Effects of the COVID-19 Infection on Women's Menstrual Cycle: A Retrospective Study at Latifa Hospital, Dubai, United Arab Emirates

Background The COVID-19 pandemic has affected all of us in one way or another. The menstrual cycle is a reflection of the female reproductive system, and it is influenced by various factors including stress and infections. Although there is little information available about how the COVID-19 pandemic has affected women's reproductive health, it has had a significant impact on women. Objective The main objective of our study is to identify if there are any menstrual disturbances following COVID-19 infection in women. Study design Our study is a retrospective study wherein 700 women recovering from COVID-19 infection were asked about any new menstrual disturbances after the infection. We collected the data using questionnaires and analyzed the data using Statistical Product and Service Solutions (SPSS, version 26) (IBM SPSS Statistics for Windows, Armonk, NY). Results Our study showed no dysmenorrhea in 90% of the participants, 81% reported no change in menstrual flow rate, a vast majority (93%) denied experiencing amenorrhea, only 4% reported a new onset of intermenstrual bleeding, and 1% reported postmenopausal bleeding. Conclusion There was no significant change in the participants' menstrual cycle following COVID-19 infection.

Repurposing of respiratory drug theophylline against Candida albicans: mechanistic insights unveil alterations in membrane properties and metabolic fitness

AIMS

Drug repurposing is an attractive chemotherapeutic strategy that serves to make up for the inadequacy of current antifungal drugs. The present study aims to repurpose theophylline (THP) against Candida albicans. THP is a methylxanthine derived from cocoa beans and tea extracts, generally used as the first-line drug for asthma and other respiratory disorders.

METHODS AND RESULTS

We investigated the antifungal activity of THP against C. albicans and non-albicans species. Mechanistic insights revealed that THP induces membrane damage. Enhanced ionic disturbances and depleted ergosterol levels with the concomitant rise in membrane fluidity due to elevated flippase activity confirmed the membrane damaging effect. THP impeded the metabolic adaptability of C. albicans by inhibiting malate synthase and isocitrate lyase enzymes of the glyoxylate cycle. In vivo efficacy of THP was depicted by increased survival of C. albicans infected Caenorhabditis elegans model.

CONCLUSIONS

This study elucidates the antifungal potential of THP with mechanistic insights.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study unveils the antifungal potential of THP, a known respiratory drug that can be further utilized for a wider range of applications such as combating fungal infections. The effect of THP with the known antifungal drugs can be exploited in the combinatorial drug approach for treating candidiasis.

Orbital masses: the usefulness of diffusion-weighted imaging in lesion categorization

INTRODUCTION

Diffusion-weighted imaging (DWI) produces contrast among different kinds of tissues according to their diffusibility characteristics. The purpose of our study was to evaluate the role of DWI including measurement of apparent diffusion coefficient (ADC) values in recognizing benignancy or malignancy of orbital masses.

METHODS

A total of 39 orbital masses were evaluated visually for signal characteristics on DWI and ADC maps. ADC values were calculated for each lesion. Visual signal characteristics were compared using the Fisher exact test. Receiver operating characteristic (ROC) analysis was carried out to determine sensitivity and specificity for distinguishing malignant from benign lesions using ADC values. The Mann-Whitney U test was applied to compare the ADC values between orbital lymphomas and idiopathic orbital inflammatory (IOI) lesions, and between optic nerve sheath meningiomas and gliomas.

RESULTS

Visual assessment revealed no significant difference between benign and malignant lesions on DWI (p-value = 0.66). However, visual assessment of ADC maps revealed a statistically significant (p-value ≤ 0.0001) between benign and malignant lesions. ROC analysis showed a sensitivity of 83.33 % and a specificity of 85.71 % when using an optimal cut off ADC value of 0.84 × 10(-3) mm(2)/s for differentiating malignant from benign lesions. Significant differences in mean ADC values were observed between lymphomas and IOI lesions (p-value = 0.05), and between optic nerve sheath meningiomas and gliomas (p-value = 0.03).

CONCLUSION

DWI is useful for differentiating malignant and benign orbital tumors if accompanied by visual assessment of ADC maps and ADC value calculations.

Knee pain amongst the poor and affluent in Pakistan

The frequency of joint symptoms was determined amongst 2022 affluent and 2210 poor adults in Karachi, Pakistan. Joint pain was significantly (P = 0.025) more common amongst the affluent (6.6%) compared with the poor (5%) and this was due to a significantly greater frequency of knee pain in the richer community (3% vs 1.8%; P = 0.008). The prevalence increased with age and was more common in females. Almost half were associated with varus deformity, suggesting the presence of associated OA in a high proportion. The overall frequency of knee pain seemed no greater than in series reported from the West. Compared with age- and sex-matched controls, body weight was significantly greater amongst those with knee pain, both amongst the affluent (P = 0.005) and the poor (P = 0.02). Control subjects were heavier in the affluent population, suggesting that the greater frequency of knee symptoms in this community was due to their relative obesity. Knee bending at prayer was most common amongst the affluent controls and may indicate that religious observance also contributed to the problem in the richer population. Squatting was a characteristic of the poor who had less knee pain than the affluent. Knee flexing could not therefore be confidently implicated. No relationship could be demonstrated between knee pain and joint laxity.

The frequency of known diabetes, hypertension and ischaemic heart disease in affluent and poor urban populations of Karachi, Pakistan

The high frequency of diabetes mellitus and coronary artery disease among people of South Asian extraction living in the West is well established. The prevalence of these disorders in Southern Asia is less certain. No previous attempt has been made to estimate their occurrence in Pakistan. In order to compare the prevalence of known diabetes mellitus, hypertension and ischaemic heart disease between affluent and poor urban communities in Pakistan, a survey of consecutive households was undertaken in a relatively prosperous and a poor area in Karachi. Information was obtained on 4232 adults evenly distributed between the two areas. Body weight and height were measured in 199 healthy subjects at the two sites. The prevalence of known diabetes in the affluent population was 4.5%, significantly higher than 1.8% in the poor area (p < 0.001). A maximal prevalence of 25% was seen in the affluent community aged 55-64. Diabetes was more common in females in both populations. The overall prevalence of hypertension was similar in the two areas although significantly more frequent in the middle aged and affluent. A history of ischaemic heart disease occurred in 1.9% of the affluent and 0.6% of the poor (p = 0.003). Healthy subjects were heavier and more obese in the richer community. Thus the susceptibility of South Asian populations to diabetes and ischaemic heart disease is also apparent in an affluent segment of Pakistani society. The phenomenon is not attributable simply to urbanization. Obesity is probably an important contributory factor. The economic implications for developing South Asian countries are serious.

The prevalence of rheumatoid arthritis in affluent and poor urban communities of Pakistan

Using previously applied methods a survey of joint symptoms was undertaken among 4232 adults, evenly distributed between affluent and poor areas of Karachi, Pakistan. Only six cases of definite rheumatoid arthritis (RA) (1958 ARA criteria) were identified in the 245 persons who complained of joint problems of at least 4 weeks duration. The prevalence was 0.9 [confidence interval (CI) 0.21-3.61] and 1.98 (CI 0.55-5.1) per thousand in the poor and affluent districts, respectively. These were substantially less than prevalence rates reported in the West but were similar to figures derived from other developing countries. There was no obvious impact of current living standards on the findings. The relative paucity of older female subjects in both the affluent and poor communities may account at least in part for the low rates observed. The infrequency of rheumatoid nodules in Southern Asians with RA illustrates the difficulty of applying existing diagnostic criteria to this community.