L. Al-Mehaisen, Tariq N Al-Shatanawi, N. Al-Husban, Soha Albeitawi, D. Hiasat, Lena Al-Kuran, O. Al-kuran
BackgroundWorldwide, cervical cancer (CC) is considered the fourth most common cancer in women. Globocandata stated 311,365 CC related mortalities in the world in 2018, 90% of them occurred in low-income countries. In Jordan, CC ranks as the 12th most common cancer among women. The primary aim of this report is to be able to decide if digital screening (DS) is reliable and worth using in our one stop gynecology clinics. Materials and MethodsThis study was done for all women who attended one stop out-patient gynecology services for routine CC screening between 1/1/2019 and 31/12/2019. Inclusion criteria requested women to be 18 years of age or more, healthy, and had previously normal cervical smear (conventional Pap smear (CPS) or Liquid based cytology (LBC)) i.e., all previous screening tests results were normal. ResultsA total number of 94 patients agreed to have the DS method done, mean age was 43 years. 25.5% were found to have abnormal screening results on DS. When compared to the national data of 12.5% abnormal smears in Liquid‐based cytology (LBC), there was a statistically significant difference in the numbers of abnormal screening results between both methods (p value of 0.000). LBC is used in most centers for CCS in Jordan ConclusionThe digital cervical screening method saves time and offers a one stop clinic management, therefore minimizing lost to follow up rate, and where colposcopy is indicated. Additionally, DS should be considered in low resource countries.
{"title":"Digital cervical cancer screening: a reliable One-Stop method ?","authors":"L. Al-Mehaisen, Tariq N Al-Shatanawi, N. Al-Husban, Soha Albeitawi, D. Hiasat, Lena Al-Kuran, O. Al-kuran","doi":"10.35516/jmj.v56i1.230","DOIUrl":"https://doi.org/10.35516/jmj.v56i1.230","url":null,"abstract":"BackgroundWorldwide, cervical cancer (CC) is considered the fourth most common cancer in women. Globocandata stated 311,365 CC related mortalities in the world in 2018, 90% of them occurred in low-income countries. In Jordan, CC ranks as the 12th most common cancer among women. The primary aim of this report is to be able to decide if digital screening (DS) is reliable and worth using in our one stop gynecology clinics. Materials and MethodsThis study was done for all women who attended one stop out-patient gynecology services for routine CC screening between 1/1/2019 and 31/12/2019. Inclusion criteria requested women to be 18 years of age or more, healthy, and had previously normal cervical smear (conventional Pap smear (CPS) or Liquid based cytology (LBC)) i.e., all previous screening tests results were normal. ResultsA total number of 94 patients agreed to have the DS method done, mean age was 43 years. 25.5% were found to have abnormal screening results on DS. When compared to the national data of 12.5% abnormal smears in Liquid‐based cytology (LBC), there was a statistically significant difference in the numbers of abnormal screening results between both methods (p value of 0.000). LBC is used in most centers for CCS in Jordan ConclusionThe digital cervical screening method saves time and offers a one stop clinic management, therefore minimizing lost to follow up rate, and where colposcopy is indicated. Additionally, DS should be considered in low resource countries.","PeriodicalId":39681,"journal":{"name":"Jordan Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43673215","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}
BackgroundGene therapy has been proposed as a treatment approach for cystic fibrosis by replacing the single defective gene, cystic fibrosis transmembrane regulator (CFTR), through topical lung delivery. Relatively few studies have addressed gene therapy for cystic fibrosis.Objectives Via referral to the published literature, this study aimed to identify any success of the gene therapy approach for cystic fibrosis regarding experimental and routine clinical outcomes in different drug development stages, and to determine any adverse effects noted. MethodologyA search of the PubMed database (NCBI) for 1989–2020 was made using predefined selection criteria for clinical trials on patients with cystic fibrosis receiving viral and non-viral lung delivery systems of the CFTR gene. Several features in the reviewed studies were examined, including clinical phase (1–3), sample size, delivery target cells/vector, and reported adverse effects. A quantitative estimate of treatment intervention success was evaluated using a meta-analysis approach.Results A total of 20 studies with 549 patients were included in the review. The studies involved the delivery of the defective gene to the lung, nasal mucosa, and sinuses, and were mainly phase 1–2, randomized controlled trials; there were no phase three studies. The vector for gene transfer was liposome or viral. % predicted FEV1 was statistically significant between intervention and control patients in two trials. Gene transfer was detected to a higher degree in intervention patients than control; this outcome measure was assessed using bronchoscopy assessment of vector-specific DNA and mRNA expression in lung and nasal mucosa. These effects, however, were temporary. The safety of the gene therapy approach was confirmed. ConclusionReportedly, the gene therapy approach is safe but has limited and temporary efficacy. Newer approaches should thus be engineered to deliver the necessary genetic material with the desired, full-scale efficacy.
