Molecular Detection of Genetic Susceptibility to Bladder Cancer in Egyptian Patients.

OBJECTIVE: Genome-wide association studies (GWAS) have identified a number of genetic variants associated with the susceptibility of bladder cancer (BC) in European and Chinese populations. Here, we assessed the association of two of these variants, rs9642880 and rs710521 in an Egyptian patients and also examined the expression of c-Myc.The basis was due to the absence of studies on Egyptian patients to determine the association between rs9642880& rs710521 and bladder cancer risk, particularly due to the known role of the variant (rs9642880) in the Progression and development of bladder cancer. METHODS: Urine samples were collected from onehundred and fiftybladder cancer patients under particular standards and fifty healthy controls. Genomic DNA was extracted,  rs9642880 G>T and rs710521 A>G polymorphisms were amplified, assessed via restriction fragment length polymorphism(RFLP) and sequenced. Urine retrieved results were compared to the histopathological diagnosis of tissue biopsies and to the results of C-Myc immunohistochemistry. Data were statistically analyzed using Microsoft Excel 2016, association between significant genotypes of the two studied variables and bladder cancer risk was performed. RESULTS: We found that the TT genotype of rs9642880 G>T was strongly associated with the risk of bladder cancer, andfor rs710521 A>G, AG genotype was also identified to has an association with bladder cancer risk.All 150 tumor sections showed positive immunoreactivity for c-Myc in the nucleus and the cytoplasm. CONCLUSION: Identifying the association to risk of bladder cancer using genetic analysis will help in the early detection of the disease.

Circulating miR-148a-5p and miR-21-5p as Novel Diagnostic Biomarkers in Adult Egyptian Male Patients With Metabolic Syndrome.

BACKGROUND: Metabolic syndrome (MetS) is a group of abnormalities related to metabolism that increase the risk of cardiac diseases, type 2 diabetes and mortality. MicroRNAs (miRs) act as regulators of many cellular and metabolic events, and any dysregulation of these tiny molecules can cause great disturbance in one's health. The main purpose of this study was to ascertain the diagnostic potential of miR-148a-5p and miR-21-5p in MetS. METHODS: Serum levels of miR-148a-5p and miR-21-5p were quantified in 118 male patients with MetS and 30 healthy controls by quantitative real-time polymerase chain reaction. Fasting plasma glucose, serum high-density lipoprotein cholesterol and serum triacylglycerol were measured by the colorimetric method. Blood pressure and anthropometric measurements were performed on each individual. All MetS patients had diabetes and had a large waist circumference, and were divided into 3 groups: group 1, dyslipidemic and hypertensive; group 2, normotensive; and group 3, normal lipid profile. RESULTS: miR-148a-5p expression was significantly upregulated in all MetS patients: group 1, 70.3±8.07 (p<0.0001); group 2, 75.0±9.17 (p<0.0001) and group 3, 33.7±6.89 (p<0.0001), when compared with control subjects. However, miR-21-5p expression was elevated only in the sera of group 1 (36.9±8.39, p<0.0001) and group 3 (48.9±12.0, p<0.0001), when compared with controls. CONCLUSIONS: Serum levels of miR-148a-5p and miR-21-5p were higher in MetS patients than in healthy controls; consequently, these serum miRs can serve as novel biomarkers for diagnosis and prognosis of MetS.

Exploring natural products-based cancer therapeutics derived from egyptian flora.

