Background and Aims: Continuing Professional Development (CPD) is essential for healthcare professionals to sustain and enhance their knowledge, skills, and competencies. Despite its global importance, CPD awareness and implementation among healthcare professionals remain limited. This study explored doctors' perceptions of CPD in Jordan and identified key barriers to their engagement. Subjects and Methods: This cross-sectional study used an online questionnaire which was distributed to Jordanian doctors following CPD-focused educational lectures. A total of 510 doctors from various specialties participated. The survey collected demographic data including workplace and years of experience, and assessed CPD awareness, attitudes, participation levels, and barriers against engagement. Descriptive statistics were used for analysis. Results: Among 510 respondents, 95% expressed interest in CPD, yet 55.4% were unaware of the required CPD hours. While 96% were willing to attend future CPD activities, only 39% considered non-CPD-accredited events. Reported barriers included time constraints (39%), work-related challenges (80%), and financial limitations (17%). Preferred learning formats included workshops (71.7%) and international conferences (67%). Conclusion: The study highlighted the strong interest in CPD among Jordanian doctors and critical gaps in awareness and participation, primarily due to logistical and financial constraints. Addressing these barriers and enhancing CPD guidelines could foster greater engagement and contribute to improved healthcare standards in Jordan.
Background: Postpartum depression (PPD) is a major public health concern on a global scale. It is one of the most frequent postpartum problems, but it frequently remains undiagnosed and untreated. It can have detrimental repercussions on the mother, the child, and the family. Aim: To explore the perceptions and knowledge towards postpartum depression risk factors in the Jordanian community in order to assess knowledge gaps on several elements of post-partum depression (PDD), and measure the association between several demographic characteristics and public understanding of and stigma around PDD. Methods: This was a cross section survey conducted between the 26th of January 2024 and 5th of March 2024, utilizing face-to-face and online questionnaires. Our questionnaire consisted of 37 questions which included demographic factors in addition to attitudes toward certain medical and cultural and psychological risk factors and predisposing factors. Inclusion criteria were both married and single Jordanian individuals with a total of 867 participants who agreed to participate in this study; exclusion criteria were individuals below 18 years of age. Results: A study of 867 participants, mostly women, assessed their awareness of postpartum depression (PPD) based on their marital status. The majority (73%) were married, and they were more likely to say "I don't know" when asked about PPD. Never-married participants reported being single, young, and uneducated mothers, which increased their chances of developing PPD. They identified psychiatric illnesses, undesired pregnancies, hereditary factors, and financial difficulties as risk factors. Never-married individuals exhibited more negative perceptions of sociodemographic characteristics that influence PPD risk, such as work level, polygamy, housing, and living with in-laws. However, married participants rated social support and postpartum variables higher than single ones, with 60% believing that PPD is more likely without family support. They also believed postpartum complications, sleep quality, and breastfeeding were related to PDD. Conclusions: The study emphasizes the need for educational screening campaigns to raise awareness about postpartum depression, improve mental health literacy, and address stigmas. It suggests targeting support systems like partners, parents, and in-laws, and promoting social support for undiagnosed mothers with PDD. Regular prenatal care visits should also include depression screening for married individuals since they displayed lack of knowledge.
