Prevalence of urolithiasis in patients presenting with acute flank pain at jordan university hospital as demonstrated by unenhanced Helical CT scan

To identify the frequency and seasonal variations of renal stone disease in patients presenting clinically to Jordan university hospital with acute flank pain. Six hundred twenty five consecutive patients who had acute renal colic and underwent unenhanced urinary tract CT were retrospectively reviewed. The presence or absence of urolithiasis, site, and number of urinary stones in each sex and in each season were determined. Renal stone disease was depicted in 40% of patients. The incidence of male to female ratio was 2.3:1. The prevalence ratio of urinary stones in male and female patients in summer and winter seasons were 1.7:1, and 1.5:1, respectively. The most common site of urinary stones was the pelvicalyceal system with a prevalence rate of 74%. Renal stone disease is more common in male than in female patients; its frequency could be affected by dietary habits, socio-economic, and environmental conditions

Hip magnetic resonance imaging: descriptive epidemiology and outcome in Jordan University Hospital

To evaluate the experience in Jordan University Hospital regarding hip magnetic resonance imaging and to compare our findings with those published in medical literature. one hundred eighty two hip magnetic resonance images performed over the period of 7 years were reviewed, 88 patients [48.3%] had normal hip magnetic resonance image and were excluded from the study while the remaining 94 images [51.6%] with variable abnormalities were included in our study. Variable hip pathologies were seen, the most common was bone marrow edema syndrome found in 22 patients representing [23.4%] of the pathologies detected, followed by transient osteoporosis in 16 [17%] patients and avascular necrosis of the hip joint in 13 [13.8%] patients. Slipped femoral capital epiphysis and Paget_s disease were the least common seen in [1.1%] for each. In Jordan University Hospital referred patients for hip MRI scanning showed diverse findings with the most common abnormality detected being bone marrow edema syndrome of the femoral head followed by transient osteoporosis and avascular necrosis. The great benefit from magnetic resonance imaging was in diagnosing transient osteoporosis, staging avascular necrosis of the hip joint and characterization of deep pelvic soft tissue masses. The prevalence of hip pathology among Jordan University hospital patients as revealed by magnetic resonance imaging was in concordance with what was published in the literature

Pituitary magnetic resonance imaging experience in Jordan

To assess the pituitary findings as demonstrated on MRI and to compare the results with the data published in the literature. One thousand, one hundred and thirty-eight pituitary MRI's with and without intravenous contrast media [gadolinium] were performed over 6 years from 2001 to 2007 in the Department of Diagnostic Radiology, Jordan University Hospital, Amman, Jordan. The patients were referred from various departments and were evaluated for pituitary, other sellar, and juxtasellar abnormalities. The results were compared with those in the published literature. Four hundred and eight-three normal scans were excluded from the study. The remaining 655 were abnormal, pituitary adenoma was detected in 327 [49.9%], microadenoma was present in 213 [32.5%], and macroadenoma in 114 [17.4%]. Partial empty sella was seen in 157 [24%], diffuse pituitary gland enlargement in 98 [14.9%], ectopic pituitary posterior lobe in 13 [2%], and other findings in 31 [4.7%]. The incidence of pituitary adenoma was equal in both genders; however, microadenoma was more common, affected a younger age group, and was predominately seen in females. The other parameters showed agreement with the published literature

Ultrasound measurement of liver span in Jordanian adults: a preliminary experience

One of the most frequent ultrasound requests by clinicians is evaluation of hepatic size. Clinical evaluation by percussion and palpation can be inaccurate, unreliable with significant inter-observer variation. Ultrasound remains a very important imaging modality when the liver is concerned because it is simple, practical and easy-to-use. Yet, ultrasound measurement of liver span didn't receive much attention, particularly in this region. The aims of this study were to establish a normal figure of liver span for adults in Jordan, to investigate relationships between liver span and several anthropometric factors including age, gender, weight, height, body mass index and body surface area and to standardize ultrasound measurement of liver span. A prospective study was carried out at Jordan University Hospital between March 2007 and April 2008, on non-selected population sample of 242 male and 275 female adults with age range of 18-76 years. Statistical analyses including correlation, regression and 95% confidence intervals were performed on the data to test the statistical significance of the various relationships between liver span as represented by midclavicular line longitudinal diameter on one side, and several anthropometric factors including age, gender, weight, height, body mass index and body surface area. Our results showed that all anthropometric variables contributed highly and significantly to the variation in female liver span. The same factors however, with the exception of body mass index, significantly contributed to the variation in male liver span, however to a much lesser extent than females. The best predictor of liver span was height in case of males, body surface area in case of females. And both height and body surface area when both genders are considered. The 95% liver span confidence intervals were 12.3-12.8, 11.9-12.3 and 12.2-12.5 for males, females, and both genders combined, respectively. Height and body surface area were the best determinants of liver span in males and females, respectively

