Tuberculous peritonitis post orchiectomy for testicular tuberculosis; a case report and literature review.

Tuberculous peritonitis, though rare, is a serious condition and its diagnosis is challenging due to nonspecific clinical symptoms and imaging findings. Likewise, tuberculous epididymo-orchitis is a clinical dilemma, as it often mimics testicular tumors. We report a case of a 62-year-old patient diagnosed to have TB peritonitis, following tuberculous epididymo-orchitis with review of the imaging features of both entities. A high index of suspicion and careful clinical assessment will help in early diagnosis and treatment of TB peritonitis, preventing potential complications. Moreover, testicular tuberculosis should be considered in the differential diagnosis of scrotal mass.

Prevalence of low vitamin D levels in patients with Hidradenitis suppurativa in Jordan: A comparative cross-sectional study.

Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the apocrine gland bearing skin, presenting various stages of flexural skin pain, erythema, painful nodules, abscesses, sinuses, and fistulas. We aimed to assess serum vitamin D levels in patients with (HS) in Jordan. a cross-sectional comparative study conducted among 110 patients with HS and 110 matched controls, who didn't previously receive vitamin D therapy. Serum vitamin D was measured and classified into normal (>30 ng/ml), insufficient (20-30 ng/ml), and low (<20 ng/ml). The mean age of the cases was 43.1 ± 12.9 years and the mean disease duration was 19.4 months. The mean body mass index among patients with HS was 30 and about 34% of them were smokers. The mean Vitamin D level was 8.4 ng/ml and all HS patients were vitamin D deficient. Patients of HS were more likely to have vitamin D deficiency compared to healthy controls. Most of the study subjects and particularly all of the patients with HS have low vitamin D levels. Smoking and high BMI, were associated with HS. We suggest the implementation standard public dietary recommendations of Vitamin D supplementation, smoking cessation, and weight reduction behaviors with further assessment of disease course among HS patients.

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.

Cosmetic dermatology training perspectives during residency: A survey-based report from Jordan.

BACKGROUND: There has been an evident increase in the number of cosmetic dermatologic procedures performed by dermatologists. Those procedures vary from a simple office-based one to more complex procedures requiring general anesthesia. Therefore, it is essential to assess the adequacy of cosmetic dermatology training among dermatology residents to meet patients' expectations. AIM: We sought to assess dermatology residents' educational exposure to cosmetic dermatology and identify the practices and educational gaps of esthetic dermatology residency programs in Jordan. METHODS: An online cross-sectional study targeted almost all dermatology residents in Jordan from April to June 2021. Forty-two dermatology residents completed an English online questionnaire that involved sociodemographic data, the resident's educational exposure to cosmetic dermatology, and the resident's opinion regarding the training programs. RESULTS: Out of the 42 participants, 16 (38.1%) were males, and 26 (61.9%) were females. More than half (54.8%) of the participants reported that cosmetic procedures were done in the department they are attending. The majority (64.3%) did not attend cosmetic training or procedures. The majority strongly agree that hands-on training is the most beneficial way of cosmetic residency training (88.1%). More than 85% believe that cosmetic dermatology training should be practical and that final-year residents should perform cosmetic procedures independently. Only 2.4% and 4.8% of the residents were very satisfied or satisfied, respectively, with the current level of cosmetic procedural training. CONCLUSION: The dermatology residents in Jordan are dissatisfied regarding the current level of cosmetic procedural training. Therefore, infrastructure must be improved; educational training quality must be improved by providing theoretical and practical education in clinics.

Time for effective cycloplegia in patients with brown iris.

We aimed to evaluate the time needed for effective cycloplegia after instillation of cyclopentolate 1% in patients with brown irides. A prospective analytical study involving 161 patients (322 eyes) with a mean (SD) age of 9.0 (3.1) years (range: 3-16 years), who attended outpatient eye clinic. All had brown irides, cyclopentolate 1% was instilled two times, 10 minutes apart, spherical equivalent (SE) was calculated using readings taken by Nidek AR-1000 autorefractometer before the first drop and at 15, 30, 45 and 60 minutes after the first drop. The time for effective cycloplegia was determined from the time point at which the 95% confidence interval of the differences between the average spherical equivalent (SE) at each point and its final value at 60 minutes was reached and remained within ±0.25 D. We found that maximum cycloplegia was reached 30 minutes after the instillation of first drop of cyclopentolate 1% in all refractive error categories (emmetropia, hyperopia and myopia) with the exception of high hyperopia subgroup (SE ≥ +6.0D) where at least 45 minutes were needed to achieve cycloplegia. Additionally no clinically significant difference in the minimum time required to achieve maximum cycloplegia was noticed in subjects under 10 years old and those aged 10 years or older with both groups needed at least 30 minutes to achieve maximum cycloplegia after the instillation of first drop of cyclopentolate 1%. In this group of patients with brown irides, most children reached maximum cycloplegia after 30 minutes of instillation of cyclopentolate 1% eye drops.

Sexual Dysfunction in Patients with Hidradenitis Suppurativa: A Systematic Review and Meta-Analysis.

