Intravenous dexmedetomidine or propofol adjuvant to spinal anesthesia in total knee replacement surgery

The purpose of this study was to compare the effect of intravenous dexmedetomidine with the intravenous propofol adjuvant to spinal intrathecal anesthesia on the duration of spinal anesthesia and hemodynamic parameters during total knee replacement surgery. Seventy five patients were enrolled into this randomized study from the 1[st] of April 2008 till the 30[th] of August 2009 for total knee replacement surgery under spinal anesthesia. They were randomly assigned into three groups, group D, group P and group C. Following intrathecal injection with bupivacaine 12.5 mg in all patients in the three groups, patients in group D received intravenous loading dose of microg/kg/hr dexmedetomidine over 10 minutes and a maintenance dose of 0.2 to 0.5 p,g/kg/hr. Patients in group P received intravenous propofol 4 mg/Kg/hr over 10 min and a maintenance dose of 0.5-2 mg/Kg/hr. Patients in group C [control group] received nothing extra to the regular IV fluid. The regression times to reach SI sensory level and Bromage 0 motor scale, the hemodynamic parameters, the Bispectral Index level of Sedation [BIS], and arterial CO[2] level were recorded. The regression time to reach SI dermatome was 149.4 +/- 14.6 min in group C, 152.8 +/- 16.6 min in group P and 209.6 +/- 25.9 min in group D. The regression to Bromage 0 was!84.6 +/- 22.8 min in group C, 190.0 +/- 21.0 min in group P, and 255.8 +/- 36.7 min in group D. Statistical analysis of regression of sensory and motor block was significant among groups [C vs. D, P vs. D, P < 0.05]. The heart rate was significantly decreased in group D in comparison to groups C and P. Sedation levels were within accepted ranges in groups D and P and not affected in the control group. Minimal respiratory depression occurred in group P and D, clinically it was not significant. Supplementation of spinal anesthesia with intravenous dexmedetomidine or propofol produces good sedation levels without significant clinical hemodynamic changes. Adding dexmedetomidine produces significantly longer sensory and motor block than propofol

prediction of diabetes and hypertension by anthropometric indices based on family medicine clinic data at Jordan university hospital

Epidemiological studies find that obesity is associated with hypertension and diabetes. Therefore it is essential to identify simple and practical anthropometric indices which can predict these diseases. Study the association and the predictability of diabetes and hypertension by the four different anthropometric indices [BMI, waist circumference, waist/hip and waist/height ratios] in a group of patients attending family medicine clinic at Jordan University Hospital. A cross-sectional clinic based survey was carried out over an eight- month period. Data for 936 Jordanian patients [573 females and 363 males] aged 25-74 years were collected for the study. Status regarding diabetes and hypertension was recorded beside anthropometric measurements. Multiple logistic regression showed that there were gender differences in the association between obesity indices and cardiovascular risk factors. In male patients, body mass index had a significant association with hypertension and it was the most predictive factor of hypertension among all anthropometric indices, while waist/hip ratio was the most predictive factor of diabetes. In females, waist/height ratio exhibited the highest degree of association with diabetes and hypertension and was the most predictive factor of both diseases. Anthropometric indices are simple and easy to apply. Since they have a strong predictor value for hypertension and diabetes, they should be used in routine health screening in primary care. Our results represent a small group of patients; we need to conduct larger studies on a national scale to develop local and regional figures which could be different from international standards

Women and domestic violence in Jordan "Tip of the Iceberg"

The objectives of this study were to explore the magnitude and determinants of exposure to physical and verbal violence among females and to examine their perceptions [beliefs] regarding domestic violence. For achieving these objectives, 480 females in the age group [15-49 years] were selected from Ma an governorate, south Jordan, using a multi-stage random sampling design. Data were collected by means of a face-to face interview using a questionnaire. Trained female interviewers collected the data over a period of one week. Data were analyzed using SPSS statistical package. The response rate is 96%. 7.7% of the sample admitted being exposed to physical violence and 14% to verbal insults and humiliations in the year preceding the survey. Age of the respondent, marital status, education, monthly income and area of residence did not show any significant association with both types of violence. Husbands and mothers were found to be the chief of perpetrators of physical and verbal violence against currently married and single women, respectively. 13.4% of women believed that the husband has the right to use physical violence to discipline his wife and 7.7% believed that he has the right to use violence. 43% and 70% respondents believed that the wife has the right to seek police help and medical help respectively. The study highlighted some aspects of the problem of domestic violence and the pressing need for more in-depth research in this field