The impact of the COVID-19 pandemic on reproductive intentions and contraceptive use among females in Jeddah, Saudi Arabia.

OBJECTIVE: Pandemics have affected many people's social and emotional lives. Conception planning, contraceptive usage, and pregnancy intentions are activities with minimal research. This study is the first to evaluate how the COVID-19 pandemic influenced reproductive plans and contraceptive use among women during the pandemic in Jeddah, Saudi Arabia, in 2022. METHODS: A cross-sectional survey was conducted by sending an online questionnaire to married women from Jeddah, Saudi Arabia. The questionnaire included demographics, personal obstetrics information, changes in pregnancy intentions owing to the COVID-19 pandemic, and questions about contraceptive usage. Qualitative data were presented as frequencies, and a χ2 test was performed to determine the relationships among the variables. RESULTS: A total of 639 women enrolled in the study; most participants were 25-34 years old, and most indicated they changed their reproductive intentions during the pandemic (49%). Family planning accounted for 25.8% of participants who changed their reproductive intentions. Only 17.5% changed their choices because of fear of the COVID-19 impact. The percentage of women using contraception was significantly reduced during the lockdown, to 36.8%. Oral contraceptive pills were the most frequently used method during the curfew period (17.5%). CONCLUSION: The COVID-19 lockdown affected the reproductive intentions of most women in Jeddah, and it significantly reduced contraceptive use.

Dramatic Effect of Botox Injection in Disabling Chronic Migraine Secondary to Inoperable Cerebral Arteriovenous Malformation.

Arteriovenous malformation is a developmental anomaly of the vascular system characterized by arteriovenous shunt through a collection of tortuous vessels without intervening capillary bed. Brain arteriovenous malformations (AVMs) may cause hemorrhagic stroke, epilepsy, and chronic headache. Migraine with aura was reported in up to 58% of females with AVM. A 23-year-old female presented with episodes of severe left-side headache for five months, throbbing in character with photophobia, phonophobia, and nausea. Brain MRI showed a large AVM in the left cerebellar hemisphere. She was diagnosed with grade six AVM, which is inoperable, and secondary migraine. Her migraine symptoms didn't respond to oral medications. However, it responded dramatically to Botox injections. Seven days after Botox injection, her headache disappeared, and her well-being improved. Three years post-diagnosis and treatment, she got married, then three months later became pregnant. During pregnancy, she followed up with neurology, obstetrics, and gynecology. She was delivered by cesarean section to minimize the risk of intracranial hemorrhage and delivered without complications. The female patient in this case with migraine secondary to inoperable brain AVM treated with Botox; she got married and delivered by C-section without complications. This case raises the following important lessons: large AVMs can present with migraine only, and Botox has a dramatic effect on the treatment and the ability to have a safe pregnancy and delivery in large AVM cases.

Relevance of Serum Levels and Functional Genetic Variants in Vitamin D Receptor Gene among Saudi Women with Gestational Diabetes Mellitus.

