Background Deliberate self-harm (DSH) involves non-suicidal acts of intentional self-injury used to cope with emotional distress. It is a pathological behavior, recognized as a strong predictor of suicide. Adolescents, undergoing intense developmental changes, are particularly susceptible. The COVID-19 pandemic worsened mental health issues, potentially increasing DSH rates in adolescents. Objectives This study investigates DSH prevalence before and after the pandemic, its risk factors, and implications for public health. Methods A cross-sectional study was conducted using the Lifestyle-Coping-Questionnaire administered in a Level II hospital’s Pediatrics outpatient clinic. The sample included 319 adolescents (12–18 years, M = 14.85) from 2019 (n = 159) to 2023 (n = 160). Statistical analysis involved logistic regression for univariable and adjusted multivariable analyses. Results DSH prevalence was 29.8% (n=95), with an 8.0% post-pandemic increase (P = 0.121). The most frequently used method was cuts (72.6%), predominantly on the upper limbs (84.1%). Among adolescents with DSH, 34.7% sought help, mainly from siblings/friends (72.7%). Additionally, 42.1% expressed a desire to die, and 15.8% mentioned seeking attention. In multivariable logistic regression, significant risk factors included health problems, lack of physical exercise, former smoking, conflicts with a partner, history of attempted suicide/DSH in family/friends, and online search for self-harm methods. Exposure to negative life events correlated significantly with DSH, including difficulty making friends, bullying, parental conflicts, violence, concerns about sexual orientation, and non-consensual sexual relationships. Drug consumption, alcohol intake ≥2 times/month, and a low World Health Organization’s well-being index were also significant for DSH. Conclusion DSH is a significant public health concern that is highly prevalent, causes substantial impairment, and is not readily apparent in most cases. This study highlights key risk factors for the early detection and prevention of DSH.

Background Diabetes mellitus is a chronic illness that has commonly led to progressive and incapacitating deterioration of patients’ condition over the past 20 years. Objectives The aim of the study was to evaluate the effects of the shot-blocker and vibration device on pain intensity and patient discomfort during subcutaneous insulin injections in hospitalized adults with type 2 diabetes mellitus (T2DM). Methods The study was conducted at the Imam Al‑Hassan Al Mujtaba Teaching Hospital, Al‑Imam Al‑Hasan Teaching Hospital, Al‑Hindia Teaching Hospital, and Imam Al‑Hussein Medical City in Holy Karbala. A simple random sample of adults with T2DM was selected in the current study from the previously mentioned setting. A total of 140 patients were classified into 3 groups, 35 patients in the shot-blocker group, 36 patients in the vibration group, and 31 patients in the control group. Results There were statistically significant differences in pain scores among the study groups (P = 0.000). The vibration group had significantly lower pain scores (P = 0.000). Similarly, the shot-blocker group also demonstrated significantly lower pain scores (P = 0.000), compared to the control group. Regarding satisfaction scores, there were statistically significant differences among the groups (P = 0.000). The vibration group had significantly higher satisfaction scores (P = 0.000). Similarly, the shot-blocker group showed significantly higher satisfaction scores (P = 0.000), compared to the control group. Conclusions The shot-blocker and vibration device are effective, noninvasive methods for reducing pain and enhancing patient satisfaction during SC insulin injections in adults with T2DM.

