Prevalence of primary dysmenorrhea and its relationship with body mass index.

AIM: To identify the association between primary dysmenorrhea (PD) and body mass index (BMI). METHODS: This cross sectional study was conducted on 370 female students (aged 18-25 years) of Immam Abdulrahman Bin Faisal University Dammam, from March 2016 till March 2017. Pretested dysmenorrhea questionnaire was filled by the students. Weight and heights of the subjects were measured, and BMI was calculated. Based on BMI, subjects were divided into four groups (underweight [UW], normal weight, overweight and obese [OB]). Subjects were also categorized into mild, moderate and severe dysmenorrhic groups based on numeric pain relating scale. SPSS version 20.0 was used to analyze the data. RESULTS: This study showed that 85.7% of the students were suffering from PD, out of which 12.7% had mild, 65.6% had moderate and 8.4% had severe dysmenorrhea. In total, 54.5% of the students mentioned that dysmenorrhea interferes with their daily activities. Whereas 55.8% of the students mentioned that they got pain relief by using non-steroidal anti-inflammatory drugs. Pair wise comparison of dysmenorrhea between different BMI groups showed a statistically significant difference in the frequency of moderate and severe dysmenorrhea between UW and OB subjects (P values 0.003 and 0.06) respectively, indicating that UW females are at a higher risk of having PD. CONCLUSION: This study indicates a higher prevalence of moderate and severe dysmenorrhea in UW as compared to the OB subjects. We recommend further studies to explore the underlying pathophysiological mechanisms responsible for this association.

Prevalence of menstrual problems and their association with psychological stress in young female students studying health sciences.

OBJECTIVES: To identify the prevalence of various menstrual problems in young females studying health sciences and to identify their association with academic stress. Methods: This was a cross-sectional study, conducted in the health colleges of Immam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia between February 2015 and February 2016. Seven hundred and thirty-eight female students aged 18-25 years anonymously completed menstrual problem identification and perceived stress scale questionnaire. The data was analyzed using the Statistical Package for Social Sciences version 16.0.  Results: Ninety-one percent of the students were suffering from some kind of menstrual problem. The different menstrual problems reported, and their incidences included irregular menstruation (27%), abnormal vaginal bleeding (9.3%), amenorrhea (9.2%),  menorrhagia (3.4%), dysmenorrhea (89.7%), and premenstrual symptoms (46.7%). High perceived stress (HPS) was identified in 39% of the students. A significant positive correlation was found between HPS and menstrual problems. Students with HPS had 4 times, 2 times, and 2.8 times increased odds ratio for experiencing amenorrhea, dysmenorrhea, and premenstrual syndrome (p less than 0.05).  Conclusion: The most prevalent menstrual problems (dysmenorrhea and premenstrual symptoms) in the target population were strongly associated with stress. Therefore, it is recommended that health science students should be provided with early psychological and gynecological counselling to prevent future complications.

Is Cronbach's alpha sufficient for assessing the reliability of the OSCE for an internal medicine course?

BACKGROUND: The number of medical students accepted into medical programs is increasing, which has made the traditional long/short case style of examination difficult to conduct. At Dammam University, the program is shifting to the use of the Objective Structural Clinical Examination (OSCE), which may solve some of these difficulties, including issues with reliability, validity index and exam duration. RESULTS: A pilot study was conducted over one semester. A total of 207 examinees in three groups took the OSCE and written exams. The OSCE consisted of 18 clinical stations and required 3-4.3 h/day. The written exam contained 80 multiple-choice questions. The Cronbach's alpha for each group was 0.7, 0.8, and 0.9. Correlations for all stations ranged from 0.7 to 0.8, which indicated good stability and internal consistency with minor differences in the progression of the indexes. The reliability of the written exam was 0.79, and the validity of the OSCE was 0.63, as assessed using Pearson's correlation. CONCLUSION: No single reliability index can be considered a perfect assessment tool to solve this issue. Thus, at least two to three indexes should be used to ensure the reliability of the OSCE.

Effect of stress on pain perception in young women.

OBJECTIVE: To determine the effect of physical and mental stressors on pressure pain threshold (PPT), and pressure pain tolerance (PTOL) values, and to compare these different types of stressors on its ability to affect PPT and PTOL values in young women. We also correlated body mass index (BMI) with PPT and PTOL in young women. METHODS: This was a self-controlled study carried out on 79 second-year female medical students in the Department of Physiology, King Faisal University, Dammam, Saudi Arabia during the year 2007. The students were assessed before, and after they were subjected to a mental (exam), and 2 physical stressors. Measurements of PPT and PTOL were carried out using a pressure algometer. The 2 physical stressors used were: cold water immersion and isometric exercise (ISO EX) with a dynamometer. Students' body mass indices were measured in addition to the measurement of blood pressure and heart rate for each student before, and after exposure to the stressors. RESULTS: All 3 stressors significantly increased the PPT values (p=0.000). The PTOL was also significantly increased immediately after exposure to the physical stressors (p=0.000), while for the mental stressor, the PTOL readings were not significantly increased. Among the 3 types of stressors, the cold water immersion was the most effective in increasing PPT and PTOL. Moreover, a significant (p=0.009) negative correlation was demonstrated between the BMI and PTOL readings. CONCLUSION: Various types of physical and mental stressors significantly increased PPT and PTOL readings in young female adults, in addition to the significant findings that students with higher body mass indices tolerated pain less.