ETHNOPHARMACOLOGICAL RELEVANCE: Egyptian plants are a rich source of natural molecules, representing considerable biodiversity due to climate variations between the Northern, Southern, Eastern and Western regions of the country. Sinai is considered a precious nature reserves preserving flora, fauna, marine organisms, and historical habitats with ancient origins. Here, traditional medicinal approaches have been used for hundreds of years. Healthy lifestyles, low levels of stress and microbial infections, and a dependence on flora and herbal medicine might in combination explain why the burden of cancer is lower in some regions than in others. AIM OF THE STUDY: The primary aim of this review is to document the plants and natural products that are used as foods and medicines in Egypt, in general, and in Sinai, in particular, with a focus on those with demonstrated anticancer activities. The documented traditional uses of these plants are described, together with their chemical and pharmacological activities and the reported outcomes of clinical trials against cancer. MATERIALS AND METHODS: A literature search was performed to identify texts describing the medicinal plants that are cultivated and grown in Egypt, including information found in textbooks, published articles, the plant list website (http://www.theplantlist.org/), the medicinal plant names services website (http://mpns.kew.org/mpns-portal/), and web databases (PubMed, Science Direct, and Google Scholar). RESULTS AND DISCUSSION: We collected data for most of the plants cultivated or grown in Egypt that have been previously investigated for anticancer effects and reported their identified bioactive elements. Several plant species, belonging to different families and associated with 67 bioactive compounds, were investigated as potential anticancer agents (in vitro studies). The most potent cytotoxic activities were identified for the families Asteraceae, Lamiaceae, Chenopodiaceae, Apocynaceae, Asclepiadaceae, Euphorbiaceae, Gramineae, and Liliaceae. The anticancer activities of some species, such as Punica granatum L., Nerium oleander L., Olea europea L., Matricaria chamomilla L., Cassia acutifolia L., Nigella sativa L., Capsicum frutescens L., Withania somnifera L., and Zingiber officinale Roscoe, have been examined in clinical trials. Among the various Egyptian plant habitats, we found that most of these plants are grown in the North Sinai, New-Delta, and Giza Governorates. CONCLUSION: In this review, we highlight the role played by Egyptian flora in current medicinal therapies and the possibility that these plants may be examined in further studies for the development of anticancer drugs. These bioactive plant extracts form the basis for the isolation of phytochemicals with demonstrated anticancer activities. Some active components derived from these plants have been applied to preclinical and clinical settings, including resveratrol, quercetin, isoquercetin, and rutin.

Childhood detention during COVID-19 in Italy: building momentum for a comprehensive child protection agenda.

Childhood detention represents an integral part of the public health response to the COVID-19 emergency. Prison conditions in Italy put detained minors at grave risk of contracting sudden acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. To date (29 April 2020), the Italian penitentiary system is housing 161 minors (147 males), most of them in pre-trial custody, as well as 50 children <3 y of age residing with their mothers in detention. Furthermore, the government reported 5265 unaccompanied minor migrants, mainly from Gambia and Egypt. The fundamental approach to be followed in childhood detention during COVID-19 is prevention of the introduction of infectious agents into detention facilities, limiting the spread within the prison and reducing the possibility of spread from the prison to the outside community. This appears challenging in countries like Italy with intense SARS-CoV-2 transmission. The current COVID-19 pandemic shows the need to provide a comprehensive childhood protection agenda, as the provision of healthcare for people in prisons and other places of detention is a state responsibility.

Assessment of healthcare professionals' knowledge, attitudes, and perceived challenges of clinical pharmacogenetic testing in Egypt.

Aim: We evaluated healthcare practitioners' perspectives regarding clinical pharmacogenetics in Cairo, Egypt. Materials & methods: We administered a paper-based survey to pharmacists and physicians practicing at Children's Cancer Hospital Egypt. The survey assessed practitioners' knowledge, attitudes, and perspectives about pharmacogenetic testing. Results: The study included 184 respondents (67.9% pharmacists; 32.1% physicians. Overall, the pharmacogenetic knowledge was low (mean = 41.7%) but attitudes toward pharmacogenetic testing and its potential clinical application were generally positive. Pharmacists responded more favorably than physicians to statements attributing the responsibility of applying pharmacogenetics in the clinical setting to their profession. However, several challenges were identified; the most common being: lack of pharmacogenetic knowledge and skill, lack of pharmacogenetic testing devices, and limited funding. Conclusion: Future efforts to promote pharmacogenetic implementation should focus on foundational education, practical training, and exploration of potential funding sources.

Protective Factors and Processes Fostering Resilience and Buffering Psychosocial Distress among Later-Life Egyptian Immigrants.

This qualitative study explores and describes the protective factors and processes that foster resilience and buffer psychosocial distress among later-life Egyptian immigrants post immigration to the US. Open-ended structured interviews were conducted with (30) later-life Egyptian immigrants who came to the United States after turning 60 years of age. Thematic analysis was used to analyze patterns within the data. The findings of this study reveal that the availability and utilization of psychosocial resources - due to opportunities embedded in their sociocultural context and coping strategies embedded in their individual strengths and cultural or religious beliefs - play a pivotal role in buffering the losses and acculturative stressors triggered by transitioning to a new environment. The findings of this study can be used to inform psychosocial and therapeutic interventions and guide the development of appropriate social work programs and services for later-life Egyptian immigrants in particular and older Arabic-speaking immigrants in general.