Background Syncope is a common symptom in pediatric clinics, with neurocardiogenic syncope being the most frequent etiology. The evaluation approach varies, as does the diagnostic yield. Objectives This study aims to evaluate the demographic and clinical characteristics of pediatric patients who present to specialty clinics with syncope. Methods This retrospective study analyzed the records of pediatric patients seen for syncope in the neurology and/or cardiology specialty clinics at Jordan University Hospital between 2021 and 2024. We examined demographic characteristics, presenting symptoms, investigations, and differential diagnoses. Descriptive statistical analysis was performed using SPSS. Results A total of 147 patients were included, comprising 64 (44%) males. Age ranged from 4 to 18 years, with 92 (63%) patients aged 10–15 years. Neurocardiogenic syncope was the most common diagnosis (108 [73%] patients). Epilepsy was diagnosed in eight patients, and one patient had a cardiac etiology. Among those tested, iron deficiency anemia was identified in 18 (12%) patients, and 31 (21%) patients had vitamin D deficiency. Brain imaging and echocardiography had low diagnostic yield. Conclusion Our findings suggest a predominance of neurocardiogenic syncope, though some patients were diagnosed with serious conditions such as epilepsy and restrictive cardiomyopathy. This study underscores the need to streamline diagnostic protocols to minimize unnecessary tests while ensuring serious etiologies are not overlooked.

Background We evaluated the impact of the Transition Assessment Post Transfer (TAPT) program, a pediatric critical care outreach team (PCCOT) follow-up initiative, on morbidity and mortality outcomes for children who received a pediatric intensive care unit (PICU) consult in the emergency department (ED) and were transferred to an inpatient ward. Objectives The primary objective of this research was to evaluate the impact of the TAPT program on PICU admission rates. Secondary objectives included a description of patient characteristics, PICU length of stay, days on invasive and non-invasive ventilation, and mortality. Methods A retrospective analysis compared pre-TAPT (2014–2017) and post-TAPT (2017–2020) periods. Patients included were those requiring PICU admission within 24 hours of hospital admission from the ED. A subgroup analysis examined patients with a prior PICU consult in the ED. The intervention involved routine PCCOT follow-up for children after PICU consultation or PCCOT activation in the ED, introduced in July 2017. Results An interrupted time-series analysis of 3 years before and after TAPT implementation included 316 children (35% female; mean age 4.8 years) requiring unplanned PICU admission within 24 hours, with 22 (7.0%) having a prior PICU consult in the ED. There were no significant differences in early unplanned PICU transfers, morbidity indicators, or mortality. Conclusions There were no significant differences in PICU transfer rates between the pre- and post-TAPT periods. Further research is needed to improve risk identification for early deterioration and assess the broader impact of TAPT.

Backgroud Cystic fibrosis (CF) is a genetic disorder affecting multiple organ systems, with varying prevalence rates worldwide. Objectives To understand the clinical and laboratory profile of people with CF (pwCF) in Jordan. Methods This descriptive study of 50 pwCF undergoing treatment at the CF clinic at Prince Hamza Hospital in Amman, Jordan, from 2016 to 2024. Results The average age of diagnosis was 4.2 years. Consanguinity was noted in 88% of the patients. Respiratory complications like chronic cough (70%) and digital clubbing (72%) were common, along with gastrointestinal and endocrine problems. Pulmonary function tests indicated a mean forced expiratory volume (FEV1) of 70.6% of the predicted value. Genetic testing revealed that the most prevalent mutations were G85E (16%), F508del (12%), and CFTRdel19-21 (10%). Microbial analysis revealed Pseudomonas aeruginosa as the predominant pathogen in 50% of sputum cultures. Bronchiectasis was identified in 56% of pwCF. The study also assessed medical management and patient adherence, finding that 58.8% of the pwCF attended the clinic regularly. Compliance with chest physiotherapy was low (5.6%). Conclusion This study contributes valuable insights into the clinical profile of patients with CF in Jordan, highlighting the need for improved early diagnosis, consistent care, and better access to therapies. The findings underscore the challenges of managing CF in a low-resource setting.

