Effect of Paractamol in Closing of PDA in Preterm Babies

Objective: We tried to collect no of preterm babies less than 32 weeks less than 1500gram admitted in NICU from 1-1-2020 till the end of 31- 12-2021 And we want to see the effects of paractamol in form of closing of ducts arteriosus in preterm babies, we used gestation age between 24 weeks till 32 weeks delivery at this period. Methods: We used paractamol in a dose of 15mg/kg/dose for three days in all preterm babies less than 1500 grams and we did Echocardiogram if PDA is present and affected the hemodynamic and stability of the babies, for example, the babies on a mechanical ventilator, received two doses of servants had hypotension and had large to moderate PDA we gave them paractamol 15mg/kg every 6 hours then we repeated Echocardiogram if still, PDA is present we gave them second course 15mg/kg/dose for 2 days. We rolled in 400 babies preterm delivered from 1-1-2020 till the end of 31-12-202we did a retrospective study to collect the data from files we saw the response of the drug in form of closing PDA and only one baby had surgery in form of PDA ligation. Inclusion Criteria: Preterm less than 32 weeks or less than 1500gram. Preterm had hypotension and need a high setting of the ventilator. Any preterm less than 32 weeks and echocardiogram show PDA. Any preterm babies whose mothers have not received antenatal steroids. Any congenital anomalies have not affected the life. Excluding Criteria: Multiple congenital anomalies. Preterm babies who died before roll in the study. Preterm babies who died within 48 hours. Any preterm had coagulopathy. Any preterm had renal failure

A simplified interventional mapping system (SIMS) for the selection of combinations of targeted treatments in non-small cell lung cancer

Non-small cell lung cancer (NSCLC) is a leading cause of death worldwide. Targeted monotherapies produce high regression rates, albeit for limited patient subgroups, who inevitably succumb. We present a novel strategy for identifying customized combinations of triplets of targeted agents, utilizing a simplified interventional mapping system (SIMS) that merges knowledge about existent drugs and their impact on the hallmarks of cancer. Based on interrogation of matched lung tumor and normal tissue using targeted genomic sequencing, copy number variation, transcriptomics, and miRNA expression, the activation status of 24 interventional nodes was elucidated. An algorithm was developed to create a scoring system that enables ranking of the activated interventional nodes for each patient. Based on the trends of co-activation at interventional points, combinations of drug triplets were defined in order to overcome resistance. This methodology will inform a prospective trial to be conducted by the WIN consortium, aiming to significantly impact survival in metastatic NSCLC and other malignancies

Unravelling the predictors of late cancer presentation and diagnosis in Jordan: a cross-sectional study of patients with lung and colorectal cancers

Objectives Late presentation or diagnosis of cancer results in a poor clinical prognosis, negatively affects treatment and subsequently lowers one’s chances of survival. This study aimed to identify the factors associated with late lung and colorectal cancer presentation and diagnosis in Jordan.Design This correlational cross-sectional study was based on face-to-face interviews and medical chart reviews from a cancer registry database. A structured questionnaire based on a review of the literature was used.Setting and participants The study participants were a representative sample of adult patients with colorectal or lung cancer who visited the outpatient clinics at King Hussein Cancer Center in Amman, Jordan, between January 2019 and December 2020, to get their first medical consultation.Results 382 study participants were surveyed, with a response rate of 82.3%. Of these, 162 (42.2%) reported a late presentation and 92 (24.1%) reported a late diagnosis of cancer. The results of backward multivariate logistic regression analyses showed that female gender and not seeking a medical advice when feeling ill combined was associated with an almost three times increased likelihood of reporting a late presentation with cancer (adjusted OR 2.97, 95% CI 1.19 to 7.43). Not having health insurance and not seeking medical advice combined was also associated with late presentation (2.5, 95% CI 1.02 to 6.12). For lung cancer, Jordanians living in rural areas were 9.29 (95% CI 2.46 to 35.1) times more likely to report late diagnosis. Jordanians who did not screen for cancer in the past were 7.02 (95% CI 1.69 to 29.18) times more likely to report late diagnosis. For colorectal cancer, those having no previous knowledge about cancers or screening programmes had increased odds of reporting late diagnosis (2.30, 95% CI 1.06 to 4.97).Conclusions This study highlights important factors associated with the late presentation and diagnosis of colorectal and lung cancers in Jordan. Investing in national screening and early detection programmes as well as public outreach and awareness campaigns will have a significant impact on early detection to improve treatment outcomes

