Amal Abu Libdeh, Hashem Alhanaktah, Eyad Al Masoud, Anas Zayad, Ahmad Al-Loubani
Pediatric patients admitted to the intensive care unit may develop a form of muscle weakness termed Intensive Care Unit Acquired Weakness (ICU-AW), which remains relatively challenging to diagnose and manage. This condition may not be as frequent in pediatrics compared to adults, yet it represents a debilitating complication among pediatric ICU patients with notable short and long-term consequences. Diagnosis relies on history and physical exam, aided by electrophysiological studies and muscle biopsies. Serial muscle ultrasound is emerging as a reliable method for early detection of muscle wasting. Preventive measures include modifying risk factors and delaying parenteral nutrition. While no definitive treatment has been identified, early mobilization, and limiting the use of sedatives may influence the outcome of this condition in pediatrics. More data is needed to assess the incidence and prognosis of pediatric ICU-AW.
{"title":"Intensive Care Unit-Acquired Weakness in Pediatrics: A Literature Review","authors":"Amal Abu Libdeh, Hashem Alhanaktah, Eyad Al Masoud, Anas Zayad, Ahmad Al-Loubani","doi":"10.58877/japaj.v2i1.185","DOIUrl":"https://doi.org/10.58877/japaj.v2i1.185","url":null,"abstract":"Pediatric patients admitted to the intensive care unit may develop a form of muscle weakness termed Intensive Care Unit Acquired Weakness (ICU-AW), which remains relatively challenging to diagnose and manage. This condition may not be as frequent in pediatrics compared to adults, yet it represents a debilitating complication among pediatric ICU patients with notable short and long-term consequences. Diagnosis relies on history and physical exam, aided by electrophysiological studies and muscle biopsies. Serial muscle ultrasound is emerging as a reliable method for early detection of muscle wasting. Preventive measures include modifying risk factors and delaying parenteral nutrition. While no definitive treatment has been identified, early mobilization, and limiting the use of sedatives may influence the outcome of this condition in pediatrics. More data is needed to assess the incidence and prognosis of pediatric ICU-AW. ","PeriodicalId":364383,"journal":{"name":"JAP Academy Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141817998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ashraf Alsawareah, Omar Yousef, Omar Ismail, Ahmad Hanandeh, Razan Aburumman, Ahmad Mahadeen
Background: Autoimmune encephalitis (AE) is a group of immunologic diseases affecting the central nervous system (CNS). It is now considered a common cause of encephalitis and often requires intensive care unit (ICU) level care. Aims: This review aims to provide intensivists with a toolkit to better recognize, diagnose, and manage patients with AE in the ICU. Sources: A search of online databases using relevant keywords yielded papers discussing the epidemiology, diagnosis, management, and outcome of AE in the ICU setting. Content: Due to the development of new antibody testing toolkits, the prevalence of AE has been on the rise during the past few decades. Timely recognition and diagnosis of AE in the ICU can significantly improve patient outcomes. Diagnostic criteria help classify patients into possible, probable, or definite AE categories based on clinical and paraclinical findings. Management of AE involves immunomodulatory and immunosuppressive therapies, along with targeting associated neoplastic processes or triggers. First-line treatments include corticosteroids, intravenous immunoglobulin (IVIg), and plasma exchange (PLEX), while second-line therapies may be required for refractory cases. AE can result in seizures, movement disorders, dysautonomia, respiratory failure, altered mental status, and psychosis. These complications require a combination of immunotherapy and symptomatic treatment for effective management. Prognosis varies but timely and appropriate management significantly improves outcomes. Keywords: Autoimmune Encephalitis, ICU, Intensive Care, Diagnosis, Management, Prognosis
{"title":"Autoimmune encephalitis in Intensive Care Unit: A Review Article","authors":"Ashraf Alsawareah, Omar Yousef, Omar Ismail, Ahmad Hanandeh, Razan Aburumman, Ahmad Mahadeen","doi":"10.58877/japaj.v2i1.117","DOIUrl":"https://doi.org/10.58877/japaj.v2i1.117","url":null,"abstract":"Background: Autoimmune encephalitis (AE) is a group of immunologic diseases affecting the central nervous system (CNS). It is now considered a common cause of encephalitis and often requires intensive care unit (ICU) level care. \u0000Aims: This review aims to provide intensivists with a toolkit to better recognize, diagnose, and manage patients with AE in the ICU. \u0000Sources: A search of online databases using relevant keywords yielded papers discussing the epidemiology, diagnosis, management, and outcome of AE in the ICU setting. \u0000Content: Due to the development of new antibody testing toolkits, the prevalence of AE has been on