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Ala’a Abandeh,1 Amer Sindiani,2 Mohammad S Nazzal,1 Nihad A Almasri,3 Afnan Megdadi,2 Linzette Morris,4 Eman Alshdaifat,5 Saddam F Kanaan4 1Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan; 2Department of Obstetrics and Gynecology, Jordan University of Science and Technology, Irbid, Jordan; 3Department of Physical Therapy, The University of Jordan, Amman, Jordan; 4Department of Rehabilitation Sciences, College of Health Sciences, QU Health, Qatar University, Doha, Qatar; 5Department of Obstetrics and Gynecology, Faculty of Medicine, Yarmouk University, Irbid, JordanCorrespondence: Saddam F Kanaan, Department of Rehabilitation Sciences, College of Health Sciences, QU Health, Qatar University, P.O. Box: 2713, 1st Floor, Building I06 Ibn Bitar, Doha, Qatar, Email saddam@qu.edu.qaObjective: This study aimed to estimate the prevalence and determine predictors of leg cramps among pregnant women in their third trimester.Methods: A sample of pregnant women in their third trimester who routinely visited local clinics in Jordan was recruited. Participants completed a socio-demographic and clinical characteristics questionnaire, the numeric pain rating scale (NPRS) for leg cramp pain intensity, the Arabic version of the Pregnant Physical Activity Questionnaire (PPAQ), the Nordic Musculoskeletal Questionnaire (NMQ), Short Form Health Survey (SF-12), Pittsburgh Sleep Quality Index (PSQI), and Hospital Anxiety and Depression Scale (HADS). In addition, magnesium (Mg) and calcium (Ca) serum levels were examined. Logistic regression analyses were used to identify predictors of leg cramps occurrence. A linear regression model was used to investigate predictors of leg cramps pain intensity among pregnant women who reported leg cramps.Results: Two hundred and five (n=205) pregnant women completed the study. The estimated prevalence of leg cramps was 58%. Logistic regression results showed that not receiving assistance with housework (OR 0.46, p=0.025), progress in the number of gestational weeks (OR 1.10, p=0.021), the number of previous pregnancies (OR 1.21, p=0.049), having leg swelling (OR 2.28, p=0.019), and having gastrointestinal (GIT) problems (OR 2.12, P=0.046) were associated with a higher odds of leg cramps occurrence. In the subsample with pregnant women with leg cramps, linear regression results showed that pregnant women with high school education versus elementary school (β=0.70, p=0.012), number of working hours (β=0.11, p=0.010), using vitamins supplements (β=− 1.70, p=0.043), having diabetes after pregnancy (β=1.05, p=0.036), having sciatica (β=0.58, p=0.028), having hip pain (β =− .33, p=0.029), and higher PSQI total score (β=0.09, p=0.020) were the significant predictors of leg cramp pain intensity.Conclusion: Many health-related conditions, as well as work and home-related work characteristics, may be considered risk factors for the occurrence of leg cramps and increased leg cramps pain intensity in pregnancy.Keywords: Leg cramps, pregnancy, prevalence, third trimester

Eman Alshdaifat,1 Nadine Absy,2 Amer Sindiani,3 Noor AlOsta,2 Hiba Hijazi,4,5 Zouhair Amarin,3 Eman Alnazly6 1Department of Obstetrics and Gynecology, Faculty of Medicine, Yarmouk University, Irbid, Jordan; 2Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan; 3Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan; 4Department of Health Management and Policy, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan; 5Department of Health Services Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; 6Faculty of Nursing, Al-Ahliyya Amman University, Amman, JordanCorrespondence: Eman Alshdaifat, Department of Obstetrics and Gynecology, Faculty of Medicine, Yarmouk University, P.O. Box: 566, Irbid, 21163, Jordan, Tel +962795780335, Email eman.shdaifat@yu.edu.joObjective: To assess the prevalence of premenstrual and menstrual symptoms and to investigate premenstrual severity’s association with perceived stress of premenstrual syndrome among medical students.Methods: This is a cross-sectional study. Data were collected between March and April 2021, a self-administered online questionnaire (Supplementary Material) was distributed to a sample of female medical students in Jordan (n=594).Results: The mean age was 21.6 ± 2.2 years, and the mean body mass index (BMI) was 22.8 ± 4.1 kg/m2. Most students were in their 5th and 6th university year, where 75.4% reported having dysmenorrhea, 45.8% used pharmacological agents for pain relief, while 54.2% used non-pharmacological means, and 58.1% occasionally skipped lectures. Most participants reported a constellation of physical and psychological symptoms. The mean for the premenstrual severity scale score was 29.3, and the mean for the perceived stress scale scores was 21.6. There was a statistically significant correlation between the premenstrual severity scale score and the perceived stress scale, between the premenstrual severity scale and absenteeism, between premenstrual severity scale and year of study, and between dysmenorrhea and the perceived stress scale, but not between the severity of symptoms and method of pain relief.Conclusion: Premenstrual and menstrual symptoms have a negative impact on students that affects their academic participation. More support should be given from universities to address the menstruation-related struggles of female students.Keywords: premenstrual syndrome, premenstrual severity scale, perceived stress scale, medical students

