Morphometric analysis of the inferior vena cava and its clinical correlations using abdomino-pelvic computed tomography: Series from a Jordanian population.

INTRODUCTION AND IMPORTANCE: This study aimed to determine the impact of DM, HTN and age on IVC dimensions as measured by CT scan relevant to guide interventions in a Jordanian population. PRESENTATION OF CASES: Two hundred patients were selected from those referred to the Radiology Department, Jordan University Hospital, Amman, Jordan for clinical evaluation. Patients were divided into three age subgroups. Age, sex, and comorbidities such as DM and HTN were identified and saved for later use. All dimensions of the IVC were measured using an abdomino-pelvic CT scanner. CLINICAL DISCUSSION: A full morphometric analysis of the IVC would provide a better understanding of the dynamicity of the IVC in relation to its blood flow. Our results revealed that the length of the IVC was significantly shorter with age (P = 0.003). DM significantly affected the length of the IVC (P = 0.044). Hypertension also significantly affected the length of the IVC (P = 0.031), but it did not significantly affect the anterio-posterior or the transverse diameters of the IVC. CONCLUSION: The length of the IVC was significantly shorter with age, DM and hypertension. Morphometric measures of the IVC are of great clinical importance as they may assist in medical or surgical intervention and follow-up.

Determining trainees' knowledge of surgical anatomy: A specialist's perspective.

OBJECTIVES: Intraoperative identification of anatomical structures can potentially reduce the risk of surgical complications. This study aims to report specialists' perspectives about the anatomical structures that third-year residents should be able to identify during surgical operations. In addition, the factors which may influence specialists' opinions are discussed. MATERIALS AND METHODS: This qualitative cross-sectional study was conducted on obstetricians and gynaecologists between 1/2/2019 and 30/10/2019. The specialists practising in a hospital with a residency programme were included, and were asked to rate the importance of structures that a third-year resident should be able to identify during operations. We performed a comparison of responses based on specialists' age, gender, practice type, years of experience, and surgical workload. RESULTS: One hundred and sixty-five specialists were recruited with a response rate of 69.3%. The mean age of respondents was 46.1 years, and they had a mean experience of 13.4 years. Furthermore, 86.6% of specialists rated all the anatomical structures as "more important". The importance of surgical structures, as rated by specialists, was not related to gender, years of experience, or surgical workload. The importance of 63% of the anatomical structures was rated higher by junior specialists than senior specialists. CONCLUSION: Knowledge of anatomical structures is vital for gynaecologic residency training. Specialist's perceptions of the importance of various anatomical structures reflect their understanding of the training requirements. Our results highlighted the important anatomical structures that third-year residents are expected to identify during surgical operations. Future research may establish a reference for the core anatomy knowledge essential for each training year.

Ameliorative effect of resveratrol against histological alterations in lung of mice induced by subchronic exposure of cigarette and waterpipe tobacco smoking / Efecto paliativo del resveratrol frente a las alteraciones histológicas en el pulmón de ratones inducidas por exposición subcrónica del tabaquismo de cigarrillos y pipas de agua

SUMMARY: This study aims to evaluate the ability of resveratrol (RSV) antioxidant to attenuate the oxidative stress condition induced by secondhand exposure of cigarettes and waterpipe smoking using animal model. Forty-eight mice were divided equally into six different groups, and RSV was delivered to certain groups intraperitoneally with a dose of 25 mg/kg/day. The process of smoking exposure was performed using a specialized smoking machine. The experiment duration lasts for six consecutive weeks. Five µm sections of lung were stained with hematoxylin and eosin for light microscopy, and 70 nm ultrathin sections of lung stained with uranyl acetate and lead citrate were prepared for transmission electron microscopy to observe the cellular ultrastructure. In lung, RSV reduced the deterioration and blebbing of bronchiole epithelium, reduced the inflammation, increased the surface area of alveolar sac, and reduced the thickening of alveolar walls. Also, blood vessels were less congested and less dilated with less diffusion of extravasated blood. Ultrastructural images illustrated that RSV protects the normal structure of alveolar septum, prevents DNA damage and alveolar degeneration, showed less degree of apical membrane blebbing and retained the uniform pattern of mitochondria. In conclusion, RSV has ameliorative effects against the oxidative stress condition induced by secondhand (side stream) exposure of cigarette and waterpipe tobacco smoking.

