Prevalence and epidemiological characteristics of patients with gastric cancer at Prince Rashid Hospital in north of Jordan

Objectives: The aim of the study is to determine the prevalence and epidemiological characteristics of gastric cancer in adult patients [>16 years] who underwent Upper Gastrointestinal Endoscopy at Prince Rashid Hospital in the north of Jordan

Methods: Analytical study on patients who underwent upper gastrointestinal endoscopy examinations at Prince Rashid Hospital between January 2011 and October 2015. Age, gender, symptoms, types and site of tumor were recorded for patients discovered to have gastric cancer

Results: Of 4115 patients who underwent upper endoscopy during the study period for different indications, only 115 patients[3%] were found to have macroscopic features of gastric cancer, and [90%] of them [104 patients] had the histopathological confirmation of gastric cancer; 70 males[67%] and 34 females [33%]; mean age was 48 [range 16-81] years. Fatigue, and bloating after meals were the most common symptoms of gastric cancer. The most common site of gastric cancer was in the distal stomach. Intestinal type and poorly differentiated carcinoma were the most common

Conclusion: The prevalence of gastric cancer in our patients who underwent upper gastrointestinal endoscopy at Prince Rashid Hospital was 3%. Studies are needed to determine the prevalence in the general population and to investigate the possible risk factors, so that a proper plan of action and treatment are put in place

Prevalence of hepatitis B and C viruses in hemodialysis patients at JRMS

The aim of our study is to evaluate the prevalence of hepatitis B and C viruses in hemodialysis patients at Royal Medical Services hospitals in Jordan for May 2014. In addition, to find out the risk factors associated with these infections. This is a cross sectional study which was carried out in 7 dialysis units at Jordanian Royal Medical Services in Jordan In May 2014. The notes of patients on maintenance hemodialysis were reviewed and the patients were interviewed by the researchers to collect data regarding the serology status of these patients and potential risk factors which could be associated with hepatitis B virus and hepatitis C virus infection. A total of 712 patients were included in this study. Fifty six percent were males and their mean age was 48. The prevalence of hepatitis B virus was 7%. The prevalence of hepatitis C virus was 16.5%. Family history of hepatitis B infection and history of dialysis outside their specified units were found in 96% of patients with hepatitis B infection with a significant P- value <0.001, while history of hepatitis B vaccination was a strong protective factor against hepatitis B infection with a significant P- value of <0.001. Risk factors associated with hepatitis C infection were: age of the patient, duration of hemodialysis, dialysis outside, family history of hepatitis C, history of kidney transplant and dental procedures. Hepatitis B vaccination is of vital importance in prevention of hepatitis B infection in hemodialysis patients. Strict adherence to infection control guidelines as well as possible isolation of hepatitis C infected patients from other dialysis patients is essential to decrease the rate of hepatitis C and hepatitis B infections

Ocular manifestations among Jordanians with inflammatory bowel disease. hospital-based study in asymptomatic patients

To study the ocular manifestations of inflammatory bowel disease and to investigate whether they are related to disease activity, site of occurrence, and presence of arthritis. A randomized controlled prospective study that was conducted at King Hussein Medical Center during the period between June 2008 and December 2008. One hundred and thirty patients attending inflammatory bowel disease clinic were enrolled in the study. First five patients attending the clinic were selected each week to ensure randomization. Data collected included type of disease, duration, treatment, presence of active disease, site of involvement and presence of arthritis. The randomly selected patients were referred to ophthalmology clinic where they had anterior and posterior segment examination by the same senior ophthalmologist. We investigated the relationship between ocular involvement and type of disease, site of involvement, presence of disease activity and presence of arthritis. Data was collected and compared with a control group of 130 normal subjects. Relatives of patients attending ophthalmology clinic for various reasons were randomly selected as a control group. P-value was calculated to see statistical significance. A total of 130 patients were studied. Mean age of patients was 46.8 years [range 16.2 to 82.2 years] with a male to female ratio of 1.1:1. Seventy patients had ulcerative colitis and 60 patients had crohn's disease. Episcleritis was seen in 12 patients, dry eyes in 9 patients and iritis in 8 patients. One patient was found to have uveitic glaucoma. None of the patients had corneal involvement, scleritis, or retinal vascular involvement. Fifty patients had active disease and 80 were in remission. All patients with episcleritis and iritis had active bowel disease. Tortuous episcleral vessels were seen in 16 patients; the majority of them had inactive disease. Patients with history of arthritis or colonic involvement had more risk of ocular involvemt. The results of our study showed that ocular manifestations of inflammatory bowel disease are related to disease activity, site of involvement and presence of arthritis