{"title":"The Efficacy and Safety of Cystic Fibrosis Gene Therapy Clinical Trials: A Systematic Review and Meta-Analysis","authors":"Ghaith M Al-Taani, A. Yehya","doi":"10.35516/jmj.v56i2.236","DOIUrl":"https://doi.org/10.35516/jmj.v56i2.236","url":null,"abstract":"BackgroundGene therapy has been proposed as a treatment approach for cystic fibrosis by replacing the single defective gene, cystic fibrosis transmembrane regulator (CFTR), through topical lung delivery. Relatively few studies have addressed gene therapy for cystic fibrosis.Objectives Via referral to the published literature, this study aimed to identify any success of the gene therapy approach for cystic fibrosis regarding experimental and routine clinical outcomes in different drug development stages, and to determine any adverse effects noted. MethodologyA search of the PubMed database (NCBI) for 1989–2020 was made using predefined selection criteria for clinical trials on patients with cystic fibrosis receiving viral and non-viral lung delivery systems of the CFTR gene. Several features in the reviewed studies were examined, including clinical phase (1–3), sample size, delivery target cells/vector, and reported adverse effects. A quantitative estimate of treatment intervention success was evaluated using a meta-analysis approach.Results A total of 20 studies with 549 patients were included in the review. The studies involved the delivery of the defective gene to the lung, nasal mucosa, and sinuses, and were mainly phase 1–2, randomized controlled trials; there were no phase three studies. The vector for gene transfer was liposome or viral. % predicted FEV1 was statistically significant between intervention and control patients in two trials. Gene transfer was detected to a higher degree in intervention patients than control; this outcome measure was assessed using bronchoscopy assessment of vector-specific DNA and mRNA expression in lung and nasal mucosa. These effects, however, were temporary. The safety of the gene therapy approach was confirmed. ConclusionReportedly, the gene therapy approach is safe but has limited and temporary efficacy. Newer approaches should thus be engineered to deliver the necessary genetic material with the desired, full-scale efficacy.","PeriodicalId":39681,"journal":{"name":"Jordan Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43084948","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}
Background Since the onset of SARS-CoV-2, this novel virus has been the focus of many studies seeking to improve the ability of healthcare systems to withstand pandemics against it. COVID-19 haspulmonary and cardiovascular implications, but its ocular effects remain a subject of debate. Objectives The objective of our narrative review is to explore the ophthalmic manifestations of COVID-19, identify research gaps, and act as a guide for further research in the field. Methods The literature search involved original studies published from January 1, 2020, up until August 20, 2021, on the PubMed database. Title and abstract screening and full text review were conducted by two independent researchers, with a third researcher resolving conflicts. Studies that met the set inclusion criteria were used for data synthesis.Results The preliminary search generated 59 articles, with 25 being data extracted. Conjunctivitis, epiphora and ocular irritation were consistently stated anterior segment manifestations. Posterior segment implications were mostly subclinical, including cotton-wool spots and retinal nerve-fiber layer thinning, but some cases were more detrimental, such as central retinal vein occlusion, posterior segment inflammation, retinal hemorrhages, and fungal infiltration. RT-PCR tests were unreliable in detecting SARS-CoV-2 infection in ocular tissues, potentially due to methodological limitations.Conclusion Anterior segment findings were significant manifestations of the novel coronavirus, but a clear resolution of posterior segment findings is yet to be made. In the absence of reliable COVID-19 ocular sample tests, all links made to SARS-CoV-2 etiology remain tentative; further research must be directed to the field with modified testing strategies.
