic marker. Gene refinement was executed through the LASSO, SVM, and Boruta feature selection algorithms. qPCR was carried out on selected samples to confirm findings. We predicted both miRNA and lncRNA targets using the ENCORI database, which facilitated the construction of a ceRNA network. Lastly, a drug-target network was derived from the CTD. RESULTS Thirteen genes related to insulin resistance in PCOS were identified via WGCNA analysis. LASSO, SVM, and Boruta algorithms further isolated CAPN2 as a notably upregulated gene, corroborated by biological verification. The ceRNA network involving lncRNA XIST and hsa-miR-433-3p indicated a possible regulatory link with CAPN2, supported by ENCORI database. Drug prediction analysis uncovered seven pharmacological agents, most being significant regulators of the endocrine system, as potential candidates for addressing insulin resistance in PCOS. CONCLUSIONS This study highlights the pivotal role of CAPN2 in insulin resistance within the context of PCOS, emphasizing its importance as both a critical biomarker and a potential therapeutic target. By identifying CAPN2, our research contributes to the expanding evidence surrounding the CAPN family, particularly CAPN10, in insulin resistance studies beyond PCOS. This work enriches our understanding of the mechanisms underlying insulin resistance, offering insights that bridge gaps in the current scientific landscape.
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Affiliation(s)
- Xi Luo
- Faculty of Life science and Technology, Kunming University of Science and Technology, Kunming, China.
- Medical school, Kunming University of Science and Technology, Kunming, China.
- Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, the First People's Hospital of Yunnan Province, Kunming, China.
- Reproductive Medical Center of Yunnan Province, the Affiliated Hospital of Kunming University of Science and Technology, Kunming, China.
| | - Yunhua Dong
- Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, the First People's Hospital of Yunnan Province, Kunming, China
- Reproductive Medical Center of Yunnan Province, the Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Haishan Zheng
- Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, the First People's Hospital of Yunnan Province, Kunming, China
- Reproductive Medical Center of Yunnan Province, the Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Xiaoting Zhou
- Faculty of Life science and Technology, Kunming University of Science and Technology, Kunming, China
- Medical school, Kunming University of Science and Technology, Kunming, China
| | - Lujuan Rong
- Faculty of Life science and Technology, Kunming University of Science and Technology, Kunming, China
- Medical school, Kunming University of Science and Technology, Kunming, China
| | - Xiaoping Liu
- Faculty of Life science and Technology, Kunming University of Science and Technology, Kunming, China
- Medical school, Kunming University of Science and Technology, Kunming, China
| | - Yun Bai
- Faculty of Life science and Technology, Kunming University of Science and Technology, Kunming, China
- Medical school, Kunming University of Science and Technology, Kunming, China
- Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, the First People's Hospital of Yunnan Province, Kunming, China
- Reproductive Medical Center of Yunnan Province, the Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Yunxiu Li
- Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, the First People's Hospital of Yunnan Province, Kunming, China.
- Reproductive Medical Center of Yunnan Province, the Affiliated Hospital of Kunming University of Science and Technology, Kunming, China.
| | - Ze Wu
- Department of Reproductive Medicine, NHC Key Laboratory of Healthy Birth and Birth Defect Prevention in Western China, the First People's Hospital of Yunnan Province, Kunming, China.
- Reproductive Medical Center of Yunnan Province, the Affiliated Hospital of Kunming University of Science and Technology, Kunming, China.
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Percy C, Turner A, Orr C. Developing a Novel Web-Based Self-Management Support Intervention for Polycystic Ovary Syndrome: Mixed Methods Study With Patients and Health Care Professionals. JMIR Form Res 2024; 8:e52427. [PMID: 38451567 PMCID: PMC10958350 DOI: 10.2196/52427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/18/2023] [Accepted: 01/10/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) represents a significant global health burden requiring urgent attention. This common chronic endocrine and cardiometabolic condition affects around 1 in 10 women and individuals assigned female at birth, with significant adverse effects on well-being, quality of life, and mental health, as well as serious and complex long-term health consequences. International guidelines for best health care practice recommend the provision of comprehensive cognitive behavioral interventions to support self-management and improve health outcomes for those living with PCOS. Web-based health interventions have the potential to meet this need in an accessible and scalable way. OBJECTIVE We aim to identify barriers to self-management and psychological well-being in women with PCOS and adapt a web-based self-management program to provide a prototype digital support intervention for them. METHODS We adapted an existing support program (HOPE) for PCOS using the antecedent target measure approach. We conducted qualitative interviews with 13 adult women living with PCOS, 3 trustees of a patients with PCOS advocacy charity, and 4 endocrinologists to identify "antecedents" (barriers) to self-management and psychological well-being. Framework analysis was used to identify potentially modifiable antecedents to be targeted by the novel intervention. At a national conference, 58 key stakeholders (patients and health professionals) voted for the antecedents they felt were most important to address. We used research evidence and relevant theory to design a prototype for the PCOS intervention. RESULTS Voting identified 32 potentially modifiable antecedents, relating to knowledge, understanding, emotions, motivation, and behaviors, as priorities to be targeted in the new intervention. A modular, web-based prototype HOPE PCOS intervention was developed to address these, covering six broad topic areas (instilling HOPE for PCOS; managing the stress of PCOS; feeding your mind and body well; body image, intimacy, and close relationships; staying healthy with PCOS; and keeping PCOS in its place). CONCLUSIONS We identified barriers to self-management and psychological well-being in women with PCOS and used these to adapt a web-based self-management program, tailoring it for PCOS, which is a comprehensive group intervention combining education, empowerment, lifestyle management, peer support with cognitive behavioral tools, and goal-setting (to be delivered by peers or codelivered with health care professionals). The modular structure offers flexibility to adapt the program further as new clinical recommendations emerge. The intervention has the potential to be delivered, evaluated for feasibility, and, if effective, integrated into health care services. Self-management interventions are not designed to replace clinical care; rather, they serve as an additional source of support. The HOPE PCOS program conveys this message in its content and activities. Future research should evaluate the prototype intervention using primary outcomes such as measures of psychological well-being, self-management self-efficacy, depression, anxiety, and PCOS-related quality of life. They should also assess the intervention's acceptability, scalability, and cost-effectiveness.
