1
|
Sweis NWG, Zayed AA, Jaberi MA, AlQirem L, Hyasat TB, Khraisat FA, Maaita W, Naser AM, Nimer A, Qatamin M, Sweis JJG, Sweis N, Al-Ani AT, Alghrabli AM, Haghighi A. Geographic variation in the association between Hashimoto's thyroiditis and Papillary thyroid carcinoma, a meta-analysis. Endocrine 2023; 81:432-449. [PMID: 37129757 DOI: 10.1007/s12020-023-03378-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/15/2023] [Indexed: 05/03/2023]
Abstract
PURPOSE The association between papillary thyroid cancer (PTC) and Hashimoto's thyroiditis (HT) remains a matter of debate. Several genetic and environmental factors have been found to influence this association. Because of the variation in these factors among different populations, we conducted a country- and region-based meta-analysis to examine whether the geographic area influences this association. METHODS We searched PubMed and Web of Science databases for original articles that investigated the association between HT and PTC from February 1955 to February 28, 2023. The included studies were stratified according to their country and region of origin. Various subgroup analyses were conducted. The primary outcome was the pooled relative risk (RR) and its 95% confidence interval (CI) for each region and country. RESULTS Forty-six studies including a total of 93,970 participants met our inclusion criteria. They originated from 16 countries distributed in five regions. Significant variation was found among countries but not among regions. Upon analysis of all 46 included studies, countries were classified based on their RR and its 95% CI. Excluding countries with pooled sample sizes <500, Sri Lanka (RR 4.23, 95% CI 2.91-6.14), Poland (RR 3.16, 95% CI 2.79-3.57) and Japan (2.68, 2.14-3.36) showed the strongest association between HT and PTC while Greece (RR 1.06, 95% CI 1.00-1.13), Spain (RR 0.70, 95% CI 0.23-2.11), and Jordan (0.62, 0.32-1.32) showed no significant association. CONCLUSION Our findings revealed a variation in the association between HT and PTC among countries but not among regions. The country-to-country variation could be due to certain genetic and/or environmental factors subject to geographic variation that influence this association. These findings may help guide health policies aiming to mitigate the risk of PTC in the HT population by helping identify high-risk and low-risk countries.
Collapse
Affiliation(s)
- Nabil W G Sweis
- The University of Jordan School of Medicine, Amman, 11942, Jordan
| | - Ayman A Zayed
- Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, The University of Jordan School of Medicine, Amman, 11942, Jordan.
| | - Mira Al Jaberi
- The University of Jordan School of Medicine, Amman, 11942, Jordan
| | - Lina AlQirem
- The University of Jordan School of Medicine, Amman, 11942, Jordan
| | | | - Farah A Khraisat
- The University of Jordan School of Medicine, Amman, 11942, Jordan
| | - Ward Maaita
- The University of Jordan School of Medicine, Amman, 11942, Jordan
| | - Ahmad Moayad Naser
- Department of Internal Medicine, Jordan University Hospital, Amman, 11942, Jordan
| | - Abdullah Nimer
- The University of Jordan School of Medicine, Amman, 11942, Jordan
| | - Mamoon Qatamin
- The University of Jordan School of Medicine, Amman, 11942, Jordan
| | - Jaleel J G Sweis
- The University of Jordan School of Medicine, Amman, 11942, Jordan
| | - Nadia Sweis
- The University of Jordan School of Medicine, Amman, 11942, Jordan
| | - Abdallah T Al-Ani
- Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman, 11941, Jordan
| | - Ahmad M Alghrabli
- Department of Internal Medicine, Jordan University Hospital, Amman, 11942, Jordan
| | - Alireza Haghighi
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Genetics, Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| |
Collapse
|
2
|
Halaseh SA, Kostalas M, Kopec CA, Nimer A. Single-Center Retrospective Analysis of Neutrophil, Monocyte, and Platelet to Lymphocyte Ratios as Predictors of Complicated Appendicitis. Cureus 2022; 14:e29177. [PMID: 36259022 PMCID: PMC9568680 DOI: 10.7759/cureus.29177] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2022] [Indexed: 11/09/2022] Open
Abstract
Aim We look at the ability of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) to differentiate between uncomplicated and complicated appendicitis. Methods and materials This was a retrospective, single-center study of 234 individuals diagnosed with acute appendicitis between January 1, 2020, and December 31, 2020. Patients were grouped into uncomplicated and complicated appendicitis subgroups. Patients with histologically or radiologically proven gangrenous or perforated appendicitis, as well as those with peritonitis or peri-appendiceal abscess development, comprise the complicated subgroup. Independent Mann-Whitney samples The U test was used to predict lab values of complicated appendicitis. Furthermore, the receiver operating characteristic (ROC) curve and area under the curve (AUC) were utilized to predict the sensitivity and specificity of laboratory results reported to have a significant connection with complex appendicitis Results The criteria were met by 186 patients, with a male-to-female proportion of 1.06:1, an average age of 36.4 years, and an average stay of 2.73 days. There were 95 individuals with complicated appendicitis. With 66.3%, perforated appendicitis was the most prevalent condition. The ratios of neutrophils to lymphocytes, monocytes to lymphocytes, and platelets to lymphocytes were linked with complicated appendicitis with a p-value of < 0.0001, and p-values = 0.015, and 0.015, respectively. Conclusion NLR, MLR, and PLR are valid, less onerous surrogate biomarkers for measuring the severity of acute complicated appendicitis and differentiating it from uncomplicated appendicitis.