the rise during the past few decades. Timely recognition and diagnosis of AE in the ICU can significantly improve patient outcomes. Diagnostic criteria help classify patients into possible, probable, or definite AE categories based on clinical and paraclinical findings. \u0000Management of AE involves immunomodulatory and immunosuppressive therapies, along with targeting associated neoplastic processes or triggers. First-line treatments include corticosteroids, intravenous immunoglobulin (IVIg), and plasma exchange (PLEX), while second-line therapies may be required for refractory cases. \u0000AE can result in seizures, movement disorders, dysautonomia, respiratory failure, altered mental status, and psychosis. These complications require a combination of immunotherapy and symptomatic treatment for effective management. Prognosis varies but timely and appropriate management significantly improves outcomes. \u0000Keywords: Autoimmune Encephalitis, ICU, Intensive Care, Diagnosis, Management, Prognosis \u0000 ","PeriodicalId":364383,"journal":{"name":"JAP Academy Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141687849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. Alkhawaldeh, Hamza Alsalhi, Mostafa Moawad, Y. Alabdallat
This communication underscores the critical gynecological and obstetric crisis in Gaza due to conflict, overcrowding, and damaged healthcare infrastructure, posing severe risks to pregnant women and children. Recommendations include immediate humanitarian aid, hospital restoration, international support for maternity care, and targeted health programs. Urgent measures are crucial for medical necessities, women's health education, mental health support, and adherence to international laws. Long-term planning for sustainable healthcare solutions is emphasized to address persistent challenges.
{"title":"Gynecological and Obstetric Crisis in Gaza Conflict Area: A Call for Action","authors":"I. Alkhawaldeh, Hamza Alsalhi, Mostafa Moawad, Y. Alabdallat","doi":"10.58877/japaj.vi.143","DOIUrl":"https://doi.org/10.58877/japaj.vi.143","url":null,"abstract":"This communication underscores the critical gynecological and obstetric crisis in Gaza due to conflict, overcrowding, and damaged healthcare infrastructure, posing severe risks to pregnant women and children. Recommendations include immediate humanitarian aid, hospital restoration, international support for maternity care, and targeted health programs. Urgent measures are crucial for medical necessities, women's health education, mental health support, and adherence to international laws. Long-term planning for sustainable healthcare solutions is emphasized to address persistent challenges.","PeriodicalId":364383,"journal":{"name":"JAP Academy Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140508800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Al-Masri, M. Al-Hussaini, M. K. Abou Chaar, H. Al-Najjar, K. Ammar
Background: Implementation of strict measures to ensure the safety of cancer patients during the coronavirus disease (COVID-19) pandemic includes modification of treatment plans, strict physical distancing measures between healthcare workers (HCWs) and patients alike, and early detection of suspected cases. Serological testing can identify immunological responses, i.e., seroconversion, in HCWs presenting with subclinical symptoms. The detection of immunoglobulin (Ig) M specific antibodies demonstrates active disease, while (Ig) G specific antibodies indicate previous exposure to SARS-CoV-2. Methods: Among HCWs in a tertiary cancer center in Jordan, a cross-sectional study was conducted to detect those who had positive serology albeit previous negative diagnosis with COVID-19. We sent an invitation e-mail, and those who met the criteria were invited to a privately designated room to sign an informed consent form and obtain a blood sample for analysis. Results and demographic data were analyzed using SAS version 9.4. Findings: We recruited 583 participants between December 2020 and January 2021, with an equal distribution between genders and a mean age of 34.04 years (±9.29). The majority of participants were from the nursing department (n=390, 66.89%). A history of an upper respiratory tract infection was reported by 144 individuals (24.7%) with varying symptoms. Positive exposure was reported in 441 participants (75.6%). IgG seroconversion was detected in 41 participants (7%), while IgM seroconversion was only detected in three (0.5%). Interpretation: There was no correlation between positive IgG seroconversion and history of upper respiratory tract infection, exposure to infected patients, or profession. Therefore, subclinical COVID-19 is hard to detect, facilitating transmission of infection. Alongside polymerase chain reaction testing, strict physical distancing, and prompt vaccination among HCWs to mitigate disease spread, frequent serological surveillance can offer a way to understand the number of infections at different times and locations within different populations.