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Affiliation(s)
- Carol Percy
- Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Andrew Turner
- Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Charys Orr
- Harris Church of England Academy, Diocese of Coventry Multi Academy Trust, Coventry, United Kingdom
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Al Maamari R, Al Hashmi I, Al Dhuli AA, Al Abri A, Al Ghaithi A, Al Sinan S. Do Health Literacy and Awareness of Polycystic Ovary Syndrome Predict the Lifestyle Choices of Arabic-Speaking Female University Students. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2023; 28:707-714. [PMID: 38205416 PMCID: PMC10775878 DOI: 10.4103/ijnmr.ijnmr_355_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 07/11/2023] [Accepted: 07/25/2023] [Indexed: 01/12/2024]
Abstract
Background Considering the increasing prevalence of Polycystic Ovarian Syndrome (PCOS) and its related complications-such as obesity, cardiovascular diseases, and infertility-in the Middle East, it is imperative to create sufficient public awareness about this issue. Accordingly, the potential link between PCOS awareness and health literacy level with the lifestyle choices of Arabic-speaking female university students was examined in this cross-sectional study. Materials and Methods This research was conducted in the Sultanate of Oman and involved 446 Arabic-speaking female university students, who completed a self-administered online questionnaire, Single Item Literacy Screener, and PCOS Awareness Tool. Results The findings showed that, while 53.50% of the study participants had inadequate health literacy, 79.80% demonstrated an acceptable level of PCOS awareness. However, this did not seem to influence their lifestyle, given that 59.20% of the respondents were physically inactive and 83.30% regularly consumed fast food. Regression analysis results nonetheless revealed that health literacy and PCOS awareness were significant predictors of lifestyle choices (F2,44 = 5.98, p < 0.05, 95% CI [4.44-5.35]). Conclusions The Arabic-speaking female university students' health literacy level and PCOS awareness are significant predictors of their lifestyle choices. Thus, the policymakers in the Arab region need to develop effective strategies aimed at PCOS prevention, focusing specifically on raising public awareness about PCOS and its negative consequences on female reproductive health. In addition, university administrators should ensure the availability of healthy food choices at their campuses as well as opportunities for physical activity to promote healthy lifestyle among all students.
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Affiliation(s)
| | - Iman Al Hashmi
- College of Nursing, Sultan Qaboos University, Muscat, Oman
| | | | - Ashjan Al Abri
- College of Nursing, Sultan Qaboos University, Muscat, Oman
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de Oliveira NM, Machado J, Lopes L, Criado MB. A Review on Acupuncture Efficiency in Human Polycystic Ovary/Ovarian Syndrome. J Pharmacopuncture 2023; 26:105-123. [PMID: 37405111 PMCID: PMC10315877 DOI: 10.3831/kpi.2023.26.2.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 03/14/2022] [Accepted: 02/28/2023] [Indexed: 07/06/2023] Open
Abstract
Objectives Human Polycystic Ovary/Ovarian Syndrome (PCOS), a frequent endocrine pathophysiology among women of fertile age, is associated with woman's lifespan endocrine, metabolic and psychological implications. Long-term usage side effects of allopathic strategies and their low efficacy made complementary medicine treatments a relevant subject for these patients. The main aim of this work is to review the efficiency of the acupuncture treatment reported in the latest studies on literature regarding PCOS patients. Methods A comprehensive literature search, in English language, about the use of acupuncture on the management of PCOS, was conducted in October 2020 using EBSCO, Cochrane, PubMed, Medline, Embase, databases for randomised and non-randomised controlled trials between 2015 and 2020 (09/2015-10/2020), following the PRISMA protocol. Results This research led us to an analysis, according to PICOS, of six final papers selected among 178 in total. The articles addressed distinct aspects of the PCOS condition, diverse acupuncture techniques and different main and secondary outcomes in agreement to the respective main objective. According to this review, acupuncture seems to be useful for the treatment of this debilitating and chronic health condition which affects millions of women worldwide, many of them part of the workforce in their community. Conclusion Despite of the display of these positive results addressing acupuncture treatments to manage PCOS major symptoms - whether they are reproductive, metabolic, or mental health features - more research is urgent. Randomized, double blinded controlled trials with improved quality design and following STRICTA and/or CONSORT recommendations are necessary to engage acupuncture as a standardized and scientific validated technique in PCOS condition.
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Affiliation(s)
- Natália M. de Oliveira
- ICBAS - Institute of Biomedical Sciences Abel Salazar, School of Medicine and Biomedical Sciences, University of Porto-UP, Porto, Portugal
- CBSin, Center of BioSciences in Integrative Health, Porto, Portugal
| | - Jorge Machado
- ICBAS - Institute of Biomedical Sciences Abel Salazar, School of Medicine and Biomedical Sciences, University of Porto-UP, Porto, Portugal
- CBSin, Center of BioSciences in Integrative Health, Porto, Portugal
- LABIOMEP – Porto Biomechanics Laboratory, University of Porto-UP, Porto, Portugal
| | - Lara Lopes
- ICBAS - Institute of Biomedical Sciences Abel Salazar, School of Medicine and Biomedical Sciences, University of Porto-UP, Porto, Portugal
- CBSin, Center of BioSciences in Integrative Health, Porto, Portugal
| | - Maria Begoña Criado
- CBSin, Center of BioSciences in Integrative Health, Porto, Portugal
- TOXRUN – Toxicology Research Unit, University Institute of Health Sciences, CESPU, Gandra, Portugal
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Coffin T, Wray J, Sah R, Maj M, Nath R, Nauhria S, Maity S, Nauhria S. A Review and Meta-Analysis of the Prevalence and Health Impact of Polycystic Ovary Syndrome Among Medical and Dental Students. Cureus 2023; 15:e40141. [PMID: 37304389 PMCID: PMC10256275 DOI: 10.7759/cureus.40141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2023] [Indexed: 06/13/2023] Open
Abstract
Women currently comprise the majority of students graduating from medical school and face unique stressors not seen with their male counterparts. In particular, during their medical education, women with polycystic ovary syndrome (PCOS) experience symptoms of the disorder, which strongly impact both their academic and social lives. This in turn influences their academic and professional future. Although women as medical professionals, in general, are happy with their careers, awareness, and understanding on the part of medical educators will definitely be helpful to women medical students in their path to being successful medical professionals. The first objective of our current study is to find the prevalence of PCOS in medical and dental students. The second objective is to find the academic and health impacts of PCOS and what type of interventions are being adopted to relieve the symptoms. Using the keywords such as "PCOS," "medical students," and "dental students", the search engines PubMed, Embase, and Scopus were used to retrieve relevant articles published from 2020 to 2022. After removing the duplicates, 11 prospective cross-sectional studies were utilized for qualitative and quantitative analysis. The pooled prevalence of 2,206 female medical students diagnosed with PCOS was 24.7%. The students in the various studies were aware of their PCOS diagnosis and were taking therapeutic medications. The most common associated complications reported were BMI abnormalities, abnormal hair growth, and acne, along with other complications such as stress and poor academic and social life. The majority also had significant family histories of concurrent clinical conditions such as diabetes, hypertension, and other menstrual abnormalities. Considering the huge impact of PCOS, medical educators, policymakers, and all stakeholders should take proactive measures to accommodate students' needs and bridge the social gap. Special awareness of needed lifestyle changes should be a part of the medical education curriculum for an inclusive educational environment, as it will minimize the gender discrepancy in academic satisfaction and professional life.