Collapse
|
3
|
Halaseh SA, Kostalas M, Kopec C, Nimer A. Bilirubin as a Predictor of Complicated Appendicitis in a District General Hospital: A Retrospective Analysis. Cureus 2022; 14:e29036. [PMID: 36237793 PMCID: PMC9552955 DOI: 10.7759/cureus.29036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2022] [Indexed: 11/24/2022] Open
Abstract
Aims The objectives of the study were to establish the function of bilirubin as a novel diagnostic tool for predicting complex appendicitis and to compare the impact of other variables such as white blood cell count (WCC), C-reactive protein (CRP), and neutrophil. Methods This retrospective, single-center cohort analysis included all patients admitted to Torbay General Hospital in Torquay, United Kingdom, between January 2020 and December 2020 with a clinical diagnosis of acute appendicitis. In addition to serum CRP, WCC, and neutrophil, serum bilirubin and other liver enzymes were obtained from the patients’ blood on admission. Results The quantitative analysis included 174 patients from the group that remained. The large majority of the sample consisted of adults and males (77% and 51.7%, respectively). Overall, 49.4% of participants in the study were diagnosed with complicated appendicitis; 74.7% of adults had complicated appendicitis, with 58.6% being male. In 68.6% of cases, perforated appendicitis was the most prevalent form of complicated appendicitis. Patients with complicated appendicitis had significantly higher WCC, neutrophil, and CRP levels than those with uncomplicated appendicitis (14.15 vs. 12.88, p = 0.016; 11.63 vs. 10.19, p = 0.007; and (89.28 vs. 40.65, p = 0.0001, respectively).. The significantly greater alkaline phosphatase and total serum bilirubin discrepancies were observed in patients with complicated appendicitis. There were statistically significant differences in the means of the patients: (18.46 vs. 10.98, p = 0.0001 and 110.64 vs. 102.24, p = 0.033). Conclusion Serum bilirubin is a crucial diagnostic aid for determining the existence of complicated appendicitis.
Collapse
|
4
|
Alqudah M, Aloqaily M, Rabadi A, Nimer A, Abdel Hafez S, Almomani A, Alkhlaifat NS, Aldurgham A, Al-Momani A, Fraij Z, Aloqaily W, Bani Abedelrahman L, AlShati A, Jabaiti S, Bani Hani A, Abu Abeeleh M. The Value of Auditing Surgical Records in a Tertiary Hospital Setting. Cureus 2022; 14:e21066. [PMID: 35155026 PMCID: PMC8826017 DOI: 10.7759/cureus.21066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2022] [Indexed: 11/05/2022] Open
|
5
|
Abufaraj M, Eyadat Z, Al-Sabbagh MQ, Nimer A, Moonesar IA, Yang L, Al Khatib W, Al-Qutob R. Gender-based disparities on health indices during COVID-19 crisis: a nationwide cross-sectional study in Jordan. Int J Equity Health 2021; 20:91. [PMID: 33823852 PMCID: PMC8022313 DOI: 10.1186/s12939-021-01435-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 03/25/2021] [Indexed: 12/23/2022] Open
Abstract
Background COVID-19 has an inevitable burden on public health, potentially widening the gender gap in healthcare and the economy. We aimed to assess gender-based desparities during COVID-19 in Jordan in terms of health indices, mental well-being and economic burden. Methods A nationally representative sample of 1300 participants ≥18 years living in Jordan were selected using stratified random sampling. Data were collected via telephone interviews in this cross-sectional study. Chi-square was used to test age and gender differences according to demographics, economic burden, and health indices (access to healthcare, health insurance, antenatal and reproductive services). A multivariable logistic regression analysis was used to estimate the beta-coefficient (β) and 95% confidence interval (CI) of factors correlated with mental well-being, assessed by patients’ health questionnaire 4 (PHQ-4). Results 656 (50.5%) men and 644 (49.5%) women completed the interview. Three-fourths of the participants had health insurance during the COVID-19 crisis. There was no significant difference in healthcare coverage or access between women and men (p > 0.05). Half of pregnant women were unable to access antenatal care. Gender was a significant predictor of higher PHQ-4 scores (women vs. men: β: 0.88, 95% CI: 0.54–1.22). Among women, age ≥ 60 years and being married were associated with significantly lower PHQ-4 scores. Only 0.38% of the overall participants lost their jobs; however, 8.3% reported a reduced payment. More women (13.89%) were not paid during the crisis as compared with men (6.92%) (P = 0.01). Conclusions Our results showed no gender differences in healthcare coverage or access during the COVID-19 crisis generally. Women in Jordan are experiencing worse outcomes in terms of mental well-being and economic burden. Policymakers should give priority to women’s mental health and antenatal and reproductive services. Financial security should be addressed in all Jordanian COVID-19 national plans because the crisis appears widening the gender gap in the economy.
