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The clinical and epidemiological features of hydatid disease in Northern Jordan.

OBJECTIVE: To elaborate on the epidemiology of hydatid disease in Jordan as a model for the Middle East, and highlight the obstacles that face disease control in the region. METHODS: The clinical and epidemiological data for 65 patients with the diagnosis of hydatid cyst (who were treated in the Department of Surgery, Jordan University of Science and Technology, Irbid and its affiliated hospitals, between January 1994 through to September 2003) were analyzed. Fifty-five patients were interviewed for details of life style. RESULTS: Forty-six percent of patients were below 40- years of age. Fifty-seven percent were females. All interviewed patients gave history of contact with dogs and history of ingestion of raw vegetable food. The latter in addition to a high zoonotic infection rate and uncontrolled animal movement were factors contributing to the high prevalence. CONCLUSION: Optimization of control programs in the Middle East requires the establishment of a regional center. Wide traveling has made it essential for physicians practicing in non-endemic areas to be aware of the diverse presentations of this disease when dealing with immigrants from endemic areas.

Adolescent↗

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↗

The seroepidemiology of Hepatitis A virus in Amman, Jordan.

Hepatitis A virus (HAV) has emerged as an important public health problem in many countries of the Middle East region and Jordan is no exception. From January 1991 to December 2001, a total of 1015 patients were diagnosed at Al-Battikhi Medical Laboratories. Samples were collected at seventeen private laboratories distributed throughout areas of the Governorate of Amman (capital of Jordan). A significant variation (P=0.03) was obtained between number of HAV cases and year. Seasonal variation in HAV cases was seen throughout the study period with maximal rates in the spring and summer months (P<0.001). The highest incidence rate (9.6/100,000 population) was detected in the year 1993 and the lowest incidence rate (1.1/100,000 population) was found in the year 2001. There was a significant difference (P<0.0001) between number of HAV cases and age group. The highest number of cases 166 (16.4%) was reported for age group 5-14 years and the lowest number of cases 18 (0.02%). Male to female ratio was 1.25: 1. There was no significant sex variation (P=0.28). A significant variation (P=0.006) was observed between number of HAV cases and districts. The present results suggested a link between the age groups, year, month and occurrence of HAV infection. Male to female ratio indicates no significant sex variation.

Adolescent↗

Gender-specific oral health attitudes and behavior among dental students in Jordan.

The aim of this study was to determine the difference in oral health attitudes and behavior between male and female dental students at Jordan University of Science and Technology (JUST). A self-administered questionnaire based on a modified version of the Hiroshima University Dental Behavior Inventory (HU-DBI) was distributed among 375 dental students. The response rate was 83.7% with 48% males and 52% females responding. Female students reported brushing their teeth more frequently than male students (P<0.001). Approximately 47% of the male students brushed their teeth less than twice daily compared to 21% of the female students. Also, female students believed in the necessity of using toothpaste during brushing more often than male students (P<0.01). On the other hand, smoking was much more frequent among males than among females (31% vs. 4%) (P<0.001). Male students indicated they had been smoking for longer periods of time than female students. This survey shows male students visit the dentist only when they have dental pain. While this was more than their female peers, it was not statistically significant (P= 0.056). In general the present study showed dental students in Jordan had poor oral health. Further research is needed to examine the students clinically for periodontal and caries conditions. Students should be encouraged to be a model for oral health for their families, friends, and patients.

Attitude of Health Personnel↗

Clinico-hormonal correlation of oligospermic patients in the below sea level environment (Jordan Valley).