Germline BRCA1/BRCA2 mutations among high risk breast cancer patients in Jordan

Abstract Background Breast cancer is the most common malignancy and the leading cause of cancer-related deaths among Jordanian women. With a median age of 50 years at diagnosis, a higher prevalence of hereditary breast cancer may be expected. The objective of this pilot study is to evaluate, for the first time, the contribution of germline mutations in BRCA1/2 to breast cancer among Jordanian patients. Methods Jordanian breast cancer women with a selected high risk profile were invited to participate. Peripheral blood samples were obtained for DNA extraction. A detailed 3-generation family history was also collected. BRCA sequencing was performed at a reference laboratory. Mutations were classified as deleterious, suspected deleterious, variant of uncertain significance or favor polymorphisms. Patients’ medical records were reviewed for extraction of clinical and tumor pathology data. Results One hundred patients were enrolled to the study. Median age was 40 (22–75) years. In total, 20 patients had deleterious and 7 suspected deleterious mutations in BRCA1 or BRCA2 genes. Seven variants of uncertain significance were also detected. After excluding patients tested subsequent to the index case in their families, highest mutation rates were observed among triple negatives (9/16, 56.3%) especially among those with positive family history of breast and/or ovarian cancer (9/13, 69.2%), patients with bilateral or second primary breast cancer (10/15, 66.7%) and those with family history of male breast cancer (2/5, 40.0%). Conclusions BRCA1/2 mutations are not uncommon among selected Jordanian females with breast cancer. The contribution of these findings to much younger age at diagnosis is debatable. Although small, our selected patient cohort shows an important incidence of deleterious and suspected deleterious BRCA1/2 mutations suggesting that genetic testing should be offered to patients with certain high risk features

Improved Estimation of the Inverted Kumaraswamy Distribution Parameters Based on Ranked Set Sampling with an Application to Real Data

The ranked set sampling (RSS) methodology is an effective technique of acquiring data when measuring the units in a population is costly, while ranking them is easy according to the variable of interest. In this article, we deal with an RSS-based estimation of the inverted Kumaraswamy distribution parameters, which is extensively applied in life testing and reliability studies. Some estimation techniques are regarded, including the maximum likelihood, the maximum product of spacing’s, ordinary least squares, weighted least squares, Cramer–von Mises, and Anderson–Darling. We demonstrate a simulation investigation to assess the performance of the suggested RSS-based estimators via accuracy measures relative to simple random sampling. On the basis of actual data regarding the waiting times between 65 consecutive eruptions of Kiama Blowhole, additional conclusions have been drawn. The outcomes of simulation and real data application demonstrated that RSS-based estimators outperformed their simple random sampling counterparts significantly based on the same number of measured units

Improved Estimation of the Inverted Kumaraswamy Distribution Parameters Based on Ranked Set Sampling with an Application to Real Data

The ranked set sampling (RSS) methodology is an effective technique of acquiring data when measuring the units in a population is costly, while ranking them is easy according to the variable of interest. In this article, we deal with an RSS-based estimation of the inverted Kumaraswamy distribution parameters, which is extensively applied in life testing and reliability studies. Some estimation techniques are regarded, including the maximum likelihood, the maximum product of spacing’s, ordinary least squares, weighted least squares, Cramer–von Mises, and Anderson–Darling. We demonstrate a simulation investigation to assess the performance of the suggested RSS-based estimators via accuracy measures relative to simple random sampling. On the basis of actual data regarding the waiting times between 65 consecutive eruptions of Kiama Blowhole, additional conclusions have been drawn. The outcomes of simulation and real data application demonstrated that RSS-based estimators outperformed their simple random sampling counterparts significantly based on the same number of measured units

Reliability Estimation of Inverse Lomax Distribution Using Extreme Ranked Set Sampling

