Men's perceptions of and participation in family planning in Aqaba and Ma'an governorates, Jordan.

Men's participation in family planning has become a cornerstone in women's reproductive health. The aim of this study was to examine knowledge, attitudes and practice towards family planning of Jordanian men in southern Jordan. In a cross-sectional descriptive study in 2012, structured interviews were made with 104 married men in Aqaba and Ma'an governorates. Although 93.5% of the men had heard about family planning-most commonly the intrauterine device (IUD) and oral contraceptives-only 45.1% reported that they and their wife currently used it. Most men agreed about a minimum 2 years' child spacing (93.3%) and starting contraception after childbirth (71.2%) and that husband and wife should share decisions about family planning (90.2%) and the number of children (89.5%). Level of education significantly affected current use of contraception, while number of children significantly affected previous use of contraception. Although married men had positive attitudes and good knowledge about family planning, this did not translate into practice of contraceptive use.

Men's perceptions of and participation in family planning in Aqaba and Ma'an governorates, Jordan

لقد اصبحت مشاركه الرجال في تنظيم الاسره ركنا اساسيا في مجال الصحه الانجابيه للمرأة ولقد كان الهدف من هذه الدراسه اختبار معارف ومواقف وممارسات الرجال الاردنيين تجاه تنظيم الاسره في جنوب الاردن ففي دراسة وصفيه مقطعيه في عام 2012 اجريت مقابلات منظمة مع 104 من الرجال المتزوجين في محافظتي العقبه ومعان وعلى الرغم من أن 93.5% من الرجال قد سمعوا عن تنظيم الاسره الذي يعتبر اللولب الرحمي وموانع الحمل الفمويه اكثر وسائله شيوعا فأن 45.1% منهم فقط ذكروا انهم وزوجاتهم يستخدمونه حاليا واتفق معظم الرجال على ان تكون المباعدة بين الولادات سنتين كحد أدني 93.3% وعلى البدء بمنع الحمل بعد الولادة 71.2% وان الزوج والزوجه ينبغي ان يشتركا في اتخاذ القرارات المتعلقة بتنظيم الاسره 90.2% وبعدد الاطفال 89.5% لقد كان لمستوى التعليم تأثير ملحوظ على الاستخدام الحالي لوسائل منع الحمل في حين ان عدد الاطفال كان تأثيره كبيرا على الاستخدام السابق لوسائل منع الحمل على الرغم من أن مواقف الرجال المتزوجين من تنظيم الاسره كانت ايجابيه ومعارفهم عنه جيده الا ان ذلك لم يترجم الى واقع ملموس في استخدام وسائل منع الحمل

Men’s participation in family planning has become a cornerstone in women’s reproductive health. The aim of this study was to examine knowledge, attitudes and practice towards family planning of Jordanian men in southern Jordan. In a cross-sectional descriptive study in 2012, structured interviews were made with 104 marriedmen in Aqaba and Ma’an governorates. Although 93.5% of the men had heard about family planning—most commonly the intrauterine device (IUD) and oral contraceptives—only 45.1% reported that they and their wife currently used it. Most men agreed about a minimum 2 years’ child spacing (93.3%) and starting contraception after childbirth (71.2%) and that husband and wife should share decisions about family planning (90.2%) and the number of children (89.5%). Level of education significantly affected current use of contraception, while numberof children significantly affected previous use of contraception. Although married men had positive attitudes and good knowledge about family planning, this did not translate into practice of contraceptive use.