RESUMEN: Este estudio tiene como objetivo evaluar la capacidad del antioxidante resveratrol (RSV) para atenuar el estrés oxidativo inducido por la exposición de segunda mano a los cigarrillos y al tabaquismo en pipa de agua, utilizando un modelo animal. Se dividieron cuarenta y ocho ratones en seis grupos diferentes, y se administró RSV a ciertos grupos por vía intraperitoneal con una dosis de 25 mg / kg / día. El proceso de exposición al tabaquismo se realizó utilizando una máquina de fumar especializada. La duración del experimento fue de seis semanas consecutivas. Para realizar la microscopía óptica se tiñeron secciones de pulmón de cinco µm con hematoxilina y eosina, y se prepararon secciones ultrafinas de 70 nm de pulmón teñidas con acetato de uranilo y citrato de plomo para la microscopía electrónica de transmisión para observar la ultra estructura celular. En el pulmón, el RSV redujo el deterioro y la formación de ampollas del epitelio de los bronquiolos, redujo la inflamación, aumentó la superficie del saco alveolar y redujo el engrosamiento de las paredes alveolares. Además, los vasos sanguíneos se encontraron menos congestionados y menos dilatados y con menor difusión de sangre extravasada. Las imágenes ultraestructurales mostraron que el RSV protege la estructura normal del tabique alveolar, previene el daño del ADN y la degeneración alveolar, mostrando un menor grado de formación de ampollas en la membrana apical y además retuvo el patrón uniforme de las mitocondrias. En conclusión, el RSV tiene efectos de mejora contra el estrés oxidativo inducido por la exposición de segunda mano (corriente secundaria) al fumar cigarrillos y pipas de agua.

The attitude of medical students towards the teaching of Anatomy

The study of anatomy is essential in understanding basic and clinical medical sciences and it is taught by various methods. This study aimed to find out the attitude of medical students in Jordan towards the various methods of teaching anatomy and their opinion regarding the relevance of anatomy in their study. An online survey was sent to the third-to sixth-year medical students at the Hashemite University, Jordan. The survey asked about various aspect of teaching anatomy. The answers were analyzed using non-parametric methods.The response rates ranged from 24% to 45% in the different groups. More than half the students believed that anatomy was interesting, but only a small percentage thought about becoming anatomists. In all the groups, plastic models were considered the most favored method of teaching and theoretical lectures were the least favored. The students preferred the number of lab session to be increased and lectures to be decreased. Text-books were not considered as a main source of study. A very high percentage of students in all the groups considered digital media as a main source of study preferring it to be incorporated more in the curriculum. A greater percentage of students in the third and fourth years thought that too much information was given in their anatomy courses. The greater percentage of students in the fifth and sixth years did not. Almost all the students believed that anatomy was important in understanding basic and clinical medical sciences and in their future profession as doctors. Modifications in the anatomy curriculum may be required. More practical sessions should be arranged, reading textbooks should be encouraged, and new technology and digital media need to be incorporated more

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Development and validation of a scale to measure the gross anatomy preparedness of medical graduates / Desarrollo y validación de una escala para medir la preparación anatómica general de los graduados médicos

SUMMARY: Postgraduate refresher courses may address deficiencies in the gross anatomy preparedness of medical graduates. However, the literature does not offer a method to identify such deficiencies. Our aim is to develop and validate a scale to measure the gross anatomy preparedness of medical graduates. First, we defined gross anatomy preparedness (the construct) as "the benchmark of personal ability in gross anatomy against the standard required for clinical practice." Next, we conducted a literature search for extant items related to our definition. To develop our scale, we grouped the items under three headings: proficiency, preference, and pertinence. Finally, we constructed item-specific response anchors to "Likertize" the items. We recruited experts to validate the content and conducted cognitive interviews to validate the response process. To evaluate the internal structure and reliability of the scale, we invited a purposive sample of 120 surgery residents to complete the scale and explored the results of the pilot test using data reduction and reliability analysis. A total of 77 surgery residents completed the scale. Varimax-rotated principal components analysis revealed three components with eigenvalues greater than one, and the components explained 64 % of the total variance. The rotated solution was consistent with the original structure of the questionnaire. The components, which represented the proficiency, preference, and pertinence item sets, explained 25 %, 23 %, and 16 %, respectively, of the total variance. Cronbach's α coefficients for the item sets were 0.72, 0.71, and 0.61, respectively. We developed and validated a scale to measure the gross anatomy preparedness of medical graduates. In addition, we offer conceptual guidelines to help users interpret the results of the scale. Outcome data are required to substantiate the predictive validity of the scale.