Influence of patient's age on prostate volume, and serum PSA levels

Prostate specific antigen could be elevated in prostatic and non prostatic diseases, therefore it is not specific for prostate pathology .We evaluated in this retrospective study other factors such as patient's age to determine its effect on the prostate specific antigen level and prostate volume in normal, benign, and malignant conditions. One hundred twenty one patients who underwent transrectal ultrasound biopsy were included in this study. The prostate volume, total prostate specific antigen, free prostate specific antigen, and percent free prostate specific antigen in normal, benign, and malignant conditions were evaluated Descriptive analysis, Two tailed student's t- test, Anova test and Pearson's correlation coefficient were used for statistical analysis. Biopsy results yielded 35 patients with prostate cancer [29%], 77 patients with benign prostatic hyperplasia [64%], and no abnormal histological finding in nine patients [7%].There was positive correlation between patient's age and prostate volume [r = 0.22, p < 0.05] Positive correlation was also found between patient's age and prostate specific antigen levels, total prostate specific antigen, and free prostate specific antigen [r = 0. 10 and r = 0. 1 8 respectively, p value was > 0.05]. Across categories no significant difference was found neither in the mean patient's age, nor in the prostate specific antigen levels [p > 0.05]. Although patient's age affects both total and free prostate specific antigen levels, but it could not be used as prostate cancer predictor

Macrodystrophia lipomatosa with syndactyly

Macrodystrophia lipomatosa [MDL] is a rare form of congenital localized gigantism characterized by hypertrophy of all mesenchymal tissues of the affected digits, with particular overgrowth of fat. Syndactyly is a rare association. We report a case of MDL associated with syndactyly affecting the hand. We describe the characteristic radiographic and MRI findings that distinguish the abnormality from other causes of localized gigantism

Maternal death due to severe pulmonary edema caused by scorpion sting: a case report

A 29 years old women parar 3 in her 32 weeks gestational age died a few hours after she had been stung by a scorpion. She presented with pulmonary oedema that probably associated with the sympathetic storm induced by scorpion envenomation. This might have contributed to respiratory failure and death

Isolated neurosarcoidosis: Case Report and Literature Review

Sarcoidosis is a multisystemic granulomatous disease of unknown etiology with a rare tendency to the nervous system. Isolated neurosarcoidosis is rare and difficult to be diagnosed clinically. A 53-year-old Jordanian male admitted to Jordan University Hospital with a history of urine retention, low back pain and feet parasthesia. Brain magnetic resonance imaging showed bilateral enlargement of certain cranial nerves and meningeal masses. Magnetic resonance imaging of the whole spine revealed meningeal and lumbar nerves thickening

Clinico-radiological correlates of achalasia

To study the clinical and radiographic characteristics of achalasia in a cohort Jordanian patients and to investigate the presence of any clinico-radiological relationships. Thirty-five cases of recently diagnosed untreated achalasia patients were studied at Jordan University Hospital, Amman, Jordan during the period of January 1999 to December 2002. Measurements of maximum esophageal and gastroesophageal [GE] junction diameters, as radiographic features, were obtained from films. The clinical features included age; gender; nature; frequency and duration of typical and atypical symptoms; total number of symptoms; calculated typical symptoms score; and diagnostic delay. Pearson correlation coefficients were calculated between radiographic and clinical features, and among the radiographic features themselves. Using Spearman's correlation coefficients, the later analysis was repeated for patients with diagnostic delay of 2 years or less and patients with more than 2 years. All results were evaluated based on the 0.05 level of significance. There were 35 consecutive achalasia patients enrolled in this study [20 females and 15 males] with a mean age of 42.3 +/- 15.6 years and diagnostic delay of 29 +/- 26 months. On average, each patient has presented 2 typical symptoms and 2 atypical symptoms. The mean typical symptoms score was almost 3 out of the full score of 6. The mean GE junction diameter was 2.4 mms and maximum esophageal diameter was 29 mms. Maximum esophageal diameter was significantly correlated with the number of typical, atypical and total symptoms as well as with the typical symptom score and diagnostic delay. Negative correlation was found between GE junction diameter and maximum esophageal diameter; but only statistically significant for patients with diagnostic delay of more than 2 years. Statistically significant relationship exists between maximum esophageal diameter and all clinical variables. Negative correlation exists between maximum esophageal diameter and GE junction diameter; however, only significant for patients with a diagnostic delay more than 2 years. The possibility of achalasia is high in patients with longer diagnostic delay who demonstrate negative relationship between maximum esophageal diameter and GE junction diameter

