Introduction: Endometriosis has a negative effect on health-related quality of life (HRQoL), well... more Introduction: Endometriosis has a negative effect on health-related quality of life (HRQoL), wellbeing and daily functioning. Endometriosis is an under-researched condition within non-western populations. Cultural representations are needed to understand the relative roles of societal norms, traditional factors, and religious sensitivities on the impact of endometriosis on HRQoL in various populations. In particular, there is a lack of emphasis placed in understanding the association of HRQoL on endometriosis in Arab women.Method: In this prospective case-control study, 2,610 Arab ancestry women in the United Arab Emirates were recruited to investigate the impact of endometriosis on HRQoL, diagnostic delay, psychological co-morbidities, work productivity, and physical activity. Participants completed the following standardized, validated questionnaires: Short Form-36 version 2 questionnaire, the World Endometriosis Research Foundation EPHect minimum clinical questionnaire version, a...
Introduction: High prevalence of gynecological conditions in women of Middle Eastern origin is re... more Introduction: High prevalence of gynecological conditions in women of Middle Eastern origin is reported, likely due to regional risk factors and mediators. The objective of this systematic review and meta-analysis is to investigate the prevalence of polycystic ovary syndrome (PCOS), endometriosis, uterine fibroids, and adenomyosis in women of Middle Eastern origin.Methods: MEDLINE, EMBASE, PsycINFO, Global Health, and Google Scholar databases were searched from database inception until 14 February 2021 to identify relevant studies. Peer-reviewed research articles that reported the prevalence of PCOS, endometriosis, uterine fibroids, and adenomyosis in the Middle Eastern population were written in English or Arabic. The primary outcome was the estimated pooled prevalence of PCOS, endometriosis, uterine fibroids, and adenomyosis in the Middle Eastern populations. The secondary outcome was to assess the evidence in the data for the presence of heterogeneity, by conducting subtype-poole...
Journal of Pediatric and Adolescent Gynecology, 2014
To establish the prevalence and impact on quality of life of dysmenorrhea among young adult Jorda... more To establish the prevalence and impact on quality of life of dysmenorrhea among young adult Jordanian females. Cross-sectional study based on quantitative self-reported anonymous questionnaire. University-based study. A total of 272 female medical students (aged 19-25 years). None. Self-reports of menstruation-related pain symptoms and methods of dealing with them. Of study subjects 152/272 (55.8%) participants had moderate and severe dysmenorrhea. Of them, 55.8% had a family history of severe dysmenorrhea compared with 33.1% of those without dysmenorrhea (χ(2) = 13.40, df = 1, P < .001). There was strong association between severity of dysmenorrhea and poor university attendance (χ(2) = 45.35, df = 2, P < .001), poor social activities (χ(2) = 32.06, df = 2, P < .001), poor relationships with family (χ(2) = 18.46, df = 2, P < .001) and friends (χ(2) = 19.14, df = 2, P < .001), and poor sport activities (χ(2) = 12.15, df = 2, P = .002). Dysmenorrhea worsens during examination periods in 50% of cases. The most common pain symptom was low back pain (60.2%). Body mass index, family monthly income and early age at menarche had no correlation with the occurrence of dysmenorrhea. Of those with dysmenorrhea, 69.4% were using analgesics. Mothers were the main source of information regarding menstruation. Dysmenorrhea is highly prevalent among young adult Jordanian females and seems to negatively affect quality of life, particularly as related to university attendance and performance and social relationships.
To investigate the immune environment of endometrial polyps (EPs). Prospective case-control study... more To investigate the immune environment of endometrial polyps (EPs). Prospective case-control study. Teaching hospital and university research laboratory. Reproductive-age women undergoing hysteroscopy dilation and curettage for benign indications. Samples were collected from women with (n = 23) and without (n = 40) EPs. Endometrial samples were immunohistochemically stained with antibodies against mast cells (MCs) and regulatory T cells (Tregs). Tryptase+, chymase+, and c-Kit+ MCs and Foxp3+ Tregs were quantified in EPs and polyp-adjacent, polyp-distant, and control endometrium. Densities of all MC types were highly significantly increased in EPs compared with adjacent, distant, and control endometrium. Chymase+ and c-Kit+ MCs were increased in density in adjacent compared with control endometrium. c-Kit+ MCs were also increased in distant compared with control endometrium. Foxp3+ Treg density was increased in EPs compared with distant and control endometrium and decreased in distant compared with control endometrium. This study provides novel insights into localized disturbances in the cellular immune environment within EPs consistent with EPs being inflammatory lesions associated with MC overactivity. Tregs are likely to be recruited to EPs in an attempt to suppress the inflammatory process due to the greatly increased presence of MCs. These immunologic disturbances are likely to be involved in the causation of abnormal bleeding and infertility in premenopausal women with EPs, and their role in the pathophysiology requires further research.
