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PURPOSE: Total Hip Arthroplasty (THA) is one of the most commonly performed orthopaedic surgeries, with hip arthritis being the main indication. This procedure is usually performed when other non-surgical methods fail to relieve patients' hip pain and improve their quality of life. However, limited information exists to identify and compare the demographics and clinical characteristics of patients undergoing this procedure in Jordan. This study aims to identify these demographic and clinical characteristics and compare the findings in terms of gender differences. METHODOLOGY: This is a retrospective study that analysed the hospital records of 650 patients undergoing THA in tertiary referral hospital in Jordan over a four-year period from January 2019 to December 2022. The collected data were classified into three categories: demographic characteristics, perioperative variables, and patients' related health profiles. IBM's Statistical Package for the Social Sciences (SPSS) version 23 software (IBM, USA) and descriptive analysis were used for data analysis. RESULTS: Two-thirds of the sample studied were female (63.4%). In terms of bleeding profiles, the mean intraoperative blood loss was 542 millilitres. The major indication for THA was degenerative hip arthritis (50.5%), followed by hip dysplasia (40.3%).. Comparing the findings of the two gender groups, females were more likely to have degenerative and dysplastic hip arthritis (221 and 157, p = 0.04 and p = 0.1, respectively) when compared to males. Although males were more likely to lose more blood during the surgery (557 ml vs. 533 ml, p = 0.33, females needed more blood transfusions both during (21 vs. 6 patients, p = 0.12) and after the surgery (57 vs. 16 patients, p = 0.006). Furthermore, females were more likely to have comorbidities such hypertension (293 vs. 179 patients, p = 0.20), and hypothyroidism (313 vs 187, p = 0.36), and diabetes (85 vs. 38 patients, p = 0.15), among many other health conditions. However, in the study sample, male smokers outnumbered female smokers (132 vs. 63). CONCLUSION: Gender highly impacted the immediate surgical outcomes of patients who underwent THA. Females were more likely to need blood transfusions both during and after the surgery and had lower post-operative haemoglobin readings. In addition, females had more comorbidities and degenerative hip osteoarthritis. We believe that raising awareness about comorbidity management, preoperative smoking cessation, and perioperative blood transfusion management can improve medical and surgical outcomes.
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Artroplastia de Reemplazo de Cadera , Osteoartritis de la Cadera , Adulto , Humanos , Masculino , Femenino , Artroplastia de Reemplazo de Cadera/efectos adversos , Artroplastia de Reemplazo de Cadera/métodos , Estudios Retrospectivos , Calidad de Vida , Jordania/epidemiología , Factores de Riesgo , Osteoartritis de la Cadera/epidemiología , Osteoartritis de la Cadera/cirugía , Osteoartritis de la Cadera/etiologíaRESUMEN
BACKGROUND: Infective endocarditis (IE) is a relatively rare but serious and life-threatening disease with substantial mortality and morbidity despite progress in diagnostic and treatment techniques. The aim of this study is to investigate the epidemiology, clinical characteristics, microbiological profile, and outcomes of IE patients in a tertiary care facility in Jordan, the Jordan University Hospital (JUH). METHODS: This is a retrospective case series study which was conducted at JUH. A total of 23 patients with either definite or possible IE according to the Modified Duke Criteria were included in the study. Medical records were reviewed, and relevant information was collected. Descriptive data analysis was performed. RESULTS: Our study identified a total of 23 patients with infective endocarditis; 65.2% were males, with a mean age of 40.4 years. The majority of patients had an underlying cardiac disease (60.9%), with the most common being congenital heart diseases (17.4%). The most commonly affected valves were the left-side heart valves, with the mitral valve (52.2%) being the most common followed by the aortic valve (34.8%). The most common organism detected in blood culture was Streptococcus viridans (21.7%) followed by methicillin-resistant Staphylococcus aureus. The most common complications among the patients were heart failure and septic shock, and the mortality rate among the patients was 13%. CONCLUSION: In patients with endocarditis, Streptococcus viridans is the most common culture-positive bacteria at JUH. One third of our patients needed surgical intervention and the mortality rate was 13%.