{"title":"Eyeing up the pandemic: A literature review of the ocular manifestations of COVID-19","authors":"Ali Mardini, Seemal AbdulQadir, K. Alhomsi","doi":"10.35516/jmj.v56i2.234","DOIUrl":"https://doi.org/10.35516/jmj.v56i2.234","url":null,"abstract":"Background Since the onset of SARS-CoV-2, this novel virus has been the focus of many studies seeking to improve the ability of healthcare systems to withstand pandemics against it. COVID-19 haspulmonary and cardiovascular implications, but its ocular effects remain a subject of debate. Objectives The objective of our narrative review is to explore the ophthalmic manifestations of COVID-19, identify research gaps, and act as a guide for further research in the field. Methods The literature search involved original studies published from January 1, 2020, up until August 20, 2021, on the PubMed database. Title and abstract screening and full text review were conducted by two independent researchers, with a third researcher resolving conflicts. Studies that met the set inclusion criteria were used for data synthesis.Results The preliminary search generated 59 articles, with 25 being data extracted. Conjunctivitis, epiphora and ocular irritation were consistently stated anterior segment manifestations. Posterior segment implications were mostly subclinical, including cotton-wool spots and retinal nerve-fiber layer thinning, but some cases were more detrimental, such as central retinal vein occlusion, posterior segment inflammation, retinal hemorrhages, and fungal infiltration. RT-PCR tests were unreliable in detecting SARS-CoV-2 infection in ocular tissues, potentially due to methodological limitations.Conclusion Anterior segment findings were significant manifestations of the novel coronavirus, but a clear resolution of posterior segment findings is yet to be made. In the absence of reliable COVID-19 ocular sample tests, all links made to SARS-CoV-2 etiology remain tentative; further research must be directed to the field with modified testing strategies.","PeriodicalId":39681,"journal":{"name":"Jordan Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49351663","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}
A. Masri, Areej M. Alfryjat, Dyala Alfryjat, Ro’ya Abu saleem, Shaima’ Elhaj
Medical students’ concerns about research publishing increase the need for evaluate their knowledge about research ethics and misconduct issues. This study carried out through Facebook group contains all sixth year medical students at the University of Jordan to evaluate medical students’ knowledge about research ethics using an adopted questionnaire of 3 parts. 158 (39.5%) out of 400 students answered the questionnaire 107 (67.3%) were females and 52 (32.7) were males, only 18 (11.4%) of them had attended extra courses, and 23 (14.6%) had co-authored published manuscript, 129 (81.6%) of them had heard about research ethics, while most of them knew that publication ethics in research are an essential elements of paper writing, their knowledge about other aspects vary from about 4.4% for the time researcher need to wait before resubmit the manuscript again and 42.8% for plagiarism definition. A score of ten had been calculated for each student with an average of 2.4 and median of 3. In conclusion, the students need more training on research ethics and misconduct as their knowledge about it was inadequate.
{"title":"Medical Students’ Knowledge about Research Ethics","authors":"A. Masri, Areej M. Alfryjat, Dyala Alfryjat, Ro’ya Abu saleem, Shaima’ Elhaj","doi":"10.35516/jmj.v56i1.228","DOIUrl":"https://doi.org/10.35516/jmj.v56i1.228","url":null,"abstract":"Medical students’ concerns about research publishing increase the need for evaluate their knowledge about research ethics and misconduct issues. This study carried out through Facebook group contains all sixth year medical students at the University of Jordan to evaluate medical students’ knowledge about research ethics using an adopted questionnaire of 3 parts. 158 (39.5%) out of 400 students answered the questionnaire 107 (67.3%) were females and 52 (32.7) were males, only 18 (11.4%) of them had attended extra courses, and 23 (14.6%) had co-authored published manuscript, 129 (81.6%) of them had heard about research ethics, while most of them knew that publication ethics in research are an essential elements of paper writing, their knowledge about other aspects vary from about 4.4% for the time researcher need to wait before resubmit the manuscript again and 42.8% for plagiarism definition. A score of ten had been calculated for each student with an average of 2.4 and median of 3. In conclusion, the students need more training on research ethics and misconduct as their knowledge about it was inadequate.","PeriodicalId":39681,"journal":{"name":"Jordan Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44193705","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}
Objective: To describe the change in angle deviation, treatment effectiveness, overall safety, and cost effectiveness of the use of a single botulinum toxin injection session in the treatment of strabismus.Methods: A retrospective analysis at a tertiary hospital in Amman, Jordan, to identify 29 patients who received a single botulinum toxin injection as a treatment of strabismus between October 2017 and March 2019. The outcome was determined by the improvement of the angle of deviation and avoidance of conventional muscle surgery. The safety profile was determined according to the incidence of adverse effects,such as overcorrection and ptosis. The economic profile included the medical and non-medical costs.Results: The average of the total angles of deviation for the whole group improved in the first assessment visit in the first week post injection from 38.97 to 19.48 prism diopter (PD). However, the deviation started to increase after the first month and continued to increase, reaching 27.93 PD in the sixth month post injection follow up. About five of the 29 patients (17.2%) had a successful outcome (angle of deviation equal to or less than 10 PD) in the sixth month post injection, while around seven of the 29 patients (24.1%) had a partial improvement and 17 of the 29 patients (58.7%) had no improvement. Only two patients (6.8%) developed overcorrection. None of the patients developed ptosis or other adverse effects after injection. The total average cost of treatment, including medical and non-medical costs, was $410. The average medical cost was $305, while the non-medical cost was $105. Conclusion: The use of a single botulinum toxin injection for treating strabismus is an effective, safe, and quick procedure to treat strabismus in some patients, especially those with mild and moderate angles of deviation. However, due to the temporary effect of the drug, it needs to be repeated for some patients and thus may be unsatisfactory in some circumstances.