Background: This study explored the association between ApaI-TaqI Single Nucleotide Polymorphisms (SNPs) in a Vitamin D receptor (VDR) and the risk of Gestational Diabetes Mellitus (GDM) in Saudi women, along with the serum levels of vitamin D. Methods: Ninety women with GDM and 90 non-GDM women were enrolled, based on the inclusion and exclusion criteria for pregnant women enrolled in a single-center study. Blood samples were retrieved from 180 pregnant women using ethylenediaminetetraacetic acid (EDTA) tubes. Serum samples were used to measure the vitamin D, 25-hydroxyvitamin D (25(OH)D or calcidiol), and lipid profiles. Blood was used to measure the hemoglobin A1c levels and to isolate the DNA. The polymerase chain reaction (PCR) was performed for the ApaI (rs79785232), BsmI (rs1544410), FokI (rs2228570), and TaqI (rs731236) SNPs in the VDR gene using restriction fragment length polymorphism analysis. Validation was performed using Sanger sequencing. Statistical analyses were performed between the patients with and without GDM using various statistical software packages. Results: The Hardy-Weinberg equilibrium analysis was statistically significant (p > 0.05). The ApaI, BsmI, and TaqI SNPs were associated with alleles, genotypes, and different genetic models (p < 0.05). Vitamin D levels were associated with deficient levels (p = 0.0002), as well as with a normal and overweight body mass index (p = 0.0004). When vitamin D levels were measured with GDM covariates, the fasting plasma glucose (FPG) (p = 0.0001), postprandial blood glucose (PPBG) (p < 0.0001), oral glucose tolerance test (OGTT)-1 h (p = 0.005), high-density lipoprotein (p = 0.022), and low-density lipoprotein cholesterol (LDLc) (p = 0.001) levels were significantly different. When similar vitamin D levels were measured for each genotype, we confirmed that the ApaI SNP was associated with sufficient levels (p < 0.0001), whereas the BsmI, FokI, and TaqI (p < 0.05) were associated with insufficient levels. The logistic regression model confirmed that the first hour of the OGTT (p = 0.005) was strongly associated with GDM, whereas the analysis of variance confirmed that FPG and PPBG (p < 0.05) were strongly associated with all the SNPs evaluated in the VDR gene. Additionally, the second hour of the OGTT (p = 0.048) and LDLc (p = 0.049) were associated with the ApaI and FokI SNP. Moreover, the first hour OGTT (p = 0.045) and lipid profile parameters (p < 0.05) were associated. Haplotype analysis revealed positive associations among the examined SNPs, which seemed compatible with the hypothesis that variants and combinations of multiple SNP genotypes enhance the risk of GDM in women. Haplotype analysis revealed that different combinations of alleles, such as AGCC, CATT, CGTC, AGTC, and CATT (p < 0.05), were strongly associated. The linkage disequilibrium (LD) analysis showed a strong association with all combinations (p < 0.05). Among the gene-gene interactions, all possible combinations showed a positive association (p < 0.05). Conclusions: Low vitamin D levels were observed in women with GDM. The ApaI, BsmI, and TaqI SNPs were associated with genotype and allele frequencies (p < 0.05). Vitamin D and the SNPs in the VDR gene were associated, according to the ANOVA, logistic regression, haplotype analysis, LD analysis, and the generalized multifactor dimensionality reduction model (p < 0.05).

Integrated traditional herbal medicine in the treatment of gastrointestinal disorder: the pattern of use and the knowledge of safety among the Eastern Region Saudi population.

BACKGROUND: Herbal medicine is commonly integrated with conventional medicine in Saudi Arabia, especially for the management of digestive disorders. However, the majority of Saudis use herbal remedies without prior consultation with a physician, which raises concerns about their appropriate and safe use. The aim of this study was to assess the level of awareness among the Saudi population regarding the proper utilization and potential adverse effects of frequently used herbs for the treatment of gastrointestinal (GI) diseases. METHODS: A cross-sectional survey was conducted in Saudi Arabia from January to March 2021. An electronic self-administered questionnaire was distributed. RESULTS: A total of 543 participants from different age groups, educational levels, and cities across Saudi Arabia completed the study questionnaire. The most commonly used herbs at home by the participants were: myrrh, parsley, black seed, chamomile, mint, anise, clove, and green tea. 57.7% of the participants perceived herbs as safer than conventional medicines; 27.3% reported that using herbal remedies over conventional medicine was a family tradition, and 21.4% used herbs because they were cheaper than conventional medicines. CONCLUSION: Herbal remedies, including myrrh, parsley, blackseed, chamomile, mint, and anise, are commonly employed for the treatment of gastrointestinal disorders in Saudi Arabia. However, the knowledge level of participants regarding potential side effects and drug-herb interactions was found to be deficient. As such, there is a pressing need for educational campaigns and community awareness programs to elucidate the proper usage of herbal remedies and to caution against their potential adverse effects.

