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

Using YouTube to Learn Anatomy: Perspectives of Jordanian Medical Students

Purpose. The study is aimed at exploring the popularity, impact, and usefulness of using YouTube in learning anatomy as perceived by Jordanian medical students studying at Jordan University of Science and Technology. Methods. The present work is a cross-sectional questionnaire-based study. First-, second-, and third-year medical students were invited to complete an anonymous questionnaire. Students’ responses were numerically coded, and the results were analyzed to reveal any statistically significant differences related to gender or level of study. Results. The results showed that 96.4% of the students used YouTube in general, 91.2% used it as a source of information, and 83.9% used YouTube as a learning tool in medical school. Further, YouTube was used by 79.1% of the students as an anatomy-learning tool. Most of these students used this platform in learning gross anatomy. The study also revealed that dissection videos were the most viewed anatomy-related content. Regarding the perceived value of YouTube as an anatomy-learning tool, the majority of the students reported that YouTube offered them useful anatomical information and enhanced their understanding, memorization, and recall of anatomical information. In addition, most of them recommended using YouTube as an anatomy-learning tool. Statistical analysis of the results revealed the presence of gender-related significant differences in students’ perspectives. Such differences were also found among students of different levels of study. Conclusion. Medical students have positive attitudes toward using YouTube in augmenting their anatomy learning. For this, educators are encouraged to adopt YouTube as an educational tool in their anatomy instruction and to create new anatomy-related YouTube videos to enhance their students’ learning.</jats:p

Medical education across three colleges of medicine: perspectives of medical students

AimThis study aimed to explore and evaluate various components of the medical education process (lectures, labs, small-group discussions, clinical rotations, and undergraduate research) in three colleges of medicine in Jordan. MethodsThis cross-sectional questionnaire-based study included 849 undergraduate students from three main medical colleges in Jordan. Statically valid responses were considered for 684 students. The participants were from Jordan University of Science and Technology, Yarmouk University, and the University of Jordan. ResultsThe distribution of students according to their admission status was 276 (40%) regular, 266 (38.9%) parallel, and 142 (20.8%) international programs. Personal interest and self-initiation were the major motives for studying medicine in 66.1%. Regarding the frequency of attending classes, University of Jordan students reported the highest rate of regular classes' attendance (93%). The study also reported that lecture notes and textbooks were the main sources of learning for medical students. The study also reported superior academic performance of students in the regular program compared to students in the parallel and international programs. Participants of the study criticized the medical curricula in the three colleges mentioned above because of the lack of active research programs. Most of the students (40%–56%) also complained that the lectures within the modules were not well-integrated, and they felt that the academic environment was moderate (48–59%). In addition, most students in the clinical phase complained of overcrowding in hospital wards during clinical rotation. ConclusionsBased on students' feedback, multiple aspects of the medical education process require substantial reform to meet the expectations of medical students in Jordan.This study was supported by the Deanship of Research at JUST (2015/513). Dr. Ayman Mustafa is currently at leave from JUST. Open access funding provided by the Qatar National Library

A cephalometric morphometric study of age- and gender-dependent shape patterns of the sella turcica

The sella turcica is an important anatomic and radiologic entity. The shape of the sella turcica varies among normal individuals and can be influenced by local factors. The normal shape of sella turcica has been categorized as circular, oval, and flat, and several variants have been described. The sella turcica increases in size with age, but there is no agreement upon significance of gender-related differences. The main objective of this study is to build up a normative database of the shape of the sella turcica in the Jordanian population with reference to age and gender. For this purpose 509 computed cephalograms: 252 males and 257 females, aged 10 to 40 years old healthy Jordanians were collected and divided into adolescent and adult age groups in both genders. Viewbox 3 software was used to determine width and height, and shape of the sella turcica was accordingly assessed. Variants of shape were also documented. Our results showed that females exhibit higher percentage of overall normal shape but lower relative percentages of oval and flat shapes, as compared with males. In contrast to males, females also show decreasing trend of normal shape as age advances. Females and males change obviously in favor of oval shape. In terms of variants, as individuals advance in age, bridging and irregular dorsum clearly predominate. In terms of width and height, significant differences were evident between adult male group on one hand and adolescent female group and adult female group on the other hand. Between age categories and within male and female groups, sella linear dimensions were significantly different between adolescent and adult age groups. The significant increase of linear parameters of sella turcica across age groups indicates that there is significant degree of growth in sella turcica across the studied age groups. However, this growth does not affect the shape of sella turcica as the shape seems to be preserved across the studied age groups. The obtained data are discussed in terms of age- and gender-related growth and degenerative bone changes