Retrospective review of epidemiological, pathological and clinical features of colorectal cancer diagnosed by colonoscopy at King Hussein Medical Center

To find out different characteristics and variables of patients diagnosed as Colorectal cancer at King Hussein Medical Center. A total of 204 cases of colonic cancer patients aged 16 years or more were identified over 4 yearperiod between January 2006 and December 2009 were reviewed at King Hussein Medical Center. The patients were divided into 2 groups according to their age; those < 55 years, and those > 55 to compare the study variables between the two age groups. Seventy five [37%] patients with colonic cancer aged under 55 years and 129 [63%] were 55 years or older. Colonic cancer was more common in men at both age groups than that in women. Localized disease was more common in the young age group. Left side colonic cancer was the most common in both age groups. Nodal involvement was almost similar in frequency in both age groups. Distant metastases were more common in the old age group > 55 years. At diagnosis, 48 [23.5%] of patients had advanced cancers [stage D] with either nodal or distant metastases. Moderately differentiated adenocarcinoma was the most common histological finding. Surgery was undertaken on 134 [65.7%] patients, with a postoperative mortality of 2 [1.5%] patients. Anti-cancer chemotherapy was given to 91 [44.5%] patients and radiotherapy was used in 7 [3.4%] patients. Eleven [5.3%] patients received chemo-radiotherapy and 20 [9.1%] patients received the three modalities of treatment. This study showed that; the frequency of colonic cancer increases with age, at the same time there is a considerable number of patients diagnosed at young age. It is common in our patients with colorectal cancers to present with advanced disease. Colorectal cancer in our group of patients had more aggressive pathological features at presentation in the young age group. Earlier diagnosis of these cancers could well serve as an achievable solution and may improve survival

Colonoscopy at King Hussein Medical Center; indications, effectiveness, safety and outcome

To find out the indications, effectiveness, safety and outcome of colonoscopy at King Hussein Medical Center. A retrospective analysis of the colonoscopy records for patients who underwent elective colonoscopy over a 7-year period [January 2000-October 2006] at King Hussein Medical Center in Amman, Jordan was done. Data collected included the number of the patients, age, gender, reason for doing the procedure, endoscopic findings, and any immediate complication. For all patients colonic preparation using Dulcolax [Biscodyl 5 mg tab] and Fortrans [Macrogol 4000-64 gm] or castor oil with normal saline and unistiffness endoscopes were used. Almost all colonoscopies were done with sedation using Mipiridine 25 mg and Midazolam 3 mg intravenously. A total of 3865 colonoscopies were included in the study, 42% percent of patients were aged less than 50 years. 89% of the colonoscopies were done for patients from physicians as outpatients and 11% for patients who were already in hospital. The number of endoscopies performed during the year 2006 per month was considerably higher [mean 65] than that done during the year 2000 [mean 30]. The main indications for colonoscopies were rectal bleeding [39%], constipation [17%], and diarrhea in 12%. In 3749 [97%] patients, the procedure was completed up to cecum. Normal colonoscopy was reported in 72.5% of patients. The most common abnormal findings were colonic cancer [29%], colonic polyps in 24% and inflammatory bowel disease in 16%. Other common findings were diverticulosis [13.4%], melanosis coli [2.4%], and vascular ectasias in 2.5%. Internal hemorrhoids was a coexistent finding in [n=30] those diagnosed as colonic cancer and [n=18] in those diagnosed as colonic polyps, but it was the only colonoscopic finding in 130 patients [12.2%]. Colonic polyps were also found as coexistent finding in 47 patients diagnosed as colonic cancer. Seven [0.018%] patients had a major complication related to the procedure in the form of colonic perforation [n=4], minor bleeding which did not necessitate blood transfusion [n=2], and stuck snare wire due to looping around a normal colonic mucosa that mandated removal by lapratomy [n=1]. Colonoscopy at King Hussein Medical Center, is safe and effective in establishing a definitive diagnosis, and rarely associated with major complications such as perforation or bleeding