Doctors on the move: a qualitative study on the driving factors in a group of Egyptian physicians migrating to Germany.

BACKGROUND: Migration of physicians has become a global phenomenon with significant implications for the healthcare delivery systems worldwide. The motivations and factors driving physician's migration are complex and continuously evolving. Purpose of this study is to explore the driving forces in a group of Egyptian physicians and final-years medical students preparing to migrate to Germany. METHODS: A qualitative study was conducted based on social constructivism epistemology. In five focus group discussions, there participated a total 12 residents and 6 final-year medical students from 7 different training and workplace locations in Egypt. The participants provided information about their motivation and planning for migration. We applied a coding framework based on the concept of push/pull factors and barriers/facilitators for migration, and used Atlas.ti software for analysis. RESULTS: The thematic analysis indicated that the migration within the study's participants results from a specific weighting of push and pull factors. Push factors are considered to be more important than pull factors. Factors related to professional development play a leading role. The route of migration towards Germany is mainly determined by the low hurdle registration and licensing requirements in this destination country compared to other countries. In some cases, Germany is regarded as a "transit country", a step on the road to other European countries. The intent, planning and preparation of migration is assisted considerably by the local formation of a community and culture of migration with multiple ways for information exchange, identity building and social support through face-to-face and online channels. CONCLUSIONS: This study specifies - in a group of Egyptian physicians and final-year medical students - the perceived push and pull factors which influenced their intent to migrate to Germany. In addition to the general wealth gap, their particular route of migration is mainly determined by the requirements in licensing and registration procedures for foreign physicians in the potential destination country. The planning and preparation of a move is substantially facilitated by their joining a social network and a community of migrating physicians.

Suicidal Thoughts, Attempts and Motives Among University Students in 12 Muslim-Majority Countries.

There is a scarcity of research on suicidal phenomena in the Muslim world. Therefore, this study aimed at investigating the self-reported prevalence of suicidal thoughts, attempts and motives in 12 Muslim countries. A total of 8417 (54.4% women) university students were surveyed by means of a self-report questionnaire. Overall, 22% of the participants reported suicidal ideation and 8.6% reported attempting suicide. The odds of suicidal thoughts were elevated in Azerbaijan, Indonesia and Saudi Arabia, while reduced ORs were recorded in Egypt, Jordan, Lebanon and Malaysia. While odds of suicide attempts were high in Azerbaijan, Palestine and Saudi Arabia reduced odds ratios (OR) were detected in Indonesia, Iran, Jordan, Lebanon, Malaysia and Tunisia. Taking drugs and using a sharp instrument were the two most frequently used methods to attempt suicide. Only 32.7% of attempts required medical attention. Escape motives were endorsed more than social motives by participants who attempted suicide. Suicidal behaviors were more frequent in women than in men. Compered to men, fewer attempts by women required medical attention. Moreover, our results show that making suicide illegal does not reduce the frequency of suicidal behavior. Results from this comparative study show that suicidal thoughts and attempts are frequent events in young adults in countries where religious scripture explicitly prohibit suicide and the frequencies of nonfatal suicidal behavior show large variation in nations adhering to the same religion.

Gender differences in Egyptian patients hospitalized with heart failure: insights from the European Society of Cardiology Heart Failure Long-Term Registry.

AIMS: This analysis evaluates gender differences in the Egyptian cohort of patients hospitalized for acute heart failure (AHF) in the European Society of Cardiology Heart Failure Long-Term Registry. METHODS AND RESULTS: From April 2011 to September 2014, 1634 patients hospitalized with AHF were enrolled by 20 hospitals all over Egypt. Of these patients, 1112 (68%) patients were male and 522 (32%) were female. Women presented with a higher admission systolic blood pressure and resting heart rate. Compared with men, women had a higher body mass index (32.5 ± 9.0 vs. 29.3 ± 4.9, P < 0.001), more frequent atrial fibrillation (34.7% vs. 22.4%, P < 0.001), and anaemia defined by haemoglobin < 12 g/dL (83.1% vs. 58.4%, P < 0.001). Women were more likely to present with heart failure with preserved ejection fraction (29.7% vs. 10.6%, P < 0.001). Women had more frequent diabetes mellitus (48.1% vs. 41.6%, P < 0.05) and hypertension (48.7% vs. 39.3%, P < 0.001) than had men, whereas smoking was rare among them (8.8% vs. 82.9%, P < 0.005). There was no significant difference in the primary aetiology of heart failure between both sexes. ACE inhibitors, beta-blockers, mineralocorticoid receptor antagonists, antiplatelets, statins, and nitrates were less frequently prescribed to women, whereas they more often received digoxin, amiodarone, anticoagulants, and calcium channel blockers. There was no significant difference in in-hospital (5.7% vs. 4.6%, P = 0.39) and 1 year mortality (27.9% vs. 25.9%, P = 0.48) between women and men, respectively. CONCLUSIONS: Men and women with AHF differ significantly in baseline clinical characteristics and management but not in adverse outcomes. These findings emphasize the importance of individualized management and need for more comprehensive recruitment of women in clinical trials.