{"title":"A Single Botulinum Toxin Injection in the Treatment of Strabismus: A Retrospective Analysis of 29 Patients","authors":"R. Shatnawi","doi":"10.35516/jmj.v56i2.242","DOIUrl":"https://doi.org/10.35516/jmj.v56i2.242","url":null,"abstract":"Objective: To describe the change in angle deviation, treatment effectiveness, overall safety, and cost effectiveness of the use of a single botulinum toxin injection session in the treatment of strabismus.Methods: A retrospective analysis at a tertiary hospital in Amman, Jordan, to identify 29 patients who received a single botulinum toxin injection as a treatment of strabismus between October 2017 and March 2019. The outcome was determined by the improvement of the angle of deviation and avoidance of conventional muscle surgery. The safety profile was determined according to the incidence of adverse effects,such as overcorrection and ptosis. The economic profile included the medical and non-medical costs.Results: The average of the total angles of deviation for the whole group improved in the first assessment visit in the first week post injection from 38.97 to 19.48 prism diopter (PD). However, the deviation started to increase after the first month and continued to increase, reaching 27.93 PD in the sixth month post injection follow up. About five of the 29 patients (17.2%) had a successful outcome (angle of deviation equal to or less than 10 PD) in the sixth month post injection, while around seven of the 29 patients (24.1%) had a partial improvement and 17 of the 29 patients (58.7%) had no improvement. Only two patients (6.8%) developed overcorrection. None of the patients developed ptosis or other adverse effects after injection. The total average cost of treatment, including medical and non-medical costs, was $410. The average medical cost was $305, while the non-medical cost was $105. Conclusion: The use of a single botulinum toxin injection for treating strabismus is an effective, safe, and quick procedure to treat strabismus in some patients, especially those with mild and moderate angles of deviation. However, due to the temporary effect of the drug, it needs to be repeated for some patients and thus may be unsatisfactory in some circumstances.","PeriodicalId":39681,"journal":{"name":"Jordan Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46926064","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}
In nuclear medicine, theranostics (combining therapy and diagnostics in one platform) is made possible through the utilization of radiopharmaceuticals for both therapeutic and diagnostic purposes by targeting one specific tumor receptor or certain molecular pathway.To make radiopharmaceuticals biologically relevant compounds, receptor ligands must be labeled with radionuclides. The possible applications are multifold and include: in vivo visualization of tumor biology; diagnosis and tumor staging; therapy planning and treatment of specific tumors.The application of theranostics results in giving the right treatment to the right patient at the right time, which is expected to improve therapeutic efficacy and increase overall compliance to therapy. For example, theranostics can be used to determine the heterogeneity of cancer lesions, which is one of the most difficult aspects of therapeutic success, allow the identification of patients who will benefit from therapy, avoid unnecessary conventional therapies, and implement salvage treatments for those who need them.The use of theranostics has seen unprecedented value for cancer patients in the last decade. Several radiopharmaceuticals are currently in use in clinical practice (e.g., [68Ga/177Lu] DOTATATE), while dozens more are still in the preclinical stages.The goal of this review article is to cover the current and future status of nuclear theranostics, particularly in the Arab world, with a focus on expanding the discipline beyond neuroendocrine tumors, castration-resistant prostate cancers, and differentiated thyroid cancers. Furthermore, representatives from different Arab countries were invited to describe their recent understanding and contributions to drive innovation in this evolving field.
