Accuracy of sonographic fetal weight estimation within 14 days of delivery in a Jordanian population using hadlock formula 1

To assess the accuracy of sonographic fetal weight estimation within 14 days of delivery in a Jordanian population using Hadlock formula 1 in the third trimester. Estimated fetal weights and actual fetal weights data were collected from the medical records of pregnant women who had undergone sonographic fetal weight estimation within 14 days of delivery over the period of March 2008 to June 2010. The analysis included 409 Jordanian women; 6 of them had twins, so the study involved estimation of 415 fetal weights, and these were compared to the actual recorded neonatal weights. Using Hadlock formula 1, we compared the estimations with the infants' actual birth weights. The data were analyzed in 2 groups: within 7 days and 8-14 days. The mean estimated fetal weight was 3,133 +/- 475 g [range 1,343-4,420 g]. The mean actual birth weight was 3,179 +/- 450 g [range 1,300-4,450 g]. The mean absolute percentage of error of ultrasound fetal weight estimation for all infants was 6.5%; however, it was 6.1 and 8.2% if the fetus was delivered within 7 days or 8-14 days of sonography, respectively. Overall, 78.8% of fetal weight estimations were within 10% of actual birth weight; however it was 81.3 and 69.9% if the fetus was delivered within 7 days or from 8-14 days of sonography, respectively. The use of Hadlock formula 1 for sonographic fetal weight estimations in Jordanian women showed acceptable results relative to the actual neonatal weight at birth. However, fetal weight estimation was more reliable when performed within 7 days of delivery

Thromboprophylaxis in neurosurgical patients at Jordan university hospital: a prospective comparative study

Venous Thromboembolism [VTE] is potentially a life threatening complication in patients undergoing major neurosurgical procedures. There has been a general reluctance over the years to use anticoagulant prophylaxis for patients with head injury or in patients who need intracranial surgery. Intermittent Pneumatic Compression [IPC] and elastic stocking are widely used as prophylaxis against venous thrombo-embolism in these patients. The aim of the study is to assess and compare the value of VTE prophylaxis using a control group with Low dose Unfractionated Heparin [LDUH] every eight hours alone with a study group using Intermittent Pneumatic compression [IPC] and elastic stocking along with Single dose Unfractionated Heparin [SDUH] at the time of anaesthesia in induction on patients undergoing brain and spinal surgery. A prospective case-control study was conducted at Jordan University Hospital, over 15 months during the period 2005-2006. A total of 223 patients were included. In the study group, 113 patients using single dose of unfractionated heparin at the time of anaesthesia induction along with Intermittent Pneumatic Compression [IPC] intraoperatively and compression Elastic Stocking [ES] post operatively were used until full ambulation. In the control group, there were 110 patients in whom unfractionated heparin at a dose of 5000 units every 8 hours was used until full ambulation or for 7 days. All patients underwent either brain surgery or spinal surgery. The characteristics of the two groups were fully comparable except for the duration of surgery which was statistically longer in the study group [P= <0.001]. Deep Vein Thrombosis [DVT] occurred in 3 patients in the study group, compared to 6 patients in the control group, of these 6 patients, 4 patients developed PE in addition to DVT and one of the four patients expired. The observed differences among these rates are statistically not significant [P=0.288]. When pooled together, patients who developed VTE in both groups were older than those who did not have VTE. This difference was statistically significant [P=0.07]. The combination of elastic stocking, intermittent pneumatic compression along with single dose unfractionated heparin at the time of anaesthesia induction is comparable in effectiveness of reducing the incidence of VTE as the low dose unfractionated heparin alone in patients undergoing neurosurgical procedures of the brain or spine, despite the trend towards better results of the combined method

Thrombophilia-related genetic variations in patients with pulmonary embolism in the main teaching hospital in Jordan

To study the frequency of Factor V Leiden [FVL], prothrombin gene mutation G20210A and methylenetetrahydrofolate reductase C677T in patients with acute pulmonary embolism [PE]; and to investigate whether these factors are more frequent in patients who have no obvious risk factors for venous thrombo-embolism compared to those with obvious risk factors. A case-control study conducted at Jordan University Hospital, Amman, Jordan during the period 2005-2007. Compared 92 patients with acute PE to 99 normal subjects. All subjects were investigated for the 3 genetically related thrombophilic factors. The frequency of these factors in patients were 22/92 [23.9%] FVL, 3/92 [3.3%] Factor II [FII] and 48/92 [52.2%] methylenetetrahydrofolate reductase [MTHFR]. In the control group, FVL was 12/99 [12.1%], FII 0/99 [0%], and 53/99 [53.5%] MTHFR. There was a statistically significant difference between patients and controls for FVL [p=0.03], but no statistical significance for FII [p=0.10] and MTHFR [p=0.85]. In patients with no obvious risk factors, the frequency of these factors were 8/29 [27.6%] FVL, 2/29 [6.9%] FII, and 14/29 [48.3%] for MTHFR compared to patients with obvious risk factors 14/63 [22.2%] for FVL, 1/63 [1.6%] FII, and 33/63 [52.3%] MTHFR. The FVL is statistically more frequent in patients with PE compared to the control group, and the frequency of FVL, FII, and MTHFR is not significantly higher in patients with acute PE who have no obvious risk factors compared to those with obvious risk factors

Characterization of enterococci causing nosocomial infections at the Jordan university hospital over a five-year period

This study was carried out to determine the relative frequency, antimicrobial susceptibility, and species distribution of enterococci causing nosocomial infections at the Jordan University Hospital [JUH] over a 5 year period. Presumptive identification of Enterococci was followed by species determination using the Crystal Identification System. Antimicrobial susceptibility was determined using the E-Test, and PCR was used to confirm species identification and determine Vancomycin resistance genotype. Enterococci were responsible for 8.4% of nosocomial infections detected in the study period, the majority of which were associated with wound and urinary tract infections. Enterococcus faecalis was the species most frequently isolated being responsible for 83% of infections, whereas Enterococcus faecium caused 16% of infections. The majority of isolates were resistant to tetracycline and gentamicin with no notable species differences. Resistance to ampicillin and levofloxacin was, however, twice as common among E. faecium as compared to that among E. faecalis. The most important finding of this study is the detection of vancomycin resistance among enterococci. It is critical to realize that resistance to the usual first choice of treatment, ampicillin, is common in Jordan and that resistance to alternative treatments has emerged