Correlation Between Optical Coherence Tomography and Photopic Negative Response of Flash Electroretinography in Ganglion Cell Complex Assessment in Glaucoma Patients.

Purpose: To investigate the correlation between the photopic negative response (PhNR) of the light-adapted flash electroretinography (ERG) and measurements of standard automated perimetry (SAP) and optical coherence tomography (OCT) in assessment of retinal ganglion cells' (RGCs) affection in glaucoma. Patients and Methods: A cross-sectional study included 40 eyes of glaucoma patients and 40 eyes of age- and gender-matched normal subjects. Participants underwent a complete ophthalmologic assessment, SAP, OCT, and light-adapted flash ERG using the extended PhNR protocol of the International Society for Clinical Electrophysiology of Vision (ISCEV). Glaucomatous eyes were divided into 3 subgroups: mild (n = 15), moderate (n = 11) and severe glaucoma (n = 14) according to the mean deviation (MD) of SAP. Measurements of SAP, OCT and ERG parameters were analyzed, and correlations between PhNR measurements and other study measurements were evaluated. Results: PhNR amplitudes and PhNR/b-wave ratios were significantly reduced in glaucoma cases compared to healthy controls, and they showed a significant and progressive decline across the three glaucoma subgroups (P < 0.05). An exception to this is PT (b-wave peak to PhNR trough) PhNR amplitude where its reduction was statistically non-significant when comparing between controls and mild glaucoma cases (P = 0.178), and between moderate and severe glaucoma cases (P = 0.714). PhNR amplitudes and PhNR/b-wave ratios correlated significantly with SAP and OCT parameters (P < 0.05). Conclusion: PhNR correlates well with SAP and OCT parameters in glaucoma assessment. PhNR could be a valuable supplementary tool for objective assessment of the RGCs' function in glaucoma.

Preference of and factors that influence future specialty among medical students in Jordan: A cross-sectional study.

BACKGROUND: Choosing future specialty is an important issue that face undergraduate medical students during their university years. Several factors may assist to formulate students' final decision. We aimed to explore the future specialty preferences and the factors that influence the choice of undergraduate students in medical schools in Jordan. METHODS: A cross sectional study conducted among the sixth year students of two medical schools in Jordan. A questionnaire was used to collect data from the students. It consisted of demographic data in form of gender, GPA, family income, and parents' level of education. In addition to data about preferred specialties, and factors that influence medical students' choice of future specialty. RESULTS: A total of 223 medical students from two medical schools were recruited to participate. Males were 49.3% while females were 50.7%, and around 22% scored an excellent GPA. Most parents of the students were bachelor degree holders (63.6% for fathers and 62.3% for mothers). Medicine (19.4%), dermatology (12.6%), and obstetrics and gynecology (11.7%) were the most chosen future specialties. Specialty appeal and thoughts of future creativity was the most chosen factor that influenced future specialty (55.2%) choice, followed by family time and less on-call duties (14.8%). Students who selected chances of fellowships as an influencing factor were more likely to prefer medicine as future specialties (p < 0.001). CONCLUSION: Medicine, dermatology, and obstetrics and gynecology were the most popular future specialty choices among undergraduate medical students. Most of our medical students claimed that selection of their specialty is based on the interest and potential creativity, family time and less on call duties. Further studies are required in a wide range to accommodate more students from the other academic years.

Comparing rates and causes of, and views on reporting of medication errors among nurses working in different-sized hospitals.

BACKGROUND: Medication errors are detrimental to patient safety and the quality of hospital services. PURPOSE: The purpose of the study was to compare registered nurses working in the small-, medium-, and large-sized Jordanian hospitals' responses in terms of reported rate and cause of medication errors and their views on medication error reporting. METHODS: This was a cross-sectional comparative design, with a total sample of 229 nurses working in different-sized hospitals. RESULTS: The rates of reported medication errors were significantly different across hospitals representing 53.5% in small-sized, 41.8% in medium-sized, and 32.8% in large-sized hospitals. No significant differences between hospitals regarding the nurses' reported causes of medication errors. Nurses' views were significantly different in all aspects of their reporting except in their failure to report (drug) error. CONCLUSIONS: The hospital's size may associate with nurses' reporting rate and nurses' views on reporting such errors. There is an urgent need for more diligent systematic efforts to prevent, detect, and report medication errors. Collaboration with other health team members, including information technology members, will enhance the outcomes associated with medication administration. The findings of this study warranted further investigations.

