Post-thyroidectomy hypocalcemia in King Abdullah University Hospital and Princess Basma Teaching Hospital, Jordan

Background: Thyroidectomy is one of the major and delicate operations commonly performed in surgical units. This study was aimed at determining the incidence of hypocalcaemia after thyroidectomy operation among patients who underwent thyroidectomy in two teaching hospitals in the north of Jordan.Methods: This was a retrospective study of 152 patients who underwent thyroidectomy in two teaching hospitals in the north of Jordan. Their medical records were reviewed to evaluate the incidence of post-thyroidectomy hypocalcaemia. Information about sex, age, extent of surgery, thyroid pathology, serum calcium level and the inadvertent removal of parathyroid glands during thyroidectomy was collected.Results: Postoperatively, 44 (29.0%) patients had their serum calcium decreased but remained within the normal range. Ten (6.6%) of the patients had transient hypocalcaemia while 4 (2.6%) had permanent hypocalcaemia. Most patients with hypocalcaemia had benign disease. Ten (6.6%) patients had had inadvertent removal of parathyroid glands but only one of them had transient hypocalcaemia.Conclusions: The incidence of post-thyroidectomy hypocalcaemia is low but exists and should be considered as a possible post-thyroidectomy complication

Waterpipe a gateway to cigarette smoking initiation among adolescents in Irbid, Jordan: a longitudinal study

SETTING: According to anecdotal evidence, waterpipe smoking may lead to the initiation of cigarette smoking among young people. This hypothesis is yet to be examined using an appropriate study design and a theoretical model for behavioral change. OBJECTIVE: To compare the risk of cigarette smoking initiation among waterpipe-only smokers and never smokers in a school-based sample of adolescents from Irbid, Jordan. METHODS: A total of 1454 cigarette-naïve participants were drawn from a longitudinal study on smoking behavior conducted in Irbid among 1781 seventh graders who were enrolled at baseline (2008) and completed the study questionnaire on smoking behavior annually until 2011. Grouped time-survival analysis was used to compare the risk of subsequent initiation of cigarette smoking between waterpipe smokers (n = 298) and never smokers (n = 1156) using adjusted hazard ratios (aHRs) and 95% confidence intervals (95%CI). RESULTS: Risk of initiation of cigarette smoking among waterpipe smokers was significantly higher than among never smokers after adjusting for potential confounders (aHR 1.67, 95%CI 1.46–1.92). The association between waterpipe and cigarette smoking initiation was dose-dependent. The risk of initiating cigarette smoking increased with increase in the frequency of waterpipe smoking (P for linear trend < 0.001). CONCLUSIONS: Waterpipe smoking led to the initiation of cigarette smoking among this cohort of Jordanian adolescents; the effect was dose-dependent

Receipt Freeness of Prêt à Voter Provably Secure

Prêt à Voter is an end-to-end verifiable voting scheme that is also receipt free. Formal method analysis was used to prove that Prêt à Voter is receipt free. In this paper we use one of the latest versions of Prêt à Voter[XCH+10] to prove receipt freeness of the scheme using computational methods. We use provable security game models for the first time to prove a paper based voting scheme receipt free. In this paper we propose a game model that defines receipt freeness. We show that in order to simulate the game we require IND-CCA2 encryption scheme to create the ballots. The usual schemes used in constructing Prêt à Voter are either exponential ElGamal or Paillier because of their homomorphic properties that are needed for tallying, however both are IND-CPA secure. We propose a new verifiable shuffle ``D-shuffle\u27\u27 to be used together with an IND-CPA encryption schemes that guarantees that the outputs of the shuffle are IND-CCA2 secure ciphertexts and they are used for constructing the ballots. The idea is based on Naor-Yung transformation[NY95]. We prove that if there exist an adversary that breaks receipt freeness then there exist an adversary that breaks the IND-CCA2 security of Naor-Yung encryption scheme. We further show that the ``D-Shuffle\u27\u27 provides us with the option of having multiple authorities creating the ballots such that no single authority can break voter\u27s privacy

Hypertension Prevalence, Awareness, Treatment and Control, and Associated Factors: Results from a National Survey, Jordan

The study examined prevalence, awareness, treatment and control of hypertension (HTN), and associated factors and to evaluate the trend in hypertension between 2009 (period 2) and 1994–1998 (period 1). A national sample of 4117 adults aged 25 years and older was selected. Prevalence rate of HTN (SBP ≥ 140 or DBP ≥ 90 or on antihypertensive therapy) was 32.3% and was higher than the 29.4% prevalence rate reported in period 1. Prevalence rate was significantly higher among males, older age groups, least educated, obese, and diabetics than their counterparts. The rate of awareness among hypertensives was 56.1% and was higher than the 38.8% rate reported form period 1 data. Awareness was positively associated with age, smoking, and diabetes for both men and women, and with level of education and body mass index for men. Rate of treatment for HTN among aware patients was 63.3% and was significantly higher than the 52.8% rate reported in period1. Control rate of HTN among treated hypertensives was 39.6%; significantly higher than the 27.9% control rate in period 1. Control of HTN was positively associated with age but only for women. In conclusion, HTN is still on the rise in Jordan, and levels of awareness and control are below the optimal levels

