incidence of normal coronary angiography on cardiac catheterization in Jordanians

To determine the incidence of normal coronaries on cardiac catheterization and its pattern of occurrence according to sex and age. This is a retrospective study conducted at Queen Alia Heart Institute in Amman-Jordan during the period 2006 to 2011. A total number of 5000 adult patients who had coronary angiography for chest pain, which were reviewed looking for the presence of normal coronaries, its frequency among males and females and its occurrence according to age groups. The overall incidence of normal coronaries on cardiac catheterization was 17.3%, with almost equal ratios for males and females [53.9% and 46.1% respectively]. Women in the age group 50 - 59 years was the commonest category [33.7%] to have normal coronary angiography, whereas the commonest age group for males was 40 to 49 years. Patients above 70 years of age were very less commonly to have normal coronaries [only in 8.5%]. Normal coronaries on cardiac catheterization is a recognized finding in both men and women. Recognition of this issue is essential in order to prescribe proper follow up and appropriate medical therapy with correction of modifiable risk factors

pattern of pacemaker induced tricuspid regurgitation

To determine the frequency and significance of tricuspid regurgitation in patients who underwent a single lead permanent pacemaker implantation. This is a retrospective study conducted at Queen Alia Heart Institute in Amman-Jordan during the period 2006 to 2009. A group of 67 patients who had a single lead permanent pacemaker implantation in that period was involved in the study. For each patient a transthorasic two dimensional echocardiography was done 6-12 months after insertion of the pacemaker; checking for the presence of tricuspid regurgitation and its degree. Males constituted 68.7% of the study sample. The majority [91%] of patients in the study group had their permanent pacemaker due to complete heart block. Tricuspid regurgitation following insertion of permanent pacemaker was found to be mild in the majority [92.5%] of patients. Significant and gross tricuspid regurgitation was not common and found only in males. Tricuspid regurgitation after permanent pacemaker is usually mild in short term follow up. However echocardiography check up is recommended to monitor the degree of tricuspid regurgitation progression in chronic term particularly in the elderly males and smokers

Pica is a cause of acute abdomen

This report is to document a rare and unique case of 18 years- old girl who presented with signs and symptoms of anemia with a cute abdomen. Medical investigation revealed a pica, which was associated with pseudo intestinal obstruction and severe anemia

Appropriateness of admissions to intensive care unit

To improve resource utilization in the intensive care unit by assessing the appropriateness of admissions, exploring the reasons for improper selection of patients for intensive care and recommendations suggested to overcome them. This is a retrospective study conducted at Princess Haya Hospital [a secondary hospital with a total of 120 beds] in Aqaba-Jordan during the period November 1st, 1999 to December 1st, 2001. All medical and surgical adult patients who were admitted to the intensive care unit were involved in the study. The intensive care unit capacity is six beds that open and run mainly by a nursing staff, with no specific intensive care unit policy or protocols. For each admission, patient demographics, diagnosis, cause of admission, length of stay in the intensive care unit and final outcome were collected. Data collected were analyzed for each patient to examine the appropriateness of admission to the intensive care unit according to the criteria for intensive care unit admissions published by the American College of Critical Care Medicine. There were 1169 admissions during the study period where 76% of admissions were medical patients and 53% had acute cardiovascular disorders. Surgical patients constituted 24% of total intensive care unit admissions with 72% of these surgical patients were trauma cases. Only 54.2% of total admissions [medical and surgical patients] were admitted appropriately to intensive care unit. The average length of stay was 2.3 days per patient. Sixty five percent of patients were discharged to hospital wards. About 15% of patients stayed less than 24 hours and a significant ratio 16.6% of admissions discharged home. The mortality rate was 11%. Establishing guidelines for admission, discharge and triage of adult intensive care unit patients is of utmost importance and is supported by the literature. Providing guidelines based on relevant literature and expert opinion will lay down the intensive care unit policy, procedures, and by laws. Subsequently, appropriate utilization of intensive care unit resources will lead to optimizing health care cost

Endoscopic findings in upper gastrointestinal bleeding patients at Prince Hashem Hospital

