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Ibdah RK, Zaitoun KJ, Altawalbeh RB, Tayyem SH, Nazzal UA, Rawashdeh SI, Khader YS, Al-Mistarehi AHW, Khassawneh BY. Prevalence of Obstructive Sleep Apnea Among Atrial Fibrillation Patients: A Cross-Sectional Study from Jordan. J Multidiscip Healthc 2024; 17:701-710. [PMID: 38375526 PMCID: PMC10875174 DOI: 10.2147/jmdh.s452589] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/01/2024] [Indexed: 02/21/2024] Open
Abstract
Background Obstructive Sleep Apnea (OSA) is a common respiratory disorder that causes intermittent upper airway collapse during sleep and can lead to various acute cardiovascular complications. Atrial Fibrillation (AF) is the most common sustained cardiac arrhythmia and is associated with an increased risk of cardiovascular hospitalization and all-cause mortality. Our study aimed to investigate the prevalence of individuals with AF and those considered at high risk for OSA. Methods A cross-sectional study was conducted with a population comprising patients who had visited KAUH cardiology clinics between 2017-2019; subjects were categorized into AF patients and general cardiology patients. Patients were surveyed for OSA using the Berlin Questionnaire to assess the degree of OSA symptoms and to classify patients into high- or low-risk groups based on their responses. Results Of the 656 patients, 545 met our inclusion criteria, of whom 192 were diagnosed with AF. Comparable demographic characteristics were observed between the AF and non-AF groups, barring higher rates of obesity (p=0.001) and smoking (p=0.042) in the AF group. The prevalence of high-risk OSA was significantly higher in AF patients (68.2%) compared to non-AF patients (29.4%), with an adjusted odds ratio of 2.473 times (95% CI: 1.434 -4.266, p=0.001) greater for AF. The age, gender, and BMI categories did not differ significantly between the two groups. Binary logistic regression revealed significant associations between OSA and risk factors such as asthma (OR=4.408, 95% CI: 2.634-7.376, p=0.001). Conclusion These results serve to display a statistically significant increase in high-risk OSA in existing AF patients, irrespective of the presence of conventional OSA risk factors; this could imply a more immediate and direct relationship between both diseases and calls to include routine screening for OSA in patients diagnosed, newly or otherwise, with AF.
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Affiliation(s)
- Rasheed K Ibdah
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Khaled J Zaitoun
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Rana B Altawalbeh
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Saad H Tayyem
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Ulla A Nazzal
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Sukaina I Rawashdeh
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Yousef S Khader
- Department of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | | | - Basheer Y Khassawneh
- Department of Internal Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan
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Rawashdeh SI, Ibdah R, Kheirallah KA, Al-Kasasbeh A, Raffee LA, Alrabadi N, Albustami IS, Haddad R, Ibdah RM, Al-Mistarehi AH. Prevalence Estimates, Severity, and Risk Factors of Depressive Symptoms among Coronary Artery Disease Patients after Ten Days of Percutaneous Coronary Intervention. Clin Pract Epidemiol Ment Health 2021; 17:103-113. [PMID: 34733349 PMCID: PMC8493832 DOI: 10.2174/1745017902117010103] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 12/30/2020] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 12/20/2022]
Abstract
Background: Depression and cardiovascular disorders are significant determinants of health that affect the quality of life and life expectations. Despite the high importance of depression screening among Coronary Artery Disease (CAD) patients, the time being to assess and treat it remains controversial. Objectives: This study aims to assess the prevalence estimates and severity of depressive symptoms and determine the risk factors associated with developing such symptoms among CAD patients after ten days of Percutaneous Coronary Intervention (PCI). Methods: All patients who underwent elective PCI between October 5, 2019, and Mid-March 2020 and diagnosed with CAD were included in this cross-sectional study. CAD was defined as intra-luminal stenosis of ≥ 50% in one or more of the coronary arteries. Depressive symptoms were screened after ten days of the PCI utilizing the patient health questionnaire-9 (PHQ-9) tool. A linear regression model was used to assess the adjusted effects of independent variables on PHQ-9 scores. Electronic medical records, clinical charts, and PCI and echocardiogram reports were reviewed. Results: Out of 385 CAD patients, a total of 335 were included in this study, with a response rate of 87%. The participants' mean (±SD) age was 57.5±10.7 years, 75.2% were males, 43% were current smokers, and 73.7% had below bachelor's education. The prevalence estimates of patients with moderate to severe depressive symptoms (PHQ-9 ≥10) was 34%, mild depression 45.1%, and normal 20.9%. Female gender, low educational level and diabetes mellitus were found to be the significant independent predictors of depression among our cohort with (t(333) = 3.68, p<0.001); (t(333) = 5.13, p<0.001); and (t(333) = 2.79, p=0.042), respectively. Conclusion: This study suggests a high prevalence of depressive symptoms among CAD patients after ten days of PCI. Approximately one out of three patients with CAD have significant symptoms of depression, which is an alarming finding for clinicians. Moreover, this study demonstrates a lack of sufficient depression recognition and management in similar study settings. Integration of mental health assessment and treatment among patients with CAD as soon as after PCI is recommended for optimal and effective treatment and to obtain the best outcomes.