Endoscopic findings in acute upper gastrointestinal hemorrhage at King Hussein Medical Center

To find out the diagnosis in patients presenting with acute upper gastrointestinal hemorrhage at King Hussein Medical Center. A total of 1118 cases of acute upper gastrointestinal hemorrhage patients aged over 16 years who underwent upper endoscopy over a six year-period at King Hussein Medical Center were studied. Most endoscopies were done within 24 hours from the occurrence of the gastrointestinal bleeding. Patients were divided into different age groups to compare the frequency of upper gastrointestinal hemorrhage between males and females in each group. The total number of patients was also divided into 2 subgroups: those below 50 years and above 50 years to compare the distribution of the endoscopic findings between young and older age groups. Upper gastrointestinal bleeding was more common in men at all age groups than that in women except in older patients [more than 70 years]. Eighty seven percent of the endoscopies were done for patients admitted to hospital through the emergency department, and 13% for patients who were already in hospital for some other reason. Sixty two percent of patients were aged over 50. The most common finding over all was duodenal ulcer [32%]. Normal endoscopy was reported in 21% of the cases. Other frequent sources of bleeding were stomach ulcers [18.5%], esophageal varices [5.2%], portal hypertensive gastropathy [0.6%]. Mallory-Weiss tears [3.3%], and gastric tumors [4.7%]. Gastric ulcers and malignancies were more common in older compared with younger age group [2 1.5%, 6.6% vs. 14%, 1.4% respectively]. Therapeutic endoscopic interventions were done in 17% of the patients; adrenaline injection for bleeding peptic ulcer in 16%. sclerotherapy for esophageal varices in 0.9% and banding in 0.1% patients. The frequency of acute upper gastrointestinal hemorrhage increases considerably with age. The most common finding for all age groups was duodenal ulcer. Malignancy was the most important finding in the older [> 50 years] age group

peripancreatic tuberculous lymphadenitis misdiagnosed as pancreatic tumor: a case report

This is a report of a 75-year-old female patient, non-smoker, diabetic, hypertensive, and known case of sero-positive rheumatoid arthritis who has a one year history of progressive weight loss, anorexia and recurrent mild central abdominal pain; in the last three weeks her abdominal pain became severe, radiating to the back and associated with nausea, vomiting and spiky fever. A physical examination, laboratory, radiological investigations including abdomen ultrasound, abdomen Computerized Tomography. Scan was performed, laparotomy was done and specimens taken from the peripancreatic lymph nodes. Histopathological study of three peripancreatic lymph nodes revealed tuberculous lymphadenitis that was mistaken by abdomen ultrasound and computerized tomography scan as a tumor of the neck of the pancreas

Endoscopic findings in upper gastrointestinal bleeding at King Hussein Medical Center

This study aimed to determine tipper endoscopic findings among patients with upper gastrointestinal bleeding [UGIB] who were presented to King Hussein Medical Center and describe its frequency in relation to age, sex and precipitating factors. A prospective study involving the first 100 patients with UGIB admitted to King Hussein Medical Center between January 2003 and November 2003 was carried out. Upper endoscopy was performed to each patient within 24 hours of presentation. Patients were inquired about current use of NSAlDs or aspirin. Data were then analyzed with respect to patients' age, sex and endoscopic findings. The results revealed that 72% of the patients with UGIB were males irrespective of the cause. Bleeding peptic ulcer disease was the commonest cause of UGIR [71%] with significant relation to the use of NSAlDs and aspirin, followed by bleeding esophagogastric varices [10%]. Malignant gastric tumors and Mallory-Weiss tears came next [6% and 4%, respectively]. Normal upper endoscopy was found in 4% of all cases of UGIB. The study concluded that bleeding peptic ulcer disease remains the leading cause of UGIB and mostly in males. There is a strong association between UGIB due to peptic ulcer disease and the use of NSAlDs and aspirin

Leech infestation causing upper gastrointestinal bleeding

This article present a case of hematemesis caused by a leech infesting the floor of the mouth, which was managed in Princess Haya Hospital in Aqaba/Jordan in October-2003. This pathological condition is extremely rare in urban areas but is frequent in endemic rural areas. We also highlighted some very interesting features of Leech due to chemicals they possess and their medicinal use