Anthropometric Analysis of the External Nose of the Egyptian Males.

OBJECTIVE: The aim of this study was to describe average nasal anthropometric measurements for young Egyptian males by using the Rhinobase® software. MATERIALS AND METHODS: This was a cross-sectional study involving the evaluation of facial photographs. Frontal, right lateral and basal photographs for 300 healthy adult male Egyptian volunteers (n = 300) were taken; then, the photos were edited using Rhinobase® Software and CorelDraw graphics (2017) software. Twenty anthropometric landmarks were determined. The calculated measurements of the soft tissue of the external nose included ten linear measurements and five angles. RESULTS: The means of the linear measurements of the external nose in this study were as follows: nasal height (56.12 mm), nasal bridge length (47.0 mm), columella length (9.1 mm), alar length (29.3 mm), morphological nose width (41.0 mm), anatomical nose width (38.0 mm), nasal tip protrusion (21.0 mm), nasal tip projection using 'Goode's method' (29.36 mm), dorsum width (9.6 mm) and nasion height (2.04 mm). The means of the angular measurements of the nose were as follows: nasofacial angle (33.1°), nasofrontal angle (144.0°), nasolabial angle (104.5°), nasomental angle (127.6°) and mentocervical angle (104.7°). CONCLUSIONS: Racial differences of the external nasal anthropometric values exist; hence, it is important to establish the average anthropometric measures for several races and ethnic groups. Measurements collected in this study can serve as a database for anthropometric average values of the external nose in healthy adult Egyptian males. Moreover, these measurements can aid in planning prior to nasal reconstruction and esthetic rhinoplasty by serving as a reference standard. Although the Rhinobase® software is an easy, reliable and safe indirect method for nasal analysis, we should be cautious during interpretation of some edited landmarks on Rhinobase® software pictures. In addition, inserting two rulers (in the horizontal and vertical dimension) allows accurate assessment of the linear anthropometric measurements. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Psychosocial risk factors and processes impeding adaptive capacities and contributing to psychosocial distress among later-life Egyptian immigrants.

This qualitative study explores and describes the transactional and cumulative psychosocial stressors that later-life Egyptian immigrants encounter upon coming to the United States, and how they impede their adaptive capacities, hinder their adjustment efforts, and impact their psychosocial well-being. Such stressors are more pronounced among those who immigrated to the United States from Egypt after reaching the retirement age of 60 for two reasons. First, they experience pre-immigration stressors that force or expedite their departure from Egypt under duress, thus incurring numerous financial and symbolic losses. Secondly, in the last developmental stage, when age-related losses are triggered, they are concomitantly exposed to a starkly different lifestyle, language, cultural norms, living and financial arrangements, roles, and relationships. All such circumstances contribute to a sense of confusion, guilt, shame, and being a burden on others, which culminate in withdrawal, isolation, and distress. The findings of this study can be used to inform psychosocial and therapeutic interventions and guide the development of appropriate social work programs, services, and policies for later-life Egyptian immigrants in particular and older Arabic-speaking immigrants in general.

Hepatitis C Virus Prevalence in Egyptian Americans in Southern California.

BACKGROUND: Hepatitis C virus (HCV) is a global medical health concern. Egypt has the highest HCV prevalence. Few studies have assessed the HCV prevalence rates among Egyptian-born expatriates. We sought to define the HCV prevalence Egyptian-born individuals residing in the Southern California area. PATIENTS AND METHODS: We screened Egyptian-born individuals in houses of worship in the Southern California area using a point of care test HCV antibody test. Results were confirmed by testing the blood for viral load. Demographic information including risk factors were also collected. Individuals were contacted with their results, and those found to be detectable HCV antibodies were referred for further testing and additional care. RESULTS: Three hundred twenty-six Egyptian expatriates from 7 houses of worship in Southern California were screened for the HCV infection. Most of the participants were screened at Coptic Churches. Nine of these individuals were found to be HCV infected (2.8%). We found an increased HCV seroprevalence in subjects were male and born in Egyptian urban areas. Five of the 9 subjects (56%) who tested positive were not baby boomers and only 2 of these 9 subjects (22%) had recognized Center for Disease Control risk factors. CONCLUSIONS: The HCV prevalence rate of Egyptian-born individuals living in the Southern California area was lower compared with the prevalence rate in the general Egyptian population, but higher than that seen in the general US population. The utility of using Center for Disease Control risk factors to define individuals at risk of HCV among Egyptian expatriates is not applicable.