L'implication des hommes dans la planification familiale est devenue une composante essentielle de la santé génésique des femmes. La présente étude, conduite dans le sud de la Jordanie, avait pour but d'étudier les connaissances, lesattitudes et les pratiques des hommes jordaniens en matière de planification familiale. Dans le cadre d'une étude transversale descriptive menée en 2012, des entretiens structurés ont été réalisés auprès de 104 hommes mariés dans les gouvernorats d'Akaba et de Ma’an. Alors que 93,5 % d'entre eux avaient entendu parler de la planification familiale (en particulier, le plus souvent, du dispositif intra-utérin [DIU] et des contraceptifs oraux), seuls 45,1 % ont indiqué qu'ils y avaient actuellement recours avec leurs épouses. La plupart des hommes convenaient de la nécessité d'espacer les naissances d'au moins deux ans (93,3 %) et de mettre en place une contraception juste après l'accouchement (71,2 %). Ils approuvaient également le fait que les décisions relatives à la planification familiale (90,2 %) et au nombre d'enfants (89,5 %) devaient être prises d'un commun accord entre mari et femme. Il existait une incidence significative entre le niveau d'études et la contraception en cours ainsi que le nombre d'enfants et l'utilisation antérieure d'un moyen de contraception. Si les hommes mariés avaient une attitude positive vis-à-vis de la planification familiale et de bonnes connaissances en la matière, ceci ne se traduisait pas, en pratique, par l'utilisation d'une méthode de contraception.

First-year results of a national abdominal aortic aneurysm screening programme in a single centre.

BACKGROUND: The UK Multicentre Aneurysm Screening Study (MASS) demonstrated reduced mortality from screening for abdominal aortic aneurysm (AAA). As a result, the National Health Service AAA Screening Programme was introduced in England. This study reports the results from an early-implementation screening centre. METHODS: Men aged 65 years were invited to attend an ultrasound assessment. Data were analysed for 15 months from the onset of the screening programme. RESULTS: A total of 6091 men aged 65 years were invited between April 2009 and June 2010, of whom 2037 (33·4 per cent) failed to attend. There were 162 self-referrals (median age 71·3 years) so that 4216 men were screened. Of those scanned, 4146 (98·3 per cent) had an aortic diameter of less than 3·0 cm, 65 (1·5 per cent) had an aneurysm measuring 3·0-5·4 cm, and five (0·1 per cent) had an aneurysm with a diameter of 5·5 cm and above. The presence of an aneurysm was more common in those who self-referred than in the invited group (P < 0·001). All 70 screen-detected aneurysms were found in white men. CONCLUSION: The prevalence of AAA was lower than expected. This reflects the younger age of this cohort compared with those in published large multicentre studies and the diverse ethnic background of the local population.

Sizing fenestrated aortic stent-grafts.

INTRODUCTION: Fenestrated aortic stent-grafts are increasingly being used to treat patients with juxtarenal abdominal aortic aneurysms (AAA). Sizing of these stent-grafts is critical to ensure success and requires detailed expert assessment of aortic morphology. At present little is known about how sizing of these stent-grafts varies between observers and the necessary tolerances involved to ensure a successful procedure. METHODS: CT scans of 19 consecutive patients with juxtarenal aortic aneurysms that underwent successful endovascular repair with fenestrated stent-grafts were selected. Sizing of fenestrated aortic stent-grafts was performed independently by four experienced endovascular surgeons and results were compared. Data from the stent-graft manufacturer was available for comparison in 12 cases. RESULTS: All observers agreed on the number of fenestrations; 16 devices had 3 fenestrations and 3 had 4. The overall inter-observer measurement error for all target vessel orientation was ± 12.6° (10.8-14.4 95% CI), and for distance between target vessels ± 5.3 mm (4.4-6.2 95% CI). The median difference in internal stent-graft diameter was 1 stent size. Agreement on fenestration type ranged from (84-95%). Comparison was performed with the manufactured stent-graft in 12 cases. The overall mean difference of target vessel orientation between the manufactured devices and the four observers was -1.3° (SD ± 6.9,-3.8-1.2 95% CI). There was less agreement between observers and device manufacturers on body and limb lengths and distal limb diameters. CONCLUSIONS: There was generally a high level of agreement between experienced endovascular surgeons in sizing the fenestrated stent component. There were differences in component lengths but these could have been accommodated by varying the degree of overlap between components.

Percutaneous access for endovascular aneurysm repair: a systematic review.