Background: TSH is a commonly used laboratory test, further data are needed to determine if specific reference ranges are needed based on gender, age, body weight, feeding status and smoking. Objective: To investigate the effect of age, gender, body mass index (BMI), food intake, and smoking on serum Thyroid Stimulating Hormone (TSH) levels among healthy adults. Methods: One-hundred healthy adults (46 males and 54 females) aged ≥ 18 years were recruited. Serum TSH levels were measured after a 9-hour overnight fast, one hour postprandially (early), and three hours postprandially (late). Results: Mean TSH levels were not statistically different in females in the fasting, early and late postprandial states compared to males. TSH levels were suppressed significantly after food intake in both females and males. Mean TSH levels were significantly higher in younger individuals (< 30 years) in the fasting and the postprandial states compared to older individuals (≥ 30 years), TSH levels were suppressed significantly after food intake in both age groups. Mean TSH levels were not significantly different between individuals with normal BMI (< 25 kg /m2) and those with overweight and obesity (BMI ≥ 25 kg/m2), in the fasting or early postprandial states, compared to those however TSH levels were significantly lower in subjects with normal BMI in the late postprandial state. TSH levels were suppressed significantly after food intake in both BMI groups. The mean fasting and postprandial TSH levels did not differ significantly according to smoking status. TSH levels were suppressed significantly after food intake in both smoking groups. Conclusion: Our data suggest that age, BMI and food intake should be considered when serum TSH level is measured in clinical practice
Background: Painful Diabetic Peripheral Neuropathy (PDPN) is a common but often overlooked complication of Type 2 Diabetes Mellitus (T2DM) that greatly affects patients’ quality of life. However, little is known about its prevalence and related factors in Jordanian patients with confirmed Diabetic Peripheral Neuropathy (DPN). Objectives: This study aimed to determine the prevalence of PDPN among patients with T2DM and confirmed DPN, and to investigate its association with specific demographic and clinical factors. Methods: A cross-sectional study was conducted from January to March 2025 at the National Center for Diabetes, Endocrinology, and Genetics in Jordan. A total of 1,102 patients with T2DM and physician-confirmed DPN participated. Data were collected through face-to-face interviews and medical records. The Arabic version of the DN4 questionnaire was used to identify PDPN, while pain severity was measured using a numeric rating scale. Results: PDPN was found in 42.9% of patients. Among those affected, 9.3% reported mild pain, 53.7% moderate pain, and 37% severe pain. Female patients had a 54% higher chance of having PDPN compared to males. Patients older than 65 were less likely to have PDPN than those under 60. Poor blood sugar control (HbA1c >8%), cardiovascular disease, and diabetic retinopathy were linked to higher PDPN risk. Despite this, only 43.6% of PDPN patients used pain medication. Conclusion: PDPN is common among Jordanian patients with T2DM and DPN. Regular screening and personalized treatment are important to manage this painful condition. Understanding the key risk factors can help improve patient care and quality of life.
Background and Aims: Social media has become an important part of university students’ lives. This study investigated the influence of social media addiction (SMA) and usage on disordered eating attitudes (EA), physical activity (PA), body shape concern (BSC), and appreciation among university students. Materials and Methods: Utilizing a cross-sectional design from three public universities in Amman-Jordan, a total of 557 students was enrolled via online Google Form in March 2024. The Arabic selected scales were SMA and usage, disordered EA, PA, body shape, and body appreciation. Results: Findings suggest a negative correlation between SMA and PA levels, with fitness influencers playing a role in motivating students towards PA. Higher disordered EA, BSC, and lower body appreciation were significantly associated with increased use of social media (p < 0.05). Disordered EA and body appreciation were associated with a higher level of PA. Furthermore, the higher SMA, body shape concern, and BMI, the lower body appreciation (p < 0.05). Conclusions: The rise in social media usage has had a negative effect on PA and body shape and appreciation among university students.