A correlation between serum levels of luteinizing hormone (LH), total testosterone (T), free T and sex-hormone binding globulin (SHBG) in normospermic and in oligospermic male people was done. This study was designed to measure serum levels of these hormones and of SHBG in people living at different altitude environments relative to sea level: at 209-408 meters below (the Jordan Valley, JV) and at 620 meters above (Irbid city, IC). In addition, a clinical awareness study of oligospermia was done in the North of Jordan (IC). Seminal analysis in 287 male people (age range, 18 to 40 years old) during the period between 12/6/1999 and 12/2/2002 showed an oligospermia of 31.4%. Serum levels of LH, total T, free T and SHBG in normospermic subjects in IC were similar to those in normospermic of the JV (3.4 +/- 1.2 vs. 4.0 +/- 1.7 MIU/ml, 19.9 +/- 4.0 vs. 20.4 +/- 5.6 ng/ml, 53.9 +/- 15.6 vs. 47.9 +/- 10.7 pg/ml, 19.5 +/- 3.2 vs. 18.6 +/- 2.16 nmol/l, respectively). Oligospermia was associated with increase in total T at both IC (27.5 +/- 4.6 vs. 19.9 +/- 4.0 ng/ml) and the JV (30.7 +/- 3.4 vs. 20.5 +/- 5.6). The higher serum level of total T in oligospermic people in both IC and the JV was associated with higher levels of SHBG compared to those levels in normospermic subjects. On the other hand, oligospermic subjects have lower serum level of free T than in normospermic males (41.5 +/- 10.0 vs. 53.9 +/- 15.6) only in IC, while in the JV, serum free T level was similar (46.5 +/- 6.1 vs. 47.9 +/- 10.7). Taken together data for both locations, IC and the JV, suggest a clear correlation between total T and SHBG levels in both groups' normospermic and oligospermic subjects.

Adult↗

Use of information and communication technology among dental students at the University of Jordan.

The aim of this study was to investigate the current knowledge, skills, and opinions of undergraduate dental students at the University of Jordan with respect to information communication technology (ICT). Dental students from the second, third, fourth, and fifth years were asked to complete a questionnaire presented in a lecture at the end of the second semester in the 2002-03 academic year. The response rate was 81 percent. Besides free and unlimited access to computers at the school of dentistry, 74 percent of the students had access to computers at home. However, 44 percent did not use a computer regularly. Male students were more regular and longer users of computers than females (p<0.001). A significant number of students (70 percent) judged themselves competent in information technology (IT) skills. More males felt competent in basic IT skills than did females (p<0.05). More than two-thirds acquired their computer skills through sources other than at the university. The main educational use of computers was accessing the Internet, word processing, multimedia, presentations, Medline search, and data management. More clinical students felt competent in word-processing skills (p<0.05) and many more used word processing for their studies (p<0.001) than did preclinical students. More males used word processing for their studies than females (p<0.001). Students used computers for personal activities more frequently than for academic reasons. More males used computers for both academic (p<0.01) and personal activities (p<0.001) than did females. All students had access to the Internet at the university, and 54 percent had access at home. A high percentage of students (94 percent) indicated they were comfortable using the Internet, 75 percent said they were confident in the accuracy, and 80 percent said they were confident in the relevance of information obtained from the Internet. Most students (90 percent) used email. Most students (83 percent) supported the idea of placing lectures on the web, and 61.2 percent indicated that this would not influence lecture attendance. Students used the Internet more for personal reasons than for the study of dentistry. More clinical students used the Internet for dentistry than preclinical students (p<0.001). More males than females used the Internet for dentistry (p<0.01) as well as for pleasure (p<0.01). Time and availability were the main obstacles to Internet use. Dental students at the University of Jordan have access to substantial IT resources and demonstrated attitudes toward the computer and Internet technology and use that were similar to other students in other nations. However, the educational use of ICT among Jordanian students remains low.

Computer Literacy↗

Gallbladder carcinoma in Jordan.

