Prevalence of menstrual irregularities after coronavirus disease 2019 vaccination: A cross-sectional study in the Eastern Province, Saudi Arabia.

BACKGROUND: Reports indicate that there are menstrual cycle disturbances following coronavirus disease 2019 (COVID-19) vaccination. The present study explored the prevalence of menstrual irregularities after COVID-19 vaccination and the association of menstrual irregularities with vaccine type, doses, immediate adverse effects, history of COVID-19 infection, and its severity. MATERIALS AND METHODS: For this cross-sectional study, 406 women of reproductive age completed an online survey about the postvaccine changes in their menstruation (cycle duration, bleeding days, and bleeding amount), COVID-19 vaccine history (doses, type of vaccine, and immediate adverse effects), history of COVID-19 infection, and its severity. Data was analyzed using SPSS; descriptive statistics were computed and Chi-square test, and binary logistic regression analysis were performed. RESULTS: Of the total 406 women, 45% reported postvaccine changes in their menstrual cycle. The most common menstrual change was increased dysmenorrhea (68%), followed by an increase in the length of the cycle (52%). There was a significant association between postvaccine menstrual changes and the age, marital status, and family history of menstrual irregularities. No association was observed between postvaccine menstrual changes and COVID-19 vaccine-and COVID-19 infection-related variables. As per the best-fit model of our predictors, the odds of having postvaccine menstrual changes were 0.41 times less in "single" women (confidence interval [CI] = 0.26-0.27; P < 0.001) and 1.714 times greater in women who had a "family history of menstrual irregularities" (CI = 1.092-2.690; P = 0.02), respectively. CONCLUSION: A substantial number of women complained of postvaccine menstrual changes regardless of their age, type of COVID-19 vaccine, doses, immediate adverse effects, and COVID-19 infection history/severity. Being "single" decreased the probability, whereas having a family history of menstrual irregularities increased the probability significantly of having postvaccine menstrual changes.

Association between sex hormones and migraine in young Saudi females.

OBJECTIVES: To assess the sex hormone levels in young Saudi female migraineurs during a migraine attack and during pain-free periods and compare them with control subjects. METHODS: A case-control study involving 14 Saudi female migraineurs and 21 control subjects was conducted between December 2019 and March 2020. Demographic and disease history data were collected through participant interviews. Blood samples were drawn during the migraine attack and pain-free periods. RESULTS: Follicular (30.00±19.60; p<0.001) and luteal (39.79±11.45; p=0.037) estrogen levels were significantly higher in patients with non-menstrual related migraine (NMM), while luteal testosterone levels (1.10±0.31; p=0.023) were significantly higher in patients with menstrually related migraine (MM). Body mass index (BMI) was higher in patients with NMM (25.77±6.53; p=0.013), and it was found to be associated with follicular estrogen (p=0.016), progesterone (p=0.018), and pain intensity (p=0.042). Luteal estrogen level was significantly lower (13.96±7.88; p=0.036) in patients with luteal onset of attack. CONCLUSION: High estrogen levels were found to mediate NMM, their effect being more pronounced with increase in BMI; whereas low luteal estrogen levels mediated MM. Young females with MM might have high luteal testosterone levels, and a compensatory protective role could be surmised accordingly.

Assessment of baroreceptor reflex sensitivity in young obese Saudi males at rest and in response to physiological challenges.

Autonomic imbalance in overweight/obese persons could lead to an increased risk of cardiovascular complications including hypertension and arrhythmias. Baroreceptor reflex sensitivity is a sensitive indicator to detect an altered sympathovagal balance in overweight/obese individuals. This study investigated the effects of overweight/obesity on baroreceptor sensitivity in young Saudi males at rest and in response to physiological challenges. SUBJECTS AND METHODS: In this cross-sectional study, spontaneous baroreceptor sensitivity at rest and in response to deep breathing, isometric hand grip exercise and moderate intensity isotonic exercise were recorded in 20 normal weight and 20 overweight/obese subjects. Finger arterial blood pressure signal, recorded through Finometer, was used to calculate baroreceptor sensitivity through cross-correlation method. The baroreceptor sensitivity data were log transformed before application of parametric tests. RESULTS: The spontaneous baroreceptor sensitivity was similar in both groups at baseline, but exhibited a significant increase during deep breathing only in normal weight (p < .001). Immediately after the isotonic exercise the baroreceptor sensitivity was significantly lower than baseline in both normal weight and overweight/obese and remained significantly lower in overweight/obese individuals compared to normal weight (p < .05) throughout the recovery period. There was a significant rise in baroreceptor sensitivity after isometric exercise in overweight/obese group only (p = .001). Pearson's correlation showed a significant negative correlation of baroreceptor sensitivity with body mass index during deep breathing (r = -.472, p = .004) and in post-isotonic exercise recovery period (r = -.414, p = .013). CONCLUSION: A significantly reduced baroreceptor sensitivity response to deep breathing, reduced baroreceptor sensitivity recovery after isotonic exercise, and an exaggerated shoot up after isometric exercise in overweight/obese suggests an altered sympathovagal balance. Baroreceptor sensitivity measurements in response to physiological challenges, deep breathing, and isotonic exercise, may be more sensitive investigations for detection of early attenuation of cardiac autonomic function. This would enable timely intervention thereby delaying complications and improving the quality of life.

Validity of maximal oxygen consumption prediction equations in young Saudi females.