Morphometric Analysis of the Corpus Callosum According to Age and Sex in Middle Eastern Arabs: Racial Comparisons and Clinical Correlations to Autism Spectrum Disorder

This study sought to examine the influence of age and sex on morphometric measurements of the corpus callosum (CC) within Middle Eastern Arab population, in order to obtain reference data and conduct racial comparisons with previously reported measurements from other ethnicities. Furthermore, it aimed to investigate CC variations that may occur in children with autism. To this end, magnetic resonance images of normal brains were acquired from three different age groups, consisting of children, younger adults, and older adults. Brain images were also acquired from boys with autism spectrum disorder (ASD). The CC length, area, and thickness were measured. The CC length was smaller in children than in the other age groups, but no difference in CC length was found between younger and older adults. The CC area and thickness were greater in younger adults than in children and older adults, and greater in older adults than in children. With regard to sexual dimorphism, the CC area and forebrain volume were larger in male children than in female children. No sex-related differences in CC area or thickness were found in adults. However, the ratio of CC area to the forebrain volume was greater in adult females than in males, owing to the smaller forebrain volume in females. The absolute length of the CC was greater in older adult males than in their female counterparts. In addition, significant differences in CC measurements were found in comparison to measurements obtained from other ethnicities. Lastly, significant reductions in CC area and thickness were found in boys with ASD compared to their neurotypical peers. In conclusion, age and sex significantly influence morphometric measurements of CC in Middle Eastern Arab population. This study points to the presence of racial differences in CC size. Finally, it reveals that children with ASD display a distinct reduction in CC size compared to neurotypical children of the same ethnicity.Funds for the conduction of this study were provided by the Deanship of Research at Jordan University of Science and Technology, Irbid, Jordan (Grant # 20160212). Publication fees were provided by a grant to MZA from the Office of Research at United Arab Emirates University, Al Ain, UAE (Grant # G00003289, Fund # 31M441)

A cephalometric morphometric study of age- and gender-dependent shape patterns of the sella turcica

The sella turcica is an important anatomic and radiologic entity. The shape of the sella turcica varies among normal individuals and can be influenced by local factors. The normal shape of sella turcica has been categorized as circular, oval, and flat, and several variants have been described. The sella turcica increases in size with age, but there is no agreement upon significance of gender-related differences. The main objective of this study is to build up a normative database of the shape of the sella turcica in the Jordanian population with reference to age and gender. For this purpose 509 computed cephalograms: 252 males and 257 females, aged 10 to 40 years old healthy Jordanians were collected and divided into adolescent and adult age groups in both genders. Viewbox 3 software was used to determine width and height, and shape of the sella turcica was accordingly assessed. Variants of shape were also documented. Our results showed that females exhibit higher percentage of overall normal shape but lower relative percentages of oval and flat shapes, as compared with males. In contrast to males, females also show decreasing trend of normal shape as age advances. Females and males change obviously in favor of oval shape. In terms of variants, as individuals advance in age, bridging and irregular dorsum clearly predominate. In terms of width and height, significant differences were evident between adult male group on one hand and adolescent female group and adult female group on the other hand. Between age categories and within male and female groups, sella linear dimensions were significantly different between adolescent and adult age groups. The significant increase of linear parameters of sella turcica across age groups indicates that there is significant degree of growth in sella turcica across the studied age groups. However, this growth does not affect the shape of sella turcica as the shape seems to be preserved across the studied age groups. The obtained data are discussed in terms of age- and gender-related growth and degenerative bone changes.This work has been supported by Grant No: 89/2015 by the Faculty of Research at Jordan University of Science and TechnologyScopu

Evidence on the Heroin-Mediated Impairment of the Oxidative Status of Erythrocytes

Away from hemorheological properties, the effect of heroin addiction on erythrocytes is poorly investigated. This study aimed to investigate the oxidative impacts of heroin administration on erythrocytes. Study subjects included chronic intravenous heroin addicts and control subjects. Hematological analysis and redox parameters were measured, including serum concentration of methemoglobin ([MethHb]), serum glutathione peroxidase-1 ([GPX-1]), serum glutathione peroxidase (GPX) activity, erythrocytic protein carbonyl content, and oxidized to reduced glutathione (GSSG/GSH) ratio. Hematological analysis revealed that addicts had a significantly higher red cell distribution width, consistent with the mild anisocytosis and poikilocytosis of erythrocytes. As compared to control subjects, significantly higher levels of serum [Met-Hb], [GPX-1], and GPX activity (p<0.001) were reported among addicted subjects. A significant association between [MetHb] and GPX activity was observed with r = 0.764 (p<0.001). Furthermore, significantly higher erythrocytic protein carbonyl contents and GSSG/GSH ratio were evident among heroin addicts (p<0.005) that were significantly associated with r = 0.429 (p=0.01). Results demonstrate preliminary evidence that heroin addiction is implicated in impaired redox status of erythrocytes. Considering the pharmacokinetics of heroin, erythrocytic antioxidant mechanisms, and turnover rate, further investigation is required to evaluate the extent and clinical outcomes, especially upon over-dose administration