Background Respiratory syncytial virus (RSV) causes lower respiratory tract infections, particularly in children under 24 months of age. This multicenter study explored the demographics, seasonality, clinical features, and outcomes of children with RSV. Objectives To describe the epidemiology, seasonality, clinical characteristics, and outcomes of infants and children admitted with Respiratory Syncytial Virus bronchiolitis Methods An eight-center retrospective cohort study included children less than 24 months old who were admitted with RSV bronchiolitis between January 2018 and December 2021. Patients’ clinical features, respiratory support, management, and outcomes were collected. Results Of the 1585 children included, 1143 (72%) were less than 6-month-old. RSV peaked during the winter months of September to December in 2018 to 2019, but occurred earlier in 2021, with the easing of post-COVID-19 restrictions. The most common clinical features were cough (97.72%), tachypnea (76.15%), and fever (75.9%). Different types of respiratory support were needed, including high-flow nasal cannula (HFNC) in 141 (8.9%) children, Non-invasive ventilation in 341 (21.5%), and intubation in 144 (9.1%). A total of 844 (53.2%) children required admission to a pediatric intensive care unit (PICU) or pediatric high-dependency unit (PHDU). The majority of children recovered uneventfully, while 19 patients died, resulting in a mortality rate of 1.2%. Conclusion To our knowledge, this is the largest cohort study focused specifically on RSV bronchiolitis in infants within the Middle East. The majority were younger than 6 months of age, and coughing, tachypnea, and fever were the most common symptoms. Seasonality differed between the pre- and post-COVID-19 pandemic periods. More than half of the cohort required admission to a PICU or PHDU. All patients who died had either prematurity or chronic comorbidities. Further studies are required to predict the risk factors for critical cases.

Background: Drug dosage errors are mistakes that occur during the prescribing, dispensing, or administering of medications, leading to patients receiving incorrect dosages. Objectives: The aim of the study was to apply health beliefs model (HBM)-based intervention in improving nurses’ beliefs toward drug dosage errors. Methods: A randomized controlled trial was conducted in pediatric wards of hospitals in Mosul from October 5, 2024, to May 1, 2025. The study involved 60 nurses, equally divided between the experimental and control groups. The HBM-based intervention focused on perceived susceptibility and severity, perceived benefits, perceived barriers, and cues to action related to medication dosage errors. The inquiry utilized the Social Science Statistical Package (SPSS) version 26 to analyze the data. The statistical methodologies employed for data analysis and outcome evaluation encompass. Results: The study results showed no significant differences in demographic variables, indicating a homogeneous sample. The training led to an increase in knowledge among nurses, with their mean score rising from 6.866 pre-study to 17.466 in post1 and 16.866 in post2, indicating an improvement from fair to good knowledge. Nurses’ beliefs also showed positive changes in almost all components of the HBM, except for perceived barriers. Conclusion: The study concluded that the HBM-based intervention was effective in enhancing nurses’ beliefs regarding medication dosage errors. The intervention significantly improved their understanding of perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy in relation to the medication safety.

Background Congenital heart disease (CHD) is a leading cause of neonatal morbidity and mortality, necessitating early detection for improved outcomes. Current screening methods, such as pulse oximetry and cardiac auscultation, have limitations when used independently. Objectives This study aimed to evaluate the diagnostic accuracy of combining pulse oximetry and cardiac auscultation for early CHD detection in neonates, particularly in resource-limited settings. Methods A prospective cross-sectional study was conducted from October 2021 to October 2022 at a University Hospital. A total of 12,708 neonates were screened using pulse oximetry and cardiac auscultation within 6–72 hours post-birth. Echocardiography served as the gold standard for confirmation. Sensitivity, specificity, and overall diagnostic accuracy were assessed for each screening method individually and in combination. Results CHD was detected in 344 neonates (3%). Cardiac auscultation was more effective in identifying acyanotic CHDs (e.g., ventricular septal defect and atrial septal defect), while pulse oximetry was superior in detecting cyanotic CHDs (e.g., transposition of the great arteries). The combined approach achieved a diagnostic accuracy of 95.5%, with 96.7% sensitivity and 92% specificity, outperforming either method alone. Conclusion Combining pulse oximetry and cardiac auscultation significantly enhances CHD screening accuracy, ensuring early diagnosis and intervention. This cost-effective approach is particularly valuable in low-resource settings, improving neonatal outcomes and reducing CHD-related mortality. These findings support the universal adoption of dual-method screening in neonatal care.