In survival analysis, the two-parameter inverse Lomax distribution is an important lifetime distribution. In this study, the estimation of R=P Y<X is investigated when the stress and strength random variables are independent inverse Lomax distribution. Using the maximum likelihood approach, we obtain the R estimator via simple random sample (SRS), ranked set sampling (RSS), and extreme ranked set sampling (ERSS) methods. Four different estimators are developed under the ERSS framework. Two estimators are obtained when both strength and stress populations have the same set size. The two other estimators are obtained when both strength and stress distributions have dissimilar set sizes. Through a simulation experiment, the suggested estimates are compared to the corresponding under SRS. Also, the reliability estimates via ERSS method are compared to those under RSS scheme. It is found that the reliability estimate based on RSS and ERSS schemes is more efficient than the equivalent using SRS based on the same number of measured units. The reliability estimates based on RSS scheme are more appropriate than the others in most situations. For small even set size, the reliability estimate via ERSS scheme is more efficient than those under RSS and SRS. However, in a few cases, reliability estimates via ERSS method are more accurate than using RSS and SRS schemes

Stress–Strength Modeling Using Median-Ranked Set Sampling: Estimation, Simulation, and Application

In this study, we look at how to estimate stress–strength reliability models, R1 = P (Y X) and R2 = P (Y X), where the strength X and stress Y have the same distribution in the first model, R1, and strength X and stress Z have different distributions in the second model, R2. Based on the first model, the stress Y and strength X are assumed to have the Lomax distributions, whereas, in the second model, X and Z are assumed to have both the Lomax and inverse Lomax distributions, respectively. With the assumption that the variables in both models are independent, the median-ranked set sampling (MRSS) strategy is used to look at different possibilities. Using the maximum likelihood technique and an MRSS design, we derive the reliability estimators for both models when the strength and stress variables have a similar or dissimilar set size. The simulation study is used to verify the accuracy of various estimates. In most cases, the simulation results show that the reliability estimates for the second model are more efficient than those for the first model in the case of dissimilar set sizes. However, with identical set sizes, the reliability estimates for the first model are more efficient than the equivalent estimates for the second model. Medical data are used for further illustration, allowing the theoretical conclusions to be verified

Frequency of Mismatch Repair Protein (MMRP) Deficiency among Young Jordanians Diagnosed with Colorectal Carcinoma (CRC)

Purpose. Microsatellite instability (MSI) caused by mismatch repair protein (MMRP) deficiency is detected in 15% of sporadic colorectal cancers (CRCs). Our aim is to investigate the frequency of MMRP deficiency in young CRC patients, using immunohistochemical analysis. Methods. This study targeted cases of CRC at King Hussein Cancer Center from 2004 until 2012 in patients 45 years of age or younger at the time of diagnosis. Clinicopathological data was obtained from 155 patients’ records. Immunohistochemistry for MLH1, MSH2, PMS2, and MSH6 proteins was performed on paraffin-embedded tissue containing carcinoma. Results. The median age of patient at diagnosis was 38 years. A total of 29 (19%) cases showed deficient MMRP(dMMRP)expression. Loss of expression of PMS2 was seen in 17 cases, 12 cases of which showed loss of MLH1 expression. Loss of expression of MSH6 was seen in 10 cases, 9 of which showed loss of MSH2 expression. One case (3.4%) showed loss of all four MMR proteins, and another case (3.4%) showed loss of PMS2/MLH1 and MSH6. There was a significant association between abnormal MMR protein expression and tumor location proximal to splenic flexure (p value 0.000), pathologic features suggestive of microsatellite instability (p value 0.000), P53 negativity (p value 0.000), and stage (p value 0.02). Patients with dMMRP CRC appeared to have a significantly better overall survival compared to patients with proficient MMRP(pMMRP)(p value 0.02). Loss of MSH2/MSH6 was significantly associated with positive family history of cancer (p value = 0.020). Conclusions. The prevalence of dMMRP tumors in this age group appears to be similar to international literature. dMMRP tumors tends to be associated with earlier stages and better outcomes compared to pMMRP cases. dMMRP can serve as a biomarker for better prognosis. These results are of value in directing the clinical management of young patients with CRC