{"title":"Theranostics in the Arab World; Achievements & Challenges","authors":"Akram Al-Ibraheem, A. Abdlkadir","doi":"10.35516/jmj.v56i2.243","DOIUrl":"https://doi.org/10.35516/jmj.v56i2.243","url":null,"abstract":"In nuclear medicine, theranostics (combining therapy and diagnostics in one platform) is made possible through the utilization of radiopharmaceuticals for both therapeutic and diagnostic purposes by targeting one specific tumor receptor or certain molecular pathway.To make radiopharmaceuticals biologically relevant compounds, receptor ligands must be labeled with radionuclides. The possible applications are multifold and include: in vivo visualization of tumor biology; diagnosis and tumor staging; therapy planning and treatment of specific tumors.The application of theranostics results in giving the right treatment to the right patient at the right time, which is expected to improve therapeutic efficacy and increase overall compliance to therapy. For example, theranostics can be used to determine the heterogeneity of cancer lesions, which is one of the most difficult aspects of therapeutic success, allow the identification of patients who will benefit from therapy, avoid unnecessary conventional therapies, and implement salvage treatments for those who need them.The use of theranostics has seen unprecedented value for cancer patients in the last decade. Several radiopharmaceuticals are currently in use in clinical practice (e.g., [68Ga/177Lu] DOTATATE), while dozens more are still in the preclinical stages.The goal of this review article is to cover the current and future status of nuclear theranostics, particularly in the Arab world, with a focus on expanding the discipline beyond neuroendocrine tumors, castration-resistant prostate cancers, and differentiated thyroid cancers. Furthermore, representatives from different Arab countries were invited to describe their recent understanding and contributions to drive innovation in this evolving field.","PeriodicalId":39681,"journal":{"name":"Jordan Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46324073","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}
Background Aims: The study aimed to examine the frequency of hypothyroidism among patients with macrocytic anemia and to compare this with the frequency of megaloblastic anemia.Materials and Methods: Routinely transferred specimens for a complete blood count test were sent to the hematology lab in our institution and prospectively screened for high mean cell volume (MCV). A total of 100 cases with macrocytosis were examined for the levels of thyroid stimulating hormone (TSH), vitamin B12 and folate levels. Statistical analysis was performed to investigate a potential association between hypothyroidism and other variables. Results: There were 52 women and 48 men. The range of age was 21–83, with a mean of 59 years. The mean MCV was 104.18 fL, while the mean hematocrit was 35.96%. Fifty-three (53%) patients had anemia. Eighteen (18%) patients had TSH level above the normal range qualifying for hypothyroidism. Among these, eight (44%) had low hematocrit and six (33%) a concomitant megaloblastic anemia. The presence of high TSH level did not show a statistically significant correlation with gender, age, vitamin B12, folate or hematocrit levels.Conclusions: Hypothyroidism is commonly present in patients with macrocytosis. Its frequency is comparable with megaloblastic anemia, and both can occur simultaneously. Routine TSH level testing is recommended in patients with macrocytosis even if hematocrit level is normal or if the patient has megaloblastic anemia.