BACKGROUND: Hidradenitis suppurativa (HS) can be a severe condition that impacts patients' health and quality of life. One aspect that can be impaired is sexual health, with many patients suffering from sexual dysfunction (SD). There are numerous articles describing this association. OBJECTIVE: We sought to synthesize and analyze the recent available evidence on HS and SD. METHODS: A systematic review was conducted. Three medical databases were used: Medline, Embase, and Cochrane. All types of epidemiological articles were included, while reviews, guidelines, protocols, conference abstracts, and case report articles were excluded. This review covers the past eight years. RESULTS: Twelve studies were included for review, with the most common study design being cross-sectional. Most studies involved surveys and questionnaires, with some using control groups to compare results. SD affected roughly half of patients with HS, and was found more frequently in women. Comorbidities included psychological conditions, such as depression and low self-esteem, as well as metabolic and cardiovascular diseases. CONCLUSION: HS is significantly associated with sexual health issues, including SD in women and erectile dysfunction in men.

Impact of socio-demographic factors on knowledge, attitude and practices toward scabies among syrian refugees in Jordan: A prospective cross sectional study.

BACKGROUND: Scabies is one of the prevalent dermatological conditions, accounting for a substantial proportion of skin diseases in developing countries. It represents a significant health challenge when an outbreak appears in homecare and refugee camps as it may lead to enormous morbidity and high treatment costs. Because Scabies can be easily prevented through education, the purpose of this study was to assess the impact of socio-demographic factors on the level of knowledge, attitude, and practices among Syrian refugees in Jordan's northern region. METHODS: A prospective cross-sectional study was conducted among Syrian refugees attending primary health centers in northern Jordan, Ramtha, Mafraq, and Irbid, from February 2021 to May 2021. The targeted population was adult Syrian refugees above the age of 18. Two thousand participants were included in this study using simple random selection. The study questionnaire included socio-demographic characteristics and knowledge questions such as hearing about Scabies, causes of Scabies, signs and symptoms of Scabies, and its way of transmission. The data was analyzed using (SPSS) version 25. RESULTS: Females with a mean age of 37.9 years old comprised the majority of the participants. The majority of the participants were married and had intermediate levels of education. The knowledge about Scabies lacked among the majority of the respondents (N = 1259); 321 respondents had moderate knowledge, while only 650 had good knowledge. A statistically significant association was found between knowledge scores and all demographic characteristics, including gender, marital status, income, and educational level. CONCLUSION: The general knowledge about Scabies among Syrian refugees is relatively low, with 1259 out of 2000 participants having a bad knowledge score. Moreover, the level of knowledge, attitude, and practices toward Scabies is highly affected by the demographic factors of the Syrian refugees' Health education for refugees is needed to improve their knowledge and help implement prevention programs.

Assessment of Serum Vitamin D Levels in the serum of Patients with Postherpetic neuralgia and its correlation to pain severity: A cross-sectional comparative study.

INTRODUCTION: Vitamin D is an essential micronutrient for the maintenance of many functions in the human body. Postherpetic neuralgia (PHN) is caused by the reactivation of the latent varicella-zoster virus (VZV) in the neurons. This study aims to assess the serum vitamin D level in patients with PHN and to correlate the level of vitamin D with pain severity. METHODS AND MATERIALS: A hospital-based cross-sectional comparative study was conducted in the period from April 2019 to January 2021. One hundred and sixty-two individuals, matched for age and gender, divided into cases and controls (81 for each). Serum levels of 25(OH)D were measured for cases and controls. Demographic data were taken, and then the diagnosis of neuropathic pain in cases was established using the Douleur Neuropathique 4 (DN4) questionnaire. RESULTS: We included 39 (52%) males in the PHN group and 36 (48%) in the control group. There was no significant difference between groups regarding age, marital status, smoking and BMI. The duration of pain in our study had a mean of 7.6 ± 3.6 months. We found the DN4 score for the pain to be negatively associated with vitamin D levels (Pearson's correlation coefficient: -0.511, P = .000). The levels of vitamin D were moderately associated with pain duration (Pearson's correlation: -0.466, P = .000). CONCLUSION: PHN patients had a high prevalence of vitamin D deficiency and those who had vitamin D deficiency were older and had higher degrees of pain for a longer duration. In PHN patients, vitamin D deficiency was moderately associated with increased severity and duration of pain.

Preference of and factors that influence future specialty among medical students in Jordan: A cross-sectional study.

BACKGROUND: Choosing future specialty is an important issue that face undergraduate medical students during their university years. Several factors may assist to formulate students' final decision. We aimed to explore the future specialty preferences and the factors that influence the choice of undergraduate students in medical schools in Jordan. METHODS: A cross sectional study conducted among the sixth year students of two medical schools in Jordan. A questionnaire was used to collect data from the students. It consisted of demographic data in form of gender, GPA, family income, and parents' level of education. In addition to data about preferred specialties, and factors that influence medical students' choice of future specialty. RESULTS: A total of 223 medical students from two medical schools were recruited to participate. Males were 49.3% while females were 50.7%, and around 22% scored an excellent GPA. Most parents of the students were bachelor degree holders (63.6% for fathers and 62.3% for mothers). Medicine (19.4%), dermatology (12.6%), and obstetrics and gynecology (11.7%) were the most chosen future specialties. Specialty appeal and thoughts of future creativity was the most chosen factor that influenced future specialty (55.2%) choice, followed by family time and less on-call duties (14.8%). Students who selected chances of fellowships as an influencing factor were more likely to prefer medicine as future specialties (p < 0.001). CONCLUSION: Medicine, dermatology, and obstetrics and gynecology were the most popular future specialty choices among undergraduate medical students. Most of our medical students claimed that selection of their specialty is based on the interest and potential creativity, family time and less on call duties. Further studies are required in a wide range to accommodate more students from the other academic years.

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.