{"title":"SARS-CoV-2 Antibodies Seroconversion in Healthcare Workers at a Tertiary Cancer Center","authors":"M. Al-Masri, M. Al-Hussaini, M. K. Abou Chaar, H. Al-Najjar, K. Ammar","doi":"10.58877/japaj.v1i2.17","DOIUrl":"https://doi.org/10.58877/japaj.v1i2.17","url":null,"abstract":"Background: \u0000Implementation of strict measures to ensure the safety of cancer patients during the coronavirus disease (COVID-19) pandemic includes modification of treatment plans, strict physical distancing measures between healthcare workers (HCWs) and patients alike, and early detection of suspected cases. Serological testing can identify immunological responses, i.e., seroconversion, in HCWs presenting with subclinical symptoms. The detection of immunoglobulin (Ig) M specific antibodies demonstrates active disease, while (Ig) G specific antibodies indicate previous exposure to SARS-CoV-2. \u0000 \u0000Methods: \u0000Among HCWs in a tertiary cancer center in Jordan, a cross-sectional study was conducted to detect those who had positive serology albeit previous negative diagnosis with COVID-19. We sent an invitation e-mail, and those who met the criteria were invited to a privately designated room to sign an informed consent form and obtain a blood sample for analysis. Results and demographic data were analyzed using SAS version 9.4. \u0000 \u0000Findings: \u0000We recruited 583 participants between December 2020 and January 2021, with an equal distribution between genders and a mean age of 34.04 years (±9.29). The majority of participants were from the nursing department (n=390, 66.89%). A history of an upper respiratory tract infection was reported by 144 individuals (24.7%) with varying symptoms. Positive exposure was reported in 441 participants (75.6%). IgG seroconversion was detected in 41 participants (7%), while IgM seroconversion was only detected in three (0.5%). \u0000 \u0000Interpretation: \u0000There was no correlation between positive IgG seroconversion and history of upper respiratory tract infection, exposure to infected patients, or profession. Therefore, subclinical COVID-19 is hard to detect, facilitating transmission of infection. Alongside polymerase chain reaction testing, strict physical distancing, and prompt vaccination among HCWs to mitigate disease spread, frequent serological surveillance can offer a way to understand the number of infections at different times and locations within different populations.","PeriodicalId":364383,"journal":{"name":"JAP Academy Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125221788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"from the Editor-in-Chief: Second Issue Highlights","authors":"Awni Shahait","doi":"10.58877/japaj.v1i2.71","DOIUrl":"https://doi.org/10.58877/japaj.v1i2.71","url":null,"abstract":"","PeriodicalId":364383,"journal":{"name":"JAP Academy Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122966368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The present article endeavors to conduct an in-depth analysis of the healthcare economy in rural communities and compare it to the urban communities within the United States. Our examination will encom-pass an evaluation of available resources, incentives, and market powers. In light of our findings, we will propose recommendations aimed at enhancing the efficiency and sustainability of the existing healthcare model within rural communities
{"title":"Economic analysis of rural health in the USA- suggested solutions for the market","authors":"EzzAddin Al Wahsh, W. Abushehab","doi":"10.58877/japaj.v1i2.50","DOIUrl":"https://doi.org/10.58877/japaj.v1i2.50","url":null,"abstract":"The present article endeavors to conduct an in-depth analysis of the healthcare economy in rural communities and compare it to the urban communities within the United States. Our examination will encom-pass an evaluation of available resources, incentives, and market powers. In light of our findings, we will propose recommendations aimed at enhancing the efficiency and sustainability of the existing healthcare model within rural communities","PeriodicalId":364383,"journal":{"name":"JAP Academy Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115838355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Urine sediment analysis is an extremely valuable yet underutilized test. Our case discussion aims to highlight its diagnostic value and emphasize the role of physicians in the performance of the test as diagnosis and management strategies may differ, leading to clinical improvement and more specific therapeutic interventions.