RESUMEN: Los cursos de actualización de posgrado pueden abordar las deficiencias en la preparación de la anatomía macroscópica de los graduados médicos. Sin embargo, la literatura no ofrece un método para identificar tales deficiencias. Nuestro objetivo fue desarrollar y validar una escala para medir la preparación anatómica general de los graduados médicos. Primero, definimos la preparación para la anatomía macroscópica (el constructo) como "el punto de referencia de la capacidad personal en anatomía macroscópica frente al estándar requerido para la práctica clínica". A continuación, realizamos una búsqueda bibliográfica de elementos existentes relacionados con nuestra definición. Para desarrollar nuestra escala, agrupamos los ítems bajo tres encabezados: competencia, preferencia y pertinencia. Finalmente, construimos anclas de respuesta específicas del ítem para "dar me gusta" a los ítems. Reclutamos expertos para validar el contenido y realizamos entrevistas cognitivas para validar el proceso de respuesta. Para evaluar la estructura interna y la confiabilidad de la escala, invitamos a una muestra intencional de 120 residentes de cirugía a completar la escala y exploramos los resultados de la prueba piloto utilizando la reducción de datos y el análisis de confiabilidad. Un total de 77 residentes de cirugía completaron la escala. El análisis de componentes principales rotados con Varimax reveló tres componentes con valores propios mayores que uno, y los componentes explicaron el 64 % de la varianza total. La solución rotada fue consistente con la estructura original del cuestionario. Los componentes, que representaban los conjuntos de ítems de competencia, preferencia y pertinencia, explicaban el 25 %, el 23 % y el 16 %, respectivamente, de la varianza total. Los coeficientes de Cronbach para los conjuntos de elementos fueron 0,72, 0,71 y 0,61, respectivamente. Desarrollamos y validamos una escala para medir la preparación anatómica general de los graduados médicos. Además, ofrecemos pautas conceptuales para ayudar a los usuarios a interpretar los resultados de la escala. Se requieren datos de resultados para corroborar la validez predictiva de la escala.

Variation in the vertebral levels of the origins of the abdominal aorta branches: a retrospective imaging study.

Our aim was to investigate the variation in the vertebral levels of the origins of the celiac artery, superior and inferior mesenteric arteries, paired renal arteries, and common iliac arteries. We conducted a retrospective imaging study in a large public secondary hospital on a nonrandom sample of 227 participants. We consecutively included adult patients who had undergone computed tomography angiography of the abdomen and excluded patients with a history of any vertebral abnormality or whose images revealed evidence of a vertebral abnormality or a congenital anomaly of any of the branches of the abdominal aorta. The primary outcome was the frequency distribution of the vertebral levels of the landmarks. The secondary outcomes were the intercorrelations of the vertebral levels of the landmarks and their relationships with age, sex, weight, height, and body mass index. The celiac artery originated at T11/T12-L1/L2, followed by the superior mesenteric artery at T12-L2, the paired renal arteries at T12/L1-L2/L3, the inferior mesenteric artery at L2-L4, and the common iliac arteries at L3-L5. The vertebral levels of the landmarks were positively intercorrelated and stronger between proximate pairs. In addition, the vertebral levels of the landmarks were related to age, but not sex, weight, height, or body mass index. The intercorrelations suggest that a considerable proportion of the variation is accounted for by 'trickle-down' variation; variation in the vertebral level of a proximal landmark results in variation in the vertebral level of the immediate distal landmark. The overarching parameter remains unidentified.

Interrater and intrarater agreement and reliability of ratings made using the Zaidi-Dayal and Richards-Jabbour scales for the shape of the foramen magnum.

Anatomists and radiologists use the Zaidi-Dayal and Richards-Jabbour scales to study the shape of the foramen magnum. Our aim is to measure the interrater and intrarater agreement and reliability of ratings made using the two scales. We invited 16 radiology residents to attend two sessions, four weeks apart. During each session, we asked the residents to classify the shape of the foramen magnum in 35 images using both scales. We used Fleiss' κ to measure interrater reliability and Cohen's κ to measure intrarater reliability. The interrater reliability of ratings made using the Zaidi-Dayal scale was 0.34 (0.26-0.46) for session one and 0.30 (0.24-0.39) for session two, and the intrarater reliability was 0.39 (0.34-0.44). The interrater reliability of ratings made using the Richards-Jabbour scale was 0.14 (0.10-0.19) for session one and 0.12 (0.09-0.17) for session two, and the intrarater reliability was 0.11 (0.07-0.15). In conclusion, the interrater and intrarater agreement and reliability of ratings made using the Zaidi-Dayal and Richards-Jabbour scales are inadequate. We recommend an objective method by Zdilla et al. to researchers interested in studying the shape of the foramen magnum.

