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.

Combined Aplasia of Frontal and Sphenoid Sinuses: A case report.

INTRODUCTION AND IMPORTANCE: The paranasal sinuses are a group of four paired air-filled spaces located within the bony skull; maxillary, frontal, sphenoid, and ethmoid sinuses. Paranasal sinuses aplasia is a rare condition that is mainly confined to the frontal sinus unilaterally. Combined aplasia of multiple sinuses along with hypoplasia of other sinuses is extremely rare. This rare case should be considered in mind before scheduling any endoscopic sinus surgery to prevent complications during these surgeries. CASE PRESENTATION: A 13-year-old male patient presented to our ENT clinic complaining of a prolonged history of persistent headache, nasal obstruction, and nasal discharge. He also complained of bilateral ears fullness and facial pain. On physical examination, bilateral purulent nasal discharge with congested inflamed nasal mucosa and both inferior turbinate. The patient was diagnosed to have sinusitis and was started on treatment. The patient returns to our clinic after several weeks with minimal improvement. Computed tomography (CT was obtained and showed completely absent pneumatization of bilateral frontal and sphenoid sinuses. CLINICAL DISCUSSION: The development of the paranasal sinuses appears prenatally which can lead to a variety of PNS anomalies. However, the aplasia or hypoplasia of the PNS is found to be rare. Aplasia is mainly found in frontal and maxillary sinuses with a prevalence of 12 % and 6 %, respectively. While the prevalence of sphenoid sinus aplasia is extremely rare and found to be less than 0.7 %. Moreover, aplasia of multiple sinuses "combined aplasia" is an incredibly unusual finding. CONCLUSION: this patient is one of the extremely rare cases of the combined aplasia of frontal and sphenoid sinuses who was diagnosed and confirmed at an early age without any skeletal, systemic, or hematological abnormalities. Despite that, this rare case should be considered in mind before scheduling any endoscopic sinus surgery to prevent complications during these surgeries.

Estrogens and the risk of breast cancer: A narrative review of literature.

In female mammals, the development and regulation of the reproductive system and non-reproductive system are significantly influenced by estrogens (oestrogens). In addition, lipid metabolism is another physiological role of estrogens. Estrogens act through different types of receptors to introduce signals to the target cell by affecting many estrogen response elements. Breast cancer is considered mostly a hormone-dependent disease. Approximately 70% of breast cancers express progesterone receptors and/or estrogen receptors, and they are a good marker for cancer prognosis. This review will discuss estrogen metabolism and the interaction of estrogen metabolites with breast cancer. The carcinogenic role of estrogen is discussed in light of both conventional and atypical cancers susceptible to hormones, such as prostate, endometrial, and lung cancer, as we examine how estrogen contributes to the formation and activation of breast cancer. In addition, this review will discuss other factors that can be associated with estrogen-driven breast cancer.

The impact of COVID-19 pandemic lockdown on smoking habits and lifestyle: A cross-sectional study.

Background and Aims: Throughout the COVID-19 lockdown, the resultant psychological disturbances led to more tobacco consumption and deteriorated smoking behaviors among smokers. In this study, we aimed to investigate the impact of the COVID-19 pandemic on the smoking behaviors of the Jordanian population. Methods: A cross-sectional online survey was designed using the Google Forms service and distributed by social media platforms. Responses were collected starting from November 12, 2020, until November 24, 2020. Results: A total of 2511 respondents completed the survey, 77.3% were females. Males were significantly smoking more than females (p < 0.0001). Smoking was significantly more common among respondents who were older than 18 years old, married, held master's and PhD degrees, and working in non-health-related fields (p < 0.0001). Participants who smoke were more likely to adopt an unhealthy lifestyle during the pandemic. Females who started smoking last year were 2.6-fold more than males (p < 0.0001). We also noticed that there is a significant relationship between those who started smoking and are <18 years, living in a family consisting of seven members or more, being unemployed, having a diploma or bachelor's degree in a health-related major, having no chronic illnesses, increasing of daily meals or night meals, almost daily sugar intake, starting to follow social media account concerning physical activity, exercising once or twice a week, and sleeping more hours per day since the beginning of the pandemic (p < 0.01). Conclusion: The results of our study showed that the lockdown had a significant impact on people's lifestyles including smoking habits. Most of our sample's smoker participants experienced a change in their smoking level mostly, an increase. While those who had a decrease in their smoking level experienced a somehow healthier lifestyle regarding nutrition and other aspects.