{"title":"Thyroid Stimulating Hormone in Patients with Macrocytic Anemia","authors":"T. Aladily","doi":"10.35516/jmj.v56i2.241","DOIUrl":"https://doi.org/10.35516/jmj.v56i2.241","url":null,"abstract":"Background Aims: The study aimed to examine the frequency of hypothyroidism among patients with macrocytic anemia and to compare this with the frequency of megaloblastic anemia.Materials and Methods: Routinely transferred specimens for a complete blood count test were sent to the hematology lab in our institution and prospectively screened for high mean cell volume (MCV). A total of 100 cases with macrocytosis were examined for the levels of thyroid stimulating hormone (TSH), vitamin B12 and folate levels. Statistical analysis was performed to investigate a potential association between hypothyroidism and other variables. Results: There were 52 women and 48 men. The range of age was 21–83, with a mean of 59 years. The mean MCV was 104.18 fL, while the mean hematocrit was 35.96%. Fifty-three (53%) patients had anemia. Eighteen (18%) patients had TSH level above the normal range qualifying for hypothyroidism. Among these, eight (44%) had low hematocrit and six (33%) a concomitant megaloblastic anemia. The presence of high TSH level did not show a statistically significant correlation with gender, age, vitamin B12, folate or hematocrit levels.Conclusions: Hypothyroidism is commonly present in patients with macrocytosis. Its frequency is comparable with megaloblastic anemia, and both can occur simultaneously. Routine TSH level testing is recommended in patients with macrocytosis even if hematocrit level is normal or if the patient has megaloblastic anemia.","PeriodicalId":39681,"journal":{"name":"Jordan Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48095155","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-Tamimi, Hadeel Albalawi, Walaa Isied, Ahmad Musallam, Fatima Qazzaz, M. Azab, Jumana Abu-raideh
Background: Antibiotic resistance is expanding worldwide at alarming rates. Middle East countries including Jordan have high prevalence of antibiotic resistance. Aims: The main aims of this review are to summarize the situation with Gram-positive bacterial infections and antibiotic resistance in Jordan, identify areas where further investigation is required, and suggest strategies to combat antibiotic resistance. Methods: A systematic literature search was conducted by two independent researchers using general and specific combinations of MeSH search terms using Embase, PubMed, Web of Science, and Google Scholar databases. Results: Staphylococci and Streptococci were commonly isolated from environmental, animal, and human samples, while Staphylococci, Enterococci, and Listeria were commonly isolated from food. Staphylococci, Streptococci, and Enterococci human colonization were documented at variable but high rates. Methicillin-resistant S. aureus (MRSA) and methicillin-resistance coagulase-negative Staphylococci (MR-CoNS) infections were common with high rates of antibiotic resistance. S. pneumoniae showed increased resistance rates to most antimicrobials. Enterococci and C. difficile resistance rates were moderate, while group B Streptococci (GBS), viridans group streptococci (VGS), C. perfringens and L. monocytogenes antibiotic susceptibility patterns were not reported. All MRSA and vancomycin-resistant Enterococci (VRE) isolates were mec-A positive, while resistance genes among CoNS, S. pneumoniae, S. pyogenes, S. agalactia, C. perfringens, and L. monocytogenes were not investigated. Conclusions: Gram-positive bacterial infections and antibiotic resistance rates were high in Jordan. Molecular epidemiology studies, a nationwide surveillance program, and action plans are urgently required to combat antibiotic resistance.
背景：抗生素耐药性正在以惊人的速度在全球范围内扩大。包括约旦在内的中东国家抗生素耐药性的流行率很高。目的：本综述的主要目的是总结约旦革兰氏阳性细菌感染和抗生素耐药性的情况，确定需要进一步调查的领域，并提出对抗抗生素耐药性的策略。方法：由两名独立研究人员使用Embase、PubMed、Web of Science和Google Scholar数据库，使用MeSH搜索词的一般和特定组合进行系统的文献搜索。结果：葡萄球菌和链球菌通常从环境、动物和人类样本中分离，而葡萄球菌、肠球菌和李斯特菌通常从食物中分离。葡萄球菌、链球菌和肠球菌的人类定植率虽然不同，但很高。耐甲氧西林金黄色葡萄球菌（MRSA）和耐甲氧青霉素凝固酶阴性葡萄球菌（MR-CoNS）感染常见，抗生素耐药性高。肺炎链球菌对大多数抗菌药物的耐药性增加。肠球菌和艰难梭菌的耐药率中等，而B组链球菌（GBS）、病毒性链球菌（VGS）、产气荚膜梭菌和单核细胞增多性李斯特菌的抗生素敏感性模式尚未报道。所有耐甲氧西林金黄色葡萄球菌（MRSA）和耐万古霉素肠球菌（VRE）分离株均为mec-A阳性，而CoNS、肺炎链球菌、化脓性链球菌、无乳链球菌、产气荚膜梭菌和单核细胞增多性李斯特菌中的耐药基因未进行研究。结论：约旦的革兰氏阳性菌感染率和抗生素耐药性较高。迫切需要分子流行病学研究、全国监测计划和行动计划来对抗抗生素耐药性。
