Supernumerary parathyroid glands in a patient with tertiary hyperparathyroidism [case report]

Supernumerary parathyroid glands could be affected by tertiary hyperparathyroidism after long-term phosphate therapy in an adult-onset hypophosphatemic Osteomalacia, and it may be the cause of refractory hyperparathyroidism. We Report a 63-years old Jordanian man who has been diagnosed at age of 26 years as having sporadic adult-onset hypophosphatemic Osteomalacia and developed tertiary hyperparathyroidism as a complication of prolonged oral phosphate therapy, which requires repeated surgical interventions. This patient had six parathyroid glands all ended with tertiary hyperparathyroidism, the 5th and the 6th gland were activated serially. This rare association is discussed along with a review of literature

Prevalence of coeliac disease among adult patients with autoimmune hypothyroidism in Jordan

The prevalence of coeliac disease among patients with autoimmune hypothyroidism has not been studied before in Jordan and other Arab countries. A cross-sectional record-based review was made of all adult autoimmune hypothyroidism patients who attended a referral centre in Jordan, during an 8-month period. Coeliac disease in these patients was diagnosed by the attending physician based on positive serological tests for anti-endomysial antibodies IgA and IgG followed by duodenal biopsy to confirm the diagnosis of coeliac disease. Of 914 patients recruited, 117 [12.8%] were seropositive for coeliac disease. Of 87 seropositive patients who underwent duodenal biopsy, 39 had positive histological findings of coeliac disease [44.8%]. Extrapolating from these findings the overall rate of coeliac disease among autoimmune hypothyroidism patients was estimated to be 5.7%. In multivariate logistic regression coeliac disease was significantly associated with older age [> 40 years], presence of other autoimmune diseases, vitamin B12 deficiency and anaemia

Glycaemic control and its associated factors in type 2 diabetic patients in Amman, Jordan

A study of 1000 patients attending a diabetes referral centre in Amman, Jordan, identified factors associated with good glycaemic control, as measured by glycosylated haemoglobin [HbA1c] levels. Glycaemic control improved significantly between the first clinic visit and at 12-months follow-up. The proportion of patients with extreme HbA1c [>/= 10%] decreased from 15.3% to 6.0% after 12 months. The percentage of patients with optimal control [HbA1c < 7%] increased from 25.4% at the first visit to 27.5% at 12-month follow-up. Multivariate regression showed that low body mass index, shorter duration of diabetes and higher baseline HbA1c were related to reductions in HbA1c between the first and 12-month visits

Infantile and early childhood masturbation: sex hormones and clinical profile

Few studies have explored the hormonal triggers for masturbation in infants and young children. Thus, we aimed to study the sex hormones and clinical profiles of masturbating infants and young children. This case-control study involved infants and young children who masturbate and were referred to three pediatric neurology clinics between September 2004 and 2006 [n=13], and a similar control group. All children underwent basic laboratory investigations prior to referral. Other tests included electroencephalography [n=8] and brain neuroimaging [n=9]. We measured dehydroepiandrosterone sulfate, 17-hydroxyprogesterone, free testosterone, estradiol, dehydroepiandrosterone, sex hormone-binding globulin [SHBG], and androstenedione in all participants. The median age at the first incident was 19.5 months [range, 4-36 months]; the median masturbation frequency, 4 times/day; and the median duration of each event, 3.9 min. The subjects masturbated in both prone [n=10] and supine positions [n=3]; two subjects used the knee-chest position. All subjects showed facial flushing; 6, friction between the thighs; 5, sweating; 9, sleeping after the event; and 12, disturbance on interruption. EEG was abnormal in one of eight subjects tested, and neuroimages were normal in all of nine subjects examined. The case and control groups had comparable levels of all sex hormones, except estradiol, which showed significantly lower levels in the case group [P=.02]. Masturbation in children seems to be associated with reduced estradiol levels, but not with other sex hormones. Further studies are needed to confirm our findings

Diabetes mellitus: the leading cause of haemodialysis in Jordan

This study aimed to define the role of diabetes mellitus as a cause of end-stage renal disease requiring haemodialysis in Jordan, and to compare diabetic and nondiabetic patients. All patients on haemodialysis in Jordan at the time of the survey in 2003 [n = 1711] were personally interviewed and additional data were obtained from medical records. Diabetes mellitus was the most common cause of end-stage renal disease [29.2% of cases]. The mean age of patients was higher in diabetics [57.5 years, standard deviation [SD] 12.3] than nondiabetics [45.4 years, SD 17.1]. Duration on haemodialysis was significantly shorter in diabetics compared to nondiabetic patients

Prevalence of missed hyperglycaemia among Jordan University Hospital mortality discharges, 1995-97

To study the prevalence of recognized and unrecognized hyperglycaemia [defined as fasting blood glucose >/= 140 mg/dL and/or random blood glucose >/= 200 mg/dL on two or more occasions], data were collected from Jordan University Hospital on all hospital deaths in those >/= 20 years of age, for the years 1995-97. The prevalence of diagnosed diabetes was 35.3% and 19.2% were missed cases of hyperglycaemia; of the missed cases, 65.7% had a blood glucose level > 250 mg/dL. Thus, the prevalence of missed hyperglycaemia among hospitalized patients is high, and greater vigilance needs to be exercised by physicians and other health professionals in reviewing laboratory results, especially those related to diabetes