Background: Colon cancer is the fourth most commonly diagnosed cancer worldwide, with elderly individuals accounting for nearly one-third of new cases. While adjuvant chemotherapy has been associated with improved survival outcomes; its effectiveness in elderly patients remains unclear. This retrospective study was conducted to assess the efficacy of adjuvant chemotherapy in elderly patients with stage 3 colon cancer. Methods: We identified all patients aged 70 years or older with stage 3 colon cancer who were treated and followed at King Hussein Cancer Center (KHCC) in Amman, Jordan between 2015 and 2020. Intramural KHCC funding was granted for MMR testing in patients who received adjuvant chemotherapy. Descriptive and survival analyses were performed in JASP 0.95.4 software. Results: A total of 66 patients were included. The median age at diagnosis was 73 years, and 39.3% were females. 74.2% had T3 tumors, and 69.6% had N1 disease. Adjuvant chemotherapy was administered to 71.2% (n=47) of patients, including 14 with deficient MMR status. Five-year overall survival (OS) favored patients treated with adjuvant chemotherapy compared with those who did not, although the difference was not statistically significant (80.3% vs 71.9%; HR 0.71, 95% CI 0.23–2.16; P = 0.538). Among patients treated with adjuvant chemotherapy, 5-year OS was 83.4% with Oxaliplatin-doublet therapy versus 70.7% with single-agent 5-FU based therapy (HR 0.59, 95% CI 0.14-2.44; P = 0.460). Additionally, there was no significant OS difference observed between different chemotherapy regimens after stratification by MMR status (P = 0.271). Conclusions: In this single-center cohort, adjuvant chemotherapy demonstrated a non-significant trend toward improved overall survival among elderly patients with stage III colon cancer; however, interpretation was limited by the small sample size.
Introduction: Individuals experiencing various psychiatric conditions may face an elevated likelihood of developing metabolic syndrome. Regrettably, the proactive efforts for primary prevention of cardiovascular diseases in psychiatric patients are often overlooked in both clinical practice and clinical research. The efficacy of statins in treating dyslipidemic psychiatric patients mirrors their effectiveness in other clinical trial settings, so statin therapy should be employed when indicated. Methods: The study was conducted at Jordan University Hospital with 134 participants from the psychiatry clinic. Patients' demographics, exercise habits, smoking history, family medical history, prescription usage, and medical records, including lipid profiles and HbA1c values, were all gathered. Results: The total number of the included patients was 134. Our findings showed that 39.8% of participants had hypercholesterolemia, and 34.6% exhibited elevated low-density lipoprotein cholesterol (LDL-C) levels. Hypercholesterolemia correlated with a longer mean duration of mental disorder diagnosis (P=0.024). Elevated LDL levels were associated with higher age (P=0.015) and users of SSRIs (P=0.009). Gender differences emerged in high triglycerides (TG), with a significantly higher percentage in males (53.2% vs 13.6%, P=0.000). Patients with psychotic disorders had a notably higher prevalence of high TG (P=0.035). Regarding low HDL, males (P=0.000) and smokers (31.3% vs 15.3%, P=0.027) exhibited a higher prevalence. Conclusion: Our findings show a significant prevalence of hyperlipidemia among psychiatric patients, which is impacted by characteristics such as smoking, male gender, advanced age, psychotic illnesses, length of diagnosis, and antipsychotic and SSRIs usage. These observations underscore the importance of enhanced screening by clinicians in psychiatry clinics to proactively address potential complications arising from dyslipidemia in this patient population
Background: White phosphorus exposure entails severe health hazards that require emergency nurses to possess specific knowledge and skill sets. This study examines the knowledge and practices of emergency nurses in Saïda, Lebanon, regarding white phosphorus exposure management, identifying gaps and recommending improvements to enhance patient care and safety in emergency settings. Methods: A cross-sectional survey was conducted in September 2024, among 121 nurses working in emergency departments in Saïda, Lebanon. Data were collected using a self-administered structured questionnaire consisting of both multiple-choice and open-ended questions and were analyzed using SPSS. Knowledge and practice scores were calculated, and statistical analyses were performed to identify significant associations. Results: The results show that 55.4% of participants demonstrated low levels of knowledge, while 65.3% had inadequate practices in managing white phosphorus exposure. A significant positive correlation was observed between knowledge and practice scores (r = 0.604, p < 0.001). Education level was significantly associated with knowledge (p = 0.011), with nurses holding a bachelor's or master's degree achieving higher scores. Participants who had received specific training on hazardous substances also had higher practice levels (p = 0.008). Among the main obstacles identified, 61.2% of nurses reported a lack of training, while 45.5% mentioned inadequate protocols and 35.5% cited insufficient equipment. Conclusion: This study highlights significant gaps in nurses' knowledge and practices regarding white phosphorus exposure. It emphasizes the need to strengthen targeted training programs, standardize management protocols, and improve access to material resources to ensure effective patient care.