The best vein to be accessed based on descriptive study of dorsal metacarpal vein.

It is well known that the most common sites for venous access are the superficial veins of the upper limb, particularly dorsal metacarpal veins and median cubital vein. Although dorsal metacarpal veins are the first choice for venous cannulation, there is scarce information about their anatomic variation. Hence, detailed anatomical information about these veins will improve the anatomic knowledge of the health care providers. Subsequently, this study was designed to study the dorsal metacarpal veins and to determine the most prominent dorsal metacarpal vein. A cross sectional study of 402 subjects (804 hands), was prepared to study the superficial veins on the dorsum of the hand among Jordanian students and staff of one of the major governmental medical colleges in Jordan, by using infrared illumination system. The obtained data was analyzed according to sex, sidedness, and handedness. Six locations of the most prominent dorsal metacarpal veins were identified. There was a significant relation between both females and males and the most prominent dorsal metacarpal vein (P=0.01). For the first time this study identified the most common location of the most prominent dorsal metacarpal vein in the fourth intermetacarpal space.

Normative Values of Peripapillary Retinal Nerve Fiber Layer Thickness in a Middle Eastern Population.

PURPOSE: Peripapillary retinal nerve fiber layer (pRNFL) thickness is subject to high variability. Normative values of pRNFL thickness remain undocumented in the Middle East. The aim of our study is to assess the normative values of pRNFL thickness in a Middle Eastern population. METHODS: A retrospective chart review of 74 patients was conducted. Outpatients who had presented to the ophthalmology clinic at the Jordan University Hospital between January 2016 and July 2018 were consecutively sampled. Measurements had been recorded using Fourier-domain optical coherence tomography. Multivariable regression models were developed to generate predicted normative values with adjustments to candidate confounders. RESULTS: The mean global pRNFL thickness was 99 ± 11 µm. The mean quadrantic pRNFL thickness increased from the nasal quadrant (75 ± 16 µm) to the temporal (82 ± 20 µm), superior (114 ± 20 µm), and inferior (125 ± 20 µm) quadrants. Gender and eye sidedness did not contribute to the variability in pRNFL thickness. The relationship between aging and pRNFL thinning is independent of diabetes mellitus type 2 and systemic hypertension. Both systemic conditions significantly predicted pRNFL changes despite negative fundoscopic findings. CONCLUSIONS: Our set of predicted normative data may be used to interpret measurements of pRNFL thickness in Middle Eastern patients. Our findings suggest that systemic conditions with potential ocular manifestations may require consideration in predictive models of pRNFL thickness, even in the absence of gross fundoscopic findings. Normative data from additional Middle Eastern populations are required to appraise our models, which adjust for common clinical confounders.

Dorsal metacarpal veins: anatomic variation and potential clinical implications.

The dorsal metacarpal veins are frequently cannulated. Cannulation success is determined by several variable anatomic features. The objective of this study is to classify, for the first time, the anatomic variants of the dorsal metacarpal veins. In this cross-sectional study, 520 university students and staff were conveniently recruited. The dorsal metacarpal veins in 1040 hands were studied. Venous visibility was enhanced by either tourniquet application or near-infrared illumination. Variant patterns of the dorsal metacarpal veins were classified. The final analysis included 726 hands, for an exclusion rate of 30 %. Eight pattern types were identified. Three anatomic features informed the variation. Bilateral symmetry of the dorsal metacarpal veins was present in 352 participants (83 % of the total). The overall frequency distribution of variants in both hands was similar (P = 0.8). The frequency distribution of variants was subject to sexual dimorphism (P = 0.001), ethnic variation (P < 0.001), and technical variation (P < 0.001). The anatomic variants of the dorsal metacarpal veins were sorted into decreasingly frequent primary, secondary, and tertiary groups. The groups may signify a progressive increase in difficulty of peripheral cannulation, in the mentioned order. As such, primary patterns are the most common and likely the easiest to cannulate, while tertiary patterns are the least common and likely the most difficult to cannulate. The preceding premise, in tandem with the bilateral asymmetry of the veins, is clinically significant. With cannulation difficulty likely signifying an underlying tertiary pattern, the contralateral dorsal metacarpal veins are probabilistically characterized by a primary pattern and are, as such, the easier option for peripheral venous cannulation.

