Menstrual Patterns and Disorders among Women in Jeddah, Saudi Arabia

Background:The menstrual disorders are the most common gynecologic illnesses. These disorders can negatively affect the quality of the adult females’ lives. This study aimed to determine the prevalence and the nature of menstrual disorders among women in Jeddah to find its relation to pain and to identify what is normal and acceptable. Methods: A cross-sectional survey was conducted from Jan 23 to 31, 2018 in Jeddah, KSA among 303 female. Frequencies and Chi-square test were used in data analysis by SPSS software. Result: This study enrolled 303 participants with a mean of 26.8 ± 6.8 years and a range of 16-52 years. The mean age at menarche was 12.9 years. The majority of the participants had a regular period (69.6%). (8.3%) had polymenorrhea and (2.6%) had oligomenorrhea. The menstrual flow length of the most women was ranged from 3 to 7 days (80.9%). The prevalence of menorrhagia was (19.1%) while hypomenorrhea was (19.5%). (74.3%) of the participants reported that they experienced moderate to severe dysmenorrhea and (49.2%) of them their daily activities were affected by the pain. (58.4%) of the responders that reported menstrual disorders used medication for symptom relief and 108 of them indulged in self-medication. (89.4%) admitted they have undergone psychological changes the few days before the menses. Conclusion: Dysmenorrhea was the commonest reported menstrual disorder (74.3%) followed by irregular menstruation (30.4%). The high prevalence of non-expert treatment in the respondents for relieving symptoms confirms the need for awareness creation, emphasizing the dangers of the possibilities of the presence of other harmful differential health disorders.

Drug Resistance in Mycobacterium tuberculosis Isolates from Northeastern Sudan.

The present study intended to determine the drug resistance patterns of Mycobacterium tuberculosis isolates among human new tuberculosis cases from northeastern Sudan using conventional and molecular techniques. Of 100 mycobacterial isolates tested by proportion method, 6% and 2% were identified, respectively, as multi drug resistanttuberculosis (MDR-TB) and non-multi drug resistant-rifampicin (non-MDR-RIF). A total of 8% was found resistant to rifampicin (RIF), 13% to isoniazid (INH), 34% to streptomycin (STM) and 12% to ethambutol (EMB). Mono-resistant were 0% for RIF, 1% INH, 18% STM and 3% ETH. The remaining 61% isolates were identified as sensitive. Resistance to pyrazinamide was evaluated conventionally for the first time in this country and was found as low as 1%. Molecularly, mutations of MDR-TB, RIF, INH, EMB and STM resistant isolates were detected in 66.7%, 87.5%, 76.9%, 66.7% and 17.6% of corresponding conventional findings, respectively. The genetic mutations were related to the following codons: rpoB 531 (71.4%) and rpoB 526 (28.6%) for RIF, katG 315 (90%) and mabA-inhA-15 (10%) for INH, embB 306 (66.7%) for EMB and rpsL (17.6%) for STM. The study showed that drug resistant tuberculosis increased steadily and provided potentially valuable information on resistant genes circulating in the community. The rapid solving of this problem can benefit both public health and patient management.

effect of hyoscine-N-butylbromide [buscopan] on the cervix during the first stage of labor [a randomized trial]

To investigate the effect of Buscopan on the cervix during the first stage of labor. Prospective, randomized, controlled study, performed at King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia. 90 patients included, 60 study cases and 30 control. The case study received 20 mg of Buscopan while control received 2 mls of saline. Data about each patients and progress of labor were collected and analyzed using either t-test or X2 test. None of the variables we study were statistically significant except the duration of the first stage of labor and the duration from administration of medication to full dilatation of the cervix, with P value of 0.004 and 0.002. Buscopan has an effect on the cervix and could help in accelerating first stage of labor

Serum zinc level of healthy individuals living in western province of Saudi Arabia

To establish a normal serum zinc level range of healthy individuals at different age group living in the Western region of Saudi Arabia. A prospective, cross section study of 276 healthy subjects, 138 males and 138 females was done. Their ages ranged from 1 month to seventy years. They were divided into nine groups according to the Recommended Dietary Allowances Classification for both sexes. Sample were collected and zinc level determined using method of Parker. Serum zinc level were found to be different at different age group, the highest were found to be at earliest stages of life and at the age of 15 - 50 years for both sexes. The serum zinc level range of all ages were found to be [0.50 - 13.90 umol/L] which is lower than the international established standard [7.65 - 22.95 umol/L]