Background: The relationship between loneliness, depression and dementia has gained attention post-pandemic. This study aimed to understand the relationship between loneliness, depression and dementia during the COVID-19 pandemic lockdown. Objective: To compare the prevalence and predictors of depression and loneliness among community-dwelling older adults with and without dementia during Jordan's initial COVID-19 lockdown. Methods: A cross-sectional telephone survey was conducted three weeks post-lockdown (2020) with 456 older adults (94 PLWD, 362 without dementia). Loneliness and depression were assessed using the 3-item UCLA Loneliness Scale, and the Geriatric Depression Scale-15, respectively. Multivariate linear regression identified predictors of depression, stratified by cognitive status. Results: Compared to patients without dementia, PLWD were significantly older (74.00 ±7.80 vs. 72.09 ±6.52, P = 0.030), and with functional dependence (P < 0.001), multi-morbidity (P < 0.001), polypharmacy (P < 0.001), and with poorer subjective health (P = 0.001). The prevalence of loneliness in PLWD (47.9%) was not significantly different from non-dementia patients (39.8%), P =0.156. Nonetheless, PLWD had significantly higher means of loneliness scores before (P=0.001), and during lockdown (P=0.02), and higher depression rates than patients without dementia (54.3% vs. 32.6%, P<0.001). Among patients without dementia, independent predictors of depression included higher loneliness scores, past history of depression, lower educational attainment, poorer subjective health, and greater fear of COVID-19 infection. In contrast, among PLWD, depressive symptoms were significantly predicted by loneliness and past history of depression, whereas fear of COVID-19 infection and subjective health were not significant predictors. Conclusion: Depression in PLWD during the pandemic was linked to enduring vulnerabilities—pre-existing loneliness and depression—rather than acute pandemic fears. Interventions should shift from general reassurance to proactive, integrated psychosocial support within dementia care.
Background: The recent attention highlighted on healthcare research has pressured researchers to publish high volume of articles to enhance personal benefits, forcing some of them to use unethical practices to withstand in a such competitive environment, falling in “publish or perish” pressure. Consequently, there was a global rise in the number of articles retractions, which is one of the parameters utilized in "RI² Research Integrity Risk Index". Most Jordanian universities were classified as red-flag according to RI². Our objective is to analyze retracted Jordanian-affiliated health-sciences articles to help Jordanian institutions to assess and prevent unethical practices and improve integrity policies. Methods: All retracted health-sciences articles with at least one affiliation with a Jordanian institute were extracted from the Retraction Watch Database. The articles were double screened for information about the number of Jordanian authors and their affiliations, along with information from the database. Retraction notes were reviewed to identify and classify the retraction reason(s). Authors were further classified by academic status. Descriptive statistics and data analysis were done using Microsoft Power BI. Results: A total of eighty-two articles were included; most were original research (n=62). Sixty-two papers involved international coauthors, and 48 were first-authored by Jordan-affiliated researchers. Out of total of 537 total authors, 143 were affiliated with Jordanian institutes. Retractions were heavily time-clustered, with 81.7% (n=67) occurring in 2021–2024. At the journal level, Cureus accounted for the largest single count (n=15), most (n=12) were case reports. Number of retractions per institution was as follows: Jordan University of Science and Technology (n=22), Amman Arab University (n=12), Ajloun National University (n=10), and the University of Jordan (n=9). We identified 16 retractions involving undergraduate authors without documented same-institution faculty supervision; 12 of which were case reports. Retractions were attributed to inadequate peer review (n=45), concerns about content/data (n=43), followed by paper-mill/authorship-for-sale (n=15), plagiarism (n=6), publisher error (n=4) and approval issues (n=2). And "others" (n=6). Conclusions: The study analyzed retracted health research in Jordan to uncover the main causes and suggest ways to strengthen research integrity. It found a marked rise in retractions after 2020 and highlighted links with student projects and open-access publishing. The authors recommend using the RI² index as an early warning tool (not a stigma) and encouraging quality-over-quantity rewards to reduce pressure on researchers and students.