Introduction: Endometriosis has a negative effect on health-related quality of life (HRQoL), well... more Introduction: Endometriosis has a negative effect on health-related quality of life (HRQoL), wellbeing and daily functioning. Endometriosis is an under-researched condition within non-western populations. Cultural representations are needed to understand the relative roles of societal norms, traditional factors, and religious sensitivities on the impact of endometriosis on HRQoL in various populations. In particular, there is a lack of emphasis placed in understanding the association of HRQoL on endometriosis in Arab women.Method: In this prospective case-control study, 2,610 Arab ancestry women in the United Arab Emirates were recruited to investigate the impact of endometriosis on HRQoL, diagnostic delay, psychological co-morbidities, work productivity, and physical activity. Participants completed the following standardized, validated questionnaires: Short Form-36 version 2 questionnaire, the World Endometriosis Research Foundation EPHect minimum clinical questionnaire version, a...
Introduction: High prevalence of gynecological conditions in women of Middle Eastern origin is re... more Introduction: High prevalence of gynecological conditions in women of Middle Eastern origin is reported, likely due to regional risk factors and mediators. The objective of this systematic review and meta-analysis is to investigate the prevalence of polycystic ovary syndrome (PCOS), endometriosis, uterine fibroids, and adenomyosis in women of Middle Eastern origin.Methods: MEDLINE, EMBASE, PsycINFO, Global Health, and Google Scholar databases were searched from database inception until 14 February 2021 to identify relevant studies. Peer-reviewed research articles that reported the prevalence of PCOS, endometriosis, uterine fibroids, and adenomyosis in the Middle Eastern population were written in English or Arabic. The primary outcome was the estimated pooled prevalence of PCOS, endometriosis, uterine fibroids, and adenomyosis in the Middle Eastern populations. The secondary outcome was to assess the evidence in the data for the presence of heterogeneity, by conducting subtype-poole...
Journal of Pediatric and Adolescent Gynecology, 2014
To establish the prevalence and impact on quality of life of dysmenorrhea among young adult Jorda... more To establish the prevalence and impact on quality of life of dysmenorrhea among young adult Jordanian females. Cross-sectional study based on quantitative self-reported anonymous questionnaire. University-based study. A total of 272 female medical students (aged 19-25 years). None. Self-reports of menstruation-related pain symptoms and methods of dealing with them. Of study subjects 152/272 (55.8%) participants had moderate and severe dysmenorrhea. Of them, 55.8% had a family history of severe dysmenorrhea compared with 33.1% of those without dysmenorrhea (χ(2) = 13.40, df = 1, P < .001). There was strong association between severity of dysmenorrhea and poor university attendance (χ(2) = 45.35, df = 2, P < .001), poor social activities (χ(2) = 32.06, df = 2, P < .001), poor relationships with family (χ(2) = 18.46, df = 2, P < .001) and friends (χ(2) = 19.14, df = 2, P < .001), and poor sport activities (χ(2) = 12.15, df = 2, P = .002). Dysmenorrhea worsens during examination periods in 50% of cases. The most common pain symptom was low back pain (60.2%). Body mass index, family monthly income and early age at menarche had no correlation with the occurrence of dysmenorrhea. Of those with dysmenorrhea, 69.4% were using analgesics. Mothers were the main source of information regarding menstruation. Dysmenorrhea is highly prevalent among young adult Jordanian females and seems to negatively affect quality of life, particularly as related to university attendance and performance and social relationships.
To investigate the immune environment of endometrial polyps (EPs). Prospective case-control study... more To investigate the immune environment of endometrial polyps (EPs). Prospective case-control study. Teaching hospital and university research laboratory. Reproductive-age women undergoing hysteroscopy dilation and curettage for benign indications. Samples were collected from women with (n = 23) and without (n = 40) EPs. Endometrial samples were immunohistochemically stained with antibodies against mast cells (MCs) and regulatory T cells (Tregs). Tryptase+, chymase+, and c-Kit+ MCs and Foxp3+ Tregs were quantified in EPs and polyp-adjacent, polyp-distant, and control endometrium. Densities of all MC types were highly significantly increased in EPs compared with adjacent, distant, and control endometrium. Chymase+ and c-Kit+ MCs were increased in density in adjacent compared with control endometrium. c-Kit+ MCs were also increased in distant compared with control endometrium. Foxp3+ Treg density was increased in EPs compared with distant and control endometrium and decreased in distant compared with control endometrium. This study provides novel insights into localized disturbances in the cellular immune environment within EPs consistent with EPs being inflammatory lesions associated with MC overactivity. Tregs are likely to be recruited to EPs in an attempt to suppress the inflammatory process due to the greatly increased presence of MCs. These immunologic disturbances are likely to be involved in the causation of abnormal bleeding and infertility in premenopausal women with EPs, and their role in the pathophysiology requires further research.
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