Dissecting the Molecular Role of ADIPOQ SNPs in Saudi Women Diagnosed with Gestational Diabetes Mellitus.

The traditional definition of gestational diabetes mellitus (GDM) is the leading cause of carbohydrate intolerance in hyperglycemia of varying severity, with onset or initial detection during pregnancy. Previous studies have reported a relationship among obesity, adiponectin (ADIPOQ), and diabetes in Saudi Arabia. ADIPOQ is an adipokine that is produced and secreted by adipose tissue involved in the regulation of carbohydrate and fatty acid metabolism. This study investigated the molecular association between rs1501299, rs17846866, and rs2241766 single-nucleotide polymorphisms (SNPs) in ADIPOQ and GDM in Saudi Arabia. Patients with GDM and control patients were selected, and serum and molecular analyses were performed. Statistical analyses were performed on clinical data, Hardy Weinberg Equilibrium, genotype and allele frequencies, multiple logistic regression, ANOVA, haplotype, linkage disequilibrium, as well as MDR and GMDR analyses. The clinical data showed significant differences in various parameters between the GDM and non-GDM groups (p < 0.05). In GDM women with alleles, genotypes, and different genetic models, the rs1501299 and rs2241766 SNPs showed a strong association (p < 0.05). Multiple logistic regression analysis revealed a negative correlation (p > 0.05). This study concluded that rs1501299 and rs2241766 SNPs were strongly associated with GDM in women in Saudi Arabia.

Saudi Community-Based Screening Study on Genetic Variants in ß-Cell Dysfunction and Its Role in Women with Gestational Diabetes Mellitus.

BACKGROUND: Diabetes (hyperglycemia) is defined as a multifactorial metabolic disorder in which insulin resistance and defects in pancreatic ß-cell dysfunction are two major pathophysiologic abnormalities that underpin towards gestational diabetes mellitus (GDM). TCF7L2, KCNQ1, and KCNJ11 genes are connected to the mechanism of ß-cell dysfunction. The purpose of this study was to investigate the genes associated with ß-cell dysfunction and their genetic roles in the rs7903146, rs2237892, and rs5219 variants in Saudi women diagnosed with type 2 diabetes mellitus and GDM. MATERIALS AND METHODS: In this case-control study, 100 women with GDM and 100 healthy volunteers (non-GDM) were recruited. Genotyping was performed using polymerase chain reaction (PCR), followed by restriction fragment length analysis. Validation was performed using Sanger sequencing. Statistical analyses were performed using multiple software packages. RESULTS: Clinical studies showed a ß-cell dysfunction positive association in women with GDM when compared to non-GDM women (p < 0.05). Both rs7903146 (CT vs. CC: OR-2.12 [95%CI: 1.13-3.96]; p = 0.01 & T vs. C: (OR-2.03 [95%CI: 1.32-3.11]; p = 0.001) and rs5219 SNPs (AG vs. AA: OR-3.37 [95%CI: 1.63-6.95]; p = 0.0006 & G vs. A: OR-3.03 [95%CI: 1.66-5.52]; p = 0.0001) showed a positive association with genotype and allele frequencies in women with GDM. ANOVA analysis confirmed that weight (p = 0.02), BMI (p = 0.01), and PPBG (p = 0.003) were associated with rs7903146 and BMI (p = 0.03) was associated with rs2237892 SNPs. CONCLUSIONS: This study confirms that the SNPs rs7903146 (TCF7L2) and rs5219 (KCNJ11) are strongly associated with GDM in the Saudi population. Future studies should address the limitations of this study.

Hyaluronic Acid: A New Approach for the Treatment of Gingival Recession-A Systematic Review.