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Affiliation(s)
- Sukaina I Rawashdeh
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Rasheed Ibdah
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Khalid A Kheirallah
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Abdullah Al-Kasasbeh
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Liqaa A Raffee
- Department of Accident and Emergency Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Nasr Alrabadi
- Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Iyad S Albustami
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Rabia Haddad
- Department of Nursing, King Abdullah University Hospital, Irbid, Jordan
| | - Raed M Ibdah
- Division of Psychiatry, Department of Neuroscience, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Abdel-Hameed Al-Mistarehi
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Ibdah RK, Alrabadi N, Rawashdeh SI, Al-Ksassbeh A, Habib A, hijazi E. A 44 years-old male patient surviving total occlusion of the left main coronary artery (STEMI) accompanied with cardiogenic shock. Ann Med Surg (Lond) 2020; 60:610-613. [PMID: 33304573 PMCID: PMC7711079 DOI: 10.1016/j.amsu.2020.11.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 11/21/2020] [Accepted: 11/24/2020] [Indexed: 11/24/2022] Open
Abstract
Introduction Thrombus occlusion of the left main coronary artery (LMCA) is a poorly prognostic condition that is commonly associated with mortality especially when complicated with cardiogenic shock. Presentation of case In this report, we presented a case for 44 years-old male patient who is not known to have ischemic heart disease. He was transferred from a peripheral hospital for emergency percutaneous coronary intervention (PCI) after presenting with anterior ST-elevation myocardial infarction (STEMI) complicated with cardiogenic shock. Discussion The PCI revealed complete occlusion of the LMCA with a thrombus which was stented and the patient regain his cardiovascular stability. The patient survived this complete occlusion that was complicated with cardiogenic shock giving the quick intervention with the PCI and the use of the circulatory support devices. Conclusion The PCI procedure with the intra-aortic balloon pump should be available and offered early for patients with STEMI complicated with cardiogenic shock. This could be very critical in increasing the survival rates for those patients. A case of a patient who survived a complete LMCA occlusion. Total LM occlusion often associated with lifethretining arrhythmia. A Primary Percutaneous Coronary Intervention with intra-aortic balloon pump should be available and offered early for patients with cardiogenic shock.
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Affiliation(s)
- Rasheed K. Ibdah
- Division of Cardiology, Department of Internal Medicine, Jordan University for Science and Technology, Irbid, 22110, Jordan
- Corresponding author.
| | - Nasr Alrabadi
- Department of Pharmacology, Faculty of Medicine, Jordan University for Science and Technology, Irbid, 22110, Jordan
- Corresponding author. Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan.