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Endocarditis Bacteriana , Endocarditis , Staphylococcus aureus Resistente a Meticilina , Masculino , Humanos , Adulto , Femenino , Estudios Retrospectivos , Jordania/epidemiología , Endocarditis Bacteriana/diagnóstico , Endocarditis Bacteriana/epidemiología , Endocarditis Bacteriana/terapia , Endocarditis/diagnóstico , Endocarditis/epidemiología , Endocarditis/terapiaRESUMEN
INTRODUCTION: Isotretinoin is a widely used, effective medication for moderate to severe acne. It is typically used for several months, which necessitates regular laboratory monitoring. However, consensus on the optimal assessment frequency is lacking. METHOD: This is a single-center retrospective study on 1182 patients who received isotretinoin for acne at the Dermatology Clinic in Jordan University Hospital over 5 years. RESULTS: Of the 1182 patients, 892 (76.57% females) met the inclusion criteria. An increase in the proportion of patients with abnormal triglycerides and total cholesterol levels from baseline to the sixth month was observed (p < 0.05). Conversely, differences in the number of patients with abnormal AST, ALT, and CBC were not found throughout treatment (p > 0.05). Moreover, there was a decrease in the neutrophil-to-lymphocyte ratio (NLR) ratio and systemic inflammatory index (SII) after the sixth month of isotretinoin treatment compared to the baseline (p = 0.012 and p = 0.021, respectively). CONCLUSIONS: We found that a baseline cholesterol level of 163.9 mg/dl and a baseline triglycerides level of 85.5 mg/dL are highly specific and sensitive in detecting grade 1 abnormalities at the one-month follow-up. This novel prediction approach serves as an effective risk stratification method for isotretinoin acne patients.
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Acné Vulgar , Isotretinoína , Femenino , Humanos , Masculino , Isotretinoína/efectos adversos , Estudios Retrospectivos , Acné Vulgar/tratamiento farmacológico , Triglicéridos , Medición de Riesgo , ColesterolRESUMEN
Solid pseudopapillary neoplasm of the pancreas is rarely encountered in clinical practice. It is a tumor with a good prognosis and overall curative rates. It primarily affects young females in their twenties. It has characteristic imaging appearances, but a definite diagnosis requires histopathological examination. The treatment goal of solid pseudopapillary neoplasm is almost always curative and aims for complete resection of the mass. Here, we present 2 cases of this rare neoplasm. The first case was managed by laparoscopic distal pancreatectomy, while the second underwent a Whipple procedure for pancreatic head involvement.
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BACKGROUND Splenic cysts are classified as either parasitic or non-parasitic cysts, with both types sharing similarities in their clinical presentation and imaging findings. Most splenic cysts are of parasitic origin, while non-parasitic splenic cysts are less common. Splenic epidermoid cysts (SECs) are a rare subtype of non-parasitic cysts and compromise only around 10% of them. CASE REPORT In this paper we present a case of 22-year-old man with no significant past clinical history, who presented with non-specific, vague symptoms, including persistent left upper-quadrant pain and discomfort for the last 2 years. A physical examination and extensive laboratory tests were inconclusive. Subsequently, the patient underwent multiple imaging studies including ultrasonography and computed tomography (CT) scan of the abdomen. His ultrasonographic findings were consistent with the diagnosis of hydatid cyst, which was further emphasized by its frequent occurrence in clinical practice, as our country is considered an endemic region. In light of this, he underwent laparoscopic splenectomy following percutaneous cyst drainage. The consequent histopathological examination revealed the diagnosis of splenic epidermoid cysts. CONCLUSIONS When encountering splenic cysts in regions where parasitic infections are endemic, special attention is needed, as physical examination, laboratory tests, and imaging studies alone are insufficient to differentiate among the types of cysts. Histopathological examination remains the diagnostic tool of choice, particularly when imaging findings are inconclusive. Splenectomy, with either a laparoscopic or open approach, is the treatment of choice for splenic cysts to prevent recurrence as well as other potential catastrophic complications.
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Equinococosis , Quiste Epidérmico , Enfermedades del Bazo , Humanos , Masculino , Adulto Joven , Errores Diagnósticos , Equinococosis/diagnóstico , Quiste Epidérmico/diagnóstico , Quiste Epidérmico/cirugía , Quiste Epidérmico/patología , Enfermedades del Bazo/diagnóstico , Enfermedades del Bazo/cirugíaRESUMEN
Mucormycosis is an opportunistic fungal infection that usually affects patients with diabetes mellitus or immunosuppression. The fungus invades the nearby blood vessels leading to thrombosis and necrosis of the organs involved. Although Mucorales can invade any organ in the body, the gastrointestinal system is an uncommon site for infection. Mucormycosis is a fatal infection, and prompt intervention is required to ensure survival. In this report, we present a case of a 46-year-old man with history of valve replacement surgery on warfarin, who admitted with abdominal pain and life-threatening gastrointestinal bleeding. Esophagogastroduodenoscopy revealed an active gastric ulcer bleeding, and the diagnosis of mucormycosis infection was confirmed with direct microscopy and histopathological evaluation from a tissue biopsy. Typically, antifungal therapy alone is inadequate to control mucormycosis infection and surgical intervention is often required. Our patient was successfully treated using antifungal therapy alone. This report presents a rare case of gastrointestinal mucormycosis in setting of valve replacement and was successfully treated with antifungal therapy.