This systematic review aimed to investigate the effectiveness of hyaluronic acid (HA) on the clinical treatment outcomes of patients with gingival recession. A systematic search was performed in PubMed, Cochrane Central Register of Controlled Trials, Embase, Scopus, and Google Scholar for studies up to 15 August 2022. Two reviewers separately selected the papers for eligibility after conducting a thorough search. The study includes randomized controlled clinical trials in which participants were given HA in addition to periodontal treatment surgical procedures. The changes following the treatment protocol were evaluated for complete and mean root coverage as a primary outcome and gingival recession gain as the secondary outcome. Three articles met the eligibility criteria out of 557 titles. In periodontal surgery, HA exhibited better results in complete root coverage and mean root coverage when compared to the control group. Gingival recession reduction, clinical attachment level, and keratinized tissue gain were significantly increased compared to the control groups. However, the comparison presented in the following study might show heterogeneity among the studies and risk of bias in general. Given the scope of this analysis, results suggest that adjunctive treatment with HA gel for root coverage could be clinically beneficial.

Measuring empathy in medical students: A cross-sectional study.

OBJECTIVE: To measure the empathy levels of undergraduate medical students, and to explore whether the empathy level has any significant association with gender, academic year and academic achievement. METHODS: The cross-sectional study was conducted at the College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia, from January to March 2020, and comprised medical students. Data was collected using the pre-validated student version of the Jefferson Scale of Empathy. Data was analysed using SPSS 23. RESULTS: Of the 391 students, 251(64.19%) were females, and 140(35.8%) were males. The overall mean empathy score was 105.18±12.51. Second year medical students showed the highest empathy score 108.59±13.33. There was minor but significant decline in empathy as the students progressed through their academic studies (p<0.05). Empathy scores were significantly higher in female students (p<0.05), and students with higher grade point average scores (p<0.05). CONCLUSIONS: The gradual reduction in empathy is alarming and demands due attention.

Knowledge, Attitudes, and Practices Toward Self-Medicating Eye Symptoms in Saudi Arabia.

Purpose: Self-medication is the selection and use of drugs by individuals to treat self-diagnosed diseases or symptoms. While some patients regard self-medicating as harmless, it is far from being a safe practice. The aim of this study was to evaluate the knowledge, attitudes, and practices toward self-medicating eye symptoms in Saudi Arabia. Patients and Methods: A cross-sectional study was conducted through an online questionnaire on a study population that consisted of Saudi nationals aged 18 and older who were using or had previously used ophthalmic medications. Results: Among the 524 responses obtained, 79.4% were female, and more than half were less than 40 years old. Participants admitting to practicing ophthalmic self-medication measured 62.4%. The most commonly self-prescribed ophthalmic medications were artificial tears (n=276), followed by antiallergic (n=57) and antibiotic medications (n=33). Many participants reported that the reason for self-treatment was for repeated and simple symptoms that did not require professional care. While approximately 51% showed high levels of knowledge about ophthalmic medications, no significant relationship was seen with their choice to self-medicate (P=0.153). Conclusion: Despite detecting a high level of knowledge and acceptable practices and attitudes among participants, a high incidence of self-medication was observed. This effect was mostly attributed to long hospital waiting times and patient self-diagnosis. Increasing the number of healthcare units and properly educating patients on ophthalmic medications may help decrease the incidence of self-medication.

Psychological impact of overweight/obesity among pediatric age group before and during COVID-19 lockdown in Saudi Arabia.