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Affiliation(s)
- Tamara Coffin
- Medicine, St. George's University School of Medicine, St. George's, GRD
| | - Jadzia Wray
- Medicine, St. George's University School of Medicine, St. George's, GRD
| | | | - Mary Maj
- Biochemistry, St. George's University School of Medicine, St. George's, GRD
| | - Reetuparna Nath
- Educational Services, St. George's University, St. George's, GRD
| | | | - Sabyasachi Maity
- Physiology, St. George's University School of Medicine, St. George's, GRD
| | - Samal Nauhria
- Pathology, St. Matthew's University, Georgetown, CYM
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Mirza FG, Tahlak MA, Hazari K, Khamis AH, Atiomo W. Prevalence of Polycystic Ovary Syndrome amongst Females Aged between 15 and 45 Years at a Major Women's Hospital in Dubai, United Arab Emirates. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5717. [PMID: 37174235 PMCID: PMC10178028 DOI: 10.3390/ijerph20095717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/22/2023] [Accepted: 04/30/2023] [Indexed: 05/15/2023]
Abstract
Objective criteria have been scarce in published data on the occurrence of polycystic ovary syndrome (PCOS) in the United Arab Emirates (UAE). It is crucial that we enhance our comprehension of PCOS prevalence in the UAE to inform key stakeholders about the disease's burden and enable comparisons with other nations. This research aimed to examine the PCOS prevalence at a large academic tertiary centre in Dubai, UAE, called Latifa Women and Children's Hospital. We performed a cross-sectional study by reviewing the electronic medical records of patients accessing care between 2017 and 2022 (5 years). By utilizing the international classification of diseases codes (ICD-10), we discovered a period prevalence of PCOS of 1.6% among 64,722 women aged between 15 and 45 years. It is worth noting that the estimated annual point prevalence rose from 1.19% in 2020 (at the beginning of the COVID19 pandemic) to 2.72% in 2022 (after the start of the COVID-19 pandemic). Therefore, the odds ratio of the risk of a PCOS diagnosis in 2022 compared to 2020 was 2.28. The majority of the women diagnosed with PCOS in this study had an ICD-10 code of E28.2. Women with PCOS were younger than the controls, less likely to be pregnant, and had a higher body mass index and systolic and diastolic blood pressure. This is the most extensive research to date examining PCOS prevalence in the UAE, and it emphasizes the significance of this condition. It is crucial to prioritize PCOS to prevent morbidity and mortality from reproductive and long-term health consequences, including infertility, type 2 diabetes and endometrial cancer, which is presently the most frequent gynecological cancer in the UAE.
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Affiliation(s)
- Fadi G. Mirza
- Latifa Women and Children Hospital, Dubai P.O. Box 9115, United Arab Emirates; (F.G.M.); (M.A.T.); (K.H.)
- Department of Obstetrics and Gynaecology, College of Medicine, Mohammed Bin Rashid University of Medicine, and Health Sciences, Building 14, Dubai Healthcare City, Dubai P.O. Box 505055, United Arab Emirates;
- Department of Obstetrics and Gynaecology, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Muna A. Tahlak
- Latifa Women and Children Hospital, Dubai P.O. Box 9115, United Arab Emirates; (F.G.M.); (M.A.T.); (K.H.)
- Department of Obstetrics and Gynaecology, College of Medicine, Mohammed Bin Rashid University of Medicine, and Health Sciences, Building 14, Dubai Healthcare City, Dubai P.O. Box 505055, United Arab Emirates;
| | - Komal Hazari
- Latifa Women and Children Hospital, Dubai P.O. Box 9115, United Arab Emirates; (F.G.M.); (M.A.T.); (K.H.)
| | - Amar Hassan Khamis
- Department of Obstetrics and Gynaecology, College of Medicine, Mohammed Bin Rashid University of Medicine, and Health Sciences, Building 14, Dubai Healthcare City, Dubai P.O. Box 505055, United Arab Emirates;
| | - William Atiomo
- Department of Obstetrics and Gynaecology, College of Medicine, Mohammed Bin Rashid University of Medicine, and Health Sciences, Building 14, Dubai Healthcare City, Dubai P.O. Box 505055, United Arab Emirates;
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Zaitoun B, Al Kubaisi A, AlQattan N, Alassouli Y, Mohammad A, Alameeri H, Mohammed G. Polycystic ovarian syndrome awareness among females in the UAE: a cross-sectional study. BMC Womens Health 2023; 23:181. [PMID: 37069554 PMCID: PMC10108484 DOI: 10.1186/s12905-023-02318-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 03/30/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Polycystic Ovarian Syndrome (PCOS) is a common hormonal disorder affecting females of reproductive age. Clinical guidelines recommend following the diagnostic criteria of PCOS based on an appropriate assessment of the patient's clinical presentation. Sufficient awareness among the population will prompt females to seek medical attention when necessary. This study aimed to assess knowledge and awareness about PCOS among females above the age of 18 years in the United Arab Emirates (UAE) and to correlate the level of awareness with women's backgrounds, demographics, and education levels. METHODS This was a cross-sectional study conducted in early 2020. 430 females over the age of 18 years were conveniently selected and interviewed in the UAE using a 21-item questionnaire that assessed participants' awareness of PCOS as a term, its causes, symptoms, complications, treatment, and prevention. 414 entries were eligible for data analysis. IBM® SPSS® Statistics version 25 was used for data entry and analysis. RESULTS 349 participants (84.3%) were familiar with the term PCOS. However, only 21.7% of them had sufficient awareness of the syndrome (95% CI = 17.77-25.71%). Being knowledgeable of PCOS was significantly associated with having a previous diagnosis (p = 0.002) and with studying or working in a medical field (p < 0.001). In addition, females who knew someone diagnosed with PCOS were 5 times more likely to be more aware compared to those who didn't (95% CI = 2.5-10.8; p < 0.001). Age, education level, and nationality showed no correlation with the level of awareness. CONCLUSIONS Overall, the level of PCOS awareness was insufficient in the study sample. Participants whose source of information was medical practitioners demonstrated more accurate knowledge. Accordingly, awareness of PCOS needs to be raised among females in the UAE, aiding early diagnosis and improving patient-oriented outcomes.
