Disease In Jordan Research Articles

The association between metabolic syndrome and coronary artery disease in Jordan

Previous studies in Jordan showed a considerably high prevalence of metabolic syndrome (MeS) and its individual components. However, data about the association between MeS and coronary artery disease (CAD) in Jordan are lacking. Therefore, this study aimed to determine the association between MeS and CAD among Jordanians. This case-control study included 269 patients diagnosed with CAD and 1026 subjects without CAD. Data collected from cases and controls included socio-demographic and clinical characteristics and anthropometric measurements. Patients were diagnosed with MeS based on the criteria of the National Cholesterol Education Program (NCEP) adult treatment panel (ATP) III. MeS was present in 65.1% of patients with CAD and in 44.0% of those with no CAD (p<0.0005). After adjusting for the important variables in the multivariate analysis, those with MeS were twice more likely to have CAD (OR = 1.94, 95% CI: 1.29, 2.93, p = 0.002) compared to those without MeS. The number of metabolic abnormalities was significantly associated with CAD, when it substituted MeS in the regression model, with a higher number of MeS components led to greater odds for CAD. The MeS, which occurs very frequently in the general population, is associated with CAD in Jordan. The identification of subjects with the MeS is conceivably useful from a clinical standpoint, as it can be anticipated that these individuals should benefit from interventions aimed at reducing cardiovascular risk.

Prevalence of Parkinson's disease in Northern Jordan

Background The prevalence of Parkinson's disease (PD) in Jordan is not known. This study describes the prevalence and clinical characteristics of PD in Northern Jordan. Methods Patients with the diagnosis of PD seen at neurology clinics in three major hospitals in Northern Jordan during the period of March 2007 to April 2008 were enrolled. PD diagnosis was established using predefined clinical diagnostic criteria. Results A total of 102 patients were included in the analysis (64 males; 63%, 38 females 37%). The mean age (SD) of patients was 63.3 (10.1) years and the mean age for onset of symptoms (SD) was 59.5 (12.1) years. The crude prevalence rate of PD was estimated to be 59/100,000. Clinical presentations of PD at onset of disease included; rest tremor (79.2%), bradykinesia (28.7%), rigidity (6.9%), gait problem (5%), and postural instability (2%). Eleven patients (10.9%) had a family history of PD. There was no association between the age of symptom onset, the presence of tremor, bradykinesia, or rigidity at onset, with stage of PD measured by Hoehn and Yahr scale. Conclusion PD is a moderately prevalent disease in Jordan. The clinical characteristics of PD patients are similar to those reported in other countries.

Flock-level prevalence of Clostridium colinum in broiler flocks with digestive disease in Jordan by polymerase chain reaction

A cross-sectional study was conducted from May to September of the year 2008 in broiler flocks in the southern and northern area of Jordan, to determine the flock-level prevalence of Clostridium colinum infection. Intestinal swabs were collected from 170 broiler flocks and tested by PCR. Among the study population, 20 flocks in both areas (11.8%, 95% confidence interval: 10 to 22%) were positive for C. colinum infection. The prevalence of positive intestinal samples in the southern and northern area of Jordan were 4.7 and 7.1%, respectively, which was statistically significant (χ2 = 3.9 df = 1, P = 0.0482). It is recommended to conduct further epidemiologic studies to determine risk factors and to evaluate the economic consequences of the C. colinum infection in the region.

Estimated Burden of Human Salmonella, Shigella, and Brucella Infections in Jordan, 2003–2004

There is limited information on the disease burden due to foodborne pathogens in the eastern Mediterranean region. This study estimates the burden of disease in Jordan for Salmonella, Shigella, and Brucella during 1 year. Nationwide population and laboratory surveys were conducted during September 2003 and May 2004, and burden of disease estimates were calculated. A validation study was conducted prospectively from August to September 2003 to provide an estimate of the internal validity of burden estimates. Each year in Jordan there are about 4.4 million episodes of diarrhea among persons >1 year of age and about 1.3 million persons seek medical care for diarrhea. For each person with laboratory-confirmed Shigella or Salmonella infection there are about 273 infected persons in the community. There are approximately 1.1 million episodes of fever and 0.7 million persons >1 year of age seeking medical care for fever each year. For each person with serological confirmed Brucella infection there are about 31 infected persons in the community. There are at least 16,260 Shigella, 6612 Salmonella, and 6912 Brucella cases yearly. This study provides baseline information of the burden of selected foodborne pathogens for 1 year in Jordan and indicates significant underreporting and under-diagnosis of Shigella and Salmonella infections.

