Vitamin D Levels in Children with Recurrent Acute Tonsillitis in Jordan: A Case-Control Study.

Background: Vitamin D is essential for many functions of the body. In addition to its primary function of regulating the absorption of calcium in the small intestine, its role in the immune system has recently been studied. The current study aimed to test the impact of vitamin D deficiency on the rate of recurrent acute tonsillitis in children. Methods: According to Paradise criteria, two hundred forty-two children with recurrent acute tonsillitis were recruited. A group of healthy children (n = 262) was also recruited as controls. Poisson regression was run to predict the number of tonsillitis episodes per year based on vitamin D levels. The mean vitamin D level in the study group was lower than in the control group (p < 0.0001). Poisson regression of the rate of recurrent tonsillitis and vitamin D level (OR = 0.969 (95% CI, 0.962−0.975)) showed that for every single unit increase in vitamin D level, there was a 3.1% decrease in the number of tonsillitis episodes per year (p < 0.0001). Conclusions: Vitamin D deficiency is associated with higher rates of recurrent acute tonsillitis. Future controlled trials should investigate the role of vitamin D supplementation in reducing the rate of recurrent tonsillitis.

The Association of IgE Levels with ADAM33 Genetic Polymorphisms among Asthmatic Patients.

Total serum immunoglobulin E (IgE) is elevated in multiple allergic diseases and is considered a good predictor of atopy. Several studies have been performed on the association of IgE levels with the polymorphism of the ADAM33 gene in asthmatic patients. The aim of this study was to determine whether there is an association between IgE levels and the genetic polymorphisms of the ADAM33 gene (T1, T2, T + 1, V4, S1, S2, and Q-1) in both healthy and asthmatic patients among Jordanians. The clinical data were collected for this case-control study from 267 asthmatic patients and 225 control subjects. Seven genetic polymorphisms (T1, T2, T + 1, V4, S1, S2, and Q-1) of the gene ADAM33 were analyzed using the polymerase chain reaction/restriction fragment length polymorphism method. The minor alleles (G) of T1, (A) of T2, T + 1, and (G) of V4 polymorphisms were associated with a significant increase in total serum IgE levels in adults but not children. The V4 genetic polymorphism, however, showed a significant association with IgE levels in both adults and children. The S1 polymorphism was significantly associated with the codominant module only in the adults. The S2 polymorphism showed a significant association (p-value < 0.05) in both codominant and recessive models. However, in the dominant model for both pediatric control and asthmatic patients, the association between the IgE and S2 polymorphism was insignificant (p-value = 0.7271 and 0.5259, respectively). This study found a statistically significant association between multiple ADAM33 genetic polymorphisms and IgE levels. Such findings add to the growing evidence that the ADAM33 gene has a major impact on IgE levels among asthmatic patients of Jordanian origin.

Patients response to pre-operative counseling for the appropriate type of bariatric surgery.

INTRODUCTION: Obesity is a major cause of metabolic and health disorders like diabetes mellitus (DM) and gastro esophageal reflux disease (GERD). Patients usually offered a professional preoperative consultation and objective information regarding the bariatric surgery type and the advantages and disadvantages of each type for best outcome and satisfaction. PURPOSE: To study the patient response to preoperative advice and recommendation and the patient's decision to undergo the recommended bariatric surgery. OBJECTIVE: To determine the statistical significance of preoperative recommendation and the patient personal choice of the type of bariatric surgery. MATERIALS AND METHODS: This original article is a cross-sectional survey of 188 patients underwent bariatric surgery between February 2015 and December 2018 in the General Surgery Departments - Bariatric Surgery Clinics in Jordan University Hospital affiliated to the College of Medicine in the University of Jordan and Al Karak Governmental Hospital affiliated to the College of Medicine in Mutah University. 144 patients underwent longitudinal sleeve gastrectomy (LSG) and 44 patients underwent Roux en-Y gastric bypass (RYGB) as the recommended type of surgery for the selected comorbidities diabetes, gastroesophageal reflux disease, or both. RESULTS: Of 188 patients data collected, 54 patients who should had undergone RYGB as the recommended type of surgery, preoperative counseling did not have a significant effect on their decision to undergo the appropriate type of bariatric surgery. The number of patients who had pre-operative recommendation = 37 (68.5%). Out of these, only 15 patients choose the surgical team recommended surgery; p-value 0.183, odds ratio 2.22, (95% confidence interval (CI) = 0.6-8.12). CONCLUSION: Preoperative surgical procedure type advice did not have a significant effect on patients' choice of the recommended bariatric procedure.