Background: The coronavirus disease 2019 pandemic has been an extraordinarily stressful situation in recent years. Stress is a physiological reaction to negative stimuli that is regulated by different neuroendocrine pathways. The female reproductive function is maintained by the menstrual cycle, which is negatively affected by hyperstimulation of stress signals. Objectives: This study evaluates the effect of the coronavirus disease 2019 outbreak on menstrual function and mental health, exploring the relationship between them. Design: The current study uses a cross-sectional, survey-based design. Methods: During this cross-sectional study, an online self-completion questionnaire was conducted among a sample of 385 Jordanian female medical students during the pandemic. The survey compared menstrual characteristics, depression, anxiety, and stress 10 months after the coronavirus disease 2019 pandemic with 10 months prior. Paired t-test, McNemar’s test, Pearson’s correlation, and multiple linear regression model were employed to analyze data using SPSS software. Results: The mean age of female medical student respondents was 19.89 years. Data showed that the menstrual cycle length significantly increased during the coronavirus disease 2019 pandemic compared with 10 months prior (32.23 days versus 30.02 days, p = 0.019). The average number of heavy bleeding days also increased during the coronavirus disease 2019 pandemic (2.82 days versus 2.42 days, p = 0.002). The proportion of females with heavy bleeding amount was more than doubled during the pandemic of coronavirus disease 2019 compared with before (27.3% versus 10.4%, p = 0.000). Unpleasant menstrual signs such as nausea and/or vomiting, breast pain, and urinary urgency were significantly increased during the pandemic ( p = 0.000, p = 0.008, and p = 0.024, respectively). During coronavirus disease 2019, a positive association between total Depression, Anxiety, and Stress Scale-21 Questionnaire score and heavy bleeding was identified ( p < 0.05). The findings also indicated that mental disorders and the incidence of amenorrhea, nausea and/or vomiting, and urinary urgency were positively correlated during the coronavirus disease 2019 pandemic. The multiple regression analysis revealed associations between several menstrual characteristics such as amenorrhea and severity of bleeding with coronavirus disease 2019-related depression, anxiety, and stress. Conclusion: This study revealed that the stress related to the pandemic of coronavirus disease 2019 could affect the female menstrual cycle and hence the quality of women’s life. Therefore, this study could serve as a baseline for planning and introducing stress mitigation interventions in crisis situations to improve the physiological and mental well-being of females and improve their quality of life.

Advanced glycation end products (AGEs) contribute significantly to vascular dysfunction (VD) in diabetes. Decreased nitric oxide (NO) is a hallmark in VD. In endothelial cells, NO is produced by endothelial NO synthase (eNOS) from L-arginine. Arginase competes with NOS for L-arginine to produce urea and ornithine, limiting NO production. Arginase upregulation was reported in hyperglycemia; however, AGEs’ role in arginase regulation is unknown. Here, we investigated the effects of methylglyoxal-modified albumin (MGA) on arginase activity and protein expression in mouse aortic endothelial cells (MAEC) and on vascular function in mice aortas. Exposure of MAEC to MGA increased arginase activity, which was abrogated by MEK/ERK1/2 inhibitor, p38 MAPK inhibitor, and ABH (arginase inhibitor). Immunodetection of arginase revealed MGA-induced protein expression for arginase I. In aortic rings, MGA pretreatment impaired acetylcholine (ACh)-induced vasorelaxation, which was reversed by ABH. Intracellular NO detection by DAF-2DA revealed blunted ACh-induced NO production with MGA treatment that was reversed by ABH. In conclusion, AGEs increase arginase activity probably through the ERK1/2/p38 MAPK pathway due to increased arginase I expression. Furthermore, AGEs impair vascular function that can be reversed by arginase inhibition. Therefore, AGEs may be pivotal in arginase deleterious effects in diabetic VD, providing a novel therapeutic target.