Changes in early and late diastolic filling pattern in patients with B-thalassemia major before and after captopril therapy

Diastolic left ventricular function has been assessed by echo- Doppler examination in 23 patients [mean age = 11.6 years] with B- thalassemia major. The results were compared with those obtained from 10 normal age-matched control individuals. Parameters showed statistically significant difference between patients and controls were peak flow velocity in late diastole [A], ratio of peak flow velocity in early to late diastole [E/A], isovolumic relaxation time [IVRT], left atrial [LA] and aortic root [Ao] dimensions, left ventricular posterior wall thickness in diastole [LPWdiast], interventricular septal thickness [IVS], left ventricular end diastolic [LVEDD] and end systolic [LVESD] dimensions. Captopril [Capoten], an angiotensin converting enzyme inhibitor, was given to these patients in the therapeutic dose [0.5-1 mg/kg body weight/24 hours]. A follow up study was done for 15 patients after 10-30 days [intermediate study]. The effect of captopril appeared in the form of decrease of A wave with an increase of E/A ratio, which probably suggest improved myocardial diastolic function. Furthermore, left ventricular end diastolic dimension displayed statistically significant decrease

study of the cellular immunity in pseudomonas aeruginosa infection

This work was done to study the effect of Pseudomonas aeruginosa on phagocytic activity and cell-mediated immunity [CMI], and to evaluate the different techniques used in estimation of both. Patients were classified into 2 groups; group I: 20 patients with P. aeruginosa urinary tract infection, and group II: 25 patients with P. aeruginosa post-operative wound infection, in addition to 25 apparently healthy subjects as a control group. The opsonophagocytic activity test, the nitroblue tetrazolium [NBT] dye reduction test, the leucocyte migration inhibition test, and T-Iymphocyte blast transformation test were used for evaluation of the phagocytic activity and CMI. All patients had a marked defect in phagocytic activity and CMI. There was a highly significant difference between the control group and each of the patients groups, while insignificant difference was found between both groups of patients. It was concluded that the defective cellular immunity may add to the morbidity and mortality rate especially in immunocompromised patients, so utmost efforts should be done for diagnosis and control of P. aeruginosa infection regarding the techniques, the leucocyte migration inhibition assay might be recommended for evaluation of CMI being easily available, economic and can give an idea about the phagocytic activity. The NBT test is the test of choice for detection of phagocytic activity because of its ability to evaluate the opsonophagocytic activity as well as the intracellular killing

Comparative study of non-steroidal anti-inflammatory drugs [NSAIDs] and their interaction with drugs affecting prostaglandins

This experimental study was carried out to evaluate the possible therapeutic and toxic effects of a more or less recent non-steroidal anti-inflammatory drug [NSAID], tenoxicam, in management of rheumatoid arthritis model in rats in comparison with indomethacin, being a standard one and piroxicam as a member of its group [oxicams]. In addition, a possible interaction between tenoxicam and both the anti- hypertensive drugs, captopril and clonidine, was also studied. This study was carried out in rats in which rheumatoid like-arthritis was induced experimentally by collagen II and complete Freund's adjuvant mixture

Assessment of a rapid method of pneumococcal antigen detection in routine sputum bacteriology

Sputum samples were obtained from 60 outpatients and inpatients admitted to Ain Shams University Hospitals with chest troubles as pneumonia, bronchopneumonia, acute bronchitis, asthmatic bronchitis and chronic bronchitis. Some of them [29] were collected before administration of treatment for at least 7 days before admission the other [31] were collected after initiation of treatment. Each group included different ages and sexes and examined thoroughly clinically and radiologically. Sputa of each group were examined by three method for detection of Streptococcus pneumoniae which is the cause of the most fatal chest diseases. These methods were Gram film, culture and latex agglutination test for pneumococcal antigen detection. In the first group the highest positive results were obtained by Gram film 69% while culture and antigen detection were apparently equal% 55In the second group the highest positive results were obtained by antigen detection latex agglutination test 80.6%, Gram film was positive in 51.6% and culture was positive in only 32.2%. As regard susceptibility of pneumococci to different penicillin generations we found that it is still the drug of choice for the treatment of pneumococcal infections

Enzyme linked immunosorbent assay compared to conventional methods in diagnosis of typhoid fever