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Affiliation(s)
- Balkis Zaitoun
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.
| | | | - Noora AlQattan
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Yahya Alassouli
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Alshaima Mohammad
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Huriya Alameeri
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Ghada Mohammed
- Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
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Kaundal A, Renjhen P, Kumari R. Awareness of Lifestyle Modifications in the Management of Polycystic Ovarian Syndrome: A Hospital-Based Descriptive Cross-Sectional Study. Cureus 2023; 15:e36889. [PMID: 37139281 PMCID: PMC10151105 DOI: 10.7759/cureus.36889] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2023] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVE Polycystic ovarian syndrome (PCOS) is a prevalent endocrinological disorder in reproductive-age women. Due to varied presentations, it's often difficult to diagnose and manage women with PCOS. Management usually focuses on treating the symptoms and preventing long-term sequelae of the disease. This study was planned to assess the knowledge among reproductive-age women (15-44 years) regarding the risk factors, symptoms, complications, and management of PCOS. MATERIAL AND METHODS This is a hospital-based descriptive cross-sectional study. A pre-validated well-structured questionnaire which included basic demographic data, menstrual history, knowledge about PCOS symptoms, risk factors, complications, prevention, and treatment, was administered. Completed questionnaires were analyzed to calculate the knowledge score of the participants and its association with their education level and occupation was seen. RESULTS A total of 350 women participated but only 334 completed questionnaires were included for final evaluation. The mean age of the study population was 28.70±6.29 years. Around 9.3% of the participants were already diagnosed with PCOS. Most of the women (43.4%) had heard about PCOS. The source of information was doctors (26.6%), the internet (6.28%), teachers (5.6%), and friends (4.7%). Obesity (33.5%), unhealthy dietary habits (35%), and genetic predisposition (40.7%) were thought as risk factors for PCOS. Most of the participants were aware that subfertility (40.1%), abortions (34.4%), diabetes (28.7%), hypertension (31.7%), cardiovascular disease (33.5%), endometrial carcinoma (35.9%), and psychological disturbances (37.1%) are among the known PCOS related complications. Eating a healthy diet (37.1%) and weight reduction (41%) can help in the management of PCOS. Around 60.5% of women showed poor knowledge, 14.7% fair knowledge, and 24.9% good knowledge regarding PCOS. Education level and occupation status were found to be significantly related to the knowledge score (P≤0.001). CONCLUSION PCOS is a prevalent condition with varied presentations which significantly affects one's quality of life. Since there is no definitive treatment for PCOS the management generally aims at managing symptoms and reducing the risk of long-term complications. To reduce the burden of PCOS-related long-term complications behavioral changes in terms of regular exercise and healthy dietary habits need to be incorporated from childhood.
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Muhaidat N, Mansour S, Dardas M, Qiqieh J, Halasa Z, Al-Huneidy L, Samhouri J, Rayyan R, AlOweiwi W, AlMohtasib J, Alshrouf MA, Al-Labadi GM, Suboh LH, Al-Ani A. Current Awareness Status of and Recommendations for Polycystic Ovarian Syndrome: A National Cross-Sectional Investigation of Central Jordan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4018. [PMID: 36901027 PMCID: PMC10001650 DOI: 10.3390/ijerph20054018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/16/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
Polycystic ovary syndrome (PCOS) is a common reproductive disorder that is related to a number of health issues and has an influence on a variety of metabolic processes. Despite its burden on the health of females, PCOS is significantly underdiagnosed, which is associated with lack of disease knowledge among females. Therefore, we aimed to gauge the awareness of PCOS in both the male and female population in Jordan. A descriptive cross-sectional study was conducted, targeting individuals over the age of 18 from Jordan's central region. Participants were recruited through stratified random sampling. The questionnaire consisted of two domains, including demographics and knowledge of PCOS domains. A total of 1532 respondents participated in this study. The findings revealed that participants have overall adequate knowledge regarding PCOS's risk factors, etiology, clinical presentation, and outcomes. However, participants demonstrated subpar familiarity of the association between PCOS and other comorbidities and the effect of genetics on PCOS. Women had more knowledge than men about PCOS (57.5 ± 6.06 vs. 54.1 ± 6.71, p = 0.019). In addition, older, employed, and higher-income populations showed significantly better knowledge than younger, unemployed, self-employed, and lower-income populations. In conclusion, we demonstrated that Jordanian women demonstrate an acceptable yet incomplete level of knowledge towards PCOS. We recommend establishing educational programs by specialists for the general population as well as medical personnel to spread accurate medical information and clarify common misconceptions about signs, symptoms, management, and treatment of PCOS, and nutritional knowledge.
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Affiliation(s)
- Nadia Muhaidat
- Department of Obstetrics & Gynecology, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Shahd Mansour
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Majid Dardas
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Jamil Qiqieh
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Zeina Halasa
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Leen Al-Huneidy
- Department of Internal Medicine, King Hussein Medical Center, Amman 11855, Jordan
| | - Jehad Samhouri
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Rama Rayyan
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Wahid AlOweiwi
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Jamil AlMohtasib
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | | | | | - Layla H. Suboh
- Department of Obstetrics & Gynecology, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Abdallah Al-Ani
- Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman 11941, Jordan
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12
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Juber NF, Abdulle A, AlJunaibi A, AlNaeemi A, Ahmad A, Leinberger-Jabari A, Al Dhaheri AS, AlZaabi E, Al-Maskari F, AlAnouti F, Alsafar H, Alkaabi J, Wareth LA, Aljaber M, Kazim M, Weitzman M, Al-Houqani M, Hag-Ali M, Oumeziane N, Sherman S, Shah SM, Almahmeed W, Idaghdour Y, Loney T, El-Shahawy O, Ali R. Association Between Self-Reported Polycystic Ovary Syndrome with Chronic Diseases Among Emiratis: A Cross-Sectional Analysis from the UAE Healthy Future Study. Int J Womens Health 2023; 15:289-298. [PMID: 36814527 PMCID: PMC9939944 DOI: 10.2147/ijwh.s398651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 02/03/2023] [Indexed: 02/16/2023] Open
Abstract
Purpose This study aimed to assess the prevalence of self-reported polycystic ovary syndrome (PCOS) among Emiratis and examine bi-directional associations of PCOS with self-reported chronic diseases, namely: diabetes, asthma, high cholesterol, and high blood pressure. Patients and Methods A cross-sectional analysis was performed using the UAE Healthy Future Study (UAEHFS) data collected from February 2016 to April 2022 involving 1040 Emirati women aged 25-67 years from recruitment centers in the United Arab Emirates (UAE). The bi-directional associations between self-reported PCOS and self-reported chronic diseases were evaluated by establishing temporality based on reported age-at-diagnoses. Firstly, the associations between PCOS (diagnosed at ≥25 years) and chronic diseases (diagnosed at <25 years) were examined, followed by PCOS (diagnosed at <25 years) and chronic diseases (diagnosed at ≥25 years). Finally, a Poisson regression under unadjusted and age-and-body mass index (BMI) adjusted models was performed to obtain the risk ratio (RR) and its 95% confidence interval (CI). Results The prevalence of PCOS in this study was 25.9%. Those with asthma and high cholesterol diagnosed at <25 years had increased risks of PCOS diagnosed at ≥25 years (RR = 1.79, 95% CI: 1.17-2.76 for asthma; and RR = 1.61, 95% CI: 1.01-2.59 for high cholesterol), compared to those respective healthier counterparts, after adjusting for age and BMI. No significant association was observed between PCOS diagnosed at <25 years and respective chronic diseases diagnosed at ≥25 years. Conclusion PCOS prevalence among Emirati women was high. Asthma and high cholesterol in earlier life were associated with PCOS in later life. Understanding how chronic disease conditions and PCOS are associated in bi-directional ways may improve the surveillance of chronic disease conditions among women with PCOS and may also contribute to more targeted PCOS prevention strategies.
