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Biomedical subjects

Kamel M Ajlouni

Publications and source records attributed to Kamel M Ajlouni.

At least 19 recordsLinked to original sources
PubMed2006

Sexual dysfunction among Jordanian men with diabetes.

OBJECTIVE: To estimate the prevalence and severity of erectile dysfunction (ED) and its correlations among Jordanian men with diabetes. METHODS: We conducted this study at the National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan, between January and August 2004. The study included 988 married diabetic men. Patients were interviewed by one of our medical staff based on a health care questionnaire and an Arabic translation of the 15-item International Index of Erectile Function. Scores of the questions in each of the 5 sexual function domains were summed up. Dysfunction was categorized as absent, mild, moderate or severe. RESULTS: The overall prevalence of ED was 62%; and we found that 30.3% had severe ED. The prevalence increased with age from 26.5% (13 out of 49) of patients <40 years of age to 91% (87 out of 96) in the age group > or = 70 years. Severity of ED increased with age as well. Multivariate logistic regression analysis identified age, glycemic control, hypertension, coronary artery disease, retinopathy and neuropathy as independent risk factors of ED. Among patients with ED, 7% reported having treatment for ED. CONCLUSION: Prevalence of ED among Jordanian diabetic patients is high. It increases with age and poor glycemic control. Other independent risk factors include: hypertension, coronary artery disease, retinopathy and neuropathy.

Adult↗
PubMed2004

Clinical and inheritance profiles of Kallmann syndrome in Jordan.

BACKGROUND: Proper management of patients with Kallmann syndrome (KS) allows them to attain a normal reproductive health. The purpose of this study is to demonstrate the presentation modalities, phenotypes and the modes of inheritance among 32 patients with Kallmann syndrome in Jordan. Recognition of the syndrome allows for prompt proper management and provision of genetic counselling. SUBJECTS: Over a period of five years (1999-2004), the clinical and inheritance profiles of 26 male and 6 female patients with Kallmann syndrome from 12 families were evaluated at the National Center for Diabetes, Endocrinology and Genetics in Jordan. RESULTS: The patients belonged to twelve Jordanian and Palestinian families and their age at presentation ranged from 4 - 46 years. Nine boys aged 4-14 years presented with cryptorchidism and microphallus, all other males presented with delayed puberty, hypogonadism and/or infertility. The main presentation among six female patients was primary amenorrhea. Intrafamilial variability in clinical phenotype was specifically evident for renal abnormalities and sensorineural hearing impairment. Familial KS was diagnosed in 27 patients belonging to five families with the X-linked mode of inheritance and two families with the autosomal recessive mode of inheritance. CONCLUSIONS: (1) the majority of cases in this study represented the X-linked form of KS, which might point to a high prevalence of Kal 1 gene in the population. (2) Genetic counselling helps these families to reach a diagnosis at an early age and to decide about their reproductive options. (3) Children presenting with cryptorchidism and microphallus in our population should be investigated for KS.

Journal Article↗
PubMed2004

Familial monozygotic twinning: report of an extended multi-generation family.

Thirteen sets of monozygotic (MZ) twins from an extended multi-generation family are reported. Zygosity was determined by interviewing families for overall physical similarity and by assessment of facial photographs. A hypothetical gene was traced back five generations to a common grandfather. Familial monozygotic twinning in this pedigree is compatible with autosomal dominant inheritance with reduced penetrance. Other plausible mechanisms of inheritance are discussed.

Family↗
PubMed2004

Effects of short term metformin administration on androgens in diabetic men.

OBJECTIVE: Metformin, an oral hypoglycemic agent, has several other metabolic and hormonal effects. This study aims at identifying the metabolic effect of metformin on androgens in diabetic men. METHODS: The study was conducted at The National Center for Diabetes Endocrinology and Genetics, Jordan University Hospital, Amman, Jordan from April 2001 to September 2001. We studied 15 men with type 2 diabetes mellitus by measuring fasting serum glucose, insulin, glycosylated hemoglobin, total and free testosterone, sex hormone binding globulin, dehydroepiandrosterone sulphate, 17-OH progesterone, luteinizing hormone, and follicle stimulating hormone before and after a short course of metformin. RESULTS: There was a significant decrease in fasting serum glucose and glycosylated hemoglobin and increase in the level of 17-OH progesterone. The remainder of the measured parameters did not show any significant change. Although serum glucose and glycosylated hemoglobin decreased insulin levels were not changed. CONCLUSION: In contrast to normal men there was no change in androgen levels in diabetics but the 17-OH progesterone was elevated.