Metopism: a Study of the Persistent Metopic Suture.

Metopism, the persistence of the metopic suture in adulthood, is a clinically significant radiographic finding. In addition to masquerading as a fracture of the frontal bone, a persistent metopic suture may be associated with other clinically significant anatomical variations including frontal sinus abnormalities. Several geographically and craniofacially distinct populations have yet to be assessed for the prevalence of metopism. This study aimed to determine the prevalence of metopic sutures in adult crania of diverse populations among which scant research exists. A total of 505 adult crania were examined for the presence of a metopic suture. A total of 13 (2.57%) demonstrated metopism. Among subpopulations, metopism was present in 8.06% (5:62) of European crania, 15.38% (2:13) of East Asian crania, 2.20% (2:91) of Egyptian crania, and 2.86% (1:35) of Bengali crania. Metopism was also found in 1 Chilean, Roman, and Tchuktchi cranium, respectively. Metopism was not seen in crania from individuals of African (non-Egyptian) descent (0:62), Peruvians (0:144), Malayans (0:23), or Mexicans (0:23). Among sexes, metopism was present in 3.77% (8:212) of females and 1.79% (5:279) of males. The prevalence of metopism differs between populations and sexes. The results of this study provide anthropological, developmental, and clinical insight with regard to metopism.

Pregnancy outcome variables and associated factors in different nationalities living in Kuwait.

This study aimed to investigate differences in pregnancy outcome among various nationalities residing in Kuwait. Cross-sectional data were collected from 369 mother-infant dyads at delivery on mother height (MH), mother haemoglobin (mHb), child haemoglobin (cHb), mid-upper arm circumference (MUAC), gestational age (GA), placental weight (PW), birth weight (BW), crown-heal length (CHL), and head circumference (HC). Significant differences among various nationalities were observed in mHb, HC, CHL, PW and MH. Kuwaiti and Indian women had lower PW and their babies had lower HC and CHL. Prevalence of anaemia (Hb <11.0 g/dL) ranged from 7.1% (Lebanese) to 30.0% (Kuwaiti) with the overall prevalence of 19.5%. Prevalence of low birth weight was 3.5%. Multiple linear regression analysis revealed PW as a significant predictor of BW, CHL and HC. Significant differences among various nationalities were observed in mHb, HC, CHL, PW and MH.The significance of these differences and their contributing factors needs further research.

"One Big Family": Pastoral Care and Treatment Seeking in an Egyptian Coptic Church in England.

Little is known about Coptic migrants' chronic disease health beliefs and treatment-seeking behaviours. Interviews to explore these issues and their relationship with church membership were conducted with 15 Coptic migrants in Southern England. Obesity and cardiovascular disease (CVD) were most frequently identified as health risks for Coptic migrants. CVD was ascribed to stress and considered amenable to spiritual healing. Lay referral to medical practitioners who were church members was common but may devalue perceptions of family medicine. The Coptic Church functions as a community that addresses members' wider vulnerability. Central to this is the "parish nurse" role of the priest.

Egyptian tale from India: application of whole-exome sequencing in diagnosis of atypical familial Mediterranean fever.

Clinical diagnosis of autoinflammatory diseases requires a high degree of clinical suspicion and clinching molecular evidence to substantiate the diagnosis. This is more so in populations with low prevalence of these disorders. In this report, we describe the case of a young man from India with recurrent fever and persistent arthritis. The patient's forefathers were of Egyptian ancestry who practiced consanguinity. Molecular genetic analysis using whole-exome sequencing suggested the presence of variants c.443A>T:p.E148V and c.442G>C:p.E148Q in the MEFV gene, earlier independently shown to be associated with familial Mediterranean fever (FMF) in a compound heterozygous state. The variants were further confirmed by capillary sequencing. This report also highlights the application of whole exome sequencing to delineate the allelic differences in the variants apart from serving as a quick genetic screening approach for autoinflammatory diseases. To the best of our knowledge, this is the first report of a compound heterozygosity for the two well-characterized variants associated with atypical FMF in a patient.