Morphometric analysis of the foramen magnum / Análisis morfométrico del foramen magno

SUMMARY: The foramen magnum is morphometrically typified by two perpendicular diameters and a distinct margin. This important anatomical landmark is subject to high interindividual variation. The objective of this study was to evaluate the dimensions and morphology of the foramen magnum in a Jordanian population. In this retrospective study, 247 individuals were consecutively sampled using the institutional picture archiving and communication system. The anteroposterior and transverse diameters of the foramen magnum were measured; the foramen magnum index was calculated; and, the shape of the foramen magnum was visually assessed. The sex-pooled anteroposterior and transverse diameters were 35.1 ± 3.2 mm and 29.3 ± 2.5 mm, respectively. The sex-pooled foramen magnum index was 1.20 ± 0.10. The diameters were significantly different (P<0.001) and positively correlated (r=0.52, P<0.001). Participant age was negatively correlated with the anteroposterior (rs=-0.15, P=0.02) and transverse (rs=-0.14, P=0.03) diameters. After controlling for participant age, there was a statistically significant difference in the anteroposterior diameter (P<0.001), the transverse diameter (P<0.001), and the foramen magnum index (P=0.02) between sexes. The foramen magnum was most commonly irregular in shape (36 % of all cases). In contrast to previous studies, we report, for the first time, a negative correlation between age and the diameters of the foramen magnum. In addition, a predominance of irregularly shaped foramen magnum was found. The finding makes an already heterogenous group of published data even more variable, prompting reconsideration of the role of visual assessment in morphometric studies.

RESUMEN: El foramen magno está morfométricamente tipificado por dos diámetros perpendiculares y un margen. Este punto importante de referencia anatómica está sujeto a una alta variación interindividual. El objetivo del estudio fue evaluar las dimensiones y la morfología del foramen magno en una población jordana. En este estudio retrospectivo, 247 individuos fueron muestreados consecutivamente utilizando el sistema institucional y de comunicación de imágenes. Se midieron los diámetros anteroposterior y transversal del foramen magno; Se calculó el índice del foramen magno y se evaluó visualmente la forma dede éste. Los diámetros anteroposterior y transversal agrupados por sexo fueron 35,1±3,2 mm y 29,3±2,5 mm, respectivamente. El índice del foramen magno, agrupado por sexo, fue 1,20±0,10. Los diámetros fueron significativamente diferentes (P <0,001) y positivamente correlacionados (r = 0,52, P <0,001). La edad de los participantes se correlacionó negativamente con los diámetros anteroposterior (rs = -0,15, P = 0,02) y transversal (rs = -0,14, P = 0,03). Después de verificar la edad de los participantes, hubo una diferencia estadísticamente significativa entre el diámetro anteroposterior (P <0,001), el diámetro transversal (P <0,001) y el foramen magno (P = 0,02) entre ambos sexos. El foramen magno era más comúnmente de forma irregular (36 % de todos los casos). A diferencia de estudios anteriores, se informa por primera vez de una correlación negativa entre la edad y los diámetros del foramen magno. Además, se encontró un predominio de forámenes de forma irregular. El hallazgo indica que un grupo heterogéneo de datos ya publicados, sea aún más variable, lo que lleva a reconsiderar el papel de la evaluación visual en los estudios morfométricos.

Effect of cigarette smoking on the structure of hepatocytes: TEM study / Efecto del tabaquismo sobre la estructura de los hepatocitos: estudio MET

The liver is one of the major organs that is indirectly affected by cigarette smoke. The aim of this project is to define the histologic and ultrastructural changes in normal liver cells after exposing animals to cigarette smoke. Thirty albino rats were exposed to cigarette smoke for 90 days, followed by morphologic examination of their livers under light microscope and electron microscope. The liver cells of cigarette smoke exposed rats showed mild swelling with increased eosinophilia. Ultrastructural examination of these cells demonstrated cytoplasm with highly proliferated and crowded mitochondria. There were many electron dense mitochondria. These mitochondria were pleomorphic in shape compared to mitochondrias of control rats. Also, loss of mitochondrial cristae and widening of the intermembranous space was noticed. It is concluded that smoking exerts cellular damage and oxidative stress on normal liver cells resulting in ultrastructural changes.