Le cancer du rein chez l’adulte. Etude rétrospective à propos de 155 cas

Objectif: Analyser les différents aspects épidémiologiques, cliniques, radiologiques, pathologiques et thérapeutiques du cancer du rein dans notre contexte. Patients et méthodes: Il s’agit d’une étude rétrospective à partir des dossiers des patients hospitalisés à notre service d’urologie pour tumeurs du rein entre 1990 et 2007. Sur les 155 dossiers consultés, 125 patients ont été traités chirurgicalement, et pour 30 patients, l’abstention a été justifiée par le stade évolué localement ou métastatique et/ou le mauvais état général. Les paramètres étudiés ont été : l’âge, la symptomatologie clinique, le bilan radiologique, le type d’intervention, les résultats anatomopathologiques et le stade histologique TNM. Tous les patients ont été revus avec un examen clinique, une échographie ou tomodensitométrie abdominale avec radiographie thoracique et une créatinémie. Résultats: Il s’agissait de 105 hommes et 50 femmes. L’âge moyen de découverte était de 60 ans (extrêmes : 18 et 85 ans). Le délai moyen entre l’apparition des symptômes et le diagnostic était d’environ 9 mois (extrêmes : 1 et 24 mois). L’hématurie était le signe révélateur le plus important noté chez 45,2% des cas. Le diagnostic a été basé sur le couple échographie – tomodensitométrie chez tous nos patients. La taille tumorale moyenne était de 10 cm (extrêmes 3 et 20 cm) lors du bilan initial. Le rein gauche était touché plus souvent que le rein droit (67% vs. 33%). Le bilan d’extension à distance était négatif chez 95 patients (61,3%), alors que 60 patients avaient des métastases viscérales et/ou ganglionnaires. Parmi ces derniers, 30 avaient un mauvais état général et/ou des métastases viscérales multiples ce qui a contre indiqué le geste opératoire. Les localisations métastatiques des 30 patients opérés étaient les suivantes: poumons (5 cas), ganglions (15 cas), os (2 cas), foie (8 cas). Plus de 80% des tumeurs étaient des carcinomes à cellules claires (carcinomes conventionnels). L’intervention a consisté à une néphrectomie totale élargie à ciel ouvert chez tous nos patients opérés. La médiane de suivi était de 62 mois (extrêmes: 6-72 mois). Trente patients ont été perdus de vue définitivement après l’intervention. Sur l’ensemble de la série, les taux respectifs de survie sans récidive à 3 ans et à 5 ans étaient de 78,4% et 47,2%. Conclusion: Le cancer du rein est une pathologie qui n’est pas rare. Sa symptomatologie est polymorphe. Le traitement de référence est la néphrectomie totale élargie. Les facteurs pronostiques les plus déterminants sont le stade (TNM) et le grade histologique de Fuhrman. Selon notre série, la néphrectomie élargie permet un taux de survie sans récidive supérieur à 85%, tous stades et types histologiques confondus.Mots clés: Cancer, rein, adulte

A study to evaluate the reliability of using two-dimensional photographs, three-dimensional images, and stereoscopic projected three-dimensional images for patient assessment

Clinicians are accustomed to viewing conventional two-dimensional (2D) photographs and assume that viewing three-dimensional (3D) images is similar. Facial images captured in 3D are not viewed in true 3D; this may alter clinical judgement. The aim of this study was to evaluate the reliability of using conventional photographs, 3D images, and stereoscopic projected 3D images to rate the severity of the deformity in pre-surgical class III patients. Forty adult patients were recruited. Eight raters assessed facial height, symmetry, and profile using the three different viewing media and a 100-mm visual analogue scale (VAS), and appraised the most informative viewing medium. Inter-rater consistency was above good for all three media. Intra-rater reliability was not significantly different for rating facial height using 2D (P = 0.704), symmetry using 3D (P = 0.056), and profile using projected 3D (P = 0.749). Using projected 3D for rating profile and symmetry resulted in significantly lower median VAS scores than either 3D or 2D images (all P < 0.05). For 75% of the raters, stereoscopic 3D projection was the preferred method for rating. The reliability of assessing specific characteristics was dependent on the viewing medium. Clinicians should be aware that the visual information provided when viewing 3D images is not the same as when viewing 2D photographs, especially for facial depth, and this may change the clinical impression

Sexual Dysfunction in Jordanian Diabetic Women

OBJECTIVE—To estimate the prevalence of female sexual dysfunction (FSD) in diabetic and nondiabetic Jordanian women

Old vaccines for new infections: Exploiting innate immunity to control COVID-19 and prevent future pandemics