BACKGROUND/AIMS: Despite advances in diagnostic and therapeutic modalities, the prognosis of gallbladder carcinoma is still poor. The purpose of this study is to look for peculiarities of primary gallbladder carcinoma in Jordan regarding its incidence, clinical and pathological aspects. METHODOLOGY: A retrospective study over a period of 19 years comprising 66 patients was reviewed; only patients treated primarily in our hospital were included. There were 40 females and 26 males (ratio of 3:2). RESULTS: The main presenting symptom was abdominal pain in 54 patients (82%); correct preoperative diagnosis was made in only 20% of cases. Cholecystectomy alone was the most commonly performed operation (32 cases), cholecystectomy in combination with biliary bypass and/or hepatic resection (16 cases), biopsy of the gallbladder was performed in 12 cases and bypass with T-tube drainage in 6 cases. Postoperative morbidity and mortality were encountered in 48% and 18% respectively. CONCLUSIONS: The incidence and clinicopathological aspects of gallbladder cancer in Jordan seem to resemble that in the west, albeit with a lower age incidence. Diagnosis remains difficult and the outcome is still poor in the majority of cases.

Adult↗

Compliance with infection control programs in private dental clinics in Jordan.

The aim of this study was to assess the compliance of general dental practitioners (GDPs) in the private sector in North Jordan with infection control measures. A pilot-tested questionnaire about infection control measures was distributed in March 2004 to 120 private practices. The response rate was 91.66 percent. About 77 percent of dentists usually ask their patients about medical history, 36 percent were vaccinated against hepatitis B, 81.8 percent wear and change gloves during treatment and between patients, and 54.5 percent wear and change masks during treatment and between patients. Most dental practitioners (95.4 percent) reported that they changed extraction instruments and burs between patients. All dental practitioners reported that they changed saliva ejectors between patients, but only 41.8 percent changed handpieces between patients. Approximately 63 percent (69/110) used autoclaves for sterilization, 47.3 percent (52/110) used plastic bags to wrap sterilized instruments, and only 18 percent (20/110) disinfected impressions before sending them to dental labs. Fourteen percent used rubber dams in their clinics, and only 31.8 percent had special containers for sharps disposal. Based on these responses, approximately 14 percent of general dentists in this sample were considered to be compliant with an inventory of recommended infection control measures. In Jordan, there is a great need to provide formal and obligatory infection control courses and guidelines for private dentists by the Ministry of Health and the dental association in addition to distribution of standard infection control manuals that incorporate current infection control recommendations.

Adult↗

Systematics and distribution of horse flies (Diptera: Tabanidae) of Jordan.

The horse fly fauna of Jordan consists of 24 species belonging to seven genera. The present study adds two new records; Tabanus unifasciatus and Tabanus lunatus. Keys and illustrations for the horse flies of Jordan are presented based on examined materials. Distribution and geographic ranges for each species is also given.

Animals↗

Tuberculous epididymitis and fertility in North Jordan.

OBJECTIVES: To describe the clinical characteristics of tuberculous epididymitis and its effect on male subfertility in a general hospital in the north of Jordan. METHODS: A retrospective case study of the hospital records of patients with genitourinary tuberculosis managed at Princess Basma Teaching Hospital in Irbid, North Jordan during the period of 1994-2001. RESULTS: Of the 16 patients with genitourinary tuberculosis, 9 were found to have tuberculous epididymitis. The mean age was 41.2 years. The main presentation was an insidious onset of painful scrotal swelling, mostly on the left side. Mean duration of symptoms was 10.6 weeks. Most patients had no history of previous tuberculosis and no Mycobacterium Tuberculosis in their urine. Six months of anti-tuberculous chemotherapy was effective, combined with surgery for scrotal abscesses. Although all patients recovered, the results on fertility are considerable. CONCLUSION: Isolated tuberculous epididymitis is the most common form of genitourinary tuberculosis. A 6-month course of anti-tuberculous chemotherapy is effective in combination with surgery for large scrotal abscesses. The fertility outcome is of concern. Sperm retrieval and cryopreservation have to be considered for potential intra-cytoplasmic sperm injection.

Adult↗

High frequency of suboptimal serum vitamin B12 level in adults in Jordan.