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Affiliation(s)
- Nirmin F Juber
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Abdishakur Abdulle
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Abdulla AlJunaibi
- Department of Pediatrics, Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | - Abdulla AlNaeemi
- Department of Cardiology, Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | - Amar Ahmad
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | | | - Ayesha S Al Dhaheri
- Department of Nutrition and Health, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Eiman AlZaabi
- Department of Pathology, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Fatma Al-Maskari
- Institute of Public Health, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
- Zayed Center for Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Fatme AlAnouti
- College of Natural and Health Sciences, Zayed University, Abu Dhabi, United Arab Emirates
| | - Habiba Alsafar
- Center for Biotechnology, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- Department of Genetics and Molecular Biology, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- Department of Biomedical Engineering, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Juma Alkaabi
- Department of Internal Medicine, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | | | - Mai Aljaber
- Healthpoint Hospital, Abu Dhabi, United Arab Emirates
| | - Marina Kazim
- Abu Dhabi Blood Bank Services, SEHA, Abu Dhabi, United Arab Emirates
| | - Michael Weitzman
- Department of Environmental Medicine, New York University of Medicine, New York, NY, USA
| | - Mohammad Al-Houqani
- Department of Medicine, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Mohammed Hag-Ali
- Faculty of Health Sciences, Higher Colleges of Technology, Abu Dhabi, United Arab Emirates
| | - Naima Oumeziane
- Abu Dhabi Blood Bank Services, SEHA, Abu Dhabi, United Arab Emirates
| | - Scott Sherman
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Syed M Shah
- Institute of Public Health, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Wael Almahmeed
- Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Youssef Idaghdour
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Omar El-Shahawy
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Raghib Ali
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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13
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Dalibalta S, Abukhaled Y, Samara F. Factors influencing the prevalence of polycystic ovary syndrome (PCOS) in the United Arab Emirates. REVIEWS ON ENVIRONMENTAL HEALTH 2022; 37:311-319. [PMID: 35538690 DOI: 10.1515/reveh-2021-0036] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 04/14/2022] [Indexed: 06/14/2023]
Abstract
Statistics indicate that at least 20-25% of women suffer from PCOS in the Gulf region. Despite its prevalence and negative implications on reproductive, metabolic, and physiological heath the exact cause of PCOS is unknown, in part due to the diversity of symptoms manifested by this disorder. In this review, we investigate causes of PCOS globally and draw on these studies, to determine the potential contributing factors for PCOS pathogenesis in the UAE population. The most frequently identified factors promoting PCOS pathogenesis that may be pertinent to this population include physiological factors such as insulin resistance, vitamin D deficiency, genetic factors, obesity, and anti-mullerian hormone (AMH) levels in the body as well as environmental factors such as air pollution, endocrine disrupting chemicals, and pesticide use. This evidence will help inform healthcare workers and government agencies to set up optimal guidelines for control and awareness of PCOS in the UAE.
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Affiliation(s)
- Sarah Dalibalta
- Department of Biology, Chemistry and Environmental Sciences, College of Arts and Sciences, American University of Sharjah, Sharjah, United Arab Emirates
| | - Yara Abukhaled
- Department of Biology, Chemistry and Environmental Sciences, College of Arts and Sciences, American University of Sharjah, Sharjah, United Arab Emirates
| | - Fatin Samara
- Department of Biology, Chemistry and Environmental Sciences, College of Arts and Sciences, American University of Sharjah, Sharjah, United Arab Emirates
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14
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Shan J, Tian H, Zhou C, Wang H, Ma X, Li R, Yu H, Chen G, Zhu J, Cai Z, Lin C, Cheng L, Xu Y, Liu S, Zhang C, Luo Q, Zhang Y, Jin S, Liu C, Zhang Q, Lv L, Yang L, Chen J, Li Q, Liu W, Yue W, Song X, Zhuo C. Prevalence of Heavy Menstrual Bleeding and Its Associated Cognitive Risks and Predictive Factors in Women With Severe Mental Disorders. Front Pharmacol 2022; 13:904908. [PMID: 35910343 PMCID: PMC9326357 DOI: 10.3389/fphar.2022.904908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 06/13/2022] [Indexed: 11/26/2022] Open
Abstract
There has been limited studies examining treatment-induced heavy menstrual bleeding (HMB) in women with severe mental illnesses. The aim of this study was to examine HMB prevalence and HMB-associated factors in young women (18–34 years old) diagnosed with bipolar disorder (BP), major depressive disorder (MDD), or schizophrenia (SCZ) who have full insight and normal intelligence. Eighteen-month menstruation histories were recorded with pictorial blood loss assessment chart assessments of HMB. Multivariate analyses were conducted to obtain odds ratios (ORs) and 95% confidence intervals (CIs). Drug effects on cognition were assessed with the MATRICS Consensus Cognitive Battery (MCCB). HMB prevalence were: BP, 25.85%; MDD, 18.78%; and SCH, 13.7%. High glycosylated hemoglobin (HbA1c) level was a strong risk factor for HMB [BP OR, 19.39 (16.60–23.01); MDD OR, 2.69 (4.59–13.78); and SCZ OR, 9.59 (6.14–12.43)]. Additional risk factors included fasting blood sugar, 2-h postprandial blood glucose, and use of the medication valproate [BP: OR, 16.00 (95%CI 12.74–20.22); MDD: OR, 13.88 (95%CI 11.24–17.03); and SCZ OR, 11.35 (95%CI 8.84–19.20)]. Antipsychotic, antidepressant, and electroconvulsive therapy use were minor risk factors. Pharmacotherapy-induced visual learning impairment was associated with HMB [BP: OR, 9.01 (95%CI 3.15–13.44); MDD: OR, 5.99 (95%CI 3.11–9.00); and SCZ: OR, 7.09 (95%CI 2.99–9.20)]. Lithium emerged as a protective factor against HMB [BP: OR, 0.22 (95%CI 0.14–0.40); MDD: OR, 0.30 (95%CI 0.20–0.62); and SCZ: OR, 0.65 (95%CI 0.33–0.90)]. In SCZ patients, hyperlipidemia and high total cholesterol were HMB-associated factors (ORs, 1.87–2.22). Psychiatrist awareness of HMB risk is concerningly low (12/257, 2.28%). In conclusion, prescription of VPA should be cautioned for women with mental illness, especially BP, and lithium may be protective against HMB.