The COVID-19 pandemic triggered an unparalleled pursuit of vaccines to induce specific adaptive immunity, based on virus-neutralizing antibodies and T cell responses. Although several vaccines have been developed just a year after SARS-CoV-2 emerged in late 2019, global deployment will take months or even years. Meanwhile, the virus continues to take a severe toll on human life and exact substantial economic costs. Innate immunity is fundamental to mammalian host defense capacity to combat infections. Innate immune responses, triggered by a family of pattern recognition receptors, induce interferons and other cytokines and activate both myeloid and lymphoid immune cells to provide protection against a wide range of pathogens. Epidemiological and biological evidence suggests that the live-attenuated vaccines (LAV) targeting tuberculosis, measles, and polio induce protective innate immunity by a newly described form of immunological memory termed “trained immunity.” An LAV designed to induce adaptive immunity targeting a particular pathogen may also induce innate immunity that mitigates other infectious diseases, including COVID-19, as well as future pandemic threats. Deployment of existing LAVs early in pandemics could complement the development of specific vaccines, bridging the protection gap until specific vaccines arrive. The broad protection induced by LAVs would not be compromised by potential antigenic drift (immune escape) that can render viruses resistant to specific vaccines. LAVs might offer an essential tool to “bend the pandemic curve,” averting the exhaustion of public health resources and preventing needless deaths and may also have therapeutic benefits if used for postexposure prophylaxis of disease

One vaccine to counter many diseases? Modeling the economics of oral polio vaccine against child mortality and COVID-19

INTRODUCTION: Recent reviews summarize evidence that some vaccines have heterologous or non-specific effects (NSE), potentially offering protection against multiple pathogens. Numerous economic evaluations examine vaccines\u27 pathogen-specific effects, but less than a handful focus on NSE. This paper addresses that gap by reporting economic evaluations of the NSE of oral polio vaccine (OPV) against under-five mortality and COVID-19. MATERIALS AND METHODS: We studied two settings: (1) reducing child mortality in a high-mortality setting (Guinea-Bissau) and (2) preventing COVID-19 in India. In the former, the intervention involves three annual campaigns in which children receive OPV incremental to routine immunization. In the latter, a susceptible-exposed-infectious-recovered model was developed to estimate the population benefits of two scenarios, in which OPV would be co-administered alongside COVID-19 vaccines. Incremental cost-effectiveness and benefit-cost ratios were modeled for ranges of intervention effectiveness estimates to supplement the headline numbers and account for heterogeneity and uncertainty. RESULTS: For child mortality, headline cost-effectiveness was $650 per child death averted. For COVID-19, assuming OPV had 20$23,000-65,000 if it were administered simultaneously with a COVID-19 vaccine \u3c200 days into a wave of the epidemic. If the COVID-19 vaccine availability were delayed, the cost per averted death would decrease to $2600-6100. Estimated benefit-to-cost ratios vary but are consistently high. DISCUSSION: Economic evaluation suggests the potential of OPV to efficiently reduce child mortality in high mortality environments. Likewise, within a broad range of assumed effect sizes, OPV (or another vaccine with NSE) could play an economically attractive role against COVID-19 in countries facing COVID-19 vaccine delays. FUNDING: The contribution by DTJ was supported through grants from Trond Mohn Foundation (BFS2019MT02) and Norad (RAF-18/0009) through the Bergen Center for Ethics and Priority Setting

Suicidal Behavior and Psychological Distress in University Students: A 12-Nation Study. Archives of Suicide Research

This study investigated the prevalence of suicidal behavior and psychological distress in university students across 12 nations. A total of 5572 university students from 12 countries were surveyed about suicide ideation, suicide attempts and psychological distress by means of a self-administered questionnaire. Almost 29% of the samples reported having contemplated suicide and 7% reported attempting suicide. Of the total sample, 51.1% scored above the General Health Questionnaire-12 ≥ 3 cut-off point, 41.6% above the GHQ-12 ≥ 4 cut-off point, and 33.8% scored above the GHQ-12 ≥ 5 cut-off point. While odds of suicide ideation were elevated in Austria and the UK, reduced ORs were detected for China, Italy, Saudi Arabia, Tunisia, and Turkey. Similarly, while odds of suicide attempt were high in Jordan, Palestine, Saudi Arabia, and to some extent in Turkey, reduced ORs were observed for Austria, China, Italy, Japan and the USA. Elevated ORs for psychological distress were seen in Japan, Jordan, Palestine, Saudi Arabia, Tunisia and Turkey but reduced ORs were noted in Austria, China, Iran, Italy and the USA. Psychological distress was strongly associated with reports of suicide ideation and attempts. Suicide ideation, suicide attempt and psychological distress are common in university students but their rates vary depending on the sociocultural context. Due attention should be devoted to the mental health needs of young adults enrolled in higher educational institutions and more cross-cultural research is warranted to better understand the etiology of the observed intersocietal variations in suicidal behavior and psychological distress