OBJECTIVE: To assess the prevalence of functional vitamin B12 deficiency status in an adult Jordanian seemingly healthy population. METHODS: We carried out this study in the Department of Physiology, Faculty of Medicine, Jordanian University of Science and Technology, Jordan from September 2004 to January 2005. We included a randomly selected sample of 216 healthy adult volunteers (male 124, female 92, aged 19-50 years) from north Jordan. We carried out the measurement of hematological variables by Micros 60-OT Analyzer. We measured the serum vitamin B12 by microparticle enzyme immunoassay and serum folate by ion-capture assay on an AxSYM Analyzer. RESULTS: We found suboptimal (<222 pg/ml) serum levels of vitamin B12 in 104 (48.1%) (male 64, female 40) subjects. The mean serum vitamin B12 level of male in all volunteers was 238.8 +/- 97.3 pg/ml, not significantly different (p=0.24) from that of female (261.8 +/- 101.6 pg/ml). The mean serum values of vitamin B12 of male in the suboptimal group (168.3 +/- 36.4 pg/ml; range 90-221) were not significantly different from that of female (178.2 +/- 27.5 pg/ml; range 113-217) (p=0.31). Of the suboptimal group, 30 subjects (28.8%) had hyper-segmented neutrophils, 38 subjects (36.5%) had low mean corpuscular volume and 8 subjects (7.7%) had sub-optimal serum folate levels. CONCLUSION: This study revealed that there was a high frequency of suboptimal serum vitamin B12 level, which is an early sign of negative B12 balance.

Adult↗

Prevalence of visual deficits among young men in Jordan.

OBJECTIVE: To report the pattern of various causes of decreased visual acuity (VA), within the age group of young (18-25 years) healthy adults in Jordan. METHODS: We carried out this retrospective study on the records of 16,550 candidates examined from June 2004 to June 2005 by the Medical Committee of Employment, Royal Medical Services in Amman, Jordan. All candidates received an ophthalmic examination as well as medical and ENT examination. We divided the candidates with visual acuity of less than 6/12 in either eye into 3 groups. RESULTS: The most important cause of decreased VA in the 18-25 years age group was refractive errors followed by amblyopia, which represents the major ophthalmic cause of employment rejection in a wide range of occupations in adult life. CONCLUSION: This study emphasize the need for early visual screening for refractive errors and anisometropic amblyopia in early primary schools, and every effort must be made to achieve the best possible acuity in young patients with amblyopia.

Adolescent↗

Hematologic status in patients with recurrent aphthous stomatitis in Jordan.

OBJECTIVE: To determine the prevalence of hematinic deficiencies in patients with recurrent aphthous stomatitis. METHODS: The study took place in the Oral Medicine Clinic of the Jordan University Hospital in Amman, Jordan, between January 1993 and December 2000. We studied the hemoglobin, serum ferritin, vitamin B12 and folate levels in 143 patients with recurrent aphthous stomatitis. We compared the results with a control group of 143 age- and gender-matched patients with a range of other oral diseases. RESULTS: In recurrent aphthous stomatitis patients, 14% were anemic and 37.8% showed hematinic deficiencies; 16.8% showed low serum ferritin; 26.6% showed low serum vitamin B12 and 4.9% showed low serum folate. In the control group, 10.5% were anemic and 18.2% showed hematinic deficiencies; 9.8% showed low serum ferritin; 12.6% showed low serum vitamin B12 and none showed serum folate deficiency. CONCLUSION: Patients with recurrent aphthous stomatitis have more hematinic deficiencies, particularly vitamin B12 deficiency, compared with controls. Correction of these hematinic deficiencies could help in the management of the disease.

Adolescent↗

Prevalence of Salmonella, Shigella and intestinal parasites in food handlers in Irbid, Jordan.