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Affiliation(s)
- Jianmin Shan
- Department of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Hongjun Tian
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Chunhua Zhou
- Department of Pharmacology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Haibo Wang
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
| | - Xiaoyan Ma
- MECT Center, Sleep Disorder Center, Tianjin Anding Hospital, Tianjin, China
| | - Ranli Li
- MECT Center, Sleep Disorder Center, Tianjin Anding Hospital, Tianjin, China
| | - Haiping Yu
- Department of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China
| | - Guangdong Chen
- Department of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China
| | - Jingjing Zhu
- Department of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China
| | - Ziyao Cai
- Department of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China
| | - Chongguang Lin
- Department of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China
| | - Langlang Cheng
- Department of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Sha Liu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Congpei Zhang
- Inpatient Department of Harbin First Psychiatry Hospital, Harbin, China
| | - Qinghua Luo
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yunshu Zhang
- Inpatient Department of Hebei Mental Health Center, Baoding, China
| | - Shili Jin
- Inpatient Department, Shandong Daizhuang Hospital, Jining, China
| | - Chuanxin Liu
- Institute of Psychiatry, Jining Medical University, Jinning, China
| | - Qiuyu Zhang
- Institute of Psychiatry, Jining Medical University, Jinning, China
| | - Luxian Lv
- Department of Psychiatry, Henan Psychiatry Hospital, Xinxiang, China
| | - Lei Yang
- Key Laboratory of Mental Health, Ministry of Health (Peking University) and National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Jiayue Chen
- Department of Psychiatry, The First Hospital Affiliated to Harbin Medical University, Harbin, China
| | - Qianchen Li
- Department of Pharmacology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Wei Liu
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Wei Liu, ; Weihua Yue, ; Xueqin Song, ; Chuanjun Zhuo,
| | - Weihua Yue
- Department of Psychiatry, The First Hospital Affiliated to Harbin Medical University, Harbin, China
- *Correspondence: Wei Liu, ; Weihua Yue, ; Xueqin Song, ; Chuanjun Zhuo,
| | - Xueqin Song
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Wei Liu, ; Weihua Yue, ; Xueqin Song, ; Chuanjun Zhuo,
| | - Chuanjun Zhuo
- Department of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Laboratory of Psychiatric-Neuroimaging-Genetic and Cor-morbidity, Tianjin Mental Health Center of Tianjin Medical University, Tianjin Anding Hospital, Tianjin, China
- *Correspondence: Wei Liu, ; Weihua Yue, ; Xueqin Song, ; Chuanjun Zhuo,
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Jakhar R, Sen ED, Dutt R. Awareness of Polycystic Ovarian Syndrome among College Going Females in Gurgaon: A Cross-Sectional Study. ANNALS OF THE NATIONAL ACADEMY OF MEDICAL SCIENCES (INDIA) 2022. [DOI: 10.1055/s-0042-1750359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
Abstract
Objectives Women not only take care of family members they are also source of power and symbol of progress in a society. At the same time, physical and mental well-being of women relies on healthy lifestyle and adequate reproductive health knowledge. With growing incidence of polycystic ovarian syndrome (PCOS), it is crucial to increase awareness about the disease among women at an early age in life. The present survey investigates awareness level of college going females about PCOS.
Materials and Methods A total of 428 females were recruited from 3 colleges in district Gurgaon, Haryana, India, based on convenience sampling. The respondents filled a self-completion questionnaire containing questions about sociodemographic details, menstrual cycle details, and questions related to PCOS.
Statistical Analysis Analysis was done using IBM SPSS Statistics for Windows, Version 23.0. Descriptive statistics was used to calculate frequency and percentage of variables. Pearson's chi-square test of independence was used to identify factors associated with awareness of PCOS. A p-value of < 0.05 was considered to be statistically significant.
Results The mean age of respondents was 19.9 ± 1.7 years (range = 18–24 years). Only 78 females (18.22%) had heard about PCOS. Being knowledgeable was significantly associated with mother's education (p = 0.001), length of menstrual cycle (p = 0.022), and family history of PCOS (p < 0.001).
Conclusion The present study indicates awareness of PCOS among college going females was very poor. There is an urgent need of increasing awareness about PCOS among young adult college going females to reduce the prevalence, for early diagnosis, and treatment of the disease. It is also needed to prevent long-term consequences of PCOS.
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Affiliation(s)
- Renuka Jakhar
- School of Medical and Allied Sciences, G. D. Goenka University, Gurgaon, Haryana, India
| | - Elina Dewanji Sen
- School of Medical and Allied Sciences, G. D. Goenka University, Gurgaon, Haryana, India
| | - Rohit Dutt
- School of Medical and Allied Sciences, G. D. Goenka University, Gurgaon, Haryana, India
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16
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Ismayilova M, Yaya S. What can be done to improve polycystic ovary syndrome (PCOS) healthcare? Insights from semi-structured interviews with women in Canada. BMC Womens Health 2022; 22:157. [PMID: 35538531 PMCID: PMC9092874 DOI: 10.1186/s12905-022-01734-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 04/25/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a common and perplexing condition affecting metabolic, reproductive, cardiovascular, and psychological health in women. Previous studies point to widespread dissatisfaction and frustration in women with the information and care they receive. Studies have found delays with the diagnosis of PCOS and gaps in knowledge in physicians regarding the diagnosis and management of PCOS. Little has been heard from women on what they think can be improved with PCOS care, especially in Canada. This qualitative study explores women's experiences navigating the healthcare system and their insights on what could be improved based on their lived experiences. METHODS Twenty-five participants were interviewed remotely over the phone by the first author between October and December 2018.Interviews were semi-structured and in-depth. Data were analyzed using thematic analysis and interpretive description methodology. RESULTS Twenty-five in-depth interviews conducted with participants across Canada (ages 18-63) revealed three overall areas in need of improvement. First, women emphasized a need for greater knowledge and awareness of PCOS in primary care physicians (PCPs) as well as the need for the medical community to prioritize women's health. Second, participants advocated for greater PCOS awareness and de-stigmatization in the general community and in women and girls, and any individuals with female reproductive systems. Third, participants brought up several needed resources, such as the need for more PCOS research to be funded and undertaken, more PCOS specialists and experts to be available, credible doctor-provided information (e.g., pamphlets, websites), and age-specific support groups and mental health supports to be available. Participants were generally unaware of existing PCOS organizations and brought up the need for established PCOS organizations to aid in the training and retraining of doctors and local awareness-building in communities. CONCLUSIONS Participants believed that PCPs in Canada needed to be well-versed on how to diagnose and manage PCOS to prevent delays in diagnosis and provide easier access to care. Further, greater awareness and de-stigmatization in the general community are needed so women can identify symptoms early and have access to support from those around them. Overall, PCOS may be an overlooked and under-prioritized condition, both in the Canadian healthcare system and general community.