Objectives: : Obesity is a primary public health concern in Saudi Arabia. The COVID-19 pandemic has profoundly affected people's lives, putting considerable pressure on children and adolescents, leading to psychological problems. Therefore, we aimed to assess obesity's psychological and behavioral impact among children and adolescents before and during the COVID-19 lockdown in Jeddah. Materials and Methods: : A cross-sectional study was conducted in the pediatric endocrine outpatient clinic at King Abdulaziz University Hospital(KAUH). The sample included 360 participants. Data were collected through clinical interviews by telecommunication from April to June 2020. Demographic factors and answers to questions about behavior, feelings, and daily life (pre and during home quarantine) were assessed against the participants' body mass index (BMI) and reported daily life difficulties. The BMI standard deviation was calculated based on the Center of Disease Control and Prevention standards. Results: Compared to other groups, a significantly higher percentage of overweight/obese participants reported low self-confidence (22.1%), 61.7% reported that their friends or family rarely bullied or picked on them and 66.4% reported that the people who they lived with rarely made fun of or bullied them due to their weight before home quarantine. Conclusion: Children with a higher BMI reported lower self-confidence than their average weight peers before home quarantine. However, a higher BMI did not increase the risk of being bullied by family members and friends. The majority of the participants changed for the worse in every research aspect during quarantine.

RésuméObjectifs: L'obésité est un problème de santé publique majeur en Arabie Saoudite. La pandémie du COVID-19 a profondément affecté la vie des gens, mettant une pression considérable sur les enfants et les adolescents, et entraînant des problèmes psychologiques. Par conséquent, nous avons cherché à évaluer l'impact psychologique et comportementale de l'obésité chez enfants et adolescents avant et pendant le confinement du COVID-19 à Jeddah. Matériaux et méthodes: une étude transversal a été menée dans la clinique externe endocrinienne pédiatrique au l'Hôpital De l'Université Du Roi Abdulaziz. L'échantillon comprenait 360 participants. Les données ont été collectées par des entretiens cliniques par télécommunication d'Avril à Juin 2020 .Les Facteurs démographiques, les réponses aux questions sur le comportement, les sentiments et la vie quotidienne (avant et pendant la quarantaine à domicile) ont été évalués par rapport à l'indice de masse corporelle (IMC) des participants et les difficultés rapportées sur la vie quotidienne. L'écart type de l'IMC a été calculé sur la base des normes du Center of Disease Control and Prevention. Résultats: comparés à d'autres groupes, un pourcentage significativement plus élevé de participants en surpoids / obèses a déclaré une faible confiance en soi (22,1%), 61,7% ont déclaré qu'ils rarement harcelés par leurs amis ou leur famile et 66,4% ont déclaré que les personnes avec qui ils vivaient se moquaient ou se faisaient rarement harceler en raison de leur poids avant la mise en quarantaine à domicile. Conclusion: les enfants ayant un IMC plus élevé ont déclaré une confiance en soi inférieure à leur pairs de poids moyen avant la mise en quarantaine à domicile. Cependant, un IMC plus élevé n'augmente pas le risque d'être intimidé par les membres de la famille et les amis. La majorité des participants a changé pour le pire dans tous les aspects de la recherche pendant la quarantaine. Mots-clés: Enfants, COVID-19, confinement, obésité, surpoids, impact psychologique.

Screening of mitochondrial mutations in Saudi women diagnosed with gestational diabetes mellitus: A non-replicative case-control study.

INTRODUCTION: Among metabolic disorders, gestational diabetes mellitus (GDM) is specified as hyperglycemia caused by glucose or carbohydrate intolerance defects. GDM is distinguished by oxidative stress, and has been connected to mitochondrial dysfunction. Previous studies have documented the relation between A12026G, A8344G and A3243G mutations in ND4, tRNALeu(UUR), and tRNALys genes in different modes of diabetes. AIM: The purpose of this study was to investigate into the relationship between GDM women and common mitochondrial mutations including A12026, A8344G, and A3243G in Saudi women. METHODS: In this case-control study, we have opted 96 GDM and 102 non-GDM pregnant women and DNA was extracted using EDTA blood and based on specific primers, Polymerase Chain Reaction was followed and then Restriction Fragment Length Polymorphism (RFLP) analysis was performed. Restriction enzymes was cross-checked with Lambda DNA and 10% of the purified PCR products were performed the Sanger sequencing analysis to reconfirm the RFLP analysis of the studied results. RESULTS: None of the heterozygous and homozygous mutations were not observed in our study. All the subjects were turned to be homozygous normal genotypes. CONCLUSION: This study confirms that A12026, A8344G, and A3243G mutations have no role in the Saudi women with GDM.