El hígado es uno de los principales órganos indirectamente afectado por el humo del cigarrillo. El objetivo de este trabajo fue definir los cambios histológicos y ultraestructurales de las células normales del hígado después de exponer a los animales al humo del cigarrillo. Treinta ratas albinas fueron expuestas al humo de cigarrillo durante 90 días, seguido de un examen morfológico de los hígados bajo microscopio de luz y microscopio electrónico. Las células hepáticas de las ratas expuestas al humo de cigarrillo mostraron una leve inflamación con un aumento de la eosinofilia. En el examen ultraestructural de estas células se observó el citoplasma mitocondrial altamente proliferado y saturado. Se observó gran cantidad de mitocondrias electrón-densas y éstas presentaban forma pleomórfica en comparación con las mitocondrias del grupo control. Además, se observó pérdida de las crestas mitocondriales y ensanchamiento del espacio intermembranoso. Se concluye que el tabaquismo ejerce daño celular y estrés oxidativo en las células hepáticas normales, lo que resulta en la aparición de cambios ultraestructurales.

Double inferior vena cava detected by CT venography and confirmed by magnetic resonance venography: embryogenesis and literature review / Doble vena cava inferior detectada a través de venografía por tomografía computada y confirmada con venografía por resonancia magnética: embriogénesis y revisión de la literatura

A hospital based prospective study was conducted from July 2001 to July 2015 at the Department of Radiology, Jordan University Hospital, Amman, Jordan. During that period, five cases of double inferior vena cava (DIVC) were discovered among a cohort of 7722 patients (3861 men and 3861 women, 49.5±16.9 years, range 16­78 years). Cases were diagnosed by contrast-enhanced Spiral CT venography (CTV) and confirmed by turbo three-dimensional (3D) time-of-flight contrast-enhanced MR venography. The majority of patients 3166 (41 %) were referred for staging and follow-up of malignancy, postoperative complications 1777 (23 %), non-specific abdominal pain 1467 (19 %), preoperative assessment 849 (11 %) and trauma 463 (6 %). Magnetic resonance venography showed higher sensitivity, diagnostic accuracy and noninvasive modality for assessment of IVC map. MRV is a more useful, noninvasive modality for assessment of IVC map. DIVC is a common anomaly, its incidence in our study found to be 0.064 %. The incidence, literature review, embryogenesis, and importance of this anomaly are discussed. In addition, sample figures of relevant cases are provided.

En el Departamento de Radiología del Hospital de la Universidad de Jordania, Amman, Jordania, se llevó a cabo un estudio prospectivo entre el mes de julio de 2001 al mes de julio del 2015. Durante ese período se descubrieron cinco casos de vena cava inferior doble (VCID) en una cohorte de 7722 pacientes (3861 hombres y mujeres 3861, de 49,5 ± 16,9 años, con un rango de edad de 16-78 años). Los casos fueron diagnosticados por medio de venografía por tomografía computada espiral con contraste (TCV) y confirmados por medio de venografía por estudio tridimensional turbo. La mayoría de los pacientes (3166, 41 %) fueron remitidos para estadificación y seguimiento de tumores malignos. Se presentaron complicaciones postoperatorias en 1777 pacientes (23 %), dolor abdominal no especificado en 1467 (19 %), evaluación preoperatoria en 849 (11 %) y traumatismo en 463 pacientes (6 %). La venografía por resonancia magnética (RMV) mostró una mayor sensibilidad, precisión diagnóstica, y resultando no invasiva para la evaluación de la vena cava inferior (VCI). RMV es una modalidad más útil, no invasiva para la evaluación de la VCI. VCID es una anomalía frecuente, encontrándose en nuestro estudio una incidencia de 0,064 %. Además se realizó una revisión de la literatura, la embriogénesis, y la importancia de esta anomalía. También, se proporcionaron cifras de muestras de los casos relevantes.

Sex-specific parameters of ascending aorta, descending aorta and pulmonary trunk by computed tomographic angiography with impact of age, hypertension, smoking and diabetes / Parámetros específicos de la parte ascendente de la aorta, parte descendente de la aorta y tronco pulmonar analizados mediante angiografía por tomografía computadorizada relacionados con el sexo, impacto de la edad, hipertensión, tabaquismo y diabetes

This study aims at establishing whether transverse diameter (TD) and cross sectional-area (CSA) of the ascending aorta (AA), descending aorta (DA) and pulmonary trunk (PT) measured by computerized tomographic angiography (CTA) altered by sex, age, hypertension, smoking and diabetes. CTA examinations of the TD and CSA of the AA, DA and PT of 100 patients aged 49.5±16.9 years (range 16­78 years) selected between January 2009 to May 2011 from those referred to Radiology Department, Jordan University Hospital, Faculty of Medicine, University of Jordan, Amman, Jordan for advanced evaluation. Measurements were made in the axial plane at the upper border of the six thoracic vertebrae. Patients were divided into three age groups. Significance of differences in parameters between age groups was calculated. Assessment ratios were considered. It was found that parameters of the three arteries were significantly larger in men than in women (P= < 0.05) and increased with age. Hypertension increased diameters of AA and DA in both genders (P= 0.001) and of PT in men (P= 0.01). Smoking significantly decreased parameters of PT in men (P= 0.01). Diabetes increased parameters of the three arteries in both genders, significantly increased parameters of PT in men (P= <0.05) and parameters of DA in women (P= <0.05). It is concluded that studied parameters were larger in men and increased with age of our patients. Distinctive differences in measurements appeared in hypertensive, smokers, and diabetic patients.