Hereditary multiple osteochondromas in Jordanian patients: Mutational and immunohistochemical analysis of EXT1 and EXT2 genes.

The aim of the present study was to investigate the molecular characteristics of hereditary multiple osteochondromas (HMO) in a subset of Jordanian patients with a focus on the genetic variants of exostosin (EXT1)/(EXT2) and their protein expression. Patients with HMO and their family members were included. Recorded clinical characteristics included age, sex, tumors number and location, joint deformities and associated functional limitations. Mutational analysis of EXT1 and EXT2 exonic regions was performed. Immunohistochemical staining for EXT1 and EXT2 was performed manually using two different commercially available rabbit anti-human EXT1 and EXT2 antibodies. A total of 16 patients with HMO from nine unrelated families were included, with a mean age of 13.9 years. A total of 75% (12/16) of the patients were male and (69%) (11/16) had a mild disease (class I). EXT mutation analysis revealed only EXT1 gene mutations in 13 patients. Seven variants were detected, among which three were novel: c.1019G>A, p. (Arg340His), c.962+1G>A and c.1469del, p. (Leu490Argfs*9). Of the 16 patients, 3 did not harbor any mutations for either EXT1 or EXT2. Immunohistochemical examination revealed decreased expression of EXT1 protein in all patients with EXT1 mutation. Surprisingly, EXT2 protein was not detected in these patients, although none had EXT2 mutations. The majority of Jordanian patients with HMO, who may represent an ethnic group that is infrequently investigated, were males and had a mild clinical disease course; whereas most patients with EXT1 gene mutations were not necessarily associated with a severe clinical disease course. The role of EXT2 gene remains a subject of debate, since patients with EXT1 mutations alone did not express the non-mutated EXT2 gene.

Removal of amoxicillin and cefuroxime axetil by advanced membranes technology, activated carbon and micelle-clay complex.

Two antibacterials, amoxicillin trihydrate and cefuroxime axetil spiked into wastewater were completely removed by sequential wastewater treatment plant's membranes, which included activated sludge, ultrafiltration (hollow fibre and spiral wound membranes with 100 and 20 kDa cut-offs), activated carbon column and reverse osmosis. Adsorption isotherms in synthetic water which employed activated carbon and micelle-clay complex (octadecyltrimethylammonium-montmorillonite) as adsorbents fitted the Langmuir equation. Qmax of 100 and 90.9 mg g(-1), and K values of 0.158 and 0.229 L mg(-1) were obtained for amoxicillin trihydrate using activated carbon and micelle-clay complex, respectively. Filtration of antibacterials in the ppm range, which yielded variable degrees of removal depending on the volumes passed and flow rates, was simulated and capacities for the ppb range were estimated. Stability study in pure water and wastewater revealed that amoxicillin was totally stable for one month when kept at 37°C, whereas cefuroxime axetil underwent slow hydrolysis to cefuroxime.

Periacetabular osteotomy and total hip arthroplasty in patients older than 40 years.

The objective of this study was to investigate quality of life (QOL) in patients with dysplasia who were older than 40 years and who underwent Bernese periacetabular osteotomy (PAO). Quality of life was compared among 28 patients who underwent PAO and 33 patients of the same age who underwent total hip arthroplasty (THA). Outcome tools included the Western Ontario McMasters Universities (WOMAC) Osteoarthritis Index and the 12-Item Short-Form Health Survey. Seventy-three percent of PAO patients achieved a "very good" (75-100) outcome or a "good" (65-75) QOL score in pain dimension and 64% in function dimension at 4 years after operation. WOMAC pain (89 vs 71, P < .005) and function (90 vs 74, P < .005) scores were significantly better among THA patients (THA vs PAO). Although THA resulted in better QOL, osteotomy still provided excellent QOL outcome in a high percentage of patients older than 40 years. However, given the results of this study, in patients older than 40 years, periacetabular osteotomy should only be done in highly selected cases.