Evaluating Nubian Population Structure from Cranial Nonmetric Traits: Gene Flow, Genetic Drift, and Population History of the Nubian Nile Valley.

Paleolithic archaeological and skeletal remains from the Nile Valley have yielded a complex picture of life along the river. Sociocultural and sociopolitical events during this time frame shaped population structure, while gene flow and genetic drift further developed it. In this study, we took a population genetics approach to modeling Nubian biological relationships in an effort to describe how an accumulation of events formed Nubian population structure. A variety of Nubian samples were utilized, spanning the Mesolithic-Christian time periods and geographically from just above the first through the third cataracts. Population genetics statistics were employed to estimate and depict biological affinities (Mahalanobis D2 with a tetrachoric matrix, principal coordinates analysis, FST, and Relethford-Blangero residuals), supplemented by spatial-temporal modeling (Mantel tests and PROTESTs). Variation was high among these groups, indicating an intricate pattern of relationships in their population history where similar levels of gene flow probably stemmed from extensive cultural contact with Egypt and other populations in a variety of contexts. Genetic drift was also apparent in some of these sites, which is consistent with social and political histories of these groups. Traditional modeling of spatial-temporal patterning was not successful, which may be attributed to the nonlinear, loose clustering of Nubian groups by site. Collectively, the archaeological, biological, and environmental evidence supports the ideas of multiple populations living in Lower Nubia during the Paleolithic and/or a new population entering the area and shaping Nubian population structure.

How risk perception shapes collective action intentions in repressive contexts: A study of Egyptian activists during the 2013 post-coup uprising.

Social psychological research has overlooked collective action in repressive contexts, where activists face substantial personal risks. This paper examines the social psychological processes motivating activists to engage in collective action in risky contexts. We investigate the idea that perceived risks due to government sanctions can galvanize action through fuelling anger, shaping efficacy beliefs, and increasing identification with the movement. We also argue that anger, efficacy, and identification motivate action intentions directly and indirectly through reducing the personal importance activists attach to these risks. We tested our hypotheses within a sample of Egyptian activists (N = 146) from two protest movements who protested against Morsi's government and the military interventions, respectively, during the 2013 anticoup uprising. In line with our hypotheses, the perceived likelihood of risks was positively associated with anger and identity consolidation efficacy and positively predicted action intentions indirectly through these variables. Risk was also associated with increased political efficacy, but only among antimilitary protesters. Anger and political efficacy predicted action intentions directly and indirectly through reduced risk importance. Results also highlighted differential significance of emotional and instrumental motives for the two protest movements. We discuss directions for future research on the motivators of collective action in repressive contexts.

Relationship between sociodemographic, reproductive, and lifestyle factors and the severity of menopausal symptoms among Egyptian women in Alexandria.

OBJECTIVE: During menopause, women often experience some symptoms which may affect their daily activities. Information about menopausal experiences among different racial and ethnic groups is important for healthcare personnel to provide appropriate and specific interventions. The aim of the present study was thus to determine the frequency and determinants of severity of menopausal symptoms among Egyptian women using the Menopause Rating Scale as a screening tool for identification of menopausal symptoms. METHODS: A total of 540 women (aged 40-65 y) were recruited in this cross-sectional study. Demographic information was collected, and the Menopause Rating Scale questionnaire was administered. RESULTS: Most frequently reported symptoms were joint and muscular discomfort (501, 92.8%) followed by urogenital symptoms (460, 85.2%). A significant association was found between the number of menopausal symptoms and working status of participants (r = 0.504, P = 0.005), number of children (r = 0.474, P = 0.042), and body mass index (r = 0.544, P = 0.006). Women who reported urogenital symptoms and self-perceived general health as poor were more frequently referred to a gynecologist for moderate-to-severe menopausal symptoms. CONCLUSIONS: Participant-related information such as working status, which was shown to increase the frequency of psychological symptoms in our ethnic group, should be noted by the physician, and a suitable approach should be adopted to achieve better therapy outcomes. Counseling about the importance of maintaining an ideal body weight and exercise should be emphasized to reduce menopausal symptoms. Appropriate advice and support in improving the overall state of the postmenopausal women is essential.