Development of a Cerebral Palsy Follow-up Registry in Jordan (CPUP-Jordan).

AIMS: This study aims to describe the development of a Cerebral Palsy Follow-up Registry in Jordan (CPUP-Jordan) and to provide a baseline child and parent demographic information, birth history of the child participants, and distribution of the participants based on topographical distribution of cerebral palsy (CP) and functional classification systems. METHODS: The CPUP-Jordan was developed using a similar framework of a follow-up surveillance programme for persons with CP in Sweden (CPUP). Standard assessment forms were utilized to collect data related to child and family demographics, child birth history, and functional classifications and physiotherapy and occupational therapy assessments and interventions. Research assistants were trained to conduct the assessments. A secured web-based system was developed to store data and disseminate knowledge maintained in the registry. Children with CP were included in the registry if they have confirmed diagnosis of CP. The ascertainment age of inclusion and the minimum age of survival required are 4 years. RESULTS: One hundred sixty-seven children were registered between 2013 and 2015 (mean age is 3.6 ± 3.0 years). Forty-two percent were born premature, and 48% were less than the normal birthweight. Perinatal causes were reported for 54% of the participants. The most common type of CP based on tone disturbance was spastic type, and the most common topographical distributions of motor dysfunction were quadriplegia followed by diplegia. Fifty-six percent of the participants had severe limitation in ambulation; 48% had restricted manual abilities, and 47% had limited communication abilities even with familiar family members and partners. CONCLUSIONS: The development of CPUP-Jordan registry for children with CP proved to be both feasible and informative. The registry baseline descriptive data were similar to those reported in previous research in Jordan supporting validity of the data. The implementation of CPUP-Jordan at national level is expected to have a positive impact on children with CP, clinicians, policymakers, and researchers.

Development of the Arabic Version of the Preschool Activity Card Sort (A-PACS).

AIM: The purpose of this study is to describe the process of developing the Arabic Version of the Preschool Activity Card Sort (A-PACS) derived from the Preschool Activity Card Sort (PACS), an internationally recognized tool, which uses parent interview, and photographs of pre-schoolers engaged in typical activities. BACKGROUND: Measuring participation among preschool children in daily activities is an essential part of the evaluation process by occupational therapists, utilizing valid and culturally relevant measurement tools. Given the newness of the occupational therapy profession in the Arab world, a major obstacle is the dearth of measurement tools especially for pre-schoolers. METHODS: Cultural adaptation of the PACS required a four phase process: collection of culturally appropriate activities using focus groups, translation, cognitive pilot testing and validation using two rounds of ranking (Delphi technique). Caregivers interviewed in all phases of the study included 115 participants. All were recruited from different geographical locations and socio-economic levels in Jordan, and were stratified by age and gender. RESULTS: Ninety-five activities were generated in the final version of the A-PACS in which 23 were specific to the Arabic culture. The activities were categorized into self-care (17), community mobility (16), high demand leisure (11), low demand leisure (17), social interaction (15), domestic (8) and education (11). Based on the A-PACS, the most common five activities of Jordanian children were drinking, walking on stairs, eating a sandwich, gathering with family and kicking a ball. CONCLUSION: A culturally adapted Arabic form of the PACS emerged from this investigation. This is the first step in developing a psychometrically sound assessment tool to evaluate participation of Arabic-speaking preschool children.

Low-molecular-weight heparin in the treatment of recurrent IVF-ET failure and thrombophilia: a prospective randomized placebo-controlled trial.

INTRODUCTION: Recently, thrombophilia (acquired and inherited) has been implicated in recurrent IVF-ET failure. The objective of this study was to determine the effect and safety of thromboprophylaxis using low-molecular-weight heparin (LMWH) in women with recurrent in vitro fertilization (IVF)-embryo transfer (ET) failure and thrombophilia. METHODS: Eighty-three women with history of three or more previous IVF failures and who had at least one thrombophilic defect were eligible for this study. Patients were randomly allocated into two groups: Group A (n = 42) received enoxaparin 40 mg/day, and group B (n = 41) received placebo (NaCl 0.9%). Both treatments started on the day of ET and continued until delivery or foetal demise was diagnosed. The primary outcomes were the implantation, pregnancy and live birth rates. RESULTS: Patients who received LMWH for thromboprophylaxis had a significant increase in the implantation and pregnancy rates compared with the placebo group (20.9% vs. 6.1% and 31% vs. 9.6%, respectively; p < 0.001 and p < 0.05, respectively). A significant increase in the live birth rate was observed in the heparin-treated group compared with placebo (23.8% vs. 2.8%, respectively; p < 0.05). The abortion rate was significantly higher in the placebo-treated group compared to the heparin-treated group (p < 0.05). The frequency of treatment complications did not differ between the two study groups. CONCLUSIONS: LMWH is a safe and effective thromboprophylactic treatment for women with thrombophilia and recurrent IVF-ET failures. The implantation rate, pregnancy and live birth rates are significantly increased with such treatment.