Administration, Oral↗
PubMed2004

Radiological findings in Wolfram syndrome.

OBJECTIVE: To determine the precise radiologic findings in Wolfram syndrome (WFS) patients using objective techniques in order to better define the reference population for the clinical evaluation. METHODS: Sixteen patients (6 males and 10 females) with WFS found in 4 families were included in this study. Fourteen patients with WFS-2 came from 3 families while 2 patients with WFS-1 from one family. All patients were studied at Jordan University Hospital, Amman, Jordan, from January 2001 through to January 2003 by definite radiologic techniques as part of a thorough clinical comprehensive assessment. These include intravenous urography, abdominal and pelvic ultrasonography, barium meal, upper gastrointestinal endoscopy and magnetic resonance imaging with and without contrast to the brain and the pituitary glands. RESULTS: Five of the female patients had a small uterus. Spina bifida was found in 7, hydronephrosis in 9 and hydroureter in 5 patients. Peptic ulcer was detected in 10 out of 14 available patients and helicobacter pylori in 7 out of 16 patients. Atrophy was detected in all brains, 9 brain stems, 12 cerebellums and 14 optic tracts of all patients. The size of the pituitary glands was variable CONCLUSION: The particular radiologic assessment of patients with WFS proofed that, urinary tract dilatation was detected in WFS-1 and WFS-2 patients though all WFS-2 patients have no diabetes insipidus. Peptic ulcer was frequently higher in WFS-2 patients. No significant radiologic difference was found between patients with WFS-1 and WFS-2.

Adolescent↗
PubMed2004

Thyroid dysfunction in patients with type 2 diabetes mellitus in Jordan.

OBJECTIVE: To investigate the prevalence of thyroid dysfunction and autoimmunity in type 2 diabetic patients. METHODS: The study was conducted at the National Center for Diabetes, Endocrinology and Genetics, Jordan University Hospital, Amman, Jordan, between March 2000 and September 2000. A group of 908 type 2 diabetic patients (T2DM) were recruited in the study and underwent investigations for thyroid functions; free thyroxine (FT4), free tri-iodothyronine (FT3) and thyroid stimulating hormone (TSH). Six hundred had performed thyroid autoantibodies, thyroid peroxidase antibodies (TPOab) or antimicrosomal antibodies (AMA) and thyroglobulin antibodies (Tgab). They were compared with 304 non-diabetics, of those 282 had performed thyroid antibodies. RESULTS: Fifty-three (5.9%) of diabetic patients were known to have thyroid disease. As a direct result of screening, new thyroid disease cases were diagnosed in 6.6% of the patients. Thus, the overall prevalence of thyroid disease was found to be 12.5%. The most common was subclinical hypothyroidism (4.1%). In the control group, the prevalence of thyroid disease was 6.6%. The most common was subclinical hypothyroidism (5%). There was a significant difference between diabetics and control subjects p=0.0064. Positive TPOab was found in 8.3% of T2DM patients (N=600) versus 10.3% in the control group (N=282) p=0.412. Positivity for both TPOab and Tgab was found to be 2.5% of T2DM versus 6% of the control subjects p=0.0155. CONCLUSION: This study suggests that diabetic patients should be screened for asymptomatic thyroid dysfunction.

Adult↗
PubMed2003

Thyroid function and thyroid autoimmunity in patients with type 1 diabetes mellitus.

OBJECTIVE: An association between diabetes mellitus and autoimmune thyroid disease is well known. We have investigated the prevalence of thyroid dysfunction and autoimmunity in type 1 diabetic patients. METHODS: Seventy-nine type 1 diabetic patients were recruited in the study, and underwent complete investigations for thyroid function, which included free thyroxine, free tri-iodothyronine, and thyroid stimulating hormone, of those only 64 patients had performed thyroid autoantibodies (TAb); anti- thyroid peroxidase antibodies (TPOAb) or antimicrosomal antibodies and thyroglobulin antibodies (TgAb). They were compared with 127 healthy subjects matched for sex and age. This study was carried out at the National Center for Diabetes, Endocrinology and Genetics, Jordan University, Amman, Jordan between 2000 and 2001. RESULTS: In the diabetic group, 7 cases (8.9%) of thyroid dysfunction were detected, 4 of these were diagnosed as subclinical hypothyroidism, whereas the other 3 had overt hypothyroidism and were on thyroxine replacement therapy. In the control group, 6 (4.7%) subjects were diagnosed as subclinical hyperthyroidism. There was a significant difference in thyroid function variables between diabetics and controls. Among type 1 diabetic patients, 7 (9.2%) had thyroid autoantibodies, 5 with positive TPOAb only and 2 with positive TAb; TPOAb or antimicrosomal antibodies and TgAb; compared with 8 (6.3%) in the control group, 4 with positive TPOAb only and 4 with positive TAb; TPOAb or antimicrosomal antibodies and TgAb P=0.68. CONCLUSION: Biochemical thyroid dysfunction and thyroid autoimmunity were evident in type 1 diabetics who were apparently euthyroid, with no significant difference between diabetics and controls.