Collapse
Affiliation(s)
- Mohammad Abufaraj
- Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, 11942, Jordan. .,Department of Urology, the Medical University of Vienna, Vienna, Austria.
| | - Zaid Eyadat
- Center of strategic studies, the University of Jordan, Amman, Jordan
| | | | - Abdullah Nimer
- School of Medicine, The University of Jordan, Amman, Jordan
| | - Immanuel Azaad Moonesar
- Health Administration & Policy, Mohammed Bin Rashid School of Government, Dubai, United Arab Emirates
| | - Lin Yang
- Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Walid Al Khatib
- Center of strategic studies, the University of Jordan, Amman, Jordan
| | - Ra'eda Al-Qutob
- Department of Family and Community Medicine, Faculty of medicine, The University of Jordan, Amman, Jordan
| |
Collapse
|
6
|
Nimer A, Naser S, Sultan N, Alasad RS, Rabadi A, Abu-Jubba M, Al-Sabbagh MQ, Jaradat KM, AlKayed Z, Aborajooh E, Daradkeh S, Abufaraj M. Burnout Syndrome during Residency Training in Jordan: Prevalence, Risk Factors, and Implications. Int J Environ Res Public Health 2021; 18:1557. [PMID: 33562100 PMCID: PMC7914676 DOI: 10.3390/ijerph18041557] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 12/13/2022]
Abstract
Burnout syndrome is common among healthcare professions, including resident physicians. We aimed to assess the prevalence of burnout among resident physicians in Jordan, and a secondary aim was to evaluate the risk factors associated with the development of burnout syndrome in those residents, including gender, working hours, psychological distress, training sector, and specialty. In this cross-sectional study, 481 residents were recruited utilizing multistage stratified sampling to represent the four major health sectors in Jordan. Data were collected using an online questionnaire, where the Copenhagen Burnout Inventory (CBI) was used to assess the prevalence of burnout. The prevalence, group differences, and predictors of burnout were statistically analyzed using STATA 15. Overall, 373 (77.5%) residents were found to have burnout. Factors associated with higher levels of burnout were psychological stress (β = 2.34, CI = [1.88-2.81]), longer working hours (β = 4.07, CI = [0.52-7.62], for 51-75 h a week, β = 7.27, CI = [2.86-11.69], for 76-100 h a week and β = 7.27, CI = [0.06-14.49], for >100 h a week), and obstetrics/gynecology residents (β = 9.66, CI = [3.59-15.73]). Conversely, medical sub-specialty residents, as well as private and university hospital residents, had lower burnout levels. We concluded that decreasing the workload on residents, offering psychological counseling, and promoting a safety culture for residents might help in mitigating burnout consequences.
Collapse
Affiliation(s)
- Abdullah Nimer
- School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.N.); (S.N.); (N.S.); (R.S.A.); (A.R.); (M.A.-J.)
| | - Suzan Naser
- School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.N.); (S.N.); (N.S.); (R.S.A.); (A.R.); (M.A.-J.)
| | - Nesrin Sultan
- School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.N.); (S.N.); (N.S.); (R.S.A.); (A.R.); (M.A.-J.)
| | - Rawand Said Alasad
- School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.N.); (S.N.); (N.S.); (R.S.A.); (A.R.); (M.A.-J.)
| | - Alexander Rabadi
- School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.N.); (S.N.); (N.S.); (R.S.A.); (A.R.); (M.A.-J.)
| | - Mohammed Abu-Jubba
- School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.N.); (S.N.); (N.S.); (R.S.A.); (A.R.); (M.A.-J.)