The Use of Molecular Techniques in Isolation and Characterization of Mycoplasma gallisepticum from Commercial Chickens in Jordan

Commercial chickens in Jordan suffer from respiratory disease of undetermined etiology. This study was designed to document the involvement of Mycoplasma gallisepticum (MG) in this respiratory disease. Seventy six different chicken flocks with respiratory symptoms (48 broiler flocks, 21 layer flocks and 7 broiler-breeder flocks) were examined serologically by commercial MG ELISA kit and bacterial isolation for Mycoplasma. Twenty four MG isolates from 76 flocks were cloned and the presence of MG in the cloned cultures was confirmed by polymerase chain reaction. The isolates were further examined using Random Amplified Polymorphic DNA (RAPD) technique. The prevalence of MG in the flocks examined was 73.5% and 31.6% by ELISA and isolation, respectively. This high prevalence in flocks with respiratory disease, confirms the endemic nature of the disease in Jordan. RAPD testing of the 24 isolates revealed the presence of 5 banding patterns that were different than the common MG F strain vaccine used in the field. This is the first study to isolate and characterize MG from chickens in Jordan.

Serological and Molecular Detection of Avian Pneumovirus in Chickens with Respiratory Disease in Jordan

Avian pneumovirus (APV) causes upper respiratory tract infection in chickens and turkeys. There is a serious respiratory disease in chickens, resulting in catastrophic economic losses to chicken farmers in Jordan. The objective of this study was to investigate the role of APV as a factor in the respiratory disease of chickens in Jordan by serological and molecular methods. Thirty-eight chicken flocks were examined by competitive ELISA (23 broilers, 8 layers, and 7 broiler breeders), and 150 chicken flocks were examined by reverse-transcription PCR (133 broiler flocks, 7 layer flocks, and 10 broiler breeder flocks). Avian pneumovirus antibodies were detected in 5 out of 23 broiler flocks (21.7%), 6 out of 8 layer flocks (75%), and 7 out of 7 broiler breeder flocks (100%). Avian pneumovirus nucleic acid was detected in 17 broiler flocks (12.8%) and 3 layer flocks (42.9%). None of the broiler breeder flocks tested by reverse-transcription PCR was positive. All of the 20 detected APV isolates were subtype B. This is the first report of APV infection in Jordan. In conclusion, the Jordanian poultry industry, vaccination programs should be adjusted to include the APV vaccine to aid in the control of this respiratory disease.

Influence of family history and lifestyle on blood pressure and heart rate in young adults in Jordan

The most prevalent disease in Jordan is hypertension. Jordan is a small, middle-income developing country in the Middle East. It has a population of 5611202 people. Few studies have examined the associated cardiovascular risk factors in Jordan. The aim of this investigation was to explore specific lifestyles in Jordan, measuring blood pressure and heart rate through a randomized cross-sectional population study. A total of 14310 adult males (7400) and females (6910) were selected in various regions of Jordan. Selected participants were interviewed by trained senior pharmacy students. They were asked whether they had hypertension or other cardiovascular disorders and if the answer was negative further questions were asked. This was followed by measurement of blood pressure and heart rate. Demographic data such as age, sex and nationality were also recorded, as was family history of hypertension. For each individual of the sample, systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate were measured three times with 10-15min intervals in a sitting position and resting state. The Student's unpaired t-test was used for statistical analysis. Results were considered statistically significant when the P value was less than 0.05. A general trend in all the results tables was a lower blood pressure among those without a family history of cardiovascular disease and higher values among those with a family history of cardiovascular disease. This study demonstrates that SBP and DBP increase with all associated risk factors if a family history of hypertension is positive. This cross-sectional study revealed the presence of a consistent and strong relationship between certain lifestyle risk factors with an elevation in blood pressure concurrent with a positive family history of hypertension.