Adolescent↗
PubMed2003

Epidemiology and management of hypertension among Bedouins in Northern Jordan.

OBJECTIVE: To estimate the magnitude of hypertension, and its levels of awareness and control of hypertension among a community of Jordanian aborigines in Northern Jordan; and to compare the study findings with findings from other Jordanian communities. METHODS: A systematic sample of 50% of all households of Qafqafa, Northern Jordan was selected and all members of the selected households were included in the study at Qafqafa Health Center, Qafqafa, Jordan. A structured questionnaire was administered to all study participants and measurement of blood pressure was performed according to a preset criteria. Data on 366 subjects included in the sample were collected during the months of April and May 2002. RESULTS: A total of 40 subjects or 10.9% were suffering from hypertension. Prevalence rate of hypertension was significantly lower than the 16.1% and 16.3% prevalence rates reported from other more modernized Jordanian communities. Logistic regression analysis indicated that hypertension was positively associated with masculinity, age, illiteracy, obesity, and with positive family history of hypertension. No association was detected between hypertension and each of smoking, Diabetes mellitus, and total serum cholesterol. This study showed that one-half (47.5%) of hypertensives were unaware of their diagnosis and more than one-half (57.1%) of those aware of their diagnosis did not achieve control of their hypertension. CONCLUSION: Population of the study community has significantly lower levels of hypertension than both semi-urban and recently urbanized Jordanian communities, and much of the rise in blood pressure levels is attributed to environmental factors. Moreover, hypertension management programs in Jordan are far below the optimal standards.

Adult↗
PubMed2003

Prevalence and predictors of diabetic foot syndrome in type 2 diabetes mellitus in Jordan.

OBJECTIVE: To detect feet changes and to identify risk factors leading to amputation among type 2 diabetics. METHODS: A total of 1142 patients with type 2 diabetes mellitus; 595 males (52%), and 547 females (48%) were seen between January and December 2001 at the National Center for Diabetes, Endocrinology, and Genetics (NCDG) Amman, Jordan. The mean age was 56.1 years (SD=10.2) and the mean duration of diabetes was 9 years (SD=7.1). All patients had a complete medical assessment including history, physical examination, glycosylated hemoglobin (HbA1c) (the mean of the last 4 readings) and microalbuminuria. Statistical analysis were performed to identify significant risk factors leading to amputation using Epi info, version 6 software. RESULTS: Mean HbA1c was 7.4% (SD=1.4). The prevalence of hypertension was 52%, retinopathy 45% and microalbuminuria 33%. Impaired vibration, position and protective sense were found in 19%, 13%, and 18%. The prevalence of all amputations was 5%. The following were strong predictors of amputation; duration of diabetes (P= 0.04), smoking (P=0.01), microalbuminuria (P=0.02), retinopathy (P=0.008), legs hair loss (P=0.003), neurological deficit (P=0.0001), ulceration (P=0.00001) absent dorsalis pedis (P=0.0006) and insulin therapy (P=0.0001). The rate of amputation was directly proportional to high HbA1c >= 8% (P=0.01). Age and gender were not found to have an impact on prevalence of amputation. CONCLUSION: Prevalence of amputation correlates with duration of diabetes, poor glycemic control, smoking, neurological impairment, peripheral vascular disease and microalbuminuria.

Amputation, Surgical↗
PubMed2003

Values, qualifications, ethics and legal standards in Arabic (Islamic) medicine.