| | - Mohammed Q. Al-Sabbagh
- Medical internship, Jordan University Hospital, The University of Jordan, Amman 11942, Jordan;
| | - Khaldoon M. Jaradat
- Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman 11942, Jordan;
| | - Zaid AlKayed
- Department of Psychiatry, Jordan University Hospital, The University of Jordan, Amman 11942, Jordan;
| | - Emad Aborajooh
- Department of General Surgery and Anesthesia, Faculty of Medicine, Mutah University, Kerak 61710, Jordan;
| | - Salam Daradkeh
- Department of General Surgery, Jordan University Hospital, The University of Jordan, Amman 11942, Jordan;
| | - Mohammad Abufaraj
- Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman 11942, Jordan;
- Department of Urology, Medical University of Vienna, 1090 Vienna, Austria
| |
Collapse
|
7
|
Samarah OQ, Nimer A, Al Karmi F, Mustafa O, Naser S, Al Omari L, Hammad Y, Ermeley Z. Role of Arthrodiastasis Using Hinged Monolateral External Fixator Without Soft Tissue Release in Advanced Stage of Legg-Calve-Perthes Disease. Ther Clin Risk Manag 2020; 16:1117-1124. [PMID: 33235455 PMCID: PMC7678712 DOI: 10.2147/tcrm.s282404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 10/25/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Presentation with the advanced stage of Legg-Calve-Perthes disease (LCPD) carries a poor prognosis, regardless of the treatment that the patient receives. The aims of this study are to assess the clinical and radiological outcomes of arthrodiastasis in advanced cases of LCPD using a hinged monolateral external fixator without soft tissue release and to raise safety issues regarding its low rate of complications. Patients and Methods Six patients with LCPD who were classified as lateral pillar types B and C and were operated on in our department were included in this retrospective study. Data collected from medical files and X-ray measurements were retrospectively reviewed. Results A total of six male patients were included in this analysis. The mean age at onset of symptoms was 8.5 years (range 7-10 years). The mean follow-up period was 46 months (range 40-50 months). Five cases were Herring C and one case was Herring B at presentation. The average distraction time was 8 days (range 7-9) and the average duration of external fixator application was 3.1 months (range 2.5-3.5 months). The range of motion of the hip in flexion, abduction and internal rotation were improved postoperatively. Pain score and limping were also improved. At the final follow-up, the mean sphericity deviation score was 10.6. The mean epiphyseal index was improved from 19.3% to 23.8%. In addition, the mean cervical index improved from 99.7% to 89.7% at the last follow-up. Femoral fractures, pin loosening, mechanical failure of the fixator, chondrodiastasis, and hip subluxation were not seen in this group of patients. Conclusion Arthrodiastasis with a hinged monolateral external fixator without soft tissue release improved both the clinical and radiological outcomes in this group of patients.
Collapse
Affiliation(s)
- Omar Q Samarah
- Department of Special Surgery, School of Medicine, University of Jordan, Amman, Jordan
| | | | | | - Osama Mustafa
- School of Medicine, University of Jordan, Amman, Jordan
| | - Suzan Naser
- School of Medicine, University of Jordan, Amman, Jordan
| | | | - Yazan Hammad
- Department of Special Surgery, School of Medicine, University of Jordan, Amman, Jordan
| | - Ziad Ermeley
- Department of Health and Recreation, School of Physical Studies, University of Jordan, Amman, Jordan
| |
Collapse
|
8
|
Hoffman R, Nimer A, Lanir N, Brenner B, Baruch Y. Budd-Chiari syndrome associated with factor V leiden mutation: a report of 6 patients. Liver Transpl Surg 1999; 5:96-100. [PMID: 10071347 DOI: 10.1002/lt.500050211] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Budd-Chiari syndrome is characterized by hepatic venous outflow obstruction. Although myeloproliferative disorders are usually responsible for this severe thrombotic disorder, deficiency or dysfunction of the natural anticoagulants can be involved. Resistance to activated protein C caused by factor V Leiden mutation has been recently identified as a major cause of thrombophilia. We report 6 patients with Budd-Chiari syndrome associated with factor V Leiden mutation combined with another acquired thrombophilic state (myeloproliferative disorder and lupus anticoagulant in 3 cases) and without another thrombophilic disorder in the other 3 cases. We conclude that factor V Leiden mutation should be evaluated in any case of hepatic vein occlusion because the prevalence of this mutation in the general population is high.
Collapse
Affiliation(s)
- R Hoffman
- Department of Hematology, Rambam Medical Center, Haifa, Isreal
| | | | | | | | | |
Collapse
|