| | - Sukaina I. Rawashdeh
- Division of Cardiology, Department of Internal Medicine, Jordan University for Science and Technology, Irbid, 22110, Jordan
| | - Abdullah Al-Ksassbeh
- Division of Cardiology, Department of Internal Medicine, Jordan University for Science and Technology, Irbid, 22110, Jordan
| | - Amjad Habib
- Division of Cardiology, Department of Internal Medicine, Jordan University for Science and Technology, Irbid, 22110, Jordan
| | - Emad hijazi
- Department of Surgery, Faculty of Medicine, Jordan University for Science and Technology, Irbid, 22110, Jordan
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Rawashdeh SI, Al-Mistarehi AH, Yassin A, Rabab'ah W, Skaff H, Ibdah R. A Concurrent Ischemic Stroke, Myocardial Infarction, and Aortic Thrombi in a Young Patient with Hyperhomocysteinemia: A Case Report. Int Med Case Rep J 2020; 13:581-590. [PMID: 33192104 PMCID: PMC7653271 DOI: 10.2147/imcrj.s279603] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 09/02/2020] [Accepted: 10/21/2020] [Indexed: 12/31/2022] Open
Abstract
We are presenting a case report of a previously healthy 39-year-old man who was found to have acute inferior ST-elevation myocardial infarction (STEMI) and acute large right middle cerebral artery (MCA) ischemic stroke with hemorrhagic transformation. Transesophageal echocardiogram and chest CT angiogram revealed two thrombi; one attached to the wall of the ascending aorta just above the right coronary artery sinus, and one at the origin of the brachiocephalic trunk. The occlusion of the coronary artery and right MCA most likely could be because of embolization from these thrombi. Extensive workup looking for underlying etiology and risk factors for these concurrent vascular events in this young man revealed hyperhomocysteinemia along with unfavorable lipid profile, and family history of premature coronary artery disease which increased the suspicion of familial hypercholesterolemia. Besides, the presence of vitamin B12 and folate deficiencies. The elevated serum homocysteine is likely a major risk factor for thromboembolism in this patient. The patient received antithrombotics and vitamin supplementations and gradually improved without any worsening of the stroke's hemorrhagic transformation. We suggest that hyperhomocysteinemia needs to be considered in the differential etiology of vascular events in young people or those with no significant history of major vascular risk factors. Besides, vitamin supplementation could be a cost-effective, safe, and efficient way to decrease elevated serum homocysteine levels and prevent vascular complications. As well as this case report demonstrates that antithrombotics can safely be used after stroke's hemorrhagic transformation without neurological deterioration or aggravation of hemorrhagic transformation.
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Affiliation(s)
- Sukaina I Rawashdeh
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Abdel-Hameed Al-Mistarehi
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Ahmed Yassin
- Division of Neurology, Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Walaa Rabab'ah
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Hussam Skaff
- Department of Diagnostic Radiology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Rasheed Ibdah
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Raffee LA, Alawneh KZ, Ibdah RK, Rawashdeh SI, Zoghoul S, Ewais AS, Al-Mistarehi AH. Prevalence, Clinical Characteristics, and Risk Among Patients with Ischemic Heart Disease in the Young Jordanian Population. Open Access Emerg Med 2020; 12:389-397. [PMID: 33235526 PMCID: PMC7678703 DOI: 10.2147/oaem.s272961] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 10/27/2020] [Indexed: 01/18/2023] Open
Abstract
PURPOSE This study aims to evaluate the prevalence of ischemic heart disease (IHD) among the young population in Jordan. We examined the risk factors that might be involved in disease incidence. Clinical characteristics, patients' living standards, and various other risk factors were considered to conduct the study. METHODS A retrospective study was conducted at King Abdullah University Hospital. Data were collected from patients who visited this hospital between January 2013 and December 2017. Only young Jordanian adults of age <50 years were included in this study. The data of 358 patients were purposively collected and analyzed (as per the determined inclusion criteria), where information related to their baseline characteristics, clinical characteristics, and related biochemical assays was reviewed. RESULTS This study showed a high prevalence of IHD among young males in Jordan. It also revealed that increased age, smoking, hypertension, unfavorable lipid profile, and obesity were the major possible risk factors for the occurrence of disease. These patients were initially diagnosed with either unstable angina or acute myocardial infarction. Initial WBCs count, particularly monocytes differential, was high in about one-third of patients, besides cardiac biomarkers. CONCLUSION The high incidence of IHD was noticed among young individuals. We suggest that more efforts should be instigated for reducing the high prevalence of IHD by adopting a healthy lifestyle, preventive attitude, and nutritious food intake.