Introduction: Although insulin plays a vital role in managing blood sugar levels, many patients are reluctant or unwilling to start insulin therapy. This hesitation stems from a range of factors—demographic, psychological, social, financial, and clinical. While these barriers have been well-documented internationally, limited research has explored them in the Jordanian context. Aim: This study will investigate the factors influencing insulin refusal among Jordanian patients with type 2 diabetes mellitus (T2DM). By identifying the main barriers, we hope to support the development of targeted strategies that improve insulin acceptance, patient adherence, and overall diabetes care in Jordan. Methodology: A cross-sectional study was conducted at Jordan University Hospital, involving 1,010 adult T2DM patients selected through systematic random sampling. Data were collected via structured, face-to-face interviews led by sixth-year medical students using a validated questionnaire adapted from Ghadiri-Anari et al. (2013). Data analysis was performed using SPSS. Results: Among the participants, 27.4% declined insulin therapy, while 17.4% expressed hesitation. Insulin refusal was significantly associated with gender, age, education, and income, whereas factors like duration of diabetes and family history showed no significant association. The most cited reason for refusal was the belief that starting insulin signified worsening disease (40%), followed by fear of hypoglycemia (34.8%) and weight gain (27.9%). Notably, 72.4% of patients did not consider insulin cost a barrier. Conclusion: Insulin refusal among Jordanian patients with T2DM is shaped by a multifaceted set of influences. Demographic variables such as age, gender, and education level significantly affect patient attitudes. Psychological concerns—especially fear of injections and hypoglycemia—also play a key role. While cost was less of a concern for most patients, lower income still showed some association with refusal. These findings highlight the need for patient-centered interventions and awareness campaigns that address fears, correct misconceptions, and support informed decision-making. Further longitudinal studies are recommended to explore how these attitudes evolve over time.
Objective: Testosterone plays a significant role in kidney function. Both hypogonadism and hypergonadism, which can affect testosterone levels, have been associated with alterations in kidney function. This review provides a comprehensive and up-to-date overview of the potential impact of testosterone therapy on kidney function among male patients. Method: We conducted a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Comprehensive search through Scopus, Embase, and Web of Science databases, with publications included up to June 11, 2023. Eligible studies included adult men aged 18 years and older who received testosterone therapy and reported kidney function outcomes, including randomized controlled trials (RCTs), and observational studies (prospective, retrospective, or case-control). Exclusion criteria included reviews, non-original articles, studies involving non-human subjects, duplicate reports, and studies with insufficient data. Statistical analysis was performed using a random-effects model, and variability was assessed using I². The review protocol was registered with PROSPERO (CRD42023456010). Results: Out of 13 articles, encompassing 39,692 individuals in the treatment group and 10,375 in the control group from studies conducted in seven different countries. The meta-analysis revealed a noticeable difference in age (MD= -0.56; 95% CI: -0.68, -0.45; p<0.001). Testosterone levels were significantly lower in the control group (MD= -0.41; 95% CI: -0.52, -0.30; p<0.001). Baseline blood urea nitrogen concentration was significantly higher in the testosterone treatment group than in the control group, with this difference being statistically significant (MD= 1.66; 95% CI: 1.10, 2.23; p<0.001). Following treatment, blood urea nitrogen was lower in the testosterone treatment group than in the control group, though this difference was not statistically significant (MD= -0.44; 95% CI: -0.93, 0.05; p=0.079). The difference in uric acid levels between the treatment and control groups was not statistically significant (MD= 0.11; 95% CI: -0.02, 0.24; p=0.08). While these non-significant findings may not directly indicate a clinically meaningful impact, they still highlight potential trends that should be explored further, especially considering that BUN and uric acid levels are important markers of kidney function and could be influenced by testosterone therapy over the long term. Conclusion: Testosterone therapy may influence kidney function, though further studies are needed to clarify its long-term effects and clinical significance.