To determine the frequency and underlying cases of upper endoscopic findings among patients with upper gastrointestinal bleeding who presented to Prince Hashem Hospital. This study was conducted between July 2002 and June 2003 involving 94 patients with upper gastrointestinal bleeding seen at Prince Hashem Hospital. Upper endoscopy was performed within 24 hours of presentation. Patients were inquired about current use of non-steroidal anti-inflammatory drugs. Data were analyzed with respect to patients' age, gender, and endoscopic findings. About two thirds of patients with upper gastrointestinal bleeding were males irrespective of the cause. Bleeding peptic ulcer disease was the commonnest cause [74%].with relation to the use of non-steroidal anti-inflammatory drugs, followed by bleeding esophagogastric varices [7.4%]. Malignant gastric tumours and Mallory-Weiss tears rated 6.4% and 4.3%, respectively. Normal upper endoscopy was found in 3.2% of all cases of upper gastrointestinal bleeding. Bleeding peptic ulcer disease remains the leading cause of upper gastrointestinal bleeding and mostly in males. There is a relation between upper gastrointestinal bleeding of peptic ulcer disease and the use of non-steroidal anti-inflammatory drugs and Aspirin. Further studies are needed to determine mortality rate and the frequency of patients who required surgery

Prognostie value of fundoscopy in malaria

Objective To detect fundoscopic abnormalities in immunocompetent adults with malaria and to assess their prognostic value. Methods A prospective study involved 543 patients with malaria seen during the period Decembre 2000 to July 2001 at the Jordanian Military hospital in Freetown, Sierra Leone. Patients were divided into three groups: uncomplicated, severe and cerebral malaria. Diagnosis of malaria was based on peripheral blood smears. All patients were HIV negative. One the day of andmission, fundoscopic examination was performed on all patients through dilated pupils. Results Ninety Seven[17.9%] of all patients were found to have abnormal fundoscopy. Retinal hemorrhage was the most common finding: 8.5% of all patients, 47.4% in respect with abnormal findings. Optic disc pallor was a minority and closely related to cerebral malaria. A significant ratio [57.1%] of uncomplicted malaria cases with abnormal fundoscopy progressed to severe or cerebral malaria within 24 hours. Conclusion Abnormal fundoscopic findings in malaria patients can be early predictor of severe infection

Complications of Chickenpox in immunocompetent adults

to determine the frequency and to describe the clinical spectrum of serious and common chickenpox complications in immunocompetent adults from December 2000 to August 2001, this study was carried out at the Jordanian Military Hospital in Freetown, Sierra Leone. A total number of 123 immunocompetent adults with chickenpox were hospitalized. the following tests were conducted on each patient: full blood count, liver enzymes, blood gases, chest radiographs and skin swab cultures. Daily clinical and laboratory evaluations were conducted on all patients looking for complications and management of those complications. Results almost half of the patients were 18-26 years old. sixteen patients [13%] developed complications and all these patients recovered with treatment. The most common [43.8%] complication was respiratory tract involvement followed by skin bacterial super infection [25%] other less frequent complications included gastrointestinal manifestations, encephalitis, mild hepatitis and mild thrombocytopenia all adult patients with chickenpox should be hospitalized in the early stage of their disease and should receive appropriate therapy to reduce the incidence of complications

Osteoarthritis of the knee in the Jordanian population

to describe the pattern of primary osteoarthritis of the knee in Jordanians, including age, sex, and relation to obesity and to assess the severity of pain and extent of disability in these patients. this is prospective study involving 74 patients with primary osteoarthritis of the knee, who met the American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the knee. The patients were seen over the period between June 1999 and February 2000, in the Rheumatology and Internal Medicine Clinics at Prince Ali Hospital. These patients were evaluated in relation to age, sex, body weight, bilaterality, and the severity of pain, which was assessed according to Hernborg and Nilsson criteria. The effect of osteoarthritis on normal joint function and the extent of disability were assessed by a local modified classification used by other authors. the majority of patients [77.1%] were above 55 years of age. Most [75.7%] were females in a ratio of 3.1: 1 [females:male], and 90.5% were overweight and obese. Only four patients [males] had unilateral knee involvement. Almost half of the patients achieved four or more scores out of five, on the Hernborg and Nilsson criteria for pain. Most [86.5%] of the patients could walk outside unaided but with pain. Half of the patients could do their daily activity but with difficulty. the pattern of osteoarthritis of the knee in Jordanians is almost similar to that in other parts of the world. There are, however, some differences including the earlier age of onset of the disease, the earlier peak age of prevalence and the variation in the female to male ratio