Comparison of T cells mediated immunity and side effects of mRNA vaccine and conventional COVID-19 vaccines administrated in Jordan.

Various COVID-19 vaccines can affect the immune system. Discrepancies have been noted in immune system characteristics, such as T-lymphocyte levels, between vaccinated and non-vaccinated individuals. This study investigates the variations in immune responses among the four administered COVID-19 vaccines, influencing factors, and clinical outcomes in Jordan. A total of 350 adults, who were at least two doses vaccinated, were interviewed and blood samples were collected for subsequent laboratory analyses. The study involved the quantification of T-cells specifically targeting anti-SARS CoV-2 using Flow cytometry analysis. BNT162b2 (Pfizer) recipients displayed significantly higher CD3+/CD4+ T-helper cell responses (90.84%, 87.46% - 94.22%) compared to non-Pfizer-BioNTech recipients {BBIBP-CorV (Sinopharm) and Sputnik V (Gamaleya Research Institute), then ChAdOx1 nCoV-19 (AstraZeneca)} (83.62%, 77.91% - 89.33%). The CD3+/CD8+ (T cytotoxic) level was notably elevated in non-Pfizer-BioNTech recipients {Sinopharm and Sputnik V then ChAdOx1 nCoV-19 AstraZeneca (73.94%, 69.38% - 78.49%) compared to BNT162b2 (Pfizer) recipients (58.26%, 53.07% - 63.44%). The CD3+ (T-cells) level showed no significant difference between BNT162b2 recipients (73.74%) and non-Pfizer-BioNTech recipients (77.83%), with both types generating T-cells. Comparing two doses of non-Pfizer-BioNTech vaccines with the third dose of BNT162b2 recipients (Pfizer), no difference in the type of immune reaction was observed, with non-Pfizer-BioNTech recipients still stimulating endogenous pathways like cell-mediated cytotoxic effects for cells. All COVID-19 vaccines administered in Jordan were effective, with respect to the total number of T cells. Non-Pfizer-BioNTech had higher in toxic T-cells and Pfizer-BioNTech was higher in helper T-cells that stimulate plasma cells to produce antibodies.

Distance Electronic Learning Strategy in Medical Teaching During the COVID-19 Pandemic: Cross-Sectional Survey Study.

BACKGROUND: Teaching hospitals have been regarded as the primary settings where doctors teach and practice high-quality medicine, as well as where medical students learn the profession and acquire their initial clinical skills. A percentage of instruction is now done over the internet or via electronic techniques. The present COVID-19 epidemic has pushed distance electronic learning (DEL) to the forefront of education at all levels, including medical institutions. OBJECTIVE: This study aimed to observe how late-stage medical students felt about DEL, which was put in place during the recent COVID-19 shutdown in Jordan. METHODS: We conducted a prospective, cross-sectional, web-based, questionnaire-based research study during the COVID-19 pandemic lockdown between March 15 and May 1, 2020. During this period, all medical schools in Jordan shifted to DEL. RESULTS: A total of 380 students responded to a request to fill out the questionnaire, of which 256 completed the questionnaire. The data analysis showed that 43.6% (n=112) of respondents had no DEL experience, and 53.1% (n=136)of respondents perceived the DEL method as user-friendly. On the other hand, 64.1% (n=164) of students strongly believed that DEL cannot substitute traditional clinical teaching. There was a significant positive correlation between the perception of user-friendliness and the clarity of the images and texts used. Moreover, there was a strong positive correlation between the perception of sound audibility and confidence in applying knowledge gained through DEL to clinical practice. CONCLUSIONS: DEL is a necessary and important tool in modern medical education, but it should be used as an auxiliary approach in the clinical setting since it cannot replace conventional personal instruction.

Prevalence of Persisting and New Symptoms Following Recovery from COVID-19 in the Jordanian Population.

Background: Many patients do not have a clear idea about the recovery from COVID-19 infection. This study focuses on the prevalence of persistent symptoms of COVID-19 infection as well as new symptoms that appear after recovery, and it aids in determining the relationships between these symptoms and a variety of variables. Methods: An online observational study was conducted between April and June 2022. It consisted of a self-administered web-based questionnaire conducted using social media platforms. Inclusion criteria were residency in Jordan, being 18 years of age or older, having recovered from COVID-19 for at least 90 days, and giving consent to participate. Participants whose infection was not confirmed by a positive PCR were excluded. Results: The most common persistent symptoms were loss of smell (34.7%), fatigue (34.6%), loss of taste (29.5%), myalgia (26.3%), and headache (25.9%), while the most common newly appearing symptoms after recovery were smell hallucinations (15.8%), fatigue (15.5%), taste hallucinations (14.9%), and focus impairment (12.9%) and smell impairment (12.8%). The symptoms persisted more in females, non-smokers, and those who needed medical care sor oxygesnation and with increased infection duration. Conclusion: The study about persistent and new symptoms after COVID-19 among Jordanians found a greater prevalence of symptoms related to the sense of smell. There is no association between persistent and new symptoms after COVID-19 recovery with comorbidities or oxygen therapy during illness. We recommend studying the effect of COVID-19 mutants and vaccination on the persistence of symptoms after recovery.