Luteal phase support with GnRH-a improves implantation and pregnancy rates in IVF cycles with endometrium of

OBJECTIVE: The objective of this study was to examine the use of gonadotrophin-releasing hormone agonist (GnRH-a) for luteal phase in a group of patients with thin endometrium (

Luteinized unruptured follicle syndrome: incidence and recurrence rate in infertile women with unexplained infertility undergoing intrauterine insemination.

BACKGROUND: The objective of this study was to determine the incidence and recurrence rate of luteinized unruptured follicle (LUF) syndrome in women with unexplained infertility undergoing intrauterine insemination (IUI). METHODS: A total of 167 women with unexplained infertility who underwent 292 cycles of IUI were enrolled in the study. All patients were treated with clomiphene citrate, 50-150 mg/daily from day 5 to 9 of their menstrual cycle. Ultrasound examination to confirm ovulation was performed on the day of IUI (day 0) and every day thereafter for another 3 days (days 1, 2 and 3). A total of 69 women who failed to conceive in the first cycle and 56 women who failed to conceive in the second cycle underwent second and third cycles, respectively. RESULTS: Of the total 167 patients who underwent first cycle, 42 (25%) had LUF. The incidence of LUF was 56.5% in 69 patients who underwent a second cycle of IUI treatment, of whom 33 patients had LUF in the first cycle with recurrence rate of 78.6%. In 56 patients who underwent 3 consecutive cycles, the incidence of LUF was 58.9% and recurrence rate of 90%. No pregnancies were recorded in patients with LUF during the study period. CONCLUSION: The incidence and recurrence rate of LUF are significantly increased in subsequent cycles of IUI. In these patients, other options of infertility treatment might be justified.

Evaluation of cervical smears at King Hussein Medical Centre, Jordan, over three and a half years.

Cervical smears taken from women referred for a check-up or with vaginal itching/discharge over a period of 3.5 years were reviewed at the King Hussein Medical Centre, Jordan. All smears were fixed with 96% alcohol, stained with Papanicolaou stain and screened microscopically. Of the smears from 1176 women aged 18-70 years, 4.5% were classified as inadequate, 7.7% were normal and 79.9% showed non-specific inflammation. Abnormal vaginal flora was found in 4.8% of cases, Candida albicans in 1.2%, Trichomonas vaginalis in 0.9% and actinomycosis in 1 case. Dysphasic changes were rare: 9 cases (0.8%) were classified as atypical squamous cells of undetermined significance (ASCUS) and 2 cases (0.2%) were low-grade squamous intraepithelial lesion (LSIL). No cases of human papillomavirus infection (HPV) or cervical carcinoma were found.

Evaluation of cervical smears at King Hussein Medical Centre, Jordan, over three and a half years

Cervical smears taken from women referred for a check-up or with vaginal itching/discharge over a period of 3.5 years were reviewed at the King Hussein Medical Centre, Jordan. All smears were fixed with 96% alcohol, stained with Papanicolaou stain and screened microscopically. Of the smears from 1176 women aged 18-70 years, 4.5% were classified as inadequate, 7.7% were normal and 79.9% showed non-specific inflammation. Abnormal vaginal flora was found in 4.8% of cases, C and ida albicans in 1.2%, Trichomonas vaginalis in 0.9% and actinomycosis in 1 case. Dysphasic changes were rare: 9 cases [0.8%] were classified as atypical squamous cells of undetermined significance [ASCUS] and 2 cases [0.2%] were low-grade squamous intraepithelial lesion [LSIL]. No cases of human papillomavirus infection [HPV] or cervical carcinoma were found

Effect of water softening on the colour intensity of routine haematoxylin and eosin stain.

Haematoxylin and eosin (H&E) is the most popular routine stain used in pathology laboratories for highlighting cellular structures. To study the effect of tap water'softening' (i.e. calcium extraction) on H&E stains, 5 sets of slides from 30 different paraffin-embedded human pathologic tissue blocks were prepared in the same way except for washing with 5 different types of water. Slides washed in untreated tap water showed the best results concerning differentiation and colour intensity, while slides washed with softened or other treated water showed poorer degrees of differentiation and colour intensity. The worst results were obtained from slides washed with water containing sodium bicarbonate. Low calcium and magnesium ions and high sodium ions in soft water adversely affect the results of routine H&E stain.

Effect of water softening on the colour intensity of routine haematoxylin and eosin stain

Haematoxylin and eosin [H and E] is the most popular routine stain used in pathology laboratories for highlighting cellular structures. To study the effect of tap water'softening' [i.e. calcium extraction] on H and E stains, 5 sets of slides from 30 different paraffin-embedded human pathologic tissue blocks were prepared in the same way except for washing with 5 different types of water. Slides washed in untreated tap water showed the best results concerning differentiation and colour intensity, while slides washed with softened or other treated water showed poorer degrees of differentiation and colour intensity. The worst results were obtained from slides washed with water containing sodium bicarbonate. Low calcium and magnesium ions and high sodium ions in soft water adversely affect the results of routine H and E stain