Heba H Hijazi,1,2 Mohammad S Alyahya,2 Rabah M Al Abdi,3 Main N Alolayyan,2 Amer M Sindiani,4 Liqaa A Raffee,5 Wegdan A Baniissa,6 Amina M Al Marzouqi1 1Department of Health Services Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; 2Department of Health Management and Policy, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan; 3Department of Biomedical Engineering, Faculty of Engineering, Jordan University of Science and Technology, Irbid, Jordan; 4Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan; 5Department of Accident and Emergency Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan; 6Nursing Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab EmiratesCorrespondence: Heba H HijaziDepartment of Health Services Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab EmiratesEmail hhijazi@sharjah.ac.aeObjective: This study aimed to evaluate the association between perceived social support during pregnancy and levels of anxiety among postpartum women using an anxiety-specific screening instrument.Methods: Using a prospective cohort design, a two-stage methodology was conducted to collect data from women seeking maternal care at the King Abdullah University Hospital in northern Jordan. In the first stage, perceived social support was assessed among pregnant women using the Medical Outcomes Study Social Support Survey. During the first six months after childbirth, postpartum women were contacted to complete the second stage, wherein their perceptions of infant-focused anxieties were assessed using the Postpartum Specific Anxiety Scale. In our study, two types of infant-focused anxieties were investigated among a final sample of 419 mothers: infant safety and welfare anxieties and practical infant care anxieties.Results: The results of multivariate linear regression analysis indicated that providing pregnant women with high levels of emotional support from close social networks (β= − 0.08, p= 0.01) and perceiving informational support from health care providers (β= − 0.71, p< 0.01) were protective factors for reducing the levels of postpartum anxiety concerning infant safety and welfare. Our findings also demonstrated that pregnant mothers who perceived high informational support from health care providers had a lower level of postpartum anxiety about practical infant care (β= − 0.20, p< 0.01). In contrast, mothers who reported receiving high tangible support from close social networks during pregnancy had a significantly higher level of perceived anxiety concerning practical infant care after delivery (β= 0.13, p= 0.02).Conclusion: Our study suggests that postpartum anxiety would be reduced if effective informational support were readily available for pregnant women. There is a clear need for building bridges between women, their families, and providers to distinguish the specific type and amount of support that should be provided to mothers during pregnancy.Keywords: postpartum anxiety, infant care, social support, pregnancy, childbirth, postnatal care, infant-focused anxieties

Amer Mahmoud Sindiani,1 Faheem Zayed,2 Eman Hussein Alshdaifat,3 Hasan M Rawashdeh,1 Wesam Al-Woshah,4 Nada Zayed5 1Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan; 2Department of Obstetrics and Gynecology, Irbid Speciality Hospital, Irbid, Jordan; 3Department of Obstetrics and Gynecology, Yarmouk University, Irbid, Jordan; 4Department of Obstetrics and Gynecology, IBN Al-Nafis Hospital, Irbid, Jordan; 5Department of Dermatology, Albalqa Applied University, Salt, JordanCorrespondence: Amer Mahmoud SindianiDepartment of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, PO Box: 3030, Irbid, 22110, JordanTel +962796025538Email amsindiani0@just.edu.joPurpose: To find out whether couples with predominant female offspring have more chances to produce more female embryos during non-medical pre-implantation genetic diagnosis (PGD) for male sex selection.Methods: A total of 125 couples who had three or more female offspring and underwent non-medical PGD for male sex selection between 2015 and 2019 were included. Nuclear DNA was analyzed by fluorescent in situ hybridization (FISH). Two-chromosome (X, Y), 3-chromosome (21, X, Y), and 5-chromosome (13, 18, 21, X, Y) probes were used for FISH. The standard protocol was followed for sperm processing and embryo culture for IVF and PGD.Results: In 83.2% of the couples, the ratio of female embryos was higher than male embryos. Independent sample t-test showed that there is no significant difference between equal and unequal embryonic groups in patients’ age, husbands’ age, sperm count, sperm motility, total male embryos, total female embryos, normal male embryos, and normal female embryos. For patients with positive pregnancy outcome, 84.6% had unequal embryonic ratio while 15.4% had equal embryonic ratio. Similarly, patients who were treated by short protocol had 85% of unequal embryonic ratio and 15% had equal ratio.Conclusion: A greater variability in the female to male embryonic ratio is produced in couples having predominantly female offspring and seeking non-medical PGD for male sex selection.Keywords: embryos, infertility, IVF, PGD