{"title":"Gram-Positive Bacterial Infections and Antibiotics Resistance in Jordan: Current Status and Future Perspective","authors":"M. Al-Tamimi, Hadeel Albalawi, Walaa Isied, Ahmad Musallam, Fatima Qazzaz, M. Azab, Jumana Abu-raideh","doi":"10.35516/jmj.v56i1.219","DOIUrl":"https://doi.org/10.35516/jmj.v56i1.219","url":null,"abstract":"Background: Antibiotic resistance is expanding worldwide at alarming rates. Middle East countries including Jordan have high prevalence of antibiotic resistance. \u0000Aims: The main aims of this review are to summarize the situation with Gram-positive bacterial infections and antibiotic resistance in Jordan, identify areas where further investigation is required, and suggest strategies to combat antibiotic resistance. \u0000Methods: A systematic literature search was conducted by two independent researchers using general and specific combinations of MeSH search terms using Embase, PubMed, Web of Science, and Google Scholar databases. \u0000Results: Staphylococci and Streptococci were commonly isolated from environmental, animal, and human samples, while Staphylococci, Enterococci, and Listeria were commonly isolated from food. Staphylococci, Streptococci, and Enterococci human colonization were documented at variable but high rates. Methicillin-resistant S. aureus (MRSA) and methicillin-resistance coagulase-negative Staphylococci (MR-CoNS) infections were common with high rates of antibiotic resistance. S. pneumoniae showed increased resistance rates to most antimicrobials. Enterococci and C. difficile resistance rates were moderate, while group B Streptococci (GBS), viridans group streptococci (VGS), C. perfringens and L. monocytogenes antibiotic susceptibility patterns were not reported. All MRSA and vancomycin-resistant Enterococci (VRE) isolates were mec-A positive, while resistance genes among CoNS, S. pneumoniae, S. pyogenes, S. agalactia, C. perfringens, and L. monocytogenes were not investigated. \u0000Conclusions: Gram-positive bacterial infections and antibiotic resistance rates were high in Jordan. Molecular epidemiology studies, a nationwide surveillance program, and action plans are urgently required to combat antibiotic resistance.","PeriodicalId":39681,"journal":{"name":"Jordan Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46794856","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}
Nuha Qasem, M. Al-ali, Md. Sanwar, Mohammad Aquily
Background During public health emergencies, the major efforts of policy makers are directed towards physical and medical consequences, and little is directed towards the psychological impact of these outbreaks. Aim To assess the psychological impact and mental health effects of the current pandemic of Corona virus (COVID 19) on the general population in Jordan. Methodology A cross-sectional study was conducted using an online survey directed towards the general population in Jordan during the period March 25th to April 2nd, 2020. Mental health effect was measured using the Arabic version of the Depression, Anxiety and Stress Scale (DASS-21), while the psychological impact was measured using questions from the Arabic version of the Impact of Event Scale-Revised (IES-R). Total number of respondents was 1946. Results The levels of depression, anxiety and stress as measured by DASS-21 questionnaire showed that 13% had severe depression, 10% had severe anxiety, and 6.3% had severe stress. There was more psychological impact compared with mental health effects on the study population, as more than quarter of the sample (26.7%) reported severe psychological impact (score >38). Factors associated with higher psychological impact and mental health effects include younger age group, being female, childless, living in the remote areas, being a bachelor’s degree student or graduate, having low monthly income and having physical symptoms in the 14 days prior to the study. Conclusion Findings of this study can inspire health projects at the national level to better deal with these psychological issues in response to the current or any future health emergencies in Jordan.