Human monkeypox virus in the shadow of the COVID-19 pandemic.

BACKGROUND: The end of smallpox in 1980 and the subsequent stopping of vaccination against smallpox was followed by the emergence of monkeypox (mpox), a viral disease of animal origin, meaning that it is transmitted from animal to human. The symptoms of mpox are similar to smallpox, except that they are less severe in terms of clinical features. In the case of public health, the mpox virus is one of the most important orthopoxviruses (such as variola, cowpox, and vaccinia) that come from the family Poxviridae. Mpox occurs mostly in central Africa and sometimes in tropical rainforests or some urban areas. Also, there are threats other than COVID-19, that must be addressed and prevented from spreading, as there has been an outbreak of mpox cases since May 7, 2022, throughout the USA, Europe, Australia, and part of Africa. OBJECTIVES: In this review, we will discuss mpox between the past, the present and during the COVID-19 pandemic. Also, it offers an updated summary of the taxonomy, etiology, transmission, and epidemiology of mpox illness. In addition, the current review aims to highlight the importance of emerging pandemics in the same era such as mpox and COVID-19. METHODS: A literature search was done for the study using online sources like PubMed and Google Scholar. Publications in English were included. Data for study variables were extracted. After the duplicate articles were eliminated, full-text screening was performed on the papers' titles and abstracts. RESULTS: The evaluation included a series documenting mpox virus outbreaks, and both prospective and retrospectiveinvestigations. CONCLUSIONS: monkeypox is a viral disease caused by the monkeypox virus (MPXV), which is primarily found in central and western Africa. The disease is transmitted from animals to humans and presents symptoms similar to those of smallpox, including fever, headache, muscle aches, and a rash. Monkeypox can lead to complications such as secondary integument infection, bronchopneumonia, sepsis, and encephalitis, as well as corneal infection that can result in blindness. There is no specific clinically proven treatment for monkeypox, and treatment is primarily supportive. However, antiviral drugs and vaccines are available for cross-protection against the virus, and strict infection control measures and vaccination of close contacts of affected individuals can help prevent and control outbreaks.

Prevalence of Dry Eye Disease Among Medical Students and Its Association with Sleep Habits, Use of Electronic Devices and Caffeine Consumption: A Cross-Sectional Questionnaire.

Introduction: Dry eye disease (DED) is a common and multifactorial disease of the ocular surface which causes visual disturbance and feelings of discomfort among patients. The prevalence rate among medical students is an important issue to consider. This study investigates the relationship between caffeine consumption, sleeping habits, use of electronic devices, and DED among a convenient sample of medical students in Jordan. Methods: This cross-sectional online survey enrolled medical students from all six medical schools in Jordan. The questionnaire, which was shared via social media platforms, assessed socio-demographics, caffeine consumption amounts and patterns, sleep quality, and the use of electronic devices and their relation to ocular discomfort, DED, and related symptoms. The ocular surface disease index (OSDI) questionnaire was also administered to quantify the symptoms of DED. Results: A total of 1223 students participated in this study (RR=24.46%); 64% were females, and 43% were in their clinical placement years. Of the participants, 317 (25.92%) had normal eyes, and 906 (74.08%) had symptomatic DED. Of the students, 1206 (98.6%) used electronic devices directly before bed, and only 399 (32.62%) used blue-light-protective glasses. Lower DED risk was linked to male gender (OR=0.535, 95% CI 0.392-0.73, p <0.01), clinical years of medical school (OR=0.564, 95% CI 0.424-0.75, p<0.01). Poor sleep quality corresponded to more incidence of DED, regardless of sleeping for 5-6 hours (OR=3.046, 95% CI 1.299-7.139, p=0.01) or for less than 5 hours (OR=3.942, 95% CI 1.824-8.519, p<0.01). Also, caffeine consumption only marginally affected its incidence, but the results were statistically insignificant. Conclusion: Female gender, basic science years, and spending more than 6 hours looking at screens were significantly associated with symptomatic DED. Caffeine consumption did not pose any significant risk to the incidence of DED.