During a one-year period, 283 food handlers in Irbid, Jordan were investigated for the presence of potential enteropathogens in their stools. The prevalence rate of enteropathogens among non-Jordanian food handlers (48.0%) was significantly higher (p less than 0.05) than that of the Jordanian group (12.3%). The isolation rates of Salmonella and Shigella were 6% and 1.4% respectively. Multi-drug resistance was frequent among isolates of Salmonella group B and Shigella spp. Intestinal parasites detected in the stools of food handlers included Ascaris lumbricoides (4.9%), Giardia lamblia (3.9%), Schistosoma mansoni, (2.8%), hookworms 2.5%, Hymenolyepis nana (1.8%), Trichuris trichiura (1.1%), Entamoeba histolytica (0.7%), and Taenia saginata (0.4%). This study emphasises the importance of food handlers, particularly the non-Jordanians, in Jordan, as potential source of food-borne infection.

Adult↗

Dental survey: patient attitudes in Jordan.

A questionnaire was used to assess the attitude of family members in Jordan to the state of their teeth, their personal oral hygiene and their acceptance of dental care. The questions were formulated to provide information without the need for dental examination. In industrial societies there is evidence of a reduction in the rate of dental decay whereas in countries such as Jordan the reverse is true. Consideration of this trend, in combination with the results of this survey, provides a strong indication that instruction in oral hygiene must be given together with increased facilities for treatment.

Adolescent↗

Comparison of the dental health status of 8 to 14-year-old children in France and in Jordan, a country of endemic fluorosis.

In the present paper, data obtained from a survey dealing with dental carie, dental fluorosis and gingival health, involving 2618 Jordanian schoolchildren, aged 8 to 14, were compared with data from another survey dealing with 1058 schoolchildren of the same age groups living in a non-fluoridated area in the west of France. As regards dental carie in temporary teeth, up to the age of 12, the dft and dfs scores were higher in France than in Jordan. Over the age of 12, the difference was no longer significant. As regards dental carie in permanent teeth, the data showing that Jordanian children are less subject to caries than the French were very highly significant. Also, it was shown that caries index in girls was higher than in boys. These data were not significant in the French survey, but highly significant in the Jordanian investigation. A possible explanation is that, due to the custom of the country, boys in Jordan drink much more tea (with high fluoride content) than girls. As regards gingival health, an interesting finding was that, compared to the French children, the percentage of Jordanian children presenting gingivitis is remarkably low. The fluoride content of the dental plaque might play a restricting and preventing role.

Adolescent↗

Epidemiology and diagnosis of human brucellosis in Jordan.

In recent reports, brucellosis has emerged as an important public health problem in the east Mediterranean region and Jordan is no exception. In 1986 and 1987, the minimal incidence rates per 100,000 persons in Jordan were 33.2 and 46.2, respectively, with no sex difference. Low incidence rates were confined to those below 4 and over 55 years of age. A seasonal incidence seen in 1986 was repeated in 1987 with maximal rates in the spring and summer months, exhibiting a strong connection with the lambing season. In-vitro sensitivity of 43 isolates of Brucella melitensis is presented. Endemicity in animals is discussed because of its direct relationship with the disease in man.

Age Factors↗

[The role of tea consumption in dental fluorosis in Jordan].

2,516 children of both sexes, six to fourteen years old, were examined in Jordan in the course of an epidemiological study. 81.11% of girls and 76.43% of boys presented severe forms of dental fluorosis according to DEAN's index. Drinking water analysis revealed fluoride concentrations ranging from 0.27 to 1.4 mg F/l. These concentrations are neighbouring optimum tolerated fluoride supplementation in drinking water. However high annual temperature mean and ten hours daily sunshine must also be taken in consideration. For social and climatic reasons, Jordanian children drink daily high quantities of tea. Analysis of tea prepared on jordanian way revealed a concentration of 1.2 mg F/l. This continuous intake of fluoride might explain the high severity of dental fluorosis in Jordan.

Adolescent↗