Variation of Torg-Pavlov ratio with age, gender, vertebral level, dural sac area, and ethnicity in lumbar magnetic resonance imaging.

Objectives: The objectives of the study were to provide normal values of the Torg-Pavlov ratio (TPR) of the lumbar spine in magnetic resonance imaging (MRI) for the Jordanian population and examine differences observed according to factors including age, gender, lumbar level, dural sac area, or ethnic group. Material and Methods: Two hundred and eighteen lumbar MRIs from the Picture Archiving and Communication System were reviewed. These were collected from three main governmental hospitals, in North, Central, and South of Jordan. The mid-sagittal diameters of the vertebral body, spinal canal, and dural canal area were measured at all levels. Patients' gender and age were documented as well. Exclusion criteria were kyphoscoliosis alignments disorders, lumbar spinal canal compression regardless of the cause, vertebral bony disease (including fractures), and the presence of technical artifacts. Statistical analyses used descriptive and correlational methods. Comparisons were made between genders, age groups, lumbar level, dural sac area in the study population using independent t-test and one-way ANOVA tests, and between ethnicities by reviewing previous reports on subjects of different ethnicities. Results: The mean TPR ratio for the study participants was 0.4502 ± 0.097. The value of TPR was widest in the 20-29-year-old group at all vertebral levels and in both males and females. Females had a significantly wider TPR than males (P = 0.003) in all age groups. TPR differed significantly between the five vertebral levels (P = 0.026). The difference in TPR between age groups was not statistically significant. TPR showed a positive significant correlation with dural sac (r = 0.203, P = 0.003). Comparison with the previous literature demonstrated variation in the TPR where Jordanian population had a lower TPR in comparison with Negros and Caucasoids whereas similar to Koreans, especially in females. Conclusion: There are significant differences in TPR according to gender, dural sac area, lumbar spinal level (except between L1 and L2), and ethnic group, but no significant difference with the age was found. The present study has identified normal values of Torg's ratio in the Jordanian population. Although the study may not be able to provide clear guidelines for use in clinical practice, it has still highlighted possible between countries variations and has identified differences in these values to different factors. Implications on clinical practice could be reflected on the diagnosis of lumbar spinal stenosis or on predicting the prognosis of lumbar spine injury.

Caudal regression syndrome: Postnatal radiological diagnosis with literature review of 83 cases.

Caudal regression syndrome (CRS) is a rare congenital disorder characterized by arrest of caudal spinal growth and associated with wide spectrum multisystemic anomalies. Herein, we presented a case of a newborn baby who did not pass meconium due to imperforated anus and was referred to the pediatric surgeon for urgent diverting loop colostomy. The conventional X-ray, abdominal ultrasound and abdominal pelvic magnetic resonance imaging (1.5 T) at 2-month-old age revealed right kidney agenesis, sacrococcygeal agenesis, vertebral bodies dysraphism and the spinal cord ends at D12-L1 with anterior and posterior bands of the terminating filaments. The diagnosis of CRS was confirmed. Through this case report, we hope to draw attention to this rare syndrome and the wide range of associated anomalies, also to consider this syndrome on the top of differential diagnosis list once the newborn has anorectal malformation mainly imperforated anus.

The impact of the coronavirus pandemic curfew on the psychosocial lives of pregnant women in Jordan.

OBJECTIVES: Worldwide the COVID-19 pandemic has negatively affected the health and psychosocial lives of people. International guidelines recommend special attention to pregnant women during pandemics and national emergencies. This study aimed to report the impact of the COVID-19 pandemic curfew on the psychosocial lives of pregnant women in Jordan. DESIGN: A cross-sectional study was conducted and included women who were pregnant during the COVID-19 curfew in Jordan, which took place between mid-March and mid-June of 2020. SETTINGS: A web-based survey that was posted on various social media platforms. PARTICIPANTS: Women who at the time of the study were 18 years of age or more, were living in Jordan, and were pregnant during the curfew. MEASUREMENTS AND FINDINGS: Data collected included women's characteristics, the impact of the curfew on the pregnancy, physical activity, and psychosocial lives and the barriers to seeking healthcare, in addition to pregnancy and delivery details, and changes in nutrition and supplements intake. A total of 877 women responded to the survey. The results showed that 21.1% of the respondents did not receive any antenatal care (ANC) during the curfew. The respondents also reported that the main barriers for seeking ANC included healthcare facilities being closed (85.2%), the need for travel permits (76.8%), financial difficulties (63.9%), and fear of catching the COVID-19 virus (60.1%). Furthermore, 93.3% reported that they had psychological stress, and 29.9% reported that they had at least one form of domestic violence. Statistically significant associations existed between various women's characteristics, obstetric, psychosocial factors, and the level of psychological stress. KEY CONCLUSIONS: The COVID-19 pandemic curfew, which was applied in Jordan, resulted in a negative impact on the psychosocial lives of pregnant women. As a result, pregnant women did not receive optimal antenatal care and experienced higher degrees of psychological stress and domestic violence. IMPLICATIONS FOR PRACTICE: The findings of our study may encourage national healthcare policymakers to ensure the provision of appropriate psychosocial support of pregnant women during large scale emergencies.