{"title":"The Importance of Urine Sediment Analysis in the Diagnosis and Management of Acute Kidney Injury","authors":"N. Imran, Sunder Valliappan","doi":"10.58877/japaj.v1i2.28","DOIUrl":"https://doi.org/10.58877/japaj.v1i2.28","url":null,"abstract":"The Urine sediment analysis is an extremely valuable yet underutilized test. Our case discussion aims to highlight its diagnostic value and emphasize the role of physicians in the performance of the test as diagnosis and management strategies may differ, leading to clinical improvement and more specific therapeutic interventions.","PeriodicalId":364383,"journal":{"name":"JAP Academy Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122309263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hemi dystonia from a mitochondrial mutation in MT-ND6","authors":"Amal Abu Libdeh, Aslan Urushanov","doi":"10.58877/japaj.v1i2.40","DOIUrl":"https://doi.org/10.58877/japaj.v1i2.40","url":null,"abstract":"Clinical Video","PeriodicalId":364383,"journal":{"name":"JAP Academy Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124039400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A 5-year old male with cyanosis: A case report of an unusual association with SARS-cov-2 antibodies","authors":"Courtney Cox, Abdallah Dalabih","doi":"10.58877/japaj.v1i2.34","DOIUrl":"https://doi.org/10.58877/japaj.v1i2.34","url":null,"abstract":"","PeriodicalId":364383,"journal":{"name":"JAP Academy Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117346812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shadi Awwad, Michleen Al-Awabdeh, Maysaa Al-Khalaileh, Hanan Al-Asbahi, M. Al-Share, Mohammad Abu-Jeyyab
Annular pancreas is a rare congenital anomaly, where a band of pancreatic tissue encircles the second part of the duodenum. Owing to its rarity neither the true prevalence nor the precise etiology of annular pancreas is known. It is usually diagnosed incidentally on imaging, during an abdominal surgery, or on autopsy. Treatment is individualized according to symptoms, ranging from close follow up to surgical interventions. In this case report, we provide an insight to a case of annular pancreas. We present the patient’s history and clinical assessment, as well as the diagnostic and therapeutic modalities.
{"title":"Annular Pancreas, A Rare Cause of Acute Pancreatitis, A Case Report","authors":"Shadi Awwad, Michleen Al-Awabdeh, Maysaa Al-Khalaileh, Hanan Al-Asbahi, M. Al-Share, Mohammad Abu-Jeyyab","doi":"10.58877/japaj.v1i2.42","DOIUrl":"https://doi.org/10.58877/japaj.v1i2.42","url":null,"abstract":" \u0000Annular pancreas is a rare congenital anomaly, where a band of pancreatic tissue encircles the second part of the duodenum. Owing to its rarity neither the true prevalence nor the precise etiology of annular pancreas is known. It is usually diagnosed incidentally on imaging, during an abdominal surgery, or on autopsy. Treatment is individualized according to symptoms, ranging from close follow up to surgical interventions. \u0000In this case report, we provide an insight to a case of annular pancreas. We present the patient’s history and clinical assessment, as well as the diagnostic and therapeutic modalities. ","PeriodicalId":364383,"journal":{"name":"JAP Academy Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132931681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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