Prevalence of medical conditions among patients attending dental teaching clinics in northern Jordan.

AIM: This study was conducted to estimate the prevalence of self reported medical conditions among dental patients attending dental teaching clinics in north Jordan. METHODS AND MATERIALS: A total of 1,509 patients were included, of which 46.1% were males and 53.9% were females. All age groups were included and ranged between 14 and 78 years. The findings were analyzed in relation to age and gender. RESULTS: Overall, gastrointestinal disease was most prevalent (11.9%), followed by bleeding tendencies (9.3%), renal disorders (8.7%), respiratory disease (8.3%), and hypertension (6.4%). Only 3.2% of the participants reported having antibiotics prescribed for them prior to a dental procedure for prophylactic purposes. CONCLUSION: Due to the high frequency of medical conditions, thorough evaluation of patients' medical and dental care histories should be a mandatory first step in their management.

Pubertal evaluation of adolescent boys with beta-thalassemia major and delayed puberty.

OBJECTIVE: To examine the hormonal status of the hypothalamic-pituitary-gonadal axis in adolescent males with beta-thalassemia major. DESIGN: Controlled clinical study. SETTING: Tertiary referral teaching hospital. PATIENT(S): Thirty-three adolescent males with beta-thalassemia major. INTERVENTION(S): Basal LH, FSH, and T were examined. All individuals received 100 microg GnRH analogue. Four hours later the hormone levels were retested. Patients with beta-thalassemia and low T levels received hCG. MAIN OUTCOME MEASURE(S): The preintervention and postintervention levels of FSH, LH, and T were examined. RESULT(S): Of the 33 beta-thalassemia major adolescents, 17 had delayed puberty. The difference in basal LH, FSH, and T levels between delayed and normal puberty beta-thalassemia groups were statistically significant. These levels were significantly lower compared with the constitutional delayed puberty group and become even more significant after GnRH analogue administration. The T levels in the beta-thalassemia group were significantly lower than in the control group. After hCG administration, the T levels remained significantly lower in the delayed-puberty beta-thalassemia compared to the normal-puberty beta-thalassemia group. CONCLUSION(S): Despite recent therapeutic advances in the management of beta-thalassemia major, the risk of secondary endocrine dysfunction remains high. Hypogonadism is one of the most frequent endocrine complications.

Lactic dehydrogenase as a biochemical marker of adverse pregnancy outcome in severe pre-eclampsia.

BACKGROUND: Pre-eclampsia is a specific disease of pregnancy with multisystem complications. We conducted this study to examine the relationship between lactic dehydrogenase concentration and the severity of the disease and the occurrence of its complications. MATERIAL/METHODS: One hundred eleven pre-eclamptic women (49 with mild and 62 with severe pre-eclampsia) and 60 healthy normotensive controls were studied prospectively at the King Hussein Medical Center between January and December 2002. Demographic, hemodynamic, and laboratory data were compared among the three groups. The symptoms and complications of severe pre-eclampsia along with fetal outcome were analyzed according to the levels of LDH (<600, 600-800, and >800 IU/l). One-way analysis of variance (ANOVA) and the chi-square test were used to compare the results. Differences were considered significant when p<0.05. RESULTS: The incidence of severe pre-eclampsia was 1.3%. Severely pre-eclamptic patients were significantly younger, with low gravidity and parity. On the other hand, they had significantly increased systolic and diastolic pressure and liver enzymes, uric acid, urine albumin, and LDH levels. The symptoms and complications of pre-eclampsia along with perinatal mortality were increased significantly in patients with LDH >800 IU/l compared with those who had lower levels. CONCLUSIONS: Lactic dehydrogenase is a useful biochemical marker that reflects the severity of and the occurrence of complications of pre-eclampsia. Identification of high-risk patients with elevated levels of lactic dehydrogenase, their close monitoring, and prompt, correct management may prevent these complications, with a subsequent decrease in maternal and fetal morbidity and mortality.

Pre-eclampsia: is it a different disease in primiparous and multiparous women?

The aim of this study was to evaluate differences in clinical and laboratory parameters and differences in the complication rates between pre-eclamptic primiparous and pre-eclamptic multiparous women. A prospective case series of 112 primiparous and 186 multiparous women with pre-eclampsia was conducted at Princess Badea Teaching Hospital; a large tertiary public health service hospital in Irbid, North Jordan. A uniform medical and surgical management protocol was implemented. The main outcome measures included antenatal, intrapartum and puerperal, maternal and foetal complications. Multiple maternal and foetal demographic, clinical and laboratory parameters were studied. As expected, the primiparous were younger than the multiparous women. After adjusting for maternal age, regression analysis revealed no difference in the systolic or diastolic blood pressure in the two groups. It was also demonstrated that there was no statistically significant difference in the clinical presentation, haematological and biochemical parameters or ultimate maternal outcome between the two groups. After adjusting for babies' sex and gestational age, it was demonstrated that there was no statistically significant difference in the following: gestational age at delivery, foetal weight, stillbirth, admission rate to neonatal intensive care unit, neonatal death rate within the first four weeks after birth and incidence of intrauterine growth restriction between the two groups.

A survey of uterine perforation following dilatation and curettage or evacuation of retained products of conception.

STUDY: Of 11,914 women who underwent dilatation and curettage over a 7-year period (1995-2002) at Princess Badea Teaching Hospital in Irbid, North Jordan, 23 patients sustained a uterine perforation. In 22 cases, the operator was a trainee. Previous gynaecological surgery had been performed in only 2 of these 23 women. CONCLUSION: Operator inexperience seemed to be the only risk factor in this very common operation.