Suicide Trends in Jordan in Correlation With the COVID-19 Pandemic: A Forensic Medicine Perspective.

Background This study aimed to examine the suicide trends among Jordanians who died by suicide before and during the coronavirus disease 2019 (COVID-19) pandemic and assess their correlation with demographic data, including gender, age, marital status, and the method used for suicide, from a forensic medicine perspective. Methodology This was a retrospective, observational, autopsy-based study. Of the 731 medicolegal autopsies performed at the Al-Hussein New Hospital at Al Salt City between 2017 and 2022, 41 confirmed cases of suicide were identified. Results The study indicated that 75% of the subjects committed suicide during the COVID-19 pandemic period, of whom 13% were children. The average age of those who died by suicide was 32.1 (SD = 12.2) years. Overall, 58.5% were single, 61.0% unemployed, and 53.7% had a mental illness. Males were four times more likely to commit suicide than females. Hanging represented 60.61% of all male suicides, followed by firearms (27.27%); however, females used poisoning. Around 60% and 25% of the study subjects were in the age group of 21-40 years and 41 and more, respectively. The study also identified a statistically significant association between gender, age, and the time of suicide (during COVID-19). The findings of this study could not confirm any association between suicide and mental illness, marital status, and employment status. Conclusions The suicide rate in Jordan increased during the COVID-19 pandemic, and it is alarming that most of those who committed suicide were at a young age and in their productive years.

Correlates of higher anxiety scores reported by women admitted for elective caesarean section.

Background: An elective caesarean section (CS) has been associated with high anxiety scores, and there are associations between higher anxiety scores and younger age, primigravidae, higher educational level, and previous experience with anaesthesia. In this study, the aim is to measure anxiety scores associated with an elective CS using two measuring scales and identify women's characteristics and obstetrics variables that are associated with higher scores. Methods: A cross-sectional study was conducted between Nov 15, 2019 and Nov 15, 2020. Women were included if they were 18 years of age or more, had viable pregnancies, and were admitted for an elective CS. Anxiety scores were measured on admission using the visual analogue scale for anxiety (VASA) and then the State-Trait Anxiety Inventory (STAI-Y). Associated factors were studied using logistic regression analyses. Results: Three hundred women were recruited. Means (SD) for the participant's age and gestation age were 30.5 (5.7) years and 37.6 (1.4) weeks, respectively. Additionally, 29.3% of the participants having a CS were primigravidae and 62.3% were for maternal indications. Furthermore, 55%, 59%, and 61% of the women had scores above the means of VASA and STAI-S components 1 and 2, respectively.Variables that showed statistically significant associations with higher anxiety scores were that the woman's age was 25-34, the CS was for foetal indications, the choice of anaesthesia was general, and the source of information for the choice of anaesthesia was a layperson. Conclusion: Higher anxiety scores are prevalent among women admitted for an elective CS. STAI-Y and VASA correlated well, and the short VASA may replace the lengthy STAI-Y in clinical practice. Identification of women with risk factors may help in implementing strategies to reduce anxiety.

The Effect of Lockdown Due to the COVID-19 Pandemic on Digital Eye Strain Symptoms Among the General Population: A Cross-Sectional Survey.

Repetitive prolonged use of digital devices without regular breaks has detrimental effects on ocular health and quality of vision. Individuals with chronic eye problems and refractive errors are at higher risk of developing digital eye strain (DES). Correction of refractive errors, adopting healthy practices will reduce its risk. The survey examined the effect of prolonged lockdown on the development and increased severity of digital eye strain (DES) symptoms among the general population. An online survey was conducted in March 2020 on social media platforms in Jordan. Data from 1,460 responders were analyzed. About half of the respondents were between 30-49 years, 28.4% were retired, 21% had chronic systemic illness, and 23% reported chronic eye problems. A rise in the use of digital devices during lockdown was reported by 957 participants, with 33% of them used digital devices more than 4 h a day. The most common symptoms before and during lockdown were headache and neck / shoulder pain have the highest associations (X2 = 280.0, 271.3, df = 4, p < 0.001 respectively). Female gender, existence of chronic eye problems and systemic diseases, and duration of using digital devices were found to be statistically significant factors associated with increasing severity of eye symptoms during lockdown. Not taking enough regular breaks from digital devices showed significant association with blurred vision at distance and near (X2 = 13.03, 10.74, df = 4, P = 0.011, 0.03, respectively). People with chronic eye problems and increased time using devices during lockdown developed new eye complaints three times more than before the lockdown and males were two times more likely than females to have more severe eye symptoms.

Household Drug Stockpiling and Panic Buying of Drugs During the COVID-19 Pandemic: A Study From Jordan.