El objetivo fue determinar si el sexo, edad, hipertensión, tabaquismo y la diabetes alteran el diámetro transversal (DT) y área transversal (AT) de la parte ascendente de la aorta (AA), parte descendente de la aorta (AD) y tronco pulmonar (TP), medidos por angiografía por tomografía computadorizada (ATC). Exámenes de ATC de 100 pacientes de 49,5±16,9 años (rango 16­78 años) fueron seleccionados entre enero del año 2009 a mayo del año 2011 por el Departamento de Radiología, Hospital de la Universidad de Jordania, Facultad de Medicina de la Universidad de Jordania, Amman, Jordania para una evaluación avanzada del DT y AT de la AA, AD y TP. Las mediciones se realizaron en el plano axial en el margen superior de las seis vértebras torácicas. Los pacientes fueron divididos en tres grupos según edad. Se determinó la existencia de significancia estadística de los diferentes parámetros entre los grupos etarios. La evaluación de las razones también fueron consideradas. Se encontró que los parámetros de las tres arterias fueron significativamente mayores en los hombres que en las mujeres (p= <0,05) y que aumentaron con la edad. La hipertensión aumentó los diámetros de la AA y AD en ambos sexos (p= 0,001) y del TP en los hombres (p= 0,01). En fumadores disminuyeron significativamente los parámetros del TP en los hombres (p= 0,01). La diabetes aumentó los parámetros de las tres arterias en ambos sexos. Ademas, aumentaron significativamente los parámetros del TP en los hombres (p= <0,05) y los parámetros de la AD en las mujeres (p = <0,05). Se concluye que los parámetros estudiados eran mayores en los hombres y aumentaron con la edad de nuestros pacientes. Diferencias distintivas en las mediciones aparecieron en hipertensos, fumadores y pacientes diabéticos.

Ultrasonographic assessment of splenic volume and its correlation with body parameters in a Jordanian population.

OBJECTIVES: To estimate normal linear dimensions and volume of spleen in Jordanians using ultrasonography, and to correlate splenic volume with age and body parameters: height, weight, body surface area (BSA), and body mass index (BMI). METHODS: A prospective pilot study was conducted on 205 volunteers (115 males and 90 females) not known to have any conditions likely to be associated with splenomegaly. The study was performed at the Radiology Department, Jordanian University Hospital, Amman, Jordan, between December 2013 and August 2014. All linear dimensions of spleen were measured, and splenic volume (index) was calculated using the standard prolate ellipsoid formula (length × width × depth × 0.523). The splenic volume was then analyzed with age and body parameters using the Pearson's correlation coefficient. RESULTS: The mean (± SD) splenic dimensions were 10.72±1.37 cm in length, 7.40±1.52 cm in width, 4.40±1.47 cm in depth, and 184.15±79.56 cm3 in volume. Men had larger spleens than women (p less than 0.0001). Age had no significant effect on spleen volume (r=0.11, p=0.12). There was a significant moderate positive correlation (p less than 0.0001), using Pearson's correlation coefficient, between the spleen volume, and other parameters (height, weight, BSA, and BMI), with correlation coefficients exceeding 0.3. CONCLUSION: A local reference of spleen dimensions was established with a different range of values reported previously.

Individual variability and marginal types of the human vertebral artery (V3) subject to the skull shape

Variability of the third segment (V3) of vertebral artery (VA) in correlation with individual shape of skull was studied by analyses of 32 MRI and angiograms of 64 arteries. According to value of cranial index, the group under research was divided into three subgroups: dolichocephalic (15.6%), mesocephalic (43.8%), and brachycephalic (40.6%). The V3 was studied according to its conventional division into three sections: vertical (vV3), horizontal (hV3), and oblique (oV3), with proximal and distal loop formations along its length. The mean diameter and length of vV3 and hV3 had minimal value in the patients with brachycephalic shape of skull. The angle between bends of proximal loop of V3 progressively increased from 67.5 ± 0.75 degree in the dolichocephalic group to 77.1 ± 0.44 degree in the brachycephalic group, while the angle between bends of distal loop was decreasing from the dolichocephalic group (79.6 ± 4.7 degree) to the mesocephalic group (74.85 ± 2.4), reaching the minimal value in the brachycephalic group (79.6 ± 4.7 degree). In the dolichocephalic group downward deviation of hV3 was more in evidence than in all the rest groups, with inclination to minimal or zero-deviation in brachycephalic group. The results have showed that the anatomical variability of V3 significant correlates with the shape of skull. The findings open up possibilities for primary diagnosis and prognosis of acute and chronic disorders in posterior circulation enabling to choose the individual surgical approach to the craniocervical junction and base of skull (AU)