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Affiliation(s)
- Liqaa A Raffee
- Department of Accident and Emergency Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Khaled Z Alawneh
- Department of Diagnostic Radiology and Nuclear Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Rashid K Ibdah
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Sukaina I Rawashdeh
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Sohaib Zoghoul
- Medical Education Department, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Abdel Salam Ewais
- Department of Accident and Emergency Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Abdel-Hameed Al-Mistarehi
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Ibdah RK, Rawashdeh SI, Harahsheh E, Almegdadi A, Al. Ksassbeh A, Alrabadi N. The Knowledge and Perception of Antiplatelet and Anticoagulant agents among Dentists in Northern Jordan. J Int Soc Prev Community Dent 2020; 10:597-604. [PMID: 33282769 PMCID: PMC7685271 DOI: 10.4103/jispcd.jispcd_70_20] [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: 02/14/2020] [Revised: 06/15/2020] [Accepted: 07/02/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES The aim of this study was to describe the attitude and perception toward antiplatelet/anticoagulant agents in patients with cardiovascular diseases among dentists in the northern district of Jordan and to compare the current practice of Jordanian dentists and the recently published guidelines regarding the management of patients taking antiplatelet/anticoagulant drugs before dental procedures. MATERIALS AND METHODS This is a cross-sectional study conducted on dentists and dental interns working at the dental clinics in northern Jordan, including dental clinics at Jordan University of Science and Technology (JUST) and the private sector. The total sample size comprised of 128 subjects (78 dentists from JUST and 50 private practitioners). The participants were interviewed using a preformed questionnaire to assess their knowledge and perceptions regarding the antiplatelets and the anticoagulant agents. RESULTS Approximately 61.5% of participants from JUST university and 20.0% of those in the private sector were aware of the use of clopidogrel (P < 0.0001). Although the overall awareness regarding other antiplatelets such as prasugrel was very low (8.6%), dentists from JUST (12.8%) showed a significantly higher level of awareness compared to the private practitioners (2.0%) (P = 0.049). More than 70% of the participants from JUST and only 46.0% of the private practitioners were aware of the consequences of interrupting treatment with clopidogrel in patients with coronary stents (P = 0.002). Almost both the participants from JUST (25.78%) and the private sector (24.22%) are consulting the cardiologists with similar frequencies before interrupting the treatment with the antiplatelet/anticoagulant agents. Participants who have clinical PhD qualifications are more aware of the recent clinical guidelines and the newest agents compared to others. CONCLUSIONS The awareness regarding the newest antiplatelet/anticoagulant agents is poor among the dentists in northern Jordan. However, the majority (62.3%) of them realize the consequences of interrupting such treatments in patients with coronary stents. Unfortunately, only a quarter of the dentists are consulting the cardiologists before interrupting the treatment with the antiplatelet agents. Proper education, courses, and workshops should be performed to the dentists to improve their knowledge about this critical issue.
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Affiliation(s)
- Rasheed K Ibdah
- Division of Cardiology, Department of Internal Medicine, Jordan University for Science and Technology, Irbid, Jordan
| | - Sukaina I Rawashdeh
- Division of Cardiology, Department of Internal Medicine, Jordan University for Science and Technology, Irbid, Jordan
| | - Ehab Harahsheh
- Department of Neurology, Mayo Clinic College of Medicine, Arizona, USA
| | - Abdallah Almegdadi
- Division of Cardiology, Department of Internal Medicine, Jordan University for Science and Technology, Irbid, Jordan
| | - Abdullah Al. Ksassbeh
- Division of Cardiology, Department of Internal Medicine, Jordan University for Science and Technology, Irbid, Jordan
| | - Nasr Alrabadi
- Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Ibdah RK, Ta'an WF, Shatnawi RM, Suliman MM, Rababah JA, Rawashdeh SI. The effectiveness of early position change postcardiac catheterization on patient's outcomes: A randomized controlled trial. Nurs Forum 2020; 55:380-388. [PMID: 32020631 DOI: 10.1111/nuf.12438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Nurses play a substantial role in maintaining patient homeostasis postcardiac catheterization. Patients frequently complain of back pain and discomfort as a result of the prolonged bed rest postcatheterization. AIM This study aims to evaluate the effectiveness of early position change postcardiac catheterization on reducing patients' pain and discomfort. SETTINGS The study was conducted at two cardiac units in a university hospital in Jordan. PARTICIPANTS A total of 120 patients were used in the study, 60 patients in each of the two groups-control and intervention. METHODS The randomized controlled trial design was used. Data were initially collected 1 hour after sheath removal postcardiac catheterization. After that, the protocol was applied to the interventional group. RESULTS Early position change 1 hour after sheath removal after cardiac catheterization was found to be effective in reducing back pain as compared with the control group (P < .001). Also, the study intervention was found to be effective in reducing urinary discomfort (X2 = 50.83, P < .001), and increasing comfort level (X2 = 120, P < .001). However, although participants in the intervention group were less likely to have constipation and hematoma than those in the control group, this outcome was not statistically significant at P > .05. CONCLUSION Early position change 1 hour after sheath removal postcardiac catheterization has significant positive effects on patient outcomes by reducing the intensity of back pain and urination problems and increasing patients' comfort level without increasing incidents of vascular complications such as bleeding and hematoma.
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Affiliation(s)
- Rashid K Ibdah
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Wafa'a F Ta'an
- Department of Community and Mental Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Rawan M Shatnawi
- Nursing Department, King Abdullah University Hospital, Irbid, Jordan
| | - Mohammad M Suliman
- Department of Community and Mental Health Nursing, Faculty of Nursing, Al al-Bayt University, Mafraq, Jordan
| | - Jehad A Rababah
- Department of Adults Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Sukaina I Rawashdeh
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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