Benign Paratesticular Fibrous Pseudotumor in a Young Male: A Case Report.

Paratesticular fibrous pseudotumor (PFPs) is an uncommon intra-scrotal mass that originated from tunica vaginalis and resulted in a reactive fibrous proliferation after a history of inflammation, infection, trauma, or hydrocele. We report here on a case of a 17-year-old man with a mass in the hemiscrotum that was found to be PFP in the orchidectomy specimen pathologic examination. The diagnosis of PFPs, before and during the operation, can be complicated despite it being a benign tumor. Radical orchidectomy is usually performed for these types of lesions. A frozen section intraoperatively is essential to avoid unnecessary radical orchidectomy and preserve testicle.

A cross-sectional study of the impact of COVID-19 pandemic on the physical activity of Jordanian population.

Background: Since the declaration of the COVID-19 pandemic on 11th March 2020, the public health recommendations have applied lockdowns and restrictions to limit the spread of the disease. These measures determined outdoor activities and access to many forms of exercise. Objective: The primary objective of this study was to examine the impact of the COVID-19 pandemic on the physical activity (PA) of the Jordanian population. Methods: A cross-sectional online survey was designed using Google Forms services and distributed on social media platforms during the first two weeks of November 2020 to evaluate the exercise activity changes during the COVID-19 pandemic in the study population. In this research, we included those who perform any form of physical activity (n = 1103). The data collected were analyzed using the Statistical Package for the Social Sciences (SPSS) version 26 (IBM SPSS Corp, SPSS Statistics ver. 26, USA). The categorical variables were summarized as frequencies and proportions and were compared using the Chi-square. For all analyses, P-value less than 0.05 was considered statistically significant. Results: A total of 1103 out of 2,511 (43.9%) respondents who participated in the survey were physically exercising during the COVID-19 pandemic. 41.8% were exercising at an irregular frequency, while 21.5% were exercising daily, 16.8% were exercising three to five times a week, and 19.9% were exercising once or twice a week. Moreover, 282 (25.6%) respondents started doing some form of exercise during the pandemic. Those significantly were less than 18-year-old, male gender, were single, were non-smokers, and had a diploma or bachelor's degree in a health-related major. These changes in the level of exercise have been attributed by 57.8% of respondents to the health aspects where they realized the importance of exercising in strengthening the immune system against diseases, including COVID-19. Conclusion: The current study showed that lockdown, due to the COVID-19 pandemic, had a positive impact on the healthy lifestyle of the Jordanian population which was attributed to their feeling of the importance of sports practice on the immune system and the availability of time for those activities. However, the younger and individuals were more aware of the importance of these practices which highlights the importance of considering other age groups in future studies of healthy behaviors.

Impact of COVID-19 pandemic on the Jordanian eating and nutritional habits.

Since the emergence of the COVID-19 pandemic, variable measures have been implemented to control the invasion of SARS-CoV-19 worldwide. Some of these measures included lockdowns for several months in some countries. In Jordan, various protocols have been implemented to deal with the epidemic, such as border closures, closures and local protocols for open days until we reach the partial opening in mid-2021. These measures and protocols have affected all sectors in the country, including the education system and the economy. In addition, lifestyle is one of the measurement issues that have been affected by government regulations during the COVID-19 pandemic. In this study, we aimed to investigate the impact of the COVID-19 pandemic on the eating and nutrition habits of the Jordanian population. An online sectional survey was built using Google Forms from Google. Responses were collected from November 12, 2020, through November 24, 2020. Researchers submitted a total of 2,511 responses. The results showed that there was a significant decrease in sugar intake (P = <0.005) with no critical fat and oil intake (P = 0.12). There was a significant change in daily consumption of fruits, vegetables, garlic, onions, and ginger, and downloads of health-related applications and supplements (P < 0.005). In addition, there was an increase in appetite, weight and number of daily meals. These changes are attributed to the extra free time due to lockdown and studying or working from home has significant impacts. However, 31.4% of respondents reported that the limited economic availability of food products and the closure of restaurants and cafes lead to a healthier lifestyle. Only 26.2% have been influenced by family members, friends, doctors, or social media to change their eating habits during the pandemic.