Purpose: Fraction of exhaled nitric oxide (FeNO) and soluble advanced glycation end-product receptor (sRAGE) are proposed as biomarkers of asthma, therefore we sought to assess their use in asthmatic children of Jordan. Patients and Methods: We conducted a case-control study at The University of Jordan Hospital. A total of 141 asthmatic children followed by respiratory pediatricians and 118 healthy children aged 4– 18 years were recruited. FeNO was measured by NObreath device and serum sRAGE by ELISA that detect endogenously soluble isoform (esRAGE) and total soluble RAGE (sRAGE). Results: sRAGE in asthmatic was half of the control (p < 0.001). In addition, ratio of esRAGE/sRAGE was two-fold higher in asthmatic (p = < 0.001). Neither FeNO nor esRAGE levels were significantly different between groups. FeNO and asthma control test (ACT) score were negatively correlated corrected for age and body mass index (BMI), (r = − 0.180, p= 0.034). For the uncontrolled asthma group, esRAGE/sRAGE negatively correlated with ACT score (r = − .329, p = 0.038). Receiver operating curve (ROC) analysis revealed significant predictive value (PV) for sRAGE and esRAGE/sRAGE in asthma detection with area under the curve (AUC) of (0.751 ± 0.031) and (0.711± .033), consequently. However, no biomarker had a significant PV for lack of control. Conclusion: The current study supports utilizing sRAGE as a marker for asthma and present a potential therapeutic target. However, our results indicate that both FeNO and sRAGE have a limited role in the management of asthmatic children or assessment of asthma control.

Background : Asthma is the most common chronic diseases that affect children and its prevalence is increasing worldwide posing a great burden on healthcare systems. A growing body of evidence suggests an association between vitamin D deficiency and asthma. The current study aimed to assess serum vitamin D level in Jordanian children with bronchial asthma and to examine the correlation between vitamin D levels and asthma severity and control. Methods: A cross sectional study was conducted in the Pediatric Chest Clinic at AlKarak Governmental Hospital South of Jordan from May 2015 to February 2016. Serum level of 25-hydroxyvitamin-D was determined for 98 Children aged 1 to 14 years and diagnosed with bronchial asthma (6-14years) or recurrent wheezing episodes(<6 years). The severity of asthma was determined based on the Global Initiative for Asthma (GINA) assessment, the Asthma Control test (ACT) and the Childhood Asthma Control Test (C-ACT). The results were considered significant if P ≤.05. Statistical analysis was performed using SPSS 21 (IBM, Armonk, NY, United States of America, 2012). Results : Vitamin D levels were deficient and insufficient in 41(41.8%) and 34(34.7%) of asthmatic children, respectively. Only 23( 23.5%) had sufficient vitamin D levels. A significant correlation was found between the severity of asthma symptoms and vitamin D deficiency (Pearson Chi-squared=.028). Conclusion : Vitamin D deficiency is highly prevalent in children with bronchial asthma in Jordanian population and correlates significantly with asthma severity. Assessment of vitamin D levels in children with bronchial asthma is required in a larger scale studies in Jordan.

Background/Objectives: Asthma is a prevalent chronic respiratory disease in children, and poor asthma control remains a major clinical challenge worldwide. In Jordan, the rising prevalence of pediatric asthma highlights a need to better understand the factors influencing asthma control and to evaluate new assessment tools. Methods: This cross-sectional study aimed to identify predictors of asthma control and to assess the clinical utility of fractional exhaled nitric oxide (FeNO) as a supplementary biomarker. A total of 329 children with physician-diagnosed asthma, aged 7–17 years, were recruited from Jordan University Hospital. Clinical history, spirometry, FeNO measurements, and Asthma Control Test scores were collected. Results: Overall, 62.6% of participants had uncontrolled asthma. Logistic regression analysis revealed that comorbidities such as obstructive sleep apnea, gastroesophageal reflux disease, allergic rhinitis, and bronchiolitis obliterans were significantly associated with poorer asthma control. Antihistamine use and elevated FeNO levels were also linked to lower odds of asthma control. Conclusions: While FeNO showed promise as a non-invasive marker of airway inflammation, its clinical application remains limited due to variability and confounding factors. A comprehensive, individualized approach to asthma management, considering comorbidities and conventional assessments, is essential. Larger, longitudinal studies are needed to establish the role of FeNO in routine pediatric asthma care.

It would be interesting to study the relationship between blood glucose lowering drugs and albumin as anti-aging therapy. Despite the title indicates commentary on this relationship, there is a lack of information to support this finding. Most of the...