Topographic and Clinical Characteristics of a Sample of Jordanian Students

Purpose: To screen for keratoconus (KC) and potential associated risk factors in a sample of medical students. Methods: This cross sectional study included 120 medical students studying at The University of Jordan. They were randomly selected from a total of 400 students. Participants responded by completing a self-administered questionnaire. Following initial clinical evaluation, corneal tomography images and indices were analyzed by an experienced ophthalmologist, after which the participants were classified into: normal, KC suspects and KC patients. Results: A total of 120 participants (mean age, 23.1 ±0.5 years) were included in this study, 70 (58.3%) were females and 50 (41.7%) were males. Two subjects had KC, demonstrating a prevalence of 1.7% while five (4.2%) participants showed at least two abnormal indices and were considered as KC suspects.Conclusion: the result of this study is similar to other studies conducted in the Middle East, which indicates a higher prevalence of KC than other western countries. Combined with the significantly impaired vision-related quality of life and the relatively young onset of disease, the burden of keratoconus represents a significant public health concern

Simulation and optimisation of a medium scale reverse osmosis brackish water desalination system under variable feed quality: Energy saving and maintenance opportunity

YesIn this work, we considered model-based simulation and optimisation of a medium scale brackish water desalination process. The mathematical model is validated using actual multistage RO plant data of Al- Hashemite University (Jordan). Using the validated model, the sensitivity of different operating parameters such as pump pressure, brackish water flow rate and seasonal water temperature (covering the whole year) on the performance indicators such as productivity, product salinity and specific energy consumption of the process is conducted. For a given feed flow rate and pump pressure, winter season produces less freshwater that in summer in line with the assumption that winter water demand is less than that in summer. With the soaring energy prices globally, any opportunity for the reduction of energy is not only desirable from the economic point of view but is an absolute necessity to meet the net zero carbon emission pledge by many nations, as globally most desalination plants use fossil fuel as the main source of energy. Therefore, the second part of this paper attempts to minimise the specific energy consumption of the RO system using model-based optimisation technique. The study resulted not only 19 % reduction in specific energy but also 4.46 % increase in productivity in a particular season of the year. For fixed product demand, this opens the opportunity for scheduling cleaning and maintenance of the RO process without having to consider full system shutdown

Delayed intravitreal anti-vegf therapy for patients during the covid-19 lockdown: An ethical endeavor

Purpose: To assess the impact of Jordanian’s Corona Virus Disease (COVID-19) lockdown on visual acuity and macular thickness in patients with macular edema receiving intravitreal injections, and to assess the ethical endeavor of lockdown among serious sight threatening conditions. Patients and Methods: This retrospective observational study included patients planned for intravitreal injections who did not complete the planned course before the lockdown (ie, before 20th of March 2020). Data included demographics, indication for the intravitreal injection, corrected distance visual acuity (CDVA), and central macular thickness on Optical Coherence Tomography (OCT) before and after the lockdown. Results: One-hundred and sixty-six eyes of 125 patients were studied, 68 (54.4%) patients were males, and the mean (± standard deviation, SD) age was 64.79 (±9.41) years. Mean (±SD) duration of delay in the planned injection was 60.97 (±24.35) days. The change in visual acuity was statistically significant for patients with diabetic macular edema (p= 0.045 improvement), patients with central retinal vein thrombosis (CRVO) (p= 0.05 deterioration), and patients with age-related macular degeneration (AMD) (p= 0.005 deterioration). Of interest, delay of more than 2 months and the previous need for 3 or more injections were significant poor prognostic factors for visual outcome for patients with diabetic macular edema (p=0.027 and 0.045). Conclusion: The impact of delay in the scheduled intravitreal injections resulted in variable outcomes depending on the indication. Triaging the urgency of patients should be based on the indication to support the equity principle of bioethics, where those in need are prioritized against others, depending on potential adverse outcome

Prevalence of Pseudoexfoliation Syndrome and Pseudoexfoliation Glaucoma in Upper Egypt

<p>Abstract</p> <p>Background</p> <p>Pseudoexfoliation (PXF) is a recognized risk factor for developing cataract, glaucoma and lens dislocation. PXF is also associated with increased risk of complications during cataract surgery due to poor mydriasis and zonular weakness. The aim of this study is to report the prevalence of pseudoexfoliation among Upper Egyptians attending the ophthalmology clinic of Assiut University Hospital.</p> <p>Methodology</p> <p>A retrospective, chart review study conducted in the period from February 2002 to August 2009. A total of 7738 patients aged 40 years or older attending the general ophthalmic clinics were included in this study. A detailed evaluation including ophthalmic and general history, slit lamp biomicroscopy, intraocular pressure measurement, gonioscopy and dilated eye examination were performed. Patients with pseudoexfoliative material on the anterior lens surface and ⁄ or the pupillary margin in either or both eyes were labeled as having PXF.</p> <p>Results</p> <p>Out of the 7738 patients included, three hundred twenty (4.14%) subjects had PXF. Mean age of PXF group was 68.15 years (SD 8.16, range 40-92 years). PXF was bilateral in 82.2% of cases. It was significantly associated with cataract, glaucoma and hearing loss. Of the PXF patients, 65% had cataract, 30.3% had glaucoma and 8.1% had hearing loss.</p> <p>Conclusion</p> <p>Pseudoexfoliation appears to be a common disorder in older individuals in Upper Egypt.</p