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Affiliation(s)
- Miya Ismayilova
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Sanni Yaya
- School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, 120 University Private, Ottawa, ON K1N 6N5 Canada
- The George Institute for Global Health, Imperial College London, London, UK
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17
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Ismayilova M, Yaya S. "I felt like she didn't take me seriously": a multi-methods study examining patient satisfaction and experiences with polycystic ovary syndrome (PCOS) in Canada. BMC Womens Health 2022; 22:47. [PMID: 35197027 PMCID: PMC8864824 DOI: 10.1186/s12905-022-01630-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 02/10/2022] [Indexed: 11/10/2022] Open
Abstract
Background Polycystic ovary syndrome (PCOS) is a common and complex condition affecting metabolic, reproductive, cardiovascular, and psychological health in women. Previous studies point to widespread dissatisfaction and delays with the diagnosis of PCOS and a lack of information provision by doctors, with few studies on Canadian populations. This multi-methods study explored the perceptions and experiences of PCOS diagnosis in Canada using an online-distributed survey and follow-up, in-depth, semi-structured phone interviews. Methods The online questionnaire was completed by 296 women aged 18–60 with a self-reported diagnosis of PCOS. The survey measured time to diagnosis, number of doctors seen, and information provided. Descriptive statistics, Chi-square tests, Fisher’s exact tests, and Spearman’s rank correlations were used to analyze the sample characteristics and correlations between the demographic factors and the outcome measures. Twenty-five follow-up interviews were held over the phone and analyzed using thematic analysis and interpretive description methodology. Results Survey respondents were dissatisfied with the information provided about PCOS (66%), lifestyle management (34%), and medical therapy (38%) at the time of diagnosis. Approximately 34% of respondents waited for more than 2 years and 41% saw 3 or more doctors before attaining diagnosis. Many did not receive any information about lifestyle management (42%) or medical therapy (28%). Interview participants encountered doctors who lacked sufficient knowledge on PCOS to diagnose, chronically dismissed concerns, and did not provide necessary medical information about the condition. Women described benefitting from self-advocation to receive the care they needed from doctors, and self-educating about PCOS using materials they could find online. Younger interview participants whose symptoms began in adolescence would often not understand the significance of symptoms until much later in life, contributing to delayed diagnoses. Conclusions Greater education on PCOS for physicians, particularly in primary care, is needed to prevent delayed diagnoses and ensure that patients are provided with reliable medical information about their condition. Greater awareness of PCOS may be necessary for the general population to help women identify symptoms, especially for adolescents and their parental figures. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-01630-3.
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Affiliation(s)
- Miya Ismayilova
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Sanni Yaya
- School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, 120 University Private, Ottawa, ON, K1N 6N5, Canada. .,The George Institute for Global Health, Imperial College London, London, UK.
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Goh JE, Farrukh MJ, Keshavarzi F, Yap CS, Saleem Z, Salman M, Ramatillah DL, Goh KW, Ming LC. Assessment of prevalence, knowledge of polycystic ovary syndrome and health-related practices among women in klang valley: A cross-sectional survey. Front Endocrinol (Lausanne) 2022; 13:985588. [PMID: 36105409 PMCID: PMC9465311 DOI: 10.3389/fendo.2022.985588] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a common metabolic and reproductive disorder affecting women of childbearing age. Its symptoms associated with androgen excess and menstrual abnormalities have great impact on the quality of life in women with PCOS. Data on the knowledge of PCOS and health-related practices among Malaysian women is scarce. This study aimed to determine the prevalence, knowledge and health-related practices of PCOS among women in Klang Valley, Malaysia. METHOD A descriptive cross-sectional study was conducted among women in Klang Valley, Malaysia using a self-administered questionnaire. Participants were conveniently recruited through online platforms. Questionnaire consisted of four sections. The knowledge scores ranged from 0-20 where < 10 was classified as poor knowledge. Health-related practices scores ranged from 10-50, with score <30 was classified as poor practice. Descriptive statistics was used to report demographic characteristics. Inferential statistics was used to report the differentiation, association, and correlations of the variables. RESULTS A total of 410 respondents participated in this survey. The finding revealed that 43 (10.49%) respondents had medical diagnosis of PCOS, 11 (2.68%) were diagnosed with PCOS based on signs and symptoms, and 135 (32.93%) were suspected with PCOS. Nearly half of the respondents had poor knowledge (47.30%) and poor practice (47.60%) of PCOS. Also, 46 (11.22%) respondents reported abnormal scalp hair loss and 30 (7.32%) respondents had diabetes. Educational levels and PCOS history were significantly associated with PCOS knowledge. Respondents with healthcare related educational background demonstrated good knowledge (p<0.01). Majority of respondents (n= 328, 80%) were unable to control their diets on weekends. Married participants and aged between 40 to 45 women showed better practice of PCOS. CONCLUSION Nearly half of the respondents had poor knowledge and health-related practices towards PCOS. Women with suspected or diagnosed PCOS should seek immediate medical help as early diagnosis and treatment for PCOS are beneficial in improving their quality of life.