OBJECTIVES: To determine the applicability of Jones, Hansen, and Wasserman predictive equations for maximal oxygen consumption (VO2max) in Saudi females.  Methods: This cross-sectional study was conducted at Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia, between March and May 2017. Maximal oxygen consumption was measured directly through the COSMED system for cardiopulmonary exercise testing in 102 girls with normal body mass index (19-25 years old). Maximal oxygen consumption was indirectly predicted by Jones, Hansen, and Wasserman equations. Paired t-test, Pearson correlation, and Bland-Altman plot were used for comparison, correlation, and agreement analysis. Results: The difference between the mean and standard deviation (±SD) VO2max values of the direct measurement (27.39±4.06 ml/kg-1/min-1), and the Jones (35.19±2.12 ml/kg-1/min-1), Hansen (33.64±0.24 ml/kg-1/min-1), and Wasserman (35.20±0.17 ml/kg-1/min-1) equations, was statistically significant (p less than 0.001). Bland-Altman plot analysis suggested a lack of agreement between direct and predicted VO2max. Pearson correlation failed to reveal any correlation between direct VO2max and VO2max calculated with any of the 3 equations. Conclusion: Jones, Hansen, and Wasserman equations for prediction of VO2max cannot be justified in the studied population. For the better prediction of VO2max, either these equations should be modified, or a new equation should be developed for the Saudi population.

Comparing levels of psychological stress and its inducing factors among medical students.

OBJECTIVE: This study aimed to determine and compare degrees of psychological stress and inducing factors thereof among first to fifth year medical students (MS). METHODS: This cross-sectional study was conducted on 468 female MS. We used the Kessler 10 Psychological Distress Inventory consisting of questions on a range of stress-inducing factors. RESULTS: A total of 67.9% students reported physiological stress. The percentage of MS without stress and with mild, moderate, and severe stress was 32%, 24%, 22%, and 21.8%, respectively. The highest prevalence of physiological stress was found among first-year students (82.6%). Stress scores significantly decreased with advancement in the year of study, except for the final year (p = 0.001). We found that the first year of medical studies (0.022), academic stress (0.001), the presence of a physical problem (0.001), and being married (0.002) were independent risk factors for high perceived stress (HPS), as shown by K10 scores >24. A total of 11.1% students consulted a psychiatrist, whereas 3.4% admitted taking some medication for stress. CONCLUSION: This study infers that the first year of medical studies, academic stress, the presence of a physical problem, and being married are independent risk factors for HPS. We recommend mandatory stress screening for MS in all medical colleges. Ideally, the screening should be repeated every six months and students identified as having HPS should be provided with counselling, mental health services, and a proper follow-up.

The association of adiposity, physical fitness, vitamin D levels and haemodynamic parameters in young Saudi females.

OBJECTIVES: In this study, we assessed the possible association of adiposity, physical fitness, vitamin D levels and haemodynamic parameters as intermediate risk factors for cardiovascular health in young Saudi women. METHODS: A total of 87 young healthy Saudi women were recruited in this cross-sectional study during 2014-2015. The body weight, height, waist and hip circumference, and plasma 25-hydroxyvitamin D (25[OH] D) levels were measured. The exercise stress test was performed to determine the pulse rate, blood pressure (BP), ECG, and VO2max. Multiple linear regression models were generated for the resting (r) and maximum (m) diastolic (D) and systolic (s) arterial BP and pulse rate (PR), adiposity markers, VO2max, and plasma levels of 25(OH) D. RESULTS: A multiple linear regression model was significant for the rDBP, mDBP, rSBP, and mSBP with adjusted R2 (6.5, 10.2, 8.3, and 4.5%, respectively). Except for VO2max in the mDBP model, none of the included risk factors were significant according to the t-test. CONCLUSION: This study showed the association of high adiposity and decreased physical fitness with haemodynamic parameters in young Saudi women. An exaggerated exercise DBP might predict future cardiovascular risk in unfit young women.

Coronary angiogenic effect of long-term administration of Nigella sativa.

BACKGROUND: Coronary angiogenesis is one of the preferable adaptive responses of aerobic training. Previous studies found inotropic and hypertrophic cardiac effects for long-term administration of Nigella sativa (NS), but no studies have explored its coronary angiogenic effect. The present study compared the effect of long-term NS- administration and exercise training on the induction of coronary angiogenesis. METHOD: Fifteen adult male Wistar rats were divided into three groups: control, NS-fed, and exercise-trained (Ex). The NS-fed rats were administered 800 mg/Kg NS orally for eight weeks. The (Ex) rats were trained on a five-lane treadmill at a speed of 18 m/min and a grade of 32° for two hour/day for eight weeks. After the experiment, the hearts were extracted and immunohistological slides were prepared using rat vascular endothelial growth factor (VEGF), platelet endothelial cell adhesion molecule-1 (PECAM-1), Von Willebrand factor (VWF) and nitric oxide synthase-2 (NOS-2) antibodies (Ab). Photomicrographs were analysed using ImageJ software, and the % of the immunostained-area of 10 fields per specimen was recorded. RESULT: VEGF was significantly higher in the NS- (2.59±1.37%) and Ex rats (2.51±1.86%) compared to the control group (1.58±0.78%) with P<0.01. The VWF was significantly lower in the two experimental groups (1.57±0.83%, 1.07±0.72%) for NS and Ex groups respectively, compared to the controls (2.38±1.72) with p<0.01. Only Ex group had a higher PECAM-1 (1.79±0.78%) and lower NOS-2 (0.83±0.57%) than the control group (1.19±1.17%, 1.25±1.19%) for PECAM-1 and NOS-2 with P<0.01 and P<0.05 respectively. CONCLUSIONS: The present study demonstrated an increase in VEGF and a decrease of the VWF in the hearts of Nigella-fed and exercise-trained rats. This might indicate the potentiality for induction of coronary angiogenesis via long-term administration of NS and exercise training. NS effect on coronary angiogenesis needs to be explored further as it might lead to a new promising preventive and therapeutic agent of the ischemic heart disease.