A System Dynamics Approach for Hospital Waste Management in a City in a Developing Country: The Case of Nablus, Palestine

Hospitals and health centers provide a variety of healthcare services and normally generate hazardous waste as well as general waste. General waste has a similar nature to that of municipal solid waste and therefore could be disposed of in municipal landfills. However, hazardous waste poses risks to public health, unless it is properly managed. The hospital waste management system encompasses many factors, i.e., number of beds, number of employees, level of service, population, birth rate, fertility rate, and not in my back yard (NIMBY) syndrome. Therefore, this management system requires a comprehensive analysis to determine the role of each factor and its influence on the whole system. In this research, a hospital waste management simulation model is presented based on the system dynamics technique to determine the interaction among these factors in the system using a software package, ithink. This model is used to estimate waste segregation as this is important in the hospital waste management system to minimize risk to public health. Real data has been obtained from a case study of the city of Nablus, Palestine to validate the model. The model exhibits wastes generated from three types of hospitals (private, charitable, and government) by considering the number of both inpatients and outpatients depending on the population of the city under study. The model also offers the facility to compare the total waste generated among these different types of hospitals and anticipate and predict the future generated waste both infectious and non-infectious and the treatment cost incurred

Prevalence and risk factors of hepatitis B and C viruses among haemodialysis patients in Gaza strip, Palestine

<p>Abstract</p> <p>Background</p> <p>The prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) and its associated risk factors among haemodialysis (HD) patients in Gaza strip was investigated using serological and molecular techniques.</p> <p>Results</p> <p>The overall prevalence of HBV among the four HD centers was 8.1%. The main risk factors were HD center (p = 0.05), history of blood transfusion (p < 0.01), and treatment abroad (p = 0.01). The overall prevalence of HCV among the four HD centers was 22%. The main risk factors were HD center (p < 0.01), time duration on HD (p < 0.01), history of blood transfusion (p < 0.01), treatment abroad (p < 0.01), and history of blood transfusion abroad (p < 0.01). Serum aminotransferases levels decreased in HD patients compared with normal population but still there was a direct association between the activity of liver enzymes and both HBV (p < 0.01) and HCV (p < 0.01) infection.</p> <p>Conclusion</p> <p>The much higher prevalence of Hepatitis viruses among HD patients compared to the normal population of Gaza strip indicates a causative relation between HD and hepatitis viruses transmission. Therefore extremely careful observation of preventive infection control measures is essential to limit Hepatitis viruses' transmission in HD centers.</p

Posterior segment causes of reduced visual acuity after phacoemulsification in eyes with cataract and obscured fundus view

Hisham M Jammal,1,3 Yousef Khader,2 Riham Shawer,3 Muawyah Al Bdour41Department of Ophthalmology, Jordan University of Science and Technology, Irbid, Jordan; 2Department of Community Medicine, Public Health and Family Medicine, Jordan University of Science and Technology, Irbid, Jordan; 3Department of Ophthalmology, King Abdullah University Hospital, Irbid, Jordan; 4Department of Ophthalmology, The University of Jordan, Amman, JordanPurpose: To determine posterior segment causes of reduced visual acuity after phacoemulsification in eyes with cataract and obscured fundus view.Patients and methods: Retrospective review of medical records of patients with cataract, obscured fundus view, and normal B-scan ultrasonography, undergoing phacoemulsification from May 2005 to March 2012 was conducted. Eyes with fundus pathology, previous trauma, surgery, glaucoma, amblyopia, or uveitic cataract were excluded. Ocular comorbid conditions, preoperative visual acuity (VA), intraoperative and early postoperative complications, and final best corrected visual acuity (BCVA) at 1 month were abstracted from the records.Results: All 201 eyes of 179 patients studied had a preoperative VA of &amp;le;6/60. Preoperative ocular comorbidity was present in 31 eyes (15.5%). Intraoperative complications occurred in 20 eyes (10%). Postoperative complications developed in 34 eyes (17.0%). One month postoperatively, 175 eyes (87.1%) achieved a BCVA of &amp;ge;6/12; whereas 26 eyes (12.9%) achieved a BCVA of &amp;le;6/18. The most common posterior segment causes of reduced VA in the 26 eyes were age-related macular disease in ten eyes (38.5%) and diabetic maculopathy in six eyes (23.1%). Similar fundus pathology was seen preoperatively in the fellow fundus in 10 of the 26 eyes (38.5%).Conclusion: One month after phacoemulsification in eyes with cataract and obscured fundus view, age-related macular disease and diabetic maculopathy were the most common posterior segment causes of reduced final BCVA. To avoid postsurgical dissatisfaction, patients with obscured fundus view in their preoperative eye should be counseled, especially if posterior segment pathology exists in their fellow eye.Keywords: B-scan ultrasonography, fundus view, macula, outcome, phacoemulsifcatio

Ankylosing spondylitis in north Jordan: descriptive and analytical study

OBJECTIVE—A study of ankylosing spondylitis in Jordan, which has been underinvestigated in this region.
METHODS—Twenty two patients were studied according to standard methodology during a period of four years. Information on HLA, the presence of uveitis, cardiac disease, and peripheral arthritis was recorded. Other variables such as age, sex, employment, and level of disability were also recorded.
RESULTS—The results reflected the characteristics of the illness and the impact of the disease on the patients and their quality of life and were consistent with the findings of other workers in the region.