Coexistence of HBsAg/Anti-HBs and HBeAg/Anti-HBe in Sudanese Patients with Chronic Hepatitis B Virus Infection: A Cross-Sectional Study

Background: Seroconversion of hepatitis B surface antigen (HBsAg) to hepatitis B surface antibody (anti-HBs) is a recognized goal of HBV therapy. This dynamic transition responsible for the coexistence of HBsAg and anti-HBs is rarely detected in clinical cases. However, with vaccination and the use of various antiviral drugs, as well as the development of new medical technologies, recognizing the coexistence of HBsAg and anti-HBs has become more common. In addition, mutations in viral genomes, immune status, and human genetic factors may also contribute to such coexistence. The current study was designed to determine the prevalence of the coexistence of HBsAg and anti-HBs and HBeAg and anti-HBe in CHB patients in Sudan. Methods and Results: This was a descriptive cross-sectional study conducted in Khartoum state from November 2018 to January 2019. The study included 70 HBV-infected patients who were positive for HBsAg for more than six months. Blood samples were tested for HBsAg/Anti-HBs and HBeAg/Anti-HBe using Commercial ELISA Kits (Foresight, United Kingdom) and (PRECHEK, USA). Demographic data were collected using a structured questionnaire, and any antiviral agent and laboratory results were also recorded for each participant. The current study showed that one case (1.4%) was reactive for the coexistence of HBsAg/HBsAb and two cases (2.8%) for the coexistence of HBeAg/HBeAb. There was no statistical difference between the coexistence of HBsAg/HBsAb and HBeAg/HBeAb with age, gender, residence, and treatment status. Conclusion: Our study indicates that the frequencies of the coexistence of HBsAg/HBsAb and HBeAg/HBeAb among Sudanese patients with chronic HBV infection were low compared to previous studies in a different population

Individual participant data meta-analysis of LR-5 in LI-RADS version 2018 versus revised LI-RADS for hepatocellular carcinoma diagnosis

Background A simplification of the Liver Imaging Reporting and Data System (LI-RADS) version 2018 (v2018), revised LI-RADS (rLI-RADS), has been proposed for imaging-based diagnosis of hepatocellular carcinoma (HCC). Single-site data suggest that rLI-RADS category 5 (rLR-5) improves sensitivity while maintaining positive predictive value (PPV) of the LI-RADS v2018 category 5 (LR-5), which indicates definite HCC. Purpose To compare the diagnostic performance of LI-RADS v2018 and rLI-RADS in a multicenter data set of patients at risk for HCC by performing an individual patient data meta-analysis. Materials and Methods Multiple databases were searched for studies published from January 2014 to January 2022 that evaluated the diagnostic performance of any version of LI-RADS at CT or MRI for diagnosing HCC. An individual patient data meta-analysis method was applied to observations from the identified studies. Quality Assessment of Diagnostic Accuracy Studies version 2 was applied to determine study risk of bias. Observations were categorized according to major features and either LI-RADS v2018 or rLI-RADS assignments. Diagnostic accuracies of category 5 for each system were calculated using generalized linear mixed models and compared using the likelihood ratio test for sensitivity and the Wald test for PPV. Results Twenty-four studies, including 3840 patients and 4727 observations, were analyzed. The median observation size was 19 mm (IQR, 11–30 mm). rLR-5 showed higher sensitivity compared with LR-5 (70.6% [95% CI: 60.7, 78.9] vs 61.3% [95% CI: 45.9, 74.7]; P < .001), with similar PPV (90.7% vs 92.3%; P = .55). In studies with low risk of bias (n = 4; 1031 observations), rLR-5 also achieved a higher sensitivity than LR-5 (72.3% [95% CI: 63.9, 80.1] vs 66.9% [95% CI: 58.2, 74.5]; P = .02), with similar PPV (83.1% vs 88.7%; P = .47). Conclusion rLR-5 achieved a higher sensitivity for identifying HCC than LR-5 while maintaining a comparable PPV at 90% or more, matching the results presented in the original rLI-RADS study

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London