Amer Mahmoud Sindiani,1 Eman Alshdaifat,2 Basil Obeidat,1 Rawan Obeidat,1 Hasan Rawashdeh,1 Hashem Yaseen3 1Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan; 2Department of Obstetrics and Gynecology, Faculty of Medicine, Yarmouk University, Irbid, Jordan; 3Department of Obstetrics and Gynecology, Faculty of Medicine, Muta University, Alkarak, JordanCorrespondence: Amer Mahmoud SindianiDepartment of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, P.O. Box: (3030), Irbid 22110, JordanTel +962796025538Fax +962-2-7201074Email amsindiani0@just.edu.joObjective: To study factors associated with the success of single dose methotrexate (MTX) treatment in women with ectopic pregnancy.Methods: This is a retrospective study of women (n=110) with ectopic pregnancy and treated with single dose of MTX. The clinical presentations, transvaginal sonography (TVS) findings, pretreatment beta-human chorionic gonadotropin (β-HCG), and progesterone values were compared between the treatment success (Group S) and treatment failure (Group F) groups.Results: The overall success rate of treatment with single dose of MTX was 75.45%. The majority of patients in both groups presented with pain and bleeding (∼ 55%), and bleeding only was the presenting symptom in about 20% of patients. Only 3 patients (3.61%) in Group S required a repeat dose of MTX. In contrast, 51.8% of the Group F patients required a repeat dose. The mean pretreatment β-HCG level was 2.3 times higher in Group F than in Group S (1734± 1684 vs 4036± 2940 IU/L). The data showed a β-HCG level of 3924IU/L as a suitable cut-off value with 76.19% sensitivity and 62.5% specificity to predict MTX treatment success. History of ectopic pregnancy had no relation with success/treatment failure or a repeat dose. None of the TVS findings were related to the outcome of the treatment, whereas pretreatment HCG level was a significant predictor.Conclusion: The single dose MTX treatment was successful in 75.45% (83/110) of cases, with 3.61% (3/83) requiring a repeat dose of the drug. Pretreatment β-HCG level is a significant predictor of the treatment outcome.Keywords: ectopic pregnancy, methotrexate, pretreatment β HCG

Amer Mahmoud Sindiani,1 Yousef Khader,2 Zouhair Amarin1 1Department of Obstetrics and Gynecology, Jordan University of Science and Technology, Irbid, Jordan; 2Department of Public Health and Community Medicine, Jordan University of Science and Technology, Irbid, JordanCorrespondence: Amer Mahmoud SindianiDepartment of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, P.O. Box: (630001), Irbid 22110, JordanTel +962796025538Fax +962 2 7095777Email amsindiani0@just.edu.joObjective: To assess a possible association between coffee and tea consumption and preterm delivery.Methods: A case–control design was implemented on a sample of women who were admitted for delivery to a tertiary hospital in the north of Jordan. Three hundred and fourteen cases and 796 controls were evaluated. The study was conducted while women were in the hospital for delivery. They were questioned about coffee and tea consumption and relevant confounding factors. Women were asked to state the average number of coffee and tea cups they drank per day.Results: The mean coffee consumption among women with preterm delivery was 0.75 cups/day ± 1.23 and the mean tea consumption was 1.47 cups/day± 1.76. Multivariable logistic analysis revealed that increased age (OR=1.05; CI=1.02– 1.08), parity (OR=3.82, CI=2.58– 5.64), history of abortions (OR=1.69; CI=1.21– 2.35), family history of preterm deliveries (OR=2.45, CI=1.33– 4.52), having treatment for subfertility (OR=12.14, CI=2.39– 61.62), diabetes mellitus (OR=2.22, CI=1.06– 4.66), worsened emotional status during pregnancy (OR=2.35, CI=1.49– 3.72), short inter-pregnancy interval (OR=1.72, CI=1.10– 2.72), no iron consumption (OR=1.46, CI=1.06– 2.03), using folic acid (OR=2.45, CI=1.33– 4.52), and black colour women (OR=2.87, CI=1.35– 6.10) were predictive for preterm delivery. After controlling for all significant predictors, coffee and tea consumption during pregnancy was not significantly associated with increased odds of preterm delivery.Conclusion: These results do not support an association between coffee and tea consumption and preterm delivery.Keywords: coffee, pregnancy, preterm delivery, tea

