Venous Thromboembolism in the Context of Reproduction: The Royal College of Obstetricians and Gynecologists Recommendations

Venous thromboembolism complicates 1–2 of every 1000 deliveries. It may manifest as deep vein thrombosis or pulmonary embolism. Pregnancy-associated venous thromboembolism is an important major cause of maternal morbidity and mortality. Prophylaxis and therapy in pregnancy are complicated by the need to take both fetal and maternal well-being into consideration. Risk factors for venous thromboembolism during pregnancy or the puerperium are multiple. They include, but are not limited to, thrombophilia, multiparity, orthopedic injuries, medical comorbidities, prior venous thromboembolism, smoking, gross varicose veins, age, if older than 35, obesity, multiple pregnancy, preeclampsia, cesarean section, prolonged labor, instrumental vaginal delivery, stillbirth, preterm birth, postpartum hemorrhage, hyperemesis gravidarum, ovarian hyperstimulation syndrome, immobility, long periods of hospitalization, and long haul travel. This chapter is a clinical guide that covers prophylaxis and therapy of pregnancy-associated venous thromboembolism, based on evidence-based research and consensus opinion

Needle Stick and Sharp Injuries Among Healthcare Workers: A retrospective six-year study

Objectives: This study aimed to examine the proportion of needle stick and sharp injuries (NSSIs) among healthcare workers at King Hussein Medical Center (KHMC), Amman, Jordan. Methods: All NSSI reports referred from departments at KHMC to the Preventive Medicine Department between 2013–2018 were retrospectively reviewed. Proportion of NSSIs were calculated and stratified according to age, gender, job title, place and site of injury and the procedure/task during which the injury occurred. Results: There were a total of 393 NSSIs. A significant association was found between the proportion of NSSIs and all tested variables (P <0.001). The reported proportion of NSSIs was highest among nurses (39.7%) followed by cleaners (36.3%), physicians (10.4%), other workers (7.4%) and lab technicians (5.9%) during the study’s six-year period. Hospital wards were the most common locations (46.1%) where injuries took place. Injuries also occurred most frequently during medical waste collection (38.2%). Conclusion: The proportion of NSSIs was highest among nurses and cleaners. Safety policies and training among high-risk groups should be reviewed to reduce the risk of NSSIs. Multicentre studies at a national level should be conducted to examine whether this study’s findings reflect national trends.Keywords: Needlestick Injuries; Safety; Self Report; Nurses; Accident Prevention; Jordan

Mapping of five candidate sex-determining loci in rainbow trout (Oncorhynchus mykiss)

<p>Abstract</p> <p>Background</p> <p>Rainbow trout have an XX/XY genetic mechanism of sex determination where males are the heterogametic sex. The homology of the sex-determining gene (SDG) in medaka to <it>Dmrt1 </it>suggested that SDGs evolve from downstream genes by gene duplication. Orthologous sequences of the major genes of the mammalian sex determination pathway have been reported in the rainbow trout but the map position for the majority of these genes has not been assigned.</p> <p>Results</p> <p>Five loci of four candidate genes (<it>Amh</it>, <it>Dax1</it>, <it>Dmrt1 </it>and <it>Sox6</it>) were tested for linkage to the Y chromosome of rainbow trout. We exclude the role of all these loci as candidates for the primary SDG in this species. <it>Sox6i </it>and <it>Sox6ii</it>, duplicated copies of <it>Sox6</it>, mapped to homeologous linkage groups 10 and 18 respectively. Genotyping fishes of the OSU × Arlee mapping family for <it>Sox6i </it>and <it>Sox6ii </it>alleles indicated that <it>Sox6i </it>locus might be deleted in the Arlee lineage.</p> <p>Conclusion</p> <p>Additional candidate genes should be tested for their linkage to the Y chromosome. Mapping data of duplicated <it>Sox6 </it>loci supports previously suggested homeology between linkage groups 10 and 18. Enrichment of the rainbow trout genomic map with known gene markers allows map comparisons with other salmonids. Mapping of candidate sex-determining loci is important for analyses of potential autosomal modifiers of sex-determination in rainbow trout.</p

Perspectives and attitudes of jordanian medical and paramedical students toward surrogate pregnancy

