Myelodysplastic Syndromes and Myelodysplastic Syndromes/Myeloproliferative Neoplasms: A Real-World Experience From a Developing Country.

PURPOSE: Myelodysplastic syndromes (MDS) include a heterogeneous group of clonal bone marrow disorders characterized by ineffective hematopoiesis. They manifest as dysplasia in bone marrow hemopoietic elements associated with peripheral cytopenias with variable risk of AML transformation. PATIENTS AND METHODS: We analyzed retrospectively registry data collected prospectively from patients with primary MDS and patients with MDS/myeloproliferative neoplasm (MPN) in the Jordan University Hospital between January 2007 and September 2021. The registry captured epidemiologic information such as date of diagnosis, age, gender, date of AML transformation, cytogenetics, MDS subtype, risk group according to Revised International Prognostic Scoring System, and survival. The registry also captured baseline ferritin, B12, and lactate dehydrogenase levels. RESULTS: A total of 112 patients with MDS and MDS/MPN were included in the registry. Median age at diagnosis was 59 years. The male-to-female ratio was about 1.2. In a multivariate cox regression model, baseline serum ferritin significantly affected survival as patients with levels exceeding 1,000 µg/L had a risk of death three times higher compared with those with <1,000 µg/L levels (P < .05). CONCLUSION: To our knowledge, our study is the first comprehensive study examining the epidemiology and prognostic factors in patients with MDS and patients with MDS/MPN in Jordan. Our results show that MDS and MDS/MPN epidemiology in Jordan is different compared with Western countries. Our results also show that baseline serum ferritin levels can be used as a prognostic marker for patients with MDS.

The Impact of War Trauma and Housing Environment on Mental Wellbeing of Syrian Refugees in Jordan: A Comparison between In-Camp and Urban Populations.

The aim of this study is to compare mental wellbeing and levels of post-trauma distress between Syrian refugees who live inside camps and those who live outside camps in Jordan through a survey-based cross-sectional design, where data were collected from 240 adult Syrian refugees in Jordan. The Arabic versions of the Mental Health Continuum Short Form (MHC-SF), and the Impact of Event Scale-Revised (IES-R) were used to quantitatively measure variables through descriptive statistics and multiple comparative analysis tests. Despite having no significant correlation with residence, findings of the MHC-SF showed significance for mental wellbeing with employment status and income. Whereas IES-R showed that camp refugees fared significantly better in terms of trauma effect than urban refugees. It can be concluded that Syrian refugees living inside camps were disadvantaged in terms of mental wellbeing but slightly less affected by war in comparison to those living in urban areas. Improved programs and policies are needed to uplift the mental wellbeing of Syrian refugees in Jordan and to minimize the destructive traumatic effects of the Syrian war on their wellness.

Characteristics of post hoc subgroup analyses of oncology clinical trials: a systematic review.

BACKGROUND: Subgroup analyses in clinical trials assess intervention effects on specific patient subgroups, ensuring generalizability. However, they are usually only able to generate hypotheses rather than definitive conclusions. This study examined the prevalence and characteristics of post hoc subgroup analysis in oncology. METHODS: We systematically reviewed published subgroup analyses from 2000 to 2022. We included articles presenting secondary, post hoc, or subgroup analyses of interventional clinical trials in oncology, cancer survivorship, or cancer screening, published separately from the original clinical trial publication. We collected cancer type, year of publication, where and how subgroup analyses were reported, and funding. RESULTS: Out of 16 487 screened publications, 1612 studies were included, primarily subgroup analyses of treatment trials for solid tumors (82%). Medical writers contributed to 31% of articles, and 58% of articles reported conflicts of interest. Subgroup analyses increased significantly over time, with 695 published between 2019 and 2022, compared to 384 from 2000 to 2014. Gastrointestinal tumors (25%) and lymphoid lineage tumors (39%) were the most frequently studied solid and hematological malignancies, respectively. Industry funding and reporting of conflicts of interest increased over time. Subgroup analyses often neglected to indicate their secondary nature in the title. Most authors were from high-income countries, most commonly North America (45%). CONCLUSIONS: This study demonstrates the rapidly growing use of post hoc subgroup analysis of oncology clinical trials, revealing that the majority are supported by pharmaceutical companies, and they frequently fail to indicate their secondary nature in the title. Given the known methodological limitations of subgroup analyses, caution is recommended among authors, readers, and reviewers when conducting and interpreting these studies.

Defining an optimal cut-off point for reticulocyte hemoglobin as a marker for iron deficiency anemia: An ROC analysis.

Reticulocyte hemoglobin (CHr) is a measure of the amount of hemoglobin in reticulocytes and a marker of cell hemoglobinization. In this study, we aimed to find the optimal cut-off point for reticulocyte hemoglobin to diagnose iron deficiency anemia using multiple methods. A total of 309 patients were included. The median age at diagnosis was 54 years. Most were females (71.2%). 68% had iron deficiency anemia. Patients with IDA had significantly lower levels of CHr compared to those who had non-IDA (p < 0.0001). The optimal cut-off value of CHr for detecting IDA, determined using various methods, was 30.15 pg. This cut-off point had a sensitivity of 87.8% and a specificity of 77.7%. CHr showed a significant positive correlation with hemoglobin, mean corpuscular volume, serum iron, serum ferritin, and transferrin saturation and a significant negative correlation with total iron-binding capacity. CHr levels correlate with most established laboratory tests for IDA. It reliably detects IDA. Our results indicate the importance of CHr in diagnosing IDA, and that CHr should be used more widely in suspected cases of IDA since it is a cheap, fast, and reliable test.

Attitudes towards COVID-19 Booster Vaccines, Vaccine Preferences, Child Immunization, and Recent Issues in Vaccination among University Students in Jordan.

Although COVID-19 vaccines have been available in Jordan for more than a year, Jordan suffers from a low vaccination rate. The aim of this study was to explore attitudes towards recent issues in vaccination among university students in Jordan. We adopted a cross sectional study design using an online questionnaire distributed in a Jordanian university with a medical school chosen at random. The survey asked about COVID-19 vaccine preferences, factors affecting COVID-19 vaccine preferences, child vaccination, and booster vaccines. A total of 417 students completed the survey. Most respondents (54.7%) preferred the Pfizer vaccine, and 6.2% refused to take any vaccine. Pfizer's efficacy against new strains is a main factor in preferring Pfizer over other vaccines (p < 0.01). Most respondents (71%) believed that vaccination is crucial to prevent COVID-19 surges from new COVID-19 strains, while 44.6% of respondents believed that children should be included in vaccination campaigns, and 70% believed that booster vaccines required more studies to prove their efficacy. Students had mixed attitudes towards many recent issues concerning COVID-19 vaccination. Studying these factors and attitudes in more depth and in different populations can pave the way towards improving vaccination rates worldwide.