The coronavirus disease that emerged in 2019 (COVID-19) has affected health, societies and economies. Policies that have been imposed by different countries to slow the spread of the disease, including national lockdowns, curfews, border closures and enforcement of social distancing measures have disturbed the drug supply chain and resulted in drug shortages. Uncertainty concerning the pandemic has also led to the panic buying of drugs and the stockpiling of drugs in households, which has amplified the problem. In this cross-sectional study, a self-developed questionnaire was distributed online in order to a) assess the practice of household drug stockpiling prior to the national lockdown in Jordan, b) investigate the factors affecting it and c) measure peoples' knowledge about the consequences of this behaviour. Results from this study show that drug purchasing was reported by 44.3% of the participants and was most common among participants from non-medical backgrounds (336, 75.7%) or those who have chronic diseases (261, 58.8%) and taking chronic supplements (282, 63.5%) regardless of their age, gender, living area or the possession of health insurance. Analgesics and antipyretics were the most frequently purchased drugs (225, 70.5%) and anticipation of their need was the most common reason for purchasing drugs (231, 52.0%). Buyers were also less aware, when compared to non-buyers, that panic buying and drug stockpiling may lead to drug shortages (204, 45.9% vs 325, 58.1%) and that this behaviour can pose a health hazard, especially to children (221, 47.5% vs 342, 61.2%). Our study shows that panic buying of drugs and household drug stockpiling were common in Jordan during the COVID-19 pandemic and this was related to participants' medical knowledge and educational backgrounds. Therefore, educating the general population regarding rational drug use is urgently needed. This is also a compelling case for the development of national guidelines for drug management that target the general population and healthcare personnel, especially pharmacists, to avoid drug shortages during crises.

Distance learning in clinical medical education amid COVID-19 pandemic in Jordan: current situation, challenges, and perspectives.

BACKGROUND: As COVID-19 has been declared as a pandemic disease by the WHO on March 11th, 2020, the global incidence of COVID-19 disease increased dramatically. In response to the COVID-19 situation, Jordan announced the emergency state on the 19th of March, followed by the curfew on 21 March. All educational institutions have been closed as well as educational activities including clinical medical education have been suspended on the 15th of March. As a result, Distance E-learning emerged as a new method of teaching to maintain the continuity of medical education during the COVID-19 pandemic related closure of educational institutions. Distance E-Learning is defined as using computer technology to deliver training, including technology-supported learning either online, offline, or both. Before this period, distance learning was not considered in Jordanian universities as a modality for education. This study aims to explore the situation of distance E-learning among medical students during their clinical years and to identify possible challenges, limitations, satisfaction as well as perspectives for this approach to learning. METHODS: This cross-sectional study is based on a questionnaire that was designed and delivered to medical students in their clinical years. For this study, the estimated sample size (n = 588) is derived from the online Raosoft sample size calculator. RESULTS: A total of 652 students have completed the questionnaire, among them, 538 students (82.5%) have participated in distance learning in their medical schools amid COVID-19 pandemic. The overall satisfaction rate in medical distance learning was 26.8%, and it was significantly higher in students with previous experience in distance learning in their medical schools as well as when instructors were actively participating in learning sessions, using multimedia and devoting adequate time for their sessions. The delivery of educational material using synchronous live streaming sessions represented the major modality of teaching and Internet streaming quality and coverage was the main challenge that was reported by 69.1% of students. CONCLUSION: With advances in technologies and social media, distance learning is a new and rapidly growing approach for undergraduate, postgraduate, and health care providers. It may represent an optimal solution to maintain learning processes in exceptional and emergency situations such as COVID-19 pandemic. Technical and infrastructural resources reported as a major challenge for implementing distance learning, so understanding technological, financial, institutional, educators, and student barriers are essential for the successful implementation of distance learning in medical education.

Bladder sensations in women with nocturia due to overactive bladder syndrome.

OBJECTIVES: Nocturia is the number of times urine is passed during main sleep. This definition tells us that it is a need to void; it does not tell us what triggers it. The aim of this study is to report bladder sensations that wake up women with nocturia (N). Descriptions of sensations in relation to various overactive bladder (OAB) symptoms, most bothersome symptoms, urinary incontinence (UI) and urodynamic findings are examined. MATERIALS AND METHODS: A prospective study of women > 18 years old presenting with OAB and nocturia. Data collected included presenting and most bothersome symptoms, descriptions of bladder sensations associated with nocturia, number of frequency and nocturia episodes, nighttime UI and urodynamic findings. RESULTS: One hundred fifty women were recruited with mean age 52 years, mean duration of symptoms 10.5 months and mean number of nocturia episodes 4.5. All women reported multiple presenting and bothersome symptoms. Fifty-five per cent had detrusor overactivity (DO). "Multiple" and "more intense" bladder sensation descriptions of nocturia were associated with advanced age, more frequent nighttime UI, when nocturia was considered most bothersome and in the presence of DO. The most frequent single description was "strong desire to void". The most frequently used combination was "strong desire to void, sudden compelling desire to void, bladder pain and full bladder". CONCLUSION: Descriptions of bladder sensations associated with nocturia in women with OAB were diverse and overlapping. It is important to report clinically and in research why patients have nocturia as this will have bearing on its treatment.