Purpose: This study aims at investigating the perspectives of Jordanian medical and paramedical students on surrogate pregnancy. Methods: A questionnaire-based cross-sectional study design was used. The sample consisted of n=328 students of both genders. The questionnaire responses were numerically coded and analyzed across gender and the level of education. Results: Approximately, 18% of the students reported good awareness about the ethical dilemmas of surrogacy. The results showed a general reluctance to accept surrogate pregnancy as the majority (80.5% of male students and 97.6% of female students) had a negative attitude toward surrogacy. In addition, undergraduate students were less supportive to surrogate pregnancy than graduate students. Religious considerations were the main reason (accounts for about 70%) for driving negative attitude toward surrogacy. Conclusion: The findings of the study indicate a general reluctance toward accepting the concept of surrogate pregnancy, which is mainly due to religious reasons

The current evidence on statin use and prostate cancer prevention: are we there yet?

An increasing amount of data supports an inverse association between statin use and cancer risk. The findings for prostate cancer, particularly advanced disease, are the most promising of all cancers studied. Use of these agents seems to also be associated with improved prostate-cancer-specific survival, particularly in men undergoing radiotherapy, suggesting usefulness of statins in secondary and tertiary prevention. Some study results might be influenced by increased PSA screening and health-conscious behaviour in statin users but these factors are unlikely to completely account for observed beneficial effects. The epidemiological evidence is supported by preclinical studies that show that statins directly inhibit prostate cancer development and progression in cell-based and animal-based models. The antineoplastic effect of statins might arise from a number of cholesterol-mediated and non-cholesterol-mediated mechanisms that affect pathways essential for cancer formation and progression. Understanding these mechanisms is instrumental in drug discovery research for the development of future prostate cancer therapeutics, as well as in designing clinical trials to test a role for statins in prostate cancer prevention. Currently, sufficient data are lacking to support the use of statins for the primary prevention of prostate cancer and further research is clearly warranted. Secondary and tertiary prevention trials in men who have been diagnosed with prostate cancer might soon be performed

Disparities in Obstetric, Neonatal, and Birth Outcomes Among Syrian Women Refugees and Jordanian Women

Objectives: To compare obstetric and neonatal characteristics and birth outcomes between Syrian refugees and native women in Jordan.Methods: We used the Jordan Stillbirths and Neonatal Deaths Surveillance System to extract sociodemographic and obstetric characteristics of the mothers and birth characteristics of newborns. Multivariate analysis was used to compare the characteristics of 26,139 Jordanian women (27,468 births) and 3,453 Syrian women refugees (3,638 births) who gave birth in five referral hospitals (May 2019 and December 2020).Results: The proportions of low birthweight (14.1% vs. 11.8%, p &lt; 0.001) and small for gestational age (12.0% vs. 10.0%, p &lt; 0.001) newborns were significantly higher for those born to Syrian women compared to those born to Jordanian women. The stillbirth rate (15.1 vs. 9.9 per 1,000 births, p = 0.003), the neonatal death rate (21.2 vs. 13.2 per 1,000 live births, p &lt; 0.001), and perinatal death rate (21.2 vs. 13.2 per 1,000 births, p &lt; 0.001) were significantly higher for the Syrian births. After adjusting for sociodemographic and obstetric characteristics of women, only perinatal death was statistically significantly higher among Syrian babies compared to Jordanian babies (OR = 1.3, 95% CI: 1.1–1.7, p = 0.035).Conclusion: Syrian refugee mothers had a significantly higher risk of adverse obstetric and neonatal outcomes including higher rate of perinatal death compared to Jordanian women

Association of Adiponectin and rs1501299 of the ADIPOQ Gene with Prediabetes in Jordan