Conception Preferences during COVID-19 Pandemic Lockdowns.

Background: The COVID-19 lockdowns imposed new challenges to couples who were planning to conceive. In this research paper, we aimed to study the perceptions of women in Jordan during the pandemic regarding fertility behavior, the desire to use assisted reproductive technology (ART) and the awareness and beliefs of potential risks related to conception. Methods: A validated online-based questionnaire was distributed to women from April-May 2020, Statistical analysis was performed using the statistical software SPSS version 22 and R software (2020); p values ≤ 0.05 were considered statistically significant. Results: The total number of participants was 814 women, with 78.2% of the participants (58.7% fertile and 76.6% infertile) believing that pregnancy during the COVID-19 pandemic could be risky. Among them, 16% and 40%, respectively, were trying to conceive during the pandemic, and 97.4% and 89.9%, respectively, were not willing to use ART if needed during the pandemic. Young, nulliparous women who were married for less than one year were significantly associated with the desire to conceive during the COVID-19 pandemic. Conclusion: This study concluded that the fertility behavior of women in Jordan changed during the pandemic, and their desire for natural conception and for using ART declined, as they believed that there were potential risks related to conceiving during the pandemic. However, the effect was greater among the general fertile population than the infertile.

Is wearing a face mask associated with symptomatic dry eye disease among medical students during the COVID-19 era? An online survey.

BACKGROUND: Coronavirus disease 2019 has necessitate the routine use of masks worldwide. This study assessed the relationship between wearing a facemask and dry eye disease (DED) among a sample of medical students in Jordan. METHODS: This cross-sectional online survey enrolled medical students from all medical schools in Jordan. The questionnaire, which was shared via social media platforms, assessed sociodemographic information, ocular and medical history, facemask-wearing habits, the use of ocular devices, and the relationship with ocular discomfort. The ocular surface disease index (OSDI) questionnaire was also administered to quantify DED symptoms. RESULTS: A total of 1,219 students participated in this study. In total, 58.3% participants were females, and 52% were in the clinical science years. Symptomatic DED was found in 71.7% of participants. Female sex, basic science years, allergy reporting, and spending more than 6 h looking at screens were significantly associated with symptomatic DED. CONCLUSION: Wearing a facemask was not significantly associated with symptomatic DED. Further studies are needed to investigate the effect of wearing a facemask on the ocular surface.

SARS-CoV-2 and Coronavirus Disease Mitigation: Treatment Options, Vaccinations and Variants.

COVID-19 is caused by a novel coronavirus (2019-nCoV), which was declared as a pandemic after it emerged in China 2019. A vast international effort has been conducted to prevent and treat COVID-19 due to its high transmissibility and severe morbidity and mortality rates, particularly in individuals with chronic co-morbidities. In addition, polymorphic variants increased the need for proper vaccination to overcome the infectivity of new variants that are emerging across the globe. Many treatment options have been proposed and more than 25 vaccines are in various stages of development; however, the infection peaks are oscillating periodically, which raises a significant question about the effectiveness of the prevention measures and the persistence of this pandemic disease. In this review, we are exploring the most recent knowledge and advances in the treatment and vaccination options as well as the new emerging variants of 2019-nCoV and the possible mitigation of one of the most aggressive pandemics in the last centuries.

Knowledge, Attitude, and Practice toward Skin Cancer Prevention and Detection among Jordanian Medical Students: A Cross-Sectional Study.