Knowledge, Attitude, and Practice of Infection Control among Dental Healthcare Personnel: The Updated Guidelines for COVID-19 in Dental Settings.

AIM: The study sought to evaluate the knowledge, attitude, and practice of infection control among dental healthcare personnel (DHCP) in dental settings, with updated guidelines and recommendations regarding the coronavirus disease (COVID-19) pandemic. MATERIALS AND METHODS: This was an observational cross-sectional study. A self-administrative online survey consisting of 45 close-ended statements was prepared, validated, and revised by an expert panel, and pilot tested with a convenience sample. The survey comprised four parts covering the following aspects: demographic data, infection control facilities in the dental office, knowledge of infection control measures, and attitude toward infection control. Data were collected, analyzed, and presented as frequencies and percentages or means and standard deviations, when applicable. The independent t-test or analysis of variance (ANOVA), as appropriate, were used for differences in knowledge and attitude scores between the groups, with the significance level of p-value < 0.05. RESULTS: Out of 176 participants, 54 (30.7%) were men, and 122 (69.3%) were women. A total of 143 participants were dental practitioners (81.3%), and more than half [94 (53.4%)] were from governmental universities, followed by those from government dental clinics [44 (25%)]. In general, most participants acknowledged the infection control facilities in their dental offices. Dental assistants, respondents working in private universities, and respondents working in the eastern region showed better knowledge than their counterparts (p < 0.05). However, no significant differences were noticed between the different groups concerning attitude toward infection control (p > 0.05). CONCLUSION: The participants exhibited acceptable knowledge and attitude, with respondents from private universities and dental assistance attaining better knowledge scores. More infection control programs and training courses should be implemented in dental settings.

Awareness of Female Genital Mutilation/Cutting Among the General Population in 2019: A Survey-based Study in Saudi Arabia.

Background Female genital mutilation/cutting (FGM/C) includes "all procedures that include the removal of the external female genitalia, partially or totally, using a blade or shard of glass for non-medical reasons." FGM/C is a harmful procedure known to violates a person's human rights. This study aims to assess the level of knowledge regarding FGM/C in Saudi Arabia. Methodology A survey-based cross-sectional study was conducted in 2019 among a representative sample of the general population of Saudi Arabia. The questionnaire consisted of a set of questions dealing with the knowledge of FGM/C. We analyzed the data by using the Statistical Package for Social Sciences (SPSS) version 21 IBM Corp., Armonk, NY), and the results were acquired by applying Pearson's chi-square test and calculating the frequencies. Results The study included 659 participants; 80.4% were females and 19.6% were males. About 93.8% knew about FGM/C while 68.3% were aware of the health consequences of female circumcision. The most common sources of information were the Internet and social media (54.4%). The overall prevalence of circumcision among the female participants was 9.4%. Conclusion Generally, our population had good knowledge of FGM/C. However, it is not enough to eliminate this practice. Health and human rights education campaigns and programs should be done to enhance public awareness. In addition, more researches about the prevalence of this tradition should be taken into consideration.

Insertion and deletion polymorphism in the alpha-2B adrenoceptor gene in pregnant women ripens gestational diabetes mellitus.