Acute Cerebrovascular Disease in Jordan: Presentation and Diagnosis

This is a retrospective study of the presentation and method of diagnosis of stroke patients who were admitted to the Emergency Department of the King Hussein Medical Center between January 2000 and December 2001. A total of 316 patients where studied. Motor weakers was the most common mode of presentation occurring in 174(55%) of cases followed by dysphasia, 53 (16%). Others had sensory and cerebellar signs. Brain CT scan was done between 2 and 24 hours and showed ischemic infarcts in 59%, hemorrhage in 12% and normal in 29%. Our results show similar values to the western literature regarding the presentation of patients and the value of neotroimaging in evaluating patients with acute stroke. Key Words: Stroke, dysphasia, ischemic infarcts. Mary Slessor Journal of Medicine Vol.4(1) 2004: 86-87

Prevalence of Blindness and Visual Impairment among Jordanian Diabetics

To investigate the prevalence of blindness and visual impairment among a population of Jordanian diabetics. A total of 986 diabetic patients were fully assessed, including complete history, examination, and laboratory tests. All patients underwent detailed eye examination, which included visual acuity, slit-lamp examination, tonometry, funduscopy, and fundus fluorescein angiography (FFA). Of all patients examined, 53.2% were male and 46.8% were female. The mean age and duration of diabetes were 55.3 and 11.9 years. Of all patients, 93.3% had type 2 while 6.7% had type 1 diabetes mellitus (DM). Over half (50.3%) were on oral hypoglycemic agents, 34% on insulin, and 14.5% on both types of treatment, whereas only 1.2% were on diet alone. The mean value for HbA1c was 7.7%. The prevalence of blindness among participants was found to be 7.4%, while 10.1% were visually impaired. Diabetic retinopathy (DR) was present in 64.1%, 37.8% had cataract, and 8.7% had undergone cataract surgery. Using multivariate logistic regression analysis, visual impairment was significantly associated with age, treatment of diabetes, and DR, while only age and retinopathy were significantly related to blindness. DM is a common disease in Jordan and DR is highly prevalent among Jordanian diabetics. National screening and educational programs are highly needed to reduce the risk of blindness and visual impairment among diabetic patients.

Clinical Pattern of Behcet Disease in Jordan

The medical records were reviewed of 124 patients (108 males, 16 females) with Behget disease attending the King Hussein Medical Center and Prince Rashed Bin Al-Hasan Military Hospital, Jordan, between January 1996 and June 2001. The clinical pattern, manifestations and clinical course in Jordanian patients were compared with those in other countries of the region. There was some variation in the frequency of lesions in the sample compared to these other countries but it was concluded that the “Silk Road Disease” does pass through Jordan without having any specific features.

Skeletal Muscle Echinococcosis: A Rare Manifestation of Echinococcal Disease.

Skeletal Muscle Echinococcosis: A Rare Manifestation of Echinococcal Disease.

Familial sarcoidosis in a jordanian family

Abstract Sarcoidosis is an idiopathic granulomatous disease involving one or more multiple organ systems, characterised by the histologic finding of noncaseating epitheloid cell granulomas. This is the first report of familial sarcoidosis in Jordan. We report a mother and her son who Presented with bilateral hilar lymphadenopathy and lung infiltrates. Sarcoidosis is a rare disease in Jordan. We reported thirty-three cases of sarcoidosis(1). Although the familial tendency is reported in many studies(2), this was not the case in our study. Though the etiology is unknown; both Prevalence of sarcoidosis in different ethnic groups and familial occurrence of the disease strongly suggest the hypothesis of a possible genetic predisposition(3).

Behçet's disease: clinical study of Jordanian patients.

Behçet's disease is a chronic, recurrent, inflammatory disorder characterized by the triad of oral and genital ulcers and ocular lesions. The etiology is unknown. This is the first report giving details of the clinical manifestations of Behçet's disease in Jordanian patients. Twenty patients with Behçet's disease were studied to determine the clinical pattern in the North of Jordan. The patients were seen in Princess Basma Teaching Hospital in North Jordan. They presented to various clinics and underwent full clinical examination. Data for each patient on all features of Behçet's disease were recorded on a standard form. A comparison was made between Behçet's disease in Jordan and other countries in the region. Of the 20 patients, 14 were men and six women, giving a ratio of 2.3:1. Their ages ranged from 14 to 58 years. All had mouth ulcers, 65% genital ulcers, 65% ocular involvement, 55% joint involvement, 35% skin lesions, 20% vascular lesions, and 5% gastrointestinal involvement. The oral ulcers were the first manifestation of the disease process in 70% of our patients. Skin lesions, genital ulcers, and involvement of the central nervous system and the pulmonary system were less frequent in our study. Although it is difficult to obtain figures as to the incidence and prevalence of Behçet's disease in Jordan, the clinical manifestations, with a few exceptions, are similar to those in other countries in the region.