INTRODUCTION: Skin cancer is one of the most growing types of cancer, especially in the Mediterranean, even though it is a preventable disease. The purpose of this study is to assess medical students' knowledge, attitude, and practice about skin cancer prevention and detection. METHODS: A cross-sectional study was conducted using a validated structured questionnaire covering the areas of knowledge, attitude, and practice of the study participants. RESULTS: The study involved 1530 students; 55.3% were females. Most of the students possessed proper knowledge about skin cancer (81%). The most prevalent skin cancer risk factors were sun exposure during the day (83.5%) and immunosuppression (71.2%). More than half of the students did not have any habits of skin examination (61.5%). 20% of the students never used sunscreen, while only 20% of them avoided sun exposure during day hours. CONCLUSION: The general level of the medical students' knowledge of skin cancer and its risk factors appeared to be higher than what is found in other studies; it is reasonable as the study participants were medical students. However, the protective behavior from the sun was inadequate when compared to the level of knowledge reported. Additional education about the behavior toward sun exposure and protection against skin cancer may be needed to be implemented in the dermatology curriculum.

Disease characteristics, determinants, and perception of use of sunscreen and sun-protective behaviors among patients of color with melasma: A cross-sectional study.

BACKGROUND: Melasma is an acquired state of hyperpigmentation that most commonly affects the face. The use of sunscreen is essential in melasma treatment. We sought to investigate patients' perspectives and behaviors toward sunscreen usage. METHODS: A cross-sectional hospital-based study targeted 418 melasma patients from May 2019 to May 2021. Data regarding socio-demographic characteristics and the knowledge, attitude, and behavior toward sunscreen and sun exposure were collected and analyzed. Furthermore, a complete clinical assessment was done. RESULTS: The mean age of the patients was 35.4 ± 8.6 years. Melasma distribution was mostly centro-facial (49.8%). The mean duration of the disease was 22.3 ± 11.6 months, with a mean Melasma Area and Severity Index (MASI) score of 18.6 ± 8.9. Only 170 patients believed that sun exposure played a role in their disease. Skin darkening was the most recognized effect of sun exposure by 92.9% of participants. 58.6% reported using sunscreen with a higher female predominance (p < .001), while males reported more broad-spectrum sunscreen usage (p < .001). The reason that was reported the most behind not using sunscreen was the high cost (94%). CONCLUSIONS: Our study showed a sound level of knowledge regarding the effects of sun exposure, and sunscreen advantages and disadvantages, with relatively inadequate translation into their attitudes and practices regarding sun-protective behaviors. The use of sunscreen among the patients was average in numbers with a higher female predominance.

Factors affecting medical student's decision in choosing a future career specialty: A cross-sectional study.

BACKGROUND: Diversity in the specialties is essential to provide optimal health care. Future career specialties chosen by the students had great significance for balanced doctor's distribution in different specialties, as it determines the composition of the physician workforce. Therefore, there has been a deeper interest in the issues of career preference among medical students. We aimed to determine and assess the factors perceived to be significantly attractive when choosing a future specialty. MATERIALS AND METHODS: A cross-sectional-based study was conducted among undergraduate medical students from all of the medical schools in Jordan from April to September 2021. The data was collected using a structured online questionnaire through social media platforms and completed by 1556 students. The questionnaire consisted of three sections. The first section included the sociodemographic data of the participants, while the other two sections included questions about future specialty and the factors that influence the student's choice. Informed consent was taken from the participants. RESULTS: Of the participants, (64%) were female. The mean age of the students was 20.9 years. Regarding the future specialty, 664 students (42.7%) preferred surgery as future specialty (females = 364, males = 300). While 505 students (32.5%) preferred specialty in medicine (females = 365, males = 140). Moreover, 349 students had no decision until now regarding their future specialty (females = 238, males = 111). Generally, the surgical specialty was the most preferred specialty, while the basic science specialty was the least preferred. Specialty in medicine and surgery was the most preferred specialty among females and males respectively. CONCLUSION: Surgery in general was the most popular specialty among medical students. Other common choices were neurosurgery, internal medicine, and pediatrics. The more attractive factors were the appeal of being in the specialty, the influence on patient's lives, the potential for patient interactions and the high income. While the least attractive factor was having a long-term relationship with the patients.

Pneumocephalus secondary to a spinal surgery: A literature review and a case report.