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Affiliation(s)
- Jia Ean Goh
- Faculty of Pharmaceutical Sciences, UCSI University, Kuala Lumpur, Malaysia
| | - Muhammad Junaid Farrukh
- Faculty of Pharmaceutical Sciences, UCSI University, Kuala Lumpur, Malaysia
- *Correspondence: Muhammad Junaid Farrukh, ; Khang Wen Goh,
| | | | - Chuan Sheng Yap
- Faculty of Pharmaceutical Sciences, UCSI University, Kuala Lumpur, Malaysia
| | - Zikria Saleem
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | - Muhammad Salman
- Institute of Pharmacy, Faculty of Pharmaceutical and Allied Health Sciences, Lahore College for Women University, Lahore, Pakistan
| | | | - Khang Wen Goh
- Faculty of Data Science and Information Technology, INTI International University, Nilai, Malaysia
- *Correspondence: Muhammad Junaid Farrukh, ; Khang Wen Goh,
| | - Long Chiau Ming
- PAP Rashidah Sa’adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Gadong, Brunei
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Zhuo C, Chen G, Lin C, Ping J, Zhu J, Wang L, Jin S, Liu C, Zhang Q, Yang L, Li Q, Zhou C, Cheng L, Tian H, Song X. Risk-to-befit ratios of consecutive antidepressants for heavy menstrual bleeding in young women with bipolar disorder or major depressive disorder. Front Psychiatry 2022; 13:1012644. [PMID: 36386987 PMCID: PMC9650378 DOI: 10.3389/fpsyt.2022.1012644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/06/2022] [Indexed: 11/24/2022] Open
Abstract
The occurrence of heavy menstrual bleeding (HMB) induced by pharmacological agents has been reported in young adult women. This study aimed to investigate a possible association between the occurrence rates of HMB and different treatment methods such as antidepressant agents alone and in combination with other pharmacological agents. The examined cohort included young women (age 18-35 years, n = 1,949) with bipolar disorder (BP) or major depressive disorder (MDD). Menstruation history for 24 months was recorded and evaluated according to pictorial blood loss assessment charts of HMB. Multivariate analyses were conducted to determine odds ratios (ORs) and 95% confidence intervals. The examined antidepressant agents had varying ORs for patients with BP vs. those with MDD. For example, the ORs of venlafaxine-induced HMB were 5.27 and 4.58 for patients with BP and MDD, respectively; duloxetine-induced HMB, 4.72 and 3.98; mirtazapine-induced HMB, 3.26 and 2.39; fluvoxamine-induced HMB, 3.11 and 2.08; fluoxetine-induced HMB, 2.45 and 1.13; citalopram-induced HMB, 2.03 and 1.25; escitalopram-induced HMB, 1.85 and 1.99; agomelatine-induced HMB, 1.45 and 2.97; paroxetine-induced HMB, 1.19 and 1.75; sertraline-induced HMB, 0.88 and 1.13; reboxetine-induced HMB, 0.45 and 0.45; and bupropion-induced HMB, 0.33 and 0.37, in each case. However, when antidepressant agents were combined with valproate, the OR of HMB greatly increased, with distinct profiles observed for patients with BP vs. those with MDD. For example, the ORs of HMB induced by venlafaxine combined with valproate were 8.48 and 6.70 for patients with BP and MDD, respectively; for duloxetine, 5.40 and 4.40; mirtazapine, 5.67 and 3.73; fluvoxamine, 5.27 and 3.37; fluoxetine, 3.69 and 4.30; citalopram, 5.88 and 3.46; escitalopram, 6.00 and 7.55; agomelatine, 4.26 and 5.65; paroxetine, 5.24 and 3.25; sertraline, 4.97 and 5.11; reboxetine, 3.54 and 2.19; and bupropion, 4.85 and 3.46, in each case. In conclusion, some antidepressant agents exhibited potential risks of inducing HMB. Therefore, a combined prescription of antidepressant agents and valproate should be carefully considered for young women with HMB.
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Affiliation(s)
- Chuanjun Zhuo
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China.,Key Laboratory of Multiple Organs Damage in Patients With Metal Disorder, Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin, China.,Department of Psychiatry, Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin, China.,Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Laboratory of Psychiatric-Neuroimaging-Genetic and Comorbidity, Tianjin Anding Hospital, Tianjin Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Guangdong Chen
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Chongguang Lin
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Jing Ping
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Jingjing Zhu
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Lina Wang
- Laboratory of Psychiatric-Neuroimaging-Genetic and Comorbidity, Tianjin Anding Hospital, Tianjin Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Shili Jin
- Inpatient Department, Shandong Daizhuang Hospital, Jining, China
| | - Chuanxin Liu
- College of Mental Disorder, Jining Medical University, Jining, China
| | - Qiuyu Zhang
- Key Laboratory of Multiple Organs Damage in Patients With Metal Disorder, Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin, China
| | - Lei Yang
- Key Laboratory of Multiple Organs Damage in Patients With Metal Disorder, Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin, China
| | - Qianchen Li
- Key Laboratory of Multiple Organs Damage in Patients With Metal Disorder, Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin, China
| | - Chunhua Zhou
- Department of Pharmacology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Langlang Cheng
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Hongjun Tian
- Key Laboratory of Multiple Organs Damage in Patients With Metal Disorder, Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin, China
| | - Xueqin Song
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Alshdaifat E, Sindiani A, Amarin Z, Absy N, AlOsta N, Abuhayyeh HA, Alwani M. Awareness of polycystic ovary syndrome: A university students' perspective. Ann Med Surg (Lond) 2021; 72:103123. [PMID: 34934483 PMCID: PMC8654774 DOI: 10.1016/j.amsu.2021.103123] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/28/2021] [Accepted: 11/30/2021] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Polycystic ovary syndrome is the most common endocrine disorder in women of reproductive age. Women with this syndrome may have infrequent menstrual periods or amenorrhea and excess androgen levels. The ovaries develop numerous small follicles and fail to ovulate on a regular basis, with subsequent subfertility in those women that wish to conceive.The etiology of polycystic ovary syndrome is unclear. Early diagnosis and treatment may reduce the risk of long-term complications such as type 2 diabetes and heart disease. OBJECTIVES To assess the knowledge and attitude of university students towards polycystic ovary syndrome at two universities in the north of Jordan. METHOD ology: This is a cross-sectional online survey that polled female students at two universities in the north of Jordan. The main outcome measures included average polycystic ovary syndrome awareness score, predictors of high awareness scores, and sources of information. RESULTS Formal diagnosis of polycystic ovary syndrome was reported by 29.9% of the 1182 students, the average polycystic ovary syndrome awareness score was M = 11.59 (SD = 4.95). Being a 6th and 5th year college student were the strongest independent predictors for recognizing the term polycystic ovary syndrome, in addition to be a student in the majors of veterinary medicine, nursing, pharmacy, or dentistry. Age was a significant predictor of polycystic ovary syndrome awareness score. Being investigated for, or being diagnosed with polycystic ovary syndrome were significant predictors of higher scores. Body mass index was a weak predictor of polycystic ovary syndrome awareness. Participants who reported to have hirsutism, acanthosis nigricans, or acne scored significantly higher than others.Healthcare professionals were the most common source of information reported by participants. Lectures were most effective in increasing awareness score but were poorly utilized outside the curriculum. CONCLUSION Although students in this study demonstrated a satisfactory level of polycystic ovary syndrome awareness and were more likely to seek information from healthcare professionals, this level of awareness should spread-out to other segments of the population.
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Affiliation(s)
- Eman Alshdaifat
- Department of Obstetrics and Gynecology, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Amer Sindiani
- Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Zouhair Amarin
- Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Nadine Absy
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Noor AlOsta
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Mustafa Alwani
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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