There are no earlier studies that reported the association of the 12Glu9 polymorphism in the alpha-2B adrenoceptor (ADRA2B) gene with gestational diabetes mellitus (GDM). We examined the potential association between the ADRA2B gene insertion/deletion (I/D) polymorphism in the Saudi population with GDM. Pregnant women with GDM have been reported to exhibit the same susceptibility as that observed in type 2 diabetes mellitus (T2DM). We have selected I/D polymorphism of the ADRA2B gene located in chromosome 2q11.1 that has been extensively related to T2DM and cardiovascular diseases. This case-control study was conducted with 200 GDM and 300 non-GDM pregnant women. Genotyping of I/D polymorphism was performed by conventional PCR method. Biochemical analyses were found to be significantly different between GDM and non-GDM subjects (p < 0.05). Genotype (ID + DD vs II, p = 0.0002) and allele (D vs I, p = 0.0002) frequencies of the 12Glu9 polymorphism were found to be statistically significant. However, a significant difference was found between allele and genotypes of I/D polymorphism of the ADRA2B gene or the clinical characteristics of the subjects. Our results obtained in this study indicate the ADRA2B gene in the Saudi women was associated with the development of GDM.

The genetic polymorphism in the STK11 does not affect gestational diabetes.

Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance of variable severity that develops during pregnancy. Recent studies indicate that GDM onset is rapid, and that women with GDM will develop other metabolic disorders such as obesity, type 2 diabetes, and cardiovascular disease in their future. Serine/threonine kinase 11 (STK11) is engaged in the insulin signaling pathway and encoded protein is an important activator of adenosine monophosphate activated protein kinase. Based on the previously reported association between the STK11 gene and diabetes, we aimed to investigate whether the rs8111699 polymorphism in STK11 has any role in gestation diabetes in Saudi women. In this case-control study, we recruited pregnant Saudi women based on biochemical analysis of their blood samples. Genomic DNA was obtained from confirmed subjects (200 GDM cases and 300 non-GDM). PCR-RFLP analysis was performed to detect the C528G polymorphism in the STK11 gene. The anthropometric and clinical data were similar between the GDM and non-GDM subjects (p > 0.05), whereas the biochemical analysis was significantly different between the cases and controls (p < 0.05). The genotype and allele frequencies between of the STK11 gene were not statistically significant difference between the GDM and non-GDM groups (OR=0.82; 95% CI:=0.6-1.0; p=0.12). Our study suggests that the rs8111699 polymorphism has no role in the development of GDM in pregnant Saudi women.

Primary Fallopian Tube Clear Cell Adenocarcinoma in Pregnancy: Case Presentation and Review of the Literature.

Primary fallopian tube cancer in pregnancy is rare and is even more so for the clear cell variant. Our case is the third case of primary fallopian tube cancer in pregnancy and the first case of clear cell adenocarcinoma of the fallopian tube in pregnancy. The patient presented with increasing pelvic pain starting in the second trimester. Serial ultrasound evaluations were performed and revealed a rapidly growing complex adnexal mass adjacent to the uterus. Her pregnancy was further complicated by spontaneous preterm labor and she delivered prematurely per vaginam at 31 weeks. She underwent an urgent laparotomy in the immediate postpartum period for acute aggravation of her right pelvic pain and fever. The diagnosis of tubal clear cell adenocarcinoma was subsequently made on histopathology examination.

Implication of SH2B1 gene polymorphism studies in gestational diabetes mellitus in Saudi pregnant women.

Genome-wide association studies have identified loci that are firmly associated with obesity. The Src-homology-2 B adaptor protein 1 (SH2B1) loci is abundantly expressed in the brain, liver, heart, muscle, and fat tissues. Gestational diabetes mellitus (GDM) is a growing health concern that usually appears during the latter half of pregnancy, and it is characterized by carbohydrate intolerance of variable severity. The SH2B1 gene polymorphism has been linked with an increased risk of weight gain in several but not all population studies. This study aimed to investigate the genetic association of rs4788102 variants in the SH2B1 gene with GDM in Saudi pregnant women. Genomic DNA samples from 200 women with GDM and 300 women without GDM were genotyped using the TaqMan method. The distribution of the GG, GA, and AA genotypes was significantly different between GDM and non-GDM women (p < 0.05). Thus, we identified rs4788102 variants as additional risk factors for GDM in Saudi women, and we suggest that these variants may have a prognostic value.