{"title":"Psychological impact and mental health effect of COVID-19 among Jordanian population","authors":"Nuha Qasem, M. Al-ali, Md. Sanwar, Mohammad Aquily","doi":"10.35516/jmj.v56i1.218","DOIUrl":"https://doi.org/10.35516/jmj.v56i1.218","url":null,"abstract":"Background \u0000During public health emergencies, the major efforts of policy makers are directed towards physical and medical consequences, and little is directed towards the psychological impact of these outbreaks. \u0000Aim \u0000To assess the psychological impact and mental health effects of the current pandemic of Corona virus (COVID 19) on the general population in Jordan. \u0000Methodology \u0000A cross-sectional study was conducted using an online survey directed towards the general population in Jordan during the period March 25th to April 2nd, 2020. Mental health effect was measured using the Arabic version of the Depression, Anxiety and Stress Scale (DASS-21), while the psychological impact was measured using questions from the Arabic version of the Impact of Event Scale-Revised (IES-R). Total number of respondents was 1946. \u0000Results \u0000The levels of depression, anxiety and stress as measured by DASS-21 questionnaire showed that 13% had severe depression, 10% had severe anxiety, and 6.3% had severe stress. There was more psychological impact compared with mental health effects on the study population, as more than quarter of the sample (26.7%) reported severe psychological impact (score >38). \u0000Factors associated with higher psychological impact and mental health effects include younger age group, being female, childless, living in the remote areas, being a bachelor’s degree student or graduate, having low monthly income and having physical symptoms in the 14 days prior to the study. \u0000Conclusion \u0000Findings of this study can inspire health projects at the national level to better deal with these psychological issues in response to the current or any future health emergencies in Jordan.","PeriodicalId":39681,"journal":{"name":"Jordan Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44681185","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. A. Al Sheikh, Z. Aslam, D. Curry, A. Wahaily, Abed Al-Mula O, A. Thwaini
Objective A clear resection margin is one of the trifecta outcomes in partial nephrectomy. We proposed a positive surgical margin scoring system and implemented it in our cases to assess its effect on the oncological outcomes.MethodsRetrospective review of prospectively collected multi-center data was performed for all the partial nephrectomy (PN) procedures performed between April 2009 and August 2019. Demographic data, RENAL nephrometry score, peri-operative data and margin status were collected. Positive surgical margin (PSM) cases were given a scoring system of I, II and III for PSM that are <3mms, 3-5mms and >5 mms, respectively. Postoperative, oncological results and adverse events were using Stats Direct. Data analysis was performed using t-test. Comparative data between the two groups was calculated using z-score calculator. p values of 0.05 or less were considered statistically significant.Results A total of 339 PN procedures were performed for histologically proven renal cancer. Forty four patients had PSM. There were 17, 16 and 11 patients with score I, II and III PSM, respectively. Those with a high RENAL nephrometry score had the highest rate of PSM (n=21) as opposed to the intermediate (n=13) and the low (n=10) score groups. After an average follow up of 38 months (10-132), a total of 21 recurrences were recorded; 14 had clear resection margins, 7 were PSM (PSM-I=1. PSM-II=2, PSM-III=4, respectively). ConclusionOverall patients with PSM status have a low chance of recurrent or metastatic disease although those with a wider PSM (III) have a higher chance of recurrent and/or metastatic disease. Tumour grade and pathological T-stage are independent factors for recurrence/metastasis. Larger cohort and longer follow up would be recommended.
{"title":"Scoring the Positive Margin Status in Partial Nephrectomy","authors":"M. A. Al Sheikh, Z. Aslam, D. Curry, A. Wahaily, Abed Al-Mula O, A. Thwaini","doi":"10.35516/jmj.v56i1.229","DOIUrl":"https://doi.org/10.35516/jmj.v56i1.229","url":null,"abstract":"Objective A clear resection margin is one of the trifecta outcomes in partial nephrectomy. We proposed a positive surgical margin scoring system and implemented it in our cases to assess its effect on the oncological outcomes.MethodsRetrospective review of prospectively collected multi-center data was performed for all the partial nephrectomy (PN) procedures performed between April 2009 and August 2019. Demographic data, RENAL nephrometry score, peri-operative data and margin status were collected. Positive surgical margin (PSM) cases were given a scoring system of I, II and III for PSM that are <3mms, 3-5mms and >5 mms, respectively. Postoperative, oncological results and adverse events were using Stats Direct. Data analysis was performed using t-test. Comparative data between the two groups was calculated using z-score calculator. p values of 0.05 or less were considered statistically significant.Results A total of 339 PN procedures were performed for histologically proven renal cancer. Forty four patients had PSM. There were 17, 16 and 11 patients with score I, II and III PSM, respectively. Those with a high RENAL nephrometry score had the highest rate of PSM (n=21) as opposed to the intermediate (n=13) and the low (n=10) score groups. After an average follow up of 38 months (10-132), a total of 21 recurrences were recorded; 14 had clear resection margins, 7 were PSM (PSM-I=1. PSM-II=2, PSM-III=4, respectively). ConclusionOverall patients with PSM status have a low chance of recurrent or metastatic disease although those with a wider PSM (III) have a higher chance of recurrent and/or metastatic disease. Tumour grade and pathological T-stage are independent factors for recurrence/metastasis. Larger cohort and longer follow up would be recommended.","PeriodicalId":39681,"journal":{"name":"Jordan Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45534695","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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