An incidental migrating intra-spinal bullet: the silent victim of celebratory gunfire.

BACKGROUND: Incidentally found intra-spinal bullets are extremely rare, and have never been reported in the literature. The aim of this study is to report a rare case of an asymptomatic migrating intra-spinal bullet, emphasizing the role of cultural context in history taking, and describing its surgical retrieval technique. CASE PRESENTATION: We discuss a case of a 10-years old boy with an incidentally discovered intra-spinal bullet opposite to the L5 vertebral level, who presented 3 months after the suspected initial insult. Following its migration to the L3/L4 level intraoperatively, the bullet was forced to spontaneously return to its preoperative position by reverse Trendelenburg Position, Valsalva maneuver and Intrathecal saline infusion, thus avoiding extending the previously performed laminectomy. CONCLUSION: The authors remind the readers that history is the cornerstone of the clinical practice, even in the most obscure cases. Many convoluted intra-operative situations could be resolved by utilizing basic anatomical and physiological principles.

Predictors of adherence with home quarantine during COVID-19 crisis: the case of health belief model.

Although Jordan has applied lockdown in response to COVID-19 pandemic, many people were not adherent to the quarantine. We aimed to examine the attitudes of the Jordanians and how these attitudes can predict their adherence using the health belief model (HBM). A cross-sectional study of 5057 participants using an internet-based questionnaire was conducted during lockdown. Multivariable ordinal regression analyses were used to estimate predictors of adherence to home quarantine. Overall, 646 (12.8%), 2078 (41.2%), and 2317 (46%) of participants showed poor, intermediate, and strict adherence, respectively. Of the HBM constructs, seriousness (ß= 0.116, 95% CI 0.027 to 0.205), benefits (ß= 0.056, 95% CI 0.002 to 0.110) and barriers (ß= -0.025, 95% CI -0.035 to -0.015) were significant predictors. We identified income insecurity (ß= -0.096, 95% CI -0.144 to -0.046), social withdrawal (ß= -0.062, 95% CI -0.121 to -0.004), religious concerns (ß= -0.149, 95% CI -0.202 to -0.096) and health consequences (ß= 0.065, 95% CI 0.011 to 0.11) as barriers. Governmental instructions were the only predictive external cue (ß= 0.055, 95% CI 0.004 to 0.014). Our findings suggest that a high number of Jordanians are adherent with the quarantine, demonstrating the ability of governmental policies in tackling potential barriers.

Analysis of the Rate and Pattern of Ventriculoperitoneal Shunt Infection and Ventricular Catheter Culture Yield: A 10-Year Single-Institute Experience.

AIM: We aimed to study the rate and pattern of ventriculoperitoneal shunt (VPS) infections at the Jordan University Hospital (JUH) over 10 years and investigate the yield of ventricular catheter tip culture in the evaluation of shunt infection. PATIENTS AND METHODS: All patients operated on at our institution for ventriculoperitoneal shunt (VPS) insertion, reinsertion, and revision between 2009 and 2018 were included. Data (age, gender, pathology, and history of shunt infection) were collected from patients' files. Rates of infection and results of culture (cerebrospinal fluid and ventricular catheter tip) were obtained from laboratory records. RESULTS: According to our hospital database, 310 patients were eligible for this study. The rate of infection was 11.1% per ventriculoperitoneal procedure, and the most common -organism was coagulase-negative Staphylococcus (CoNS) which was the cause of infection in 51.4% of the cases. Twenty-one percent of proved shunt infection cases showed a positive ventricular catheter tip culture. CONCLUSION: The rate and pattern of shunt infections at our institution are comparable with the international figures and data. Methods of catheter tip culturing should be improved to increase the yield of this practice.