INTRODUCTION: We report a case of pneumocephalus, which is identified as the presence of air in the cranial cavity and is a rare complication after spinal surgeries, in addition to a literature review of similarly reported cases. CASE PRESENTATION: The patient is a 63-year-old male who developed pneumocephalus after undergoing a minimally invasive left side decompression at L3-L4 with left L4 foraminotomy even though there were no signs of dural tears or Cerebrospinal Fluid (CSF) leaks. After the diagnosis of pneumocephalus using brain Magnetic Resonance Imaging (MRI), the patient was treated conservatively and was discharged after 3 weeks without developing further complications. DISCUSSION: Pneumocephalus is defined as an abnormal accumulation of air within the cranial cavity. It can occur due to a variety of causes but rarely due to gas forming bacteria. Many theories are suggested concerning the pathophysiology of pneumocephalus, the inverted bottle theory, the ball valve theory, the Nitrous Oxide (N2O) theory, and as we outweigh in our case, gas forming bacteria theory. Pneumocephalus can be treated surgically, nevertheless, conservative management methods of such cases are usually followed. CONCLUSION: The aim of this study is to draw further attention to the management and diagnosis of such surgical complication. A more extended research is needed to provide a full comprehensive approach to deal with this problem if faced in the future. To the best of our knowledge, this study reports the first pneumocephalus case induced by a postoperative bacterial infection in the global English based medical literature.

Clinical Features of COVID-19 Patients in Jordan: A Study of 508 Patients.

BACKGROUND: The symptoms of COVID-19 have a wide range of severity ranging from no symptoms at all to mild symptoms, such as fever, cough, sore throat, general weakness. Moreover, in some situations, patients may develop severe complications as pneumonia, and sepsis, leading to death. This study aims to investigate the characteristic features of COVID-19 patients based on their medical condition prior to COVID-19 diagnosis. METHODS: A retrospective cohort study took place between the 1st of April 2020 and the 31st of June 2020 in Prince Hamzah Hospital, Jordan. Patients were diagnosed by the Real-Time Reverse Transcriptase (RT)-PCR Diagnostic Panel, either through screening or for those who developed symptoms. During this period, patients who tested positive for COVID 19 were admitted to the hospital regardless of their symptoms according to the local government health policies. A total of 508 Patients were involved and divided into two groups based on the presence or absence of chronic illnesses prior to COVID-19 diagnosis. RESULTS: A total of 371 patients were medically free (220 males and 151 females). Among them, 153 patients were symptomatic (41.2%), with an average hospitalization of 18 days. Generalized malaise, dry cough, and fever were the most common reported symptoms (51%, 45.8%, and 41.8%, respectively). On the other hand, the total number of COVID-19 patients with predefined comorbidities was 137 (93 males and 44 females). Among them, 86 patients (62.8%) were symptomatic, with an average duration of admission of 19.3 days. Similar to medically free patients, dry cough, generalized malaise, and fever were the most commonly reported symptoms (50%, 43%, and 38.4%, respectively). There was a statistically significant correlation between the presence of chronic illnesses and the development of symptoms among COVID-19 patients (P = 0.0001). CONCLUSION: Dry cough, generalized malaise, and fever were the most commonly reported symptoms among our patients regardless of their medical condition. The average duration of hospitalization in medically free patients was less than patients with comorbidities, and it was less among asymptomatic compared to symptomatic patients. More than half of our COVID-19 patients were male and asymptomatic. A significant correlation between patients' medical condition and the possibility of developing symptoms in response to COVID-19 was identified.

Impact of COVID-19 on medical students' mental wellbeing in Jordan.

COVID-19 has spread throughout the world and has resulted in significant morbidity, mortality, and negative psychological impact. This prospective cross-sectional study is exploring the effect of the pandemic on mental health of medical students. The study was conducted at six Jordanian medical schools using an online survey to collect students' socio-demographic and academic data. Assessment of mental wellbeing status was done using Kessler's psychological stress scale (K10); the impact of COVID-19 on life activities and strategies followed to manage the situation were also examined. A total of 553 medical students were recruited for the study. Men constituted 40.1%, and women were 59.9%. Students reported that COVID-19 has affected the aspects of physical fitness (73.1%), study (68.4%), and social relationships (65.6%) the most. Sixty-six percent of the students were concerned about family members' affection, and more than half (58.4%) explained their concerns about the inability to get clinical sessions and labs. Cooking, baking, and hobby practicing were the most popular methods to improve their mental wellbeing. About half of the participants had a severe mental disorder, and only 13.2% were likely to be well. The study indicates that half of our medical students suffer severe mental disorders, with physical fitness, exercise, and studying being among the most affected aspects during the COVID 19 pandemic. It is recommended that measures need be taken to alleviate students' stress, which might have deleterious effects in many aspects.