Wasim Khasawneh,1 Amer Sindiani,2 Saif Aldeen Rawabdeh,1 Abdelwahhab Aleshawi,3 Dana Kanaan1 1Department of Pediatrics and Neonatology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan; 2Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan; 3Department of Ophthalmology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, JordanCorrespondence: Wasim KhasawnehDepartment of Pediatrics, Jordan University of Science and Technology, Irbid 22110, JordanTel +962796041117Fax +96227095777Email wakhasawneh@just.edu.joPurpose: To review the indications and clinical profile of neonatal admissions at King Abdullah University Hospital in Jordan.Materials and Methods: We conducted a cross-sectional review of all neonates admitted to the neonatal intensive care unit between September 2016 and September 2018. Collected data include demographic characteristics, indications for admission, morbidities and mortality, and discharge outcomes. Findings were reported among term and preterm infants.Results: A total of 1444 infants were admitted during the study period of whom 1332 (92.2%) were inborn and 612 (42.4%) were term neonates. Of the 832 preterm infants, 545 were late preterm (34– 36 6/7 gestation) and 125 had very low birth weight (˂ 1500 grams); 925 (64%) were born by cesarean section. Respiratory failure of the newborn (41.2%) and prematurity (33.3%) were the main indications for admission among the whole cohort. Maternal prolonged premature rupture of membranes (PROM) was observed in nearly half the admissions of term infants. Hypoxic ischemic encephalopathy (3.2% vs 0.7%, p 0.01) and congenital anomalies (5% vs 1.2%, p 0.03) were more common in term infants. The rate of bronchopulmonary dysplasia was 39% among < 28-week and 28% among < 32-week premature infants. Sepsis was encountered in 59 infants. The overall mortality rate was 3.8%. Prematurity was the main predisposing factor for mortality (Adjusted OR: 9.9, 95% CI: 3.5, 27.6).Conclusion: The majority of neonatal admissions at our institution are term and late preterm infants delivered by cesarean section. Prematurity, respiratory failure of the newborn, and suspected sepsis due to maternal PROM are the leading causes of admission. The mortality rate is within WHO target to achieve Sustainable Development Goal 3. Population-based studies are needed to make better conclusions that represent the whole Jordanian population. A revisit for the indications of cesarean deliveries may help to improve the neonatal outcomes.Keywords: neonatal outcomes, Jordan, NICU admissions, neonatal mortality

Abstract Monkeypox (MPX), an orthopoxviral disease endemic in Africa, is now a public health emergency of international concern (PHEIC) as declared by the World Health Organization in July 2023. Although it is generally mild, the overall case fatality rate was reported to be 3%, and the basic reproduction number (R0) is > 1 in men who have sex with men (MSM, i.e., Portugal (1.4), the United Kingdom (1.6), and Spain (1.8)). However, R0 is < 1 in other settings. In concordance with the smallpox virus, it is also expected to increase the risk of adverse outcomes for both the mother and the fetus. The outcomes of the disease in an immunocompromised state of pregnancy are scary, showing high mortality and morbidity of both mother and fetus, with up to a 75% risk of fetal side effects and a 25% risk of severe maternal diseases. Therefore, it warrants timely diagnosis and intervention. The reverse transcription polymerase chain reaction (RT PCR) test is the standard approach to diagnosis. We summarized the recent findings of MPX on pregnancy, and the associated risk factors. We also give recommendations for active fetal surveillance, perinatal care, and good reporting to improve outcomes. The available vaccines have shown promise for primary disease prevention.