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Burnout among the clinical dental students in the jordanian universities.

BACKGROUND: The study aimed to evaluate the level of burnout among the clinical dental students in two Jordanian universities. METHODS: A total of 307 students from the two schools were surveyed using Maslach Burnout Inventory survey. Scores for the inventory's subscales were calculated and the mean values for the students' groups were computed separately. Kruskal-Wallis and Mann-Whitney tests were carried out and the results were compared at 95% confidence level. RESULTS: The results showed that the dental students in both Jordanian universities suffered high levels of emotional exhaustion and depersonalization compared to reported levels for dental students in other countries. The dental students of the University of Jordan demonstrated a significantly higher (p < 0.05) level of emotional exhaustion than their counterparts in the Jordan University of Science and Technology. CONCLUSIONS: The findings indicated that dental students in the Jordanian universities presented considerable degrees of burnout manifested by high levels of emotional exhaustion and depersonalization. Studies targeting students health and psychology should be carried out to determine the causes of burnout among dental students. The curricula of the dental schools in the two universities should be accordingly improved to minimize burnout among the students. KEYWORDS: Burnout; Emotional exhaustion; Depersonalization; Personal accomplishment; Maslach Burnout Inventory.

Prevalence of temporomandibular joint disorders among students of the university of jordan.

BACKGROUND: This study aimed to investigate the prevalence of temporomandibular disorder (TMD) among students of the University of Jordan. METHODS: Information about the symptoms of TMD and the possible risk factors were collected using specifically designed questionnaires. The collected data sets were treated statistically using the SPSS release 14 package. RESULTS: The results of the present investigation showed that pain in or about the ears or cheeks was the most prevalent symptom whereas locking of the temporomandibular joint (TMJ) was the least prevalent. Nearly one-third of the investigated sample (31.4%, 346/1103) had no symptoms of TMD whereas 68.6% (757/1103) had at least one symptom. Students of health science studies had significantly the highest risk in developing TMJ clicking compared to students studying pure science or humanitarian studies. CONCLUSIONS: TMD is of a high prevalence among students of the University of Jordan, particularly among students of health and science studies, which signify the role of stress in the development and/or progression of TMD. The findings of this study are alarming and entailing further investigations to identify risk factors associated with TMD in order to establish measures for prevention and treatment. KEYWORDS: TMD; Clicking; Health sciences; Humanitarian studies.

Topical phenytoin ointment increases autograft acceptance in rats.

OBJECTIVE: To examine the effectiveness of topical phenytoin in preserving the skin viability and increasing acceptance rate of autograft. METHODS: We conducted this study in the Central Laboratory Animal House of Jordan University of Science and Technology, Irbid, Jordan during the period from September 2004 to June 2005. Forty-two rats were divided into 2 equal groups; full thickness dorsal skin wound (4 cm2) was created in the rats. Twenty-one rats were treated with phenytoin (10% w/w ointment), the other 21 (control) were treated with standard dressing and Vaseline. An autograft was performed one week after treatment. Rats were examined for the presence of healthy granulation tissue, reduction in wound surface dimensions, and time for complete graft attachment. RESULTS: Phenytoin ointment had significantly increased wound bed viability and the rate of graft acceptance (p-value <0.0001). Twenty rats had successful grafting (10% phenytoin); while only 3 rats out of the 21 control had successful grafts. The mean time to complete graft attachment and hair growth in the grafted skin was 6.6 +/- 0.5 days. The mean wound contraction measurements (taken just before grafting) were as follow: control group 59.2 +/- 11.6%, and phenytoin group 55.7 +/- 9.2, difference in skin contractility was not statistically significant. Skin viability was evident by increased vascularity and granular tissue formation at the edges of the wound. CONCLUSION: Phenytoin appears to be an effective method for enhancing the take of the full-thickness skin graft. Further clinical use and evaluation of topical phenytoin ointment in skin grafting are merited.