The Abbasid era heralded a significant epoch marked by remarkable advancements in various scientific disciplines, notably medicine. Successive rulers of this era embarked on a competitive endeavor to leave indelible marks on the progression of both arts and sciences. This paper aims to elucidate the historical trajectory of medical education during this period, elucidating how eminent physicians orchestrated the establishment and management of hospitals while imparting their expertise to aspiring medical practitioners. Much of the foundation of contemporary medical education, encompassing bedside instruction, informed patient consent, resident training incorporating rounds and clinical documentation, culminating in comprehensive qualifying examinations and professional supervision by regulatory entities, can trace its roots back to the Abbasid era.
Type 1 Diabetes Mellitus (T1DM) is an autoimmune disorder characterized by the progressive destruction of pancreatic beta cells. Coxsackie B Virus (CVB), particularly CVB1, CVB3, and CVB4, has been identified as a key environmental trigger in the pathogenesis of T1DM, particularly in genetically predisposed individuals. This narrative review synthesizes two decades of evidence (2005–2025) to explore the mechanisms by which CVB contributes to autoimmunity and emerging prevention strategies. CVB induces beta cell autoimmunity through molecular mimicry, bystander activation, and persistent viral infections that promote chronic inflammation and immune-mediated beta cell damage. Specific serotypes, such as CVB3 and CVB4, have been shown to have stronger associations with T1DM onset, emphasizing the importance of targeted interventions for these serotypes. Recent advancements in prevention strategies include multivalent CVB vaccines, antiviral agents such as pleconaril, and immune-modulating therapies like tolerogenic vaccines and regulatory T cell (Treg) expansion. However, challenges remain regarding their safety, timing of administration, and immune cross-reactivity. Early diagnostic efforts focused on biomarkers such as CVB-specific antibodies, islet autoantibodies (e.g., GAD65, ICA, ZnT8), and HLA risk alleles are crucial for identifying individuals in the latent phase of T1DM. To mitigate the risk of CVB-induced T1DM, an integrated public health approach—combining virological surveillance, vaccination campaigns, and early immunological screening—is essential. We recommend prioritizing longitudinal cohort studies, the development of safe multivalent vaccines, and investment in community-based early detection programs. A collaborative, multidisciplinary approach is vital to prevent or delay T1DM onset in at-risk populations
Background: In Chronic Kidney Disease (CKD), both the markers of coagulation and anticoagulation, which are predictors of the disease process and its complications, were profoundly disturbed. This study will discuss further the correlations of both markers with renal function, identify the predictors of Glomerular Filtration Rate (GFR), and make use of higher-order statistical analyses in exploring diagnostic and prognostic value. Methods: The current study measured the markers of coagulation and anticoagulation D-dimer, fibrinogen, Protein C, and Protein S among 100 CKD patients, along with renal function parameters such as GFR and serum creatinine. Other statistical procedures used were correlation, multivariate regression, cluster analysis, receiver operating characteristic analysis, interaction analysis, Kaplan-Meier survival, and machine learning algorithms. Path analyses were used to estimate direct and indirect effects of markers on GFR. Results: Elevated D-dimer (0.69 ± 0.29 mg/mL) and fibrinogen (372.04 ± 80.39 mg/dL) levels were associated with reduced GFR, while higher Protein C (67.90 ± 22.56%) and Protein S (64.93 ± 24.08%) levels correlated with better kidney function. Multivariate regression identified hemoglobin (β = 1.20), Protein C (β = 0.80), and Protein S (β = 0.75) as positive predictors of GFR, whereas D-dimer (β = -5.50) and fibrinogen (β = -3.50) were negative predictors (P < 0.001). Cluster analysis revealed three distinct groups based on GFR and coagulation profiles, with severe CKD associated with elevated D-dimer and fibrinogen and reduced Protein C and Protein S. ROC analysis showed D-dimer to be the most accurate marker for predicting reduced GFR (<60 mL/min; AUC = 0.91, sensitivity = 90%, specificity = 85%). Kaplan-Meier survival analysis demonstrated shorter survival times in patients with elevated D-dimer and fibrinogen levels (P < 0.001). Path analysis highlighted the complex interplay of coagulation markers on GFR, with D-dimer and fibrinogen exerting negative effects and Protein C and Protein S showing positive influences. Conclusions: Coagulation and anticoagulation markers may be of critical importance in the very process of CKD, carrying loads of diagnostic and prognostic importance. Advanced statistical and machine learning methods provide a profound understanding of these relations and form the basis for personalized CKD management strategies.