A retrospective study of human cystic echinococcosis in Jordan.

Some 676 human cases of cystic echinococcosis (CE) were recorded from 18 major hospitals in Jordan from January 1985 to October 1993. The number and origins of the cases indicate that CE is an endemic and widespread disease in Jordan. Operations for the extraction of hydatid cysts represented 0.1% of all surgical operations carried out in the surveyed hospitals during the study period (excluding Caesarean sections). The mean annual surgical incidence of CE was estimated to be 0.5-8.2 per 100,000 population, depending on the governorate studied, with an overall mean of 2.9 per 100,000. Incidence was higher in the more rural eastern and south-western governorates than elsewhere, and more cases fell in the 21-30-year age group than in any other. Many more of the cases were female than male (443 v. 233; P < 0.001). The liver was the most common organ infected (54.5% of cases), followed by the lungs (12.1%), and multiple hydatidosis usually involved the liver.

Hereditary thrombophilia among 217 consecutive patients with thromboembolic disease in Jordan.

This is a four-year prospective study on patients admitted or referred with thromboembolic disease to Jordan University Hospital or to the Thrombosis/Haemostasis Laboratory at the University of Jordan. The aim of the study was to find the relative prevalence of hereditary thrombophilia. For the purpose of this work, hereditary thrombophilia was diagnosed in the absence of an acquired cause of thrombophilia in addition to two of the following: 1) positive family history of thrombophilia, 2) confirmed same deficiency in a closely related family member, 3) the deficient protein is constantly below 2 SD of the normal mean on repeated testing. All ages were admitted to the study. Acquired systemic factors or local factors known to cause thrombosis or affect the levels of proteins opposing thrombosis were excluded. There were a total of 217 patients (102 males and 115 females) with confirmed thromboembolic disease. Their mean age was 34 years. A total of 49 patients (26 males and 23 females) fulfilled the criteria of hereditary thrombophilia. There were 17 cases of protein C deficiency (PC), 15 protein S deficiency (PS), 10 antithrombin III deficiency (ATIII), 3 dyfibrinogenemia, 2 heparin cofactor II deficiency, and 2 plasminogen defects. In this group most of the thrombosis was venous. A positive family history was obtained in 65.3% of patients with hereditary thrombophilia. Twenty-seven additional relatives with deficiency were identified upon family studies. The calculated prevalence of hereditary thrombophilia in Jordan is put at 1/25,000. Screening for PC, PS, and ATIII is advocated in young patients who have thromboembolic disease, especially when there is a positive family history of thrombosis.

Leishmanin skin test survey in a focus of high endemicity of Leishmania major in Jordan

Cutaneous leishmaniasis (CL) is an endemic disease in Jordan. From 1973 to 1978, a total of 524 cases was reported with almost half of them occurring in the Jordan Valley (Oumeish et al., 1982). In the following years the number of cases recorded from this area has considerably increased. Many subjects were infected in the area of Swaimeh, a small village of about 2000 inhabitants not far from the Jordan River (data from the Ministry of Health). Here, parasites isolated from man and the rodent reservoir Psammomys obesus have been identified isoenzymatically as Leishmania major, agent of zoonotic CL (ZCL) (Saliba et al., 1988). As part of surveillance activities for ZCL in the Jordan Valley, a preliminary survey was carried out among the population of Swaimeh in October 1991, which revealed an impressive prevalence of scars suggestive for past L. major infections. It was thus decided to carry out a leishmanin skin test (LST) in the village in order to obtain epidemetric indices of ZCL. Leishmanin was prepared from the WHO reference strain of L. major (MHOM/SU/73/5-ASKH) according to the techniques and safety procedures described by Gramiccia et al (1990). LST was performed through intradermal injection of 0.1 ml of leishmanin (5 x 105 parasites) and reactions were read 48 h after inoculation by the ball-point pen method (Sokal, 1975). Reactions with an induration size of 5 mm or more were recorded as positive. 399 inhabitants of Swaimeh were carefully examined for the presence of active/past leishmanial lesions and tested with leishmanin. Active lesions were microscopically confirmed. The LST results according to age groups are reported in Table 1. Overall, 350 subjects (87.7%) reacted to the antigen. A positive response was found in 100% of subjects over 5 years. Active leishmanial lesions were found in 8 subjects only (2%), all being LST positive and belonging to age groups from 3 months to 4 years. High correspondence (99.4%) was found between positive LST and presence of active/past lesions.