The extent of awareness of southern Jordanian people to thedifference between venous thrombosis and arterial thrombosis / El grado de concienciación de los habitantes del sur de Jordania sobre la diferencia entre trombosis venosa y trombosis arterial

Objective: Venous thrombosis (VTE) and arterial thrombosis are two different diseases. Although they differ in causes, types, and treatment, they share many risk factors. Many people are not able to differentiate between them. So assessing the awareness of people toward these two diseases and determining the variables that affect their awareness was the aim of the study. Methods: This is a cross-sectional validated questionnaire which was conducted on social media. It targeted the southern Jordanian public above 18 years between October and December 2022. Results: A total of 630 people participated in the current study. Only 42.2% knew the cause of arterial thrombosis compared to 58.7% in case of venous thrombosis. More than half (63.2%) of the participants knew that there is a difference between venous and arterial thrombosis. DVT (36.8%) and PE (23%) were correctly identified as types of VTE, while only myocardial infarction was identified as a type of arterial thrombosis by 52.2% of respondents. About 69.5% and 80.2% of respondents think that venous and arterial thrombosis are fatal, respectively. Regarding the socio-demographic variables that affect the awareness of the public, old age, high educational level, working, and earning at least 500 JD per month were significantly associated with better awareness of the study population about venous and arterial thrombosis with a p-value of 0.0027, < 0.001, 0.0017, and < 0.001 respectively. Conclusion: The current study reveals that there is a lack of awareness about VTE and arterial thrombosis and the difference between them among the southern Jordanian public. VTE and arterial thrombosis are preventable diseases, so more attention should be given by increasing the educational campaign and the initiatives of public health about the difference between them in terms of signs and symptoms, risk factors, and complications.(AU)

Assessment of the knowledge and practice of Jordanian family medicine practitioners regarding vitamin B12 screening for type 2 diabetes mellitus patients on metformin

Background: Metformin is one of the most important treatments for type 2 diabetes mellitus (T2DM) patients. Mostly metformin has a safe profile but in some cases, it may cause some serious long-term hematological and neurological side effects mainly due to vitamin B12 deficiency. It is proven that there is a strong association between B12 deficiency and hematological and neurological manifestations, especially for T2DM patients on metformin. Hence, the American Diabetic Association (ADA) recommends vitamin B12 screening for those on metformin for a long duration. Objectives: To evaluate the knowledge and practice of family physicians among diabetic patients on metformin, and to evaluate the factors that enhance and prevent vitamin B12 screening. Method: A validated questionnaire was designed and distributed online for family medicine practitioners between the period of in June and September 2022. 147 family physicians participated in the study. A scoring system was used to calculate the knowledge, practice, and total scores. Results: The results reveal a high total knowledge score among participants about vitamin B12 manifestations and screening in T2DM patients. However, only half of the participants follow the ADA recommendations routinely (53.06)%. The total practice score is low as most participants (87.7%) answer only 9 of 18 questions correctly. Moreover, the results show that those who follow ADA recommendations routinely have better knowledge and practice scores (p-value 0.00406). Conclusion: More awareness about ADA recommendations and the practice of vitamin B12 screening in T2DM patients who use metformin for family physicians is required, either by encouraging them to order B12 through workshops and continuous learning programs or by the availability of tools needed to test B12 (AU)

A Cross-Sectional Survey of Knowledge, Attitude, and Practices Regarding Influenza Vaccination Among Jordanians Aged 18-64 Years with Chronic Diseases.

Objectives: Influenza is a frequent infectious disease that can be prevented and is associated with significant mortality and morbidity. The most economical way to prevent influenza is through vaccination, although this method is not widely used. This study aimed to assess the seasonal influenza vaccination rates and the knowledge and attitudes of Jordanian adults with chronic illnesses toward the influenza vaccine. Materials and Methods: A cross-sectional design was employed. A 26-item online survey was used to gather data about patients' knowledge of and attitudes toward the influenza vaccine as well as their status as influenza vaccine recipients. Results: A total of 19% of the 564 study participants received an influenza vaccination. Most (81%) of individuals reported inconsistent vaccination uptake. The most important factor affecting vaccination is the belief that the flu is not a threat (39%) and that their doctors did not advise them about the vaccination (32%). Participants with no health insurance and those with public insurance had a lower level of vaccination than those with private insurance (p= 0.008). Conclusion: The adult population of Jordan with chronic diseases has subpar immunization rates. What is also revealed is a blatant misunderstanding about the value of routine influenza vaccination. These findings emphasize how urgently the public needs to be made aware of the effectiveness of the influenza vaccine.

Study of Adherence Level and the Relationship Between Treatment Adherence, and Superstitious Thinking Related to Health Issues Among Chronic Disease Patients in Southern Jordan: Cross-Sectional Study.