Pseudotumour cerebri in pregnancy: a case report

Pseudotumour Cerebri is a rare disorder, which occurs in the reproductive age group. It is relatively rare in pregnancy. We report one case of Pseudotumour Cerebri which was diagnosed preconceptially and was initially treated with corticosteroids. When pregnancy was diagnosed, the corticosteroid was discontinued and treatment was changed to repeated lumbar punctures. Symptomatic relief was achieved and the patient had an unremarkable antenatal course. A 3050 g full term female was delivered vaginally with apgar scores of 9 and 10 at 1 and 5 minutes respectively. Seven similar cases were reviewed which also diagnosed preconceptially. Clinical presentation, modalities of treatment and outcome of pregnancy are discussed

Comparison between postpartum lactate concentration in the umbilical artery and apgar score

Postpartum lactate concentration in the umbilical arteries was measured in 237 patients by means of the enzymatic method, using the lactic acid [LA] pack in the Du Pont Automatic Clinical Analyzer. Blood samples were taken immediately postpartum and Apgar scores were determined at one and five minutes, whereby the lactate level in the umbilical artery was found to be higher than the normal adult level [0.6-2.2 mmol/l]. The lowest level was 1.1 mmol/l and the highest was 7.7 mmol/l, with a mean of 3.26 mmol/l, and a standard deviation of 1.36. It was also found that in 184 patients the lactate concentration was less than the mean and only one newborn had an Apgar score of less than 7 at five minutes. In 53 patients, the lactate concentration was more than the mean and 13 newborns had an Apgar score of less than 7 at five minutes. When comparing the frequency of low Apgar scores [less than 7] at five minutes in the two groups [above and below the mean], using the Z-score, there was a statistically significant difference [P < 0.01]. Using the lactate level as a method of assessing the newborn in comparison with the Apgar score, the sensitivity was 92.86% and the specificity was 82.06%

Palliative cytoreductive surgery in advanced ovarian carcinoma

Seventeen patients with advanced epithelial ovarian carcinoma underwent aggressive cytoreductive surgery ["Debulking"] at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Thirteen patients [76.5%] had large bowel surgery, 5 [29.4%] had colostomy, and 2[11.8%] had urinary tract segmental resection performed. All patients received postoperative chemotherapy in the form of cis-platinum and cyclophosphamide. The patients were divided into two groups: group 1 [N = 9] consisted of those patients who died within 12 months of undergoing surgery, and group 2 [N = 8] comprised of those who survived for more than 12 months following surgery. Data from these patients was analysed and eight factors including nationality, age, parity, menopausal status, ascitic fluid volume, stage and grade of the carcinoma, as well as its histological type were studied. However, except for the stage of the disease, none of these factors was found to be significant in predicting survival of more than 12 months following surgery. We conclude that cytoreductive surgery has a role in palliation, however, the variables presented cannot be utilised to predict survival in females with advanced carcinoma of the ovaries

Female genito-urinary fistulae

During the period from 1987 until 1989, twenty-eight female patients with genito-urinary fistulae were seen at King Abdulaziz University Hospital, 78.6% of which were of obstetrical etiology. Thirteen patients had small fistulae [< 2cm] and fifteen patients had large fistulae [> 2cm], nine of which were considered to be giant fistulae [> 5cm]. The patients' age, parity, nationality and duration of their fistulae are presented. Our experience of repairing twenty-four fistulae showed that the cure rate was higher in small fistulae [90.9%] compared to large fistulae [69.2%]. The cure rate was also found to be higher in patients who underwent the abdomino-vaginal approach [71.4-100%], compared to those who underwent the vaginal approach [66.7-83.3%]

Non-Hodgkin's lymphoma in pregnancy

Non-Hodgkin's lymphoma is rarely reported during pregnancy. Only 32 cases have been reported in the English literature over the past 50 years, in which well-documented cases of non-Hodgkin's lymphoma were diagnosed and treated during pregnancy. In this paper, we report another three patients with non-Hodgkin's lymphoma which were diagnosed and managed during pregnancy. The first patient was treated with multiagent chemotherapy [cyclophosphamide, vincristine, bleomycin and prednisone], during pregnancy the outcome of which resulted in a healthy infant. The second patient had an ovarian lymphoma which was treated surgically by Caesarean hysterectomy, bilateral salpingo-oophorectomy and staging. The outcome was a healthy male infant. The third patient died immediately after diagnosis