The value of the Enzyme Linked Immunosorbent Assay [ELISA] in serodiagnosis of typhoid fever was assessed with a collection of sera from 110 feverish patients bacteriologically proven to have typhoid fever [74 acute and convalescent samples]. 15 cases were negative by both ELISA and Widal test. High titers of antibodies were found by ELISA [against O and H s.typhi antigenic components]. The sensitivity of ELISA was 86.4% whereas that of widal test was 70.2% for O agglutination and 64.8% for H agglutination, in case of acute sera. In case of convalescent sera, both ELISA and Widal test had the same sensitivity 86.1%. ELISA was found to be economical reproducible as well as suitable for handling large number of sera. This study has provided an evidence that ELISA conserves as a good substitute for Widal test in the diagnosis of S.typhi infection

Experimental and clinical evaluation of a mixture of medicinal plants commonly used in folk therapy of diabets mellitus

A mixture of raw dried and grounded medicinal plants [Nigella Sativa, Chamomella, Damsesa, Mahlab and Aloe]and two legumes [Helba and Termis] in a proportion of one volume of each medicinal plant, and five volumes of each legume has been largely used in Folk medicine by many diabetics for better control of blood glucose Ievel. The present study was conducted to examine the effect of this mixture on fasting and 2 hours post prandial serum glucose levels and fasting serum insulin level in alloxan diabetic albino rats and in parents with type II diabetes mellitus. The results revealed that oral administration of the tested mixture to alloxanized rats [0.5 gm/kgm/day] and to diabetic patients [5 gm/day] for two or four weeks produced statistically significant lowering of fasting and 2 hours post prandial serum glucose levels accompained with a significant elevation of serum insulin level. Histopathological examination of pancreas of alloxanized rats demonstrated that this mixture produced a marked increase in the size of islet tissue with significant recovery of the destructed B-cells. This study is a preliminary report of the antidiabetic action of this tested mixture. Further well controlled studies are required to evaluate the efficacy and safety of long term use of this mixture and to investigate the possible underlying mechanism [s] for it's antidiabetic action

Interaction between butorphanol, pentazocine and digitalis on the cardiovascular system, experimental study

In the present work, an experimental study of the possible interactions between digoxin and two opioids [pentazocine and butourphanol] on the cardiovascular system was conducted both in vivo and in vitro. l. V. injection of pentazocine or butorphanol produced a significant hypodigitalised as well as in intravenously or orally digitalized dogs, with no effect on electrocardiographic tracings. Each of these opioids when administered alone or with digoxin infusion to the isolated rabbit heart was found to induce significant decrease of the myocardial contractility but no changes in the mean coronary flow. The possible mechanisms underlying these interactions were discussed, and it could be concluded that pentazocine or butorphanol must be used cautiously during digitalis therapy owing to their potential negative inotropic and hypotensive effects

Nonspecific vaginitis in relation to the use of oral contraceptives and intrauterine contraceptive devices with special reference to gardnerella vaginalis

This work included 54 females in the child-bearing period, 36 were nonspecific vaginitis [NSV] patients, and 18 normal controls. They were classified into 6 groups; 3 - groups of NSV patients and 3 groups of normal controls, using intrauterine contraceptive devices [IUCD] or oral contraceptive or not using either. Vaginal swabs were examined microscopically and cultured aerobically on vaginalis agar and G.C. agar and anaerobically on Rogosa and Schadler agar. Bacterial counts were done for anaerobes, lactobacilli and gardnerella vaginalis [9. vaginalis]. G. vaginalis was isolated more and in high count in NSV patients using IUCD and oral contraceptive in comparison with NSV patients not using either method. In NSV patients, high count of anaerobes was associated with increased G. vaginalis count and low lactobacilli count. In normal controls not using either method of contraception, no anaerobes were detected and there was increased lactobacilli count. G. vaginalis isolates were considered as part of normal flora being present in low count. The two methods of contraception were associated with high count of anaerobes particularly IUCD and also high count of G. vaginalis was associated with the use of both methods

Pressure-volume characteristics of the left atrium in children, adolescent, and adults with chronic rheumatic mitral incompetence

37 patients of different age groups with chrnoic rheumatic mitral incompetence and atrial fibrillation were studied by haemodynamic and angiocardiographic methods. The following parameters were measured in each patient: pulmonary capillary wedge pressure [PCWP]; left atrial [LA] wall tension at end ventricular systole, LA maximal volume [LAV max], and LA wall compliance. Results showed lower PCWP [p<0.007], large LAV max [p<0.03], and higher LA wall compliance [p<0.01] in the young age group [below 15 years]. Among other factors the LAV max seemed to depend on the magnitude of LA wall tension [p<0.0001] and compliance [p<0.0001]. PCWP was mainly found to be function of LA wall compliance [p<0.008] in all ages and at different values for LAV max. We conclude that young patients have larger LAV max and lower PCWP probably because their atria are more compliant