In this study, 271 pre- and in-service science teachers in Israel were surveyed on their level of awareness about green chemistry and sustainability, as well as attitudes toward environmental education. Of the total participants, 123 were in-service science teachers with different seniority levels teaching in elementary, middle, and high schools. The remaining participants were teacher candidates studying at different institutions. The main source of the data was derived from a 34-item questionnaire that assessed teachers' awareness of green chemistry and sustainability and attitudes toward environmental education. The findings illustrated that the teachers' sustainability and green chemistry awareness was low in general, although their views on environmental education were mostly positive. In-service science teachers were found to have more knowledge about green chemistry and sustainability than pre-service science teachers. Notably, in-service science teachers with more than 10 years of teaching experience were found to have more knowledge than those who have less experience. Teaching implications and possible future studies were presented as well.

Abstract Aims To describe the level of knowledge of undergraduate students in Jordan toward COVID‐19 in children in respect of the clinical signs of the disease, modes of transmission, protection measures against the disease and satisfaction with governmental measures. Design A cross‐section was utilized in this study. Methods An online survey questionnaire was utilized in this research study. All undergraduate students in Jordan were able to take part. The size of the sample was 799. Knowledge toward COVID‐19 among children was used to assess the participants' knowledge about COVID‐19. Results The findings indicate that the students had a good understanding of the clinical signs, mode of transmission and protection measures and were satisfied with governmental measures. According to the students' responses, the resource they used the most was social media followed by news channels. Our study also found that medical specialty students had more knowledge toward COVID‐19 than non‐medical.

Both the IGF1 axis and hypovitaminosis D play a role in childhood obesity, either as a cause or a causality. While some studies suggest an interrelation between vitamin D status, IGF1, and obesity, this mechanism remains obscure. The aim of this study, therefore, was to explore associations between four genetic polymorphisms in the IGF1 axis in hypovitaminosis D-related obesity. The study included 116 pre-pubertal Israeli Arab children (52 girls), mean age 9.4 ± 2.6. Serum 25(OH)D was measured and anthropometric measures were obtained. Genomic DNA was extracted from peripheral EDTA-treated anti-coagulated blood using a standard protocol. Genotypes were determined using the Taqman allelic discrimination assay. The IGF genetic score was computed according to the additive genetic score model. A moderate-to-high negative correlation (r = 0.580, p < 0.05) was seen between the vitamin D status and body mass index (BMI) percentile of participants with high GS. Yet, no correlations were seen between vitamin D status and BMI percentile for participants with a low-to-moderate genetic score (GS) (GS ≤ 2). These results suggest that IGF1 genetic scores associated with elevated circulating IGF1 may indicate a tendency toward developing hypovitaminosis D-associated obesity.

Background: Obstetric Violence (OV) is a public health matter that affects women and their children with an incidence rate between 18.3–75.1% globally. The delivery institution of public and private sectors represents a potential factor contributing to OV. This study aimed to assess OV existence among sample of pregnant Jordanian women and its risk factors domains between public and private hospitals. Methodology: This is a case-control study including 259 recently delivered mothers from Al-Karak Public and Educational Hospital and The Islamic Private Hospital. A designated questionnaire including demographic variables and OV domains was used for data collection. Results: A significant difference was seen between patients delivering in the public sector compared to patients delivering the private sector in education level, occupation, monthly income, delivery supervision and overall satisfaction. Patients delivering in the private sector showed a significantly less physical abuse by the medical staff compared to patients delivering in the public sector, and patients delivering in a private room also showed a significantly less OV and risk of physical abuse compared to patients delivering in shared room. In public settings, medications information was lesser versus the private ones, additionally, there is significant association between performing episiotomy, physical abuse by staff and the delivery in shared rooms in private settings. Conclusion: This study showed that OV was less susceptible during childbirth in private settings compared to public settings. Educational status, low monthly income, occupation are risk factors for OV; also, features of disrespect and abuse like obtaining consent for episiotomy performance, delivery provision updates, care perception based on payment ability and medication information were reported.

