The prevalence of high risk obstructive sleep apnoea among patients with type 2 diabetes in Jordan.

OBJECTIVE: To estimate the prevalence of Obstructive Sleep Apnea (OSA) among patients with type 2 Diabetes Mellitus (T2DM) in Jordan, and to explore the association between sleep apnea and clinical and demographic variables. METHOD: A cross-sectional study was carried out from the 1st of November 2011 to the 1st of February 2012 on 1143 patients with T2DM (aged 30-90 years) at the National Center for Diabetes, Endocrinology, and Genetics (NCDEG). The center is considered to be the only referral center in the country and accordingly, the patients represent the population in different parts of the country. All participants completed the Arabic version of the Berlin Questionnaire and were categorized as either low or high-risk patients for OSA. RESULTS: A total of 1143 patients with T2DM were included in this study. There were 587 (51.4%) males and 556 (48.6%) females. The findings showed that 554 (48.5%) patients were at high risk for OSA and 589 (51.5%) were low risk for OSA. Logistic regression analysis revealed that age, smoking, and neck circumference were significantly correlated with high risk for OSA. The clinical and demographic variables were also collected for analysis. CONCLUSIONS: The study found that high risk for OSA was highly prevalent among Jordanian patients with T2DM and that age, smoking and neck circumference were significantly correlated with OSA. Health care providers should be made aware of the high prevalence of sleep problems affecting patients with diabetes and should consider the appropriate screening and treatment for these patients, therefore improving their quality of life.

Male transient hip osteoporosis: are physicians at a higher risk?

SUMMARY: Data of 17 male patients with a final diagnosis of transient osteoporosis (TO) of the hip seen at the radiology department of a university hospital over a period of 7 years were retrospectively studied. Comparison of the proportion of doctors among TO cases with that among other hip joint pathologies revealed a significant difference. PURPOSE: The objective of this study is to present clinical and radiological findings of hip TO and to assess the association of the condition with patients' occupation. MATERIALS AND METHODS: Data of 17 male patients with a final diagnosis of transient osteoporosis of the hip seen at the radiology department of a university hospital over a period of 7 years were retrospectively studied. RESULTS: The diagnosis of transient hip osteoporosis was in accordance with the published literature for clinical, imaging findings, and laboratory results. Among the 17 cases of male transient hip osteoporosis, 65% were physicians and 12% were commercial pilots. Comparison of the proportion of doctors among TO cases with that among other hip joint pathologies revealed a significant difference. Abnormal low hormone levels of testosterone and 25-cholicalciferol (vitamin D) were detected in three and two patients, respectively. CONCLUSION: The preponderance of physicians among patients with transient hip osteoporosis has not been previously reported. Etiological contribution of endocrine pathology and type of occupation to the causation of transient osteoporosis merits further research.

The standard clinical smell testing protocol of the National Center for Diabetes, Endocrinology and Genetics in Amman, Jordan: JOR test.

OBJECTIVE: The aim of this study was the development of a simple clinical smell test that can be applied in Jordan and its validation against one of the standard tests, the University of Pennsylvania Smell Test (UPSIT, Sensonics Inc, Haddon Heights, NJ). DESIGN: A prospective validation study of a locally designed smell test was done. SETTING: The study was conducted at the National Center for Diabetes, Endocrinology and Metabolism in Amman, Jordan. PARTICIPANTS: Fifty subjects were recruited to participate in this study. Twenty-five were normal healthy individuals, and 25 were patients with Kallmann syndrome. INTERVENTION AND MAIN OUTCOME MEASURES: All 50 participants underwent 2 tests, the UPSIT and the locally designed test (JOR test). The scores of all patients in both tests were compared. Test-retest reliability was determined in the same 50 subjects. All patients completed the study. RESULTS: Subjects who scored within normal limits on the UPSIT scored 8 to 10 on the JOR test, and people who were abnormal on the UPSIT scored between 0 and 5 on the JOR test. The correlation between the scores of both tests was almost perfect (r = 0.984, P = .000). When both tests were classified as normal and abnormal, there was a complete agreement (kappa statistic = 1). Both sensitivity and specificity were 100%. CONCLUSION: Given its highly significant correspondence to the UPSIT and the odor thresholds of Jordanians, our test proved valid and useful as a cross-cultural clinical test of olfactory function. In addition, it is an inexpensive, rapid test. Unfortunately, the data lacked persons with moderate impairment of smell. Therefore, the new test may not be used to assess this category of patients.

Cerebellar hypoplasia, hypergonadotrophic hypogonadism, retinitis pigmentosa, alopecia, microcephaly, psychomotor retardation, and short stature: "D-CHRAMPS syndrome".

We here report a rather novel syndrome of dysmorphic features, short stature, microcephaly, alopecia, psychomotor retardation, retinitis pigmentosa and secondary amenorrhoea. This may present a new complex multisystem disorder distinct from those reported in the literature and we propose the acronym D-CHRAMPS for this novel disorder.