Background: Although skin diseases are common among Jordanian adults, there is insufficient data on the distribution of skin diseases confirmed by biopsies, and most previous studies in Jordan are based on clinical diagnosis with no collaboration on the corresponding biopsy results. Objectives: To determine the different patterns and diagnoses of skin diseases confirmed by skin biopsies in the Jordanian population and their distribution according to demographic variables. To assess for the common types of skin cancer in Jordan Methods: This retrospective study includes skin biopsy specimens received from January 2022 to December 2023 at the Department of Pathology, King Abdullah University Hospital. The histopathological diagnoses and demographic data were collected and summarized in a Microsoft Excel sheet. Data was analyzed using descriptive and graphical statistical methods. Continuous variables were summarized using means and standard deviations (SD), categorical variables were presented as frequencies and percentages. All analyses and figures were performed using R statistical software (Vienna, Austria). Results: A diverse cohort of 1,184 patients, with a mean age of 45 years was retrieved. The most common clinical presentations are papules (33.37%) and plaques (32.92%). Malignancies were identified in 10.48% of cases with a predominance of basal cell carcinoma (BCC) (5.49%), and squamous cell carcinoma (SCC) (3.13%), Notably, seborrheic keratosis (22.80%) and warts (14.36%) were the most frequent benign lesions, which are often clinically misidentified, emphasizing the role of histopathology for definitive diagnosis. Histopathologically, benign tumors constituted the largest category (19.51%), followed by eczema (14.48%) and pigmentary disorders (14.40%).
Background and Aims: Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disease. There is increased evidence that Toll-like receptors 2 (TLR2), which are a part of innate immunity, play a role in the pathophysiological changes in AD. The study aims to estimate the serum TLR2 concentration among children with AD compared to healthy controls, and to explore the relationship between serum TLR2 concentration and AD severity and total Immunoglobin E (IgE) level. Patients and Methods: This case-control study enrolled 156 participants, with 76 atopic dermatitis (AD) cases and 80 controls. It was conducted at the outpatient clinics of Al-Fayhaa Teaching Hospital between December 2020 and March 2021. The study involved interviewing the parents of the participants, detailed clinical examination with assessment of disease severity, and laboratory tests including total IgE and serum TLR2 concentration. Results: Serum TLR-2 concentrations were lower in AD cases (median= 761.9 pg/ml) than in controls (median=1528.5 pg/ml; P=0.00002). Significantly higher TLR2 levels were seen in patients with elevated IgE (P=0.013) and severe form of AD (P=0.005). Conclusions: Although lower TLR2 concentrations could indicate their role in AD pathogenesis, higher TLR-2 levels were seen in more severe cases or patients with elevated IgE. This suggests a complex mechanism of TLR2 in the immune dysregulation that occurs in AD. This might refer to the involvement of TLR2 in both the onset and exacerbation of AD, particularly in severe forms.