INTRODUCTION: Recent developments in aortic stent-graft technology have led to an increase in the use of wholly percutaneous endovascular aneurysm repair (P-EVAR). The literature was systematically reviewed to analyse the results of P-EVAR. METHODS: A systematic review of P-EVAR was performed using Ovid-MEDLINE in-process and other nonindexed citations and Ovid-MEDLINE and EMBASE (January 1991-July 2009). Primary outcomes reviewed were success rate and loco-regional complications. Secondary outcomes included; operative time, hospital stay, time to ambulation, blood loss and cost. Prospective randomised and controlled nonrandomised studies were included as were case series (retrospective and prospective). Case reports, letters, review articles and non-English language articles were excluded. RESULTS: Twenty-two papers were identified. These included randomised trials (n=1); prospective nonrandomised (n=10) and retrospective studies (n=11). P-EVAR was attempted in 1087 patients (1751 groins). Overall success rate of percutaneous arterial closure was 92% (90.1-93.9, 95% CI). Access related complication rate was 4.4% (3.5-5.3, 95% CI). Seven studies provided data on access related complications in open access cohorts (O-EVAR). In these studies, P-EVAR was associated with fewer access related complications (RR 0.47, 95% CI 0.28-0.78, p=0.004). P-EVAR was associated with reduced operative time. CONCLUSION: P-EVAR appears safe and effective in selected patients. Local access related complications were low. Further work is required to identify the most suitable candidates for P-EVAR.

CMV colitis presenting as acute abdomen requires early diagnosis and treatment to avoid mortality.

OBJECTIVE: Acute CMV-colitis is an unusual cause of emergency colectomy in a general surgical department. The aim of this article is to report our experience on CMV colitis as a cause of acute abdomen. METHODS: Five patients were referred to general surgery during a three-year period with acute abdomen due to gastrointestinal CMV disease. All patients underwent serology for CMV except case 5. In all patients a gastroscopy or colonoscopy or both, based on individual clinical symptoms, was performed. Abdominal CT scan was requested in patients 1 and 2. Antiviral therapy was instituted in all patients. One patient (case 5) underwent surgery without prior diagnosis of CMV. RESULTS: There were four men and a woman with a median age of 56 years. Abdominal CT revealed perforation in one patient, later confirmed at laparotomy. Four patients had a positive CMV diagnosis either on serology or tissue biopsy or both. Three patients were treated surgically of whom two died of multiorgan failure. CONCLUSIONS: CMV may behave in the intestine as a non-pathogenic bystander. However, any condition that compromises the immune status may be sufficient to trigger its virulence. Severe colitis commits clinicians to start or increase immunosuppression regimens, whereas in gastrointestinal CMV disease such an approach inevitably aggravates the clinical picture. Tissue biopsy remains the gold standard test in CMV colitis. However, a positive diagnosis by 'any means' should prompt early antiviral treatment. Surgery should be limited to acute complications of CMV colitis and to unresponsive disease.

Prevalence, recognition and management of mental disorders in primary health care in Northern Jordan.

This study examined the prevalence of psychiatric disorders and assessed factors that are assumed to be related to recognition of this morbidity among clinical patients. A total of 794 patients aged 18 years or older participated in the study. Using an Arabic-translated version of the General Health Questionnaire (GHQ-28), the prevalence of psychiatric morbidity was found to be 61%. The highest prevalence rates of psychiatric disorders were found in the 40 years and older age group, in female subjects, in uneducated and highly educated groups, in unemployed individuals, and in patients who were perceived to have 'fair' or 'poor' physical health. Multiple logistic regression analysis revealed that unemployment and perceived severity of physical illness were positively correlated with psychiatric disorders, but no significant correlation was found with sex, age or level of education. The physicians in the present study were able to detect morbidity in only 24% of the patients. Among patients with psychiatric disorders, recognition of this morbidity was significantly greater in women, in patients who had consulted with their family doctors, in patients previously known to their physicians, and in patients with mild physical illness than in their counterparts. The most common lines of psychiatric management used in this study were referral to psychiatrists (47%) and psychotropic medication (16%).