Introduction: Although Jordan has made significant progress toward expanding the utilization of facility‐based intrapartum care, prior research highlights that poor service quality is still persistent. This study aimed to identify quality gaps between women's expectations and perceptions of the actual intrapartum care received, while exploring the contributing factors. Methods: Utilizing a pre–post design, quality gaps in intrapartum care were assessed among 959 women pre‐ and postchildbirth at a prominent tertiary hospital in northern Jordan. Data were gathered using the SERVQUAL scale, measuring service quality across reliability, responsiveness, tangibles, assurance, and empathy dimensions. Results: The overall mean gap score between women's expectations and perceptions of the quality of intrapartum care was −0.60 (±0.56). The lowest and highest mean gap scores were found to be related to tangibles and assurance dimensions, −0.24 (±0.39) and −0.88 (±0.35), respectively. Significant negative quality gaps were identified in the dimensions of assurance, empathy, and responsiveness, as well as overall service quality (p < 0.001). The MLR analyses highlighted education (β = 0.61), mode of birth (β = −0.60), admission timing (β = −0.41), continuity of midwifery care (β = −0.43), physician's gender (β = −0.62), active labour duration (β = 0.37), and pain management (β = −0.33) to be the key determinants of the overall quality gap in intrapartum care. Conclusion: Our findings underscore the importance of fostering a labour environment that prioritizes enhancing caregivers' empathetic, reassuring, and responsive skills to minimize service quality gaps and enhance the overall childbirth experience for women in Jordan. Patient or Public Contribution: This paper is a collaborative effort involving women with lived experiences of childbirth, midwives, and obstetrics and gynaecologist physicians. The original idea, conceptualization, data generation, and coproduction, including manuscript editing, were shaped by the valuable contributions of stakeholders with unique perspectives on intrapartum care in Jordan. [ABSTRACT FROM AUTHOR]

Premenstrual syndrome (PMS) has various symptoms that occur during the luteal phase of the menstrual cycle and subside after menstruation. Anxiety and depression are prevalent in women with PMS and may exacerbate the severity of PMS. Vitamin D and calcium deficiency may have a role in developing anxiety, depression, and musculoskeletal pain (MSP). The aim of this study was to evaluate selected premenstrual symptoms in relation to serum vitamin D levels, daily calcium consumption, and psychological symptoms among women with MSP. The study population consisted of 108 women with MSP and 108 healthy controls. Information about premenstrual symptoms and calcium consumption were collected. Psychological symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS). Vitamin D was determined by electrochemiluminescence immunoassay. Women with MSP had lower serum vitamin D levels, lower daily calcium consumption, higher HADS scores for anxiety and depression, and higher frequency of severe premenstrual symptoms including fatigue, headache, irritability, mood swings, anxiety, depression, and social withdrawal compared to controls (P < 0.01). Abnormal HADS scores for anxiety and depression were associated with increased severity of premenstrual symptoms (P < 0.05). Deficient vitamin D and calcium consumption were associated with abnormal HADS scores for anxiety and depression (P < 0.05) and with increased severity of premenstrual headache, irritability, anxiety, and depression (P < 0.05). Low calcium consumption was associated with increased severity of premenstrual irritability, anxiety, depression, and social withdrawal (P < 0.05). The results suggest that vitamin D deficiency, low calcium consumption, psychological symptoms, and MSP could be interrelated and implicated in the etiology severe premenstrual symptoms. Further studies are necessary to assess whether vitamin D and calcium supplements can relieve MSP and premenstrual symptoms. [ABSTRACT FROM AUTHOR]

To separate and purify organic contaminants, the employment of liquid membrane technology based on the Polymer Inclusion Membrane (PIM) technique is a major alternative. This technology has been extensively employed on an industrial, hospital, and academic laboratory scale. This work produced PIM membranes using dibenzyl ether, polyvinyl chloride, and copoly-eugenol divinyl benzene (Co-EDVB) 8%, respectively, as plasticizers, support polymers, and carriers. Also, the optimization test for phenol transport was conducted utilizing parameters for the impact of membrane thickness and transport duration. The plasticizer effect, different salt kinds, salt concentrations, repeated use, and longevity factors were used to assess the robustness and stability of the PIM membrane. The findings indicated that the type T54 membrane's thickness and a twenty-four hours transit period were the ideal conditions for phenol transport. The proportion of phenol concentration that was successfully delivered to the receiving phase under these ideal circumstances was 89.03 percent. Also, it was discovered that the PIM membrane's stability and durability were impacted by the use of plasticizers and salt. The membrane life was increased to up to thirty-four days by adding sodium nitrate salt to the source phase at a concentration of 0.01 M. [ABSTRACT FROM AUTHOR]