Elucidating the pharmacokinetics of anticancer agents is essential for optimising their safety and therapeutic efficacy. Pharmacogenetics and pharmacogenomics (PGx) provide a framework for understanding individual variability in drug response and minimising adverse effects by analysing genetic variants that affect drug-metabolising enzymes and membrane transporters. In oncology, where safety and efficacy are critical, personalised treatment guided by PGx markers and clinical recommendations is gaining increasing importance. Variants such as CYP3A4*14, *1, *18 and ABCB1 1236CC were associated with reduced imatinib efficacy and an elevated risk of toxicity. CYP2D6*17, *29, *4, *10, and *41 alleles were linked to diminished tamoxifen efficacy, while CYP2D6*17, *41, *10, and *5/*5 were reported in relation to various stages of relapse. Genotypes GSTP1 rs1695 c.313A>G (AG and GG), ABCC1(c.3173G>A and rs9332430), ABCB1 (c.1236C>T and 3435C>T), ABCC2 (–24C/T, rs2804398, and +9383C>G), as well as ABCC4 rs943288, were associated with increased toxicity from platinum-based therapies. Variants UGT1A1*28, *6 and UGT1A7 were implicated in irinotecan-related toxicity. Additionally, DPYD*2A (rs3918290), *13 (rs55886062), rs67376798, and HapB3 (rs75017182) were strongly associated with severe fluoropyrimidine-related toxicities and increased treatment-related mortality. As PGx research advances, its integration into routine oncology practice will be essential for optimising therapeutic outcomes and supporting a more individualised approach to cancer treatment.
Objectives: The study examined the effects of genetic variations in TNF-α-308G/A, as well as TNF-α gene variants, using PCR-SSP to analyze individual characteristics. Method: Researchers used molecular and immunological methods to investigate genotypes and alleles associated with asthma incidence, including 50 asthma patients and 40 healthy individuals. Results: It was demonstrated that polymorphisms and the risk of developing asthma were correlated among asthma patients. The findings showed that, in comparison to the control group, asthma patients had considerably (P<0.05) greater levels of TNF-α-308G/A alleles than GA heterozygotes (TNF-α-308G/A). Conclusion: Gene promoter polymorphisms may affect asthma sensitivity to TNF-α-308G/A, as evidenced by the strong association between the GG and AG gene genotypes and cytokine levels and disease development. The development of asthma and immunological markers (TNF-α) are closely related. One perspective holds that there is a correlation between allergic rhinitis and the development and risk of asthma. It has been successful to use HDM immunotherapy to assist patients in establishing long-term clinical and immunological tolerance.
Background: Competence in physical examination is essential for medical students, particularly in musculoskeletal assessment. Anterior Cruciate Ligament (ACL) injuries are common and typically evaluated through a combination of clinical history, imaging, and physical tests. This study aimed to assess the ability of medical students from two medical schools to perform three commonly used ACL tests: Lachman’s test, anterior drawer test, and Lever sign (Lelli’s test). Methods: In this cross-sectional study, 200 fifth-year medical students from two medical schools in Jordan participated during their orthopedic surgery rotations. Each student performed the Lachman’s, anterior drawer, and Lever sign tests on two patients with MRI-confirmed ACL tears and two healthy control subjects. Student performance was evaluated based on correct execution of each test. Comparisons were made between institutions and against a senior resident benchmark. A simulated learning curve model was also generated to illustrate progression across training levels. Results: A total of 200 fifth-year medical students were evaluated. Correct test performance was highest for the Lever sign (92.0%), followed by the anterior drawer (85.5%) and Lachman’s test (81.5%). No significant differences were observed between students from the two institutions (p = 0.192–0.731). Performance was higher on control subjects compared to ACL-injured patients. Senior residents demonstrated superior performance across all tests: Lachman’s (p = 0.004), (p = 0.001), and Lever sign (p = 0.027). Simulated learning curves indicated higher AULC values for the Lever sign (281.5) compared to the anterior drawer (270.8) and Lachman’s test (263.8), suggesting differences in the relative ease of skill acquisition. Conclusion: Medical students performed ACL special tests with varying success, reflecting the differing technical demands of each maneuver. The Lever sign was most consistently performed correctly, while the Lachman’s and anterior drawer tests showed lower performance compared to senior residents. Simulated learning curves emphasized skill acquisition differences, supporting the need for structured, progressive training to improve orthopedic examination competency.