Background: For disease management, numerous drugs are prescribed. However, long-term treatment adherence is still unsatisfactory. Culture influences beliefs regarding medication, particularly irrational ideas that affect treatment adherence. The Middle East, notably Jordan, is affected by a lack of awareness of these attitudes with regard to treatment adherence. Objective: Investigating the adherence level among patients with chronic diseases in southern Jordan. To determine whether certain demographic traits, different disease factors, and superstitions have any impact on treatment adherence. Patients and Methods: A cross-sectional study that assessed treatment adherence and superstitious thinking-related health issues were conducted among chronic disease patients who had reviewed intrinsic medicine clinics at the Karak governmental hospital. Results: For 314 participants, treatment adherence was categorized into three levels low-adherent patients made up 27.7% highly-adherent patients made up 49.4%, and the remaining adhered at a medium level. Treatment non-adherence was more common in the elderly and female, according to the chi-square analysis. Additionally, the classification of superstitious beliefs into three categories revealed that different percentages of the study population held low superstitious beliefs 21%, medium superstitions 54.1% and high superstitions 24.8% beliefs. The chi-square analysis revealed that the elderly, female, and low-educated patient groups were the highest in superstitious thinking. Multiple regression analysis revealed that educational level and superstitious thinking explained 0.223 of the treatment adherence variances. Treatment adherence is positively influenced by educational level ß (0.244) value, but superstitious thinking is negatively influenced by ß (-0.302) value. Conclusion: In conclusion, about half of the participants highly adhered. The results of the multiple-regression analysis indicate that superstition and education were two variables that impacted treatment adherence in this study. While superstitious beliefs lead to lower treatment adherence, education has the opposite effect. Finally, it is recommended to promote patient education to reduce superstitious beliefs, improve medication adherence.

Variability of CYP2C8 Polymorphisms in Three Jordanian Populations: Circassians, Chechens and Jordanian-Arabs.

CYP2C8 is a member of Cytochrome P450 enzymes system. It plays an important role in metabolizing a wide range of exogenous and endogenous compounds. CYP2C8 is involved in the metabolism of more than 100 drugs, typical substrates include: anticancer agents, antidiabetic agents, antimalarial agents, lipid lowering drugs and many others that constitute 20% of clinically prescribed drugs. Genetic variations of CYP2C8 have been reported with different frequencies in different populations. These genetic polymorphisms can lead to differences in the efficacy and safety of different types of medications metabolized by CYP2C8. The aim of this study was to investigate the allele frequencies of CYP2C8*3 (rs10509681 and rs11572080) and CYP2C8*4 (rs1058930) polymorphisms in three populations living in Jordan; Circassians and Chechens and Jordanian-Arabs and compare those frequencies with other populations. A total of 200 healthy Jordanians, 93 Circassians and 88 Chechens were included in this study. Genotyping of CYP2C8*3 and CYP2C8*4 polymorphisms was done by using polymerase chain reaction (PCR) followed by Restriction Fragment Length Polymorphism (RFLP). Using the Chi-square test, we found that the prevalence of CYP2C8*3 and *4 among the three populations were significantly different. Moreover, the mutant allele CYP2C8*3 (416A) was only detected in the Jordanian-Arab population with an allele frequency of 0.082, while the mutant allele CYP2C8*4 (792G) was detected with frequencies of 0.065, 0.122, 0.017 in Jordanian-Arabs, Circassians and Chechens, respectively. As our results show, CYP2C8*3 was undetectable in our Circassians and Chechens samples, on the other hand, Circassians had the highest allele frequency of CYP2C8*4 compared to Chechens and Jordanian-Arabs. These genetic variations of the gene encoding the CYP2C8 drug metabolizing enzymes can lead to clinical differences in drug metabolism and ultimately variations in drug effectiveness and toxicities. This study provides evidence for the importance of personalized medicine in these populations and can be the foundation for future clinical studies.

Dispensing errors and self-medication practice observed by community pharmacists in Jordan.

BACKGROUND: Drug dispensing is the major function of community pharmacists, the pharmacists should have the ability to counsel the patients and be aware of dispensing errors. Self- medication is a universal phenomenon that is widely practiced in developing countries and it may lead to irrational usage of drugs. OBJECTIVES: The objectives of this study were identifying the factors that associated with dispensing errors and how to minimize them and identifying patients' reasons for self-medication, drugs purchased as Over-The-Counter drugs, patients' source of drug information. METHODS: A cross-sectional survey of a stratified random sample of three hundred registered community pharmacists in all Jordanian regions (north, middle and south). Statistical analysis was done by using SPSS software version 17.0. RESULTS: The majority of respondents were female (72.7%). Poor doctor's handwritten prescription was the major identified factor that associates with despising errors (3.78 out of 5) and improving doctor handwritten or using printed prescription was the most appreciated factor in reducing these errors (4.62 out of 5). Regarding community pharmacists' opinions toward self-medication practice, the majority said that it is not acceptable (4.12 out of 5) and most of the time it leads to bad sequences. Financial problem was the major reason behind self-medication (4.72 out of 5), analgesics/antipyretics were most drug groups that dispensed as OTC drugs (4.85 out of 5) and the pharmacists were a major source of patient' drug information. CONCLUSION: Drugs dispensing errors and self-medication practices are widespread in Jordan and they should be regulated and restricted throughout applying strong policies and laws. They should be strictly enforced among pharmacies and there is a great responsibility to increase community awareness regarding appropriate drugs using.