The relationship between lifestyle and the frequency of polycystic ovary syndrome in Saudi female residing in Riyadh

Background: Polycystic Ovary Disorder (PCOS) is perceived as the most widely recognized endocrinopathy in reproductive women. This study aimed to assess the relationship between the lifestyle and frequency of polycystic ovary syndrome in Saudi Arabia.Methods: This is a case-control study conducted on females at princess Nourah University (PNU), King Fahad Medical City (KFMC) and malls in Riyadh city, Saudi Arabia. The study included females in the reproductive age including 401 controls and 122 PCOS cases.Results: History of pregnancy related disorders was higher among the PCOS women in comparison to controls, while abortion represented the highest percentage in both cases and controls. Family history of polycystic ovary syndrome was doubled in cases than controls. There was significant increase in the percentage of hypothyroidism and hyperlipidemia in polycystic ovary syndrome patients (P <0.001). Snoring, use of oral contraceptives, high prolactin level, incidence of menorrhagia and urinary tract infection were significantly higher in cases than controls (P <0.001). In addition, there was no difference between controls and polycystic ovary syndrome cases regarding their dietary intake. On the other hand, physical activity was significantly higher in controls compared to polycystic ovary syndrome group.Conclusions: This study supports previous studies that revealed a relation between polycystic ovary syndrome and endocrinological disorders such as hypothyroidism, hyperprolactinemia, and obesity. On the other hand, there is no relation between dietary intake and PCOS, however exercising regularly can decrease the possibility of having the disease

Evaluation of inhaled nitric oxide (iNO) treatment for moderate-to-severe ARDS in critically ill patients with COVID-19: A multicenter cohort study

Background: Inhaled nitric oxide (iNO) is used as rescue therapy in patients with refractory hypoxemia due to severe COVID-19 acute respiratory distress syndrome (ARDS) despite the recommendation against the use of this treatment. To date, the effect of iNO on the clinical outcomes of critically ill COVID-19 patients with moderate-to-severe ARDS remains arguable. Therefore, this study aimed to evaluate the use of iNO in critically ill COVID-19 patients with moderate-to-severe ARDS. Methods: This multicenter, retrospective cohort study included critically ill adult patients with confirmed COVID-19 treated from March 01, 2020, until July 31, 2021. Eligible patients with moderate-to-severe ARDS were subsequently categorized into two groups based on inhaled nitric oxide (iNO) use throughout their ICU stay. The primary endpoint was the improvement in oxygenation parameters 24 h after iNO use. Other outcomes were considered secondary. Propensity score matching (1:2) was used based on the predefined criteria. Results: A total of 1598 patients were screened, and 815 were included based on the eligibility criteria. Among them, 210 patients were matched based on predefined criteria. Oxygenation parameters (PaO2, FiO2 requirement, P/F ratio, oxygenation index) were significantly improved 24 h after iNO administration within a median of six days of ICU admission. However, the risk of 30-day and in-hospital mortality were found to be similar between the two groups (HR: 1.18; 95% CI: 0.77, 1.82; p = 0.45 and HR: 1.40; 95% CI: 0.94, 2.11; p= 0.10, respectively). On the other hand, ventilator-free days (VFDs) were significantly fewer, and ICU and hospital LOS were significantly longer in the iNO group. In addition, patients who received iNO had higher odds of acute kidney injury (AKI) (OR (95% CI): 2.35 (1.30, 4.26), p value = 0.005) and hospital/ventilator-acquired pneumonia (OR (95% CI): 3.2 (1.76, 5.83), p value = 0.001). Conclusion: In critically ill COVID-19 patients with moderate-to-severe ARDS, iNO rescue therapy is associated with improved oxygenation parameters but no mortality benefits. Moreover, iNO use is associated with higher odds of AKI, pneumonia, longer LOS, and fewer VFDs

Environmental Pollutants PM2.5, PM10, Nitrogen Dioxide (NO2), and Ozone (O3) Association with the Incidence of Monkeypox Cases in European Countries