The effects of mode of delivery, maternal age, birth weight, gender and family history on screening hearing results: A cross sectional study.

INTRODUCTION: Congenital hearing impairment is one of the principal issues that make distress to families especially those with a family history of hearing problems. Early detection of hearing impairment can make a difference regarding cognitive, attention, learning, speech, and social and emotional development of babies. Otoacoustic test emission is a very common screening test that can be used to pick up early cases and relieve family stress. We tried to evaluate the factors that may disrupt our results regarding the OAE test. METHODS: A cross-sectional study included infants who were admitted to the nursery unit alone. Infants who were admitted to the NICU unit, infants with craniofacial anomalies, infants with vernix in the external auditory canal, and Infants with Stigmata associated with a syndrome known to include a sensorineural hearing loss were excluded from the study. Both transient evoked otoacoustic emissions (TEOAE) with distortion product otoacoustic emissions (DPOAE) Screening tests were performed by the same professional audiologist experienced in neonatal screening. RESULTS: A total of 1413 newborns (733 males and 680 females) were included in the study. Among them, 1368 babies (96.8%) passed the first OAE in both ears, while 45 babies (3.2%) didn't pass the first OAE in one or both ears.Significant correlations between the female gender and family history of congenital hearing loss with failure of the first OAE test results. Moreover, vaginal delivery (VD) infants had a 1.5-fold higher failure rates of first OAE test screening results in comparison to caesarian delivery (CD) infants. CONCLUSION: Our study demonstrated higher failure rates of the first OAE in female infants, vaginal delivery infants, and infants with a family history of hearing impairment. It is recommended to postpone the first phase of hearing screening for those infants until the first scheduled vaccine appointment to achieve higher compliance attendance, and decrease family stress associated with false-negative results of the test.

Electronic Smoking Behavior Among Adult Males in Jordan.

The use of Electronic cigarettes (E-cigarettes) has considerably expanded especially among adults. This paper highlights the behavior regarding E-cigarettes uses among adult males in Jordan. Moreover, we studied the electronic cigarette devices, the electronic cigarette liquids used in them, and the health-related complaints associated with e-smoking. Among smokers, we studied the association between E-cigarette use and their interest in smoking cessation. A questionnaire-based study regarding electronic cigarette prevalence and awareness among Jordanian individuals was conducted with a total sample size of 1536 participants. The questionnaire was distributed using Facebook and WhatsApp social groups. In this study, we included data of a total of 254 adult male participants after excluding non-E-cigarettes smokers, female smokers, and male smokers younger than 18 years old from the previously published study (Electronic Cigarettes Prevalence and Awareness among Jordanian Individuals) to describe electronic smoking behavior among adult males in Jordan. We described smoking behavior, electronic smoking technologies and materials, source of knowledge, and believe regarding electronic smoking among participants. A total of 254 E-cigarette smokers have participated in this study. 104 participants (40.9%) were found to smoke both traditional and electronic cigarettes, 111 (43.7%) quit traditional cigarette smoking and switched to E-cigarettes, and 39 (15.3%) individuals are exclusively e-smokers. More than half of the participants (n = 144; 56.7%) believe E-smoking is not addictive, and 213 (83.8%) suppose that the overall health effects attributable to E-smoking are less severe and not as serious as those related to traditional smoking. The use of E-cigarettes increased both nationally and globally in the past few years and is considered an emerging modality of smoking among non-smokers. Social media and other internet websites are the main sources of knowledge regarding E-cigarettes. Health-related issues and addiction are thought to be less than traditional smoking in considerable percentages of E-smokers. A more comprehensive conception of E-smoking patterns in Jordan is required to approach this phenomenon. Health authorities in collaboration with governmental policymakers are obligate to adopt strict recommendations to control the promotion of E-smoking through social media and other internet websites to limit its distribution among people especially youths.