Many historians claim that the Western world pioneered in the setting of ethical, legal and professional standards in the practice of medicine. Informed medical consent is proposed by some as an American invention. Others claim that patient rights and legal protection propose have stated in the early decades of the 20th century. This review is an attempt to uncover the facts regarding the way Arabs practiced medicine during the golden era of Islam. Eight hundred to fifteen hundred AD this includes the qualification of physicians according to a well designed curricula covering the science and humanity of medicine. The rules governing the quality control of health care delivery system and to some degree the principles of informed medical consent and to a lesser degree the principles of litigation are discussed. We hope that this paper will be a call to all humanity loving persons to end prejudices against other people and to stop stereotyping.

Arab World↗
PubMed2002

Cerebellar hypoplasia, hypergonadotrophic hypogonadism, retinitis pigmentosa, alopecia, microcephaly, psychomotor retardation, and short stature: "D-CHRAMPS syndrome".

We here report a rather novel syndrome of dysmorphic features, short stature, microcephaly, alopecia, psychomotor retardation, retinitis pigmentosa and secondary amenorrhoea. This may present a new complex multisystem disorder distinct from those reported in the literature and we propose the acronym D-CHRAMPS for this novel disorder.

Adolescent↗
PubMed2002

Effects of short term metformin administration on androgens in normal men.

OBJECTIVE: To study the effect of metformin on androgens in normal men. METHODS: A total of 12 healthy males volunteered to participate in the study. A blood sample was obtained from each of them and analyzed for the following: Testosterone (total and free), sex hormone binding globulin dehydroepiandrosterone sulphate, 17-hydroxyprogesterone, luteinizing hormone, and follicle stimulating hormone. In addition, each participant was subjected to a glucose tolerance test and his insulin level was measured. Metformin 850 mg twice daily for 2-weeks was given to each subject after which the above tests were repeated. A paired t-test was used to assess the statistical significance of any observed differences before and after metformin. RESULTS: After metformin administration, there was a significant reduction in serum level of total testosterone (p=0.0001), free testosterone (P=0.002), and 17 hydroxyprogesterone (p=0.0001). There was also a significant increase in serum level of sex hormone binding globulin (p=0.009) and dehydroepiandrosterone sulphate (P=0.0008). Serum levels of luteinizing hormone and follicle stimulating hormone showed no significant changes. Similarly, there were no changes in fasting plasma glucose, fasting serum insulin, weight, or blood pressure. CONCLUSION: Metformin administration was associated with a reduction in total testosterone, free testosterone, and 17-hydroxyprogesterone and an increase in sex hormone binding globulin and dehydroepiandrosterone sulphate in normal males. The clinical significance of these findings needs further investigation.

Adult↗
PubMedDate not supplied

Sleepwalking associated with hyperthyroidism.

OBJECTIVE: To report several cases of hyperthyroidism in patients presenting with the unusual symptom of sleepwalking and to discuss the possible pathophysiologic basis for this novel association. METHODS: After encountering and reporting the first case of new-onset somnambulism in a patient presenting with thyrotoxicosis at our institution, we routinely inquired about the sleep history of patients with thyrotoxicosis, questioning both the patients and family members when applicable. Those patients who actually had sleepwalking episodes coinciding with the onset of thyrotoxicosis underwent close follow-up, and the relationship between the sleepwalking and the results of thyroid function tests was analyzed. In addition, we reviewed the literature on psychiatric disorders and sleep problems, and the pathophysiologic rationale for a cause-and-effect relationship is discussed. RESULTS: We collected 8 cases of patients with new-onset sleepwalking episodes that coincided with the start of thyrotoxicosis. The disappearance of the sleepwalking with successful achievement of euthyroidism supports a cause-and-effect relationship. This hypothesis is further supported by the absence of a family history, the adult onset, and the relapse of sleepwalking in 2 of the patients when their thyrotoxicosis became poorly controlled as a result of noncompliance with medications and its subsequent disappearance with reachievement of euthyroidism. Of note, such a presentation was seen only in patients with thyrotoxicosis caused by diffuse toxic goiter or Graves' disease and never in patients with other causes of thyrotoxicosis. CONCLUSION: New-onset sleepwalking could be caused by thyrotoxicosis or, more specifically, by thyrotoxicosis resulting from diffuse toxic goiter. The mechanism is hypothesized to be related to the combination of prolongation of non-rapid eye movement sleep and the associated fatigue. Specific inquiry about this unusual presentation of thyrotoxicosis is encouraged, and more studies are needed to confirm and evaluate its extent.

Adolescent↗