Type 2 diabetes mellitus (T2DM) is a worldwide health problem caused by resistance to insulin action. This chronic debilitating diseaseis preceded by a stage, known as prediabetes, in which a healthy lifestyle can delay the disease. The discovery of biochemical changes in prediabetes is important to identify individuals at risk of developing T2DM and in explaining disease pathogenesis. Adiponectin is secreted by fat cells and is linked with insulin resistance. Adiponectin levels are dysregulated in prediabetic subjects. This relationship had not been tested in Jordan. We recruited 130 subjects with prediabetes and 130 control subjects. We measured serum levels of adiponectin and genotyped subjects for three single nucleotide polymorphisms (SNPs) in the ADIPOQ gene; rs266729, rs1501299 and rs2241766. In multivariate analysis, we found that serum adiponectin lowers the risk of prediabetes (p = 0.002; odds ratio (OR), 0.764; 95% confidence interval (CI), 0.646&ndash;0.905). The rs1501299 SNP of the ADIPOQ gene was associated with prediabetes in our population (p = 0.041). Specifically, in multivariate analysis, the GT genotype of rs1501299 increased the risk of prediabetes (p = 0.010; OR, 2.350; 95% CI, 1.231&ndash;4.486) as well as the TT genotype (p = 0.006; OR, 4.774; 95% CI, 1.551&ndash;14.693). Our findings indicate that serum adiponectin and SNPs in the ADIPOQ gene are associated with prediabetes in Jordan

Mapping and evolution of candidate sex determining loci, sex chromosomes, and sex linked sequences in rainbow and cutthroat trout

Fish provide an intriguing model for the study of how sex determination mechanisms evolve. Salmonids have an XX-XY mechanism for sex determination where males are the heterogametic sex. Sex chromosomes of most salmonid species can not be cytogenetically distinguished suggesting that they are at an early stage of evolution. Salmonids have also evolved from a common tetraploid ancestor 25-100 million years ago. The role of genome duplications in shaping the karyotype of vertebrates is well established. The presence of a genome duplication event in salmonids' recent evolutionary history makes them a good model for understanding the structuring of genomes following polyploidization. This dissertation examines the evolution of sex determination mechanisms, and the evolution of duplicated loci following polyploidization using the two model salmonid species rainbow trout (Oncorhynchus mykiss) and cutthroat trout (Oncorhynchus clarki). In this dissertation, we first show that unlike other Pacific salmon and trout species examined, rainbow and cutthroat trout have their sex locus on the same linkage group which appears to be largely homologous. We then use a BAC clone containing sequences of one of the markers used to establish synteny between the sex chromosomes of the two species, to identify the Y chromosome of cutthroat trout. We also test the linkage of a number of candidate sex-determining genes to the Y chromosome of rainbow trout. We exclude the role of all of the tested genes as candidates for sex-determination. We also describe duplication of one of the candidate genes, Sox6 and discuss its inheritance in our mapping families. Sox9, a candidate sex-determining gene is part of a chromosomal block shown to be conserved among different species. Recent evidence indicates conservation of the block in rainbow trout. Two Sox9 gene copies were isolated from rainbow trout, Sox9 and Sox9[alpha]2. Previous evaluations of their evolutionary history gave ambiguous results. We hypothesize that mapping of Sox9 and Sox9[alpha]2 would allow us to more properly evaluate their evolutionary relationship. The map position of Sox9 and Sox9[alpha]2 genes indicates that Sox9 belongs to the Sox9b clade while Sox9[alpha]2 belongs to the Sox9a clade

Attitudes of Medical and Health Sciences Students towards Abortion in Jordan

Background. Jordan laws on permitting abortion are considered moderate. Religion is one of the key determinants of people’s attitudes towards abortion and plays a crucial role in people’s readiness to accept or refute this practice. In this study, we examined the attitudes of medical and health sciences students towards abortion. Methods. In this cross-sectional study, a self-administered questionnaire survey was distributed to students at Jordan University of Science and Technology. Attitudes towards abortion were tested using 16 items that were included in the survey. Descriptive statistics and logistic regression models were used in the analysis. Results. A total of 1324 students in the medicine and dentistry colleges participated in the study. Two-thirds of the participants were women. Most participants were 20–25 years old, and they grew up in a family of 6–8 members. The overall attitude towards abortion was negative, except if the pregnancy was a threat to the mother’s life (91.5%) or if the conception occurred from rape (54.2%). Otherwise, the students indicated that every conceived child has the right to be born (76.8%) and that abortion is considered murder (53.1%). Furthermore, the students who were more likely to support abortion were those attending the medical college, living in a city, and/or raised in smaller families (p=0.04). Conclusions. Compared with other students, medical students were more supportive of abortion. This implied the necessity to include training on safe abortion in the medical curriculum and increase public awareness of the importance of safe abortion