Background. Monkeypox, also known as monkeypox disease, is caused by the monkeypox virus (MPXV), which is a zoonotic infection. The swift spread of human monkeypox cases has caused an alarming situation worldwide. This novel study aimed to investigate the association of particulate matter air pollutants PM2.5, PM10, Nitrogen dioxide (NO2), and Ozone (O3) on the incidence of monkeypox cases from May 1, 2022, to July 15, 2022. Methods. The data on air pollutants PM2.5, PM10, NO2, and O3 and monkeypox cases were recorded from the date of occurrence of the first case of monkeypox in the United Kingdom, Spain, France, Germany, Italy, the Netherlands, Switzerland, and Portugal from May 1, 2022, to July 15, 2022. The daily concentrations of PM2.5, PM10, NO2, and O3 were recorded from the metrological website “Air Quality Index-AQI,” and daily human monkeypox cases were recorded from the official website of “Our World in Data.” The mean values along with simple, multiple, and Spearman Rho correlations were performed to investigate the relationship and strength of association between the concentrations of air pollutants and cases of monkeypox. Results. The environmental pollutants PM2.5, PM10, NO2, and O3 were positively associated with monkeypox cases in the United Kingdom, Spain, France, Germany, Italy, the Netherlands, Switzerland, and Portugal. The analysis further revealed that for each 10-unit increase in PM2.5, PM10, and NO2, levels, the number of monkeypox cases was significantly augmented by 29.6%, 9.7%, 13%, and 80.6%, respectively. Conclusions. Environmental pollutants PM2.5, PM10, NO2, and O3 have been positively linked to the number of daily monkeypox cases in European countries. Environmental pollution is a risk factor for the increasing incidence of monkeypox daily cases. The regional and international authorities must implement policies to curtail air pollution to combat the cases of monkeypox in European countries and worldwide

Spirometry profiles of overweight and obese individuals with unexplained dyspnea in Saudi Arabia

Background: Obesity is a common cause of dyspnea. However, the impacts of obesity on spirometry parameters, particularly among individuals with unexplained dyspnea, have not been well investigated. Objectives: This study aimed to explore the prevalence of overweight and different classes of obesity and their effect on spirometry parameters among subjects with unexplained dyspnea in Saudi Arabia. Methods: We conducted a retrospective electronic medical record review of individuals with unexplained dyspnea who visited our pulmonary clinic between January 2016 and December 2022 and assessed the association of body mass index (BMI) with spirometry parameters. After we classified the subjects based on their BMI values, we determined the impacts of increased BMI on spirometry parameters. Results: The sample included a total of 978 subjects with unexplained dyspnea. The prevalence of overweight and obesity among our study sample was high (33 % and 47 %, respectively). All spirometry parameters: forced vital capacity (FVC) L, forced expiratory volume in 1 s (FEV1) L, forced expiratory flow at 25–75 % (FEF 25–75 %) L/sec and peak expiratory flow (PEF) L/sec were significantly lower in obese individuals with dyspnea compared to normal weight subjects. In addition, our findings showed a negative correlation between BMI and FVC, FEV1, FEF 25–75 %, and PEF. Conclusion: The high prevalence of obesity and overweight and the impairment of lung function because of high body weight among subjects with dyspnea point to the need for routine assessment and the evaluation of nutritional status in primary health care facilities for early intervention

ANTICOAGULANTS AND THROMBOLYTICS IN PREGNANCY, A SYSTEMATIC REVIEW

Background: In the developed countries, pulmonary thromboembolism associated with pregnancy (VTE) continues to be the principal cause of direct maternal death. Despite thorough treatment and preventative recommendations from several national authorities, reductions in mortality due to VTE have been negligible. Anticoagulation is still the cornerstone of prenatal care and has to be given to all patients with proven or high-risk PE. The preferred medication is low molecular weight heparin (LMWH), which has a known pharmacodynamic profile. Despite the massive utilization of these drugs there is actually little evidence supporting their efficiency in recurrent pregnancy loss reduction. Objectives: The study aims to summarize current evidences regarding the usage of anticoagulants and thrombolytics in Pregnancy. Methods: For article selection, the PubMed database and EBSCO Information Services were used. All relevant articles relevant with our topic and other articles were used in our review. Other articles that were not related to this field were excluded. The data was extracted in a specific format that was reviewed by the group members. Conclusion: A common cause of maternal death, pulmonary embolism-related fatalities still occur often in pregnant women with pulmonary embolism. One-third of pregnant women with pulmonary embolism and hemodynamic failure were reported to undergo systemic thrombolysis. There is an urgent need to improve prevention and care techniques for this vulnerable patient population. LMWHs are widely used for several different purposes as well as for the treatment and prevention of VTE during pregnancy and puerperium. Although the medicine has been found to be both safe and effective, there is no scientific proof to support its usage for all indications. In pregnant women with thrombophilia who are at high risk of developing these issues, prenatal prophylactic dalteparin does not prevent venous thromboembolism, pregnancy loss, or placenta-mediated pregnancy difficulties and is linked to an increased risk of mild bleeding. Enoxaparin may not offer any meaningful benefits to people suffering from recurrent abortion. However, in one study, the miscarriage rate was significantly lower when enoxaparin was used compared with untreated controls