Relationship between the paraoxonase 1 gene glutamine 192 to arginine polymorphism and gestational diabetes mellitus in Saudi women.

OBJECTIVES: Gestational diabetes mellitus (GDM) is recognized as an imbalance between insulin resistance and insulin secretion, leading to maternal hyperglycemia. Previous studies in a Saudi population indicated a high frequency of Paraoxonase 1 glutamine 192 to arginine (PON1 Q192R) polymorphism, suggesting this polymorphism as an additional risk factor. The present study was designed to explore the possible association between the PON1 Q192R polymorphism and GDM in a Saudi population. METHODS: This case-control study was carried out in 500 pregnant women, including 200 GDM cases and 300 non-GDM women. Genotyping for PON1 Q192R (rs662) variants was performed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). RESULTS: The results of the present study indicates that Q192R polymorphism was significantly associated with GDM in a Saudi population with the minor allele frequency (MAF) (p=0.0007). Q192R genotypes and alleles showed a strong association with GDM (p=0.009 and p=0.0007, respectively). CONCLUSION: In conclusion, these findings suggest that the PON1 Q192R polymorphism has high MAF in GDM in the studied Saudi population.

Insulin receptor substrate-1 (IRS-1) Gly927Arg: correlation with gestational diabetes mellitus in Saudi women.

Pregnant women with gestational diabetes mellitus (GDM) and type 2 diabetes mellitus (T2DM) share a common pathophysiology associated with similar risk factors. Genetic variants used to determine the risk of developing T2DM might also be associated with the prevalence of GDM. The aim of the present study was to scrutinize the relationship between the G972R polymorphism of the insulin receptor substrate-1 (IRS-1) gene with GDM in the Saudi female population. This is a case-control study that monitored 500 Saudi women. Subjects with GDM (n = 200) were compared with non-GDM (n = 300) controls. We opted to evaluate rs1801278 polymorphism in the IRS1 gene, which plays a critical role in the insulin-signaling pathway. Genotyping was performed with the Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) method. The frequency of the rs1801278 polymorphism was significantly higher in women with GDM than in women with non-GDM (for TT + CT versus CC: P = 0.02). Additionally, there was a significant increase in the frequency of the Arg-encoding mutant allele from GDM to non-GDM (for T versus C: P = 0.01). Our results suggest that the rs1801278 polymorphism in the IRS-1 gene is involved in the occurrence of GDM in the Saudi population.

Risk factors for ectopic pregnancy after in vitro fertilization treatment.

OBJECTIVE: To identify risk factors for ectopic pregnancy after in vitro fertilization treatment. METHODS: We conducted a study among women who conceived after IVF treatment and evaluated the possible risk factors for ectopic pregnancy. The parameters evaluated were demographics of the patients, cause of infertility, and risk factors for ectopic pregnancy, including tubal infertility and previous ectopic pregnancy. RESULTS: Of 365 women, 18 women had an ectopic pregnancy and 347 others had an intrauterine pregnancy (control group). The incidence of IVF ectopic pregnancy was 4.9%. The mean age was 34.2 ± 1.4 years in the ectopic group and 34.3 ± 0.2 years in the control group; mean BMI was 23.8 ± 1.0 in the ectopic group and 24.5 ± 0.9 in the control group. Previous ectopic pregnancy, previous IVF ectopic pregnancy, or smoking did not affect the occurrence of ectopic pregnancy in this population. Logistic regression analysis demonstrated that tubal factor infertility and previous surgery for endometriosis were risk factors for IVF ectopic pregnancy. CONCLUSION: Tubal factor infertility and previous surgery for endometriosis appear to be risk factors for ectopic pregnancy after IVF treatment. Other factors that usually contribute to spontaneous ectopic pregnancy, including previous ectopic pregnancy, pelvic infection, and smoking, were not risk factors for IVF ectopic pregnancy in our study.